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Sunday, 19 November 2017

2. Does Trainting Help Psychoanalysis or Hurt it?
      My question could sound frivolous because it cannot be answered before asking another preliminary question: what else is psychoanalysis if not what we are trained to practice? Training- up till now- is the only formal and settled way of acquiring knowledge and expertise in psychoanalysis. It is also the only way to formerly join the psychoanalytic community. The implicit characterisation of psychoanalysis as practice creates a paradox: psychoanalysis is the practice of psychoanalysis.
      In the first part I stressed that the psychoanalytic movement has benefited from the notion of training and the institute system. It allowed giving the new discipline the needed outline to grow and build an identity and to identify its membership. However, when the movement reached full extension and expansion and popularity in the late sixties and the early seventies it started to show signs of fatigue. Those signs showed themselves in a telling way: a trend toward divisions. The one analysis generated several schools, and the schools, with their explicit titles, claimed to be new modalities of psychoanalysis. Yet, they were merely expanding the boundaries of the theory (haphazardly most of the time), indirectly criticizing the limitations of the Freudian Theory and trying to replace it. The result was deterioration in the status of significance and distinction which psychoanalysis enjoyed since its inception. There was also noticeable decline in the interest of young professional in joining the movement. The schools of psychoanalysis created confusion instead of delivering clear ideas of what they suggested to replace the classical theory with. Notwithstanding, all the factions that came out of the main psychoanalytic body maintained the same method of qualifying its members: training in the accredited training institutes. In other terms: whatever the position the new schools took from psychoanalysis, psychoanalysis remained an issue of training. Psychoanalysts, whatever their theoretical bend could not see in psychoanalysis anything beyond its practice. 
      In the last part I tried to show that if it was not for Klein and Kleinian’s psychoanalysis, psychoanalysis would have stifled to death under the weight of ego psychology.  To make that statement relevant to a discussion I would say that ego psychology had a settled and established theoretical formulation of the intrapsychical components and their dynamic interactions, i.e., it had “things to know and to do”. For example, psychoanalysis (the practice) was to strengthen the ego to cope with the demand of the id and the super ego. Theory and practice were substitutes for each other. Klein and the Kleinians thought about those givens, questioned their nature, origins, their implications in understanding the psychical phenomena and what they stand for. For instance, identification was not any more a psychical happening that results from assimilating and owning a characteristic or an attribute of the object, i.e. not a mechanism.  Kleinian psychoanalysis viewed identification as part of the process of the formation of the subject. By doing that the psychoanalytic theory moved from giving things to know to explaining what to be known first. The most significant product of Kleinian psychoanalysis was a new conception of development: what happens to the intrapsychical configuration when the infant starts to have objects and relates to others? Development was not a happening to the psychosexual constituents of the subject, but a transformation in the dealing with the world: external and internal. They were in search of the meaning of what we encounter in clinical practice, and came up with concepts that sometimes were useful (the true and false self) and sometimes not so useful (the paranoid- schizoid position and the depressive position).  The difference between the two schools was that one had firm knowledge that does not need more thinking, and the other was inviting the process of thinking about what is known, because naming them did not explain much. Repeating my self: still although the Kleinians introduced several totally new conceptions to psychoanalysis about what we encounter in its practice and opened the eyes to the need to learn more about those concepts, the Eitingon model of training remained the core of psychoanalytic knowledge. Psychoanalysts refused (not resisted) to see psychoanalysis outside its practice mode despite the vast interest of the none clinicians and the intellectuals in psychoanalysis, since the end of the second world war.
      It was not only the Kleinians who kept the hart of psychoanalysis beating. In France, the end of the first split allowed some of the most dedicated and academicians analyst establish a new society that introduced the scholarly study of the Freudian text; an approach that left ego psychology behind and advance a new and brilliant approach to psychoanalysis. Even Lacan, who was for a while one of that new trend still delivered a dozen Seminars in his “return to Freud” which were exceptionally revealing of Freud’s genius. After that he began his own trip in psychoanalysis. Although I do not know what happened in South America except some responding to both Klein and Lacan, I cannot dismiss the possibility of some great psychoanalysis there judging by Matte-Blanco’s work on the unconscious. Although in both France and South America some significant improvement were introduced to the systems of training was still the only open door to learn psychoanalysis.  
      The Kleinian approach to psychoanalysis showed that there is more to ‘learn’ about the human subject than what training system was offering in the late forties and early fifties. The strong emergence of Keinianism proved that psychoanalysts should take serious steps to explore new domains of the intrapsychical field. Training was lagging behind the novel conceptions that exceeded the stale theory of ego psychology. Kleinianism and the new additions that came from the French and the South American schools of psychoanalysis opened psychoanalysis to the humanities (which existed but was still limited). The new discoveries in infancy could have started child psychology in the fifties on a brilliant course of research and findings. Bion’s theories of thinking and group dynamics could have given projective techniques (Rorschach, TAT, drawing, etc.)  major push to explore the Alfa and Beta elements and functions in psychometry and provide social and industrial psychology with a new vision of small and large group dynamics. Even Ego Psychology, which was almost dying, had things to offer to psychotherapy by the innovations suggested by Rappaport and Gill. There were things to learn and to do in psychoanalysis beside training. Better, the limited understating of psychoanalysis kept the analysts captives of the concept of training and the institutes as the only places for that training to take place. Conflating and fusing (confusing) learning and training in psychoanalysis hurt psychoanalysis badly, not only because it made us, psychoanalysts, miss the chance to link with the humanities, but made other psychoanalyses have the same fate of ego psychology. We turned the psychical processes into operational definitions; for example instead of talking about the ego as ‘ a thing’ we talked about the introjection of ‘part objects’ as a thing that actually happen. Worse, Kleinian psychoanalysis seemed to have something to say about the oral phase and much less to what happened after the infant dealt with the transitory objects, although the way of thinking about the old psychosexual model of developing could have benefited from the Kleinian additions to the oral phase, and extended it to the other psychosexual phases.
      Turning thought into concrete entities, or turning psychical processes into psychical concepts is almost a hidden unconscious agreement not to question each other about what we mean by what we say [ you know what I mean; we are both Kleinians or Lacanians]. This attitude is seldom if ever found in academia, but it is a the pervasive attituded in the training institutes in psychoanalysis: we are not supposed to expect more from training than training. What complicates matters more is that candidates are usually trained by senior analysts who have known affiliations to a school or another. Confusing training with learning made idealizing the training analysts take a disguise in idealising the school the TA follows. It less infantile or neurotic. The problem with the negative role the TA plays in training is not related to the position of the TA, and would disappear by eliminating that post. The problem is limiting psychoanalysis to the idea of training, which in itself puts all the emphasis on training and putting learning outside the equation of the formation of the candidate. The institutes of psychoanalysis are not supposed to be places to learn psychoanalysis but places to trained to practice it. If the reason is not that the TA is a clinician and not a teacher, then it is because the time and the organization of the curriculum in the institutes do not permit enough time to get into the basic propositions of the intrapsychical configuration.  Thus, the learning part in the formation of the new generation is reduced to knowing some fixed conceptions of a very dynamic filed of activity.  What is taught in the institutes is ready made concepts, description of processes that have clinical importence but are meaningless without a good theoretical verification and explanation.
      The answer to my question of does training hurt psychoanalysis is yes. Training blocks learning and gives the impression that what is to be learned regarding psychoanalysis is the technique of practicing it as psychotherapy. It is common in the institutes discourage the candidates who inquire about something implicit in a technical issue. This notion is an inherited parochial belief that psychoanalysis is psychotherapy and every thing else is merely application of its theory. Firstly, we do not have a theory of psychoanalysis yet. Secondly, psychoanalysis is part of and belongs to the humanities; it has a clinical application in the field of psychopathology. Thirdly, psychoanalysis could be taken both as a transitive verb and as a noun: as a verb it is an act that requires training, but as a noun it is a body of knowledge that demands learning. It started as an act but by now it is an important body of knowledge, clearly a component of the human sciences (idiographic sciences), and it is a big mistake to think that that its body of knowledge that could be obtained from other fields of the humanities is of no major importance to the clinicians.

      It is not a secret that psychoanalysts are the ones who reject (not just resist) changing the status quo in psychoanalysis. They are always ready to look into the flaws of the structure of their organizations and try to make modifications here and there. But, they are not ready to see that it is not simply a practice that could be learned by training. There are two obvious points: training in analysis is not learning psychoanalysis, and the institute system of training is not only outdated, it is counterproductive. Why then analysts do not want admit to those two obvious points and work on changing the institute model that was once our reason of existence and now is the threat of our demise. 

Saturday, 11 November 2017

Psychoanalysis: training or learning?

I am disappointed by the  new psychoanalyst’s he level of knowledge of the basic psychoanalytic concepts, and the way they understand and use the works of the main prominent creative psychoanalysts of the past. I base my dissatisfaction on what I regularly read in four main psychoanalytic journals.  My dissatisfaction does not come from disagreeing with what they publish, but from the distorted idea of psychoanalysis which they convey in their works, and using- in inappropriate ways- the works of genuinely creative minds of the past. I lived the glorious days of the splits in the British and the French societies, the rise and fall of ego psychology in the USA, and the birth of the schools of psychoanalysis. Yet, there was always a well protected and preserved core of psychoanalysis among the adversaries, i.e., there were somethings too fundamental to be distorted to fit a debate; the place of the unconscious (not the repressed) in the psychical phenomena, the place of the primary process in interpreting the patient’s material, and the significance of the transference in the psychoanalytic situation. I think the explanation of that unspoken agreement amongst the old and senior analysts came from firm, sturdy and well conducted system of training. We were all trained in psychoanalysis whatever the institute belonged or dominated by some prevailing ideas. I believe that the reason behind what I consider deterioration in contemporary psychoanalysis relates to training more than any other offered causes. That is what I want to discuss in this post. To be clear from the beginning, I am critical of the current attempts to modify, improve, and correct the flaws of the institute system of training despite the serious and sincere intentions of the people who are trying that. I will explain.   
First, I think the tripartite system of training was very logical at the start of the psychoanalytic movement. It guaranteed proper competence in practicing psychoanalysis. However, we have to remember that in the time Abraham and later Eitingon the theory of psychoanalysis was still evolving and there was more than a decade before Freud come to write “The Outline”. Moreover, despite Freud’s remarkable insights regarding the practice of psychoanalysis, which he wrote in 1912, there was little appreciation of its deep understanding of the process of psychoanalysis (I wrote a more extensive version of this idea in my book explaining the classical theory). All in all, psychoanalysis did not have a stable body of knowledge or a clear system of practice that correspond to that theory at the time. Training was necessarily done in institutes. All trades (and psychoanalysis at that early period was merely a budding trade) were doing that in the system of guilds that was the foundation of the industrial revolution and the birth of academia too.
1.The link between training and the theory:
It took the psychoanalytic movement three decades or more to come up with the notion of training the new comers to the movement. At the beginning, training was not the main objective but was the means to screen membership to the movement, and to give the message that recognising one’s affiliation to the movement has to be legitimate by the approval of the already recognised analysts, who ‘founded’ of the movement. This sensible condition became sort of tradition. The objective was very modest and legitimate at the time, because psychoanalysis was merely a new discipline looking for an identity (despite the majority of its members were physicians, some were not and Freud was of the opinion that it does not belong solely to medicine). Thus, establishing institutes for training was very logical because psychoanalysis as a new discipline with very little true literature to learn from had to rely on the old and experienced generation to transmit to the new generation their experience and knowledge; particularly in a one-to-one basis.
In the early phase of building the movement the three branches of training-seminars, supervision, and personal analysis- proved to be the natural and the only available way to transmit experience and knowledge; through personal contact. There was no way to show how analysis is done but by undergoing a period of personal analysis (that it is how it gained the title of didactic analysis). I do not remember the name of the analyst who suggested that didactic analysis is also essential so the psychoanalyst could get rid of his own difficulties. Supervision was also didactic in a more concrete sense of the term. The formation of local communities of analysts initiated the idea of systematizing revision of the available literature, and the seminars were established as the third leg in the tripod of training. Better, training reflected the state of affair in psychoanalysis at the time of its onset, and aimed at transmitting the experience of the old to the new in the fashion of training.
Up till Freud’s passing psychoanalysis was continuing the discovering the intrapsychical and exploring its transformations. As an example, Freud’s discovering of the contribution of infantile sexuality in psychical conflict brought out the notion of the sexual Trieb the ego Trieb. This polarity evolved to eventually become life and death polarity. The cathartic theory evolved into a theory of psychical transformations and constructs (I wrote about Freudian’s other theory that should replace the cathartic theory in 2013). However, Freud kept chasing a final configuration of his discoveries till the end, and maybe gave in to his daughter by accepting her version of ego psychology as a final articulation of the theory. Understandably, training changed into a refined, elaboration, and expansion of the demands of the tripartite system, and founding the institute model of training as the only way of learning psychoanalysis. However, Anna Freud’s presumption that the theory has already been completed, and it only needs to be practiced as such was heading for a big surprise: She just identified the beginning of psychoanalysis. 
While Anna Freud thought that ego psychology is the final version of a theory of the intrapsychical Melanie Klein was turning her attention from exploring the intrapsychical to its origin and early formation.   Her contribution was almost declaring the end of the Road for the Freudian psychology and the beginning of using it to explore something seriously new about the subject. The difference between A. Freud’s mechanisms of defense and Klein’s projective identification was like one closing the door on something established and the other is opening the door for crossing that established limit. Anna Freud calcified and reified the intrapsychical by making a neat description of its content, while Klein gave it life by showing its interpersonal origin and relational framework. Psychoanalysis was stepping out of Freud’s original frame work, thus was changing. Training remained the same tripartite system but personal analysis was expected to become more intense to meet the Kleinian conception of the intrapsychical. Although Kleinianism was not the school of thought in France, for instance, the extended length of time for personal analysis was adopted by the two traditional societies ( while the Lacanians made sort of a mockery of it). They added another aspect to personal analysis in training: a period of personal analysis before applying for training. I think this was a reflection of considering personal analysis separate from training and should be a matter of agreement between analyst and analysand.
The end of pure Freudian psychoanalysis of pressure, defense, and decathecting as the main intrapsychical dynamics, and the rise of psychoanalysis of the processes and transformations was a major theoretical change. Nonetheless it did not affect training in any noticeable way! It is an important question but answering it needs more examination of changes in psychoanalysis itself.
The distinction psychoanalysts made between ‘drive’ psychology and ‘relational’ psychology was interesting, useful but wrong. Classical psychoanalysis was not a drive psychology but of Trieb: the psychology of the representation of a wish in the mind. A representation of a wish IS the psychical, and comes as a manifest that has a content that necessitates its discovery by psychoanalysis. The psychology of the interpersonal is the psychology of the birth of the subject within early relations with the caregivers and the re-emergence of old relational configurations in the contemporary interpersonal relations of the subject. Better, Klein’s psychoanalysis was turning Trieben into be a bridge between the past and the present.  
Could that change have required revision of training and its parochial system? Yes, but the flawed distinction between drive psychology and relational psychology distracted us from the main issue. Nonetheless, it introduced to the training a novel issue in the practice of psychoanalysis: what is the best aspect of psychoanalysing that could reveal the unconscious link between the manifest and the latent in a psychical event? Without paying much attention to the nature of the Kleinian breakthrough analysts (unconsciously) were stated to look for the best method to reach the unconscious link between the manifest (the patient’s complaint) and its content. Better, analysts noticed that they have a chance to read in the patient’s interpersonal relations the unconscious link between the manifest and the latent. In the seventies of last century, the psychoanalytic scene exploded with the schools, which were merely the choice the analysts make in practicing psychoanalysis. 
The schools of psychoanalysis do not offer novel theories of the psyche as the followers think or prefer to think. The schools are not more than a preference of the medium the analyst choses to look for the unconscious. Arguing this point more and better would show that psychoanalysis (training) has to respond to those changes.

In the next section I will address a thorny topic: Does the idea of training the psychoanalysts serves psychoanalysis or hurts it?