Psychoanalysis and Psychotherapy
Robert M. Young Online Writings
THE VICISSITUDES OF TRANSFERENCE AND COUNTERTRANSFERENCE:
THE WORK OF HAROLD SEARLES
'Why Harold Searles?' you ask. Some of you may have come because you have an answer of your own and are curious about mine. I dare say, however, that by far the larger number came because of the phrase 'the vicissitudes of transference and countertransference' and hoped that Searles or I might have something to say that sheds light on this flavour of the month. I hope you won't be disappointed.
When I say 'flavour of the month', I mean that countertransference is everywhere these days. One begins with the two classic texts: Heinrich Racker's Transference and Countertransference (1968) and Searles' Countertransference and Related Subjects. (1979). But beyond those and without any attempt on my part to be systematic or even to search, the following titles have turned up on my desk in recent months: Essential Papers on Transference (Esman 1990), Essential Papers on Countertransference (Wolstein, 1988), Countertransference: A Comprehensive View. (Slakter, 1987), Countertransference: The Therapist's Contribution to the Therapeutic Situation (Epstein and Feiner, 1983), The Power of Countertransference: Innovations in Analytic Technique (Maroda, 1991), Countertransference: Triumphs and Catastrophes (Giovacchini, 1989), Between Analyst and Patient: New Dimensions in Countertransference and Transference (Meyers, 1986), Countertransference: Theory, Technique, Teaching (Alexandris and Vaslamatzis, 1993) and - inevitably - Beyond Countertransference (Natterson, 1991). This list includes only books and collections on the subject; the literature is awash with articles, as well.
What's all the fuss about? I think I know the answer. The vogue of the concept of countertransference is an index, in my opinion, of a widespread turning away from scientistic models of psychoanalysis based on classical Freudian, neo-Freudian and even so-called contemporary Freudian thinking. It represents a turning towards humanistic and story-telling models of the analytic relationship. I cannot pose a neat dichotomy, however; nor would I wish to. Klein and the classical Kleinians were nearly silent on the subject of countertransference, and there is reason to believe that Klein took a very conservative position on the matter (Grosskurth, 1985, p. 378). There were two notable exceptions, as you will see. However, it could be argued that the work of Wilfred Bion is about very little else, though it's not labelled that way, and the same could be said of Donald Meltzer.
A deepening of our understanding of transference and countertransference and concentrating on the most primitive aspects of the relationship on the part of both patient and analyst seems to me to characterise recent Post-Kleinian writings. I am thinking, for example, of important papers by Irma Brenman Pick (1988) and Betty Joseph (1985). It is also a central feature of much recent interesting work of writers in the Independent Group, for example Nina Coltart, Neville Symington, Gregorio Kohon (all in Kohon, 1986), Christopher Bollas (1987, chs. 12 and 13), Patrick Casement (1985, 1990) and like-minded people abroad, e.g., Joyce McDougall (1980, ch. 7) and André Green (1986).
That's enough of lists. I'll unpack them later. For the moment I want to offer a trailer on Searles before leading up to his work in my own way. One reason I suspect that he's less well-known in this country than he ought to be is the meanness of his American publishers. Only one of his four books is in paperback, and that one costs £22.95. If you bought the rest at, respectively, £37.50, £42 and £49, you'd have spent £151.45, and if you went the whole hog and added the excellent book-length dialogue between him and Robert Langs at a 'mere' £27.95, you'd have blown £179.40. You can get the complete works of Klein for £50 and those of Freud for half the price per volume you'd pay for Searles and all twenty-four volumes of Freud for £500 and 15 volumes in paperback for about £125. Searles' publishers, International Universities Press and Jason Aronson, ill-serve him and the rest of us by pricing him out of the market in spite of many pleas to bring out paperbacks. The only reason his schizophrenia essays are in paperback is that The Hogarth Press controls the British rights, and they routinely allow Karnac to do paperbacks. Affordable access to significant thinkers is important, especially for people of limited means who are doing trainings.
I think Searles is the friend of the therapist's secret knowledge, things we know for ourselves but rarely share with colleagues. Consider for a moment a few of his more tantalising titles: 'The Patient as Therapist to His Analyst', 'The Effort to Drive the Other Person Crazy...', 'Scorn, Disillusionment and Adoration', 'The Psychodynamics of Vengefulness', 'The [suspiciously] "Dedicated Physician" in the Field of Psychotherapy and Psychoanalysis', 'The Function of the Patient's Realistic Perceptions...', 'Transitional Phenomena and Therapeutic Symbiosis', 'The Development of Mature Hope in the Patient-Therapist Relationship'. Don't those titles whet your appetite? Don't they conjure up a friend who knows good secrets one cannot easily share with rigid, rule-bound and priggish colleagues and supervisors?
Searles knows the secret that our patients do look after us, that there is (at least a phase of) symbiosis or mutual dependency in the relationship, that the things they accuse us of are often bullseyes and that the projections that evoke our countertransference don't just find an echo but a home in our characters. He is also spot on and hilarious on the sadistic pleasure a part of the patient's mind often gets from frustrating all our concern and our efforts, including our efforts to hide how furious they can make us. What the titles of these and about sixty other papers say to me is that it's all much more complicated than some of the simplistic and scientistic models imply, that its messy and that both common sense and our deepest selves must be kept in play. Searles is the man whose delightfully-told tales can help us achieve this without entangling us in sectarian wrangles.
Now I want to say something about 'vicissitudes' and then sketch the history of ideas of transference and countertransference. Here are some of the definitions of 'vicissitudes' in the big Oxford English Dictionary: 'the uncertain changing or mutability of something'; 'alternation, mutual or reciprocal succession of things or conditions, esp. alternating succession of opposite or contrasted things'. An example from 1720 says, 'Take compassion of the fleeting inconstancy and vicissitude of the dangers with which we poor mortals are surrounded' (p. 3626). The dictionary conveys, then, threatening change and contrast.
My impression is that the concepts of transference and countertransference have undergone fundamental changes since the classical texts. In the beginning there was a stolidity or permanence to transference, while countertransference was basically a nuisance, something to be got rid of, evidence for an incomplete analysis, something that limited how far one could go with a patient. There was a change, however, in the post-World War Two period. Donald Winnicott (1947), Margaret Little (1950) and Paula Heimann (1949-50) wrote articles drawing attention to what can be learned from the countertransference. Their view was that something was put into the analyst by the patient and that it should be attended to as important material, access to which came up from the analyst's unconscious. Hate was Winnicott's example. These essays caused quite a stir. In particular, Annie Reich (1951) objected that engaging with this sort of stuff smacked of id psychology, not the proper place to be working, which was the ego (presumably draining the Zuider Zee). We find here the association between countertransference and concentration on primitive, pre-verbal material which characterises my understanding of the importance of the issue.
There was a growing emphasis on countertransference, but the approach was cautious. For example, when Heimann took up the issue again a decade later, her concluding point was that close attention to what the patient put into one would decrease the incidence of countertransference, a very odd idea to a current eye (Heimann, 1959-60, p. 160). In the meantime, Roger Money-Kyrle had written a paper of fundamental importance in which he stressed the normality and importance of countertransference and made the point that when one interprets it mistakenly as a result of one's own unresolved problems, it's not a simple matter to put right. Before one can fix it, the patient has moved on, grasped the lack of rapport and is now relating to a damaged object, a situation that calls for some real effort to re-establish intimate communication. I think of this period in the history of the idea of countertransference as an intermediate one, in which opinion had shifted, somewhat cautiously, from getting rid of countertransference to attending carefully to it, but still, as I understand the literature, in a rather negative vein.
The third phase brings us up to the present. It has a number of features, but the main one is an almost complete reversal of relative significance between the transference and the countertransference. Putting the matter bluntly, transference is still the arena of the relationship between patient and analyst which must be interpreted and worked through, but by far the greatest emphasis on how we know what the transference is comes from monitoring and working from the countertransference. There is also a move from transference onto whole objects to relating to part-objects.
Irma Brenman Pick captures this wonderfully. First, countertransference is ubiquitous: 'Constant projecting by the patient into the analyst is the essence of analysis' (Pick, 1985, p. 37). Second, 'the patient does not just project into an analyst, but instead patients are quite skilled in projecting into particular aspects of the analyst... the wish to be a mother, the wish to be all-knowing or to deny unpleasant knowledge, into the analyst's instinctual sadism, or into his defences against it. And above all, he projects into the analyst's guilt, or into the analyst's internal objects. Thus, patients touch off in the analyst deep issues and anxieties related to the need to be loved and the fear of catastrophic consequences in the face of defects, i.e. primitive or persecutory anxiety' (p. 41). In conclusion, she says, 'Of course in these situations the patient massively projects parts of the self and internal objects into the analyst; such patients also arouse in the analyst feelings of being helpless and at the mercy of vengeful exploitive behaviour whilst the patient indulges in imperviousness to the analyst's needs. The task of experiencing and bearing these feelings whilst at the same time not becoming alienated from those parts of the patient that are genuinely defective and in need of support is a considerable one' (p. 45).
So far, I have sketched three phases in the history of the concepts of transference and countertransference. Let's call the first 'objectivist': transference is in the foreground; the therapist is a smooth mirror, observing and interpreting mistaken projections onto a whole object. Countertransference is a relatively infrequent contaminant, a failure of objectivity due to the therapist's insufficiently analysed subjectivity. The second phase - of Winnicott, Little, Heimann, with Money-Kyrle somewhere between this group and the later one - can be dubbed 'projectivist'. The patient projects into the therapist, there is something to be learned and one's own - now inevitable - vulnerabilities must be dealt with. In the projectivist phase the transference is still centre stage. The third phase takes us to a situation in which projection into the therapist is 'the essence' of analysis, and part-object relations and relentless searching out of the most subjective and damaged parts of the therapist is the rule. Bearing this and thinking under fire constitute the task. I call this phase 'dialectical', because it is well and truly the domain of vicissitudes, and the relationship is more than interactive; it is mutually constitutive at many levels.
All of which brings us to Bion's notion of 'container and contained' (Bion, 1959, pp. 103-4; Hinshelwood, 1991, pp. 231-36, 246-53) and his injunction to 'abandon memory and desire'. Both of these boil down to rather mystical ways of urging us to dwell in the countertransference. He says, 'The only point of importance in any session is the unknown. Nothing must be allowed to distract from intuiting that' (Bion, 1967, pp. 17-18). The disciplines he proposes are designed to remove intellectualist, cognitive levels of attention and reflection, to open up access to unconscious processes: put into one, evoking resonances, achieving rapport. One becomes a container, taking in and bearing toxicity; holding it and detoxifying experiences and returning them in due course in an an acceptable form as food for thought for the patient. He quotes a letter from Freud to Lou Andreas-Salome: 'I know that I have artificially blinded myself at my work in order to concentrate all the light on one dark passage' (p. 20).
That letter brings to mind a parable from Racker which is my last point of historical exegesis before I bring Searles to centre stage in my story. This is another way of conveying the idea of 'free-floating attention' which was common to Freud's and Bion's notions of the analytic attitude. Like Freud's letter, it, touches on the senses. One day an old Chinese sage lost his pearls. 'He therefore sent his eyes to search for his pearls, but his eyes did not find them. Next he sent his ears to search for the pearls, but his ears did not find them either. Then he sent his hands to search for the pearls, but neither did his hands find them. And so he sent all of his senses to search for his pearls but none found them. Finally he sent his not-search to look for his pearls. And his not-search found them' (Racker, 1968, p. 18).
The first thing I want to say about Searles is that in 1949 he wrote a wonderful paper entitled 'Concerning Transference and Countertransference' (Searles 1978-79). He submitted it to two prestigious journals, both of which rejected it. (Indeed, he tells us that he has had many such experiences - Langs and Searles, 1980, p. 116). In it he argued 'that transference phenomena constitute projections, and that all projective manifestations - including transference reactions - have some real basis in the analyst's behavior and represent, therefore, distortions of degree only. The latter of these two suggestions implies a degree of emotional participation by the analyst which is not adequately described by the classical view of him as manifesting sympathetic interest, and nothing else, toward the patient. It has been the writer's experience that the analyst actually does feel, and manifest in various ways, a great variety of emotions during the analytic hour' (Searles, 1978-9, p. 165). He proceeds to celebrate this 'richness of emotional participation' by the analyst. He 'believes that the analyst's emotions need to become the subject of as precise and thorough investigations, in regard to their positive value in therapy, as are those of the patient himself' (p. 179). He argues that 'our aim should be to remain maximally aware of our changing feelings during the analytic hour, not only because these feelings will be communicated behavioristically to the patient - via variations, no matter how subtle, in our tone, posture, and so on - but also because our feelings are our most sensitive indicators of what is going on in the interpersonal situation' (p.180). He refers to Fenichel and French as adumbrating his view and Rioch to the effect that 'There is no such thing as an impersonal analyst, nor is the idea of the analyst's acting as a mirror anything more than the "neatest trick of the week"' (p. 181).
Note that the year - 1949 - falls within the same period when Winnicott, Little and Heimann were moving some way toward Searles' position. Note also that he couldn't get the paper published. (It finally appeared in the context of the dialogue with Langs). I think this is because of the scientistic orthodoxy of Freudianism in America, dominated by immigrants from the Continent who sought to represent psychoanalysis in terms of forces, energies, structures, topographies and other expressions of a model based on analogies and metaphors drawn from physiology and physics and a view of the analyst as a scientific subject, with the patient as an observed object. To become a psychoanalyst in America until very recently one had to go to medical school and become a doctor. I know; I embarked on that path in that period, and I can assure you that psychoanalysis was taught in major centres in utterly scientistic terms, with authority for its concepts and validity sought from physics, physiology and biology. All of this was worked out with great care and elaborate schemata in the highly-respected writings of Heinz Hartmann (1958), Ernst Kris(1950) and Rudolph Lowenstein (1963) and set out in systematic form by David Rapaport and Merton Gill in a succinct paper in the International Journal of Psycho-Analysis, 'The Points of View and Assumptions of Metapsychology' (1959), which Rapaport developed at length in a longer version which appeared as a monograph in the series Psychological Issues and also in a prestigious multi-volume work, edited by Sigmund Koch and entitled Psychology: A Study of a Science. Rapaport's title was The Structure of Psychoanalytic Theory: A Systematizing Attempt (Rapaport, 1959, 1960). There are five points of view: the dynamic, concerned with psychological forces, which have directions and magnitudes and resultants; the economic, concerned with psychological energies, which have laws of conservation and entropy; the structural, concerned with hierarchically organised abiding configurations; the genetic, concerned with origins and development which follows 'an epigenetic groundplan'; the adaptive, concerned with survival and relations with the environment (Rapaport and Gill, 1959). The longer version also included gestalt, organismic and psychosocial points of view.
I have sketched this approach, not because I want to commend it to you, but in order to give you some idea of what Searles was - and, to a considerable extent, remains - up against. Since the beginning of psychoanalysis there have been two broad tendencies, both strongly represented in Freud's own formation and writings. The first was the scientistic. I say 'scientistic', rather than 'scientific', because the language of a putative science of mind has always had to be drawn by analogy from disciplines in the natural sciences. The reasons for this lie deep in the heritage of Cartesian mind-body dualism, whereby mind was defined negatively, as that which does not have the attributes of body, which were extension, figure and motion. Mind, according to Descartes was, a thinking substance, whose essence was volition. Whenever people have tried to formulate a scientific language for the mind, they have employed mental entities in spatial and physical terms which are, strictly speaking, inappropriate, such as structures, energies, forces. Ideas are described as impacting on one another like the billiard balls of a corpuscular physics, thus giving rise to the notion of the association of ideas, beloved of psychologists from Locke and Hartley and Condillac to Freud and still part of the common psychological language of our own time (See Young, 1970, 1990, forthcoming, ch. 1).
Freud was veritably heir to this tradition, having studied and done research in the Helmholtz School of physicalist physiology in the laboratory of Ernst Brücke (Bernfield, 1944. 1949, 1951; Amacher, 1965; Gay, 1988, pp. 22-37). He published papers in neuroanatomy and physiology; his first book was entitled On Aphasia (1891), while his first comprehensive sketch of a general psychology was cast in physicalist terms and entitled 'Project for a Scientific Psychology' (1895). It was written in a conceptual language which Rapaport found congenial.
It would be misleading and unscholarly to say that Freud turned his back on this way of thinking. Indeed, the whole framework of ideas of the theoretical chapter of The Interpretation of Dreams (1900, ch. 7) makes no sense at all unless we grasp Freud's formation in reflex theory and cerebral topography. We can still see vestiges of this way of thinking in the brain-shaped diagram which turns up in The Ego and the Id (S. E., vol. 19, p. 24) and the egg-shaped one in Lecture XXXI of the New Introductory Lectures (S. E., vol. 22, p. 78). Moreover, his great metapsychological essays - especially the one entitled 'The Unconscious' (1915) - are in this tradition, as was his lifelong belief that cerebral physiology would one day fill in the material or bodily parallel to his psychological accounts (Young, 1986).
But the parallel mental story became increasingly important, and he came to believe that it was right to remain strictly on psychological terrain and to postulate a psychophysical parallelism. That story was both mentalistic and cultural. That is, it opened out into the history of literature, wit, drama, myth, philosophy - in short, to humanism. You will all be aware of the fact that when the European émigrés went to America in flight from Hitler, they faced the rule that a psychoanalyst had to be a medical doctor, a rule Freud deplored and against which he essayed in 'The Question of Lay Analysis', which advocated a broad education for analysts, including humanistic studies (Freud, 1926) . It is said that the rigours of being a medical intern in a California hospital at age forty-eight killed Otto Fenichel (Jacoby, 1983, pp. 131-2). This form of legitimation and restrictive practice has only been struck down very recently, as a result of a successful lawsuit by lay analysts which threatened to bankrupt the International Psycho-Analytic Association for being, in the terms of the court's judgement, 'in restraint of trade'.
British psychoanalysis, in contrast, has always been hospitable to laypeople, and some of its most distinguished analysts have had no scientific backgrounds, the Stracheys, for example. It is often said that this was a factor in Anna Freud's remaining in England, since she had no medical qualifications. Nor did Klein or many of her followers.
The point of all this is that humanism is much more open to fully interpersonal ways of thinking about people. I don't want to exaggerate the contrast, though. Margaret Little was criticised for being too interpersonal and confessional and also had a candid paper on the vicissitudes of transference and countertransference rejected by her British colleagues (Little, 1985, 1990; Young, 1994, ch. 4). Klein had begged Heimann not to deliver her first paper on countertransference and told Tom Hayley in the late 1950s that she thought countertransference interferes with analysis and should be the subject of lightning self-analysis (Grosskurth, 1985, p. 378). Positions similar to Little's and to Searles' are still frowned upon by orthodox Kleinians, for example, so-called 'expressive uses of the countertransference', as described by Coltart, Symington and Bollas - all members of the Independent Group of the British Society. Even so, I think Searles might have got a better hearing in Britain, where prose is frequently spoken. Indeed, as I have said, his schizophrenia papers were published in the International Library of Psycho-Analysis, then edited by Masud Khan, and began with an Editorial Introduction by J. D. Sutherland, an Independent who was then Director of the Tavistock Clinic. Searles, in turn, frequently cites British writers, for example, Balint, Bion, Heimann, Little, Milner, Rosenfeld, Winnicott - all of whom go for the primitive and were, like Searles, individualists - 'characters' who went their own ways.
Now, you will be amazed to hear that I feel that I have sufficiently set the scene so that I shall refer to practically nothing but the ideas and writings of Harold Searles for the remainder of this essay. First, some general points about his writings and his character. He is robust, honest and believes more than anyone else I have read that he relationship between therapist and patient is, in many fundamental respects, fully reciprocal. I don't mean that he advocates co-counselling or some other form of taking turns. I do mean, however, that his notion of the therapist's position is that she or he is as much at risk and exposed as the patient. This is not true, as I read their works, of any of the other writers I have mentioned. In contrast to different combinations of them, he also lacks certain attributes. He is not gnomic or mystical. He is not elitist. He is not an aesthete. He is not moralistic. Although this might not please him, I think of him as feisty (what wouldn't please him is that I think of Norman Mailer that way, too). He is extremely funny in admitting how cross he is that he is not often cited in the literature, especially in America. He admits to a strong sense of isolation (Langs and Searles, 1980. p. 84; 1992). He also thinks that lots of his colleagues are cowardly about the sorts of people they will take on and try to help. (The fear of litigation plays a part here. Someone in America has recently been successfully sued for treating a manic-depressive with psychoanalytic therapy.) He thinks the decline of psychoanalysis as practised by his orthodox colleagues in America is richly deserved, and he has, on the whole 'shunned' (his word) the American Psychoanalytic Association (Langs and Searles, 1980, pp. 72, 82; 1992). I hope you will read the book-length interview with Langs and the one with Martin Stanton we published in Free Associations. (Langs and Searles, 1980; Searles, 1992). Both show him as a lovely, irascible man.
At the heart of all that makes his work appealing and clinically helpful is, in my opinion, a single thought. It is that when the patient projects, he or she strikes home. The original, purist and objectivist notion of transference is that the patient has simply made a mistake. In his first paper on the subject Searles quotes Fenichel's formula: 'An analyst giving a transference interpretation says, schematically: "It is not I toward whom your feelings are directed; you really mean your father"' (quoted in Searles, 1978-9, p. 176). He then finds in Freud, Fenichel, French and others warrant for a fundamentally different approach. From Freud he picks out the phrase, 'they do not project into the sky, so to speak, where there is nothing of the sort already. They let themselves be guided by their knowledge of the unconscious...' (quoted p. 177). Similarly, Fenichel says of the patient that 'the hatred is never projected at random but is felt usually in connection with something that has a basis in reality... This basis has, of course, to be extremely exaggerated and distorted in order to be made available for this purpose...' (ibid).
Searles' whole oeuvre grows out of this single insight, and all his writings appear to me to be an exploration of the space between the reality that the patient is on to and the therapist's ability to be honest about the realistic basis of the projection. He says that he 'has very regularly been able to find some real basis in himself for those qualities which his patients - all his patients, whether the individual patient be most prominently paranoid, or obsessive-compulsive, or hysterical, and so on - project upon him. It appears that all patients, not merely those with chiefly paranoid adjustments, have the ability to "read the unconscious" of the therapist. This process of reading the unconscious of another person is based, after all, upon nothing more occult that an alertness to minor variations in the other person's posture, facial expression, vocal tone, and so on, of which the other person himself is unaware. All neurotic and psychotic patients, because of their need to adapt themselves to the feelings of the other person, have had to learn as children - usually in association with painfully unpredictable parents - to be alert to such nuances of behavior on the part of the other person' (pp. 177-8).
You may say that this is old hat and that it has been said at length by Langs and by Casement. Indeed, Searles tells us in a lovely Postscript to the dialogue with Langs (where he tells Langs off for patronising him) that he had at one time thought that Langs had plagiarised his ideas (Langs and Searles, 1980, pp. 305-6). Langs and his supporters have implied something similar about Casement's ideas 'on learning from the patient' (surely Casements acknowledgements on pages 57 and 70 belie this), and it is said that a whispering campaign about this is an explanation of why Casement's book did not sell well in America. It's ironic, isn't it, that all this paranoia is flying around when what is at issue is how much we pick up from one another. It is also worth mentioning that Searles was way ahead of his time in 1949 and, in my opinion, still is.
You may also say that the form of interaction he describes is perfectly well-conveyed by one version of the Kleinian notion of projective identification, whereby the patient splits off a taboo or unwanted part, projects it into another person (there are huge debates about whether or not another person is required; Americans say yes, British say no - see Ogden 1979; Spillius, 1988, vol. 1, pp. 81-86; Young 1992). The projection seeks from the total repertoire of that person's potential a corresponding feeling, evokes an exaggeration of it, and says, 'It's not mine; it's his!' Much of the commerce of racism lies here. 'I don't have these desires: black people do.' 'I'm not greedy: Jews are' (See Young, 1994, ch. 5). In a marriage, such projections, taken up and reprojected (again, often in amplified form), can provide the neurotic basis for stable, though unhappy, unions, as Main has shown (Main, 1989, pp. 100-01).
If Langs, Casement, Main and various Kleinians have got the point, what's so wonderful about Searles? The answer is simple. He places himself more starkly at risk. He is more candid, self-revealing (by which I do not mean merely autobiographically), implicated. Many writers acknowledge the process and the interactions. Searles acknowledges and takes responsibility for his own insides. There is a serious point about the analytic frame here. Many people - and I am one of them - are very uncomfortable about some versions of expressive uses of the countertransference. Put simply, it's not on to retaliate or spill out one's own problems. Finding the line between aloofness and incontinence is hard, and the matter cannot be settled in the abstract. Closing the gap between the reality discovered in the therapist and the way the patient 'goes to town on it' is one way of describing the analytic task. A more conventional therapist would say, 'Take back the projections' and treat the extent to which this has occurred as a measure of progress. Searles would say that they aren't all projections: 'These are my feelings; let's just get things into proportion'. I once told my analyst something unbearably distressing about my son. He said, 'What has this to do with you?' Of course, it had much to do with me, but by no means that much.
You may say it's just because I'm an American (even though I've lived in England for over thirty years) and find unbuttoned people more trustworthy, but I feel that Searles has that line between aloofness and incontinence in view all the time and stays on the right side of it with a stubborn authenticity. But he doesn't do it by rule-following. That's where he differs from Langs, who, in my opinion, is trying to evolve a psycho-technology in this matter, and his way of doing so is to write more and more, rather rabbinically specifying microtechniques. To pursue the religious image, Searles has grasped the essence of the law, which is not captured in the letter of it, and can therefore act spontaneously.
I think the reason he has got it right is that he is satisfied to the tips of his toes and the core of his being that being human means that we all do have psychotic, psychopathic, perverse, homosexual, hating, envious, spiteful, omnipotent, etc., etc., parts. He has no profoundly defensive scores to settle with the patient, so his unconscious is on the wavelength that Bion recommends. This means that his case materials are tremendously helpful to other therapists. He provides us with a vast fund of notes to compare with ours. His first book is a rich panorama about the role of the non-human environment in normal development and schizophrenia. As is the case with all his thinking, he offers a richly interactive picture at many levels, including the projective and introjective uses we make of nature, pets, and all sorts of external objects. This use of the nonhuman is well-known with respect to the delusions and hallucinations of psychotic people, but Searles characteristically shows that the same relationships occur in all of us in varying degrees and at various times. A particularly important feature is the infant's wish to merge with the environment, an impulse that recurs throughout life. Searles is eloquent on this matter, since it is clear that he greatly loved the place where he grew up, the Catskill region of upstate New York, which, in his words, 'possesses an undying enchantment, a beauty and an affirmation of life's goodness which will be part of me as long as I live' (Searles 1960, p. ix; 1992). He has always felt that life's meaning resides not only in human relationships but also in relations with the land itself - the hills, lakes, rivers and, in other ways, the urban landscape. In my opinion, the issues about the inner and outer worlds explored in this difficult book are of central importance to human survival, a thesis which Karl Figlio (1993) is developing with respect to the Green Movement. As Searles rightly says, we ignore this relationship at our peril (Searles, 1960, p. 6).
His analysis of the nonhuman environment includes examples from cartoons, fairy tales, animals, pets - all as bearers of transference feelings, projections and identifications. He draws on philosophy, anthropology and folk tales to illustrate the animism and anthropomorphism which are commonplace in all cultures, including our own. He suggests that much of our delay in realising the psychoanalytic importance of these matters is because they stir up psychotic anxieties from a period in infancy and childhood 'when the world around us seemed, oftentimes, comprised largely or even wholly of chaotically uncontrollable nonhuman elements' (pp. 38-9). These anxieties recur in dealing with, for example, home plumbing, carpentry, videos, and income tax returns, as we all know. He refers to the interchangeability between the human and nonhuman, that is, the lack of a qualitative distinction between them (p. 45).
He says, 'I believe that every human being, however emotionally healthy, has known, at one time or another in his life, the following feelings which... hold sway in psychotic, and to some degree in neurotic, patients: feelings of regard for certain elements in his nonhuman environment as being integral parts of himself - and upon the loss of such objects, feelings of having lost a part of himself; a resentful conviction that some animal or inanimate object is being accorded more consideration and more love that he himself is receiving; anxiety lest he become, or be revealed as, nonhuman; desires to become nonhuman; and experiences of his own reacting to another human being as if the latter were an animal or an inanimate object. Further, I think it could readily be shown that normal, adult human beings frequently undergo "phylogenetic regression," in waking life as well as in dreams, as a means of gaining release from the demands of interpersonal living and as a means of gaining a restoration of emotional energy so that, refreshed now, they can participate in more strictly human interpersonal relatedness with new freshness and vigour' (p. 55).
I won't pursue this theme in his work, except to commend the book to you, even though , as he admits, it's in parts a tough read, but it sheds floods of light on the whole area described by Winnicott as transitional objects and phenomena (a theme to which Searles returns repeatedly in later writings, esp. 1979, ch. 22), on the love of nature, on natural and urban disasters, on Mickey Mouse, Tom and Jerry, the Roadrunner and the Pink Panther, as well as mothers and babies of all ages. He returns to this issue again and again and concludes that in our relations with the nonhuman environment, we are dealing with displacement of mother-directed feelings, both of dependency and of sadism (Searles, 1965, p. 29). Reflecting on this book in a characteristically candid moment of self-revelation (in this case about his tendency to be self-isolating), he says, twenty years after it appeared, 'I finished one of the chapters midway along in the manuscript, and came home and cackled exultantly to my wife, "They'll have to have an oxyacetylene torch to get through that one!" Not many people bother equipping themselves with oxyacetylene torches, so it's no great surprise that the book hasn't been read as much as I often wish it had been' (Langs and Searles, 1980, p. 79). He tries again in innumerable passages in later writings and, in particular, in a fine essay on 'Unconscious Processes in Relation to the Environmental Crisis' (Searles, 1979, ch. 13).
Throughout his writings barriers which one takes for granted are dismantled and relationships which were thought to be very one-sided are shown to be much more nearly fully reciprocal than one thought. For example, he roots much mental distress in failed attempts to heal one's parents and gives some poignant personal history to support this. He argues that a phase of deeply regressed symbiosis is characteristic of much of the best analytic work. Most famously, he argues that therapists and patients seek to drive one another crazy and that this struggle is one of the main elements in successful psychotherapy with schizophrenics (Searles, 1965, p. 273).
The aforementioned concept of symbiosis looms large in his writings. It refers to mutual dependency of a highly-regressed kind, and he offers a series of stages of symbiotic relatedness - passing from pathological symbiosis to autism to therapeutic symbiosis (which can be preambivalent or ambivalent) to a more mature and integrated stage he calls individuation. These are not rigid developmental stages in therapy and need not be passed through in every case, but the general theme is important and conforms to his profoundly dialectical model of the interpersonal relations between therapist and patient.
He says is his first book, 'For the deepest levels of therapeutic interaction to be reached, both patient and therapist must experience a temporary breaching of the ego boundaries which demarcate each participant from the other. In this state there occurs... a temporary introjection, by the therapist, of the patient's pathogenic conflicts; the therapist thus deals with these at an intrapsychic, unconscious, as well as conscious level, bringing to bear upon them the capacities of his own relatively strong ego. Then, similarly by introjection, the patient benefits from this intrapsychic therapeutic work which has been accomplished in the therapist' (Searles, 1960, pp. 421-22, quoted and reaffirmed 1979, p. 520). In the centre of this storm there is 'a struggle as to whose will be the psychopathology in question' (Searles, 1979, p. 527). The parallel with Bion on container/contained and detoxification is remarkable.
I'll quote another passage referring to a point when things begin to get better: 'I have described it as characteristic of this phase of transition between autism and therapeutic symbiosis that the analyst now begins to find it possible effectively to make transference interpretations. This is in contrast to the earlier, autistic phase, during which he had to adapt to long stretches of time during which he was given the feeling of being useless, neglectful, irrelevant, uncaring, incompetent, and, more than anything else, essentially nonhuman, precisely for the reason that the patient needed to regress, in his experience of the analyst, to the level of the young child's experience of the mother as being something far more than merely human, as a person is seen thorough adult eyes. The patient needed to come to experience the analyst as being equivalent to the early mother who comprises the whole world of which the infant is inextricably a part, before he has achieved enough of an own self to be able to tolerate the feeling-experience of sensing her as separate from his own body, and the two of them as separate from the rest of the actual world. The transition phase likewise stands in contrast, as regards the timeliness of transference interpretations, to the subsequent phase of therapeutic symbiosis, in which such interpretations are almost limitlessly in order' (Searles, 1979, p. 173).
An attentive listener - especially one with Kleinian ears - would have experienced trip-wires about early object relations and timing of transference interpretations, which might lead to a premature sniffiness about Searles' theoretical leanings. But stay! One of my main reasons for commending him to you is that he wears his theory lightly, even professes not to have much (which is never the case, of course), so that one can benefit from his stories and his ability too dwell honestly in the realm of primitive interactions, without getting unduly tangled up in doctrinal disputes.
Before signing off I want to mention two more themes. The first is the subject of one of the funniest and most liberating essays I have ever read. It is a confessional critique of the noble therapist, or - in the American context - the 'dedicated physician'. Searles' examples get right down into the pit of horrible feelings between therapist and patient. He points out that the young therapist 'is often genuinely unaware of feeling any hatred or even anger toward the patient who is daily ignoring or intimidating or castigating him, and unaware of how his very dedication, above all, makes him prey to the patient's sadism' (Searles, 1979, p. 73). He recalls overhearing a patient saying to his therapist, 'The pleasure I get in torturing you is the main reason I go on staying in this hospital' (p. 74). A chronic schizophrenic woman once said to him, '"You should have the Congressional Medal of Spit." The first seven words of that eight-word sentence conveyed heartfelt admiration; but the last one, said with no break at all in the rhythm of her speech, was uttered in unalloyed contempt', switching instantaneously from loving to hateful feelings (Searles, 1986, p. 193). His serious point is that 'it is folly to set out to rescue the patient from the dragon of schizophrenia: the patient is both the maiden in the dragon's grip, and the dragon itself. The dragon is the patient's resistance to becoming "sane" - resistance which shows itself as a tenacious and savage hostility to the therapist's efforts' (p. 75). He recalls discovering with wry amusement that Uccello's painting of St. George and the Dragon has the interesting feature that the dragon from which he is supposed to be rescuing her is actually a pet on a chain, apparently under her control (pp. 83n, 84). Those of you who are familiar with the Kleinian literature on aspects of the patient's mind which derive from the death wish or Thanatos, as well as recent writings about 'the gang in the mind' and 'pathological organisations' (e.g., Rosenfeld, 1988, p. 249), will find Searles' case material very congenial and fresh.
His clinical point about the harm the stance of dedication produces is this: 'We tend, thus, to make the patient feel both idealized and diabolized by us, with a hopelessly unbridgeable gulf between these two so-different creatures we are calling upon him to be, toward us. At the same time that we are unwittingly calling upon him to fulfil our diabolized image of him, we are unconsciously looking to him to provide our life with its central meaning, to give us a raison dêtre, to make real our idealized self-image. I want to emphasize that it is no pernicious thing consciously to regard the patient as supremely important and meaningful to oneself. For us consciously so to relate to him cannot but enhance his self-esteem and help him to become whole. The pernicious thing is that we repress both our idealized image and our diabolized image of him, hide both from ourself, and at the same time act out both these toward him by inappropriately employing, in psychotherapy and psychoanalysis, the traditional dedicated-physician-treating-his-patient approach which, however conventionally accepted in the practice of medicine generally, conceals and reinforces the wall between patient and doctor when we employ it in this field' (p. 81). He sees this attitude as a major barrier to the kinds of symbiosis outlined above, since it walls off the very negative emotions between patient and therapist which have to become apparent and unthreatening as a result of lowering defences, so that the essential symbiosis can occur and be worked through (p. 87).
If there was space, I would take you on similarly unbuttoning tours of the supervisory relationship and paranoid structures in the therapeutic team, but you can by now guess what horrid and enlightening honesties he comes up with. Instead, I'll close by offering a taste of his most famous and beloved paper, the eighty-page tour de force, 'The Patient as Therapist to his Analyst'. Most of those pages are filled with case material to illustrate a thesis I have found hard to doubt since the first moment I heard it: 'that innate among man's most powerful strivings toward his fellow men, beginning in the earliest years and even the earliest months of life, is an essentially psychotherapeutic striving' (Searles, 1979, p. 380). (It should be noted, if only in passing, that there are religious ways of making this observation about the human spirit.) He claims that the patient is ill because, and to the degree that, his own psychotherapeutic strivings towards lovedones have been frustrated and repressed. The patient's illness - in transference terms - expresses his unconscious wish to cure the therapist (pp. 380-81). Searles claims that no other aetiological factor in mental illness is anywhere near this one in importance (p. 381).
By the time we get to the end of this utterly fascinating essay and grasp its central place in his writings, two things are clear. The first is that the classical analytic position, in which the therapist is not a real person to the patient, is mad. He says of classical psychoanalysis, 'to the degree that it is rigorously classical, it is delusional' (p. 458). The second thing that is clear is that countertransference is the royal road both to schizophrenia (p. 562) and to the psychoanalytic process more generally. As he puts it in a more recent paper on the subject, 'I cannot overemphasize the enormously treatment-facilitating value, as well as the comforting and liberating value for the therapist personally, of his locating where this or that tormenting or otherwise upsetting countertransference reaction links up with the patient's heretofore-unconscious and unclarified transference-reactions to him. In other words, the analyst's "own" personal torment needs to become translated into a fuller understanding of the patient's childhood-family events and daily atmosphere. I find it particularly helpful when a "personal", "private" feeling-response within myself, a feeling which I have been experiencing as fully or at least predominantly my "own," becomes revealed as being a still deeper layer of reaction to a newly-revealed aspect of the patient's transference to me' (Searles, 1986, p. 214).
I said at the beginning that I thought I knew why countertransference is flavour of the month: that its vogue is an index of a profound turning away from objectivist and scientistic models of the psychoanalytic process and toward humanistic and story-telling approaches. Searles is, in my opinion, the best around. Surely he deserves a medal for honour, for writing so movingly, and for retaining his integrity during decades, awash with his own and others' spit, working with patients few would take on? In his Postscript to the dialogue with Langs he expresses his desperation and frustration at Langs' patronising treatment of him, including feeling at one point that Langs was trying to destroy him (p. 124), at another that he felt murderous toward Langs and in reaction had the fantasy that the only question left to him was whether to hang himself in his office or in the store room (p. 260). In his own defence, Searles wrote, 'I felt that you entirely failed to realize that I am one of the world's leading experts on the psychoanalytic therapy of schizophrenic patients and very possibly the world's leading expert' (p. 308). He has worked with one woman for thirty-nine years and a number of others for extensive periods. He concludes that he has seen a number of patients move from a high percentage of schizophrenic psychopathology to a much-improved level of functioning but only one who became completely well. In a recent interview he reflected stoically on his work and mused, '...what are we supposed to do for the poor bastards? Just continue to shock them?' (Searles, 1992, p. 331) He continues try to help such people and to be devoted to nurturing their humanity.
His work is also important to my understanding of a much wider issue, which Richard Rorty, in a lovely essay on 'The Contingencies of Selfhood' (1989, ch. 2) describes as the final victory of metaphors of self-discovery and of poetry over metaphors of discovery of something 'out there' in nature, which includes, of course, treating our own inner world in objectivist terms, as if it was 'out there', as well. When we look within, I think it more fruitful, more human and more hopeful to find interpersonal relationships which can best be understood in moving and poignant stories, however fraught and distressing, rather than some rendering of mental physics, chemistry or biology - or even of linguistics - all of which serve, in my experience, to distance us from ourselves and one another.
Objectivity - the claimed guarantee of truth proffered by science - doesn't even work for so-called 'things' in nature. In spite of the official scientific account, we experience nature animistically and anthropomorphically, and so do the scientists (See Young, 1993, 1993a). We could get onto better terms with nature if we did so more honestly and full-bloodedly. Why on earth should we treat other subjects and our own inner world as objects? Human nature is human, and Harold Searles' profoundly plain-speaking and compassionate work helps one to have the courage to bear this truth and not succumb to reification - the treatment of relations between people as though they were relations between things. His forthrightness about the madness which we share with the patient and the vicissitudes of the process of working through it, is a big advance on that other form of madness which is called orthodoxy. He invites us to acknowledge and live with the nearly unbearable fact that nasty, borderline and psychotic phenomenon both sides 'will be encountered in any deep-reaching course of psychoanalysis or intensive psychoanalytic therapy, for these phenomena are part of the general human condition' (Searles, 1986, p. xii).
This is the revised text of a talk delivered to the Arbours Association, London, in November 1991. A version of it has appeared in the Journal of the Arbours Association 9:24-58,1992. It will also appear in Free Associations in 1995.
(Place of publication is London unless otherwise specified.)
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Address for correspondence: 26 Freegrove Road, London N7 9RQ
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