Issue 6

DIVISION REVIEW DIVISION A QUARTERLY PSYCHOANALYTIC FORUM

NO.5 FALL 2012

A QUARTERLY PSYCHOANALYTIC FORUM

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DRUCK | GELLMAN | LIBBEY | REIS | SALBERG

SUMMERS | Reflections on Division Practice Survey

BASS & MOSS | On Keeping Thought Erotic

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NANCY MCWILLIAMS INTERVIEWED

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WHAT’S IN PLAY?

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DURHAM | Subjugating Women of Color

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MATHES | Akerman

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David LICHTENSTEIN, Editor

The party game Truth or Dare reflects a principle that is at work in all forms of play.

It is the paradoxical act of freely choosing a condition of constraint. If one person asks, “truth or dare?” and the other replies by affirming either of those two conditions, then what follows is a discursive structure in which what is liberating is the same thing as what is constraining. The Mobius strip of constraint and freedom is the essential character of play and it permeates all cultural discourse.

In Truth or Dare, ordinary speech rules are subordinated to a fundamental rule, and the ordinary right to refuse either an indelicate question or command is freely suspended for as long as one is playing. The paradoxical structure of play is that freely choosing a binding rule generates a new form of freedom, with characteristics determined by the particular rule.

The principle of subordinating subsequent speech acts to a fundamental rule is

shared by psychoanalysis. Indeed, although psychoanalytic treatment is not in fact an instance of play, since it is intended for a purpose other than the enjoyment of the act itself, it does draw significantly from the structure of play. The logic of play and game theory is deeply woven into the fabric of the psychoanalytic act, as has been noted by many analysts.

A defining feature of the psychoanalytic rule is the constraint to speak without constraints. One is bound by the rule to speak

Official publication of Division of Psychoanalysis (39) of the American Psychological Association

CONTENTS BOOK REVIEWS 4

Stories from the Bog: On Madness, Philosophy, and Psychoanalysis (Contemporary Psychoanalytic Studies)

by Patrick B. Kavanaugh

Marilyn Charles

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Uprooted Minds: Surviving the Politics of Terror in the Americas

by Nancy Caro Hollander

Sue Grand

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Lacanian Psychotherapy: Theory and Practical Applications Michael J. Miller

Ona Nierenberg

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The Letters of Sigmund Freud & Otto Rank: Inside Psychoanalysis

by E. James Lieberman and Robert Kramer

Martin Winn

ROUNDTABLE ON SILENCE 18

With Contributions From

Andrew B. Druck; Melinda Gellman; Mary Libbey; Bruce Reis; Jill Salberg

EDITOR

David Lichtenstein CHAIR, PUBLICATIONS COMMITTEE

Henry M. Seiden CONTRIBUTING EDITORS

Ricardo Ainslie, Steven David Axelrod, Christina Biedermann, Chris Bonovitz, Steven Botticelli, Ghislaine Boulanger, Muriel Dimen, William Fried [REMINISCENCE], Patricia Gherovici, Peter Goldberg, Adrienne Harris, Elliott Jurist, Jane Kupersmidt, William MacGillivray, Paola Mieli, Donald Moss, Ronald Naso, Donna Orange, Robert Prince, Allan Schore, Henry M. Seiden [ON POETRY], Robert Stolorow, Nina Thomas, Usha Tummala, Jamieson Webster, Lynne Zeavin PHOTOGRAPHY BY

Mac Adams

COMMENTARY 27

Frank Summers

29 Alan Bass &

IMAGES EDITOR

Reflections on the Roundtable Discussion of the Division Practice Survey

Tim Maul DESIGN BY

On Keeping Thought Erotic: Some Problems in Contemporary Theory and Practice

Donald Moss

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Jennifer Durham

True Self, False Self: The Role of Popular Media in Subjugating Women of Color

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Robert F. Bornstein &

Robert M. Gordon

What Do Practitioners Want in a Diagnostic Taxonomy?

Comparing the PDM with DSM and ICD

RESEARCH Steve Axelrod,

Bridging the Gulf Between Research and Clinical Practice: A Special Series for DIVISION/Review

Sherwood Waldron & the Division 39 Research Committee

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Steve Axelrod

A Summarized Interview with Nancy McWilliams March 26, 2012

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FILM 38

Bettina Mathes

La Captive, directed by Chantal Akerman

Henry M. Seiden

Finding in the Sound a Thought: Matthew Arnold’s “Dover Beach”

Manya Steinkoler

Subscription rates: $25.00 per year (four issues). Individual Copies: $7.50. Email requests: divisionreview@optonline. com or mail requests: Editor, Division/Review 80 University Place #5, New York, NY 10003 Letters to the Editor and all Submission Inquiries email the Editor: dlichtenstein@gmail.com or send to Editor, Division/Review 80 University Place #5, New York, NY 10003 Advertising: Please direct all inquiries regarding advertising, professional notices, and announcements to Kristi Pikiewicz at divisionreview.managing.editor@gmail.com

DIVISION | REVIEW accepts unsolicited manuscripts. They should be submitted by email to the editor: dlichtenstein@gmail.com, prepared according to the APA publication manual and no longer than 2500 words

WIT[Z] 42

DIVISION | REVIEW a quarterly psychoanalytic forum published by the Division of Psychoanalysis (39) of the American Psychological Association, 2615 Amesbury Road, Winston-Salem, NC 27103.

© Division Of Psychoanalysis (39) of the American Psychological Association. All rights reserved.

Nothing in this publication may be reproduced without the permission of the publisher.

ON POETRY 41

Hannah Alderfer, HHA design, NYC

Shakespeak

ISSN 2166-3653

LETTERS 45

William Fried

A Letter from Santa Fe

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Ahmed Fayek

Letter to the Editor 2

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WHAT’S IN PLAY? from page 1

On the Photography of Mac Adams Welsh-born Mac Adams graduated from Rutgers’s important MFA program in the late ’60s, a period when tendencies branching out of minimalism changed the austere gallery space into the “art context,” a laboratory where all was permitted. Conceptual, Body, Performance, and Installation Art acted out upon raw interiors below Manhattan’s Houston Street, pouring or dispersing materials on floors when not tearing them up (Matta-Clark) and throwing meat cleavers at walls (Le Va) once revered as surfaces upon which art was hung. Adams cast an analytical eye upon the residual debris of these actions noting the resemblance to the crime scene or other sites of death. In the mid-70s he began to stage and photograph sequential “mystery” tableaux, casting his family and social circle in composed vignettes laden with details, “clues,” that were to be read, interpreted, and applied from one generously scaled black and white image to the next. Adam’s constructs prefigured the lauded “Pictures Generation” engagement with cinema and elevated the photograph as a communicating medium chosen over painting. A unique feature of Adam’s practice is the inclusion of physical objects and meticulously contrived décor along with his narrative images; encounters with actual motorcycles, bubble baths and life boats transform the normally passive gallery visitor into the implicated witness.

Fictional Victorian Sherlock Holmes is currently big box office on screens large and small. What attracts today’s device connected youth to this woman-shunning, cocaine injecting savant? A one word answer would be “forensics”; also applicable in explaining the surge of interest in the art of Mac Adams. macadamsstudio.com z Tim Maul Images Editor 3

without boundary. And, the player who accepts this rule is bound to an impossible task. No one can “say everything that comes to mind” without selecting or censoring, and in that impossibility, indeed in choosing to play by that impossible rule, a process is set in motion that generates the effects that have proven so useful and illuminating in our clinical endeavor. To play well is to fully engage this impossible rule and to thereby derive the maximum benefit from the encounter.

Of course there are two players in the psychoanalytic game. The analyst is bound by a different rule albeit one tied to the fundamental rule, and indeed it too is a rule that reference is impossible to follow absolutely. The rule for the analyst is: using no other means than speech, act in such a way as to facilitate the other player’s adherence to the fundamental rule of speaking without constraint. The analyst is constrained to act in a way that facilitates the other player’s freedom to speak, and nothing else. The rules for both players are based upon the supposition that the therapeutic benefits derive from the game itself and thus it should be faithfully played. This of course is the pure form of the psychoanalytic game, and like all pure forms exists only virtually as a point of. It is another distinctive feature of psychoanalysis that the real benefits derive not only from playing the game but also from the moments when this pure form breaks down, as it inevitably does. Playing the game well means that the breakdowns are successfully incorporated in the play.

Several pieces in this issue of D/R address this question regarding the unique characteristics and fundamental rules of the psychoanalytic encounter. Ona Nierenberg in her review of Michael Miller’s book Lacanian Psychotherapy discusses how far the rules can be stretched before the game changes into another form, a game of a different type, related perhaps to psychoanalysis but not, in fact psychoanalysis.

Donald Moss and Alan Bass consider the speech of the analyst according to the rule of neutrality and discover that if neutrality is defined as that quality of speech in the analyst that affords the greatest degree of freedom to the other player, then it has some surprising characteristics. Characteristics that they identify as erotic, a quality not usually consider neutral, and one that invites us to consider the relationship between Eros and Play.

In an interview, Wilfred Bion once answered a question about whether all that took place in an analysis was talk. He said, “No, we are also silent”(see Reiner in this issue of D/R). Bion in his characteristically evocative way was effectively pointing to the way that speech works not only in terms of what is said but also by how, and when, it is deployed. And thus that silence is an expressive act in the psychoanalytic dialogue.

In this issue, we present a roundtable on silence with pieces from five psychoanalysts from differing orientations. They take on one of the best known but often-misunderstood aspects of the psychoanalytic playing field, namely, the analyst’s silence. They address the silence of the analysand as well, and in so doing, alert us to an important truth: the fundamental rule, to say whatever comes to mind, can also be followed by expressing silence. One is always also free to say nothing.

The wager when one sits down to play chess is that by strictly following the rules new possibilities emerge, and they always do. It is true as well in artistic creation. As Henry Seiden has shown in these pages, poets work in a given form even as they strain its bounds, as they inevitably do. Painters chose a canvas of a given size and proportion, a palette of a certain range, brushes and other tools of a certain kind, and then make something new from those constraints.

The wager of psychoanalysis is likewise that something new emerges play-like from a constraining formal structure. z

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BOOK REVIEWS

Mind Bogging

Marilyn CHARLES

is at his best when he is telling stories from his life, inviting the reader along with him on a journey, attempting to understand the minds and experiences of the individuals he encounters in the back wards of state institutions. Weaving seamlessly between his patients’ narratives and the story of his own becoming, he also offers chapters that more specifically articulate his philosophy.

Kavanaugh speaks from his many years of experience reaching across the gaps between self and other while working with

the bog” (p.2). From this perspective, the unconscious is structured—and therefore can only become known—in relation to the systems of meaning that underpin one’s culture. These archaic memories have an impact, even though they may not be accessible to the conscious mind. Through his case vignettes, Kavanaugh illustrates ways in which trauma and primitive memories may be spoken through the symptom, and become visible through movements, expressions, or gestures. He advocates for a profound “being-with” that enables the analyst to resonate deeply and profoundly with the other’s experience.

Kavanaugh conceptualizes the analyst as a “mind-poet,” assigned to the role of the “One who Remembers” (p.23). For Kavanaugh, the analyst’s receptivity helps the patient, in turn, be more receptive to his or her own internal knowings. From that po-

negotiated and established. From that frame of reference, the analyst is a witness to a story that becomes known through the telling. The analyst’s job is to be open enough to this story that it can be told. In this way, the focus of the work is on understanding the organizing purposes and meanings of an individual’s life. For Kavanaugh, it is only in this way that morality is discovered.

Following McDougall’s (1985) conceptualization of “theaters of the mind,” Kavanaugh views psychoanalysis in the context of a theater of the everyday, such that symptoms become dramatizations of meanings that have not yet found words.

Rejecting a conceptualization of psychosis as a biomedical condition, instead Kavanaugh speaks of “madness as a complex sociocultural phenomenon having, at once, its adaptive and protective purposes, expressive and communicative dimensions, and ideothetic

individuals in dire distress. He begins by situating us at the beginning of a 40-year journey, in a massive county psychiatric hospital, and first explains his interest in the assumptions underlying the ways in which “care” is offered. He argues against a biological view of illness, stating that madness—and psychoanalysis—“are inseparable from the cultural and historical context in which they make their appearance” (p.xviii). He advocates a move from the medical, scientific paradigm toward conceptualizing madness as a literary, spiritual, and mystical phenomenon, stressing that the individual cannot be known outside of the life narrative through which his own unique story might be told.

Kavanaugh also situates himself in the heritage of Irish storytellers, the “magical power and cultural memory that resides in

sition, the patient is invited to take up the role of the One who Remembers and to turn within for answers. From this perspective, the goal of the analytic process is the furthering of the capacity for free association, and thereby the capacity to know oneself. That turn inward is also where Kavanaugh locates the ethics in which his practice is based. He contends that the health care environment in which psychoanalysis has been embedded privileges the interests of the collective over the individual, and pushes toward a paternalistic relationship that is disrespectful of those seeking assistance. Because of the importance he places on the individual and the development of a personal narrative, Kavanaugh views psychoanalysis not as a science, but rather as an art, a constructive process through which meanings are

and multiple meanings generated from the person’s unique life-world and experiences” (p.99, italics in original).

In later chapters, Kavanaugh focuses more explicitly on ways in which psychoanalysis can function as a performance art. Following Artaud (1974), he shows how psychoanalysis can be viewed as a “Theatre of Cruelty” (Artaud, 1958, cited in Kavanaugh, p.115), through which social and psychic realities are revealed. Artaud developed a vision of the theater in which realities could be represented directly through movement and gesture, “a unique language of the stage…[that] looks beneath the mask of the civilized and demands that the audience viscerally see and speak with the more barbaric, primitive, and real aspects of self and other” (Kavanaugh, p.115).

In his new book Stories from the Bog, Patrick Kavanaugh offers us a lens for his vision of psychoanalysis as an art rather than a science. A master storyteller, Kavanuagh Stories from the Bog: On Madness, Philosophy, and Psychoanalysis (Contemporary Psychoanalytic Studies) by Patrick B. Kavanaugh, New York, NY: Rodopi, 238 pp, [Hardcover] $64.80

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Parallel to Artaud’s conception, Kavanaugh describes his inpatient work as a type of theater in which primitive anxieties play out, conceptualizing internal representations from the past as ghosts or spirits that signify the essence of our past encounters. As these phantoms come forward, he contends, aspects of their truths are revealed through the associative/interpretive process of psychoanalysis. Kavanaugh advocates entering into this process so that one might speak from his immersion in the experience of the other, to give words, as best he might, to the experience of the other. He positions Artaud’s Theatre of Cruelty as a turn toward recognizing painful realities in the form of representation rather than reason, in this way inviting the type of unconscious participation that is so crucial to the work of psychoanalysis. For Kavanaugh, psychoanalysis is a “performance art…as produced, directed, and choreographed by the subject and as communicated via the associative-interpretive process” (p.129).

In Chapters 8 through 10, Kavanaugh focuses more explicitly on psychoanalysis

It Happens Here

as it has evolved as a positivistic discipline.

Arguing for a view of psychoanalysis as an art, he offers a “fractured fairytale” through which he critiques psychoanalysis as it has evolved within the scientific/medical establishment. He advocates for a more pluralistic view through which discourse can prevail and ideas can evolve. He then advocates for a new vision of psychoanalysis, one that moves against the constraining tendency toward institutionalization and constricting standardization of psychoanalytic theory and practice. More useful, he suggests, is a conceptualization of psychoanalysis as a humanistic discipline in which questions of competency can be taken up in an evolving discourse that can grow with the field. In this vein, Kavanaugh argues for a literary, spiritual, and mystical sense of madness. From this perspective, the best model for learning is apprenticeship, through which one’s identity can evolve. He conceptualizes psychoanalytic practice in the shamanic tradition, such that psychoanalytic knowing evolves through a learning process that “itself enters and takes place in the spirit realm”

(p.195). Such learning, he contends, is facilitated by an immersion into “the rhythms and rhymes and meanings and purposes of whatever reality unfolds” (p.200).

Those familiar with Kavanaugh’s unique voice will enjoy this compilation of his clinical and theoretical works, in which a master storyteller and master clinician offers a unique view of psychoanalytic work as an evolving process through which meanings can be made and manifested. Those not familiar with his work are in for a treat. In an era in which scientism and constricting standards threaten to squeeze the life out of psychoanalytic theory and practice, Kavanaugh is a refreshing voice, reminding us of the richness and importance of this work and of the being-in-it-together that is the sine qua non of psychoanalysis. z REFERENCES Artaud, A. (1958). The theatre of cruelty. In E. Bentley (Ed.), The theory of the modern stage (pp.66–81). New York, NY: Penguin..

Artaud, A. (1974). Collected works of Antonin Artaud. (V. Corti, Trans.). London, UK: Calder & Boyars.

McDougall, J. (1985). Theaters of the mind: Illusion and truth on the psychoanalytic stage. New York, NY: Basic Books.

Sue GRAND

Is it possible to maintain hope, when massive forces are arrayed against us?

Reading Nancy Hollander’s Uprooted Minds: Surviving the Politics of Terror in the Americas, this question comes to mind. In this formidable work, Hollander peels away our remainUprooted Minds: Surviving the Politics of Terror in the Americas (Relational Perspectives Book Series) [Paperback] by Nancy Caro Hollander New York,NY: Routledge, 432pp., $37.95, 2010 ing illusions about a just world. Interweaving history, politics, political/economic/cultural critique, and psychoanalysis, she exposes the covert power structures operative for decades in the Americas. These are ruthless forms of capitalism that deprive their citizens while immobilizing them with hatred and terror. To Hollander, these forms of government have dominated both North and South America.

She makes this case persuasively. Hollander is both a psychoanalyst and a social activist.

She has spent many years exposing, and examining, the authoritarian regimes of South America. In this, and in her prior work (Love in a Time of Hatred), she unpacks the inner workings of these authoritarian regimes.

She asks hard questions. How do torture regimes gain force and power? How do they

terrorize, bewilder, starve, and immobilize an entire populace? In studying these questions, Hollander applies an interdisciplinary lens. Freudian and Kleinian theory is used to illuminate the structure, and functioning, of these governments. But this author also has a very thorough grasp of economic, social, and political history; for Hollander, this history is inseparable from her psychoanalytic investigation. Indeed, this book makes a formidable, if secondary argument: that psychoanalysis had its origins in social consciousness, and cultural critique. This author would say that she is not creating a new methodology, however, but rather applying the forgotten tools of psychoanalysis.

Hollander argues that neoliberal power structures are plundering the planet, eviscerating democracy, sanctioning torture, violating human rights, eradicating the social contract, starving the poor, and impoverishing the middle class. To Hollander, these practices have been ascendant since the 1970s.

They are consolidated, and re-enforced, by the fusion of government and corporations. And collective resistance has been immobilized: as citizens, we live as isolates, paralyzed bystanders to our own predicament. This paralysis, too, is the brainchild 5

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of neoliberalism. Throughout the Americas, concern for the other is effectively upstaged by “national security,” by the arousal of hate and terror, by the invisible erosion of democratic/economic protections, and through the mysterious agencies that operate surveillance, torture, and detention.

To make her argument, Hollander marshals her considerable knowledge as a psychologist/activist working with Latin American activists during and after the “Dirty Wars.” She draws historical parallels to pre-WWII Germany, and to post-9/11 United States. Reading Uprooted Minds, one is struck by the uncanny resemblance in these three strands of authoritarianism. Of course, there are relative, and significant, degrees to our fascist transformations, but the parallels are disturbing and inescapable.

Reading this book, the sentiment “It couldn’t happen here” begins to shift to “It is happening here.” This work is well documented, and densely argued. Reading it, one cannot doubt the menace lurking beneath the democratic surfaces in the United States. We are living it. The penny drops, the veil falls away, and there is the sense that one knew, but that one didn’t really know, before. This is a bold, insistent awakening that dismantles

BOOK REVIEWS

our cherished fictions as citizens. We are not living in a social contract. We have lost our economic safety net, our human rights, and our democracy while we weren’t looking.

This condition is not transient; it did not happen at random. It required strategic planning by invisible cabals who knew how to exploit our infantile trust and how to inflame our paranoid-schizoid anxieties.

The first time I read this book, it had a very disturbing effect. I felt much as I did when I visited Auschwitz. I felt crushed by the vastness, and malignity, of power. I felt the hopelessness of ordinary people, caught in the machine. I was awed by brave acts of resistance. This resistance seemed noble, and impossible, and inspired. It seemed like the last act of the dignified self: passionate, inevitable, and doomed. What can ordinary people possibly hope for, when they stand up to the terror machine? When I reached the end of Uprooted Minds, I was convinced of Hollander’s analysis. I also felt like I did at the Roman Forum. There was the same perversity of power, the cruelty, and the same excess of greed. There was that familiar sense of heroic awe and impossibility. Like the Romans, neoliberalism seems to have infinite resources, and infinite reach. It has spread its tentacles through disparate countries and cultures, and commandeered the global economy. All of this was planned long ago, while “we” were living our own naïve lives.

Hollander awakens us. But how do we maintain hope, when we awaken? When we face our contemporary challenge, depression and hopelessness can consume us. Our own paralytic affects can then facilitate the mission of the state: collective activism is neutralized.

There I sat, book in my lap, annihilated by the truth that I had already known. I felt left with nothing. And I wondered, briefly, who could survive this book without redissociating its contents, or repudiating its argument? How, after all, does one go on living, and take in such devastating truths? I wanted the author to give me hope, and somehow, I thought that she had given me none. Oh, of course, there is great praise of individual activists throughout the work. But upon first reading, this did not counter my sense of annihilation. However, I was asked to review Hollander’s book, and so I was required to read it for a second time.

This time, I saw that her book was actually infused with the greatest hope of our times. It is not simply a study of neoliberalism and the politics of terror. It is a close study of what I (Grand, 2009) have called our “small heroes.”

Hollander traces their activist collectives, and demonstrates that “small heroes” can, indeed, stop the machine. In particular, Hollander studies the activist-psychoanalysts who resisted in Germany, and then, later, in South America. Their efforts were infused with dread, but they were not impotent.

In the aftermath of WWII, psychologists have been preoccupied with some of the questions asked about the Argentine Junta: who are the perpetrators, and what makes them practice such cruelty (Grand, 2000)? We hoped that this inquiry would lead to knowledge, and knowledge would lead to prevention. What have we discovered? Only that there is no clear answer, and that human nature is readily moved to the practice of atrocity. If we had hoped to discover an answer,

…psychoanalysis was thoroughly infused with progressive politics and social activism.

Emigration, assimilation, the desire for status, and the dread of new authoritarian regimes: all of these factors pressured psychoanalysts to espouse a politically neutral discipline, severed from its original social consciousness. and thereby to prevent further abuses, we have utterly depressed ourselves in the process. In genocide and in war, ordinary neighbor turns against ordinary neighbor, wielding machetes, operating the “blue room,” filling mass graves.

If we have been discouraged in our findings, recently we are learning to turn this question on its head. The question is not: what is the nature of human destructiveness, and how could they do this? The question is: who is the person (or group) who can refuse, and resist, this malignant conversion? During mass violence, there are always those who will not.

We need to study those who will not. How is compassion maintained when incitement unleashes cruelty? What cultural, relational, and psychic processes create this ethical fortitude?

In my view, this is the interesting question, and this investigation is where our hope lies.

And upon second reading, I discovered that Hollander is making a significant contribution to this question. She takes us inside the maelstrom of violence and terror and exploitation, and then she studies those who still keep faith with the other. And once again, her analysis proceeds on multiple levels at the same time.

She examines her heros’ family histories; their formative political/historical context; their communal bonds; and the ways in which they are nested in cultural forms that do, or do not, support the ethical position. As always, this is threaded through with depth psychology.

This inquiry into the “small hero” succeeds because it is embedded in Hollander’s secondary argument: that the birth of psychoanalysis shared a zeitgeist, and a methodology, with Marxism. Hollander argues that in critical epochs of social oppression, 6

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psychoanalysis was thoroughly infused with progressive politics and social activism.

Emigration, assimilation, the desire for status, and the dread of new authoritarian regimes: all of these factors pressured psychoanalysts to espouse a politically neutral discipline, severed from its original social consciousness. In these urgent times, it appears to us as if we have to create a first link between social activism and psychoanalysis. According to Hollander, our own adaptation to neoliberalism has caused us to lose the link that was already there. To this author, this lost link is another example of hegemonic practices infusing our normative unconscious (Layton, 2006), and immobilizing our resistance. If we can jettison the neoliberal infection in psychoanalysis, we are perfectly positioned to study the small hero.

Collectively, we can have an effect.

In some ways, then, Hollander’s secondary argument rescues us from despair as we awaken to the realities of neoliberalism. We are living in difficult times. Global conditions are volatile and insecure. Things are bad and about to get worse. It is no surprise that fundamentalists are predicting End Times. There are tsunamis and droughts and forest fires and nuclear meltdowns; war refugees and climate refugees; shrinking food and water supplies; economies plundered by banking cabals; the disassembly of social supports, with “austerity” measures inflicted on the poor. Democracies are hollowed out by antidemocratic legislation, by an obsession with “security” and surveillance. In the United States, our last president legitimized torture and indefinite detention. Our current president has a private kill list, which can now include a US citizen. A new form of government has been unleashed: unfettered capitalism set loose by fascism.

Most of us face these realities every day. We know, and yet, we cannot know the fullness of humanity’s endangerment. We are insecure, but we need our own illusions of security. We need to tell ourselves it’s not so bad. It’s been bad before, and somehow, it got better. It’s worse somewhere else, and it could never get that bad here. Our fictions shield us from helplessness, and they allow us to abandon the other, until we discover, belatedly, that the Other is us.

We cannot relinquish our illusions unless we see evidence of hope. Hope about the ethical position, hope about human solidarity, activism, and resistance. Hollander has given us that hope. z REFERENCES Grand, S. (2000). The reproduction of evil: A clinical and cultural perspective. Hillsdale, NJ: Analytic Press.

Grand, S. (2009). The hero in the mirror: From fear to fortitude. New York, NY: Routledge.

Layton, L. (2006). Attacks on linking: The ucs pull to dissociate individuals from their social context. In N. Hollander, L. Layton, S. Gutwill, (Eds.) Psychoanalysis, class and politics: Encounters in the clinical setting (pp.107–118).

New York, NY: Routledge.

BOOK REVIEWS

Cutting with Lichtenberg’s Knife In 1912 Jung boasted, in a letter from America, that his modifications of psychoanalysis had overcome the resistances of many people who hitherto refused to have anything to do with it. I replied that this was nothing to boast of.

—Sigmund Freud, “On the History of the Analytic Movement” I am not concerned with the truth that may be contained in the theories which I am rejecting, nor shall I attempt to refute them…I wish merely to show that these theories controvert the fundamental principles of analysis…and that for this reason they should not be known by the name of analaysis.

—Sigmund Freud, “On the History of the Analytic Movement” Lacanian Psychotherapy: Theory and Practical Applications by Michael J. Miller, New York, NY: Routledge. 246pp, $36.95, 2011 In the fall of 1975, Lacan paid a rare visit to the United States. Convinced that he was a world-famous superstar, he announced upon his arrival in New York that he wanted to make a private visit to the Metropolitan Opera House. “Tell them I am Lacan,” he said. His academic hosts were a bit flustered, but knowing the consequences of crossing their imperious guest, they hit upon an ingenious solution: an urgent call was placed to the director of the Metropolitan, telling him that Jean-Paul Sartre wanted to visit, with the caveat that the visit would be absolutely incognito. Flattered and delighted by the prospect of entertaining such an eminent celebrity, the director agreed at once. Having been warned in advance not to address the French visitor by name, the gracious reception came off without a hitch, and a delightful and memorable day ensued. It was said that Lacan could not have been more delighted by his welcome. (Roudinesco, 1997, p.376–377) This fabulous tale reveals a material truth: misrecognition and miscommunication mar/k Lacan’s reception in the United States. A devoted and active analyst for more than 50 years whose teaching ceaselessly questioned the formations of the unconscious and the practice of psychoanalysis, it is well-known that Lacan’s passage into the United States has not taken place primarily through institutions of clinical training and practice. In this country, with some exceptions, the teaching and study of Lacan’s writings are much more likely

Ona NIERENBERG

to occur in university humanities departments, including comparative literature, literary theory, media studies, feminist theory, intellectual history, and philosophy.

While this peculiarly American divide does not imply an a priori problem,1 taking it up as such is the motivation for Michael J. Miller’s recent text, Lacanian Psychotherapy: Theory and Practical Applications (2011). For Miller, American psychotherapists’ lack of exposure to Lacan creates an unnecessary impediment to what he believes could and should be Lacan’s wider embrace in what he broadly calls “the American clinic.” With this book, Miller embarks upon a project to reroute what he perceives to be the errant path of Lacan’s thought, aiming to retrieve it from its extraterritorial position vis-à-vis American psychodynamic psychotherapy.

Miller hopes to show us “what might a Lacanian approach to psychotherapy actually look like” (p.xvi), thereby making the strangeness of Lacan’s work familiar to American clinicians for whom it may be unheard of, unintelligible, or unimportant.

Miller’s book focuses exclusively on Lacan’s writings of the 1950s and early 1960s.2 Although he does not explain why, one possible reason for this self-imposed constraint may be that Lacan’s works from that period are often explicitly addressed to psychoanalysts practicing in America and “American Freudianism”—in particular, the founders and representatives of ego psychology. Miller provides his own iteration of this well-documented inaugural period, when Lacan’s unique position in the Freudian field was established. As is widely known, the early Lacan was highly engaged in a critique as passionate as it was unique, a rallying cry for psychoanalysts to return to the radicalness of the unconscious and its laws as discovered by Freud. Thus, Lacan called his project a “return to Freud,” heralding the importance of sustaining psychoanalysis as a break from other notions of the subject and entreating psychoanalysts not to abandon their peculiar position in the clinic of the dispossessed for the mirage of the ego. Thanks to ego psychology, Lacan believed that the unassimilable kernel of truth, Freud’s “good news,” was in danger 1. In America, the transference to the text and desire to read that leads to study in the humanities often allows for a more open engagement with Lacan’s texts than does the furor sanandi and scientism that more typically lead to graduate studies in the psy- disciplines. That is why, in my opinion, efforts to provide wider exposure to Lacan’s thought within the psy- discplines may be a false solution to a mistakenly diagnosed problem (an issue leading directly to the broader question of lay analysis).

2. Given that Lacan’s work continued until his death in 1981, with substantive shifts in emphasis and elaboration, an explanation of this self-imposed limit by the author would have been most helpful.

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of having its future eclipsed by the seductive prepsychoanalytic illusion of the unified subject. Lacan called upon psychoanalysts to return to the unheimliche nature of the Freudian discovery, locus of fantastical evanescent surprises such as the dream, the lapsus, the parapraxis, and the joke (witz).

This period of Lacan’s work highlighted the function and field of speech and language as cause of the human subject in all its estrangement from wholeness, and redirected psychoanalysts to the division of the parleetre (the speaking/being) in relation to the Other.

As a graduate of the Duquesne University program, Miller had the rare experience as a clinical psychology graduate student of being taught by a practicing Lacanian analyst and author (also one of the foremost translators of Lacan), Dr. Bruce Fink. He cites his work with Fink, his professor and supervisor, as inspiration for showing American clinicians “[w]hat happens when we use Lacan?”; for offering an “evaluat[ion]” of Lacan’s theoreti-

…Lacan’s famously baroque style, made even more arduous in English translation, has led American clinicians to too quickly dismiss the work and thus miss out on the clinical “utility” Lacan might offer. cal work by “chronicling its attempted application” (p.xvii); and for “tak[ing] a closer look at how Lacan can be useful” (p.xviii). Miller posits that the dearth of “clinical illustrations of Lacan’s theories,” is a crucial as well as surmountable obstacle to Lacan’s popularity among American psychotherapists: “[T]here are few concrete illustrations of Lacan’s theories, written such that they may be taken up constructively by the reader and considered as an option for practice” (p.xvi). Thus, Miller pairs four of his own clinical examples with a particular Lacanian essay or concept that he believes the case best illustrates (or vice versa). This allows him to demonstrate the technique he calls “listening to the letter,” by which he means paying careful attention to the material of a patient’s speech. It is Miller’s premise that Lacan’s famously baroque style, made even more arduous in English translation, has led American clinicians to too quickly dismiss the work and thus miss out on the clinical “utility” Lacan might offer. He takes as his mission to prove that “Lacan’s conception of lanaguage [can] be practical for psychotherapists practicing in the real world” (p.189) by creating a method out of Lacan’s supposed madness.

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The frequently intimidating and always challenging terrain of the Freudian/ Lacanian field provides fertile ground for a sympathetic, even encouraging, response to Miller’s stated project, which is to be distinguished for its uncompromising emphasis on the clinical encounter as a domain of speech and language. Nevertheless, I believe that this book cannot simply be counted as an addition to the cannon of secondary literature that is indespensable to all of us who have the desire to read Lacan. I am not referring here to its many confusions of theory and concepts; after all, this would not be the first or last exegesis to stumble in its efforts to fix the meanings of such elusive concepts as “the phallus,” “desire,” and “the letter.” In my opinion, this book presents the reader with a difficulty that supercedes any potential criticism about its content, provoking us to question its very foundation.

Its contradictions, paradoxes, and misuses of languge require us to interrogate at what point application (practical as it may be) becomes an act of obliteration of its source.

This is a question that both Freud and Lacan devoted considerable effort to with respect to the term “psychoanalysis.” Miller unwittingly calls upon us to do the same through his act of nomination. By authorizing himself to name a practice “Lacanian psychotherapy,” he opens himself up to a direction of inquiry other than evaluating the “utility” of his intended project. It is Miller’s act of naming, his assumption that invoking the name of Lacan is sufficient to establish something called “Lacanian psychotherapy,” that I have taken as my point of departure.

Let us begin by taking Miller at his word in his enthusiasm for Lacan on “The Purloined Letter,” which cautioned analysts that the search for hidden meaning obscures the truth of what is “readily observable, the ‘obvious,’ in plain sight” (p.40). We begin, then, with the curious case of the book’s title. While I would wager that this is the first time the word “practical” has been uttered in the same breath as Lacan’s name, it is certain that Lacan referred to “psychotherapy” only insofar as he assiduously distinguished that practice from psychoanalysis. But not only is “Lacanian psychotherapy” an oxymoron, it is also a misnomer given Miller’s rationale to report the results of “what happened when I applied some Lacanian principles to relatively short-term psychotherapies” (p.xviii).

If he had confined his ambitions to telling us “what might attunement to language mean for psychotherapy as directed by a nonanalyst” (p.26) and come up with a title more appropriate to such an aim, his book might have become an interesting contribution to the timely and important conversation about the place of psychoanalysis in the mental

health professions. However, Miller has a significantly different goal, which is to associate the name of a psychoanalyst whose life’s work was devoted to exploring and upholding the specificity of the practice of psychoanalysis with a practice, psychotherapy, in which he never engaged.3 As a result, we are led to wonder if “Lacanian psychotherapy” is but another name to add to the series of resistances to psychoanalysis as a unique endeavor (medicalization, ego psychology, repression of the death drive) that have been so abundantly generated by its enemies and friends alike.

Given its raison d’être to function as a literal teaching of “listening to the letter,” it is all the more notable that confusions of terminology and slippages of language are so pervasive throughout this book with respect to the terms psychoanalysis and psychotherapy. Nowhere does Miller examine the fact that there are differences between the practice and theory he would like to “apply” (psychoanalysis) and the domain of his desired “application” (psychotherapy).

Significantly, this lack lends itself to the creation of an illusion of synonymy, as if there could be a perfect rapport between the two. Miller presumes continuity, whereas psychoanalysis (according to both Freud and Lacan) is the product of a rupture and exclusion, its exile from bordering disciplines such as psychology, psychiatry, and philosophy the cause for its very existence.

“American analyst or analytic therapist” (p.xv) is a typical Millerian phrase, presupposing via their coupling that the one is substantively equivalent to the other. We also find the surprising pairing of “Lacanians and the rest of psychodynamic clinicians” along with a reference to “a dialogue between Lacanian theory and more mainstream psychodynamic therapists,” (italics mine, p.xvi), which presume “psychodynamic clinicians” or “psychotherapists” as the general category to which “Lacanians” are subsumed.

This supposition of the synonymy between “Lacanians” and “psychodynamic psychotherapists” is furthered by Miller’s prevalent use of the trope “the clinician” as a catchall category. What is most revealing, however, is that there where Miller does mark the distinction between psychoanalyst and psychotherapist, he does so in the form of an authorial disclaimer: I am not an psychoanalyst…although I do consider my work with these patients to have been analytic in nature…This admittedly curtails my rights to speak as an authority, and puts 3. As Freud writes, “I am of course perfectly ready to allow that everyone has a right to think and write what he pleases; but he has no right to put it forward as something other than what it really is” (Freud, 1914, p.60).

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my project in danger of relying on too little knowledge…While this is a viable objection, I must clarify that my aim is not to speak as a psychoanalyst, nor do I wish to portray myself as an authority on all matters Lacanian…This may be problematic to those who are invested in a purist approach to Lacanian praxis (whatever that may be), but I contend that my position—as a non-analyst—helps the honesty and rigor of this project. I can afford to be excited and fascinated by Lacan’s work, hopefully without becoming its zealous missionary. (italics mine, p.xvii–xviii) Of course, not every treatment is a psychoanalysis, nor it is necessary for every clinician to be a psychoana-

lyst, but it is essential to know the difference. This pained paragraph exposes the underside of Miller’s insistence that there is no real consequential distinction between a psychotherapist and a psychoanalyst. His authorization to speak on “matters Lacanian” can only be achieved at the cost of insulting and undermining his potential critics in advance (ouch!). While this may function as the support for his claim that psychoanalytic listening can be learned from a book, there is absolutely no support for attributing such a notion to Lacan.

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Miller is right to point out that “[j]ust as there are qualitative differences between the way a trained musician and the casual listener will hear music, we find a difference between proper psychoanalytic listening and everyday listening” (p.12). Where he goes awry, however, is to imagine that psychoanalytic listening can be found in a book, via acquistion of knowledge and its application (“technique”). On one of the many occasions Lacan sought to capture what is peculiar to psychoanalysis, he said, “analysis is what one expects from an analyst” (Lacan, 1991/2007, p.53). While this statement may appear at first glance to be a perfect example of the inscrutable style that Miller disparages, if we do not turn away too soon, we may notice that its peculiar structure is not

a tautology. Lacan, who insisted that psychoanalysis could not be defined in terms of standards and norms (this many times per week, that many minutes per session), refers us to the psychoanalyst as the measure of psychoanalysis. Why? Because there is an absolutely inextricable knot between the formation of a psychoanalyst and the practice of psychoanalysis, that is to say, psychoanalytic listening. No matter how divisive their orientations, all schools of psychoanalysis would agree that there is one defining aspect of psychoanalytic training: the analyst’s own analysis. This lived experience is not necessary for the practice of psychotherapy,

which requires only a course of study with a period of supervised practice, just like medicine, dentistry, or law. Advisable as it may be, there is no necessity for a psychotherapist to go through psychotherapy, because the “training” as such presumes that the practice is completely teachable and learnable as a universal discourse and graduated knowledge on the model of the university.

This is far from the “impossible profession” as Freud defined it, which undermines the ideal of the transparency of knowledge and creates something that can only be transmitted the way it is practiced, one by one. Lacan never ceased to emphasize this imperative that had been announced by Freud—the need for each analyst to experience the surprise, horror, and awe generated by the encounter with one’s own unconscious; to discover the signifiers that mark one’s own desire, history, and body; and to permit the fall of the idols and identifications that have functioned as sustenance, support, and guarantee of one’s unconscious enjoyment. This is the sine qua non of analytic formation, but even at that, there is no guarantee. Nevertheless, according to Lacan, without it there is no possibility of being able to hear the absolute alterity of the subject of the unconscious, no way to conduct the cure.

In fact, Miller reveals that he cannot but falter on this very subject by repeatededly questioning his own interventions and wondering how to orient himself to the speech of his patients. For all his certainty regarding “listening to the letter,” he nevertheless keeps bumping up against his uncertainty regarding what to listen for. He is troubled by his acknowledgement that “my punctuations [of the patient’s language] were chosen according to my own subjectivity” (p.61, emphasis in the original) and feels unable to satisfactorily answer an imagined interlocutor’s query: “How can I claim to be respecting the patient’s subjectivity when I am arguably subtly manipulating him into associating to ideas which I, and not he, have deemed to be important?” (p.62). He worries “how does a therapist remain a therapist and not become a persecutory English teacher?” by repeating the patient’s “mistakes” back to him and, furthermore, expresses concern regarding “the clinician’s authority over the language of the patient” (pp.90–91). He also feels it necessary to caution the therapist who may take up his method not to “set himself up as an authority upon ‘proper’ language and put the patient in an inferior position based on class, ethnicity, educatinal type, or home region” (p.194). Miller’s persistent doubts highlight that the practice of listening as defined by psychoanalysis is not simply a “technique” to be acquired, but is an effect of a relation to the unconscious that cannot be learned solely through study and supervision.

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Miller’s case narratives highlight the problem of what he calls “applied psychoanalysis.” If one were to follow Miller’s prescription for “listening to the letter,” one would come away with the belief that the signifier, according to Lacan, is nothing but “words, words, words!” and that they are important only insofar as they lead to the uncovering of hidden meanings. Most telling are his case examples, which invariably lead from a repeated word Miller takes note of and highlights to the ultimate revelation of a pivotal preconscious memory that functions as a kind of catharsis. For example, one patient complains of his lack of productivity in various aspects of his life. Through Miller’s repeated attention to this word and other words he supposes to be related by meaning (i.e., “void,” “stuck”), the therapy leads to a discovery of the patient’s traumatic experiences with toilet training, which Miller reports subsequently allows the patient to “move.” While this may build a case for the importance of listening to the patient’s speech, it is nevertheless to be distinguished from analytic listening. Lacan, whose warning to analysts was that “two ears are too many,” opposed understanding to the listening that opens to the surprise of the signifier as the split between meaning and what is said.

One reason that Miller misses this point is because his reading of Lacan excises one of the three registers that is fundamental to Lacan’s teaching—the Real, which is knotted to the Symbolic and the Imaginary. For Lacan, these registers only exist with respect to one another, and he shows this by the figure of the Borromean knot. Excluding the Real (there is not one mention of it in Miller’s text) allows for the mistaken notion that language is all in Lacanian psychoanalysis. In fact, Miller’s goal of “applying” psychoanalysis is founded on this exclusion. While it is true that the early Lacan focuses primarily on the relation between the Symbolic and the Imaginary, the Real is always present (and becomes a pivotal part of his later work). Even in the early Lacan that Miller focuses on, we could say that his famous revision of the Saussurean diagram indicates the presence of the Real by the bar that severs the signifier from the signified. The human subject, the subject of psychoanalysis, exists only as an effect of the language, but that does not imply that the subject is only and all language: according to Lacan, the human subject comes into being precisely because the relation of the human animal to language is one of lack. The mythical entry into language severs us irrevocably from wholeness and totality, permitting the subject as such to exist, and producing a remainder, the theorizing of which Lacan called his one and only innovation: objet a. It is that little letter, “a,” object cause of desire,

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that specifies the position of the analyst, and it is that little letter that Miller has no place for. Lacan places the object a at the center of the three intertwined rings of RSI, because this algebraic sign (as Lacan called it) indicates an impossibility in relation to the desire of the Other that will come to be figured by the subject as a loss through analysis. The particular form given to the fantasy of how to recuperate this loss will establish the coordinates of jouissance, as well as the signifiers of desire. This is the logic of the phantasm, where symbolic (signifier), imaginary (narcissism), and real (jouissance) are knotted together, and without appreciating this structure there is no way to “listen to the letter.” For the sake of readability, sense, and meaning, Miller has gotten rid of the real dimension of jouissance that Lacan found increasingly important for the last 25 years or so of his teachings and his life. There is no question that Lacan’s seminars of the 1970s and 1980s are challenging, even impossible, to read in a way that would make them more accessible to a wider number of readers. It is always possible to decide that such a labor is not in line with one’s desire. But Miller’s strategy is to mock the difficulty of this late work as a mere artifact of Lacan’s personality, while choosing to call his own work “Lacanian.” This is an uncanny repetition of the repudiation of the late Freud by the ego psychologists, a history Miller obviously

Birth Trauma

knows well, but fails to see as pertinent to his own relation to Lacan.

Perhaps the most important contribution of Miller’s book is that it forces us to reckon with the question of “application.” This is of particular concern when it comes to psychoanalysis, which provokes resistance by its very existence as the bearer of truths no one wants to know anything about. Before Lacan, Freud was forced to take up this issue many times. Most painful is his account of his splits with Adler and Jung in “On the History of the Psychoanalytic Movement” (1914/1999). Referring to the latter, he writes, “It may lastly be said that by his ‘modification’ of psychoanalysis, Jung has given us a counterpart to the famous Lichtenberg knife” (Freud, 1914/1999, p.66). And what is this no longer famous knife? The invention of Georg Christoph Lichteberg, an 18th-century satirist, aphorist, and physicist (who was one of Freud’s favorite sources for witticisms and paradoxes), it makes its “appearance” in the humorous “Miroir d l’ame: a consolation for the unfortunates born on 29 February,” which consists of “an inventory of objects which Lichtenberg claims to have found by chance in the library of an eccentric English collector” (Riolo, 2007, p.4). Included in this text is a blank page that, Lichtenberg explains, depicts “a bladeless knife with no handle.”

Freud first mentions this paradoxical implement in his book on the witz, to illustrate a

particular form of logical violation that seeks to “maintain a connection which seems to be excluded by the special conditions implied in its content” (Freud, 1905/1999, pp.60–61n1).4 Thus, when he invokes “Lichtenberg’s knife” to describe Jung’s work, it is to tell us that Jung has departed absolutely “from all the points which I should regard as the essence of psychoanalysis” and yet is “unwilling to give up [his] connection with psycho-analysis” (Freud, 1905/1999, p.60). Without question, Miller makes the case that reading Lacan has been influential to his clinical work and incited him to pay careful attention to his patient’s speech. This can be heard as welcome news in a field increasingly dominated by the deafening call for so-called empirically based treatments. Nevertheless, by naming his work and his book“Lacanian psychotherapy,” is he not left clutching Lichtenberg’s phantom instrument, unable to make a cut and accept the loss that this ethically implies? z

and, until his break with Freud, Rank was jealously viewed by Freud’s other disciples as the acknowledged “favorite son” and “heir.”

The 30 or so letters “of medium and major importance” (p.x) from Freud are quite interesting, and help add detail to a portrait of the close relationship between Freud and Rank, as well as the differences between them that led ultimately to Rank’s expulsion from Freud’s inner circle.

Additionally, the letters add depth to an understanding of the psychoanalytic movement in the years preceding WWI up to Rank’s definitive departure in 1926.

Rather than being a simple collection of correspondence, which would in any case have resulted in a rather slim volume, the editors have elected to interleave these letters with a synopsis of the events that the particular letters refer to, or descriptions of events that were taking place during the time that the letters were written. The aim seems to have been to give a richer understanding of the significance of the letter’s contents, and

is generally a successful attempt. Having no letters from the years 1919 to 1921, the editors rely instead on other sources for their history of those years (p.91).

In 1905, at age 21, Rank first met Freud, presenting him with a manuscript of an essay on The Artist. Freud was sufficiently impressed to eventually hire Rank as the secretary of his Wednesday Psychological Society, “stipulating that he finish academic high school (Gymnasium) and go on to the University” (p.2). Freud’s initial relationship to Rank was that of a mentor, guiding Rank’s academic as well as his eventual psychoanalytic development. This relationship, which began promisingly, grew into one of great importance for both men before its dramatic demise some 20 years later with Rank’s removal from Vienna and ultimate establishment in the US. The history of the break, as it is generally presented by Rankians, is one of a steady theoretical development on the part of Rank that Freud ultimately would

REFERENCES Freud, S. (1905/1999). Jokes and their relation to the unconscious. Standard Edition, 8.

Freud, S.. (1914/1999). On the history of the psychoanalytic movement. Standard Edition, 14.

Lacan, J. (1991/2007). The other side of psychoanalysis: The seminar of Jacques Lacan, Book XVII. (R. Grigg, Trans.).

New York, NY: W. W. Norton.

Riolo, F. (2007). Freud and Lichtenberg’s knife. Italian Psychoanalytic Annual, 1, 59–60.

Roudinesco, E. (1997). Jacques Lacan. (B. Bray, Trans.).

New York, NY: Columbia University Press.

4. Freud provides another joke to amplify: “Is this the place where the Duke of Wellington spoke those words?”— “Yes, it is the place, but he never spoke those words.”

Martin WINN

The Letters of Sigmund Freud & Otto Rank: Inside Psychoanalysis, by E. James Lieberman and Robert Kramer, consists largely of Otto Rank’s letters to Sigmund The Letters of Sigmund Freud & Otto Rank: Inside Psychoanalysis, by E. James Lieberman and Robert Kramer (eds.), Gregory Richter (trans.), Baltimore, Md: The Johns Hopkins University Press, 384pp, $34.95, 2011.

Freud. Far fewer of Freud’s letters to Rank have survived: only about a quarter of the 250 letters are from Freud, and of those, a third are consigned to the appendix “Minor Letters.” Those letters are by and large quite uninteresting (“I am in possession of a registered letter addressed to you” reads one entire letter from Freud to Rank) (p.293).

Despite the relatively modest number of letters compared to Freud’s other correspondences—Freud and Ferenczi exchanged 1,240 letters—Rank was widely considered the closest to Freud of all of his disciples

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not allow, and is well represented in the preface to a biography of Rank written by Lieberman (1985): If the maternal side of Freud had been stronger, he not only would have understood women better, but he might have allowed his protégé to separate more freely. Instead of nurturing Rank’s selfcreation, Freud withdrew as though it were a threat. (p.xxxi) The beginning of the divergence with Freud occurs when Rank published his book The Trauma of Birth in 1924, the same year that he and Ferenczi published “The Development of Psychoanalysis,” in which they argue for an “active” therapy.

Rank’s “birth trauma” theory challenged Freud’s insistence that the relation to the father is primordial and constitutes the first identification. Rank proposed a “preoedipal” stage that takes precedence over the oedipal, and consisted of the primordial relation of the infant to the mother. Freud was initially impressed with Rank’s book, writing to Abraham in its defense, “I do not hesitate to say that I regard this work as highly significant, that it has given me much to think about, and that I have not come to a definitive judgement about it”(Jones, 1957, p.61).

However, Freud was troubled by Rank’s reduction of the role of the father, who in Freud’s judgment functioned as the representative of the “authority that does not permit incest” (p.62). Freud’s hope was that Rank’s contribution would lead to “fruitful discussions” and to the general advancement of psychoanalytic theory (p.62). Freud was less sanguine about “active therapy.” In a letter to Ferenczi he issued a prescient warning that it could lead away from psychoanalysis on “a path for traveling salesmen” (Lieberman & Kramer, 2012, p.181).

As Lacan has noted of Freud’s position on the primordial identification to the figure of the father in Group Psychology and Analysis of the Ego (1921): “This is very odd to be sure, and is to be placed in contradiction with everything that the development of analytic experience is found to have established concerning the primacy of the child’s relationship with the mother. There is an odd discordance between Freudian discourse and the discourse of analysts” (Lacan, 1991, p.88).

In line with Lacan’s view, Rank could then be seen as one of the first to have tried to address this discordance, and he was certainly not the last. In fact, the preoedipal primordial link to the mother is a basic tenant of the object relations school, which owes its existence to Otto Rank.

Through the late forties and fifties ego psychology struggled with the same dilemma,

and by the sixties influential ego psychologists like Spitz, Mahler, and Jacobson, who all studied infant behavior, were describing early attachment issues that emphasized the infant’s relation to its mother (Jacobson, 1964; Mahler, 1968; Spitz, 1965).

By the early 1950s, when Lacan began delivering his first seminar, it was a widely accepted truism that Freud’s insistence on the significance of the position of the father was an outmoded relic of Victorian beliefs.

It will be left to Lacan to adequately confront Freud’s seemingly discordant insistence on the primacy of the role of the father, and to explain why Freud remained rightly adamant on this point.

Lacan (1991) addressed this “discordance” by reminding us that our work with our analysands is a “reconstructive collabora-

There is no preoedipal stage that developmentally leads to an oedipal stage, there is only the intervention of the paternal metaphor that retroactively structures everything that has gone before, and is thus structurally “primordial.” tion” (p.88). By this he meant that the analysand speaks about his lived experience and something emerges that we interpret, not on the basis of the live events, but on the basis of what is said about those events. This is because the lived experiences are taken up in language, and it is language that structures them. It is in the relation of one signifier to another that “it is possible for this gap that we call the subject to open” (p.88). It is in the effects of this link between one signifier and another that an unconscious thought is represented.1 The introduction of language will, nachträglich, restructure the events that chronologically preceded it. As early as A Project for a Scientific Psychology of 1895, Freud used the term nachträglich (“afterwardness”) to describe when “a memory is repressed which has only become a trauma by deferred action”2 (p.356). Lacan considered this an extremely important concept, indicating that the lived events of the subject are structured logically rather than chronologically. That is, the introduction of language as a third term introduces the symbolic register, the register of the symbolic father. It is the introduction of language that acts as the incest taboo. This is 1. “Millionaire” and “familiar,” for example (Freud, 1905, p.19).

2. The Strachey translation of nachträglich actually controverts and obscures the significance of the term.

Nachträglich in not a deferred action, “due to some kind of storing procedure, between stimulus and response” (Laplanche & Pontalis, 1973, p.114).

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the logical “first moment” that constitutes primary trauma and that, nachträglich, or in Lacan’s terms, après-coup, gives meaning to the chronologically prior events.

The prior events become traumas aprèscoup, but only secondarily in relation to the chronologically later event. There is no preoedipal stage that developmentally leads to an oedipal stage, there is only the intervention of the paternal metaphor that retroactively structures everything that has gone before, and is thus structurally “primordial.”

Hence, birth trauma is not primordial, but only becomes a trauma nachträglich, once the trauma of castration, as a primordial trauma, is encountered.

Additionally, the symbolic structure of language pre-exists the birth of the infant and, unless the subject is destined to be psychotic, there is a place already prepared in language for him by his parent’s unconscious desires. The emphasis on the so-called preoedipal does not recognize that the parents themselves are already immersed in the symbolic order. They are already subject to the structure of language, and their child is “always already” (as Althusser would say) determined by the symbolic order.

Rank’s position was thus apparently less heretical than an initial attempt to address analytic experience. And at least initially, this is how Freud seemed to have viewed Rank’s work.

On the other hand, Freud’s supporters responded by characterizing Rank as having undergone either some sort of “conversion” that, in the words of A. A. Brill, “invariably involves deep emotional upset. My feeling about Dr. Rank is that it is this emotional upheaval that is responsible for his present confusion” (Lieberman, 1985, p.292), or as manifesting the inevitable outcome of mental disturbance: “It took a couple of years before it became plain that a manic phase of [Rank’s] cyclothymia was gradually intensifying” (Jones, 1957, p.47).

Freud himself eventually wrote to Rank: The exclusion of the father in your theory seems to reveal too much the result of personal influences in your life which I think I recognize, and my suspicion grows that you would not have written this book had you gone through an analysis yourself.

(Lieberman & Kramer, 2012, p.208) There are many possible factors that contributed to Rank’s break with Freud, not least of which was the fact that, as Freud noted, Rank never underwent an analysis. Among Rank’s many enduring contributions to psychoanalysis, an ironic one would be the increased awareness of

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how central one’s own analysis is in the formation of a psychoanalyst. Unfortunately, at that time, the importance of an analysis was misunderstood; the requirement to undergo an analysis was more likely to be prescribed as a kind of “punishment” for bad behavior. Later, the International Psychoanalytic Association would impose a “didactic” analysis as a kind of academic requirement, but it was not until Lacan that the significance of the relation between the end of an analysis and occupying the position of an analyst was actually addressed.

Rank’s response to Freud’s letter was particularly bitter. He attributed Freud’s criticism to the influence of “rabble-rousers” like Abraham about whom, in Rank’s opinion, Freud deludes himself:

psychoanalysis (p.467). “In fact, they punished their students for their own ambivalence. At the same time, they consolidated the one trend that Freud always wanted to avoid: the shrinkage of psychoanalysis into an annex of psychiatry” (p.467).

The other response to Freud’s illness was what Bernfeld characterized as “outbursts of the id forces” exemplified by Rank’s behavior.

The more light there is, the more pleasant it will be for me, as the profound ignorance of people like Abraham, among others, will be all the more apparent. Do you really believe, Professor, that an argument from someone like Abraham will impress me when I’ve lost faith even in your judgement in this matter?

It was Rank’s belief that Freud’s impending death was the signal for him to establish himself as the reigning psychoanalyst that precipitated Rank’s break with Freud. When Rank responded to Freud’s comment that his “condition” had stabilized by accusing Freud of “denial,” Rank was showing his cards: his expectation and hope that Freud would die.

Seen “in the light” of the crisis caused

by Freud’s illness, while Rank’s birth trauma theory may have begun initially as an attempt to address the discord that Lacan notes, Freud’s illness was the more significant catalyst that unleashed the unconscious motivations for Rank’s challenging of Freud. As Rank’s letter cited above makes clear, Rank himself unconsciously linked his theory and Freud’s illness through the signifier “denial.” Rank accused Freud of denial in relation to the veracity of Rank’s theories, denial in relation to the true motives of those of Freud’s disciples who criticized Rank, and then, in the conclusion to his letter, he accused Freud of denial of the true state of his “condition.”

The phantasm expressed by Rank’s theory was precisely to deny the significance of the father in order to protect himself from the guilt associated with Freud’s “life-threatening illness.” Guilt, because Rank was counting on that death to cement his own position. What better way to declare oneself innocent than to declare the father, and therefore his death, unimportant?

In Rank’s phantasm, the mother, or “Mother” as Lieberman and Kramer insist on writing throughout their book, is a benevolent, omnipotent figure, a totality for whom the figure of the father, as representing a bar to incest, doesn’t exist. If there is no father who pronounces the incest taboo, there is no threat, there is nothing to fear, nothing to lose, no cost. In a letter of August 22, 1922, Rank had written to

He then concluded his letter with a sarcastic reference to Freud’s health: I was very glad to hear from you directly that you’re satisfied with your condition, if one can trust the psychology of denial, this good condition will last a very long time. (Lieberman & Kramer, 2012, p.219) Freud’s “condition” at that time was his cancer, which had been diagnosed roughly at the time that Rank began to develop his theory of birth trauma. Initially, Freud’s “condition” was thought to be so dire that he was assumed to have only months to live. His doctor apparently feared that if Freud was informed of the gravity of the initial prognosis, he was at risk of suicide.

Instead, only Freud’s immediate family, and Rank, were informed. Thus Rank’s position as heir-apparent was solidified, although initially in secret, even from Freud.

As Siegfried Bernfeld (1962) noted in his paper “On Psychoanalytic Training,” by the summer of the following year Freud’s cancer was under control and Freud could now hope to live for many more years.

Freud’s “death and resurrection,” Bernfield wrote, was decisive for the development of psychoanalytic training (p.467). One response to the threatened loss took the form of a “reaction-formation” that expressed itself in the establishment of “a rigid selection of newcomers, and…the institution of a coercive, long drawn-out authoritarian training” to safeguard the future of

For Rank, Freud’s impending death had been the signal to go his own way.

Since he was impatient and had started his departure somewhat too early, he found himself on Freud’s recovery with his bridges burned and could only advance into nowhere. (p.467)

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Freud about a “Scientific Campaign” that he and Ferenczi were starting “against the overestimation of the castration complex” (Lieberman & Kramer, 2012, p.140).

Thus, neither the infant nor “Mother” are subject to any privation, or loss.

Indeed, this was the conclusion that Rank eventually arrived at with his emphasis of “will.” His conception of the outcome of a treatment in which the patient through an act of will becomes the “creator of himself ” (p.268), is, in the final analysis, to take oneself for God (“I am that I am,”

Exodus 3:14). It is not surprising that Jones regarded The Trauma of Birth as “written in a hyperbolic vein more suitable for the announcement of a new religious gospel” (Jones, 1957, p.58).

An interesting note in this context is that one of Rank’s responses to his apparently brutal, distant father was to abandon his surname of Rosenfeld, and, at the age of 19, rename himself Rank after a character from Ibsen’s Wild Ducks. The belief that one could give birth to one’s self is at worst delusional, and at best a neurotic belief that the work of a true analysis would undo (as Freud’s letter cited above indicates).

While Rank’s birth trauma theory attempted to negate the position of the

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father (understood as uncastrated), that position returned “in act,” in the sense of an “acting out” in Rank and Ferenczi’s active therapy, since it was founded on the notion that the analyst functions as an uncastrated master. The analyst “knows” all about the analysand even before the analysand has said a word, and is therefore justified in injecting the answers as soon as possible without waiting for the possibility that the analysand will discover something new that neither the analysand nor the analyst were aware of.

…reported in lurid terms the extraordinary doctrines that Rank had been inculcating in New York, and the confusion he had thereby created; Rank’s pupils had gleefully related that it was no longer necessary to analyze dreams, nor to make any interpretations beyond that of birth trauma, and they were relieved also from going into the unpleasant topic of sexuality. (Jones, 1957, p.71) When it became clear that Freud was in fact not in denial about his condition, Rank, back in Vienna, and faced with stern criticism from a very much alive Freud, had a second crisis in which he then retracted his theories: Suddenly I found myself again, leaving behind me a condition which I now understand as neurotic, and have come to recognize in Professor’s life-threatening illness the trauma that precipitated the whole crisis and, furthermore, the type and mechanism of my reaction to it in terms of my personal childhood and family history—the Oedipus and brother complex. (Leiberman, 1985, p.249)

It was Freud’s acknowledgment of the failure of an “active” method that had originally led him to abandon suggestion as a technique. It was the shift to “free association” that founded the radical discovery that is psychoanalysis: the hysteric is the one in possession of the truth (at the price of not knowing it). If the analyst thinks he knows the truth he only perpetuates his own ignorance of the unconscious. The analyst does not occupy an omnipotent position—a position that, in fact, no one occupies, least of all the one who takes himself for a master.

Freud was justifiably alarmed by Rank’s activities during his first stay in the US when he received a letter from Brill that:

In order to salvage his status, and to undo the damage he had caused, Rank offered to return to America and to publicly recant his former views. Freud was the only one willing to believe in Rank’s reversal.

However, once back in the US, Rank remained silent rather than renouncing his previous position. It was palpably clear that he knew he had burned his bridges and, in Bernfeld’s words, “can only advance into nowhere”(1962, p.467) in the psychoanalytic movement, and rather than address his “personal childhood and family history”(Leibeman, 1985 p.249), he ultimately took up his birth trauma and active therapy mantle again.

Unfortunately, these phantastic theories were extremely influential in the US. During his stays in America, Rank gave numerous talks in which he preached his theory of birth trauma and active therapy, and attacked Freud’s insistence on the importance of the Oedipus complex and the castration complex, while elevating the role of the mother as central.

That Rank’s views were so wildly popular in America, land of religious fundamentalism and Puritanism, is not surprising. Rank’s technique also appealed to an American ideology of “pragmatism,” with its emphasis on brevity, the “here and now,” “self-creation,” active intervention and guidance on the part of the therapist, and the “real” relationship between therapist and patient, as opposed to transference.

On his website dedicated to Otto Rank, Leiberman has noted that: 13

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Otto Rank’s emphasis on will, relationship and creativity appealed to psychologists Rollo May, Carl Rogers, Esther Menaker, Paul Goodman, and Henry Murray. Noted psychiatrists influenced by Rank include Frederick Allen, Marion Kenworthy, Robert Jay Lifton, Carl Whitaker, and Irvin Yalom; writers and critics include Ernest Becker, Maxwell Geismar, Max Lerner, Ludwig Lewisohn, Anais Nin, Carl Rakosi, and Miriam Waddington.

Some of Rank’s ideas which seemed radical in his time are now in the mainstream of psychoanalytic thought: the importance of the early mother-child relationship; the ego, consciousness, the hereand-now, and the actual relationship—as opposed to transference—in therapy. He anticipated and influenced interpersonal, existential, client-centered, Gestalt, and relationship therapies. (n.d.)

Given the provenance of Rank’s theories, the degree of his influence for American psychoanalysis (even as it disavowed him), as well as for many strains of psychology and psychotherapy that followed, has, to say the least, a tragicomic aspect.

Rank’s influence was due precisely to the fact that he attacked the very premise of psychoanalysis, undoing Freud’s frightening “Copernican” displacement of man’s consciousness from the center of the world.

Freud’s concluding remarks from Studies in Hysteria that “much will be gained if we succeed in transforming your hysterical misery into common unhappiness” ( 1893–1895, p.305) was hardly a welcome thought for a country that has the “pursuit of happiness” guaranteed in its constitution. Rank offered a happy vision of a “pre-Copernican,” preFreudian, preoedipal view of the human as potential master of his universe.

In addition to the collaboration and eventual break between Rank and Freud, their letters reveal a great deal about the internal relations of Freud’s inner circle. In reading the letters, as well as Jones’s 1957 biography of Freud, and Freud’s comments and letters to his other disciples, one is struck by the level of imaginary conflict taking place. There are constant accusations back and forth of “death wishes toward the father” and “brother complexes” that underlie disagreements. Freud too is constantly wary in the same vein; Lou Andreas-Salome writes in her diary: I understand very well that men of intelligence and ability like Otto Rank, who is a son and nothing but a son, represent for Freud something far more to be desired [than Carl Jung, or Victor Tausk]. He says of Rank: “Why is it that there can’t be six

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such charming men in our group instead of only one?” Even in his wish for a half-dozen the individuality of the man referred to is put in some doubt. And yet just this serves to reassure Freud in the face of threatening “ambivalence.” During one evening’s discussion, when Rank lectured on regicide, Freud wrote the following note to me on a piece of paper: “R. disposes of the negative aspect of his filial love by means of this interest in regicide; that is why he is so devoted.”

(Lieberman & Kramer, 2012, p.25) In the letters from the years 1922 to 1924, beginning in a chapter entitled “Fratricide,” the other members of Freud’s committee and the younger analysts surrounding them were subject to harsh criticism by Rank, who was constantly complaining of the inadequacies and foibles of his colleagues. Jones and then Abraham, whom Rank clearly saw as his chief rivals, were the main targets of his ire. Only Ferenczi, with whom he formed a close tie, escaped unscathed. Freud’s responses varied; sometimes he was in agreement, sometimes he seemed to attempt to stay above the fray, and at other times he appeared to actually foster the conflicts among his disciples. In one particularly charged letter Freud wrote to Rank, Perhaps you haven’t fully appreciated the motivation for my regret, recently expressed, that I didn’t permit you to study medicine. In that case I believe there’d be no doubt about the person to whom I’d bequeath the leading role in the psychoanalytic movement. As things stand, I’d wish that Abraham’s clarity and correctness could be melded with Ferenczi’s talent, and that Jones’ inexhaustible pen could be added as well. (p.135) As Bernfeld (1962) justly noted, this configuration would have escalating repercussions by 1924, when Freud’s cancer was first diagnosed: Freud’s illness transformed the incipient squabbling into all-out war among his disciples, effectively destroying the “Committee,” and decisively marking the subsequent trajectory of the psychoanalytic movement and the transmission of psychoanalysis.

That there was so much internal conflict among Freud’s disciples raises a significant question: was there something particular to the way Freud conceptualized the structure of the Committee that inevitably lead to its demise?

Freud’s idea of his group as constituted by sons organized around a father followed his conception of society laid out in Totem and Taboo (1913), founded on the murder of the primordial father by his sons. Jean Allouch (1991) read this “myth” as Freud’s

interpretation of the conflicts that developed in the Committee. Allouch noted that Freud “presents a familial-ist reading of these conflicts (notably the identification of the student as son), a version that was from the beginning largely admitted by the persons concerned” (p.193).

In conceiving of the Committee as structured along familial lines, Freud misrecognized the incompatibility between family and psychoanalysis. Allouch noted that the two “never stop manifesting something close to an antinomy” (1991, p.191).

Lacan wrote in 1938 that “the individual who does not struggle to be recognized outside the familial group will never attain a personality before dying” (Lacan, 1984, p.35). One aim of a psychoanalysis is for the analysand to find a way out of the labyrinthine impasses of their family “drama.”

Allouch lamented, “It could seem that the family, at one moment undone by psychoanalysis, always ends up, at the end of who knows what sort of alchemy, recreating itself and then taking over psychoanalysis” (1991, p.191).

Freud proposed the Oedipus complex to conceptualize the “drama” of the family.

In his seminar of 1968, L’enverse de la psychanalysis, Lacan called the Oedipus complex “Freud’s dream.” Lacan then asked: as a dream, what is it designed to mask? His answer: that the father is castrated (1991, p.115). Freud and his disciples, with all their talk of “brother complexes” and “regicide,” phantasized Freud as occupying an omnipotent role within his group, masking the fact that the father is castrated. This consigned Freud’s disciples to a position of impotence and rivalry. Freud’s illness and impending death heightened the impotence and rivalry to an unbearable level of angst.

As Bernfeld noted, the disciples reacted in two distinctly pathological manners. In a manic episode triggered by his belief that he was the chosen heir, Rank developed a theory of a fatherless family,3 while believing himself to be the uncastrated master. The others erected the bureaucracy that became the IPA, with its regulations, qualifications, requirements, and exclusions, the ultimate aim of which was to safeguard against castration.

Then they sought a guarantee by aligning themselves with medicine, the perceived uncastrated masters, thus reproducing their position of impotence in relation to a master.

The end of a psychoanalysis, in the words of Moustapha Safouan (1983): …concerns the relation of the analysand not to the person of his analyst, but 3. Jones reported an encounter with Rank and Rank’s pregnant wife in March 1919 in which Rank remarked “in a dismal tone that men were of no importance in life; the essence of life was the relationship between mother and child” (1957, p.58).

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to analysis. It is, if I can express myself in this manner, the moment where the algorithm of the sujet-supposé-savoir 4 delivers its secret of being also the algorithm of what Lacan calls the “ternary component of the analytic function,” or as well of [being] the object…a.” 5 (p.68) The significance of this moment, which is a logical moment, is precisely the recognition of castration: there is no all-knowing master in the person of the analyst; rather, there is the object a, the remainder that is left over as a result of the operation of castration, and that causes desire. It is the recognition of the operation of castration that will allow the analysand to act in accordance with his desire. Desire, which the will opposes and masks.

The end of an analysis is marked by a shift from a position of impotence to one of impossibility. At first blush, this doesn’t sound like much of an improvement. However, the position of impotence is one of constant frustration and envy, the epitome of neurotic misery. “Impossibility” signifies a loss that has to be mourned and that releases the analysand from the impasse of impotence. The recognition of desire is founded on the recognition of a loss that sustains desire as, among other things, the possibility of a substitution, of something else in place of the lost object, in place of the neurotic hope for the return of the lost object.

Any association of psychoanalysts must strive to sustain the relations of its members “not to the person of the analyst, but to analysis.” In the case of a psychoanalytic association, Saphouan’s distinction is less an allusion to the notion of a group that derives its coherence from a shared identification with a concept or belief, than to the adherence to psychoanalytic truth.

This relation to psychoanalysis is opposed by the “alchemy” that Allouch noted, an alchemy that is inherent in the imaginary relations fostered by group structure. Lacan remarked in The Ethics Of Psychoanalysis that he read in Jones (Lacan doesn’t mention where) “[a] sort of exclamation on the sublime virtues of social pressure without which our contemporaries, our brother men, would present themselves as vain, egotists, sordid, sterile, etc. But one is tempted to punctuate in the margin, but are they anything else?” (1992, p.25).

Certainly any attempt at developing an organizing structure is contingent and risks failure; the history of psychoanalysis 4. “Subject-supposed-to-know” or “supposed-subjectof-knowing.” The position that the analysand initially ascribes to the analyst: the one who is supposed as knowing the answer to the analysand’s suffering. Rank will mistake himself for an actual sujet-supposé-savoir.

5. The lost object, the object—cause of desire.

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is littered with failed attempts at creating a truly psychoanalytic association, the worst failures having been the most successful bureaucracies! If the attempts have failed it is because they are confronted with a structural impossibility, but paradoxically, it is only the recognition of that impossibility that offers a possibility of a successful outcome.

If an association of psychoanalysts is to sustain the relation of its members to psychoanalysis, it must somehow account for the impossible. An organization that derives its coherence on the basis of a phantasm of an omnipotent master can only result in an impasse, consigning its members to futility and impotence.

It was not until about 16 years after the initial appearance of the life-threatening illness that threw his followers into disarray that Freud finally succumbed to his cancer on September 23, 1939. Barely more than one month later, on October 31, 1939, Otto Rank died from a sudden, rapidly progressing illness, perhaps an infection or a reaction to medication he was taking for kidney problems. His last reported remark: “Komisch” (comical, strange, peculiar) (Lieberman, 1985, p.389). z REFERENCES Allouch, J. (1991). J. L. en Gel in ELP (Collective). Le Transfert dans tous ses eratta, Paris: EPEL (pp.189 -210) Bernfeld, S. (1962, October). On psychoanalytic training. Psychoanalytic Quarterly, pp.453–482.

Freud, S. (1950 [1887 - 1902]) Project for a scientific psychology, The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. I, London, UK: Hogarth Press.

Freud, S. (1895d [1893–1895]). Studies on hysteria. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. I, London, UK: Hogarth Press.

Freud, S. (1905). Jokes and their relation to the unconscious., The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. VII, London, UK: Hogarth Press.

Freud, S. (1913). Totem and taboo. London, The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. XIII, UK: Hogarth Press.

Freud, S. (1921). Group psychology and analysis of the ego. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. XVIII, London, UK: Hogarth Press.

Jacobson, E. (1964). The self and the object world. New York: International Universities Press, Inc. Jones, E. (1957). The life and work of Sigmund Freud (vol.

3). New York, NY: Basic Books.

Lacan, J. (1984). Les complex familiaux. Paris, France: Navarin.

Lacan, J. (1991). The other side of psychoanalysis: Book XVII. New York, NY: W. W. Norton .

Lacan, J. (1992). The ethics of psychoanalysis: Book VII. New York, NY: W. W. Norton.

Laplanch, J., and Pontalis, J.-B. (1973). The language of psychoanalysis. New York, NY: W. W. Norton.

Lieberman, E. J. (1985). Acts of will. New York, NY: Free Press.

Leiberman, E. J. (n.d.) Otto Rank psychologist and philosopher (1884 Vienna–1939 New York). Retrieved May, 2012 from http://www.ottorank.com/essays Lieberman, E. J., and Kramer, R. (2012). The letters of Sigmund Freud & Otto Rank inside psychoanalysis. Baltimore, MD: Johns Hopkins Press.

Mahler, M. (1968). On human symbiosis and the vicissitudes of individuation. New York: International Universities Press, Inc. Safouan, M. (1983). Jacques Lacan et la question de la formation des analysts. Paris, France: Seuil.

Spitz, R. (1965). The first year of life. New York: International Universities Press, Inc. 15

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Jean Laplanche

Freud and the Sexual

Essays 2000toto2006 2006 Essaysfrom from 2000 “Freud and the Sexual ” is the English translation of Laplanche’s most recent volume: Sexual: La sexualité élargie au sens freudien which represents the culmination of his work. Laplanche’s late style is clear, direct, accessible, and often witty.

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Fall 2012: J.-B. Pontalis: “Brother of the Above” translated by Donald Nicholson-Smith.

Initially published as Frère du précédent, this short book, part memoir, part psychoanalytic theory, part literary criticism, was awarded the Prix Medici Essai in 2006.

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Jean Laplanche: • Entre séduction et inspiration: L’homme translated by Jeffrey Mehlman (2013) • Problématiques VI: Après-coup translated by Dorothée BonigalKatz (2014) • Problématiques VII: Le fourvoiement biologisant de la sexualité chez Freud translated by Donald Nicholson-Smith (2013) Christophe Dejours: • Le corps d’abord translated by Sophie Leighton (2013) Dominique Scarfone: • Laplanche translated by Dorothée Bonigal-Katz (2013)

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ROUNDTABLE ON SILENCE

Silence: Now More Than Ever Contemporary Relational and Freudian Perspectives Can we speak about what cannot be heard but only experienced? Can we capture silence in the clinical work (a firefly perhaps) and portray it in writing? This discussion is an outgrowth of a not-quite-formulated idea of Melinda Gellman’s. She had noticed that silence as a topic of interest or concern has seemed to drop out of the psychoanalytic conversation that we have with each other at meetings and in journal articles. In conceptualizing this roundtable she wanted to ponder this with a group of analysts who represent many differing theoretical positions and to put them in dialogue with each other. Each contributor will offer his or her reflective meditations on silence in the analytic encounter. They have written brief but illuminating essays, each one capturing some aspect of the experience of silence, its presence, its absence, and some of the interplay thereof.

Our field has generated many theories, and along with these approaches, it has developed stereotypes. I would like to make a brief mention of these stereotypes and suggest that our panel today will redress some of these, hoping to reinvigorate intellectual conversation. The topic of analytic silence might bring to mind the caricature of the silent Freudian analyst, neither speaking nor answering questions. It might also include the Kleinian analyst, who is always interpreting and talking. And not just any talk, but specifically about breasts and penises and devouring and ripping apart with greedy destructiveness or deep despair over injuring the beloved—a definitely not so silent analyst. The Kohutian self psychology analyst is mirroring and reflecting back to the patient what feels far less

like talking, perhaps rephrasing or returning a kind of recognition of what the patient has been saying. Then there is the caricature of the relational analyst, also often talking and enacting and self-disclosing, all while engaging the patient. No wonder we may be missing a bit of silence around here!

How accurate are any of these stereotypes? Like anything in life, there is a grain of truth to all of the characterizations, with each one capturing some of the paradox about the benefits and dilemmas in all analytic encounters.

As an introduction to the panel, I want to recall something about our early ancestors, specifically Freud and Ferenczi. I believe that silence for Freud was perhaps not as harsh a boundary as some later analysts from the postwar generation would have had us believe. In my reading of Freud I find him surprisingly unorthodox, weaving silence into the warp and weft of the fabric of the talking cure. He will ask patients to say whatever comes into their minds, but then can easily have a long conversation with them about some point he finds interesting and important. Here is but one example from his analysis, in 1933–1934, of the poet H.D., Hilda Doolittle. She writes, The Professor himself is uncanonical enough; he is beating with his hand, with his fist, on the head-piece of the oldfashioned horsehair sofa…Consciously, I was not aware of having said anything that might account for the Professor’s outburst. And even as I veered around, facing him, my mind was detached enough

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Jill SALBERG

to wonder if this was some idea of his for speeding up the analytic content or redirecting the flow of associated images.

The Professor said, “The trouble is—I am an old man—you do not think it worth your while to love me.” (1956, p.21) I want to counterpose this with Ferenczi, who refers to himself as an enfant terrible (p.127) in his essay “Child Analysis in the Analysis of Adults” (1931). In this essay he starts by defending Freud from accusations of orthodoxy by opponents of psychoanalysis. Ferenczi embodied paradox, writing first, “I urged the patient to deeper relaxation and more complete surrender to the impressions, tendencies, and emotions which quite spontaneously arose in him (p.129).” But then a few lines later he announces, “Now in certain cases it transpired that the analyst’s cool, expectant silence, and his failure to manifest any reaction had the effect of disturbing the freedom of association (p.129).” My sense is that Ferenczi was, without overtly stating as such, arguing for flexibility and freedom in the analyst’s relationship with silence and with speech.

We can see a disruption in our caricatures: Freud is quite noisy, pounding his fist and beseeching his patient, while Ferenczi, in many ways the birth mother of enactments, can either proffer a cool waiting silence or acknowledge its limits. z REFERENCES Doolittle, H.D. (1956). Tribute to Freud. New York, NY: Pantheon.

Ferenczi, S. (1931). Child analysis in the analysis of adults. In M. Balint (Ed.) Final Contributions to the problems and methods of psycho-analysis (pp.126-142). London, UK: Hogarth Press.

ROUNDTABLE ON SILENCE

Silence: Now More Than Ever It is often the first question someone asks, when considering analytic work: Will you talk to me? Or, how active are you? Or, I’ve heard that analysts are pretty quiet: do you talk much? From the very beginning of many treatments, the question of the analyst’s silence is at center stage. The question carries many embedded issues, like: How much contact will we have? Will you be with me or too separate from me? Will I be alone here as I expose myself? Are you too Freudian, meaning, are you the stereotypically detached, distant, removed, unaffected analyst?

The question “Will you talk to me?” is clear, stark, and direct, and, yet, it is misleading. It is incomplete, just as the topic of “silence” itself is incomplete. While it is true that every patient—every person in every relationship—wants someone who will talk to him or her, they also, perhaps even more, want someone who will truly listen to them, hear them, understand them, really get them and know who they are. What patients say they want is someone who will speak to them, but what they want even more, what they really want, is a relationship where they feel heard and understood. They can’t ask directly whether the analyst is available for such a relationship. Often they don’t realize that that is what they want, or the desire for relationship is too conflicted to acknowledge. All this is too difficult to articulate at the beginning of a potential treatment, so the patient asks a related and easier-to-ask substitute question: will the analyst speak to them? It is up to the analyst to understand that, in this question, the patient is also asking whether the analyst will listen to them and how he will respond to what he hears.

To hear someone, the analyst must listen. To listen, the analyst must be quiet.

Speech and silence are two sides of the same coin. This coin is the nature and form of an analyst’s participation and expression of contact in an analytic treatment. If you listen to Frank Sinatra, Ella Fitzgerald, Billie Holiday, Fred Astaire, Louis Armstrong, Willie Nelson, and Ray Charles sing the same song, you will hear a different song each time, even though the songs have the same lyric and melody. The differences lie in the voices, the phrasing, the arrangements, the syncopation, the affect, the soul, all of which provide context for the lyrics and, put together, create an idiosyncratic performance. The interplay of silence and speech, which gives color to the form of patient-analyst contact, works in a similar way to define a particular analytic relationship and treatment.

We cannot speak of silence outside of a context. Part of this context is cultural.

Andrew B. DRUCK

Words are embedded in connotations and assumptions. The word “silence” connotes, at least to me, a kind of harsh, almost aggressive, withdrawal and removal from the other. Silence, with these connotations, becomes easily seen as opposed to contact.

The word “silence” feels different from the word “quiet.” Silence feels more absolute.

Quiet feels more holding, more inviting, more receptive, more connected.

Furthermore, to consider the nature of silence in analytic work, we need to move away from our psychoanalytically and historically ingrained habit of thinking about things as dichotomous (silence versus speech, unconscious versus conscious, activity versus passivity, real relationship versus transference relationship, even relational theory versus Freudian theory).

Movement away from the assumption of dichotomy to the idea of simultaneity changes our focus. An analyst is both real and unreal at the same time (rather than real or unreal), always in a dynamic figureground relationship. It’s a complicated gestalt, in which both sides are always active and potentiate each other. The analyst experienced as transference object highlights his patient’s unconscious activity, but the resonating unconscious imagoes also strengthen the impact and power of his actual, current, holding, and affirmative functions. At the same time, the analyst experienced as real object helps stabilize the patient and makes transference regression safe, more possible, and more manageable.

Transference aspects pull toward depth, regression, past, and “unreality” even as their countervailing actual aspects simultaneously stabilize and anchor the patient in “reality” and the present.

In the same way, silence is in continuous interplay with speech. Quiet is the context for talk; it is the frame for talk and for the session. Quiet and speech are, together, ever-present aspects of a patientanalyst communicative dimension, which includes verbal and nonverbal interaction, participation, and restraint. Talk without the frame of silence too easily becomes conversation. Silence alone can risk an atmosphere dominated by runaway regressive fantasies. Our speech, in interplay with our quiet, both together in the overall analytic context, become a form of connection, communication, and interaction in an analytic relationship that titrates constantly opposing pulls in an analysis, such as opposing pulls for structural stabilization and for transference regression, opposing pulls for closeness and for separation, and opposing pulls for contact and for distance 19

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and space. Silence and speech frame each other in a fluid figure-ground interactive process and help locate a patient-analyst couple in a particular balanced moment of present and past, now and then, real and unreal, stabilization and destabilization.

Traditionally, the analyst’s quiet has been understood as an aspect of analytic technique, a technique embedded in a particular theory of etiology and remedy.

Thus, silence expressed the analyst’s abstinence. The analyst’s abstinence, along with his neutrality and relative anonymity, optimally frustrated the patient’s unconscious transference wishes so that they could be felt, verbally expressed, and understood by analyst and patient. In this way, the patient’s

Talk without the frame of silence too easily becomes conversation. Silence alone can risk an atmosphere dominated by runaway regressive fantasies. Our speech, in interplay with our quiet, both together in the overall analytic context, become a form of connection, communication, and interaction in an analytic relationship. unconscious filled the room and took center stage. As elements of this way of thinking have been critiqued, silence has become demonized. Much of this critique revolves around different ideas about etiology and mutative effect. So, for example, those who believe that transference is predominantly coconstructed and that elements of the patient’s unconscious fantasy are cocreated more than uncovered have different ideas about the analyst’s optimal posture. Implicit in many of these critiques is the idea that the quiet analyst is the removed, detached analyst and that silence signifies the analyst’s withdrawal and nonparticipation. In this view, the analyst’s silence now represents all that is seen as the worst part of Freudian work.

However, if we move past how the dimension of quiet and speech is embedded in a particular theoretical context and we ask how this overall communicative dimension works in any kind of psychoanalytic treatment, then we can better understand its function. Thus, I would like to ask how quiet facilitates and maintains any analytic process, from any analytic school.

Quiet and speech, communication and

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restraint, are a gestalt that patient and analyst implicitly negotiate from the start. The interplay of speech and quiet creates an atmosphere within which patient and analyst feel comfortable, safe, and understood.

Such an atmosphere may include room for allowing a patient’s silence, for accepting a particular patient’s wish to be alone in the presence of his quiet analyst. There needs to be space, in any treatment, in any kind of analysis, for patient and analyst to notice things that are not immediately available and expressible. This is accomplished through some sort of gap, a delay in the interaction between patient and analyst.

The interplay of speech and quiet is part of what creates this kind of gap, a therapeutic space that makes possible reflection, understanding, and discovery, as well as containment of affect, a holding environment, and a place within which the patient and analyst survive all sorts of conflicted self and object states. Patient and analyst fill this gap and create an idiosyncratic affective analytic relationship within which implicit transference reactions are felt and move toward actualization. It is in moments of quiet that regressive processes can occur, and new associative thoughts can come to mind. Speech and quiet work synergistically in this process. Each in their own way provokes new thoughts and feelings, and then provides an opportunity for these new feelings and thoughts to be assimilated and understood. Both provocation and integration may come from the outside, through verbal and nonverbal communication, and from the inside, through patients and analysts’ thoughts, affects, and reveries in quiet moments. My point here is that both quiet and speech play off each other, under the rubric of the overall therapeutic relationship.

In quiet times, conscious and unconscious experiences have room to interpenetrate and flower. What is “really” intended by the analyst becomes quickly subsumed by what patient and analyst experience in the quiet atmosphere. For example, quiet time can be intended as the analyst’s way of accommodating to a patient, a way of facilitating a space for analytic regression, a way of being together in a close, loving, protective manner, a way that shows respect for the patient’s quiet and wish for space.

Quiet may be consciously meant to convey the analyst’s waiting to understand something better, and the analyst’s patience as he thinks about what the patient is saying.

These factors have to do with the analyst’s conscious intent. However, such intent is quickly relegated to a background position as the patient’s and analyst’s experience of this quiet takes center stage. If one analyst does not respond to his patient’s remark, he

may be experienced as silent and withholding. If another analyst is quiet as his patient tells him tearfully about a hurtful event, he can be felt as quietly comforting. If an analyst does not get provoked when he is attacked, he can be experienced as holding and containing. In all three cases, the analyst is silent, but the three situations are vastly different and are embedded in different emotional contexts.

Moreover, the analyst’s decision about whether to speak or remain quiet at a given moment is not always a conscious decision. The choice reflects the intersubjective context, the current transference-countertransference relationship, the analytic third, as Ogden (1994) puts

dimension is one aspect of what Gil Katz (1998) calls the enacted dimension of an analysis. I wrote above of the silence-speech dimension as creating the gap, the necessary potential space, in any analytic process.

However, we can also understand this dimension, from a different vantage point, as embodying the cutting edge of the transference, often in enacted form. Dynamics of the transference-countertransference situation at a particular analytic moment often become focused on the dimension of silence versus speech.

To conclude, I have tried to describe how the idiosyncratic syncopation of talk and quiet that develops between patient and analyst gives color to a particular ana-

it. An analyst’s decision to remain quiet, or his decision to speak (and, parenthetically, what he can conceive of saying and what he lets himself feel at a given moment)—all of these decisions swim on the affective current of a given session.

At some moments, an analyst’s silence feels (and is) angry; at other times, it feels (and is) loving; sometimes it feels (and is) withdrawn. In all cases, whether the affect is transmitted verbally or nonverbally, predominantly in the words or in the spaces, a patient’s and an analyst’s experience become, at some point, the focus of analytic exploration.

Thus, silence can be seen as part of a communicative dimension in an intersubjective context at a given moment in a particular analysis. This communicative

lytic relationship. The analyst’s quiet can be considered as part of an overall context, a communicative dimension that includes expression and restraint. I believe that, within this context, optimal silence allows for a gap, a kind of potential space, within which unconscious affects and thoughts may emerge. Furthermore, the constantly shifting balance between speech and quiet is part of an underlying enacted intersubjective process and can provide information about unconscious transference-countertransference enactments. z

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REFERENCES Katz, G. (1998). Where the action is: The enacted dimension of analytic process. Journal of the American Psychoanalytic Association, 46, 1129–1167.

Ogden, T. H. (1994). The analytic third: working with intersubjective clinical facts. International Journal of Psychoanalysis, 75, 3–19.

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Different Kinds of Silence

Melinda GELLMAN

Why do I keep talking? She’s barely muttering…not even looking at me…so why do I try so hard? Guessing my way through the silence, I hardly felt analytic. Laura sat in silence—with no eye contact and a ring of fire around her to keep me away. Yet she came.

Why? When I pursued the bulimia she told me about in the first two sessions, she said she now had it under control. She consistently claimed not to know why she was here, or why her friends thought she needed therapy— surely they did not know she was throwing up…While most treatments get to points of impasse, Laura’s began with one.

of psychoanalysis and its technique. It has filtered into our larger culture as the butt of jokes about how patients and analysts interact—caricatures of either person falling asleep, or wondering if the other is listening. Yet more recently, silence is an element that often drops out of our professional case presentations in favor of more dramatic and active tales of therapeutic action.

As paradigms have shifted to include, along with the verbal, all that is implicit and enacted in the relationship, our job description has shifted from observing and interpreting our patients to participating and engaging

Peter, on the other hand, would not stop talking. If he hadn’t planned what to say, he could easily and cleverly riff on any observation, offer up memories, or beat me to the punch by confessing bad behavior about his addictions, complete with explanations. Peter had so much to say, with so little feeling attached. And then there were quiet lapses— often midsentence—when he went very far away. Inquiries about his destination drew humiliation and anger. Peter sought treatment because addictions cultivated to sooth him began to cost more than they avoided. Once he came, I felt he wanted to keep me silent.

Silences may confound us, numb us, distract us, frustrate us, or overwhelm us with hosts of feelings that inform our interventions. Silence in the consulting room has held an essential place in the development

with them. We aim to create safe, not frustrating, spaces for this to happen. The emerging gold standard for doing good work, further pressured by time constraints, is to fully engage patients of different stripes within the dyad.

But what has happened to silence in the process of our evolution? Has it been eclipsed by our cultural responsiveness to the privileging of constant social media, multitasking, and action? Do we understand authenticity in a way that favors speech, but interferes with the capacity to be alone in the presence of another? And how does the conversation include phone sessions and Skype? Has silence folded into the Everything that is enactment? Is getting better measured in terms of relating well with others, but not by the capacity for rich interiority?

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We know that silence is not necessarily a quiet, thoughtful place. It can be an empty evacuated place, with no thought at all. Thinking itself can be painful or can threaten to overwhelm. Potential demands and impingement of the analyst’s questions and thoughts heightens the risk. So the mind goes blank for safety—shutting out thought and mental processing in order to escape the perceived or imagined discomfort, even to the point of sacrificing the potentially good or reparative impact of the analyst’s mind. Blank; there is just nothing to say.

Affect, too, can be shut off or disconnected from experience—resulting in no feelings to speak of. The therapeutic encounter threatens the disruption of feelings, as well as thoughts, or sharply reveals their absence.

When dissociated affect is accessed, whether precipitating treatment or in the course of it, it offers an opportunity to deepen analytic work, or alerts an overwhelmed mind to further dissociate. Silence may hide a history of traumatic experience and an overdeveloped dissociative organization that makes any feeling hard to find. This kind of silence suggests the emotional numbing that trauma patients often report or demonstrate. Less dissociated patients may also report memories, events, or dreams, but have little to say about how they feel. We find it hard to get traction.

Sometimes, a patient’s observed silence masks a very noisy and tumultuous, rather than numb, place, where bad internal objects are unleashed and run free. These silences feel busy to us, and we feel shut out of something going on. By our presence and desire we threaten to enter, and the patient pushes us out more violently for safety. Acting silent in the encounter conceals a mind that cannot remain blank, but rather becomes a screen for projecting and replaying horrors stored and embellished in memory, with gripping feelings attached. The analyst does not know but can often intuit the noise and content from countertransference and from shifts in the patient’s affect and body. As the patient is internally retraumatized, we feel the silence casting us in the role of all those who failed to witness and act in the past.

And then there are silences that are not so rancorous, but instead are vessels carrying hosts of formulated and unformulated thoughts and feelings in the therapeutic encounter. Listening to and deciphering these silences, unique to the moment in time, reveals feelings and conflicts to be metabolized and symbolized in the dyad. Such silence may indicate sadness or resentment, or conceal tension and confusion, or replicate loneliness and loss. And silence in treatment can scream the embarrassment, shame, and guilt

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that comes with telling harbored secrets and regretful behavior—heightened by risking the therapist’s real or imagined judgments and losing the analyst’s love.

More peacefully, silence is, and becomes in the course of a successful treatment, a calm, thoughtful, reflective place, one we don’t feel shut out of but instead are pleased with, eager to hear what patients will articulate about their own experience, or their experience of us in their presence. We value their agency and capacity to do the analytic work, as inner life can be reflected upon and spoken about.

We are likewise freer to move into different kinds of silence ourselves, alongside and in response to the thoughtful patient, collecting our own thoughts and feelings about the therapeutic process we are engaged in.

After two consultations where Laura spoke slowly and intelligently but said little, she fell into silence. She carried a disciplinary write-up from the nursing manager at the hospital where she worked, offering someone else’s voice to explain why she was there. Inquiring about the problems cited, or her life more generally, felt like pulling teeth.

She did let me know she had struggled with eating disorders since adolescence, and had resumed binging and purging over the last months. What troubled her most was not her relationship with food, but the lost weekends avoiding everyone.

Waiting for Laura to take the lead and break her silence proved vastly unproductive, spurning storms of various sorts and acting out, all of which she was unavailable to process. Waiting out her silence also felt cruel, like abandoning her to bad objects inside.

Over time I learned just how bad these objects were. The perpetrators of her past, and the complex emotions around her predicament, had been dissociated and encapsulated.

This adaptation limited her emotional and social life, but got her far enough to work in an ER and then be hired as a hospital staff nurse on a medical floor. After a year or two, the exposure to sick bodies, pain, and many families had destabilized her. Laura became flooded with flashbacks and abusive, terrifying selfstates. Binging and purging was sedating, but unable to contain her through the week.

Laura could not tell me all of this.

Despite working hard to get to therapy and impeccably adhering to our schedule, all she could do when she arrived was hide. But there was no safe place inside to hide; it was a noisy tormented place, escaped only by numbing, trancelike states with no thought.

Her hiding beckoned me to find her, and in this treatment, I concluded that I would take an active stance and would not be rendered silent by hers. I hated being shut out, watching and feeling her inner world overwhelm her, and hated becoming another predictably bad object who watches without any say in

the matter. So I actively talked, guessed at the meaning of her utterances, disclosed my experience of her in our moments together, trying to translate into words her tone and body expressions, and trying to interpret her motivation for treatment. However, in my own silence I questioned my analytic skills, and doubted my ability to bear painful countertransference. Perhaps I was just rationalizing…sadistically imposing and forcing on her my privileging of relating?

With Peter, on the other hand, I found it essential to refrain from speaking too much. In early sobriety, he realized how afraid of quiet he actually was. Peter’s emotionally labile and intrusive mother had been very determined to fix him. Her response to his learning difficulties in middle school was home schooling—which caused humiliation before his peers, and more time alone with her. He found solace by hiding on his bedroom floor, watching his mother’s feet from under his bed, and delaying to answer when she called. Peter’s silence in therapy offered him intermittent escape, often indicating self-protection from slights I may not have even detected. But paradoxically, silence also risked contact with pain, deprivation, and certainty that others would find him terribly disappointing, including me. He felt pressured to keep talking—in order to continually “make” and control a connection to me, and to avoid feeling his own feelings.

My response to Laura’s silence allowed a new object relationship that I believe kept her in treatment by demonstrating the willingness—unlike important people in her past—to see her pain and work to find her. In part, the resonance of my observations and interpretations helped; I know this because we both suffered dearly when I was off base. But more important than accuracy was my perseverance. What would be terribly intrusive to a patient like Peter communicated to Laura my belief that there was someone worthwhile hiding in there, hoping to be found. In the process, I modeled for her a reality that does not have to cave to the psychic equivalents of her inner fears and flashbacks. Had I not gone looking for her, I would have replicated the passivity of her mother and her community, who failed to witness or feared to intervene in the events of her youth, effectively refusing to fight for her. A silent stance would not create a holding environment, but reinforce abandoning her to a tormented internal one.

Peter’s chatty adaptation likewise served him well. He developed a personable gregarious style that helped him grow a successful neighborhood law practice. Getting along with local merchants, law enforcers, and, later, drug dealers kept him flush in referrals.

The pain and fear around September 11 destabilized Peter, flooding him with fear and loss, and his substance use increased. In early sobriety he quieted down, and quietly wept 22

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with shame about his behavior when using, and sadness about time squandered. He was also very quiet on the way to formulating anger at his parents for his sense of humiliation and damaged self-esteem. I remain very moved by Peter’s sincerity and self-discovery.

I am mindful to give Peter room and time to feel and think, and to let me witness his experience without fixing him. He learned in treatment that it’s not only safe to come out from under his bed, but that it’s actually best if he brings his feelings and mind with him. His silences have grown more related than dissociated. He no longer zones out with no recall, but associates more freely and is curious to trace the links and jumps in his process.

Recently, a new kind of silence has emerged, indicating a new dynamic. I’ve noticed that Peter pauses just before sharing his own insight into his psychology or what occurs between us. It’s a shy silence, embarrassed yet excited, as he hesitates. I feel teased, wondering why he would hold back now. I learned that Peter is neither checked out nor withholding, but instead nervous about whether it is really safe to show me how competent and adequate he in fact is. Can he really be strong, authentic, and smart without damaging our relationship?

So Peter pauses, and then goes on. And my silence while I wait is not empty either. He reads my interest, acceptance, and eagerness to relate to his subjectivity, and is reassured.

Peter and Laura continue to look a lot different, but both developed in treatment a similar place inside, where interiority became valued, productive, and safe. I am pleased to say that Laura made herself available to be found, and that being silent together changed vastly over the duration of the treatment.

Greater integration allowed her to reflect on herself, rather than switch within herself.

I stopped feeling I was leaving her in silence, but that she more fluidly visited safe interior spaces in the course of sessions. I became more relaxed, as quiet no longer signaled an immediate collapse into withdrawal, numbness, or seduction by the ghosts she carried.

Toxic silences did indicate setbacks to the numbing or noisy kind that kept me out. But as Laura grew more secure in holding onto her own mind, they were of shorter duration, with readily identifiable triggers, and we increasingly trusted that such states pass.

Laura’s shameful silences also shifted, becoming less dire and rejecting of me, as they indicated more subtle and sensitive envy and her desire to be my friend.

It may seem artificial to isolate silence from all of the therapeutic process, but it can remind us, as we too inhabit noisy, busy worlds, to slow down, to listen for different kinds of silence and track its changes, and to locate our different responses that inform the clinical choices we make in a field that is ever interactional. z

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Radio Silence

Mary LIBBEY

After 30 seconds or so, I realize there is no sound. I feel a sudden heightened alertness. Many channels have gone to only one channel. And that channel is silent. Radio silence. All of a sudden, my patient and I are not fellow travelers. I feel a heightened sense of the separate existence of each of the two of us in the room. In the dark, I search for other channels of communication coming from my patient, from the energy in the room, from within myself. This is not business as usual. In my mind, I go back over what was said prior to the silence.

As I quell a looming internal scramble, I begin telling myself: give it a little more time.

What’s occurring to me. I have time to feel this through.

For the patient who becomes silent, an amalgam of thoughts, feelings, and fantasies, conscious and unconscious, somehow in relation to the moment, have come together unawares. A patient’s silence is rarely a conscious decision; rather, it accomplishes by virtue of its unknown quality a communication from the unknown.

While its specific meaning is different any time it occurs, I think of it as evidence of heightened involvement, whether vis-á-vis the analyst or vis-á-vis something internal, and as such, a patient becoming quiet for longer than usual has this similarity across patients: something is up.

In my experience there are, very broadly speaking, two groups of affects patients experience in silence—overwhelming discomfort, and, alternately, comfortable, calm, inner-directed interest. In the first kind of silence, if I ask what’s going on, the patient will respond with a variant of “I don’t know” or “I’m stuck.” I’ve had patients who don’t even respond. I usually see this as— again, broadly speaking—anxious blocking.

If the patient is left to break this kind of silence on their own, he or she may eventually say something dramatic like, “I can’t do this. Maybe I shouldn’t be in therapy.” An overwhelmed state has taken over, resulting in an inability to continue, a “petrified” fear—a “deer in the headlights,” and with it, more often than not, a steadily increasing sense of shame and inadequacy. If it continues, it sometimes turns to anger, blaming the therapist for the humiliation. There is also waiting in a patient’s uncomfortable silence—waiting for the analyst to speak, waiting for something unknown, waiting for the session to end. On the other extreme, a patient in a comfortable silence is entering a zone, a gone-on-pause in terms of out loud relating lost in thought, dwelling in a place of going on being, similar to the reverie one experiences sometimes when slowly waking

up in the morning. There has been an exit from the here and now—a move inward, with its sense of timelessness. Thoughts float in and out from the nooks and crannies of the patient’s mind, a “ticking over,” as Winnicott (1971) termed it. Sometimes there is a coalescence into something new and important. These, of course, are the extremes of patients’ experiences when silent, and they tend to be related to where in the course of the treatment we are.

I find the silences early in a treatment to be very different from those that occur in the tumult of a middle phase, as well as different from those that occur in the steady work of the last phases of a treatment. In effect, these are developmental stages of the treatment relationship. Early on in a treatment, when I am new to my patient, and he or she is narcissistically vulnerable, there is the greater likelihood of painful silences: “I’m on the spot”; “Is there a right way to do this?”; “Am I safe with this person?”; “Where do I go next?” Self-consciousness coats all thoughts and feelings early on. The patient is in the earliest stage of a relationship, on an emotional teeterboard between hope and flight, psychic safety and psychic annihilation, and which way it teeters will depend upon this stranger’s, this analyst’s, communications of safety or danger. The patient’s silences are the outward evidence of helplessness, and if their silence is allowed to continue, the analyst will have communicated danger. On the other hand, the analyst will communicate safety if he/she helps the patient to pick up and continue after they have been left to their own devices and things have jammed up. In the beginning phase of a treatment, there is too much both persons do not know about the other to make an accurate decision to not intervene, assuming the work will proceed, or interpreting a silence as being useful. When narcissistic vulnerability is too great, and the heightened objective glare of the other is too intense, the patient cannot think, much less work on themselves. When this kind of silence occurs, it is time for guiding and educating, conveying your total interest in the patient’s experience, as opposed to allowing apprehensions to grow.

In middle phases, I find that patients’ silences are more often associated with the deeper, more ingrained transferential and conflictual aspects of the patient’s character. The re-creation of long-standing internal dyads, fears of strong negative feelings, and fears of criticism or retaliation from the analyst have been activated and are available for working through over and over.

Silences often turn out to be the unconscious expression of the reluctance to get 23

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into this kind of material, or the enactment of an earlier relationship or event, the full experience of which has never been felt.

For example, one patient of mine seemed to grip the couch in long silences, her body seemingly frozen. As a teenager she had been raped by her older brother and several of his friends; she had actually gone along with this, needing to be valued and included. Holding herself down in silence on the couch was an enactment of that trauma, as was much of her frozen life.

Another patient who had long painful silences on the couch that neither of us could help her with turned out to be enacting mourning for her younger brother, who died in childhood and whom she had never mourned. After several years of treatment during which I only knew about the emotionless fact of his death, out of one silence she spoke of her feelings about him for the first time. It was as if, on the couch in her long silences, she was in his coffin with him underground, and in turn instead

I find the silences early in a treatment to be very different from those that occur in the tumult of a middle phase, as well as different from those that occur in the steady work of the last phases of a treatment. In effect, these are developmental stages of the treatment relationship. of him, and in turn being him on the couch.

Memories of the brother, and all of her mixed feelings about him, emerged after an initial sad memory came up in a long silence, which she then told me about. Visits to his grave for the first time since his death many years earlier followed these sessions, where she talked to him. In such cases, intervening is trickier. Interrupting the silence and bringing the patient back to the here and now can mean sacrificing important links for the patient from the there and then.

Late in a treatment, with patients I know well, when there is more of a sense of “fellow travelers” between us, there is the possibility that a patient’s becoming silent is more like going on pause. Without any sense of changing things between us, the patient becomes contemplative. In these silences, I am aware of feeling quiet, watchful, hopeful.

I have a sense of opportunity, a sense of impending change, similar to the feeling I have when a patient announces that they had a dream. At these times, conflictual feelings

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between us lay low in a silently agreed upon peace. In these silences, it is as if, less than consciously, the patient feels the unusual safety of being able to turn, without conscious thought or intent, memory, or desire, completely inward. It seems to me that this is the developmental capacity to be alone that Winnicott (1958) writes about. When the silence ends, it lifts, like a fog, rather than breaks. Often, when the silence lifts, the patient voices positive feelings about themselves or about the analyst. I have come to think of these silences as functioning like a chrysalis, the definition of which is “a butterfly or an insect in an immobile, nonfeeding, transformation stage between larva and imago” (Collins English Dictionary, 2003).

A product of growth, preceded by years of work, is emerging, unseen and unheard by the analyst, on its own. What comes into the patient’s mind may ultimately coalesce in the form of a recovered memory, or a new feeling, or a new integration of self and object relationships.

I would like to close with a vignette of this last kind of silence late in a 12-year treatment that ended recently. This patient, a 38-year-old single professional when he began treatment, felt then that he was an unmanly loser, both with women and in his chosen career. His development of secondary sex characteristics had been delayed in his adolescence. His problem went unremarked upon by his depressed father, and minimized—perhaps even liked—by his

doting mother, whose position toward him he described as, “You don’t need to go out and have a life in the world. You can stay here with me.” He felt intense resentment as well as guilt toward his parents. He began treatment as a hypermacho, weight-lifting motorcyclist who believed that there was a “Holy Grail”: becoming a rock star and having sexual access to the most beautiful women in the world. He believed anything less meant he was a loser. He actually aspired to this, having sex with as many women as possible, as often as possible, and when alone practiced his guitar for hours at a time into the night. Late in treatment—when these adolescent aspirations for a “perfect life” had disappeared, and he was steadily advancing in what had actually always been a successful career, and living with a woman he loved— he would periodically spend as much as five minutes quiet on the couch, usually toward the end of sessions. When these silences began and I asked him about them, he would say he was just thinking about this or that— his girlfriend, or somebody at his job, nothing special, something ordinary. I learned to leave him to these silences. During this time he was also being given good-bye parties at work, prior to leaving a current position for one of much greater responsibility in another setting. In one session, one of his long silences lifted and he said: You know I feel ashamed every time something happens in my life that

is about me. Just because it’s a thing that’s true, about me, it will lead to public humiliation. Somewhere in my past experience, being true about me occasioned those experiences. It’s a backpack I have to carry. The ashamed boy won’t go away, but the ashamed boy is raising his head and moving forward, shame and all. I’ll live with it. I don’t care.

Because I know I’m real. Really me. My sister says about her therapy that she just doesn’t want to die confused. I will not die confused. If I die because I cracked up on my motorcycle, I’ll die happy.

These were new integrations of separate feelings and ideas that had come up continuously throughout the treatment.

These integrations came about because of the work that preceded the silence, not because of the silence. The periods of silence were transformation interludes, when many separate images, ideas, and feelings were coalescing, without visible movement or audible sound. The period of silence was the final forerunner to giving his own voice to this new integration, as well as a final forerunner to successfully leaving treatment and living it. z REFERENCES Collins English Dictionary-Complete and Unabridged.

(2003). New York, NY: Harper Collins Publishers.

Winnicott, D. W. (1971). Playing and reality. New York, NY: Tavistock/Routledge.

Winnicott, D. W. (1958). The capacity to be alone.

International Journal of Psycho-Analysis, 39, 416–420.

Silence and Quiet: A Phenomenology of Wordlessness I would like to begin by making a distinction: to contrast silence not with speech, as is often done, but with quiet. Silence, I will assert, is the absence of speaking that psychoanalysis only understands by reference to issues of technique. Quiet, I will hold, is a more expansive term when thought of psychoanalytically, associated with lived experience in a relationship between patient and analyst. Quiet is an experience that I will refer to as embedded in a practice of psychoanalysis. A practice differs from a technique in that it is an engagement in the interaction that takes prominence over the application of a method. I should add at the outset that these terms, silence and quiet, have largely been used interchangeably in the psychoanalytic literature, so my separating them out is in part intended to illustrate the varieties of experiences of the silent and quiet analytic pair.

To speak of silence is to immediately speak of issues of technique (e.g., Arlow, 1961; Calogeras, 1967). The silence of the analyst has been considered a technical parameter of the analytic approach; the silence of the patient, a technical issue to be addressed by any number of interventions.

I would assert that silence in the psychoanalytic setup can only be thought of as the absence of speech, given the original parameters of the talking cure. Silence is muteness, a refusal to speak when expected. This absence of sound is the condition that has conventionally been understood either to inhibit or facilitate the psychoanalytic process, depending upon whether it is performed by patient or by analyst.

Wedded in this way to speech, silence is inseparable from considerations of method and methodology. It is thus bound to matters of control, science, and the rule-bound 24

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Bruce REIS

reproduction of a method—the psychoanalytic method.

Interpersonally, silence in the psychoanalytic setup is associated with terms such as withdrawal and withholding, when thought of from the perspective of technique. The patient withdraws into silence. The analyst withholds his reactions.

Retreat, refusal, and detachment are the forms through which silence is always wedded to the absence of speech in the analytic dyad. Withdrawing and withholding are by definition positions that draw the individual back into him- or herself, and out of the relation. Such mute, narcissistic retreats reveal the solitary nature accorded to silence. One is silent alone. Silence renders one alone, out of contact, out of communication.

But is this always a problem? And shouldn’t there be a place in our theory for silent withdrawal? Winnicott (1963, p.188)

ROUNDTABLE ON SILENCE

importantly reminds us that “there is something we must allow for in our work, the patient’s non-communicating as a positive contribution.” He writes: “We must ask ourselves, does our technique allow for the patient to communicate that he or she is not communicating? For this to happen we as analysts must be ready for the signal: ‘I am not communicating,’ and be able to distinguish it from the distress signal associated with a failure of communication.” Here Winnicott gives us the kind of balance he often provides, this time by allowing for the psychoanalytic space of noncommunication to be one of positive solitude and privacy and for the action of withdrawal to serve as a basis for what he calls a “capacity for withdrawal” that underlies an ability for absorption in a task.

By contrast, quiet may be the absence of words, but it is not necessarily solitary.

Where silence signals withdrawal and withholding, quiet marks a “with-ness” between patient and analyst. A child may be quiet, on the other side of the room from its mother, and be with her, that is to say, even be alone, in the presence of another, as the mother is with her child (Winnicott, 1958). It is not a withdrawal so much as it is a togetherness without words. They may be engaged with one another through eye contact, or may be involved in their own pursuits, but they are with each other in a way that does not evoke words like retreat, refusal, or detachment.

Quieting may be an active verb as well.

When a mother attempts to soothe her overly aroused child she says “shhh.” She tries not to silence the child, but to calm her, to quiet her. Here we have the definition of quiet as the ability to be put at rest rather than to be silenced. An analyst calms her patient by speaking quietly, calmly, perhaps reassuringly; and the patient finds themselves taking deeper breaths, feeling less overwhelmed.

Most often this occurs without conscious awareness, allowing the dyad to settle into a quieter place in the analysis. Perhaps they go on to discuss what had upset the patient so, but now they can do that without feeling danger or being overly alert. One person quiets the other, uses her own capacities to foster a decreased arousal in the other. One may be silenced, or one may be quieted.

An analyst is quiet, perhaps engaged in reverie. Not a retreat or detachment, but exploring the depths of unconscious linkage between the analyst and the patient. There is no technique to this dream space, only the ability to dream, and associate fluidly. The patient may be speaking during the analyst’s reverie, or he/she may not. But the feeling of an engaged, quiet analyst is completely different from that of a technically silent one. Here is an example of a silent patient and a quiet analyst. Again, it was Winnicott (1968) who advised the analyst to not seek

understanding, or exercise the intellectual skills they have acquired in the course of being analysts. With a silent patient, Winnicott takes great care to not “put words in his mouth,” as the saying goes: [A] rather silent patient tells the analyst, in response to a question, a good deal about one of his main interests, which has to do with shooting pigeons and the organization of this kind of sport. It is extremely tempting for the analyst at this point to use this material, which is more than he often gets in two or three weeks, and undoubtedly he could talk about the killing of all the unborn babies, the patient being an only child, and he could talk about the unconscious destructive fantasies in the mother, the patient’s mother having been a depressive case and having committed suicide. What the analyst knew, however, was that the whole material came from a question and that it would not have come if the analyst had not invited the material, perhaps simply out of feeling that he was getting out of touch with the patient. The material therefore was not material for interpretation and the analyst had to hold back all that he could imagine in regard to the symbolic meaning of the activity which the patient was describing.

After a while the analysis settled back into being a silent one and it is the patient’s silence which contains the essential communication. The clues to this silence are only slowly emerging and there is nothing directly that this analyst can do to make the patient talk. (p.210) In this quotation I think we can nicely see how silence and quiet may be thought not as opposed to each other, but in a dialectical relationship with each other, so that the analyst’s quiet, for instance, is a foreground phenomena, with the potential for his silence (as an artifact of his analytic method always present and informing the creation of quiet).

The patient is allowed his silent withdrawal and Winnicott understands this as “the essential communication.” To quote Thomas Ogden (1999, p.123): “To privilege speaking over silence, disclosure over privacy, communicating over not-communicating, seems as unanalytic as it would be to privilege the positive transference over the negative transference, gratitude over envy, love over hate, the depressive mode of generating experience over the paranoid-schizoid and autistic contiguous modes.”

The analyst also needs to be quiet inside, to listen to what is happening, to listen to what gets set off inside of him when sitting with the patient. Speech tends to dispel this kind of inner quiet. This is what led the British Independent analyst Michael Parsons to recently critique relational approaches 25

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as “internally rather busy” (2009, p.264).

Parsons finds an approach in which the analyst is busy disclosing their own internal process, asking the patient about their reactions to the analyst and their interventions and about what may be going on between them, as an impediment to a kind of deep listening to what is going on inside of the analyst.

Parsons writes: “In the analyst’s inner world, just as with the patient, the responses which matter most are those that need time and space to surface out of the unconscious. I think we need to listen slowly” (2009, p.264).

The context of listening slowly is one factor that makes the psychoanalytic conversation different from ordinary social conversation. One cannot but live this kind of slow listening as a “being-with” the patient (Reis, 2009). Slow listening depends on a quiet that

…quiet may be the absence of words, but it is not necessarily solitary. Where silence signals withdrawal and withholding, quiet marks a “withness” between patient and analyst.…It is not a withdrawal so much as it is a togetherness without words. is not silence. The quiet analyst may be without words for some time before commenting on an experience. They may live through quite a lot with their patient and not necessarily seek to symbolize or make understandable after the fact what has transpired between them. For that matter, the quiet patient may be taking repose. He may have found an area of life where speech is not demanded of him.

Ironic that in the context of the talking cure he finds the oasis of quiet that allows peace and space for reflection, a space to be alone, with his analyst. Sitting quietly with another person over time is one of the most intimate acts available to us as people. z REFERENCES Arlow, J. A. (1961). Silence and the theory of technique.

Journal of the American Psychoanalytic Association, 9, 44–55.

Calogeras, R. C. (1967). Silence as a technical parameter in psycho-analysis. International Journal of Psycho-Analysis, 48, 536–558.

Ogden, T. (1999). Reverie and interpretation: Sensing something human. London, UK: Karnac.

Parsons, M. (2009). Reply to commentaries. Psychoanalytic Dialogues, 19, 259–266.

Reis, B. (2009). Performative and enactive features of psychoanalytic witnessing: The transference as the scene of address. International Journal of Psycho-Analysis, 90(6), 1359–1372.

Winnicott, D. W. (1958). The capacity to be alone. In The maturational processes and the facilitating environment, New York, NY: International Universities Press, 1965 (pp.29–36).

Winnicott, D. W. (1963). Communicating and not communicating leading to a study of certain opposites. In The maturational process and the facilitating environment New York, NY: International Universities Press, 1965, (pp.179–192).

Winnicott, D. W. (1968). Interpretation in psycho-analysis. In C. Winnicott, R. Sheperd, & M. Davis, (Eds.), Psychoanalytic explorations (pp.207–212). Cambridge, MA: Harvard University Press.

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Reflections on the Roundtable Discussion of the Division Practice Survey Frank SUMMERS

In the last issue of DIVISION/Review, several active members gave their comments on the Division Practice Survey conducted

by Steve Axelrod. The results of the survey showed that our average member has a very limited psychoanalytic practice. The mean number of individual patients seen is about 18 per week almost exclusively on a once per week basis. On average, only 2.8 patients are seen twice per week and 1.3 for three or more weekly therapeutic hours. While most respondents to the survey valued their analytic training, they do little analysis or even analytic therapy.

The very small number of patients seen more than once per week is clearly a major source of concern for the participants in the roundtable discussion, and they proposed a variety of factors that may be at play, all of them undoubtedly important in the shrinking of analytic practice to an almost nonexistent level among our members. Suggested reasons included: a clash of generations, our failure to recognize the importance of culture, derisive and unfounded attacks on analytic therapy from undergraduate professors, insurance cutbacks, myths about psychoanalytic therapy as lacking in evidential basis, and the belief that we practice an outmoded and ineffective form of therapy. These prejudices affect not only potential patients, but also young people interested in pursuing clinical careers.

Students hear at both the undergraduate and graduate levels that psychoanalytic therapy is a relic of the past that has been found to be expensive and lacking in beneficial results.

There can be no question that analysis and analytic therapy have lost status and no longer appear to be a viable way to make a living to many young clinicians.

These reasons are all undoubtedly contributing to the deterioration of analytic practice, but I wonder if we cannot take the discussion to a different level by asking why these factors are so powerful. For example, we might wonder why even clinically active undergraduate and graduate psychology professors have adopted a hostile, demeaning view of analysis.

One need only peruse any introductory psychology text to find a clue. Psychology is defined as “the behavior of living organisms” because “that is what can be observed” (Zalat, 2007). These simple statements are the entirety of the epistemological explanation given for defining psychology as “behavior,” a view that excludes psychoanalytic theory from the field. This epistemological position, if it may be called that, is erroneous in a number of ways, as I have shown

elsewhere (Summers, 2011). Here I wish to note only that this textbook definition of psychology, rather than formulating a method that befits the subject matter, defines the field by a preconceived method. No argument is given, because none is thought necessary, that the presupposed method is appropriate for the study of the psyche.

When such transparently flawed reasoning about the very nature of an entire discipline goes unquestioned, the error is not simply an intellectual mistake, but a cultural phenomenon. “Scientism,” flawed as it is, has long dominated the culture of American social science. Accordingly, academic psychology has made “behavior” its subject matter because studying the measureable allows psychology to regard itself as a “science.” And to be included among the sciences is the highest compliment any discipline can be given in the culture of scientism. Because psychoanalysis does not meet the criterion of measurability, it is not regarded as a science, and so within the culture of scientism it is delegitimized.

Given the cultural context of American social science, I find it somewhat surprising that psychoanalytic thinking has survived as long as it has in some psychology departments. Psychodynamic scholars who continue to have influence in clinical psychology programs are fighting a brave struggle against a belief system that stands in staunch opposition to the psychoanalytic way of knowing.

The wonder is that there are psychoanalytic scholars who manage to keep functioning and in some instances play leadership roles despite their apostasy. The existence of analytic influence in some graduate programs may be testimony to the intrinsic value of analytic thought and its hold on those who possess intellectual curiosity about the depths of human experience.

Psychology’s imitation of the natural sciences only answers the inquiry at the academic level. One wonders: why is the culture of academic psychology dominated by the need to be regarded on a par with the natural sciences? Universities are embedded in a society that tends to define reality by the material and the quantifiable. What can be given a number is accorded more credibility than quality of experience. That is why natural science has always had much higher prestige than social science in the United States. And today the wonders of contemporary technology serve to intensify the passion for material production and achievement that pre-existed the current computer revolution.

E. L. Thorndike made perhaps the most egregious ontological error in the history 27

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of ideas when he said, “If it exists, it can be measured.” Those who claim consistency as one of their inviolable scientific principles conveniently overlook the immeasurability of Dr. Thorndike’s statement. The fact that Thorndike’s woefully mistaken statement is the unchallenged credo of American academic psychology shows that his contention reflects a value system deeply embedded in the dominant culture, a cultural “unthought known.” And to that culture of quantification, materialism, and objectification psychoanalysis does not belong.

So, the deligitimization of psychoanalysis cannot be left at the door of a university value system that represents the society it serves. If one defines materialism in the broadest sense of seeing the material as the criterion for truth and reality, the hegemonic American culture is steeped in a materialistic value system.

The culture clash is not a narrow academic theoretical debate. It is a fundamental conflict between a culture that valorizes the material and quantifiable, on the one hand, and a discipline that engages human subjectivity, on the other. It serves psychoanalysis to see that the reasons for its fragile status go beyond today’s circumstances, such as insurance cutbacks and ethnic insularity. Seeing that the battle line is drawn at a confrontation of different cultures, of conflicting value systems, provides a clear vision of the strength of the force opposing the growth of psychoanalysis and of the battle in which it is engaged.

Ultimately, my argument is that the crisis of psychoanalysis is nothing short of a confrontation with mainstream American culture. Pessimism understandably abounds because there is little sign that the hegemonic culture will somehow find analytic thought a valued addition to society. If analysis looks to mainstream culture for recognition, it is, if I may paraphrase an old song, “Looking for love in all the wrong places.” That fact has led analysts to the pessimism that permeated the roundtable discussion.

But, the fact that the culture shows little respect for analysis, while a major problem at the level of concrete everyday practice, is ironically a reflection of the unique contribution and strength of the analytic process in its battle with the wider society. The value system of the culture that rejects analysis is not serving its citizenry well, as attested by the staggering amount of depression, anxiety disorders, substance abuse, and eating disorders, among other forms of pathology that pervade American society. In one typical study, approximately half of Americans surveyed reported at least one episode of serious

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emotional disorder during their lifetime, and 30% were afflicted with emotional distress during the previous 12 months (e.g., Kessler, 1994). Dissatisfaction with daily living in the United States is endemic.

This cultural dis-ease shows that many people, perhaps the majority of Americans, feel their lives are unsatisfying and a sizable portion are miserable. The culture of quantification and measurability has little to offer them. If the purpose of life is to produce numbers, of whatever type, the experience of individual can be of little import. No matter how carefully depression is measured, the individual is still depressed. Affect disorder, substance abuse, and characterological dissatisfaction are all a product of a culture that pays all too little attention to the experiences of its members. The citizens are expected to produce, and those who do not suffer the consequences. The “manic society,” as Peltz (2005) has called it, offers no succor to the abused child, the depressed adolescent, or the adult suffering from low self esteem.

Psychoanalysis has the opportunity to step into this breach by offering an experience and approach to human suffering that stands in rare and clear contrast to the culture of objectification. The very fact that psychoanalysis eschews measurement and behavior in favor of listening to the overt and covert meanings of the individual and engages that experience makes it a unique offering in today’s world. Psychoanalysis need not emulate the hegemonic culture by trying to prove our “scientific” worth in conventional terms, for the strength of analytic thinking lies precisely in its opposition to the reduction of human experience to behavioral patterns.

For the same reason that analysis is excoriated by mainstream culture, it provides a unique perspective on both the individual and the culture. Not only despite of, but because of, the inherent opposition of analysis to the dominant culture, one can find hope for more than survival. The possibility is there for a potentially powerful impact of analytic ideas not just on individuals, but also on the culture itself. The transformation of children, adolescents, and adults into natural objects of production has led to a silent opposition in the form of widespread dissatisfaction, even desperation, and a virtual epidemic of psychic symptoms in large portions of the American citizenry. Only a field outside of the mainstream can take a good look at that morass of despair and offer something fresh. It is up to psychoanalysis to take advantage of that opportunity. But to do that the analytic community has to conceive of itself as offering a perspective that stands in proud opposition to the mainstream culture. The battle of opposing cultures has to be engaged head to head.

For the same reason psychoanalysis finds a welcome reception among some

in the humanities. Contemporary literary criticism often uses psychoanalytic ideas, and some philosophers find psychoanalytic thought a useful perspective in their efforts to understand the human condition. And here lies a ray of hope: psychoanalysis is warmly received and utilized among some scholars in the humanities, most notably in literary criticism, to a far greater extent than is the case in psychology.

“Marketing” psychoanalysis might well be helpful, but if the marketing campaign is built on the efficacy of analytic work, its effect is likely to be limited because such a campaign will be confined to a battle over statistics and outcome studies. For those hungry for recognition, understanding, and engagement with their experience, statistics are not going to be decisive. What matters to them is to have their hunger for a human experience

built on a human relationship, and it is in direct human interaction that it is best understood. Moreover, it is imperative that minority populations are central to this effort.

The growing ethnic “minority” population cries more loudly than those in the majority culture to have its experience heard. What psychoanalysis offers is the enrichment of human experience, and that need is great at all levels of today’s world.

The value of analytic work is felt most immediately early on in the treatment, often long before any symptomatic improvement occurs, as patients realize their behavior and communication is taken seriously. As one of my patients told me, “You are the first therapist who has ever listened to me!” Most people see the value of depth psychotherapy when they realize that their experience is the focus. Precious few Americans are getting

sated, and that is the market for psychoanalytic therapy. What must be “marketed” is not statistics, but a human experience, a willingness to listen and understand without reducing experience to behavior or measuring it against an external norm.

That is why psychoanalysis as an alternative that proposes to focus on human experience rather than behavior is best introduced by direct human contact: giving talks to community groups, joining discussions of existing groups and culture, such as religious and social organizations.

Psychoanalysis more than any treatment is

that opportunity in today’s world, but many want it, and psychoanalytic therapists, perhaps uniquely, can provide it. z

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REFERENCES Kessler, RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of Gen Psychiatry. 51(1), pp.8-19.

Peltz, R. (2005) The Manic Society. Psychoanalytic Dialogues 15 (3): pp.347-366.

Summers, F. (2012). The Tyranny of Objectivism, Psychoanalysis, and the Rebellion of the Subjective.

International Journal of Applied Psychoanalytic Studies, 9 (1), pp.35-47.

Zalat, J. (2007). Introduction to psychology. 9th edition. New York, NY: Wadsworth

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On Keeping Thought Erotic: Some Problems in Contemporary Theory and Practice

Alan BASS and Donald MOSS

What follows is not a standard psychoanalytic paper. It is an essay about problems that we think psychoanalysis faces from within. It is not based on any empirical studies, but rather on our long experience as analysts, teachers, supervisors, and participants in professional meetings. These experiences have led us to certain opinions about what has gone wrong in psychoanalysis.

We are concerned with the same questions that dominate the profession: How is psychoanalysis to deal with its increasing marginalization? Is it ever to regain the therapeutic and intellectual impact it once had? There have been many attempts to demonstrate the

efficacy and even cost-effectiveness of analytically oriented treatment. These are laudable, and serve an important public function. But such studies take basic theory and technique for granted. They do not examine the question of what gave psychoanalysis such clinical and cultural import at one time. We believe that the answer is simple: psychoanalysis had the most complex and innovative theory of mind extant.

It was a theory that deliberately challenged many commonsense assumptions. It produced a novel form of treatment that not only offered the possibility of relief from suffering, but did so based on the premise that the relief could

only come from the encounter with everything within oneself that common sense could not encompass. It is our opinion that contemporary psychoanalysis is losing that stance.

We begin with a clinical example. It is chosen to illustrate the analyst coming up against the limits of commonsense thinking, even the common sense of received psychoanalytic knowledge.

The patient is a 35-year-old man, whose professional successes have won him international acclaim. He is in the second year of his analysis, initiated by his doubts regarding his own capacity to love and, more generally, his capacity for anything good. He feels his

acclaim and the apparent affection of family and friends are the products of fraud, easy to achieve—people can be fooled. The only figure whom he cannot fool is the analyst. The premise of the analysis is this, that his goodness is false, that his “rottenness” is the only enduringly true baseline. There is no disturbing this baseline. Two years of experience with him has provided the analyst with many opportunities to experience what he means by the baseline’s durability.

What follows is from a recent session: The patient is berating himself about his way of being in analysis. He can’t even 29

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say what he’s doing here. If someone were to ask him what he talks about, he would be unable to tell. What an idiot he is. All this time and he still doesn’t know what he’s talking about. I said to him that the question as he poses it is both cruel and ill-informed, that it’s designed to be unanswerable and to make its recipient feel himself a failure. I was meaning to illuminate the cruelty lurking in the hour.

His response was to agree, to express amazement, to wonder why he didn’t see the cruelty that I saw, and then to shift his attention now to how useless he is in the analysis if he can’t even see cruelty when it’s right in front of his face.

I said that what I said seemed to confirm what he was feeling, because he hadn’t thought it himself. If he hasn’t thought it, what good is he?

He then spoke of how he is unable to really appreciate what I do, because when I do something good it just reminds him of his incapacity to do what I’ve just done. That no matter how much he tries he is unable to really use and appreciate what I offer him.

I said that I thought that in speaking harshly about himself he, in fact, was also, indirectly showing his appreciation of me.

He then said that this was the most “profound” sense of understanding he’d ever experienced, that no matter what he did to me I could always find a way to point out something useful to him, that I wasn’t blocked in by his ways of seeing me and that my capacity not to be blocked was what allowed him to proceed so successfully with his own life and that he himself would never, could never, achieve that capacity.

At this point in the session, I gave up and was silent for the rest of the hour.

I was then feeling as useless and as fraudulent as the patient. When I give what I have, the patient takes from it something I do not want to give. When I have nothing to give, I feel a sense of despair. Despair either way— thought seems to promise nothing.

But, at precisely this moment, this moment of despair, when nothing I have seems to me to be useful, right here is where work as a psychoanalyst begins.

By “work as a psychoanalyst” we mean the work of thinking that would make being a psychoanalyst here, with this patient, possible. The “thinking” we have in mind is of a kind demanded precisely by this situation, a situation that cannot be adequately worked on by the application of what has become psychoanalytic common sense.

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One might call such common sense “borrowed thinking,” a notion that warrants expansion. To many it may seem that this clinical sequence exemplifies, for example, the working of projective identification; to others, the sequence might be best understood by referring to notions of idealization and envy; to others still, the sequence might represent the effect of the sustained, disavowed, and stabilizing workings of masochism. There are other likely conceptualizations with the power to make sense of the clinical sequence. Many such conceptualizations were, in fact, available to the analyst here. The point we mean to emphasize is that, although available, none of the conceptualizations could be animated enough, could be made to feel alive enough, for the analyst to put it to use. In this sense, then, the range of available conceptualizations was “borrowed.” They had the status of thought that had its life elsewhere. At the crucial moment, it did not seem to matter what the thought was, nor what its origin was—the “borrowed” thought might, in fact, have been “borrowed” from the analyst’s own repertoire of once-enlivened thinking. “Borrowed” thinking, then, is a version of inert, de-erotized thinking. It might be seen as a kind of “psychic retreat”—to use Steiner’s term—for the analyst.

What is most alive in the sequence is that the patient brings one to the edge of what one knows, which is why we are presenting an example without resolution. Everything offered is turned into a confirmation of what the offer is meant to illuminate or disturb. Particularly vexing is the force of what seems the patient’s “masochism”: a kind of abjection and self-debasement. Here, confronting what seems like willed debasement, is where common sense ends. Common sense appeals to the primacy of pleasure, to the avoidance of pain. When the manifest difference between pain and pleasure, suffering and relief, is obliterated, the effective reach of common sense is also obliterated. Much of what had once been profoundly uncommon sense has now been incorporated into commonsensical psychoanalysis. By that we mean that thinking here, with this patient, about, say, “masochism,” gets one nowhere. In fact, it immobilizes the process. The analyst must make a kind of jump, a kind of jumpthought, in order to work effectively with this man. This requirement, if fulfilled, would, as we say in our title, keep thought “erotic.” By “erotic,” we are referring to a particular form of sustained tension, bracketed on one side by collapse and on the other by the satisfaction of impulse. In the example above, the analyst was unable to keep thought erotic; instead, his thinking collapsed. He could have, on the contrary, directly expressed his exasperation, satisfying an impulse instead of bearing the tension of sustained delay. Keeping thought erotic is a requirement of neutrality, the opposite of withdrawing into a pseudoneutral silence, as the analyst did here. By “neutral,”

we mean something quite different from maintaining a position equidistant from id, ego, and superego. We mean, instead, a kind of thought that maintains equidistance from collapse and satisfaction, thought that keeps itself in a prolonged state of excitement. Here, the analyst’s experience of withdrawal, of being at the limit of the known, indicates just where the work to become neutral, to erotize thought, is situated.

This kind of jump-thought leads into a zone marked by an inseparable mix of pain and pleasure. Sexuality and Eros point in the same direction—toward a zone in which pain and pleasure are inseparable and common sense breaks down. This, then, is the problem: to keep thought erotized enough so that it has the force to carry the analyst toward a zone in which the separation between pain and pleasure is not a given. And at the same time, to keep thought inhibited enough so that once in that zone he/she forswears most, if not all, of that zone’s temptations—including the temptations either to withdraw into pseudoneutrality or to avoid the encounter with the limit of the known. What makes thought erotic, then, is its capacity to expose itself and to be exposed to tremendous temptation, bearing that temptation—in an important sense, feeling it—while nonetheless delaying gratification, perhaps permanently. A silence that bears this strain is on the way to becoming “erotic thought.”

When the analyst is unsure how to proceed he/she encounters cracks and fissures in an edifice experienced as stable, or as stable enough. These cracks and fissures are not only practical clinical problems, but problematics that potentially allow for an exploration of practical and theoretical consequences, and so an enhanced knowledge of the nature and status of psychoanalysis. One of the extraordinary features of clinical psychoanalytic literature is that particular problems with particular patients prompt reflection on questions of technique, diagnosis, metapsychology, developmental theory, and so on, whereby we come to understand more fully what we have been working with all along— both its meaning and its limitations. From an individual case or a compendium of similar cases, questions emerge about the meaning, the validity, and the future of psychoanalysis.

Breakdowns, as in the clinical example, may impede the development of refined knowledge, because they often result from enormous pressures against “thinking.” Or they may produce knowledge, if the analyst sustains the pressure. The “thinking” we focus on here puts one into direct contact with one’s sense of conceptual incapacity, into contact with one’s limits. The analyst may feel at a frontier, at a point of discomforting proximity to impulse, to deed. This proximity to impulse makes such “thinking” feel dangerous. It also gives such thinking its erotic charge. It drives toward the unaccustomed.

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Conceptual Background The entire history of psychoanalysis can be seen as one of jump-thoughts, astonishment that accepted wisdom fails us. Freud was particularly adept at this: he used crises to transform painfully won knowledge. Our point is that this process is intrinsic to psychoanalytic practice. Sometimes analysts write about their crises, but fall back on received wisdom to resolve them. To watch this process at work is also very instructive. We offer a brief survey of the history of some jumpthoughts and/or the failure to make them.

To develop an effective treatment of hysteria, Freud also had to develop a new theory of mind. The necessary combination of theory and practice is what makes psychoanalysis exciting: it promises clinical effectiveness exactly at the point where one has to think something new, and usually counterintuitive. Take the original Breuer-Freud clinical point: hysterics suffer mainly from reminiscences. Breuer and Freud do not fail to note how “extraordinary” it is (1895, p.7).

It is extraordinary because it raises difficult theoretical questions: How can memories of which one is not aware have such impact?

How can memory act with the force of lived experience? What is “mind” if it can do this?

The “extraordinary” has an essential relation to thought. It is a provocation: how can that be? It is somewhat painful: one is taken aback if indeed it is that way. If it is that way, is there something wrong with one’s assumptions about how things are? The extraordinary can lead to intense pleasure: embrace the provocation and the pain opens up the unexpected gratification of thinking otherwise. Freud’s famous recapitulation of the three great narcissistic wounds to mankind— the earth revolves around the sun, man is descended from animals, the ego is not master in its own house—stresses pain, but all three wounds have also led to the pleasure of new thoughts, thoughts that have had enormous practical import. However, once the practical import of the new way of thinking is absorbed, it becomes a new form of common sense, perhaps what Kuhn calls “normal science” (1970). While this is true in all fields, it has a particular status in psychoanalysis. It can impede therapeutic efficacy.

What must be stressed here, however, is that astonishment and the pain into which it may force one do not, before the fact, promise anything. It is the absence of promise that makes such pain as painful as it is. What makes the combination of astonishment and pain nonetheless productive is another aspect of “neutrality,” an enduring sense that one must proceed therapeutically precisely where one encounters a limit, and must somehow continue tinkering with what Freud famously called the theoretical “scaffolding.” One may feel, along with astonishment, a sense of the

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forbidden, a sense that one is risking recklessness and has only the recollection of the scaffolding’s previous reliability as encouragement.

Freudian theory offers insight into this affective basis of thought. In “Formulations on the Two Principles of Mental Functioning,” Freud defined thinking as the inhibition of immediate discharge, i.e., wish fulfillment (1911, p.220). To inhibit discharge is to sustain tension, to tolerate frustration. This is painful, but it is a pain that is supposed to lead to a pleasure. (The baby who cries because it does not attempt to assuage hunger through hallucination is fed.) But Freud also knew that thinking and pain were erotic stimuli, as he said in “Three Essays on the Theory of Sexuality” (1905, pp.202–203). Later, in “The Economic Problem of Masochism,” he also said that sustaining sexual tension is itself intensely pleasurable (1924a, p.159). Psychoanalytically, it is not far fetched to imagine the possible pleasure that comes from the pain of wounds to accepted thought. Nor is it far fetched to imagine that new theories create the need to seduce others to this painful pleasure. The history of the most important advances in psychoanalytic thought is one of effective seduction into the pleasure of more clinical-theoretical pain.

Some examples: not only did the initial search for an effective treatment of neurosis eventually produce the astonishing new picture of mind as something other than consciousness, it also produced a new theory of sexuality that defied common sense (sexuality is not inherently linked to reproduction) and offended conventional morality (the disposition to perversion is universal). Within the small community of analysts, these ideas quickly became the doctrine of an opposition between the conscious ego and unconscious sexuality.

By 1914 Freud knew he had to subvert his own theory. He found that even in neurosis there were narcissistic elements that were obstacles to analytic treatment. To understand narcissism, and to see it as a necessary part of the entire theory, Freud had to question his own doctrine of opposition between the ego and sexuality. This was uncomfortable, and in fact produced both obscurity and expansion (an approach to psychosis, a new conception of the ego, the apparently oxymoronic idea of narcissistic object choice, the introduction of the ego ideal). In Freud’s own account, without this subverting extension of his own theory he could not have arrived at an understanding of another clinical difficulty. To treat depression, the new theory of narcissism itself had to encompass the idea of conflict between the ego ideal and the ego as modified by identification with lost objects. We tend to lose sight of how strangely novel this conception of intrapsychic conflict was in 1917. For the analysts of that time it subverted what had come to feel like “normal science,” psychoanalytic common sense.

And then Freud found it necessary to make another jump-thought, because he was painfully astonished by something that contradicted dream theory: the repetition of trauma in dreams. “Beyond the Pleasure Principle” remains one of Freud’s most controversial works, much of its theory still as strange as Freud knew it was in 1920. But consistent with the pain and pleasure of thinking unconscious processes, Freud was willing to subvert his theory of the drives—also by then psychoanalytic doctrine. He extended his conception of narcissism into Eros and introduced a death drive, an irreducible self, and other directed destructiveness that works against Eros. This is a way of thinking about psychic conflict that puts more emphasis than ever on pain. Freud links repetition of pain in dreams to the kind of repetition of pain in the transference that he calls demonic. But he also thinks of libido and self-preservation (Eros) together as expansive tension. Loewald, more than anyone else, emphasized the novelty of Freud’s conception of a drive not necessarily linked to tension reduction (1980, pp.79–80).

There is certainly the promise of greater clinical effectiveness here, by virtue of getting analysts to confront both the darkest areas of the psyche and the basic assumption that drives only tend toward tension reduction.

When Freud reverses himself on the nature of anxiety (1926), he confesses his embarrassment as he overturns his own theory— “It is not pleasant to admit…” (p.109). But it is not difficult to imagine the great pleasure he obtained from developing the structural theory, crystallizing the conception of the superego, and giving a much more precise account of the defenses. No one doubts the clinical efficacy of this thinking. And there are other astonishments in Freud’s late work.

The question of female sexuality (1931) led to the “discovery” of a “prehistoric civilization” in the mind: the preoedipal period. We can smile today at Freud’s confining these discoveries to women, but we immediately grasp their clinical importance. Less wellknown is Freud’s late return to the question of perverse relations to reality, leading to the new ideas of ego splitting and disavowal.

Freud again knew that he was subverting his own theory here, the theory whose model of the unconscious was based on repression (1940a, pp.202–204). When Freud makes fetishism, the most conspicuous example of disavowal and ego splitting, the model of compromise formation, he is potentially starting again from the beginning. This is why his very last message to us begins: “I do not know if what I have to say is long familiar and obvious or new and puzzling. But I am inclined to think the latter” (1940b, p.275).

One can only imagine the painful pleasure it gave a dying exile to make such a statement.

And the possible clinical leverage for dealing 31

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with what Freud in this context called “the inconsistencies, eccentricities, and follies of men” (1924b, p.152) is enormous.

There are many other similar examples throughout the history of psychoanalysis, some as successful as Freud’s, some not. On the whole, one can say that the more successful examples are the ones that took the theory in entirely new directions as a response to clinical difficulties. For example, both Karl Abraham, in his “A Special Form of Resistance to the Psychoanalytic Method” (1927), and Helene Deutsch, in her paper on the as-if personality (1942), had the courage to report about patients who should have been analyzable, but were not. However, each tried to shoehorn an understanding of these patients into conventional Freudian theory without much success. Nonetheless, each was willing to shoulder the pain of a problem, and to go public with it.

Melanie Klein’s encounter with the surprising extent and intensity of infantile aggression and anxiety—like Freud’s death instinct, an encounter with the darkest aspects of the psyche—led to a new kind of theorizing and clinical work, whose shocking effect she was the first to articulate. She knew that she was creating “a horrifying, not to say an unbelievable picture” of infantile sadism (1926, p.130).

Klein’s delineation of vicious cycles of incorporation and projection, of splitting of the object, of sadistic fantasies, and especially of the great difficulty and importance of taming aggression, demonstrated a willingness to open herself to pain, and to theorize exuberantly about it. Psychoanalysis would be immeasurably poorer and less effective without the entirely novel idea of the paranoid-schizoid and depressive positions, and everything they imply about anxiety, defense, reparation, and guilt. Any glance at our literature will show how fruitful the idea of projective identification has been. The modifications of technique, and the increased emphasis on countertransference, remain controversial, but the controversy itself has been a crucial source of clinical-theoretical painful pleasure.

The Ethics of Practice and The Erotics of Theory Even this abbreviated history reveals that jump-thoughts are essential to clinical responsibility, to the ethics of practice. It is in the nature of our work that we reach moments of impasse, confusion, and failure of what we presume we know. This is an irreducible problem in our field, a problem that never will and never should go away. We work by inference, and so construct theories that are not conventionally verifiable or falsifiable. (Psychoanalysis is not the only field to do so.) But for some time now, there has been a “detheorization” of psychoanalysis, and emphasis either on the conventionally

COMMENTARY

verifiable or on psychological common sense.

Privately we bemoan that there is a paucity of new ideas. But we do not realize that it is the move away from the necessity of counterintuitive theorizing that is responsible for the lack of excitement and innovation, and for analysts’ private and/or public concerns about the ethics of their practice.

It is very much our intent to make mischief here. This is like the life drive as Freud defines it—a tension-raising mischief-maker that counters the pull toward inertia (1923, pp 45–46). The emphasis on the conventionally verifiable or on common sense offers relief from sustaining the tension of theoretically informed clinical work, a relief that actually leads to inertia. Clinical reports often seem to

of an unreachable goal (Rome) (1985, p.347).

Precisely because of the inferential nature of such theorizing, Freud also knew he had to accept a double bind: one has to develop theories and one has to know that they are always replaceable (the “scaffolding”). The overall message of Freud’s work is that the analytic ethic entails resisting seduction into the inertia of theory avoidance or theory rigidification.

As therapists we all know that common sense is indispensable for dealing with many of the conscious difficulties of life, but as psychoanalysts we also know that it has to fail completely when it comes up against what is beyond its grasp. While the argument that psychoanalysis is an empirical science like any other is false, this does not mean that psycho-

to remain “neutral,” meaning that the analyst sustains commitment to this astonishing, and often enigmatic, procedure. For the analyst, it is only by way of a conceptual commitment to a particular version of psychoanalytic process that the work of keeping thought erotic can make sense. In our opinion, the analyst’s “metabolization” of the pain of delay—avoiding both collapse and gratification—is an essential component of the analytic frame. If the analyst lapses into the pseudoneutrality of using conventional wisdom as a form of tension relief, then the analyst is not maintaining this aspect of the frame. Without this frame, effective analysis cannot take place.

In effect, we are expanding one of the most important technical rules of psychoana-

be filled with a way of thinking difficult to distinguish from folk psychology. Our impression is that more and more, candidates veer so sharply away from integrating our rich theories with their clinical work that one has to wonder what is happening in their training. When theories that arise from clinical pain make mischief, the potential for pleasure, excitement, and aliveness is enhanced. Bored, unthinking, exclusively commonsensical clinical work is not effective clinical work. It would be absurd to allege that all theorizing has the enlivening effect we envisage. But it is equally absurd to pretend that one can be a pleasurably, if painfully, alive analyst without new and difficult theories. Do we think often enough about the inertia of psychoanalytic common sense or borrowed thought in our discussions of countertransference? Are we aware enough of the inherent tendency in all of us to avoid the pleasure-pain of Eros in the way we think about and speak to patients?

There is another ethical dimension to these questions. Freud expressed this very well in various remarks about metapsychology.

“The Interpretation of Dreams” is an eminently clinical work, but as Freud works toward its conclusion he stops and says that he has reached a point at which he can go no further without developing a theory of what dreams tell us about mind (1900, p.511). The letters to Fliess recount the pain Freud endured writing this chapter, which became for him the symbol

analysis can dispense with either the ethics or the pleasure-pain of the scientific attitude: the responsibility for thinking what common sense says is unthinkable. This ethical position is not a grim submission to a scientific superego, but rather the promise of enhancement from the pain of challenging thought, what Nietzsche (1974) called joyful knowledge.

lytic treatment. Freud says the patient’s free association must be complemented by the analyst’s silent free association. The analyst must not give himself the privilege he asks the patient to forego: censoring whatever comes to mind. We are asking analysts not to censor their own experiences of painful withdrawal from the patient at a point of impasse, because, as in our clinical example, we see such moments as the place where the most crucial work takes place for the analyst, the place at which the affective, cognitive, and ethical dimensions of analysis come together in demanding counterintuitive jump-thoughts.

Do we convey this stance in our teaching and supervision? As supervisors, do we permit ourselves to feel at an impasse, or do we withdraw into a pretense of superior knowledge?

Following is an example from a case in which a supervisor came up against the necessity of the jump-thought. The candidate analyst, an already-experienced clinician, had been seeing his patient in analysis for many years.

She was the kind of patient first mentioned

by Abraham (1927) and Deutsch (1942), and today conceptualized as concrete, desymbolizing, with a perverse relation to reality. The candidate had absorbed basic psychoanalytic principles, and was using them—to no avail.

A common occurrence in this treatment was that when the analyst would interpret the patient’s anger at him in relation to the patient’s own associations about her anger at her father,

The Theory of Clinical Breakdown We return to the question of clinical/ theoretical breakdown, as in the initial clinical example. The analyst is on the verge of doing all sorts of things to avert the immediate demands of the situation. Do we remember that that task of continuing, of proceeding into an unpromising mix of astonishment and pain, is also what the patient faces? The burden of saying the next thing on one’s mind—regardless of its lack of promise, its likelihood of pain, its incomprehensible uselessness—puts the patient into a situation congruent with the analyst’s. This congruence also contributes to what we mean by the erotic dimension of the analyst’s thoughts as neutrality. The couple is in it together, seeing where the process itself will take them. It is this shared attachment to the process that also gives the analysis its erotic edge. In moments of threatened breakdown, the process becomes a kind of force that holds an analysis together when the two positions in the room seem incompatible. This force is, in effect, that toward which the analyst aims 32

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the patient would respond: “Of course I’m angry at you. You’re acting just like my father.”

The analyst would experience such moments as a breakdown in his own capacity to think.

He saw no way to say something that would not be met by the patient’s “of course”—call it the impasse of accepted wisdom. He was in despair, as in our initial clinical example, and questioned the ethics of continuing this treatment. Was he exploiting the patient? He also felt himself to be in a power struggle with the patient. Each session, he said, felt like a round in a boxing match, which usually ended in technical points for her. It is easy from the outside to understand enactment, the living out of defensive fantasy in the transference, a perverse relation to reality, defenses against symbolization. But what most bothered the candidate analyst was the patient’s commitment to the process. What was keeping her going? He felt he was running on empty.

While this example has already been published from the point of view of the theory of concreteness (Bass, 2000), the supervisor’s affective experience has not been previously described. It was tempting to pretend to have superior interpretive knowledge of psychodynamics, even though the supervisor actually felt his own thinking to be as jammed as the supervisee’s. The jump-thought was this: the supervisor’s job, at first, was not to teach the supervisee what to interpret. Rather, the supervisor too had to sustain the tension of the impasse, and to find within its tension what we are calling “erotic thought”—and/or neutrality. The supervisor realized that just as he could not be pseudoneutral with the supervisee, so too the supervisee could not be pseudoneutral with the patient. This meant tolerating the tension of not making useless interpretations based on received wisdom— ”borrowed thought.” The supervisee found it very difficult simply to stop doing what had not been working for years, and yet to remain in the process with the patient. Tracking this experience led to new, counterintuitive theoretical perspectives for the supervisor, particularly around the idea of defense against the analytic process itself. The supervisor then could help the supervisee sustain the tension of counterintuitive theory, just as he had had to sustain the tension of a counterintuitive clinical approach.

We all face this kind of experience. One can consult the literature, speak with colleagues, etc., but it also has to be part of one’s analytic attitude to take such difficulties as opportunities to endure and transform a troubled commitment. The supervisee in the example for a long time had no idea that this was possible; he could only grimly proceed with what he already knew.

Nothing in his training had prepared him for this kind of situation, had taught him that breakdown is where psychoanalysis starts.

The necessity of keeping thought erotic in its inevitable relation to pain and to countertransferential attempts to evade neutrality can be central to supervision. If the supervisor assumes that he/she has the answers that the candidate lacks, then the supervisor can foreclose the experience of impasse, which is the route to jump-thoughts. The message to the candidate can be: fit your patient into this way of thinking, which has become analytic common sense for me. Given the inevitable authoritarian structure of supervision, many candidates will comply, and will attempt to convince himself/herself and the supervisor that now the work is going better, when in fact it is not. This all too familiar situation inevitably increases the candidate’s private despair.

Experience and Pain At its best, psychoanalytic theory contains an explanation of why it cannot be applied directly. This is why Freud early on said that each psychoanalytic process takes its own course. It is easy to give lip service to this idea, and very difficult to put it into practice. This is yet another function of neutrality. We are faced with “learning from experience,” that our knowledge and experience will always be tested. As soon as clinical work is grounded in a theory of unconscious processes, one is in the position of having to embrace anomaly and the counterintuitive—which is what all scientific advances depend upon.

“Learning from experience” is of course a reference to Bion, who in Elements of Psychoanalysis (1963) provides an important account of the role of pain in psychoanalytic treatment (comments are added in brackets): The work of the analyst is to restore dynamic to a static situation. …the patient maneuvers so that the analyst’s interpretations are agreed; they thus become the outward sign of a static situation…[This was precisely the case in our first clinical example; in the second example there was no agreement at all. But both treatments were static.] The lesson to be drawn…is the need to deduce the presence of intense pain and the threat that it represents to mental integration…an analysis must be painful, not because there is necessarily any value in pain [although there can be if it is the pain of Eros], but because an analysis in which pain is not observed and discussed cannot be regarded as dealing with one of the central reasons for the patient’s presence. The importance of pain can be dismissed as… something that is to disappear when conflicts are resolved; indeed most patients would take this view. Furthermore it can be supported by the fact that successful analysis does lead to diminution of suffering; nevertheless it obscures the need…for the analytic experience to increase the patient’s [and the analyst’s] 33

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capacity for suffering even though patient and analyst may hope to decrease pain itself.

The analogy with physical medicine is exact; to destroy a capacity for physical pain would be a disaster in any situation other than one in which an even greater disaster—namely death itself—is certain. (pp.60–62) Bion here describes the necessary double bind of analysis and of analytic training: to reduce pain we must expand the capacity for it. He does not integrate this idea with Freud on the double bind of Eros: life as pleasurable pain will always be met by the tendency to reduce pain. Psychoanalysis as both theory and practice is inevitably deadened when they are used in the service of evading the pain of the astonishing, the puzzling, the unfamiliar, the counterintuitive, the anomalous. To restate our major point: deadened analysis, deadened training, and the despair they mask is not ethical analysis. The “greater disaster” that Bion speaks of—death itself, perhaps the death of psychoanalysis—are symptomatically manifest in theory avoidance and rigidification of theory into common sense. But confrontation with this disaster and its pain are the greatest potential resources for a living, erotically thoughtful psychoanalysis. z

REFERENCES Abraham, K. (1927). A special form of resistance to the psychoanalytic method. In D. Bryan & A. Stachey [Eds.], Selected Papers on Psychoanalysis [pp.303-315].London, UK: Maresfield Reprints, Bass, A. (2000). Difference and disavowal: The trauma of Eros. Palo Alto, CA: Stanford University Press.

Bion, W. (1963). Elements of psychoanalysis. London: Karnac.

Breuer, J., and Freud, S. (1895). Studies on hysteria. S.E. 2.

Deutsch, H. (1942). Some forms of emotional disturbance and their relationship to schizophrenia. Psychoanalytic Quarterly, 11, 301–321.

Freud, S. (1900). The interpretation of dreams. Standard Edition 4–5.

Freud, S. (1905). Three essays on the theory of sexuality.

Standard Edition, 7.

Freud, S. (1911). Formulations on the two principles of mental functioning. Standard Edition, 12.

Freud, S. (1914). On narcissism. Standard Edition, 14.

Freud, S. (1917). Mourning and melancholia. Standard Edition, 14.

Freud, S. (1920). Beyond the pleasure principle. Standard Edition, 18.

Freud, S. (1923). The ego and the id. Standard Edition, 19.

Freud, S. (1924a). The economic problem of masochism.

Standard Edition, 19.

Freud, S. (1924b). Neurosis and psychosis. Standard Edition, 19.

Freud, S. (1926). Inhibitions, symptoms, and anxiety.

Standard Edition, 20.

Freud, S. (1931). Female sexuality. Standard Edition, 21.

Freud,S. (1940a). An outline of psychoanalysis, Standard Edition, 23.

Freud, S. (1940b). The splitting of the ego in the process of defense. Standard Edition, 23.

Freud, S. (1985). The complete letters of Sigmund Freud to Wilhelm Fliess. (J. Masson, Trans. and Ed.). Cambridge, MA: Harvard University Press.

Klein, M. (1926). Early stages of the Oedipus complex and of superego formation. In Psychoanalysis of Children (pp.123148). New York, NY: Delta.

Kuhn, T. (1970). The structure of scientific revolutions.

Chicago, IL: University of Chicago Press.

Loewald, H. (1980). Papers on psychoanalysis. New Haven, CT: Yale University Press.

Nietzsche, F. (1974). The gay science. (W. Kaufmann, Trans.). New York, NY: Random House.

COMMENTARY

True Self, False Self: The Role of Popular Media in Subjugating Women of Color Jennifer DURHAM

Subversion of the woman’s voice to conform to the values, institutional practices, and aspirations of society has been explored through a psychodynamic lens by a variety of authors (Charles 2011, Belenky, Klinchy, Goldberg, & Tarule, 1986; Jandeska and Kraimer, 2005). I would like to continue this exploration within the context of popular media’s perpetuation of such subversion with respect to the oppressed female in general, and the Black woman in particular. Being pushed to sing the songs of the institutional choir rather than one’s own takes on new dimensions when the melody not only distorts one’s true voice but the lyrics literally devalue and demean one’s personhood in a manner that maintains the oppressive state. In short, I would like to highlight how popular media fuels the Black woman’s oppressive traverse between being silenced and having someone else’s words put in her mouth.

An Exploration of Multiple Voices and Women of Color This idea of having two competing voices or consciousnesses is not foreign to psychoanalysis. Winnicott introduced the notion of the true self and the false self. He stated “Other people’s expectations can become of overriding importance, overlaying or contradicting the original sense of self, the one connected to the very roots of one’s being” (Klein, 1994). Winnicott suggests that there is a danger of the authentic self being smothered and distorted by the false self, which is in alignment with societal norms (Winnicott, 1965).

It becomes dangerous when such mores are more than just a burden that can leave one feeling inauthentic, but function as a mechanism to undermine a woman’s attempts at equity and personhood as she faces oppressive structural barriers that have historically related to both gender and race.

Fanon describes Blacks as having dual consciousness (Fanon, 1967). The first is an original self that is hidden from society and perhaps even oneself. The second reflects the cultural and institutional norms of the dominant group, often at the expense of equity and self-actualization. I would suggest that the original consciousness is intimately aligned with pursuing equal status for the authentic self within the world. That it recognizes the difference between gaining status and equity by twisting the authentic self into a version that is compatible with societal norms, and gaining that equity as an authentic human being. Fanon argued that the existence of these two selves is rarely without stress and can result in a smothering or misrepresentation of

a person’s true being that facilitates inequity and subjugation.

The perspectives of both Winnicott and Fanon raise issues regarding the subversion of the woman’s voice that may be unique to the experiences of women of color. While both theorists suggest a relationship between the two selves, in the case of women of color, this relationship mirrors society’s oppressive structures. If her true voice is silent, and her false voice reflects and perpetuates an ideology that promotes her inferiority with respect to gender and race, then in essence she is perpetuating her own oppression. The first and authentic consciousness is silenced, and the second is a distortion that mimics the dominant group’s self-serving interpretation of her.

The Role of Popular Media Unfortunately evidence of these struggles are fueled by aspects of popular culture.

Let us consider the popularity of the story

by Stokkett, The Help. The novel, written by a white woman about the experiences of gender and racial oppression during the civil rights era in Mississippi, was on the New York Times bestseller list for 26 weeks. The story focused on the experiences of Black maids and their daily challenges with racism and oppression and went on to be made into a movie that grossed over 35 million dollars in its first five days. It is a sweet and poignant story, but unfortunately not an authentic one.

It is clear from the critiques of the novel by historians and anthropologists that the multidimensional experiences of Black female domestics were not portrayed in the story and therefore silenced (Sharpless, 2010; Tucker, 1988). I’m not quite sure if Miss Stokkett decided to write a book about the experiences of Black women from her own perspective without consulting historians or the women themselves, or if she did so and was unable to capture the painful dimensions of the phenomenon, but their true experiences were suppressed. Absent were the constant threats of sexual exploitation and rape and how many Black women had to choose between economic survival and placing themselves in this type of danger on a daily basis.

Absent were the implications and ramifications of this situation on their love relationships with Black men. Also missing were the guilty feelings related to neglecting the needs of one’s own children to take care of someone else’s who may grow into your child’s future oppressors. The authentic voices of the Black women were silenced.

However, when the movie was made, Black actresses said the words and portrayed 34

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the bastardized experiences as they were written for them. With no disrespect to these very talented women, it is here that the distortion of the true voice to conform to society’s oppressive interpretations of the authentic self is illustrated. This is not to imply that Black women are unable to speak for and advocate for themselves, but to suggest that traversing between being silenced or parroting someone else’s interpretation of you as satisfied and subjugated is a journey that is costly psychologically and may perpetuate an oppressive state.

This is illustrated in popular music also.

Kelly Rowland, a member of the former Grammy award-winning group Destiny’s Child, has often been overshadowed by the group’s main singer Beyonce. Miss Rowland has recently had a number one single that was played exhaustively during the summer of 2011. Prior to this hit she had a somewhat unremarkable and some would argue failed solo career where her songs focused on the emergence of an independent girl next store.

She collaborated on or wrote many of the lyrics. So what was so special about this song from summer 2011 that propelled her to number one? The independent woman/girl image was replaced by a hyper sex-charged subservient female. The song, entitled “Motivation,” is about how a male partner should use Miss Rowland as motivation to climax. This infuses popular culture with misogynistic inferior and subservient images that threaten the personhood of Black women, which of course includes Miss Rowland herself. Inauthenticity takes on unique dimensions when the voices of women of color are either silenced or distorted to maintain oppressive states. Popular media can fuel this phenomenon through the production of books and media that silence or distort the voices of women of color. z REFERENCES Belenky, M.F.,Clinchy, B.M., Goldberg, N.R. and Tarule, J.M. (1986) Women’s Ways of Knowing: The Development of Self Voice, and Mind. New York: Basic Books.

Charles, M. (2011) What does a woman want.

Psychoanalysis, Culture and Society 16 (4) 337-353.

Fanon, F. (1967) Black Skin, White Masks. New York: Grove Press.

Jandeska, K.E. and Kraimer, M.L. (2005) Women’s perceptions of organizational culture, work attitudes and rolemodeling behaviors. Journal of Managerial Issues 17: 461-478.

Sharpless, R. (2010) Cooking in Other Women’s Kitchens, Domestic Workers in the South 1865-1960. Chapel Hill: University of North Carolina Press, Stockett, K. (2009). The help. New York: Amy Einhorn Books, G.P. Putnam’s Sons.

Tucker, S. (1988)Telling Memories Among Southern Women: Domestic Workers And Their Employers in the Segregated South.

Baton Rouge: Louisiana State University Press.

Winnicott, quoted in Josephine Klein, Our Need for Others (London 1994) p.241 Winnicott, D.W. (1965) Ego distortion in terms of the false self. The Maturational Process and the Facilitating Environment: Studies in the Theory of Emotional Development. New York: International UP Inc., pp.140-152.

COMMENTARY

What Do Practitioners Want in a Diagnostic Taxonomy?

Comparing the PDM with DSM and ICD

Robert F. BORNSTEIN and Robert M. GORDON

What do practitioners want in a diagnostic taxonomy? How do clinicians compare the Psychodynamic Diagnostic Manual (PDM) with the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD)?

The DSM and ICD are based on a medical model. The DSM, a product of the American Psychiatric Association, has been a topic of great controversy in recent years.

While many psychologists and other mental health professionals are concerned (quite rightly) about the proposed changes in the DSM-5, it’s important to place this debate in context by noting one important—but often neglected— truth: we are not required to use the DSM-5.

The only diagnostic taxonomy that we are required to use by law is the World Health Organization’s ICD. All insurance companies that accept and process claims electronically must accept ICD-9-CM diagnosis codes; and soon, the ICD-10 will be required for insurance claims.

The DSM/ICD emphasis on symptoms rather than underlying processes stands in sharp contrast to the way most psychologists view patients. Although the American Psychological Association has not yet produced a psychologically based taxonomy of psychopathologies, the Alliance of Psychoanalytic Organizations did exactly that in 2006. In contrast to the ICD and DSM, the PDM (PDM Task Force, 2006) does not list symptom patterns in isolation, but considers the whole person as a complex individual with integrated—and sometimes conflicting—behavioral, emotional, cognitive, and social features.

As Bornstein (2011) noted, whereas the DSM tends to focus on surface behaviors and their associated mental states (e.g., thought patterns, affective responses), the PDM emphasizes underlying psychodynamic processes (e.g., implicit motives, conflicts, defenses), with more modest

attention to expressed behavior. The PDM translates more readily into process-focused treatments and makes explicit the links between early causal factors and present-day symptoms. In this way, the PDM provides the clinician with a more heuristic and clinically useful picture of the patient, not just the patient’s pathology.

We believe that DSM and ICD diagnoses should be integrated with PDM processfocused data to enhance case conceptualization and treatment planning. To facilitate this sort of integration we developed a clinicianfriendly coding form—the Psychodiagnostic Chart (PDC)—that allows the practitioner to combine DSM and ICD diagnostic data with PDM-derived information regarding level of personality organization, overall mental functioning, and other salient psychological variables. (You can obtain copies of the PDC from either of us; e-mail rmgordonphd@rcn. com or bornstein@adelphi.edu.)

The impetus for the PDC came from Gordon’s (2009) survey data, which suggested that practicing clinicians of various theoretical orientations find the PDM useful in conceptualizing patients. To address questions of what practitioners want in a diagnostic taxonomy, and how practitioners compare the PDM with the DSM and the ICD, we conducted a followup study, recruiting expert practitioners from various state psychology listservs, the Division 39 website, and other psychology websites. We asked them to (1) use the PDC with at least one patient and (2) complete an online survey evaluating key features of the PDM, DSM, and ICD. Fifty practitioners have taken the survey to date, with 80% of respondents having doctorates and 20% master’s degrees; 54% were women. Half of the respondents identified themselves as psychodynamic (50%); the rest were eclectic (22%), cognitive-behavioral (12%), humanistic/existential (10%), systems (4%), and other (2%).

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Practitioners rated on 7-point scales how useful various PDM-derived diagnostic dimensions were in understanding patients, and we contrasted these ratings with practitioners’ ratings of information derived from the DSM and ICD (1 = Not at All Helpful; 7 = Very Helpful). Some preliminary findings: z 68% rated PDM Personality Structure as “helpful-very helpful.” z 58% rated PDM Mental Functioning as “helpful-very helpful.” z 44% rated PDM Dominant Personality Patterns or Disorders as “helpful-very helpful.”

In contrast: z 18% rated DSM GAF scores as “helpful-very helpful.” z 14% rated ICD or DSM symptoms as “helpful-very helpful.”

Additional analyses suggested that the utility of the PDM is not limited to analytic therapists: practitioners with other theoretical orientations rated PDM-derived constructs as positively as did psychodynamic practitioners. Thus, the PDM may be useful to clinicians from an array of theoretical perspectives. Moving forward, the PDC may help facilitate use of the PDM in clinical and research settings, and allow clinicians to integrate DSM/ICD and PDM data more easily. As work begins on the PDM-2, such assessment tools promise to play a central role in enhancing psychodynamic assessment, diagnosis, and treatment. z REFERENCES Bornstein, R. F. (2011). From symptom to process: How the PDM alters goals and strategies in psychological assessment. Journal of Personality Assessment, 93, 142–150.

Gordon, R. M. (2009). Reactions to the Psychodynamic Diagnostic Manual (PDM) by psychodynamic, CBT, and other non-psychodynamic psychologists. Issues in Psychoanalytic Psychology, 31, 55–62.

PDM Task Force. (2006). Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations.

RESEARCH

Bridging the Gulf Between Research and Clinical Practice: A Special Series for DIVISION/Review Division 39 Research Committee (Steve Axelrod, Series Editor; Sherwood Waldron, Committee Chair)

Our profession and its reputation depend on the vital engagement between psychoanalytic practice and research. We believe that over the past 50 years clinical research has meaningfully aided practice, often in ways we take for granted. However, internecine battles and a lack of mutual understanding between researchers and clinicians have obscured the fact that many good clinicians are influenced by research.

The newly constituted Division 39 Research Committee, in collaboration with D/R, has initiated this regular series with two related aims in mind: first, to show in practical terms how leading clinicians and researchers use important research findings to inform practice; and second, to take the engagement between psychoanalytic research and practice to the next level, where it can have a vital impact on our membership and our profession.

Our format for this series will be to interview prominent clinicians and researchers

about the ways in which research findings have influenced their clinical work. Prior to the actual interview, we will ask our “subjects” which research findings have made a difference in how they work with patients, and if we are not familiar with the research we will review the findings. In the interview itself we will discuss why they thought these findings were important and how they affected their practices, with illustrative clinical vignettes. We will also ask our “subjects” for their reflections on and suggestions for the integration of research and practice.

We want to emphasize again that our goal will be to demonstrate that research has real clinical utility. We will focus not on the “truth” of these findings per se or even their place in the overall research canon, but rather on their usefulness—our major interest will be the subjective experience of the working psychoanalytic clinician. If ours is an “impossible profession,”

then anything that helps and guides the clinician is of value.

Our first interview is with Dr. Nancy McWilliams. Nancy is familiar to many readers as a past president of Division 39 as well the author of a number of important, widely read books on psychoanalysis, including Psychoanalytic Diagnosis, Psychoanalytic Case Formulation, and Psychoanalytic Psychotherapy: A Practitioner’s Guide. She is on the faculty of the Graduate School of Applied and Professional Psychology of Rutgers University and has a private practice in psychotherapy and psychoanalysis in Flemington, New Jersey.

Nancy is a particularly good choice to initiate the series because her writings are so informative, not only about psychoanalytic diagnosis but also about specific aspects of treatment of individuals suffering from the spectrum of emotional difficulties to be found in practice. z

A Summarized Interview with Nancy McWilliams, March 26, 2012 Steve AXELROD

Introduction—Biography and Practice Nancy McWilliams has a long-standing interest in presenting psychoanalysis in a way that is accessible to students from a range of backgrounds, and who are treating a wide variety of patients. Passionately interested in individual differences, she has cultivated a clinical practice with a patient population that is diverse in terms of race, ethnicity, sexual orientation, and diagnosis.

Perspective on Research and Practice McWilliams feels that when it comes to research, our field has continued to suffer from some of the arrogance that typified it during its heyday—the sense that our ideas are self-evidently correct and don’t need to be tested through controlled empirical study. She sees other systemic factors contributing to the research/practice split: z Analytic institutes are typically not university based, so there is an absence of dialogue with other intellectuals and researchers z PsyD programs (which she otherwise supports) de-emphasize research in favor of clinical training

z The increased difficulty of the tenure and promotion process in academia requires an increased involvement in grant application processes and thus less likelihood that researchers’ extensive experience with practice will inform their research.

Nancy noted that contemporary researchers often lack empathy for the kinds of problems clinicians deal with and can be contemptuous of therapists for not taking the time to read research. On the other hand, therapists view research as not relevant to them, especially when it comes to randomized control studies with cherry-picked patients, delimited treatment time spans, and outcomes measures limited to the relief of observable symptoms. This kind of research in particular leaves McWilliams cold, as it does not address the kinds of complex growth and development that matter to therapists.

Nancy finds some areas of research particularly interesting and relevant to practice.

Long-term outcome studies of therapy as it is actually practiced are very important, though they are expensive and difficult to do. She is interested in psychotherapy process studies 36

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like those done by Sampson and Weiss (e.g., Weiss, Sampson, & the Mount Zion Psychotherapy Research Group, 1986). She also notes the importance of therapist and patient personality and relationship variables in determining outcome. As an example of this, she gives Blatt and Zuroff ’s (2005) article on the therapeutic alliance and personality variables in both therapist and patient.

She would like to see more research done on therapist personality variables; for example, the common positive factors of therapist warmth and authenticity and the negative impact of the therapist’s narcissism.

Looking a bit farther afield, Nancy suggested that she has found some nonclinical social science research to be relevant, such as attribution research. She also feels that some of the neuroscience research has been very important and relevant to clinical practice. Much of the interview focused on the neuroscience research.

Research Applied to Practice Nancy discussed three major areas of neuroscience research and their applicability to clinical work.

RESEARCH

1.

Jaak Panksepp’s work on anxiety centers in the brain (e.g., Panksepp, 1998; Panksepp & Biven, 2012).

Panksepp has differentiated between two major types of anxiety that are mediated by different brain regions and circuitry.

The PANIC system is linked to separation and attachment, is mediated by serotonin, and is helped by SSRIs. The FEAR system is heir to our fear of predators and is experienced as annihilation, paranoid, or psychotic anxiety. This form of anxiety is relieved by benzodiazepines and alcohol, not

by SSRIs, which is why patients with this type of anxiety often have substance abuse problems, especially with alcohol and other “downer” drugs.

Differentiating these types of anxiety, about which a long clinical literature preceded Panksepp’s research, informs the therapist’s approach. We need to speak to patients differently according to the type of anxiety they experience. Patients with anxiety based on the FEAR system will not respond well to intervention themes of attachment, feelings of loneliness, etc.

They need a different presence from us, and interventions that focus on the fear of fragmentation.

2.

LeDoux’s work on emotional memory (e.g., LeDoux, 1996, 2002).

Joseph LeDoux did a series of experiments in the nineties that demonstrated that emotional memory is permanent, and that our belief as psychoanalysts that we could correct early emotional conditions was falsely sanguine. In fact, we can help patients deal with their emotions in certain more constructive ways, but we can’t undo those emotions. The fact is that traumatized patients can do better through therapy, but can’t expect to “recover” their pretraumatized self. They need to mourn the loss of their sense of innocent safety and learn to differentiate current stresses from the emotionally engraved traumatic ones.

These findings have helped shift Nancy’s therapeutic approach with some seriously disturbed patients. Looking back, she wonders if she didn’t “mis-ally” with some traumatized patients, expecting a degree of change that contributed to patients’ demoralization based on the knowledge that she hadn’t gone through the experiences they had gone through. Over time, she has come to better appreciate the limits of how much patients can change, shifting her focus from the possibility of transformation to the reality of accepting permanent emotional change and helping the patient cope with its effects.

Nancy discussed a patient with multiple personality disorder whom she was treating when she read LeDoux’s work.

This patient seemed to assume that “enough goodness” in the transference would heal her and extinguish her experiences of being overwhelmed. When Nancy shifted the therapeutic approach to a more realistic appreciation that this patient would never be “untraumatized,” the patient responded with anxiety and disappointment on the one hand and relief on the other. Her ability to work through and integrate these (previously dissociated) affective states was therapeutic.

3.

Mark Solms’s studies indicating that traumatic memories are not repressed, but instead are never laid down and stored in the first place (KaplanSolms & Solms, 2000; Solms & Turnbull, 2002).

In early trauma, glucocorticoids can overwhelm the hippocampus, meaning that episodic memory (“I was there and it happened to me”) is never achieved, although other forms of memory (somatic and emotional) do register. Thus, in cases of early trauma, the psychoanalytic model of repressed memory is not applicable. Those few remaining analysts who use an old model of repressed memory and embark on a quest to uncover “what really happened” are not only using poor technique, but are also disregarding important scientific findings.

Nancy noted the implications of these findings for the analyst’s authority. The idea that you as the analyst know the truth and can make the relevant interpretations has been deconstructed by relational analysts, and further called into question by Solms’s studies on the effects of trauma on memory. As analysts we have to tolerate ambiguity and uncertainty, and help our patients do the same. We and the patient may know that something (traumatic) happened, but may never know exactly what it was. Regardless, we may need to help the patient deal with the consequences of trauma, in some cases looking outside the treatment for historical validation, and taking active measures to avoid retraumatization.

Drawing more personal conclusions from her own clinical experience as well as research findings, McWilliams feels that she has come to tolerate intense transferences better than she did in the past. She has come to differentiate her own experience in treatment, in which she was able to analyze the transference and link it to past experiences, from the transference experiences of traumatized patients, who may not be able to attach the intense transference experiences to events per se. What is therapeutic for these patients is to tolerate more than to analyze the intense transferences.

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Understanding the different “unconsciousnesses” of different patients (Fonagy’s [e.g., Fonagy, Gergely, Jurist, & Target, 2002] concept of mentalization is relevant here) is an integral part of how we can grow as therapists and people.

The Future of Research Toward the end of the conversation, Nancy came back to two visions of how clinicians can benefit from research. First, on the level of inquiry, interest, and curiosity, she hopes to learn more about the impact of temperament and personality differences on the therapeutic process. (For example, she noted that, according to recent research done in Australia [Hyde, 2009], most therapists have depressive temperaments, are self-critical, and move toward people. This might not be the right fit for some patients.)

And second, she feels that research plays an important part in our need to advocate for the profession of psychoanalysis. Whether it be Shedler’s (2010) meta-analysis of therapy outcome or Susan Lazar’s (2010) comprehensive report on the preventive effects of long-term therapy, research is critical to the survival of our profession.

In closing, McWilliams made a plea to both researchers and clinicians for mutual respect. Clinicians have to respect how hard it is to do good research and researchers would do well to respect the difficulty and complexity of the clinical project. She feels that the small group of psychoanalytic researchers who do clinical work deserve our special support. z REFERENCES Blatt, S.J., & Zuroff, D.C. (2005). Empirical evaluation of the assumptions in identifying evidence based treatments in mental health. Clinical Psychology Review, 25, 459-486.

Fonagy, P., Gergely, G., Jurist, E.L., Target, M. (2002).

Affect regulation, mentalization and the development of the self.

New York; Other Press.

Hyde, J. (2009). Fragile narcissists or the guilty good: What drives the personality of the psychotherapist?

Unpublished doctoral dissertation, Macquarie University, Sydney, Australia.

Kaplan-Solms, K. & Solms, M. (2000). Clinical Studies in Neuro-Psychoanalysis. London: Karnac Books.

Lazar, S.G. (Editor) & Committee on Psychotherapy of the Group for the Advancement of Psychiatry (2010).

Psychotherapy Is Worth It: A Comprehensive Review of Its Cost-Effectiveness. Arlington, VA: American Psychiatric Publishing, Inc. LeDoux, J. (1996). The Emotional Brain: The mysterious underpinnings of emotional life. New York: Simon & Schuster.

LeDoux, J. (2002). Synaptic self: How our brains become who we are. New York: Viking.

Panksepp, J. (1998). Affective Neuroscience: The Foundations of Human and Animal Emotions. New York: Oxford University Press.

Panksepp, J., & Biven, L. (2012). The archaeology of mind: Neuroevolutionary origins of human emotions. New York: Norton.

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65, 98-109.

Solms, M., & Turnbull, O. (2002). The brain and the inner world: An introduction to the neuroscience of subjective experience. New York: Other Press.

Weiss, J., Sampson, H, & the Mount Zion Psychotherapy Research Group (1986) The Psychoanalytic Process: Theory, Clinical Observation, and Empirical Research. New York: Guilford Press

FILM

Closer to You

Bettina MATHES

Words must be followed. Images come to us. But there are films that return me to words—my own words and that of others. Films that go slowly. Films that are opaque. Films that don’t impress me with feelings that aren’t mine. Films that don’t “say” anything. Films that frustrate. Films that are often made in France.

La Captive, inspired by Proust’s La Prisonière, is such a film. A film about obsession and jealousy, about the destructive (and sometimes necessary) urge to manipulate and possess the person we love, about the obstacles we create in order to desire, and how they hold us captive. About Simon (Stanislav Merhar), a wealthy young man, and his (lesbian) lover Ariane (Sylvie Testud), who stays with him in his palatial Paris apartment, indulging his obsession. A film that contains neither judgment nor explanation. A quiet film. The little dialogue there is is mostly whispered. A film in which language is (mostly) a dead end. Simon: “What were you thinking?” Ariane: “Nothing.” Simon: “Nothing? Tell me, Ariane, what you’re thinking?”

Ariane: “If I had thoughts, I’d tell you, but I don’t.”

This film about obsessive love can itself become an obsession.

Since its release in 2001 I must have watched La Captive close to 100 times, perhaps more. The slow rhythm, the irresistible beauty of the framing, the near-static images, the lack of emotions in the acting and the photography (no drama, no psychology), the quiet drive toward death.

My words are clinging to the surface. This is not an interpretation.

Names—white letters on a dark screen. It is night. I hear before I see. The sound of breaking waves on a shore; slowly they come into focus. One after the other. Chasing, catching up, and crashing.

A revolt against the stillness of the letters. Or is it the other way round? The written word an escape from the unthinkable fluidity of the sea? Who owns whom? / La Captive / As the credits continue, I concentrate on the ocean. The waves are stronger now, roaring.

White crests dancing on a sea of darkness—approaching me, drawing me in. The list of names and titles feels like a distraction—why should I care? / Un film de Chantal Akerman / Ninety seconds into the movie and I know it’s going to end where it started: à la mer, la mère, the mother, the sea. I wonder what this journey will be like for me. Un film de Chantal Akerman.

...

“Works of art exercise a powerful effect on me,” Freud writes in The Moses of Michelangelo. “This has occasioned me…to spend a long time before them trying to apprehend them in my own way, i.e. to explain to myself what their effect is due to.” For Freud, an explanation is always a thing from the past. And the past is always before us. And so he proceeds, through a tender description of what is there before his eyes in the church of San Pietro in Vincolo, to invent a past for the Moses of Michelangelo. How did he become who he is? What happened before the sculptor froze him in time?

Psychologically speaking, this invention is a finding (the German “Erfindung” captures both meanings). It contains aspects of Freud’s own life filtered through the fictional character of Moses. “No piece of statuary has ever made a stronger impression on me than this.

How often have I mounted the steep steps from the unlovely Corso Cavour to the lonely piazza where the deserted church stands, and have essayed to support the angry scorn of the hero’s glance!

Sometimes I have crept cautiously out of the half-gloom of the interior as though I myself belonged to the mob upon whom his eye is turned.” How close can he get?

Freud knew he was taking a risk when he prepared The Moses of Michelangelo for publication. He insisted that the essay appear anonymously as “by***” (Freud’s identity wasn’t revealed until 1924, ten years after its first publication). I’m curious about that risk. I want to follow Freud’s impulse (and some of his words) and 38

take La Captive personally, and by doing so say something more general about the film, something that can be shared. Simon is not Moses. Will they get on?1

...

The sound of waves crashing on the shore fades into the whir of a Super 8 film projector. An amateur movie. Shaky. Grainy. Silent.

A small group of young women on a beach: swimming, splashing, hugging, playing volleyball. Joyful and carefree. A film within a film.

Simon plays the same short sequence over and over again. Closeups of the women’s faces as they rest, huddled together for warmth and company. Relaxed faces, soft and inviting; curious faces, confident and elusive. Who are they to each other? If he could read their minds, he would know what love feels like. His words come slowly: “Je,…je, je vous . . .” Stop, rewind, and go. He concentrates on Ariane and Andrée. They are close, very close. But what does that mean, being close to someone? The camera zooms in on Ariane’s face, losing focus, her eyes wide open. Will she take him in? He moves toward the screen, blocking the light of the projector, his body a black silhouette. He enters the image. “Je vous aime bien.” At last!

Love is found, captured, contained in a picture. How long until he will lose it again?

Cut. End of home movie. But that doesn’t mean we’re not watching a film. From now on we will be in the cinema of Simon’s mind. If you ever wanted to know what obsession looks like from within, this is your movie.

Freud: I realize that this cannot be merely a matter of intellectual comprehension, what the artist aims at is to awaken in us the same emotional attitude, the same mental constellation as that which in him produced the impetus to create.2 Paris, Place Vendôme, deserted on a perfect summer day. A tracking shot of Ariane walking to her car, slender and elegant in a silvery, close-fitting dress and high heels. Her pace certain, determined, unswerving. Something tells me she knows she is being observed. The sound of her stilettos sharp and crisp on the pavement.

Too sharp, too crisp. In whose head am I? Simon is in his car, watching. As she drives off in her Peugeot convertible, he secretly follows in his Bentley. Montmartre, Musée Rodin, Bois de Boulogne—wherever they go, they are always alone. Paris never seemed so unreal.

One can’t be a tourist in someone else’s fantasy. The long drive gives me time to study his face through the windshield. Who is this guy?

When I look at him I see sadness: the swollen eyes, the inward gaze, the mouth both soft and insolent, the face inanimate from suppressed aggression. The sadness of meals served on stainless steel plates, of paintings no one ever looked at, of songs never sung, of a loss too painful to grieve. This is not the face he shows to the world; this is his private face, the face he sees when he looks into the mirror—which isn’t very often.

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On the bottom of this sadness there is a longing and a fear. The fear of disappointment that makes him wary of other people: he will watch but he won’t take part. The longing to be contained: he is always inside, even when he leaves the house. Akerman knows how to reveal the comfort and the rigor of interior spaces. Flights of rooms, doorways, mirrors, windows, windshields, the backseat of a car, narrow alleys, and tree-lined country roads present frames within the frame of the screen, protected spaces that satisfy his need for safety and certainty. No alarms and no surprises, please. Into this self-made prison only one person is admitted: Ariane. She knows the game, likes it, and plays by the rules.

He will be the stalker, but she gets to choose the location. The Musée Rodin, for instance. Hide and seek. Footsteps on creaking hardwood floors, sculptures mute to the touch, immortal bodies, frozen flesh. He glides more than he walks, stiff and erect like a robot, as if on drugs or in a trance. His eyes are fixed on her. No one else exists. She leads, he follows. No words, no glances, nothing is exchanged. The marble bust of a woman whose hair is arranged in a spiraling knot (yes, we’ve seen this before) catches her attention.

Is this what he sees in her: a French version of Madeleine/Judy in Vertigo? Is this how he thinks of their relationship: a re-enactment of Hitchcock’s masterpiece? Simon as Scottie?

love with her while she is asleep. Does she mind? “No, not at all,” she says. When no one is watching, when the object of his desire is there and not there, that’s when he feels safe. “My odors don’t bother you?” Ariane asks from behind the screen. That’s when his mind gets stuck in a phrase: “au contraire—on the contrary,” he replies. “On the contrary?” “Yes, on the contrary. On the contrary. On the contrary.” Repeated four times, the phrase becomes a reassuring mantra, a secret code that confirms the availability of opposition and obstacle, of law and order. Of lovers meeting on either side of the fence, speaking through a hole in the wall. They get up. Face to face they stand, fingers touch, lips merge, his chest on her breast. Ariane a phantom behind the glass, elusive. He wants to kiss her through the looking glass, and he wants to leave the mirror intact. Narcissus in the bathtub. Who is going to dry his hair?

Freud: [It has been said that] the great secret of the effect produced by the Moses lies in the artistic contrast between the inward fire and the outward calm of his bearing.…I feel the lack of something in [this explanation]. Perhaps it is the need to discover a closer parallel between the state of mind of the hero as expressed in his attitude and the contrast between his outward calm and his inward emotion.

Not quite. Akerman evokes Vertigo, and moves on. The reverence to Hitchcock prepares us for a detour from the way this story of male jealousy normally unfolds. In Vertigo, Scottie transforms Judy into the dead Madeleine. Simon has no intention of remaking or remodeling Ariane. Change is frightening; the future is boring.

We can always trust Hitchcock to have his psychology right in place, but Akerman doesn’t plant obvious clues to help us with the interpretation. We are free to let the images resonate with our thoughts and feelings.

Freud: I can recollect my own disillusionment when, during my first visits to San Pietro in Vincoli, I used to sit down in front of the statue in the expectation that I should now see how it would start up on its raised foot, dash the Tables of the Law to the ground and let fly its wrath. Nothing of the kind happened.

Instead the stone image became more and more transfixed, an almost oppressively solemn calm emanated from it and I was obliged to realize that something was represented here that could stay without change; that this Moses would remain sitting like this in his wrath forever.

Here they are: Simon and Ariane in the bathroom, each one in their own tub, side by side, like twins, but in different rooms. A long, slow sequence, just one take with minimal camera movement.

In the place of a wall there is an opaque window between the two bathtubs that reminds me of a mirror or a screen in a movie theater.

We remain on Simon’s side. Stretched out in the tub, calm and tranquil, he speaks about his desire for Ariane: her body, her sex, her odors so strong they make him dizzy, draw him in; how he makes 39

I know what he wants. He wants transparency and fusion, total knowledge. He wants a mirror. He wants to enter her head, live inside her mind, feel what she feels, think what she thinks.

He wants more. What he has is never enough. Because what he really wants is shelter, like a baby in the mother’s belly. How to get there? He wants to be found, but he can’t get lost. He wants to be taken in, but he can’t take the risk to ask for it. There’s shame in dependency. He must not be seen like this. He possesses where he once wanted to be possessed. He sees where he once wanted to be seen.

The tender monotony of his days and nights. He is not living, he is killing time. If Akerman didn’t tell us how much time has passed—the next day, the day after tomorrow—we wouldn’t know.

Wanting. Waiting. Always waiting: for Ariane to leave the house and to come home; for Andrée to report; for the slip of the tongue, the white lies, the moment of confession. And that endless list of the same old questions.

Simon: So tell me.

Ariane: What?…We went to the pool.

Simon: You went to the pool? And so?

Ariane: And so?

Simon: And tomorrow?

Ariane: Tomorrow?

Simon: Yes. Ariane: Tomorrow I have my singing lessons.

Simon: I thought it was on Thursdays?

Ariane: Yes, sometimes it’s on Thursdays.

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And then he stumbles right into Ariane’s other life. On his way out, in the courtyard of his apartment building, he is captured by two female voices singing the famous and famously sensual duet “Ed intanto che diletto” from Mozart’s Così fan tutte.

(We’ve heard Ariane practicing this song in her room.) The lyrics describe a flirtation between a man and a woman, but the song’s sensuality springs entirely from the erotic power of the women’s voices mingling, touching, caressing each other. As if to say, it doesn’t matter what we say, as long as we keep speaking. He looks up, puzzled by the emotion in the air. Ariane on her balcony, relaxed, attentive; an opera singer by the open window, seductive in her red dress. The women can’t see each other.

They’ve never met. They play it by ear. As their voices flow back and forth like birds, as the temperature rises, as they accommodate one another, it is impossible for him to tell who leads and who follows. He knows he is missing something, and it frightens him. Here it is: the erotic climax of the film, the sexual act he and Ariane will never perform. The two women are enough for themselves; they have everything they need, including the freedom to shut the window and go to bed, alone.

Confusion. But his jealousy will get him through. More of the same! What goes on between two women that doesn’t go on between a man and a woman? He must know. He jumps to conclusions: gender is the obstacle between him and Ariane. He goes to question a lesbian couple. It’s not the same, they say. “There are no explanations. It’s just not the same.” But a difference that can’t be defined in opposition to an other doesn’t make sense to him. He keeps asking: “Is it about bodies?” “No. It’s not so simple.

It’s not the same thing. There are no words.” I’m mesmerized by the women’s refusal to step into his world of definitions and principles. This is not about gender, they insist. It’s about intimacy that cannot be known as one knows a fact (clear-cut and hard), about desire that cannot be explained and owned, about understanding that a woman’s desire for another woman is not always a desire for sameness and fusion. He is not ready to give up, not quite yet: “Do you think of someone else when you make love?” (How bold. The question comes as a surprise even to himself.) “Sometimes. Once you close your eyes, you’re free.” This is his problem: he sleeps with his eyes wide open.

...

When I look at him I see a boy, or a girl: the smooth features without the slightest trace of stubble; the velvety hair; the soft voice, more a whisper than a shout; the lavender clothes; the wanting, raw and shy. Where is the mother? That is the unasked yet continuously felt question at the heart of Akerman’s film, and Simon’s world.

waiting to be reborn. The most moving and revealing moment of the film occurs when Grandmère cannot fill the lack, when she holds him—his head resting in her lap—and has to let him go unconsoled.

Tears streaming down a face as empty as a blank sheet of paper. He’s not crying, he’s shedding tears. Tears for fears. But what about the pain? The hurting? All his life he has been waiting for a feeling that never comes.

Freud: What we see before us is not the inception of a violent action but the remains of a movement that has already taken place. In his first transport of fury Moses desired to act, to spring up and take vengeance and forget the Tables; but he has overcome the temptation and he will now remain seated and still, in his frozen wrath and in his pain mingled with contempt.

It is Ariane who breaks the spell, releases him. “To dare love a girl—it takes courage,” he says. “Everything takes courage,” she replies. In a final gesture of love, before she disappears from his life, escapes from his unbearable need to control, she leads him to the sea—though he is the one driving the red Peugeot. A luxury hotel right by the ocean. Night is falling. The wind is picking up.

They order a meal although they are not hungry. They order champagne although there is nothing to celebrate. Last supper.

Before the food arrives Ariane goes for a swim. We know what an excellent swimmer she is; nothing to worry about. Simon watches the waves from the terrace, dark shadows creeping up the balustrade keep him company. The entrance to the underworld.

Suddenly a thought stirs him into action: Ariane, she’s in danger!

Ripping off his clothes, he races down to the water. We haven’t seen him like this: he’s frantic. Here is where we lose him. We can only guess what’s going on out there. Two bodies fighting? One body struggling to rescue the other? Perhaps. At dawn we find Simon on the sea in a small boat steered by a fisherman. The boat is coming closer. Simon’s figure fills the screen — lonely, vulnerable, motherless. Wrapped in a blanket, disheveled, exhausted, shivering like a newborn baby being washed up the shore. This time someone will find him.

...

The best films return us to our singular experiences of the world. Today, where the vast majority of movies are little more than marketing tools designed to keep us as far away as possible from our needs and frustrations, going to the movies for most people is a form of window shopping: presented with an inexhaustible stream of objects waiting to be bought, we leave the cinema reassured that everybody wants the same things, that all we need is to shop.

How soft a whisper can get. z

To Nicola Burg.

The images on pp.38-40 are from the film La Captive by Chantal Akerman.

NOTES 1. Freud’s 1912 paper “On a Special Type of Object Choice Made by Men” is the obvious match for Akerman’s film. As with most obvious choices, this match would have told us nothing new or interesting, neither about psychoanalysis nor about the film.

2. Quotes are from Freud’s essay “The Moses of Michelangelo”.

He lives with his grandmother. They love each other dearly.

Every time Grandmère, slightly bemused, wanders into the frame, the mother’s absence is evoked. Like a ghost that dare not speak its name. No one ever mentions her. A loss too big to feel. He has no words. None. He lost his mother before he had her. A stillborn baby, 40

REFERENCES Freud, S. (1910). On a Special Type of Object Choice Made by Men (Contributions to the Psychology of Love I), Standard Edition 11.

Freud, S. (1914). The Moses of Michelangelo, Standard Edition, 13 CREDITS La Captive (Chantal Akerman, France 2000, 118 min)

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ON POETRY

Finding in the Sound a Thought: Matthew Arnold’s “Dover Beach” Henry M. SEIDEN

Mathew Arnold’s “Dover Beach” (written in 1876) is one of the most beautiful poems in the English language. Beautiful for its music and its imagery. For its historical scope and philosophical clarity. For its honest ambivalence: optimism against pessimism. For the way it sets the beauty of the natural world against the melancholy of loss— and against uncertainty and existential anxiety. For its meditation on what love can mean.

To appreciate the poetry of another age is to overcome some difficulties. The unstated assumptions and the intellectual struggles of that age, the ground against which the figure of the poem is set, may well be opaque to us. Readers may remember that Matthew Arnold (1822–1888) was a Victorian poet, essayist, and literary critic.

The great thinkers of his time wanted to make the world right with new science and technology, with new social, psychological, and economic theory, with cultural development generally. This was the age of Darwin, Marx, and soon Freud. But the dark side of belief in progress is doubt—of optimism, pessimism.

The poets of Arnold’s age sought spiritual truth, and the beauty that signaled it, in a world undergoing deeply unsettling technological, social, economic, and religious change. And lurking within the celebration of the Beautiful was the anxiety that beauty could be glimpsed only briefly and thus couldn’t be relied upon. The great Romantic, William Wordsworth, as early as 1798 (in “Tintern Abbey”), celebrated the memory of his youthful communion with the natural world. But even as he celebrated, he felt himself (only five years later!) already past the possibility of such communion. Gerard Manley Hopkins in 1877 (in “God’s Grandeur”) would insist eloquently on the spiritual beauty of the world even as he bemoaned its despoliation. The world he saw was “seared with trade; bleared, smeared with toil; and wears man’s smudge.” At the risk of simplifying a large and complex history: this was an age that wanted to believe but was oppressed by doubt.

“The sea of faith,” as Arnold says, was retreating like the tide.

Historically, Arnold wasn’t quite modern: the last wholesale destruction of the belief in the essential goodness of the world is understood as coming with World War I. But surely he prefigures Modernism. He hears faith’s “melancholy withdrawing roar.” In that, and in his ability to evoke the sound in his reader’s ear—even in the ear of a (postmodern) 21st-century reader—he is one of us.

“Dover Beach” starts with an image of great tranquility but within the first stanza it becomes clear that this will be no picture postcard.

The poem opens with such lovely music! The waves roll up the beach and down again in the rhythm of the reader’s breathing. The sea is calm; the tide is full. There is the tranquil bay, the night air, a splendid view, a geographical and historical perspective. But then in the sound of the sea, of the pebbles grating on the shore, there is a “tremulous cadence” in which we find “an eternal note of sadness.”

The melancholy feeling is carefully registered and philosophically clear-headed: the sound in itself isn’t sad. We find the sadness in it. There is no pathetic fallacy here. The imputation of emotion and intention to a nonhuman universe is understood as a human reading, a human projection with a long history going back at least to the ancient Greeks, to Sophocles’ awareness of the “turbid ebb and flow of human misery.”

To find and make such meaning (again) gives us a moment (again) of sweet, sad beauty. The sadness makes what’s beautiful more beautiful. But the finding is inherently anxious—it gives us our terrifying loneliness too. We want “a land of dreams, various and beautiful.” But we know the natural world “hath really neither joy, nor love, nor light / Nor certitude, nor peace, nor help for pain.”

Well, this is modern. This is the psychoanalytic vision, a vision that had its birth in the Victorian age, is it not? We live in our unreliable 41

Dover Beach The sea is calm to-night.

The tide is full, the moon lies fair Upon the straits;—on the French coast the light Gleams and is gone; the cliffs of England stand, Glimmering and vast, out in the tranquil bay.

Come to the window, sweet is the night-air!

Only, from the long line of spray Where the sea meets the moon-blanch'd land, Listen! you hear the grating roar Of pebbles which the waves draw back, and fling, At their return, up the high strand, Begin, and cease, and then again begin, With tremulous cadence slow, and bring The eternal note of sadness in.

Sophocles long ago Heard it on the Aegean, and it brought Into his mind the turbid ebb and flow Of human misery; we Find also in the sound a thought, Hearing it by this distant northern sea.

The Sea of Faith Was once, too, at the full, and round earth's shore Lay like the folds of a bright girdle furl'd.

But now I only hear Its melancholy, long, withdrawing roar, Retreating, to the breath Of the night-wind, down the vast edges drear And naked shingles of the world.

Ah, love, let us be true To one another! for the world, which seems To lie before us like a land of dreams, So various, so beautiful, so new, Hath really neither joy, nor love, nor light, Nor certitude, nor peace, nor help for pain; And we are here as on a darkling plain Swept with confused alarms of struggle and flight, Where ignorant armies clash by night. and anxious inventions. We want meaning and make meaning out of our longings. But all we really have is the existential possibility of being “true to one another.” And even then we can’t escape our anxiety: we live our lives conflicted and ignorant “as on a darkling plain.”

Then again (and maybe this is Matthew Arnold and maybe it’s my reading of him), we do find our thoughts! That is, we transform the inhuman sounds of our universe—inner as well as outer—into human experience. And we find the consolation of being able to share that experience. On the beach—or in the consulting room. z

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When Dumbness, or Unbehagen Before the Master, Becomes “Shakespeak,” Comradery and Joy in Shared Lack Manya STEINKOLER

I taught Shakespeare’s Coriolanus this summer in an Introduction to Literature course at a community college. Students from Azerbaijan, Albania, Japan, Israel, Italy, Bangladesh, China, the Philippines, Mexico, the south Bronx, and even two heavily tattooed Iraq war veterans still in their twenties wrestled with this late Shakespearean masterpiece. The jumble of accents, cultural ideologies, life experiences, and even ages— one student was in her midsixties and going to college for the first time, one African American working mother of two was doing the same—would prove magical; a kind of nonmeaning and missed meaning that was always present and served paradoxically like a witch’s brew to buoy up the text, allowing the class to embark together on the journey of Shakespeare’s ravaging, violent, and disarmingly poignant drama with communal enthusiasm and pathos.

Community college students struggle in an introductory literature course with reading and writing, and especially struggle while reading Shakespeare’s tragedy aloud.

One student in particular, Arpad, a 30-yearold accountant from Bangladesh, always in a dress shirt and tie, was utterly not understandable. His accent was so thick and his syntax so obscure that no one in the class, including me, ever understood him. However, Arpad raised his hand eagerly to respond to almost every question. He came to class passionately engaged, his text marked up, prepared to contribute to any discussion. The problem, of course, was that no one had any idea what he was talking about.

Our in-class discussions focused on the problem of speech for Coriolanus, and of the impossibility of his symbolic place, despite his magnificent achievements as a military hero. We spoke of his role as his mother’s phallus, of Volumnia’s power and certainty, and of Coriolanus’s love-hate relation with Aufidius, a passionate lover/antagonist he meets in a mirror he cannot see.

Despite Arpad’s incomprehensibility, he regularly volunteered to read aloud, much to the discomfort of his fellow students and even to my own. I almost never understood him, and was relieved when I could hang on to one word or two and hope I had understood the rest. I let him speak, now and then making either the valiant effort or ersatz show of trying to make out what it was he was saying. Initially, students were annoyed; it was evident that they didn’t want me to call on him. I sometimes asked him to write out what he wanted to say

or to spell a word, so that he could share his thoughts with all of us. I said aloud in front of the class that it was difficult to understand him, but that his passion touched others and we wanted to hear what he had to say. Sometimes, not knowing what to do, I pretended to understand him, nodding my head for him to continue. At other times— completely mystified—I would respond, “Are you sure about that interpretation?” or “Maybe you should think about that some more.” I nodded, and he nodded in return, happy, I conjectured, to have been “understood,” or to have his words seem at least to land somewhere receptive to them.

Midsemester, one of the students came to my office and said that the class was relieved that at least I was able to understand him. His classmates, she said, had no idea what he was talking about. I was glad they thought I understood him, and kept my ignorance to myself. Occasionally, another student would try to help him out, interpreting his speech to me and to others. Only later, when reflecting upon this experience, would I recall what I had learned from psychoanalytic work—understanding is overrated. An able analyst once told me he worked better and had a stronger clinical effect on his patients in a foreign country, since he was less duped by meaning. Somehow I must have remembered this. So, as with Shakespeare’s difficult text, we were subject to yet another language we did not understand but that seemed, to its speaker at least, to make perfect sense. Over time, as they would the text, the class would grow to love Arpad; teasing him gently, he came to have a place as the one whom no one understood. Students appreciated and even admired him because he cared; he was invested; he wouldn’t give up.

The last day of class, students performed scenes from the play with an open book.

Many practiced for weeks in small groups.

Arpad was the only student who memorized his lines and performed sans book in hand. He chose the famous scene in which Coriolanus “pretends” to solicit the voices of the people of Rome in order to satisfy his mother’s desire that he become consul. “Your voices!” yells the Roman warrior, who earlier single-handedly “made widows of the women of Corioles.” “Your voices!” Coriolanus calls out repeatedly, the repetition here underlining only how much the hero has no interest in the people’s voices whatsoever.

“I say your voices!” Arpad thundered at his “Roman classmates,” several of whom were on stage with him at the front of the class (this 42

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included the Italian, who yelled out, “That’s me!”). Arpad held out his hands, entreating the people; “Romans!” he yelled to his classmates, “Your voices!” his accent was still present, but less pronounced. Not only had he memorized the lines, he acted them; he “was Coriolanus” and we understood him! The scene culminated in his classmates’ roaring applause. The students called out his name, “Arpad! Arpad!” and he bowed, beaming and shy at the same time. Everyone in the room knew we were applauding something important that concerned confidence, courage, the human right to speak in the face of the totalitarian wish for silence, and that Coriolanus was not the villain here, but in an impossible position as the mouthpiece for his mother’s desire. “Your voices!” Arpad said once again after the scene was over, as he took a bow and his classmates cheered him.

Why had Arpad chosen this scene—a scene in which Coriolanus lies about wanting the people’s voices? Why was it the lie that would allow Arpad to speak, to perform?

What was Arpad saying about speech, meaning, about being in a foreign culture, about the lie behind the Other’s wanting to hear? About my own listening to him in class? What was he saying about being heard? About being understood? About Shakespeare? About the power of theater to speak truth?

Arpad wrote a letter to me the week after the class was over, thanking me for his newfound love of Shakespeare, something he had felt was previously impossible for him. “I know, professor, you will ask me to analyze. You always ask us to analyze.

You would ask me why I was able to learn a scene where the calling for people’s voices was false. I must tell you in all sincerity that I do not know the answer. But I hear in my mind your voice asking me this question. I do know that this was a voice I could speak— the voice that pretended to want other voices—but really didn’t want them at all. I read that scene and I knew that I could do that one!”

Arpad was able to speak the voice of someone who did not want to hear others; someone who was also suffering from another’s command over him. He was able to speak this voice to all of us—so that we could hear that someone who only “pretended to want to hear.” It was important enough to him that he memorized the entire scene and spoke the lines so that we understood him.

I could not help but think of Arpad when asked to discuss the signifier Unbehagen

WIT[Z]

in terms of psychoanalytic formation today and of David Lichtenstein’s invitation to us to speak, asking us to speak of the people who claim to want us and “support our desire” as trainees but don’t really want our voices, people who have often forgotten their own desire in the name of some other demand or wish for power. So I take up this invitation by way of a series of vignettes about training, about the abuses of transference and power, about the dis-ease of groups and in groups and of in-groups, about those in power whose voices often go unquestioned. *Names and places have been changed to protect the guilty-innocent and the innocentguilty and even those who think they don’t belong to either category.

Fabissina, claimed in her East Saxon-Breton dialect that she would accept questions after her talk. This proved true for any and all supporters of the Empire, but she was far less enthusiastic for others’ questions.

Surely, no one blames Frau Fabissina for her coldness and rigor; such qualities are her greatest appeal, allowing her to achieve arch villain status as an “ASS,” Analyst Star of the School. Moreover, everyone knows that Wookiee is virtually impossible to understand, as evidenced in Chewbacca’s loud guttural “uwu-uuuuooaagh.” Initially, the Wookiees’ questions as well as those of the various droids who were present in the amphitheater were completely ignored by the Frau, whose frown and wrinkled sneer

followers of Vader were assumed to not have any knowledge. It was perhaps more precise to say that as a consequence of nonmembership in the Empire, they were dispossessed of knowledge. The glaring fact, well known by the Rebel Alliance, that the Wookiees started Wookieepedia was not only unknown to Frau Fabissina—but was also utterly irrelevant, inconsequential, and unimportant. All Wookiee knowledge and the entire Wookiee language was deemed null and void despite its known association with Lalangue vowel drivel and despite the famous song “Making Wookiee” about the importance of Wookiee making, the inevitable boredom in traditional marriage, and the straitjacket of socially supported

The Death Star Last year a conference was held organized by the minions of Vader.1 Following one of the speeches of one of the featured speakers (all of whom quoted reverentially the Jedi master who had turned to the dark side), several Wookiees, droids, and Ewoks in attendance were brave enough to ask questions. A featured speaker, a guest star from the Austin Powers film series, Frau

had nothing to do with an alliteration of her German name. The Ewoks, used to such treatment, resorted to high-pitched squealing among themselves. The Death Star was not interested in minor Star Wars characters anyway; let’s face it—some planets are more important than others. And Jabba the Hutt was just a passing fad. No one cares what Ewoks think! They have no oil, no natural resources, no potential psychoanalysts-in-the-making, and have never entered an athlete in the Olympics.

But since the only questions to follow her lecture were from Wookiees, Ewoks, and droids, Frau Fabissina was forced to call on them if only for the sake of proper intergalactic protocol. It was more than clear that all those who spoke who were not

forms of meaning. No wonder they make such strange noises! The further fact that Chewbacca was an excellent fighter pilot in outer space and a very hairy hunk was similarly dismissed, as was the potential contribution of Wookiees to the theory of masculinity, to the theory of the transitional object (between ape and human) (not to mention the potential Kafka revisionism and allusion to Deleuze’s “Becoming Wookiee”), and, of course, Chewbacca’s relation to the Italian ciabatta (a linguistic similarity not unremarked on by the well-known Lacanian Dany Nobus—ask him about this one). It is also averred by several retired Jedi present that the Wookiee, Ewok, and droid presence was an attempt at nonparanoicising the differences between the Rebel Alliance

1. in Shakespeare, “to vade” means to disappear.

While George Lucas may have played on “invade,” the Shakespearean meaning is just as important here. We also note the similarity to “vide,” Lacan’s word for void or emptiness.

We note the reference to Heidegger’s jug and Das Ding in the name that was not chosen. Darth Vider, however, would have been impossible, since “vider” means to empty and is commonly used as a word that means to go to the toilet. Darth Vider would have been a super-villain excreter. But these are associative hypotheses that have no place in this essay.

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and the Death Star. Only members of the Empire were deemed “supposed to know.”

The rest of the entire universe was desupposed and thus effectively dispossessed of knowledge. At the conference, several earthlings (including the author of this vignette) were invited to train at the Empire’s school, known as the “Global Youniverse of Psychoanalysis,” better known by the acronym GYP. The Rhinal Solution At one point the author of this article was invited to a dinner of the high-level members of a top-secret inner sanctum meeting about the establishment of psychoanalytic training in New York and the putting into effect of the Rhinal Solution— the establishment of the only legitimate school of psychoanalysis that snubs its nose at all other schools the world over, École de la Shnoz. At dinner she was asked by the cigar-smoking commandant, a deep-voiced woman with a cropped moustache, “Are you with us or against us?” She had a sneezing fit and had to leave the table.2 Managing the Transference Managing the transference is apparently a very important part of analytic work.

For some analysts, this applies to the “instituting” of the transference in the first place.

I am so glad this is a technique that one can have control over as an analyst, because one can therefore control one’s patients at all times, like robots. Otherwise I might not know what the patient had transference to or how I was involved in the patient’s desire. Now that I know this is all “manageable,” I am well on my way to being properly trained. I will give two such examples useful to our discussion of training and the formation of analysts. Several years ago I was invited to attend a conference in the Midwest where a midranking analyst from a very prestigious school was giving lectures. There was a Jewish holiday family event I was avoiding, and so I decided to go.

I had never been to the Midwest, and had only seen buffalo on West 79th Street at the Natural History Museum and on Mutual of Omaha’s Wild Kingdom. Later that year, I was invited to Paris to give a paper—and lo and behold, the analyst who had spoken in the Midwest was the chair of my panel!

I saw that all of us invited were carefully matched with analysts whose lectures we had recently been to. The school wanted to “manage our transference” and hoped that by so matching us to analysts whose lectures we had attended, we would be more likely to have transference to the school and join their movement. The fact that we 2. A colleague who read this passage commented succinctly, “There is no transference management at the zoo.”

hear the Unbehagen in the “cult” in such an example should in no way dissuade us from “the analyst’s desire.”

In another example of what would turn out to be “mistaken” “transference management,” three analysts giving a week-long seminar would intermittently remain silent at questions from the audience. Only some questions were answered; others were met with an austere silence.

Several audience members found this silence truly analytic and useful in terms of unconscious processes. It turns out that the audience’s microphones were not working, and two of the analysts on the panel had hearing aids. This in no way negates the idea of transference management—clearly transference took place. The fact that it was accidental, unpredictable, and unmanageable in such an instance is surely beside the point and due to easily surmountable technical difficulties.

In a supervision group in which I currently participate, one participant, an analyst in training, related what her supervisor said about the patient she presented to us: “If he is not on the couch, it is not analysis.” What struck me about this patient was how he might be benefiting from his analyst’s gaze.

Moreover, he was free associating, he was in the midst of a transference relationship, and he dreamed regularly for his sessions. But “a patient has to use the couch for the work to be called ‘analysis.’ ” This is surely understandable and an important rule of psychoanalytic training. We don’t call exercise “working out” unless it is an activity performed in a gymnasium. If you run in the park, it is called running. If you do aerobics videos in your apartment, you do aerobics videos in your apartment. If you lift weights in your garage, well, you lift weights in your garage. If you pole vault or mountain climb, you pole vault or mountain climb, even if it is in your apartment or part of your fantasy or delusion. Of course, the word “working out” has also been used to discuss the doing of math problems or what people do with regard to problems in relationships. “I’m working out the calculus problem, Dad! Leave me alone!”

“I don’t have attention deficit disorder; I’m just working out the cramp in my left calf.”

“Joe and Sheryl are working out their marital problems with a couple’s therapist,” but that really isn’t important. Similarly, the fact that the word “analysis” has been used to describe work in the varied fields of chemistry, business, linguistics, philosophy, mathematics, intelligence, computer science, and statistics is irrelevant. The fact that there is “aura analysis,” a term used to describe the energy field of a subject’s body, or that there is also “bowling analysis,” a notation describing a cricket bowler’s performance, is similarly irrelevant to “psychoanalysis” and 44

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the presence of the body of the patient on the couch. Besides, what do we know about cricket anyway?

I had a manicure the week before I was leaving Paris and my summer hospital internship. The manicurist cut my cuticle and my finger bled. She had been talking on the phone while she was manicuring my nails. I soaked my finger later that night but it still became infected. When I went to work at the hospital with my bandaged and infected finger the next day, a senior analyst said, “Ah! Classic castration anxiety! You are leaving us and you are sad so you somaticize hysterically.” Later that day, I asked how that was an example of psychoanalytic interpretation. The analyst replied that my defensiveness proved that it was true and that with more clinical experience, I would learn such things. A diligent student, I was able to learn that my cat allergy is my way of phobically signaling the void, my miniscus tear skiing in Aspen was a primitive attack on a frustrating breast—the fact that it was in my knee was evidence of displacement, and the cramps in my feet when I run long distances are evidence of my wish to have a baby. I am surely on my way to being cured.

The Choice of Analyst Many years ago when I was looking for an analyst in Paris, I saw several famous people whose work I had read and who had visited the United States. In the very first interview, one wanted to know what the other one had said at my preliminary interview. One asked me why a beautiful woman wasn’t married with children. One gave me a lesson on Lacan. And one told me that I should become a member of his school and train to be an analyst and that I would be accepted if I agreed to be analyzed by one of the school members.

Shakespeak The last day of class, when students performed scenes from the play, Modou from Guinea and Amanda from Mumbai did a small dance they invented to conclude their scene, a kind of Afro-Bollywood number that had the class in uproarious laughter.

“What was that?” I asked, laughing. “Why did you think of dancing at that point in the play?” I asked. “Because this class is not about Shakespeare, it’s about Shakespeak!”

Modou exclaimed as they resumed their funny dance moves in an encore to student applause. “What is Shakespeak?” I asked them, interrupting the applause. “It’s when you don’t get it—but at the same time you get something,” said Modou, stomping his feet. “No, no! It’s when you get it—but you don’t get something,” Amanda rejoined, moving her hands and shaking her hips.

We’ll stop there. z

LETTER

A Letter From Santa Fe: Retreat, Div. 39, 4/17-18/12

William FRIED

The Division 39 board held a retreat for its members and the chairs of its committees on the Tuesday evening and Wednesday prior to the annual spring meeting in Santa Fe, New Mexico. The retreat began at 5:30 pm on Tuesday with a plenary session at which the facilitator, Macario Giraldo, introduced himself and presented his credentials. He said that he was a clinical psychologist and psychoanalyst trained at the Washington School of Psychiatry, where there is a strong program in

far too large for comfortable communication, and he asked whether we might tighten it by removing some of the unused chairs and bringing the ones on which we were sitting closer together. There was some discussion of the problem this might pose for latecomers, but the group agreed that they could be accommodated whenever they arrived. Eventually the number of attendees totaled approximately 43, but a significant remnant arrived late.

general population. Macario’s third request was for an act that would show the participants’ ability to use wit and humor in their engagement with each other. Accordingly, he urged that everyone laugh heartily and aloud. Again, the group obliged. Finally, he instructed the retreaters to sing the tetradic chord a second time, apparently to express the confidence that, whatever the temporary disruptions caused by anger and wit, eventually, harmony would again prevail.

group studies in which he participated both as a candidate and a faculty member. He added that he has had many years of experience facilitating groups such as ours. He then introduced his wife, Mabelle, as his cofacilitator, and described her qualifications: an art therapist by profession, she, too, has had extensive training and experience in conducting group events. Dr. Giraldo had been introduced to the board at its January meeting in New York, where he had asked the members to reflect on their experiences as psychoanalysts “at this time in your practice; at this time in your life; and at this time in the American culture” in preparation for the retreat.

The initial large group meeting was held in a spacious ballroom at the La Fonda Hotel. The chairs had been prearranged in an oval configuration, and people sat wherever they chose. The participants engaged in a lot of greetings and informal conversation, paying scant, if any, attention to the stipulated 5:30 pm start of the session. Several minutes beyond the planned starting time, when it seemed as though the group would not, itself, assume the responsibility for beginning to work, Macario raised his voice to request attention, and delivered the information about himself and his wife described in the first paragraph.

At this point, Henry Seiden observed that the oval described by the seating was

A schedule had been distributed that specified, in addition to the sequence and timing of the meetings, how each participant would be assigned to one of four small groups, each addressing a different theme.

Group A would deal with “Diversity and Generativity”; Group B with “Power and Authority”; Group C with “PsychologistPsychoanalyst Identity Issues”; and Group D with “Practice and Survival.” There were 11 people assigned to Groups A, B, and C, respectively, and 10 to Group D. Next, Macario directed that each group repair to one corner of the large ballroom.

The groups accomplished this with little difficulty, although some stragglers had to be told where to go. Macario then indicated that he wished the groups to perform four essential exercises. The first, a demonstration of harmony, consisted of each group’s singing one note of a chord a third higher than the previous group. The result was a short-lived tetrad, akin to the sound typical of barbershop quartets, that apparently satisfied Macario’s requirement for a symbol of the participants’ harmonious inclinations. The second task involved an equally symbolic demonstration of anger and discord: Macario asked the attendees to scream as loudly as they were able and they obliged, albeit with somewhat less enthusiasm than might have been evinced by a less highly self-controlled sample of the

I was reminded of a short poem by Yeats called “The Lover’s Song”:

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Bird sighs for the air, Thought for I know not where, For the womb the seed sighs.

Now sinks the same rest On mind, on nest, On straining thighs.

It is crucial at the inception of an action that may strain the ties that bind people that they be assured of the eventual restoration of calm and order.

The initial exercise completed, the participants were directed to resume their previously heterogeneous positions in the oval of chairs. The facilitator now suggested that people speak spontaneously about their dreams, fantasies, and expectations regarding the retreat, but expressly prohibited any attempts at interpreting these. A long silence ensued, as often happens at precisely this juncture in every group experience I’ve ever attended that conforms to the model of a group relations, Tavistock, or T-Group event. Despite the avowed purpose of establishing a group culture by speaking of what comes to mind, people act—for all the world—as though they are shocked by the facilitator’s implication. They sit in thickening silence until someone ventures a remark.

LETTER

In this case, the speaker was, appropriately enough, Bill MacGillivray, president of Division 39 and initiator of the retreat, the person who had persuaded the board it would be useful to have one and whose efforts mobilized and focused the board’s resources and energies for it. Bill briefly expressed his gratitude for having found a home in the Division, which answered his need to belong to a psychoanalytic organization that harbored many disparate tendencies under the unified purpose of sustaining psychoanalysis and psychoanalytic psychotherapy and supporting their growth. He spoke of feeling privileged to have risen, by degrees, to his current position of leadership.

A few others essentially echoed Bill’s focus on the importance and significance for them of Division 39 as a place in which they felt safe, welcome, and uniquely nourished.

Laurie Wagner then remarked that, because there were people in attendance whom she did not know, it might be appropriate for everyone, in turn, to introduce themselves.

There being no immediate objection, Laurie implemented her suggestion by introducing herself, appending a short summary of the various governance positions she has occupied, first in sections, then in the Division, and finally in APA. Apparently content to do likewise, the person next to her gave a similar recitation, followed by the person next to him. The process seemed on track to complete a circuit of the oval when Macario wisely—it seemed to me—shorted the circuit and urged that the group return to his original prescription that they share their dreams, fantasies, and expectations about the retreat.

Some members responded by describing dreams about the deaths of parents, and reconciliations with them, especially mothers. A few of the new, young people said that they were pleased to be members of the group. Marilyn Metzl asserted that she’d recently attended a presentation at which people spoke about how they got their names and that doing so had stimulated some fascinating discussion. A minute or two later, I announced that my name is “K,” a disclosure that surprised all those who, in my substantial tenure on the board, have known me as Bill. I explained that my mother wished to honor her deceased father by giving me his name but was deterred by his having been called “Kalman,” a name she felt was too foreign and oddsounding for an American child. Because it was his first name, however, her sense of protocol required that it be mine. Her compromise was to give me his first initial and a derivative of his middle name, “Wolf.” Thus, “Kalman Wolf,” by a tortured and ingenious effort at translation, became “K. William.”

This situation, I continued, has consigned me to membership in a persecuted minority,

those who are forever unable to complete any form that calls for one’s first name and middle initial, as what form does not?

It has also left me with a deep and enduring identification with the protagonist of Kafka’s novels whom the reader meets as simply “K,” long before we learn that his full name is Josef K. Like him, I harbor a profound mistrust of groups and organizations and did not hesitate to voice this to my fellow retreaters. To his credit, on hearing me say this, Macario endorsed its importance for a group that, until that moment, had shown little inclination to be critical of their shared experience.

ranged location, their charge to discuss theme A, Diversity and Generativity. It will be noted that this theme had already been designated the responsibility of Group A, but, by the facilitator’s decree, was to be the focus of the initial meeting of all the small groups. These sessions were allotted an hour, after which a half-hour period of “reflection” was scheduled. Some participants requested clarification of the concept, and were told that people were at liberty to construe it according to their own interpretation.

What followed was a plenary session in which the configuration known in group parlance as the “fishbowl” was used. It consisted

My contribution was followed by those of others who spoke about their concerns for the retreat, the division, and the themes that they had been given to explore. At 7:00 pm, Macario ended this introductory session and the group repaired to another room for dinner. The atmosphere was convivial, and unlike many group facilitators, Macario and Mabelle joined us for dinner and engaged with us quite spontaneously.

The next morning each of the four groups held a separate meeting in a prear-

of two concentric ovals, the inner composed of Group A on one side and Group B on the other; the outer was likewise composed of Group C on one side and Group D on the other. Two members of Group A were asked to communicate their group’s findings to Group B, who were asked to respond to these communications with questions. The process was then reversed, with two members of Group B now sharing the findings of their group with Group A, whose members were to ask questions. Groups C and D, from

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their position in the outer oval, were given the task of commenting on the process they were observing in the inner oval.

The proceedings I have just described were repeated later in the day: small group meetings were followed by large ones in which the morning’s positions were reversed, with Groups C and D in the inner oval, and A and B in the outer. Lunch was served between 1:00 pm and 2:30 pm, and there were half-hour periods of “reflection” between most meetings. The two facilitators, Macario and Mabelle, visited each of the small group meetings, making occasional observations and suggestions. At the

During the final half hour, from 6:30 pm to 7:00 pm, people shared their reactions to the retreat with considerable unanimity.

They described feeling pleased with the substantive focuses and outcomes and gratified at the emotional and relational effects. Even those who’d expressed initial skepticism had changed their minds and now thought the idea to have been highly worthwhile. My first inclination was to be quiet, but in the end, I asked for the microphone and offered my opinion that the value of such a retreat tends to be a function of the degree to which the participants are willing to risk regression to get to the issues underlying the decision

The very next day, Thursday, the Division 39 board held its regular all-day meeting beginning at 8:30 am in the Inn at Loretto, a locale separate from the La Fonda, where the retreat had taken place.

Perhaps the planners had anticipated the advisability of interpolating an appropriate boundary between the two activities, or maybe it was nothing but a logistical desideratum. However that may be, the distance did not turn out to be sufficient to prevent contamination of the board meeting by the pathogens stirred up during the retreat.

Item 1 on the board’s predistributed agenda was “Welcome and Call to Order: Dr. MacGillivray.” Bill did call the meeting to order but then, in an extraordinary divergence from the agenda, proceeded to explain the meaning of his own name and to elaborate on the family circumstances that led to its being given him. His rationale for doing this, though not entirely clear, seemed to be to convey something of the diversity of his history and background.

The “Summary of the Retreat” he sent to the participants afterward begins with an item that illuminates his intentions further, albeit retrospectively. He wrote, 1. Diversity starts with the individual, with our stories: recognize our “individual” diversity and multiple identities.

2. Have our stories, our journeys, part of our communications, not only of our “stars” [quotation marks his].

final large group meeting, two representatives of each small group sat in the inner oval and conducted a dialogue with the others while everyone else sat in the outer oval. After this, all of the participants were asked to sit in a single large oval, as they had at the inception of the exercises the night before. In fact, there was a remarkable and, no doubt, deliberate symmetry to the entire structure of the experience, one that recalls the return to harmony after discord/ anger, and wit/humor.

to have the experience. By this criterion, I said, the retreat was not a success. As after the comments I’d made about my name, Macario seemed to nod a confirmation.

But no one took up my dissent, and the working session ended in an ambience of harmony apparently deemed desirable, if I were to judge by Tuesday’s overture. The group left the ballroom for the more festive environs of a reception where they were able to eat, drink, and engage with each other nonprescriptively.

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Thus, he seemed motivated both to tell something of his story and to render it of equal importance to those of our “stars,” by which I presume he means the luminaries of our profession who have name recognition and are likely to draw crowds when they present at conferences.

Wittingly or not, he also gave tacit license and approval for the other board members to do likewise, and they did so unhesitatingly. No sooner had Bill finished his précis, than the person on his left began hers, and after hers that of the next person, and so on, until all of the 40-odd board members had given renditions of their own.

Moreover, few of these equaled the brevity of Bill’s account: the narratives seemed rather to become longer with each successive person and finally leveled off at about two minutes each. By the time everyone around the conference table had taken a turn, the clock read 10:30 am, and nothing on the official agenda had been addressed.

Although the board then proceeded to attend to the items on its agenda with efficiency and dispatch, adjourning an hour earlier than scheduled, the singular and spontaneous event that had occurred first

LETTER

thing in the morning was barely mentioned either during the remainder of the meeting nor among board members who spoke with each other in the course of the conference.

Clearly, however, something momentous had happened, the more dramatic for the peculiar absence of analysis and elaboration that characterizes the intercourse of the members, both as a board and as psychologists/psychoanalysts. It was as though they had enacted a conflict that could not be thought about or reflected on, and it had subsequently, stealthily, and quickly slid back under the radar of consciousness.

To some of my closer colleagues on the board I suggested that the universal sharing of personal data and experience that had taken place had been a response to unfulfilled hopes and expectations stirred by the retreat and that these had been largely unconscious. It was these to which I had referred in my comment at the final plenary session about the failure of the group process to provoke the degree of regression that is necessary to attain the optimal outcome for such an experience.

I should add here that I was not entirely surprised by Bill MacGillivray’s starting the board meeting by explaining the meaning of his name and the circumstances of his acquiring it, for he’d previewed this revelation in a remark to me over lunch on Wednesday.

It was an apparent response to my discussing my own name at the initial plenary on Tuesday evening. I seem to have stirred a response in Bill that was of sufficient cogency to motivate his comment to me and, in the interval between it and the board meeting, to endow the idea with enough force to impel Bill to preempt the written agenda in order to give it voice and priority.

That the theme (thus carried from Marilyn Metzl’s mentioning the presentation she’d attended at which people spoke about how they’d gotten their names; to my speaking of my name; to Bill’s comment to me and then to the entire board, about his; and finally, all the board members’ explication of theirs) was names suggests that there was a profound, unmet need for recognition among the participants in the retreat. Why this would be so, and why at this time, are subjects for fruitful speculation.

One possibility is that the recent explicit emphasis on the recruitment and maintenance of a younger, more diverse membership to carry the work of sustaining and growing psychoanalysis into the future may have provoked a latent fear of effacement and loss of status among the majority of board members, an entrenched old guard. Another consideration is that many board members may harbor an unconscious envy for what Bill MacGillivray, in his summary of the retreat, referred to as the “stars” of our profession, whose names are instantly recognized

because they are associated with records of achievement. As those responsible for the governance and structuring of the division, the board members might see themselves as an anonymous support system for the public platforms on which the “stars” make their acclaimed and well-attended appearances.

If the latter observation has any validity, it would derive from the oft-noted conflict between bureaucratic and charismatic predilections to which systematic attention was first drawn in the writings of Max Weber. The power and influence of charisma is rooted in an individual’s personal gifts and requires no official sanction or approval. The power and influence of bureaucracy is attained by such legitimate means as election and due process. Looked at in this way, people become “stars” by virtue of their gifts and need not answer to constituted authority, whereas constituted authority (in this case, the board) must answer to its constituency and uphold the structures of the organization. That tensions should exist between the two should come as no surprise. It should also come as no surprise that, for complex reasons, these tensions might be hidden.

At another level, we can recall that people who work closely together—as the board does—have difficulty when their underlying conflicts (which may be conceptualized as Bionian basic assumptions) are neglected.

They can obstruct and sabotage the work of the group fatally if not addressed. The retreat should have had this objective, but instead it took the form of something conceptual and substantive, an intellectual defense of the sort that is entirely congenial for so highly intellectualized and intelligent a group.

In this situation, the need for recognition was the tip of the iceberg, only a precondition for the work of confronting the basic assumptions. Thus, the outpouring of personal material was an expression of the need to begin such a process, but also the implicit acknowledgment of the resistances to doing so and the absence of opportunity.

It will be recalled that when Laurie Wagner had proposed and initiated a prototype of the personal go-around that later occurred at the board meeting, the process was curbed by Macario. He correctly foresaw that its continuation would have constituted a simulacrum of work that, in effect, would serve to delay and perhaps ultimately subvert the actual work of engagement to share expectations, dreams, and fantasies. During the board meeting, but more pointedly, at the retreat, the participants embodied the supreme irony of a group of psychoanalysts and psychoanalytic psychologists who do not want their resistances analyzed, or their unconscious conflicts exposed.

Parenthetically, I would surmise that as an experienced and sensitive facilitator and 48

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psychoanalyst, Macario must have gauged and been guided by the group’s disinclination for regression and exploration of underlying conflicts, and decided to respect the group’s implicitly conveyed limits. In this, he was acting the good analyst who defers in the face of strong resistance.

I’ve already discussed the theme of peoples’ names as it arose in the retreat and the board meeting. Another such pervasive motif was that of home. Among the attendees there was frequent reference to Division 39 as a place where people felt at home or, alternatively, where they had found a home in which they felt comfortable, welcome, and safe. The unspoken subtext to this theme is that home is the domain of family and that families are, at best, a mixed blessing.

They frequently oscillate between function and dysfunction and their agendas are often occult. As a result, finding a home—even in asylum—is never without its own attendant perils. The danger derives from the tendency of those who view the second home as reparative of the first, to forget that conflict is as relational as breast-feeding. It must not be ignored that, after the Fall, the serpent, too, was expelled from Eden, to ply a profitable trade among the sons and daughters of man. Even those who believe that the Savior brought the wherewithal to expunge the effects of original sin are painfully aware that life after rebirth is just as fraught and treacherous as it was the first time around.

Another recurrent theme of the retreat was that of the death of parents, especially mothers. One possible interpretation of the material in which this theme was manifest is that the participants in the retreat, people for whom Division 39 holds a deep meaning as a home, also view it as an alma mater (a nourishing mother), and are afraid that it is dying. If, in fact, it is, the principal cause of death may be none other than the unconscious conflicts among its members that have become irreconcilable because they have been placed beyond the reach of intervention. Moreover, the board appears, unconsciously, to have conflated Division 39 with psychoanalysis itself, and so their fears for its demise are experienced as the peril of the imminent death of the entire field.

Division 39 is a group of people interested in psychoanalysis. Psychoanalysis is, among other things, a methodology for gaining access to experiences of inner strife and conflict for the purpose of alleviating the strains, contradictions, self-delusions, and contortions of spirit that threaten to diminish and deplete lives. The board of an organization that represents such a praxis should, in my view, embrace the necessity to apply it to its own functions and operations. I think we have been remiss in doing so both during and after the retreat. z

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Letter To the Editor: Something is missing in the discussion about “the crisis in psychoanalysis.” Namely, which psychoanalysis are we talking about?

We do not have one psychoanalysis as before.

There is also no denying that the fancy names of the contemporary schools of psychoanalysis have produced theoretical rebuttals of the Freudian doctrine but no comprehensive theoretical replacements. Those theories do not have a model of development (necessary to refer psychopathology to a point of fixation or repetition compulsion) or a system of diagnosis based on their theoretical premises (to connect theory with technique) to claim the right to BE psychoanalysis.

This is not the problem; this is the symptom of a problem. The problem is that Freud left us two theories. The one we are familiar with is an extension and elaboration of the catharsis theory, which is based on the repression of unacceptable urges, ideas, fantasies, etc. The other is what he discovered from listening to his patients’ associations, but did not articulate in a final form. Just to mention some of its features: between 1900 and 1905 he discovered the working of the

primary process, infantile sexuality and the function of the after-effect, Trieb and mental representation and the system Ucs. Between 1913 and 1915 he discovered the formative process of identification (not a pathological mechanism), narcissism as the replacement for the libido theory, and revised, in a major way, the three concepts of Trieb, the unconscious and repression (wrongly assigned as papers on metapsychology: they are papers on psychology). He remained captive of the useless framework of the theory of catharsis and nobody dared to criticize it while he was alive.

After his death the situation of psychoanalysis unraveled: a flawed articulated theory of catharsis and a flawless theory of psychoanalysis that is waiting to be articulated.

The disintegration in our indiscipline with the controversies in Great Britain, the splits in France and the collapse of ego psychology in the US created the need for substituting Freud’s authority with the authority of the institution: an authority that has no real foundation in the form of a defined theory, therefore it had to invent rituals, rules, hierarchies, and other paraphernalia to sustain itself…and farewell to substance.

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The unbehagen in psychoanalysis is stemming from the honesty of the young idealizing generation who discovers that they did not learn enough, train well, guided and supervised properly. I know that from experience. When I was teaching in The Montreal Institute and the other branches of the Institute, the candidates expressed their disappointment that the first two years that were dedicated to Freud were not enough. Some who knew better asked for studying some of the French works because they wanted to learn of the “other” things about Freud.

My take on the matter is that because Freud’s real theory of psychoanalysis is lying there in his text unspecified, psychoanalysis has become sclerotic with the remnants of the theory of catharsis. A new generation of training and supervising analysts who are in charge of the institutes at the present time, and the institutes of the “contemporary” institutes have a very poor conception of the Freudian doctrine and are doing a bad job teaching and supervising. Could that defect be remedied: yes but only when we agree to put our cards on the table: which psychoanalysis are we talking about? z Ahmed Fayek, Ottawa, ON

T O

F R I E N D

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Announcements The Johanna K. Tabin/Division 39 Book Proposal Prize for a First Book by a Psychoanalytic Author Division 39 and APA Press are delighted to announce the fifth annual prize for a first book by a psychoanalytic author.

The winner receives a $1,000 cash prize, certificate of recognition, and guarantee of publication by the APA Press. The aim of this prize is to encourage psychoanalytic writing by Division 39 members who have yet to publish a psychoanalytic book. We look for good writing, originality, as well as clinical and scholarly relevance. While some previously published material may be included, the proposed book should consist primarily of new work and promise to be an original and coherent monograph.

Edited collections of previously published papers are not acceptable, nor are edited volumes of contributions by more than one author. Simultaneous submissions to other publishers will disqualify the entry.

The proposal should consist of: 1) a cover letter to include the author’s identifying and contact information 2) a full CV 3) a statement of sufficient length to describe the mission, scope, and potential contribution of the project to psychoanalysis 4) a table of contents; and 5) one, and only one, sample chapter.

Submissions are accepted in hard copy only and must be in quintuplicate. Blind review evaluations are conducted by the Book Proposal Committee, the editor of APA Books, and an Honorary Judge.

All submissions for the 2013 award must be submitted by December 31, 2012, to: Book Prize Division of Psychoanalysis 2615 Amesbury Road Winston Salem NC 27103 Questions should be addressed to: Frank Summers, PhD, ABPP by email: Franksumphd@gmail.com

The Power of Witnessing: Reflections, Reverberations, and Traces of the Holocaust—Trauma, Psychoanalysis, and The Living Mind NEW YORK BOOK LAUNCH, January 27, 2013 Nancy R. Goodman, PhD and Marilyn B. Meyers, PhD (ed/writers), Routledge Press, 2012 Date: Sunday January 27 Time: 2:30-4:30pm Location: Museum of Jewish Heritage, 36 Battery Place, NYC (downtown, www.mjhnyc.org) 51

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NON-PROFIT ORG. U.S. POSTAGE PAID Washington, D.C. Permit No. 6348

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750 First Street, NE Washington D.C. 20002-4242 Forwarding Services Requested

NOTES ON CONTRIBUTORS Steve Axelrod, PhD, practices psychotherapy and psychoanalysis as well as organizational consultation in New York City. He is a graduate of the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis. Steve initiated the Practice Survey in 2008, has been active in a number of division-wide efforts to advance the profession, and is a Contributing Editor to DIVISION/Review.

Alan Bass is practicing analyst in New York City, and is a training analyst and faculty member at IPTAR and the Contemporary Freudian Society. He is the author of two books (Difference and Disavowal: The Trauma of Eros and Interpretation and Difference: The Strangeness of Care), many articles, and the translator of four books by Jacques Derrida. He also teaches psychoanalysis in the graduate Philosophy Department of The New School for Social Research.

William Fried is a clinical psychologist and psychoanalyst in addition to a photographer. Dr. Fried is a member and on the faculty of the Institute for Psychoanalytic Training and Research and is past president of Section 1 Division 39, PsychologistPsychoanalyst Practitioners. He practices psychoanalysis and psychotherapy in Manhattan. He is a contributing editor of DIVISION/Review.

Melinda Gellman is a psychologist and psychoanalyst in private practice in New York City. She is affiliated with the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis and teaches at the Institute for Contemporary Psychotherapy

Robert M. Gordon, PhD, ABPP, is Board Certified in Clinical Psychology and Psychoanalysis in Psychology.

Sue Grand is in private practice in NYC and

at Adelphi University. Dr. Bornstein has published widely on personality dynamics, diagnosis, and treatment. His research has been funded by grants from the National Institute of Mental Health and the National Science Foundation, and he received the American Psychological Association’s 2005 Theodore Millon Award for Excellence in Personality Research.

Teaneck, NJ. Dr. Grand is on the faculty at the NYU Postdoctoral Program in Psychoanalysis; faculty at the Mitchell Center for Relational Psychoanalysis; Visiting Scholar at the Psychoanalytic Institute for Northern California; and Visiting Scholar at the NYU Trans-disciplinary Program in Trauma and Violence. She is the author of The Reproduction of Evil: A Clinical and Cultural Perspective and The Hero in the Mirror: From Fear to Fortitude.

Marilyn Charles is a staff psychologist at the

Mary Libbey is a faculty member and supervisor

Austen Riggs Center and a psychoanalyst in private practice in Stockbridge, MA. Marilyn has presented her work nationally and internationally, publishing over 70 articles and book chapters and four books: Patterns: Building Blocks of Experience, Constructing Realities: Transformations Through Myth and Metaphor, Learning from Experience: a Guidebook for Clinicians, and Working with Trauma: Lessons from Bion and Lacan.

at the NYU Postdoctoral Program in Psychoanalysis and Psychotherapy and a faculty member and training analyst at the Institute for Psychoanalytic Training and Research. She is in private practice in New York City.

Robert F. Bornstein is Professor of Psychology

Andrew B. Druck, PhD, ABPP, is a Fellow (training and supervising analyst), past President, former Dean of training, and faculty member at the Institute for Psychoanalytic Training and Research (IPTAR). He is a clinical assistant professor of psychology, faculty member, and supervising analyst at the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis. He is the author of Four Therapeutic Approaches to the Borderline Patient and editor, along with Carolyn Ellman, Norbert Freedman, and Aaron Thaler, of A New Freudian Synthesis.

Jennifer Durham is a certified School Psychologist and is on the Faculty of the Derner Institute at Adelphi University. Dr. Durham is the author of many articles and presentations in the area of Social Justice in Mental Health.

Bettina Mathes, PhD, is a Manhattan-based writer and culture critic. She is the author of numerous books and essays including most recently Psychoanalysis Interruptus (Psychoanalysis, Culture & Society 2011); her book Verschleierte Wirklichkeit (Veiled Reality) won the Prize “Best Book in the Humanities” in 2008. She teaches at The School of Visual Arts.

Donald Moss, MD, is in the private practice of psychoanalysis and psychotherapy in NY. He is on the faculty of the Institute for Psychoanalytic Education, NYU Medical Center, and author of numerous articles over the past 25 years, and on the Editorial Boards of JAPA, Psychoanalytic Quarterly, American Imago, DIVISION/Review, and Studies in Gender and Sexuality. His most recent book is entitled 13 Ways of Looking at a Man Routledge.

Ona Nierenberg, PhD, is a psychoanalyst practicing in New York and aclinical psychologist working at Bellevue Hospital Center. She has published articles on psychoanalysis, sexuality, and the 52

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discourse of science, as well as on licensing and the question of lay analysis. She is a member of Apres Coup Psychoanalytic Association.

Bruce Reis is a Clinical Assistant Professor in the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis, and a visiting faculty member at several psychoanalytic institutes in the United States. In addition to practicing in Manhattan, Dr. Reis lectures internationally, and serves on the editorial boards of numerous psychoanalytic journals. He is a member of the Boston Change Process Study Group.

Jill Salberg is faculty and clinical consultant at the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis and the Stephen Mitchell Center for Relational Studies. She has written on Freud, gender, termination and the intersection of psychoanalysis and Jewish studies. She is a contributor and the editor of the book Good Enough Endings: Breaks, Interruptions and Terminations from Contemporary Relational Perspectives.

Manya Steinkoler, PhD, has done analytic training and clinical work in Paris. She is a professor of literature at BMCC, an analyst in formation at Après Coup, and is in private practice in New York City.

Frank Summers, PhD, ABPP, is president of Division 39 (Jan 2013), clinical professor at the Feinberg School of Medicine, Northwestern University, a supervising and training analyst at the Chicago Institute for Psychoanalysis, and a faculty member of the Chicago Center for Psychoanalysis and several other psychoanalytic institutes. Winner of several teaching awards and more than 40 papers in professional journals, his fourth book, The Psychoanalytic Vision, is due out in early 2013. Dr. Summers maintains a private practice of psychoanalysis and psychoanalytic psychotherapy in Chicago, Illinois.

Sherwood Waldron is a psychiatrist and psychoanalyst from New York, who first studied outcomes of childhood neurosis into adult life with a control group 40 years ago. He formed the Psychoanalytic Research Consortium (PRC) as a vehicle for the collection, safeguarding, and distribution of audiorecorded psychoanalyses and psychotherapies. Dr. Waldron and his group have developed the Analytic Process Scales, new scoring methods to use the Shedler Westen Assessment Procedures to evaluate change, and Dynamic Interaction Scales to assess relational aspects of treatments.

Martin Winn is a Lacanian psychoanalyst practicing in New York. He is an analyst, supervisor, and member of Après-Coup Psychoanalytic Association. As a member of the Après-Coup faculty, he conducts a yearly workshop in the Après-Coup Formation Program Foundation Series.