Part Five:

The Irrational Resistance to Changing Psychoanalysis:

I define the gist of my Post: New Horizons for Clinical Psychoanalysis by two aimed for objectives: First: Bring to attention that clinical analysts have stopped considering their field an ever-evolving field in the area of clinical work, and put most of their energy and creativity in recycling recycled concepts (several times) of the original theory of psychoanalysis. Second: that clinical psychoanalysts are not giving attention to the deteriorated condition of psychoanalysis, both as theory and clinical practice, although the claimed the responsibility to bring psychoanalysis out of its slumber. Temporarily, I would say that the closed community of psychoanalysts and the institute system of training that is archaic and strained are insolating analysts and candidates from the outside world of the humanities and do not allow or accept non-analytic criteria to measure their activities against.

A closed community is not closed by force but by choice; analysts seem to like it like that. Everything in the field of psychoanalysis show that change is desirable, required, and most of all inevitable, that is if we care to keep psychoanalysis viable we are inclined to be part of its future. All the efforts made to maintain the status quo have failed. Wallerstein, over thirty years ago suggested the big tent idea. That was-against his expectation-a call for whoever to spread their own tents. The recent efforts to resuscitate psychoanalysis locally or internationally are just delaying its demise. Although there are not many suggestions to revive it there is undeniable irrational resistance to considering changing the status quo. The irrational is continuing the failed solutions with hope that next time one will work instead of trying a new solution

What is new that calls for change?

There are two issues that are seldom considered by clinical psychoanalysts because they insist on denying the obvious: they are dealing with new and different patients that they study in the Institute training. They overlook the fact that humans now are very different from what they were two hundred years ago, for instance. We change and make our changes change us. Over time changes affect our psychical and social life, they generate new and different emotional concerns, even new moralities. We form different ideas on maters of society and individual responsibility which in turn demand new ways of bringing up our children, thus influencing the intrapsychical dynamics of the individual. Those changes might not interest the limited clinical psychoanalyst but there no way away from studying the factors that impact clinical practice and our views of psychopathology. It is unlikely in todays practice of clinical psychoanalysis to encounter patients that are similar to the patients that were treated by our predecessors. Anxiety hysteria for one, was the neurosis of preference for the middle-class females of Vienna a hundred years ago. Now it would not be called a neurosis anymore but just feminine silliness or neuro myalgia. Patients fifty years ago, came with symptoms, when patient of nowadays come with the complaints about their lives. Without considering that fact we will not notice that our theoretical mess and confusion about practice come from refusing to change, while the patients are changing. Thirty years ago, there was still room in the field of psychopathology to name new kinds of patients. They came without displaying neurotic symptoms so we were able to call them ‘narcissistic disorders’, but not any more. Most of the very successful and well adjusted people and leaders of our time would be diagnosed that way if we are not carful to acknowledge that we humans have changed lately and could not be understood using old nosologies.

Secondly, all the previous attempts at formulating a comprehensive theory of psychoanalysis were derived from poor and hasty theoretical configurations of psychopathology. The reason is that psychopathology was a novel way of looking at human nature. The novelty was also in finding new vocabulary to describe the new discoveries. The new vocabulary was implicitly suggestive of a sort of explaining the described behaviour (repression, defense, resistance sublimation, etc.). The newness that was introduced by the psychoanalytic movement to the budding branch of psychiatry generated the idea of psychotherapy. For the old generations of psychoanalysts this novelty did not cause any confusion. They did not concern themselves with what is not pathological; the normal was just normal. They were working with symptoms and to a degree some purely psychical complaints that had some semblance to symptoms. Although it took time before we started to spread our wings to apply psychoanalysis to “non-pathological’ manifestation of the human subject, we did not have anything else to use but our theory of psychopathology. Frequently some of us came up with ridiculous explanations of ordinary phenomena and considered that “application” of psychoanalysis. Applied psychoanalysis of the time was not applying the psychoanalytic method of investigation of certain phenomena, but applying the theory itself of psychopathology on non-pathological phenomena, both individual and groups. The necessary distinction between a general theory of the unconscious (a theory of the subject) and a specific theory of the unconscious ( a theory of the patient) was not made in those works; psychoanalysts then were fascinated by their newly discovered freedom to engage-with authority- in any sort of debate about the human subject and his phenomena.

The outcome is what we have now: desperate attempts at formulating theories to regain a superiority lost, when we have made almost no new clinical discoveries for decades. Confusing what the analyst listens to with the practice of a new presumably new psychoanalytic theory is now accepted as our advanced clinical psychoanalysis. What I mean is: the analyst who identifies himself as a self psychologist convinced himself that he is listening to the self and not to what the object relationist listens to. Presumably, if the self psychologist still considers himself a psychoanalyst he should be honing in on something unconscious in whatever the patient is talking about. The psychoanalytic technique of practice is looking for the unconscious in whatever patient’s is presenting in his speech. Thus, a smart response to my interjection would be that the analyst listens to what he considers more demonstrative of the unconscious than other things. A smart reply to the smart response is: what do we psychoanalysts endeavour to achieve with our patients: change ‘their’ selves, their intersubjective relationships, their object relations, etc., or try and help the patient change himself so he could later change whatever he likes or dislike about himself?

What is new in clinical psychoanalysis is calling mere unsupported view points psychoanalysis, under the guise of contemporary theories. We, clinical analysts neglected our responsibility of preserving the original theory, and adapting the newness of psychopathology to that theory not adapting the theory to the original conceptions of psychopathology. I will give example a little later.

The Source of Resistance to Change:

The contemporary literature of psychoanalysis is rife with poorly recycled ideas of earlier analysts; mainly the second generation (Klein, Bion, Winnicott, Hartmann, Fairbairn, etc.). When those ideas and their terminologies were first published we (third generation) new what they meant: they were terminologies that explain the vocabulary of the first generation in a manner that is offering the chance to formulate a theory of the subject. The good-enough mother, the good object, the alpha and beta functions, did not stand for something new; they meant a mother that give the child a healthy Oedipus triangle, a father that encourages his daughter to be attached without guilt or shame, or coexistence of primary and secondary processes creating the link between fantasy and thought. Compare that with a young analyst (20..!) who translated Freud famous adage of where id was ego should be as the: “growing up (the task of the child) and getting better (the task of the patient) have to do with transforming id into ego. Freud’s adage was a metaphor that expressed the outcome of interpretation in a good practice, then, the young clinical analyst used that adage as a concrete replacement to making the unconscious conscious.  The original and its explication are now a theoretical idea that has no roots, except historically. Contemporary psychoanalysts and the candidates of recent believe that if they could use those adages of the older generation analysts correctly then could claim that they are doing clinical analysis as well as those other analysts. Just as an additional clarification to that: could any new analyst tell me what is the clinical equivalent to “the persistence of searching for the good object”, or how could I convey to the patient, in the simple direct language of interpretation or reconstruction, such neurotic inclination? I had candidates in supervision and in the seminars who knew all the concepts and the vocabulary of the old and the latest improvised theories but did not understand them or know what they could extract from them to use in practice. They were flaunting their knowledge, which in fact worked as a barrier between them and understanding psychoanalysis: Listen to the patient (not to Winnicott or so and so), Understand (not invite Klein to understand him for you), Interpret, and reconstruct the patient’s associations (which must have told you his specific experiences not some generic stories).

What is new and has to change starts with training and the link between Institute training and the psychoanalytic organizations. The reason is that psychoanalysis now is more involved and more elaborate to be communicated and transmitted to new generations of already keen candidates in five or six hundred hours of seminars and supervision. It is also in foundational links with several human sciences that were not existing when the training institutes were first established. Changing training to meet the requirements of a modern psychoanalyst will demand and force radical adjustments in both in system of trainingg, the faculty that will train, consequently the psychoanalytic institution and its professional functions, A threat that made some privileged psychoanalysts resist and fight against, even if irrationally.

How to go about that when and if we manage the resistance to change.