This is the first two parts of a long posting.

The Double Helix of Psychoanalysis  

Preamble:

My views are stemming from my personal experiences as a clinician and supervisor, understanding of the history of psychoanalysis, and observing its present condition from the point of view of a clinical psychoanalyst. However, I can see that it is not right to be critical of certain things that pertain to clinical psychoanalysis without being more specific about them and not having-at least- some conception of their rightful substitutes.  Specifically, I should be able to show what would be advantageous in moving training from the present institute system to academia, not just blaming it for what I personally think of the deterioration of clinical psychoanalysis.

To do that, I intend to show first what I consider basic defects in training in the IPA accredited institutes, not based on in their wanting curricula but based on intrinsic flaws in the system itself. Firstly, there is an important attribute of psychoanalysis that was missed from the beginning, but should be underlined now so we would not miss the point and continue misunderstanding psychoanalysis. This point, when and if recognised, would show the inadequacy of the institute system, not only now but from the beginning. However, in fairness to the pioneers in training it would have been impossible for them to consider this missed point for a reason I will mention a little later. This point could have been the cause of most (if not all) the internal conflicts in our organizations.

Secondly, I will try to show that the best curriculum in this system would not meet the demands of the practice of psychoanalysis now-a-days. There is no clear admission, or serious recognition that the field of psychopathology and the pole of patients have changed since the institute system was painstakingly established over ninety years ago.  

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1.Freud’s Two Areas of Interest:

Most new ideas that catch the attention of the thinkers at any  episode in history-whether in the field of physical sciences, human sciences, philosophy, or even matters of ordinary daily life, become movements. Evolution in the nineteenth century, existentialisms in the twentieth, the climate in the twenty first century were and still are, in a way, important movements, i.e., had followers and advocates who defended them from the attacks and criticisms they provoked when they were firstly originated.  A movement is not merely a novel idea, but an idea that changes an established way of thinking in the minds of, firstly a minority before it becomes the ideology of the majority. It also impacts areas outside its initial concerns. They are literally “movements”, announcing the futility of remaining in a stagnant point of knowledge and not moving beyond it. Movements, as new ways of thinking, impact the individuals’ old self perceptions and the way they previously positioned themselves in life. Most of all, successful movements, once established, they point to their future development and possible revisions.

Psychoanalysis was at its beginnings in the late nineteen hundred, just a new idea about psychopathology. It was few unorganized ideas coming from Freud; a physician treating psychoneuroses and using hypnosis as a new method. However, it became a movement, soon after, but in a peculiar way. Freud was venturing in the field of psychoneuroses and exploring new ideas about them and their treatment. He was not a pioneer in that respect but more of a follower of the French school and of his mentor J. Breuer. He wanted to make a profession of that new endeavour. At the same time, and without clear awareness or known intention, he got interested in understanding some human phenomena that did not pertain -in anyway- to psychopathology or the field of medicine. He spent over ten years studying dreams, jokes, and parapraxes, while still practicing his profession. These were issues that pertained to common and natural human phenomena and could have stimulate the mind of thinkers and philosophers and maybe a curious cultured physician! Nonetheless, Freud approach to those old puzzling manifestations of the human subject was different; he was interested in the subjective aspects in them (the structuring individual input in their formation). This unique approach was inevitably leading  to the subject’s internal psychical life and its role in structuring his psychological life in general and his psychopathological discontents too.

 He discovered that dreams, jokes and parapraxes have a latent meaning dormant behind their manifest content. The absent content of a phenomenon always-somehow- leaves traces in its manifest formation that lead to it. He became aware that everything human has a latent content that links with the manifest in particular ways.  Freud’s finding of such a misleadingly banal and insignificant matter had a major impact on the birth of psychoanalysis. Discovering the workings of the primary process in dreams, parapraxes and jokes, in addition to paying attention to the psychological factors in purely neurological conditions like aphasia, aphonia, apoplexy, etc., encouraged and enticed him, if not forced him, to abandon hypnosis. He gave up hypnotism (1892-1894) to encourage the patients to free associate instead. He was able-with the patient in full consciousness- to read in what he talks about the hidden text of the latent content. A theory of catharsis, which was the main product of the technique of hypnosis should have met its expected demise (it still hovers over psychoanalysis).  It did not, mainly because Freud continued to consider the revealed content or the unconscious equivalent to the hypnotic catharsis. Psychoanalysts- originally and for a long time- were medical people who applied to psychoanalysis the medical model of the functional theory of causes and effects. Thus, the repressed became the cause of the psychoneuroses, like an infection or a dysfunction that causes the psychoneuroses (we still think that cure comes with discovering something hidden and the more of that the better).

 In 1896, Freud called his work with patients “psychoanalysis,” borrowing the term from Breuer who used it strictly to mean the method of examining the patients’ symptoms. Freud went further to use the verb “psychoanalysing” to connote his budding new method of treatment, which was improvised to replace hypnotism. Eventually and naturally he used the term to describe his work as a whole; with natural and pathological phenomena alike. He had a good reason to do that. Beside being the same person doing both jobs he realised that his interpretation of a dreams or a parapraxis follows the same psychoanalytic method he uses in examining symptoms and doing therapy. He found out that what he discovers in his non-clinical work and in the psychoanalysing patients was the working of the primary process: forging a link between the manifest and the latent. No attention was payed to the fact that psychoanalysis has become, in a gradual way, a term that combines two- originally-separate lines of interest: psychopathology and psychodynamics.

 The few peoples who sought after Freud to learn what and how he made his discoveries knew from the beginning that they were forming a cohesive group and creating a movement. Expectedly, the early seekers of psychoanalytic knowledge were physicians, since Freud’s identity and work was the treatment of pathological conditions. Freud also knew that he was starting a movement because he realised from the beginning, and maintained this conviction till the end, that he did not discover something but he was unfolding a process of discovering things about something new (the human subject). Psychoanalysis was born, thence, as a movement. Freud and his new followers were more inclined to see the fusion of the two fields of interest and pay no attention to their fundamental separateness. They were a double helix in a singular endeavour.  The reason was rather a false or deceiving belief: it looked as if both areas of interest were supporting and confirming the findings of each other. Any serious look at Freud’s literature would show that the non-clinical area was supplying the clinical area with new insights and also better vocabulary, while the clinical aspect added very little to the psychoanalytic discoveries outside the clinical sphere. In other terms, the exchange of findings was grossly disproportionate and lopsided in favour of the non-clinical. In my opinion, clinical work produced only four discoveries: the Oedipus position, Narcissism, the deviations in the in the subject’s intrapsychical dynamics, and transference. The most obvious proof to the contribution of the non-clinical to the clinical field is Freud’s attitude toward the interpretation of Dream. For a period of time, interpreting dreams was the ‘golden road’ to the unconscious and an important part of the practice of psychoanalysis. Ultimately it became clear that doing that would interfering with the desired easy-flow of the analytic process. He recommended not sacrificing the session for a good interpretation of a dream anymore (Freud,1911 e). The Ucs. that could be discovered in dreams could also be uncovered in many other analytic material in the sessions. Nevertheless, the import of dreams remained central in psychoanalysis because “The Interpretation of Dreams (1900a)” contained the discovery of the dynamics of the primary process, the various formations of expressing ideas, the configuration of the topographic model, and several other notions that were supported by the work in parapraxes. The unequal contribution of the two lines of interest to psychoanalysis is evident in Freud’s several attempts at using the clinical discoveries in interpreting the non-clinical area. He was not very convincing in his papers on Gradiva or his work on Leonardo Da Vinci. At the same time, the two papers of “On Negation” and the “Uncanny” dealt with very central clinical issues (as I will discuss in a later posting). Without noticing, Freud was thinking and elaborating his thoughts about the human subject separately from his clinical work. His 1915 papers (the metapsychology papers confirm that.

However, the medical followers of the movement formed the majority of Freud’s early disciples, and the non-clinical ones stayed at the fringes of the movement. In addition, Freud could not realize (but we can) that he was working on two distinct features of the human subject and their separateness should be kept palpable. He, as the creator of the two helixes, did remind of their distinction from time to time, but mostly neglected this distinction. This lack of recognition made most of us clinicians, use the term psychoanalysis as synonym for clinical work and consider the non-clinical aspect merely applications of clinical psychoanalysis. The clinicians gave the movement its present identity, which does not pay attention to the necessity of having a theory of psychopathology when we work with patients, and another distinct theory about the human subject, whom we do not deal with but still we examine his manifestations and phenomena.  Most of the refusal to accept that distinction comes from clinical analyst who do not want anyone to share with them ‘psychoanalysis’ and harbour a sense of supremacy for being psychoanalysts. Working with the human subject is a distinct field that also needs their own distinct psychoanalytic theory.

 This misconstrue of the link between the clinical and the non-clinical caused several uncalled-for results; the most damaging is creating a false hierarchy of importance, legitimacy, competency, adherence to the purity of psychoanalysis, and most of all the right to speak for the movement. Clinical analysts were and still are so engrossed in the identity of the clinician that they consider themselves the only qualified authority to do the teaching and training in psychoanalysis. The result is very damaging to both clinical psychoanalysis and the other aspect, which Freud carelessly amalgamated in the clinical helix. Although the philosophers, especially the German idealists, tried for almost three centuries to get to the nature of the human subject, the window to his subjective nature remained shut to them. Freud managed to open that window and get to the intrapsychical dynamics of subjectivity, but only in his discoveries outside the field of clinical practice.  Although he had vague ambitions that one day the two helixes will unite (his letters to Fleiss), he maintained a separate but defined interest outside psychopathology and psychotherapy (from Totem and Taboo to Moses and Monotheism). His letters to Fleiss show a vague conviction that he might find in the mundane phenomena of religion, social phenomena, art and history, etc., some insights about in psychopathology.

Those two lines of interest did not come close to each other until 1905. His book on infantile sexuality and its early manifestations in childhood linked with his original interest in the role of sexuality in psychoneuroses. Sexuality as a natural urge was replaced with the concept of Trieb (wrongly translated by instinct and misled analysts since to call classical psychoanalysis drive psychology). Sexuality took a different meaning than just being a scene of some social moral preferences, or a drive of social attributes. Trieb introduced the notion of representation as the basis of psychological life. Those fundamental discoveries were not products of clinical work. However, the traditional predefined line between pathology and health prevented the clinical psychoanalysts, including the non-medical- to accept that the foundation of psychoanalysis is not in the clinic but in the psychology of the human subject.

 The distinction I am making here between the clinical (the patient) and the non-clinical (the human subject) would be considered by the clinical psychoanalysts superfluous if not facetious. We, clinical psychoanalysts do not accept the exitance of any psychoanalysis outside clinical work, and look at the efforts made by the non-clinicians to learn and work with the psychoanalytic theory as amateurish and simple attempts to have a link with psychoanalysis. There is a major mistake in this line of thinking. Because the patient is before anything and after all a human subject clinical psychoanalysis should put psychopathology in the context of a theory of the human subject: put the part in the context of the whole. But, we do not have a theory of the human subject yet and we blocked the interested of the non-clinicians from working on one to be the background for what we clinician do with the patients. At the same time, our clinical theory is presently in disarray; we no longer have a theory of psychopathology. Considering psychoanalysis a field of only clinical work forces us to see everything about the patient from the spectrum of psychopathology, which distorts our understanding of our clinical work. In my opinion: all the work and confusion about transference and counter transference, the legacy and recommendations of the wise old analysts about the patient-analyst’s relations, the acting out of transference distortions, etc., come from looking at the patient without any clear idea (theory) of the human subject that embodies the patient. As an example: we interpret the patient’s fantasy of being special from the way he constructs his social situations. Yet, we do not know how his sense of being special could be derived from his social life. If we are lucky or very good we will use the psychoanalytic jargon to guide us to the unconscious in the patient, but our theory (ies) does not tell us anything about how the unconscious (Ucs,) is formed in the human subject. I am talking here about the systemic and non-repressed unconscious, not the dynamic and topographic unconsciousness.

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2.The subject, the patient and the two topics of psychoanalysis.

The separateness of the manifest from the latent is not the cause of separating the remembered from the forgotten, i.e., it is not the cause or the effect of repression. This separateness took few hundred thousand years for homo-sapiens to actualize, and generate human culture. It is an inherent qualification of any and all psychological phenomena. It is obvious that human civilization and modernity came as result of replacing primitive conceptions of the world with  realistic ideas, and  in a limited way about ourselves. Developmentally, it is noticeable in children a gradual trend to push aside the primary process way of knowing and expressing knowledge, and a parallel movement to replace it with the workings of the secondary process. This process that affects the change from primitiveness to modernity and from infancy to maturity had to deal with a simple but basic problem. The workings of the primary process, individually and socially, does not disappear (where would it go!); it lurks behind as a background for the newly acquired secondary processes. A link between the two types of processes have to be established to make homo-sapiens deal with this split, and to make the child grownup. Language emerged in the realm of homo-sapiens, as it does in childhood as a product of that separateness and the link between the primary and the secondary side of facts. Language bridges the manifest and the latent through creating links between the primary and the secondary processes, which coexist in tension.

Although Freud was not the first to recognize that separateness and the links within, which best called by Ricoeur “the equivocality of language”. Freud  was the first to put it in perspective and apply it reading a dream and listening to patients talking as the means for psychoanalyzing them. Another first for Freud ,in that regard, was identifying what is latent and what could be its manifest and the code of translation one into the other; condensation or metaphor, displacement or metonymy, and the plastic presentation of ideas (he even tried something like a dictionary of sorts in his work on symbols). But, Freud genius was in distinguishing between the language of psychopathology and the patient’s ordinary speech, i.e., the speech of the human subject and the speech of the patient within his own subjectivity. Language in the human subject links the manifest with the latent in a manner that aims at introducing them to the person to understand, while in the patient the linguistic links (in specific areas of the patient’s life) aim at disguising the latent and even mislead in reading his manifest, (or maybe is distorted by the psychopathology).

We reach here a very technical and professional point that attracted the attention of many clinical psychoanalysts but did not get a satisfying answer to all: What is the language we-clinical psychoanalysts- use in practicing psychotherapy (psychoanalyzing)? Is the psychoanalytic vocabulary apt and suitable for conveying interpretations? I will answer this equation in the next part of this posting.

Language is not only verbal, it uses more than words to link the manifest with the latent. It has the flexibility to use more than one signifier to signify the same signified, but eventually everything it uses could be made verbal. The primary process managed to say things through other means than words but could also render anything to verbalization. This feature creates a rift within the human subject that could become his psychopathology. The patient’s spontaneous proclivity is to disguise the latent content; thus, this rift should be considered  a basic attribute of psychopathology. The clinical psychoanalysts depend on the human subject in the patient n to make things get known.

 Freud’s double preoccupations was not something clearly identified or seriously considered at any stage in the history of the movement. The non- clinical analysts were not considered psychoanalysts to take their work seriously, and they remained outside the analytic movement. They were rather hesitant to show their, or call it psychoanalytic. Nevertheless, at the end of the fifties of last century and till the mid sixties there was a spontaneous outburst of non-clinical psychoanalytic activities in the world that encompassed psychologists, philosophers, cinema people, theatre, visual art, thinkers, linguists anthropoglots, etc. The sudden great revival of a previously modest and quite interested non-clinicians in psychoanalysis cemented a strange idea in the minds of clinical psychoanalysts: clinical psychoanalysts can dabble in the none psychopathological fields, but the work of the none clinical people is not supposed to be called psychoanalysis, even if it were purely related to the general theory of psychoanalysis. There is a good reason for that. The clinician has to have a pre-psychoanalytic academic knowledge and training in psychopathology. Yet, psychoanalysts gave themselves the right to delve in none clinical matters, whatever poor and limited their understanding of those issues. This discrepancy strongly suggests an inflated self-image of the clinical psychoanalyst. Worse, it indicates a wrong and distorted understanding of psychoanalysis itself.  As we will see later, the system of training and the nature of the psychoanalytic organization prescribed a peculiar situation: ‘psychoanalyst’ became an identity, but only for those clinician who were trained the accredit training institutes.

A closer look at the identity of the psychoanalysts requires some reconsideration: clinically Freud was dealing with the patient but in the non- clinical domain he was exploring the human subject. This distinction is necessary although it is likely to make some ask: isn’t the human subject and the patient one and the same? It goes without saying that they are, but in psychoanalysis they were discovered separately; the patient was apparently discovered through his symptoms and suffering when Freud was treating people with hypnosis. During that same time he discovered the human subject through his dreams, jokes, slips of the tongue, religion, art, morality, etc. The patient in psychoanalysis was a human being suffering and exhibiting symptoms but was in a way different in his sickness; he did not know that he was alienated from himself and his intrapsychical dynamics were affecting his subjectivity. Thinkers and philosophers and even popular sayings acknowledged, in different degrees, the innateness of alienation in the human subject but did not identify it as such. Freud’s approach in psychotherapy, even from the very early hypnosis phase, was to restore the human subject in the patient. Despite the pathological alienation of the subject in the patient, the subject was still there waiting to be restored.

However, the question remained unanswered: who is the “human subject” who baffled the philosopher and is supposed to gain full clarity in psychoanalysis. The clinical psychoanalyst does not see the problem this way; he remains relating to the patient as the subject who is hiding something without knowing what he is hiding. In other terms, the puzzling human subject is not recognized or noticed by the clinician because what concerned the ordinary clinician is what the subject is hiding, and to very few they how the hiding happens. Freud was more of the second type of clinician. He discovered another thing about the human subject: being susceptible to getting psychologically sick. The natural and normal psychical manifestations of the subject are malleable   enough to sometimes take the form of sickness: love becomes hate, pain becomes pleasure, remembering could go in the wrong direction, etc. this leads to the fist step toward defining the human subject: a person whose rift between the primate process and the secondary process gets affected and loses its malleability and produces fixed links which stops the subject from utilizing the advantages of the natural links between the two types of processes.

The domination of the clinical aspect in psychoanalysis was an unplanned but unfortunate event. The non-clinical aspect of psychoanalysis did not have a proper chance to be developed and the clinical analysts became convinced that developing it is part of their responsibility. Thus, the early formation of the psychoanalytic organization just happened to be a community of clinical psychoanalysts who assumed the impossible task of surviving within their created Ghetto. They did not feel the need to change that mistake even when they were facing their gradual extinction. On the contrary, they derived a certain feeling of superiority and security in keeping it that way, denying that all the living professions around them are open scientific communities.

 The most detrimental outcome of this seemingly unintentional outcome of the history of the movement was exasperated by the early way psychoanalytic knowledge was transmitted from the older who knew it to the younger who wanted to learn it. It was transmitted in the form of training (not as an education as Jane hall stipulated in a recent posting). Psychoanalytic knowledge and experience did not have a history and were still in their infancy and just started to gel into a defined theory. The old generation was right in assuming the role of teachers, trainers, the ones who had the material and the instruments of transmitting psychoanalysis from generation to generation. But now, psychoanalysis evolved enough to distinguish between its two helices and finding new details within each helix to strongly call for a major revisions of the psychoanalysis of the human subject, the clinical theory (ies), the educational models to transmit it knowledge, and its links with the other idiographic sciences.

 In the next two parts of this post I will try to address the significance and possible pitfalls of theorizing in psychoanalysis.