Psychoanalysts have learned so much in the years since Freud founded our discipline. We have so much yet to learn. A pluralistic perspective has helped us try to contain new knowledge within a psychoanalytic frame of reference. However, psychoanalysts no longer agree on what constitutes this frame of reference. Our fundamental concepts have been stretched to include heterogeneous and contradictory ideas. Our theories are no longer coherent with one another. These are the growing pains of a relatively young discipline but how are we to help our candidates find their way, steady their orientation and take heart in our changing landscape? How are we to equip them to establish and to communicate the rationale for our ideas and our therapeutic activities both to other disciplines and to the community at large?
Teaching candidates a critical perspective on psychoanalytic knowledge offers them an orienting framework. The critical perspective I will describe is an epistemological perspective, a focus on knowledge itself, its grounds, limits, forms and validity. This critical perspective teaches candidates to think about thinking and about the process of knowing as distinguished from believing.
An educational goal of a critical perspective is to help candidates appreciate the influence of competing epistemologies in our field. Is psychoanalysis a science, of a special kind? Is it rather a hermeneutic or interpretive discipline? A kind of relationship or an art? If candidates understand that epistemological values shape the methods we use to investigate, the evidence we accept, the phenomena that interest us, the inferences we draw from our observations, and the way we define our field, they can understand our knowledge is not only discovered but is also constructed. It will give them conceptual tools to think about the assumptions and intentions that underlie these constructions, to evaluate psychoanalytic knowledge based on them, and better grasp the nature of the controversies that have left psychoanalysts unable to agree on what psychoanalysis is. It is crucial for candidates to understand we are struggling with the question of whether a multiplicity of theoretical meanings is inherent or desirable in the development of our thinking and/or is a transitional phase as we strive for a different integration in our thinking. Our answer to such a question reflects our epistemological values.
Established traditions from other disciplines offer methods that can help us clarify and critically evaluate the state of our knowledge. Two of these are: empirical methods, particularly from the life sciences, and interpretive methods from the hermeneutic tradition. They can be used separately or be combined. While each has had a complex history of debate and controversy, they could be roughly summarized as follows:
Empirical methodology strives for theoretical unity, precision in defining theoretical terms, and the capacity to test hypotheses and to predict the consequences of hypotheses. It relies on rules of evidence that constrain the ways we move from observations to inferences about these observations, and it demands some capacity for disconfirmation of our hypotheses. The goal is to refine our knowledge of the real world so it progresses over time. Adopting this epistemological stance allows us to test our ideas in order to see if one idea is better than another.
In contrast to this, interpretive methods from the hermeneutic tradition strive to understand meanings as they are embedded in changing contexts. Knowledge expands through the plasticity of language and meanings and by the extensibility of concepts and theories. It is not progressive but rather is dependent on its context, historical time and culture. The logic of hermeneutic methods relies on intelligibility, coherence, consistency, accuracy, inter-subjective reliability and narrative fit in judging one interpretation against another. Adopting this epistemological stance allows us to preserve concepts that have different meanings in different theoretical schools.
These two epistemological strategies represent different perspectives on knowledge and different contexts for distinguishing knowledge from opinion or belief. A working familiarity with these differing strategies allows candidates to distinguish clinical from epistemological differences in our arguments and to use these conceptual and methodological tools to sharpen their critical reasoning as they develop their own psychoanalytic ideas.
As we try to help our candidates think systematically about our conceptual and theoretical foundations, it is helpful for them to understand that knowing is a process and that a body of knowledge has a kind of structure of its own.
A fundamental question of epistemological concern is: What do we want to know about? What phenomena interest us? The negative of this question is equally important: What phenomena will we not include? These questions help us define the boundaries of our discipline, the domain of knowledge that we intend to know about. The question of what is the domain of psychoanalysis is at the center of current controversies and confusions. The growth of knowledge both within our discipline and in other disciplines, the proliferation of our theories, and the widening scope of those we seek to treat have made the task of delineating our domain more complex. This new context raises new questions. For example, how are we to think about the associations of analysands who take psychotropic medications, or who have experienced significant trauma, or who have affective or other disorders? How are we to think about the relevance to psychoanalysis of information coming to us from the cognitive sciences, the affective neurosciences and from the observations of infants and children? Different psychoanalytic thinkers may disagree on what belongs under the purview of psychoanalysis.
A second fundamental question is: How do we intend to know? By what methods do we establish knowledge? It is important that candidates appreciate the kinds of questions and efforts that are involved if we want to establish grounds for knowledge. Here, the hermeneutic and empirical traditions serve as examples. Each tradition seeks correspondence with something in the real world of experience and tries to provide a degree of objectivity in order to give us criteria for judging one hypothesis or interpretation against another. Each tradition attends to the relationship among data, evidence and knowledge. Each tradition spells out the intellectual processes and methods of discovery and justification.
The psychoanalytic situation allows for a fertile process of discovery of meanings. The process of scientific justification within the psychoanalytic situation is more difficult for us. Our interpretations reflect our hypotheses. We have not been able to find reliable ways that our observations and hypotheses can be refuted by experience. We have relied on clinical evidence. However, when we do this, we encounter significant epistemological problems.
One of these is the relationship between our theories and our observations. Theoretical bias colors what we see and what we infer. Consequently, we can’t reliably distinguish our observations from our inferences. What we consider evidence is biased by theory as well. Another epistemological problem is our inability to deal with the problem of suggestion as this may contaminate our data.
Despite the daunting epistemological challenges that face a discipline whose focus is on unconscious phenomena experienced inter-subjectively, psychoanalysts with the help of colleagues in other disciplines, can set out to design an epistemology that is suited to our needs and to devise methods that will help us find a more reliable basis for our inferences and our evidence. We will need the help of our future analysts in this effort.
Twenty years ago, the Columbia Center for Psychoanalytic Training and Research introduced classes in methodology and critical thinking in all four years of the core curriculum, the Critical Thinking Sequence. I described this curriculum in my paper, “Thinking About Curriculum: An Epistemological Perspective” (PQ, 2007). What follows is an abbreviated version.
Classes in critical thinking are integrated in both our theory track and our process track. In addition, there are three classes on Controversies about Psychoanalytic Technique for senior candidates in the third through more advanced years. In each year, the critical thinking classes are designed to stimulate questions important for the issues raised in the courses.
Critical Thinking I, “The Relevance of Child Observation for Psychoanalysis,” comprises three classes taught at the end of the first year following a yearlong course on child development. The educational goals of these classes are: 1) to introduce candidates to an epistemological perspective, 2) to clarify the epistemological problems that occur when we try to use data and information from another discipline, and 3) to illustrate a controversy between two psychoanalysts, Daniel Stern and Andre Green, who disagree strongly about the relevance of data from outside the psychoanalytic situation.
We want to highlight that clinical hypotheses based on phenomena in different settings, obtained by different methodologies, and understood from different perspectives, reflect different interests, focus and conceptions of how the mind functions. Consequently, the concepts and theories that emerge from these different perspectives may not be comparable. Daniel Stern is interested in the representation of real experience, the “now,” the “coup,” as he calls it. Andre Green is interested in experience as it is elaborated in fantasy, the “après coup.” Each perspective is formed in observing and drawing inferences about unobservable mental states. This allows us to raise the problem of theoretical bias and projection for both the clinical perspective and the observational perspective. Each also has the problems inherent in reasoning by analogy. In comparing these different perspectives on what might be of interest to psychoanalysis, we are able to show candidates the kinds of problems that face anyone interested in making inferences about subjective states and unconscious states.
The readings are drawn from a dialogue between Green and Stern, in Clinical Observational Psychoanalytic Research: Roots of a Controversy and from each analyst’s view on the child’s psychic representation of a mother who becomes depressed after being a lively presence for her child. The tone of the exchange serves as an illustration of what can happen when psychoanalysts feel pressed to defend their beliefs about what psychoanalysis is.
We try to show the candidates how to put the discussion on another footing, the epistemological differences between an observational and a psychoanalytic perspective. Green thinks there is no real child in the psychoanalytic situation, “The model for psychoanalysis is the dream…. Psychoanalysis is incompatible with observation. Observation cannot tell us anything about the intrapsychic processes that truly characterize the subject’s experience.” In contrast, Stern thinks memory traces in the form of schema of being with the other organize subjective experience by providing a foundation for representation of the self and other and for fantasy. He thinks the observation of infants offers generative hypotheses about the functioning of the mind in areas of interest to psychoanalysis, transference for example.
We ask the candidates what they consider the advantages and disadvantages of each perspective. We explore the possibility and the problems associated with combining these perspectives. We pose questions facing our discipline in many areas. How are we to decide if one idea is better than another? How are we to decide when we are wrong?
Critical Thinking II is “The Pluralist Perspective,” two classes at the beginning of the second year that also serve as an introduction to the second-year theory course, Psychoanalytic Theories. This course introduces candidates to the development of psychoanalytic ideas from ego psychology, object relations and self psychology, as well as the ideas of important theoreticians like Klein, Bion and Lacan. Candidates often experience this course as a dizzying immersion in psychoanalytic thought. The educational goals of Critical Thinking II are: 1) to explore the epistemological dimensions of a pluralist perspective, 2) to provide an orienting frame for thinking about different schools of thought, and 3) to explore the concept of fantasy as an example of a fundamental concept that contains contradictory ideas in different schools of thought, 4) to reacquaint the candidates with the Critical Thinking Sequence. The reading for these classes is my paper, “Thinking About Curriculum: An Epistemological Perspective.”
We encourage candidates to think about each theoretician and school of thought in relation to a set of epistemological questions and a set of clinical questions. The epistemological questions we suggest are: 1) How is the domain of psychoanalysis being described? 2) What phenomena are included and excluded? 3) What mode or modes of investigation are being described? For example, free association, countertransference, empathic immersion are modes of investigation. 4) What is considered evidence? 5) Is there an attempt to explain phenomena beyond meaning?
The clinical questions we suggest are: 1) What model of mind is the reference for theory? 2) What model of pathogenesis is the reference for theory? 3) How is the role of the analyst being described? 4) How is the
psychoanalytic situation envisioned? 5) How is therapeutic action being envisioned? We want candidates to be able to distinguish epistemological and clinical issues.
In order to discuss the advantages and disadvantages of a pluralistic perspective, we explore the concept of fantasy from the ego psychological perspective and from the Kleinian perspective. These perspectives differ on the nature of fantasy, on the nature of mind and on the mental capacities that contribute to fantasy. I present a case so we have a clinical basis for the discussion.
For this year, we integrate a critical perspective in relation to clinical process and technique.
One course, “Critical Thinking about Psychoanalytic Process III,” is embedded in the psychoanalytic process course in each year of the core curriculum.
The educational goals are: 1) to introduce candidates to an epistemological perspective as they learn about psychoanalytic process in an interrupted but continuous case presentation, and 2) to model a collaborative scrutiny and critical attitude toward our theories, our concepts and our rules of inference and evidence.
In the interrupted continuous case design, two analysts comment on the same case for eight weeks in each year of the core curriculum beginning in the second year. Each new second-year class begins with a different pair of instructors who stay with the class for the next three years. One of the analysts helps the candidates deepen their understanding of psychoanalytic process; the other helps candidates deepen their understanding of psychoanalytic thinking itself. An interrupted continuous case allows the teaching analysts to form a relationship with the candidates, with the case and with each other. We hope to provide an opportunity for candidates to identify with a way of thinking about psychoanalytic thinking over time.
A second course, “Critical Thinking about Psychoanalytic Technique,” is for senior candidates beginning in their third year. Three classes are devoted to discussing a controversy that involves technique. Two analysts from differing theoretical orientations present their ideas about a technical issue in relation to a case one of them presents. The educational goals are: 1) to offer candidates an opportunity to hear faculty give their views on controversies and ideas that involve technique, 2) to explore the larger themes that underlie their differences and, 3) to offer candidates an opportunity to hear the ideas of candidates in other classes. Some examples of topics for discussion are: 1) perspectives on the interpretation of aggression, 2) perspectives on interpretation of unconscious fantasy and 3) perspectives on the interpretation of defense. Candidates are strongly encouraged to express their views.
Critical Thinking IV, “A Critical Evaluation of Psychoanalytic Knowledge,” is a mini-course of six classes whose educational goal is to help candidates consolidate their understanding of epistemological issues and more particularly to familiarize them with points of view about epistemology and with methods in two traditions, the empirical and the hermeneutic. One class each is devoted to the scientific point of view and to the hermeneutic point of view including their epistemological values and their methodologies. A third class explores a rigorous attempt by the philosopher, Paul Ricoeur, to validate Freud’s ideas. Ricoeur’s paper, “The Question of Proof in Freud’s Psychoanalytic Writings” is particularly useful because he concludes that both hermeneutic and empirical methods are needed, each for a different dimension of theory.
Psychoanalysis is a discipline whose focus is on subjective and unconscious phenomena in both the analyst and the analysand. However, as Freud maintained, psychoanalysis as an activity and as a discipline stands on three legs. Psychoanalysis is a therapeutic procedure, a theory about the nature of mind and development, and a vehicle for research into the nature of mental life. Each leg has a different goal. It is easy to forget theoretical and explanatory goals in the heat of the therapeutic endeavor. Questions of efficacy, case selection and outcome rest on an understanding of therapeutic action or actions that derive from an understanding of the nature of mind, development and mental experience. More than ever before in this country, psychoanalysts need to be able to establish and to communicate the rationale for our therapeutic activities and for our ideas. We can give our candidates the tools they need to do this. We can teach our candidates to tend to psychoanalysis as a discipline and a body of knowledge.
From the Issues in Psychoanalytic Education Editor
At this time of transition and the inception of the new APsaA Department of Psychoanalytic Education, Ellen Rees’s article focuses on what matters most in psychoanalytic education under APsaA’s auspices: its integrity and rigor. To that end she outlines the principles of teaching candidates critical thinking, followed by a description of the curriculum designed to cultivate it at the Columbia Center for Psychoanalytic Training and Research.
—Luba Kessler