4. Theory and its Impact on Training in Psychoanalysis.

It is expected that psychoanalysts will receive the idea of the need for a theory of the human subject separate from a theory of psychoanalysis, and a theory of psychoanalysis spate from a theory of psychopathology as utter nonsense. Freud and his early disciples did not see any dissections in their subject matter to make them reconsider their theory. Notwithstanding, the development of psychoanalysis and its evolution shows that those distinctions were not possible at the onset of the psychoanalytic movement, but were waiting for a later time and new changes to demand attention.

We lived close to a century with one theory that was supposed to comprise all that. Once psychoanalysis became an integral part of the Western (global) culture, those distinctions forced themselves on us, i.e., cultural and human sciences. It became clear to the thinkers and the philosophers that what was missing in their philosophy of the human subject was not the absence of a concept of the unconscious because some philosophers uncovered it and recognized it but they did not find the link between the conscious and the unconscious. The result was that each looked as if is it is an ontological entity in its own right, thus unfathomable. Psychoanalysis did not just dispel this misconception; psychoanalysis (actually Freud) showed two things about this insight: consciousness and the unconscious are one thing and are mutually affecting each other, and the link between them is not of cause-effect nature, but a structuring link in which the unconscious structures consciousness. This insight is now the attribute of all human sciences: the structure of the phenomena and not their causation. When Freud reached the early conclusions regarding psychopathology, he gave birth to the concept of Trieb (the pressure put on the mind to react) and the initiator of the process of representation (vorstellung), and paved the way for and the demise of the cathartic theory. psychoanalysis became a theory of the process of representation. Unintentionally, a theory of the human subject was forcing its way as new area of psychoanalysis that could exist and evolve outside the boundaries of a theory of psychopathology or the theory of the patient.

After many twist and turns between 1905 (infantile sexuality) and 1915 ( the wrongly called his papers on metapsychology) Freud comes to a new of his surprising insights. He re-examines the three clinical concepts of Repression, Narcissism and the unconscious ( a little later the concept of regression) to stipulate that they are not ontologically unique entities, but are complex entities that have two forms: a primal and a subsequent form (primal repression\repression proper, primary narcissism\secondary narcissism, systemic unconscious\dynamic unconscious). This division, which parallel the split between the primary and secondary processes has more than what meets the eye. But within the context of this blog I could just say that it makes a distinction between the subject and between the patient and the patient and the individual. Psychopathology resides in the domain (dynamics) of primal repression and repression proper, between primary narcissism and its secondary forms, within the three spheres of the unconscious.  The three papers of 1915 put the distinction between a theory of clinical psychoanalysis and a theory of psychopathology in new perspective. Psychopathology moved away from being caused by repression and expressed in defense mechanism to basic structural differences between the primary (primare or the origin of, and the secondary) on one side, and the primal (Ur.) which is no longer exist but is replace by a sequel. Lacan once said that we should take Freud literally: I neither remember in which seminars or understood well what he meant by that, but it is important to underline this idea. Gifted and unique thinkers like Freud get insights that they themselves do know the extent of their impact on us (mortals)’. Einstein did not know all what was dormant in putting Gravity in the context of space-time protocol.

The distinction between psychoanalysis and psychopathology is obvious when we think of the different possible links between the primal and sequel, on hand and the primary and secondary (I expanded on this point in my book:“Freud’s Other Theory of Psychoanalysis”). I know- as a clinical psychoanalyst- that not all my colleagues would agree to the importance the distinctions I am making. I respond by saying: look at the theoretical mess we have, the confusion about what is psychopathology and what is technique, how the confusion in those areas are allowing us to submit to the deteriorating condition of psychoanalysis as inevitable (to some it is an exiting period). Imagine surgeons following different books of anatomy. It is imperative to review what is left of psychoanalysis for us to learn, to teach, to practice to train and include in the rest of the clinical discipline and sciences.

Freud, and his early disciples thought of “their” psychoanalysis as one and the only theory that was; which was true for few decades. Because there was no distinction in their minds between psychoanalysis and psychopathology the two helices got confused and we-the newer generation- tried to fill the gap with whatever we thought to be psychoanalysis. We tried, from within a theory of psychopathology to form theories of psychoanalysis, so we gave all efforts, even the unintended, the attribute of ‘theories of psychoanalysis’. From ego psychology to presently the “Interpersonal Defense Theory” (the latest I heard of) we named them all new psychoanalytic theories. Unfortunately, and maybe it was natural, Freud started from the two ends of the spectrum of the two helices, so his theory started from the point of juncture between a theory of psychoanalysis and a theory of psychopathology. Thus, the theory of psychoanalysis came out very confusing. Do we approach the patient from his human subject nature, or do we approach the human subject from the dormant or inactive patient in him (or in all of us)? [ keep in mind our eagerness to find a diagnosis for " a simply an ignorant, badly brought up, unethical rich man]. 

There is a latent question in this understanding of our mess: should we not be troubled by the absence of the distinction between the three theoretical configurations? The immediate expected answer is no.  Since the patient is initially a subject, and each subject has a patient dormant in him, there is are implicit overlaps that one theory out of three separate theories? My answer to the objection a flat no. The human subject is analysed within a social frame work, the person will be approach from the commonality between the individuals of his type, and the patient is seen in a background of deviations within his intrapsychical dynamics. The three theories make us avoid the temptation of the easy idea of  the overlap.

Freud’s intuitive faculty made him approach both the human subject and the patient from the point where they meet and then divert; the unconscious. [I prefer calling it the Aconscious   because the un-conscious means undoing what was originally conscious, when in psychoanalysis the “unconscious’ is something that does not enter consciousness but sends representation that links with the preconscious from the side of consciousness. At the present time psychoanalysts are not in agreement on the connotation of the Ucs.: is it ontologically an entity, is a dynamic state of affairs, or is it a topographic system? They are also in disagreement on what to change in the patient to be more of himself as a human subject. They are did agreeing on what are  the best means to achieve what they decide to work on changing (free associating, intersubjective exchanges between patient and analysts, etc..

As the situation stands now the theoretical mess has a direct impact on training in psychoanalysis. The most apparent effect of that situation is not knowing what we should train the new generation to do. Less apparent is how to train, because the traditional (old) method was sufficient fifty years ago, when clinical psychoanalysis was still manageable and the literature was still in the making (without the schools and the theoretical plurality). Thirdly, we have to know now who should be doing the training? Previously, when psychoanalysis was still a trade to be learn from a master-tradesmen in specialized institutes of the trade it was easy to assign this responsibility to senior psychoanalysts, who were expected to be qualified to do all Those things. The were identified from the beginning as training analysts and given special status in the psychoanalytic community. It is not difficult to notice and underline in red (colour of danger) that that system relies on recycling knowledge from a generation to the next. As in all systems of recycling, material things or immaterial, we have to expect a deterioration in the outcome of the recycling; Training analysts, by definition, deliver already recycled psychoanalytic material. This is very obvious in the literature: the literature of psychoanalysis fifty years ago was full of novelty and more impressive despite being mush less rich than contemporary psychoanalysis because analysts were discovering new things. Presently, the field of clinical psychoanalysis looks as if psychopathology has dried out. More alarming, is that the contemporary psychoanalysts confuse improving theories with discovering new things. 

Tuckett (I.J.P.A, 2005) said: “It has been difficult to know what does and what does not constitute competent psychoanalytic work and so equally difficult to assess when it is being practiced and when it is not. This makes difficult any form of disciplined evaluation of the outcome of training, which has a series of problematic outcomes for psychoanalytic practice, psychoanalytic institutions and the relationship to allied disciplines and professions”. This very clear and pragmatic statement put the need for a serious review of out theoretical mess in focus. It would be really be sad (and funny too) if we-the professionals of insight-  not notice that now-a-days training in psychoanalysis has no foundation to stand on, despite all the quaffable about training analysts, certification, standards of professional competence, and which institutes to be acknowledge witch are not psychoanalytic enough. 

I will try in the near future and in a separate posting to deal with the psychoanalytic theory. It is my domain of interest and knowledge. Hopefully, the theory of the human subject will find some analyst or analysts, and some dedicated human scientist to deduced it from the abundant literature in the humanities and philosophy that are psychoanalytic (structural theories).

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Addendum: Conscious Resistance:

The people who are supposed to take the steps to move training from the institutes to academia, the training analysts and the senior members of the organization, are the ones who show the most resistance to that call. Lately training has been under scrutiny and showing signs of strain. I say that with confidence because the topic of choice of the day is the training analyst. The majority of the negative aspects of training has been dumped on the flows and faults of the way training analysts are “misbehaving” {a general accusation directed to them by training analysts!!} We thus have one conclusion to reach: whatever the training analyst will do to improve training by straitening out themselves, they will fail. They will fail because training analysis at the present time- as they and we all know- is ineffective and insufficient for preparing even clinical psychoanalysts, to carry on with their specialty, Contemporary psychoanalysis needs and also demands a full time training.

Full time training can only be done in academia, because it needs more than experienced analyst to do proper training. The privileged training analysts of today claim to know it all and can take the whole load of training on themselves. This is resistance, but not the unconscious resistance we encounter in psychoanalysis. It is conscious resistance to be demoted and becoming one of several equally qualified faculty in a department of psychoanalysis. Moreover, their tenurial status in the institutes will be subject to the academic standers, which is not based on students’ idealization but on actual excellence. There is another subtle point known to the training analysts who were also in on the politics of the organization: not all training analysts are equal: there are a few who are chosen to fill the empty chairs of power when they get empty; one can lose that privilege if showed some deviation from the privileged few. We should not hope for the present training analysts who control their institutes to change.