Many years ago I figured out that I write to understand something that is puzzling me in psychoanalysis, and in this way gradually refining and clarifying what was puzzling to me. So, in 2006, when I was feeling especially puzzled (and intrigued) by a number of issues regarding the psychoanalytic method, I started working on what eventually became my latest book on psychoanalytic technique, Creating a Psychoanalytic Mind: A Psychoanalytic Method and Theory (Routledge, October 2013). The premise of the book, and what I understand as the profound nature of the psychoanalytic endeavor, was captured by Marilia Eisenstein when she said:
Analysis is uncompromising in relation to other therapies because it alone aims, other than bringing relief from a symptom, at aiding our patients to become, or to become again, the principal agents in their own history and thought. Am I too bold in insisting that this is the sole inalienable freedom a human being possesses?
Until the late 1990s, I was exploring what I saw as a new role for ego psychology in more precisely understanding the use and function of psychoanalytic interventions. Then, starting in 2000, I became increasingly involved in discussions about European views of psychoanalytic technique. One luckily unavoidable partner in these discussions was a Swiss trained analyst, Cordelia Schmidt-Hellerau. Also, regularly attending the meetings of the European Psychoanalytic Federation and the International Psychoanalytical Association, and collaborating and debating with colleagues from different countries and schools on panels and in workshops, opened my eyes for other views than those prevalent in my own North American culture.
As it is true for most analysts throughout the world, we feel most comfortable in using the methods of clinical work as we have learned them, and being confronted with a different approach may first render us uncertain or even aversive. However, my journey turned out to be more exciting and stimulating than I could ever have anticipated.
Over the last decades, psychoanalysis in the United States underwent some major necessary corrections and changes with regard to the analyst's subjectivity and the interrelationship of both partners in the consulting room. Usually new ideas attract our attention to a degree that tends to outshine older valuable ones, and we moved toward a greater focus on the experience of the relationship, and the waning of interest in understanding the analysand's mind, and the methods that aid this process (e.g., free association, defense analysis, dream interpretation, the significance of the unconscious, along with the decreased emphasis on the erotic in favor of early deprivation, attachment, and the focus on trauma rather than conflict).
When I was studying how these later issues were treated in other countries, I noted some developmental shifts in the psychoanalytic method amongst the major theories that have brought us closer together than has often been recognized. Today French psychoanalysts, some London Kleinians, some Latin American analysts, and contemporary American Freudians are, in many ways, thinking along similar lines, even though our languages and some concepts may still keep us apart. As I understand it, the basic paradigm shift in the psychoanalytic method in these cultures revolves around thinking about thinking.
As an aside I probably need to point out that one cannot think about thinking without appreciating the multiple feelings and fantasies that affect it. Further, it does not rule out the importance of the relationship in psychoanalysis. However, this paradigm of thinking about thinking has allowed us to better understand unique ways patients communicate or attempt to not communicate. We have also come to know more about patients' states of readiness for interpretive success, and the ways we may help or hinder this process. We've also come to realize that how we help a patient know his own mind is as important as what he comes to know. Thus, I point to similarities between Andre Green's statement, “the aim of an interpretation is not to produce insight directly but to facilitate the psychic functioning that is likely to help insight,” and my own view that one purpose of an interpretation is the capacity to think of one's thoughts as mental events. These ideas are similar to those of Betty Joseph whose assumption is, “that real psychic change is more likely to be promoted by the detailed description of how the patient is using the analyst, using interpretations, or using her mind in a given session, and then to move to the way the patient's history, and unconscious phantasies express themselves in the immediacy of the processes and interactions in the session” (Feldman 2004). Ferro, writing from a Bionian perspective, suggests there is not an unconscious to be revealed but a capacity for thinking to be developed.
Fred Busch, Ph.D., is a training and supervising analyst at PINE Psychoanalytic Center, a geographical supervising analyst of the Minnesota Psychoanalytic Institute, on the faculty of the Boston Psychoanalytic Institute and Massachusetts Institute of Psychoanalysis, and a member of IPTAR.
Stefano Bolognini wrote in 2010 of a “shadow zone,” where we hold on to excessive simplification of the theoretical field by staying within the confines of our own psychoanalytic culture. “The symptom of this shadow zone is precisely the incapacity for an interchange with the ‘non-self,‘ which is unconsciously feared as dangerous and too disturbing.” In the ideas expressed in this book I have tried to move from my own “shadow zone,” and hope it will further the light in our own thinking as well as in our exchanges with colleagues in other countries.