UNFREE ASSOCIATIONS
INSIDE PSYCHOANALYTIC INSTITUTES
by Douglas Kirsner
[ Contents | Chapter: | 1 | 2 | 3 | 4 | Conclusion | Bibliography
Conclusion:
The trouble with psychoanalytic institutes
Conflicts, problems and even scandals have damaged these psychoanalytic institutes. However, as we have seen, many of the conflicts ultimately found some form of resolution. The NYPsaI has become far more open, democratic and pluralist. The BPSI managed constructive relationships with its breakaway institute and both have prospered. The CPsaI became much more democratic and open. LAPSI and the APsaA came to live with theoretical differences which for a time, locked them in seemingly irreconcilable conflict The APsaA has itself become considerably liberalised and open to questioning received assumptions. In the face of urgent pressures both from the outside world and from within the institutes, many analysts persisted and ultimately achieved considerable reforms. However, in my view, these changes were achieved despite intrinsic problems that remain at the heart of psychoanalysis and its institutions. The detailed histories of the institutes differ in many ways: the region, personalities, institutional structure, local flavour, and other factors make for the considerable variety that I have explored in each instance. In this chapter, I want to explore the fundamental themes around which I believe these various histories all revolve. I argue that despite the reforms that have taken place, the underlying problems have not changed.
We have seen that issues concerning the right to train are crucial determinants in psychoanalytic controversies. An excellent heuristic device for understanding trouble in psychoanalytic institutes could be: 'Search for the training analyst problem!' But why training? In many other disciplines, it is easier to find more public and objective data to settle issues. However, psychoanalysis is different, partly because of the kinds of deep philosophical and religious questions raised by the psychoanalytic search and metaphor. Answers to questions about the nature of the self, the mind, emotions, relationships, and human nature are not quantifiable, or easily classified and standardised. They are often experiential, subjective, uniquely individual, interpersonal and philosophical. The nature of this complex field is suffused with uncertainty and ambiguity.
As we have seen, psychoanalysis is far more than a field of academic exploration; it is a movement and therapeutic endeavour. These aspects of feed back to the intellectual discipline. Psychoanalysts make claims to therapeutic knowledge and their institutions qualify practitioners. But what is the basis of these qualifications? Given the nature of the discipline and the level of knowledge within it, I would argue that the claim to knowledge implied by qualification is far greater than the real level of knowledge. Instead of facing this central issue, analysts often substantiate the knowledge implied by qualification in terms of anointment. Writ large in the history of the New York Psychoanalytic Institute, anointment is present in all the others as significant factors in their development.
A major aspect of the problem, as I observed in the Introduction, is that a basically humanistic discipline has conceived and touted itself as a positivist science while organising itself institutionally as a religion. This fundamental misunderstanding has had serious conceptual and institutional ramifications that have impaired the development of the field. Analysts often approach psychoanalysis with an inappropriate paradigm, 'as if' it were a science on the model of the natural sciences, or a religion. But as a number of psychoanalytic theorists have argued-among them, Christopher Bollas and Joyce McDougall-psychoanalysis is not a science, and its findings are not scientific in any recognised sense of the word. We might speculate that the part played by analysts in fostering their discipline's present-day decline may well reflect a systemic misconception of their own discipline, and the resultant, widespread creation of what Bollas termed a 'false expertise'.1 It becomes problematic when analysts approach psychoanalysis with an inappropriate paradigm, 'as if' it were a science or religion.
(I)
Psychoanalytic training is unusual in that it does not take place in universities-as is the case with psychology and psychiatry-but in its own institutions which are supposed to serve not only training but research functions. Because Freud was not enamoured of the university, psychoanalysis was domiciled in autonomous, free-standing institutes and societies. Psychoanalysts kept away from involvement with universities or other public institutions, preferring to lord over psychoanalysis themselves. In this respect, psychoanalysis bears a structural resemblance to a political movement or a religion, a parallel Freud encouraged.
Since Freud identified psychoanalysis with his own beliefs, those who disagreed with him, from Jung to Ferenczi, were often forced to leave the fold. Beginning with Freud, psychoanalysts insisted on calling their field 'our science'; they kept themselves isolated with strict boundaries as to whom they would allow in. As Freud pointed out in The Interpretation of Dreams, he had always divided people into his hated enemies and his brothers. He wrote that his 'emotional life has always insisted that I should have an intimate friend and a hated enemy'.2 This foreshadowed later attitudes in psychoanalysis. One of Freud's analysands, Roy Grinker Sr., pointed out:
Faith in the 'great man' is the impetus for the beginning of a 'movement'. It is also responsible for exclusion of nonbelievers, as Freud's Vienna group forced him to do to some members of the Swiss psychoanalytic society, over Bleuler's protests, and which caused that great psychiatrist to withdraw his support of the psychoanalytic movement. It is responsible for Freud's writing to Ferenczi not to be troubled with other theories for, 'We possess the truth'. It is questionable whether any other young science even as an early movement was as cultist, as self-contained, and as mystically oriented.3
Freud made adherence to his principles especially important, with the consequence that psychoanalytic education became over the years akin to a process of anointment. In ways reminiscent of the injunction cited in Exodus-"Then shalt thou take the anointing oil, and pour it upon his (Aaron's) head" (Exodus. 29:7)-this subjective process, like a modern-day rite of consecration, has allowed those analysts deemed good enough to be the 'real' psychoanalysts to anoint in turn their own candidates and trainees. It is no surprise, then, that the persistence of this self-perpetuating method for the transmission of knowledge has played a significant role in most institutes since the very dawn of psychoanalysis.
Anointment was well in place, in fact, already in 1911, when Freud appointed a secret organisation, the so-called 'Committee,' to safeguard psychoanalysis against its enemies. In 1913 Freud gave its members rings. He was seized by Ernest Jones' idea of a 'secret council composed of the best and most trustworthy among our men to take care of the further development of psychoanalysis and defend the cause against personalities and accidents when I am no more'.4 Freud's role in the setting up of orthodoxy within the psychoanalytic movement is quite ambivalent; he both resisted rigid adherence to ideas, constantly revising his own ideas throughout his life, while he fostered orthodoxy in his attitudes to the rise of the movement and his treatment of those who disagreed with him.
From early on, psychoanalysts conceived of their field as an inner sanctum of sorts, to which admission has always been highly selective and where the 'science' of psychoanalysis could be fashioned and preserved in near-splendid isolation. Even in the heyday of psychoanalysis in the United States, in the 1950s and 1960s, when half the chairs of university departments of psychiatry were analysts, the institutes of which they were members called the tune. The authoritarian, sometimes cultish approach that closed off the outside world did not reduce the appeal to the many psychiatrists and patients who were banging loudly on analytic doors. Unwilling at the time to have their analytic gold diluted with the psychotherapeutic copper of psychologists, social workers and the like, psychoanalysts remained content to develop what they called 'our science' behind the walls of their own institutes.
But psychoanalysis is not an established science. It is not a unified body of information from which derives a unified practice that can be readily and empirically tested. In point of fact, and by almost any account, psychoanalysis is an experiential, subjective, personal and interpersonal exploration for which there are no validating objective criteria. If anything, psychoanalysis is about unknowing, about the unconscious which is not known, about the uniqueness of individual discovery. In a way, this contradicts the very possibility of qualification from a psychoanalytic institute, since 'qualification' implies transmission and mastery of a body of knowledge consensually acknowledged as such. In the absence of such a consensus, then, psychoanalytic education has come to depend on the justification of its truth claims through authoritarian approaches reminiscent, as I've suggested, of some organised religions rather than through the kind of open, critical inquiry which, at least in theory, can take place in universities. Rigid, authoritarian, and closed to new ideas, the mainstream of psychoanalysis-itself often fiercely divided along the lines of the narcissism of minor differences-has generally regarded the world as heathens who disagree with 'our science' because they cannot or will not understand.
Historically, then, it has been a hallmark of much psychoanalytic education for mystification to transform illegitimate power into irrational authority. Secrecy and lack of detailed public evidence have long fostered opportunistic practices of anointment.
(II)
The history of the psychoanalytic profession is rife with schisms, as Joyce McDougall aptly illustrates in an article entitled "Beyond Psychoanalytic Sects," from her book, The many faces of Eros.5 Moreover, in line with my contentions concerning the doctrinaire training practices of institutes, McDougall has recently stated:
I think our greatest perversion is to believe we hold the key to the truth... Any analytic school who thinks this way has turned its doctrine into a religion... when we make our particular psychoanalytic theories into the tenets of a faith, then we're restricting our whole capacity for thinking and developing... But what is our insecurity? Perhaps it's partly determined by the transmission of a psychoanalytic education which is largely based on transference: the attachment to one's analyst, as well as to supervisors and teachers, is permeated with strong transference affects. This may result in the idealization of thinkers and theories as well as leading to the opposite-the wish to denigrate them. But I guess this is part and parcel of the history of psychoanalysis and something we must strive to understand.6
The profession's penchant for idealisation originates, unequivocally, with its very founding, as psychoanalysis has always been synonymous with the figure of Freud-who identified himself with psychoanalysis and psychoanalysis with him.7 In a feedback system of sorts, whereby Freud's own sense of being destined for greatness was enhanced by the quasi-mystical power that is inevitably conferred on those of courageous vision and unflagging determination, he exercised a commanding appeal over those around him. And while the scope of his explorations and insights have yielded one of the most far-reaching and systematic understandings of the human condition ever propounded, it is Freud's role as a codifier that has driven psychoanalytic training and psychoanalysis as a movement. His own patriarchal and charismatic example-in a field where no single paradigm of achieved knowledge has ever generated assent-has served as a model throughout much of the history of psychoanalytic training. Suffice it to think of the power and influence exerted by the figure of Jacques Lacan in recent decades, or of the contentiousness that still animates, after nearly fifty years, relations between Kleinians and Freudians in Britain. As McDougall suggests, however, the model of idealisation/denigration is a pervasive and, indeed, a structural one. It is by no means limited to the loftier and more influential stages of psychoanalytic politics world-wide, but finds a correlate in the day-to-day life and management of even the smallest and most inconspicuous of institutes or training centres. Training issues are everywhere and routinely resolved by fiat. Passionate power struggles, on the model of those between Freud and Jung, or between Anna Freud and Melanie Klein, or between Lacan and the IPA, have always been ubiquitous, and can elicit a zeal that rivals forms of the most uncompromising fundamentalisms.
Today, where training is concerned, most psychoanalytic disputes involve mythological 'standards' based more on passed down versions of the truth than on the examination of evidence. Psychoanalytic concepts are not univocally defined, and in consequence of this are the source of often raucous debate. Even members of the same schools are often deeply divided about their approaches. What is the nature of the body of knowledge to be transmitted in the training? Given that there are no agreed-upon definitions and approaches, no agreed-upon 'unit of measurement' in psychoanalysis or agreed way of measuring it, its status as a developed science is questionable. As Christopher Bollas and David Sundelson suggest in their book The New Informants: "It will take a long, long time indeed for psychoanalysis to come to anything like a convincing definition of itself." At the same time, however, there is, as Bollas and Sundelson assert, the creation of a 'false expertise' among psychoanalysts. "By assembling colleagues who agree with them and with whom perhaps, they can write books on a clinical topic, psychoanalysts can create the illusion that true science has taken place. But technical papers, conference appearances, and statistics about patients presumably suffering from a given syndrome are the trappings of expertise, not the substance." 8
(III)
Many socio-economic and historical explanations have been offered for this behaviour. But I want to propose another which I believe goes to the heart of the matter. My suggestion applies to psychoanalytic institutions but has general ramifications on the institutionalisation of ideas in professions that demand qualifications from an unreal knowledge-base.
A qualification certifies that a person has been trained to be fit or competent to perform a given task. In the psychoanalytic profession, a graduate of a psychoanalytic training program is certified as competent to perform therapeutic psychoanalyses. This implies that the graduate is competent in the application of a learned body of knowledge. The concept of qualification depends on the idea of a legitimate body of knowledge that is transmitted through training conferring expertise and competence. In psychoanalysis this is the work of Freud and his followers in theory and technique, and much of what is taught is regarded as established truth. Freud did not see psychoanalysis as a profession, i.e. as an organised group of qualified practitioners. Today, however, psychoanalysis is a profession, often with quite rigid, formalised requirements Graduation requires a good deal of tenacity, sacrifice, commitment and perspicacity. Psychoanalysis as a profession involves clients who trust in some esoteric knowledge of the practitioners. There is a presumption of knowledge and skill in qualification, and clients consult on the basis of the presumed competence conferred by professional training. Institutes of psychoanalysis act as gatekeepers for the profession and attempt to ensure 'quality control'.
A clue to the problems in psychoanalysis comes from asking a further question-why do disputes surround training issues? This reason stems from a contradiction between the nature of the psychoanalytic field and that of the training of practitioners. This is the case whether psychoanalysis is a science or an art. If it is an art, then what is it doing in a seminary or trade school with an ersatz body of knowledge to be stamped as having been inculcated in a qualification? If it is a science, then where are the public evidential support, protocols, units of measurement and criteria which is demanded by science? And where is the agreed-upon body of knowledge to be applied for training in the practice? In any case, if it is a science, it is a young one with at best few established truths. If it is an art, then the differences between individual analysts and patients cannot be standardised, quantified or readily measured.
Since there is scant agreement about anything in detail, how can analytic 'standards' be other than a myth? Outside of anointment, what can be the meaning of a 'qualification' in psychoanalysis? Where qualification is not based on a real body of knowledge, disintegration products abound, leaving the way open for the rule of power plays, anointment, cultism, personality, psychopathology and politics. Power plus mystification gives rise to irrational authority in the form of anointment. There is a folie à deux here. Mystification serves the immediate emotional needs of everyone in the system for an answer, for a putative certainty that can establish a qualification as real. It thus inspires some collusion on the part of candidates. In this situation qualification derives from an authority in training dependent on a claim to knowledge that is unwarranted and is thus suffused with mystification. I believe that the way that this atmosphere of anointment has persisted in psychoanalysis has been through the medium of the training analysis and the appointment of those who have the right to train. These issues have always lain at the heart of all analytic disputes.
Before the 1920s psychoanalytic training as such did not exist. Analytic societies were scientific clubs with no accredited schools or curricula. The approach to teaching was student-centred, flexible and individualised. In fact analytic training originally took one to one and a half years.9 Freud's recommendation for a personal analysis included analyses which might have lasted only a few weeks. Freud himself, in fact, did not insist on personal analysis as a prerequisite to practice.
The mandate in the 1920s for a personal analysis as part of analytic training should thus be seen within a context in which the analysis was potentially short and relatively non-intrusive. It was didactic, more in the nature of a sampling of analysis. Nonetheless, there were strong and principled arguments against mandating even this exercise on the basis that personal analysis should be left up to the candidate and should not be connected with an Institute.10 Along these lines, we might consider how a personal analysis was not a requirement in the New York Psychoanalytic Society until 1937 when, in reaction to an influx of unanalysed training analysts from Europe, it only then became a fixture of training.
Generally speaking, it is important to remember that the relatively small numbers of faculty and students involved with early training meant that everyone knew or knew of one another. Institutes were separate and part of a loose federation of analytic institutes which got together mainly for scientific congresses. These informal structures starkly contrast with the later enormous institutionalisation of psychoanalysis. They gave way to very formal psychoanalytic organisations with complex rules and regulations for training in accredited institutes. For example, with its regulations, site visits and accreditation of individual institutes the International Psychoanalytic Association is the only international professional organisation that sets standards for individual countries and members. The American Psychoanalytic Association is a component member of the IPA but has special status in organising its own training standards. It is a national certifying organisation that, at least in theory, controls and regulates its individual component institutes and their training through its myriad formal committees and regulations.
With Hitler came the changes to the ecology of psychoanalysis throughout the world and the epicentre moved to the US. With this move and the rise in the fortunes of the psychoanalytic movement came increasing institutionalisation. As psychoanalytic historian, Sanford Gifford observed,
Our so-called American character also brought to the analytic movement our inveterate passion for Robert's Rules of Order, for writing and rewriting constitutions and by-laws, and for generating committees within committees within committees. Although we have created a vast psychoanalytic empire, we may well ask whether there is some relation between our enormous consumption of energy in organizational activities and our rather exiguous theoretical output. Our foremost American analysts have produced a substantial literature of commentary on classic texts, elegant exegeses and magnificent clinical applications, but for theoretical innovations we have always been dependent on the work of émigré analysts. (Erikson, Rapaport, Mahler, Kohut, Kernberg).11
While anointment clearly played an important role in the early days, there was little else about training that was set in stone at that time. Freud was alive and served as referent, model and mentor; just as importantly, he was also known to change and revise his ideas constantly, in a search for truths that precluded premature ossifications of theory. Moreover, analyses were short, and there was, as yet, no fixed body of knowledge that was passed down as absolute truth. For all of its flaws, the early life of psychoanalytic societies was not as mystified and oppressive to its students and members. It encouraged-indeed, presupposed-a shared commitment to the energetic development of the field, a field of inquiry which went well beyond the therapy.
It is, of course, important not to romanticise the early days. From its inception, the position of the training analyst in Vienna was always a very powerful one. The program of study was informal and individualised with training analysis common to all candidates. It was left almost entirely to the judgement of the training analyst to determine whether a candidate had successfully completed the analysis and could be accepted into the Institute; an unfavourable report could seal the fate of a candidate. Margaret Mahler suffered this fate, for example, as her anointment at the hands of Helene Deutsch was delayed for a number of years.12
We can say, then, that historical factors have always conditioned the particular way in which analytic training would be carried out. Short, preparatory, mandatory analyses originally intended to give the trainee a taste of analysis lengthened into a situation where years and years of analysis assumed primary significance. As analyses became longer, 'deeper', and more formalised, a procedure which was to provide would-be analysts with a taste of the process and clarify personal blind spots became a supertherapy aimed at altering the character structure of the candidate. As psychoanalysis became more institutionalised and professionalized, it was then presumed that problems in the classical approaches would be remedied by introducing into the analytic relationship a greater degree of formality and distance.
(IV)
In what Lewin and Ross (who surveyed American psychoanalytic education in 1960) referred to as a classic example of 'syncretism' (i.e. a situation involving 'the use of conflicting and irreconcilable assumptions'), psychoanalytic educators have become increasingly aware that there is a problem in training both for a profession and a science.13 According to Lewin and Ross, psychoanalytic education and psychoanalytic procedure exist in two worlds:
The two models 'psychoanalytic patient' and 'student' complement, alternate with, and oppose each other. A psychoanalytic treatment is sui generis. The education introduces a parameter for the therapeutic procedure, and the analytic procedure an even larger one for the education. The institutes are unavoidably trying to exert two effects on the student: to 'educate' him and to 'cure' or 'change' him. Hence the student as a phenomenon fits into two conceptual frameworks: he is the pedagogic unit or object of teaching and the therapeutic unit or object of psychoanalytic procedure.14
To complicate matters further, however, both these frameworks normally involve the single looming figure of the training analyst. In a 1927 paper to the Innsbruck Congress of the IPA, Helene Deutsch herself noted how the training analyst is often in a conflicting role because of the double task implied in the role. Already in 1927 then, the two functions-that of therapist and that of teacher-were often seen to contradict each other.15
Moreover, as Siegfried Bernfeld argued, 'the training analyst is not, as Freudian method demands, a mere transference figure. He is instead a part of the patient's reality, a powerful and even decisive factor in it'. Bernfeld maintained that "by policy and circumstance, the institutionalized training analysis thus bears the features of a non-Freudian technique."16 While there have been reforms in the rules surrounding the training analysis, Anna Freud could say in 1983 that the problem of training had not changed much in the previous 45 years. She said that her 'colleagues who first advocated the introduction of the training analysis at the Marienbad Congress-if they had known of all the dangers, of the positive and negative transferences, and splits, and hates, etc.-would probably never have advocated it! They would have said, "Let them be as they are!"'17 As Bernfeld observed, 'We possess no way by which we can rationally rank the membership into Good, Very Good and The Best analysts. Yet strangely, that is exactly what has taken place. The membership of all our groups is divided into members who are good enough for the simple paying patient and into really good ones who take care of our future membership'.18 However, the selection of the 'really good ones,' today as in the past, does not necessarily relate to their analytic abilities. As the histories detailed in this book show, I have concluded that ideological splits and conflicts in psychoanalytic institutes were and often remain rooted in the issues of appointment and anointment that surround the figure of the training analyst.
(V)
The informal training of the early generation of analysts can be linked with the enormous creativity that characterised that small original group.19 The later formalised, bureaucratic training correlates with far less creativity, a result that is scarcely an endorsement of the 'improvements' in training and reflects, in my estimation, the inimical effects of the growth of psychoanalysis as a movement on its development as a discipline. In fact, while many analysts continue to define psychoanalysis as a science, it still relies for its evidence on the 'laboratory' of the analytic hour-an essentially private exercise which bases its supposedly scientific claims almost exclusively on analysts' later accounts of cases in the form of broad, overarching and basically indisputable assertions. This is clearly not commensurate with a scientific approach. 'Scientific' articles in psychoanalysis generally look to confirm, and not to refute, clinical hypotheses.20 Because analysts know little about each others' work, ideas stem more from speculation than from a warehouse of communal experience and knowledge.
The problem here has partly to do with a fundamental misunderstanding that confuses psychoanalysis with the model of the natural sciences. The symptomatology-aetiology-pathology conceptual model, with all its sequelae, is a widespread one in contemporary psychoanalysis. Indeed, many psychoanalytic institutes instantiate this model in their training, assuming a body of knowledge which is, however-because if its very nature-far from codified and altogether resistant to systematisation.
In psychoanalysis there is little, if anything, that is agreed upon by all schools or even within schools. Notions such as 'transference', 'the unconscious' or 'analytic process' mean quite different things to different schools, and a confusion of tongues invariably develops.21 It is as though everybody agreed that it is seven hundred miles from New York to Chicago but nobody agreed what a mile was. Or, one can imagine a scenario in which people from a number of different countries have agreed that a piece of merchandise is worth two bits of money, but nobody has specified which currency or denominations of money were used. If we say that everybody agrees that the unconscious and transference are important concepts and then we think, for example, of the Freudian, Kohutian, Kleinian or Jungian currencies and of the enormous differences within these currencies, we have an identical situation.
When people have their own definitions of concepts and use them in their own way, communication results in a tower of Babel. Because the same words have quite different meanings, it is both misleading and misguided to say that there is agreement about basic concepts just because analysts mouth the same words, or to maintain that there is an established common ground. If people can't agree about basic definitions, how can they communicate about anything more complex? Moreover, it is no secret that analysts apply concepts differently and idiosyncratically. Even where analysts approach their patients stereotypically, of necessity every psychoanalysis is unique. This datum may well bespeak the nature of psychoanalysis as art-it is, however, certainly no measure of a 'scientific' technique. I am not saying that agreement about basic definitions is a sufficient condition for the development of the field, but it is a necessary one. Once analysts manage to speak the same language, then the development of appropriate new ideas becomes possible.
It is no surprise, then, that in the absence of an agreed-upon language training standards and expectations are also increasingly localised, and subject to the convictions and/or whims of the anointed. Cliques predominate and issues of power become paramount in defining whose 'standards' and what knowledge or curricula will prevail. Like a religious movement which progresses through the laying on of hands from generation to generation, psychoanalytic power is often legitimated through the processes of anointment described above. Again, this is exacerbated by the insular and pyramidal structure of analytic institutes. It is in this way, as Otto Kernberg maintained, that psychoanalytic education became transmuted over the years into a process that came to reflect uncannily both the seminary and the trade school models.22 In fact, much analytic education (from the Latin educere, to elicit or bring forth) is if anything an exercise in 'miseducation,' since by-and-large the guild nowadays does not so much draw forth the unique talents of students (and inspire them, in turn, to 'educate' their patients) as systematically move them towards conformity with their own teachers and analysts. Consider, again, Joyce McDougall's thoughts on the matter:
The experience of personal analysis and case supervision, as well as the close teacher-pupil relationship that characterizes the transmission of psychoanalytic knowledge, are all marked by strong positive and negative transference affects. These, if not recognized, may readily be used in near-perverse ways. They certainly contribute to the violence that usually accompanies our theoretical and clinical divergences. The sanctification of concepts and the worship (or denigration) of their authors appear to me to be sequels to unresolved transference ties. Adherents then become 'disciples' who no longer question their theoretical models or continue with their own creative research. The unquestioning dedication of such disciples to their analytic schools of though may dissuade them from truly hearing their patients and thus prevent them from searching for further insight when their patients do not fit their theories. In certain respects, these disciples appear to have incorporated their leader's theoretical stance without any true introjection of, and identification to, the psychoanalytic goal: a constant search for the truth-one's own and that of one's analysands.23
(VI)
Even though there are great divergences about the nature of psychoanalytic knowledge and theory, there is considerable agreement about who the good analysts are. How can this be so? Edgar Levenson has argued that psychoanalysts of every persuasion use the same algorithm in their praxis, framing what the patient says, putting it in some kind of order, and elucidating that order in terms of the patient-therapist relationship. Good psychoanalysts of all schools share an ability to elucidate more data by shining a broad beam that further illuminates the patient's particular world. The wisdom and experience attained through using this algorithm is transmitted to candidates in both supervision and analysis with varying results.24
To be a good psychoanalyst requires, I believe-in addition to an unequivocal ethical commitment and stance and some psychoanalytic experience and wisdom-three qualities. One is a high-level capability in cognitive processing and abstraction that Elliott Jaques has described. This involves an ability to move between the general and particular, and to process in a parallel manner both hypotheses and 'facts' that counter and challenge one's own views.25 A second quality involves a particular form of personal intelligence. This refers to a kind of therapeutic intelligence, an ability to think psychologically about oneself and others, a singular capacity for empathy and understanding that results from a highly developed sense of, and respect for, self and of others.26 Finally, the use or creation of a good psychoanalytic theory is important.
Clearly, analysts differ in their abilities to meet all three of these criteria. A very few can claim the first two in addition to the use and creation of major theoretical advances. While Freud might come under this category, there would be less agreement (but still some) about other contributors such as Heinz Kohut, Sandor Ferenczi, Melano Klein, Wilfred Bion, and Jacques Lacan. My personal belief is that someone is generally acknowledged as a competent analyst when the first two qualities, of cognitive and personal intelligence, are sufficiently developed or noteworthy as to override any theoretical shortcomings. Paradoxically, I also believe that the advances registered or claimed by psychoanalysis as a 'science' rest on a kind of illusion generated by the individual clinical achievements of analysts who, because of cognitive and personal gifts, are able to practice artfully-that is, to work successfully with patients-despite their training.
Psychoanalytic therapy is inherently difficult. The task is an exploration of the mind that involves, on the part of both patient and analyst, considerable ability for abstraction, questioning of deeply-held assumptions, the free play of ideas in an open-ended partnership over a number of years. Since there is no major corpus of established knowledge that the analyst can realistically apply as a template, the inherent creative capabilities of patient and analyst must be enjoined. Analysts need the ability, as Heinz Kohut once told me, to recognise their vantage points, to play with ideas, to be relativistic.27 If these capabilities do not reach the level of the requirements of the analytic task, dogmatic templates often fill the vacuum. An important aspect of the fall of psychoanalysis lies in the institutionalisation of psychoanalytic ideas, involving the application of ideas by a larger number of less capable analysts who used codified stereotypes to fill the hole left by the uncertainties of creative exploration in a new and difficult field.28
(VII)
For psychoanalysis to take a different route in the future, matters of training will have to be addressed, and alternatives proposed to the prevailing situation. One such move could be in the direction of abolishing the mandatory training analysis. This would steer institutes away from the transmission of a relatively unquestioned body of knowledge towards more open and sceptical questioning and research. It is generally acknowledged, along these lines, that the chance for institutes to be allied with universities has generally passed. With few exceptions (Columbia, for one), by not becoming part of academia or at least adopting the university's culture of critical inquiry, an historical opportunity was irretrievably lost. But, in line with Kernberg's suggestions, the idea of developing within psychoanalytic institutes a culture and environment reflective of the university and art academy milieu is a desirable if not a vital one.
Secondly, the problems of anointment necessitate a radical deinstitutionalization of training. Arguably, it is questionable whether qualification as an analyst even needs to be bestowed by an institute. The issue of who authorises an analyst has occupied quite a number of analytic thinkers and practitioners, not the least of whom was Lacan; and the idea that analysts ultimately authorise themselves (and cannot really be authorised by anyone else) seems quite appropriate to the nature of the field, at least in its present state. That present state is nicely summed up in the founding statement of a newly established training centre in London, itself the product of yet another in an endless line of schisms:
Psychoanalysis can be understood as a cultural term of reference underpinning a multiplicity of disciplines. Indeed it has become one of the dominant forms of psychological intelligibility, insisting as a topic of centrality in the theorising of the ways we are together within contemporary culture. Nevertheless, it is merely a chapter in the history of folk psychology. In other words, since the beginning of time people in suffering have turned to others for means of solace, always already informed by some form of symbolic exchange. Psychoanalysis purposefully defies clear definition as it is resistant to any attempt at unification, so that any reconfiguration will occur through the acknowledgement that it is not one, is not up for ownership or enclosure, nor can it appropriately be appropriated.29
There needs to be in psychoanalysis a reorientation towards research which must be interdisciplinary and critical, much more in line with the model first envisioned by Freud. Freud's exemplary statement-"Nothing ought to keep us from directing our observations to our own selves or from applying our thought to criticism of itself"30-would act as a searing critique of many of the world's psychoanalytic institutes, whose rites of qualification have stood in the way of the field's development. To my mind, the basic problems of training are both structural and conceptual, and require urgent attention if psychoanalysis is to regain its lost credibility as both a cultural discourse and a therapy. In the meantime, however, the gap between the small base of verifiable knowledge and the high level of 'pretend' knowledge fostered by training and practice has grown to such a worrisome extent that the very question of what constitutes 'knowledge' is less and less posed nowadays.
Insofar as psychoanalysis is a method of sceptical inquiry into the unknown aspects of the human mind, it is more akin to philosophy and literature than to medicine or the natural sciences. The very nature of its inquiry, moreover, would seem to presuppose that psychoanalysis be organised in ways that might depart from the hierarchical and rigid institutional superstructures that govern, say, medical associations. The major problems with codifying and institutionalising psychoanalysis, and sealing it off from both internal and external criticism, came about through decades of valuing the movement over the method. One of Freud's major mistakes, in this sense, derived from his preoccupation that a growing focus on the therapy of psychoanalysis would destroy its chances for recognition as a science. This concern led to his consolidation of the movement, an attitude which in the long run compromised the very development and ambitions of his 'science' while fostering an imperialism antithetical to psychoanalysis' supposed method of unfettered inquiry. Moreover, the unfree and, allow me to say, narcissistic institutions bred by the psychoanalytic movement have proven regressive in more than one way. In fact, some of the negative reactions to psychoanalysis on the part of today's 'Freud bashers' have much to do with the exaggerated and quasi-omnipotent claims that have been made on behalf of the therapeutic efficacy of psychoanalysis. Psychoanalysis as a panacea is fantasy, not reality. But it has long been oversold, at least in the United States, as a cure-all for a remarkably broad range of human sufferings and emotional disorders. This exaltation, born of an illusory and deceptive self-celebration, has not only contributed to the tarnished reputation of psychoanalysis; it also betrays the discipline's sadly limited capacity for genuine introspection and critical self-assessment in a challenging and rapidly changing world.
Freud's ideas became an pivotal part of the twentieth century zeitgeist. Even the strongest of the Freud-bashers has to reckon with, if not to adopt outright, many psychoanalytic concepts that have transformed our view of ourselves and our relationships. Such reasons are enough to suggest that psychoanalysis is in no danger of disappearing from our cultural horizon any time soon; the risk will increase, however, the more psychoanalysis remains identified with the psychoanalytic profession as now constituted. Already the steep decline of institutionalised psychoanalysis is all but assured. Like would-be seminarians before the prospects of a priesthood that makes less and less practical and existential sense, fewer and fewer candidates are attracted to psychoanalysis, which itself attracts fewer and fewer patients. Still, people in suffering will continue to turn to others for means of solace, as our species has since the beginning of time. And no matter what drugs and other forms of treatment become standard, we will continue to need 'talking cures' to deal with the ways we are and want to be; with our dreams, fantasies, ambitions and perversions; with the ways we treat other people, and wish to be treated by others. We will continue to be plagued and impassioned by the timeless concerns of love, history, ethics and desire. To this end, and throughout their history, psychoanalysts have long espoused what Freud, Kohut, Klein, and a host of other masters have proposed as solutions to the problems of human existence. The time may now be upon psychoanalysis to revive, instead, the once-defining spirit of open, sceptical questioning of all concepts and teachings, including those most dear to the profession. It is time, perhaps, for psychoanalysis to be reminded of the wisdom of an Eastern maxim: 'We seek not to imitate the masters, rather we seek what they sought'. For as Christopher Bollas has tellingly admonished: 'Psychoanalysis just has to survive "the psychoanalytic movement". If it survives psychoanalysts and their schools, then it will grow and develop. But this remains to be seen'.31
1 See introduction; C. Bollas & D. Sundelson, The new informants: the betrayal of confidentiality in psychoanalysis and psychotherapy, Jason Aronson, New York, 1995, p. 136.
2 S. Freud, The interpretation of dreams, 1900, S .E. IV & V, p. 483.
3 Grinker Sr., 'Identity or regression in American psychoanalysis?', Arch. Gen. Psychiatry, 12, 1965, p. 114.
4 Freud-Jones, cited by Jones, Sigmund Freud: life and work, The Hogarth Press, London, 1953, Vol. 2, p. 153; Dire mastery: discipleship from Freud to Lacan, trans. N. Lukacher, Johns Hopkins University Press, Baltimore, 1982. Anointment can be seen as an important aspect of the discipleship in psychoanalysis that François Roustang has explored so ably.
5 J. McDougall, The many faces of Eros: a psychoanalytic exploration of human sexuality, New York, Norton, 1995..
6 J. McDougall, in A. Molino, Freely associated: encounters in psychoanalysis with Christopher Bollas, Joyce McDougall, Michael Eigen, Adam Phillips and Nina Coltart, Free Association Books, London, 1997, p. 91.
7 S. Freud, On the history of the psychoanalytic movement (1914), S.E. XIV, p. 7.
8 Bollas and Sundelson, The new informants: the betrayal of confidentiality in psychoanalysis and psychotherapy, Jason Aronson, New York, 1995, pp. 136-37.
9 M. Balint, 'On the psychoanalytic training system', Int. J. Psycho-Anal., 29, 1948, p.167.
10 See S. Bernfeld, 'On psychoanalytic training', Psychoanalytic Quarterly, 31, 1962: 453-82.
11 S. Gifford, For Psychoanalysis in the United States, Edgar Wallace IV, ed., typescript, 1995, p.113.
12 P. Stepansky, ed. The memoirs of Margaret Mahler, The Free Press, New York, 1988, pp. 64-65.
13 R. Wallerstein, 'The future of psychoanalytic education', J. Amer. Psychoanal. Assn. 20, 1972, p. 595.
14 B. Lewin and H. Ross, Psychoanalytic education in the United States, Norton, New York, 1960, pp. 46-47.
15 H. Deutsch, 'On supervised analysis', Introduction by Paul Roazen, Contemporary Psychoanalysis, 19. 1983, p.60.
16 S. Bernfeld, 'On psychoanalytic training', p. 476.
17 A. Freud, 'Some observations', in E. Joseph and D. Widdocher, eds., The Identity of the psychoanalyst, International Psycho-Analytical Association Monograph Series, Number 2, International Universities Press, New York, 1983, p.259.
18 S. Bernfeld, 'On psychoanalytic training', p.481.
19 Even in 1924 there were only 41 members of the Vienna Psychoanalytic Society (P. Federn and E. Freud, Supplement, Journal of the history of the behavioral sciences, VIII, 1, January, 1972, p. 29).
20 See E. Peterfreund, The process of psychoanalytic therapy: models and strategies, The Analytic Press, Hillsdale NJ, 1983; Peterfreund, 'The heuristic approach to psychoanalytic therapy' in J. Reppen, ed., Analysts at work, The Analytic Press, Hillside NJ, 1985, pp. 127-143; K. Colby & R. Stoller, Cognitive science and psychoanalysis, The Analytic Press, Hillsdale, NJ, 1988.
21 A study of analytic process by analysts from the Columbia Psychoanalytic Institute indicated scant agreement among analysts about the nature and definition of such a fundamental issue as analytic process. They believed that the ambiguity surrounding this term was scarcely unique to that term. 'It would seem that when analysts speak to each other using the term, AP, the communication is illusory-sabotaged by the erroneous belief that they share an understanding' (S. Vaughan et al, 'The definition and assessment of analytic process: can analysts agree?', Int. J. Psycho-anal., 26, 78, 5, October, 1997, pp. 965-66).
22 O. Kernberg, 'Institutional problems of psychoanalytic education', J. Amer. Psychoanal. Assn., 34, 4, 1986: 799-834.
23 J. McDougall The many faces of Eros: a psychoanalytic exploration of human sexuality, New York, Norton, 1995, p.234
24 E. Levenson, The ambiguity of change, an inquiry into the nature of psychoanalytic reality, Basic Books, New York, 1983, p. 8, 55.
25 E. Jaques, Requisite organization (2nd ed.), Cason Hall, Falls Church, VA, 1996, p. 22.
26 See H. Gardner, Frames of mind: the theory of multiple intelligences, Basic Books, New York, 1993, p.237-76
27 D. Kirsner, 'Self-psychology and the psychoanalytic movement: an interview with Dr Heinz Kohut', Psychoanalysis and Contemporary Thought, 5, 3, 1982, pp. 488-89.
28 See E. Jaques, Requisite organization (2nd ed.), Cason Hall, Falls Church, VA, 1996; E. Jaques and K. Cason, Human capability, Cason Hall, Arlington, VA, 1994. Wilfred Bion put it aptly: 'Freud talks about 'paramnesia' as being an invention which is intended to fill the space where a fact ought to be. But is one right to assume that a paramnesia is an activity which is peculiar only to patients and to pathological existence? I think psychoanalysis could be a way of blocking the gap of our ignorance about ourselves, although my impression is that it is more, We can produce a fine structure of theory in the hope that it will block up the hole for ever so that we shall never need to learn anything more about ourselves either as people or organizations. I suggest that we cannot be sure that these theories which are so convenient and which make us- both as individuals and as a group- feel better because they appear to make an inroad into the enormous area of ignorance, are therefore final. One would like to say, 'Thus far and no further', but if one carries on this same procedure then one is back again in contact with this vast area of ignorance'. (W. Bion, Bion in New York and Sao Paolo, Clunie Press, Pertshire, 1980, p. 30).
29 C. Oakley and H. Oakley, From Chris and Haya Oakley's founding statement for 'The Site for Contemporary Psychoanalysis,' in The THERIP Newsletter, London, Spring, 1998.
30 S. Freud, The future of an illusion (1927), S.E. XXI, p.34.
31 C. Bollas, in A. Molino, ed., Freely associated: encounters in psychoanalysis with Christopher Bollas, Joyce McDougall, Michael Eigen, Adam Phillips and Nina Coltart, Free Association Books, London, 1997, p. 50.
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Kirsner, Unfree associations, Conclusion