Training in the Age of Learning Psychoanalysis

I will start with an issue that was the fabric of my postings in- at least- the last two years. When the term ‘psychoanalysis’ is mentioned in a conversation with ordinary people they assume that we are talking about psychotherapy. Analysts are slightly different. They think of the profession of psychotherapy. Those two assumptions are partially right, but incomplete. Psychoanalysis is the body of knowledge of which an aspect of it could be a profession of psychotherapy. But there is more to it than that. Psychoanalysis is discoveries in the nature of our psychical quality of lif. This quality created the duality of the subjective I and the objective me, and the potential and the need for language to facilitate a link between those two aspects of within the human being, and the emerging phenomenon of communication between humans. The emergence of language uncovered the subject’s sense of being, which is the uniqueness of homosapiens among other creatures. We also do not just see; we like or dislike what we see, i.e.., we have a psychical life that parallels our physical sense of being or self. Freud found out that the psychical nature of our existence could be analyzed to reveal immense unobvious features that go beyond the obvious and the conscious. A substantial part of our consciousness of consciousness is unobvious. Psychoanalysis, thus, is not psychotherapy; it is the knowledge we already learned and should continue to learn about the psyche and was also able to explain aspects of the subject’s psychical psychopathology. Better, psychoanalysis is the “knowledge” that we could acquire from analyzing what is pathological in terms of the natural, and from analyzing the natural in terms of the pathological.  

Basic Psychoanalysis:

At the beginning of the psychoanalytic movement, in the late nineteen century, there was nothing of psychoanalysis to be taught. The first papers on technique came out twelve years after the Interpretation of Dreams. Maybe after 1912 some material on the technique of psychoanalytic therapy were derived from the shared and combined observations of other clinicians. The notion of a theory of psychoanalysis took a central place in the history of the movement around the time of founding the IPA’ (1910). Psychoanalysis’s first shot on theory was the libido theory, which became the basis of Ego Psychology few years later. Ego psychology freed psychoanalysis from the captivity of psychopathology but led it to the field of psychical mechanisms. Without the concept of the libido, which was used as the initiator of psychical life, the problem of the force behind the psychical mechanisms had to be resolved. Psychoanalysis became a theory of psychodynamics in which the libidinal energy and the mechanisms combine to create the psychical phenomena. Obsessive compulsive phenomena were created by anxiety regarding rage that had to be dynamically turned into symptoms.  Psychoanalysis did not offer any serious material to learn but became rich in vocabulary with some grammar (common terminology like the blockage of the libido, reinverting the libido in the self, etc., and few elaborations of old insights. It created a limited field of communication between analyst but without a language that none analysts too could learn and speak. (A. Freud’s ego psychology and Klein’s object relations were accents not languages for psychoanalysis). Other analysts tried to construct their own language of psychoanalysis like Lacan, but it was impossible to do that without sharing an explanation of psychoanalysis. If we talk without the listeners agreeing on what we are speaking-because of the absence of a common language there will be no chance to translate to each other what we are saying.

What is psychoanalysis??!!

It will take a lot of time and space to answer this question. I also cannot say that what I endeavored to do to answer this question for myself would be satisfactory to others. However, if I mention the names of analysts who did magnificent work in the domain of explaining psychoanalysis you will know what I mean: Matte-Blanco, Laplanche, Ricoeur, Bouvet, Erickson, Bion. They worked on the vocabulary of psychoanalysis and used it as the framework or background of their psychoanalytic meanings. For example, Erikson put psychoanalysis in the framework of building the intrapsychic in the early years of life, while Ricoeur put it in the framework of understanding the significance of interpretation in psychical life. Thus, an Ericksonian could talk to a Bouvetian about trust and mistrust in the context of Orality and they could understand each other. Psychoanalysis must be understood as one of the human endeavors, not a simple system of reaching the unconscious that parallels an associated consciousness.

 

Mistake:

I hope you will forgive me in making the mistake the mistake I am trying to correct now. It could be referred to something unconsciously playing with my understanding of the unconscious, or it might be just “a return of the repressed”.

In the past posting I used a clinical experience to show the manner the practicing psychoanalyst usually deals with the unconscious aspects in a patient’s associations. Instead of showing what may be a better way to give the unconscious the chance to unfold in a gradual way I went directly to its content.  

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While in training my patient mentioned with some annoyance that sometimes he feels that his deceased mother is behind him watching what and how he does things. My supervisor (very Kleinian) asked me to ask the patient where exactly his mother stands behind him when he feels her presence. Although I very seldom ask my patients questions, I asked the patient, the first time he mentioned his difficulty with his mother’s presence. ‘She stood a couple of feet behind him to just feel her presence but not see her’. I mentioned to him that she stands in the same space I occupy with him laying on the couch i.e., he could be speaking about me too in his complaint. My remarks were meant to show the patient that his speech could unconsciously reveal things that he is talking about two subjects and could speak about them together or separately, if in a different context.

This remark came from realising that the patient-in an unconscious way- created a metaphor that (also unconsciously) depicted the psychoanalytic situation as the situation and relationship he lived with his mother growing up. The metaphor was quite revealing of this patient’s tendency to construct other situations in the same manner. In other terms, the patient’s unconscious identification of me with the mother reveals several possible unconscious leanings in his psychological relations with people: need for approval, narcissistic sensitivities, repressed anger, potential to regression to dependency demands.

The point I wanted to underline with this correction I am trying to make is that the analyst has to uncover the unconscious in the relationship with him before just going around our rich vocabulary to find the best term to use to form his interpretation.

This remark was instrumental in analyzing his relationship with his mother through his transference relationship with me. In other terms, the unconscious is not something conscious that became unconscious, or something happened before the emergence of consciousness during psychoanalysis, so it was never conscious in the first case. The unconscious is a psychical process that is active all the time, shaping the present by something of the past. The unconscious creates -by participation of consciousness- the psychical life of the subject as a natural part or aspect of the living present. The unconscious in this case is not a psychical entity, it is the psychical process that made the patient’s phantasy of his mother watching him, and analyst listening to him, overlap one mentioned event. His upset about his mother’s interference meant something else too.

What I would like to strongly emphasises is that we should discover WHAT is unconscious in the analytic situation and gradually use it to rebuild the evolution of the original events that furnishes the unconscious in the patient’s life in general. The most unnoticed thing (which is the most important) is hurrying up to find a term, a verb, a concept a word in our repertoire of vocabulary that could explain what we are doing when we should avoid the closure on the process of analyzing for no gain from making the best choice.  

A clinical example could be useful. While in training my patient mentioned with some annoyance that sometimes he feels that his deceased mother is behind him watching what and how he does things. My supervisor (very Kleinian) asked me to ask the patient where exactly his mother stands behind him when he feels her presence. Although I very seldom ask my patients questions, I asked the patient the first time he mentioned his difficulty with his mothers presence. ‘She stood a couple of feet behind him to just feel her presence but not see her. I mentioned to him that she stands in the same space I occupy with him laying on the couch i.e., he could be speaking about me too in his complaint. My remarks were meant to show the patient that his speech could unconsciously reveal things that he could speak about if in a different context. This remark was instrumental in analyzing his relationship with his mother through his transference relationship with me. In other terms, the unconscious is not something conscious that became unconscious, or something happened before the emergence of consciousness, so it was never conscious in the first case. The unconscious is a psychical process that is active all the time, shaping the present by something of the past. The unconscious creates -by participation- the psychical life of the subject as a natural part or aspect of the living present. The unconscious in this case is not a psychical entity, it is the psychical process that made the patient’s phantasy of his mother watching him, and analyst listening to him, overlap one mentioned event. His upset about his mother’s interference meant something else too.

What we call unconscious is the process that makes an event a psychical event, i.e., a meaningful event. Without a contribution from an unconscious process to our regular present events they will all be void of meaning. Waiting for the bus to arrive means waiting because it unconsciously relates that to somethings related to time. The unconscious is the process that manages our psychical life; therefore, it is not an entity but the process that creates entities of the present events. The unconscious, in that sense, is something to study because as a process we will always have to elicit it from consciousness, which requires a good grasp of its formation and functioning.

Studying the Unconscious:

          After more than a century of making the unconscious explain things to us-psychoanalysts- it is time to study the unconscious itself. The reason is that we -psychoanalysts- mean several and differing things when we use the term unconscious? The most serious about that is not the absence of agreement on its meaning but the absence of clear disagreements on its connotation. We keep hedging about that for reasons: we consider it a psychical entity, the reversal of consciousness, the outcome of a process of repression that we assume its presence, or at least we consider it a thing. Therefore, there is no ‘ one understanding’ of the basic essential of our practice.

My suggestion comes from the fact that Freud did not explain his multiple definitions or identifications of the term unconscious. He started with the unconscious as the content of what is consciously rejectionable. He then moved from its status as an object (content) to a more subjective connotation of the individual’s own psychodynamics and subjective dealings with his own self creating his own preference to the unconscious. It changed from being an entity of rejected instinctual urges to become the processes that manage altering the personal rejection of a certain content. Thus, the uncosncious could get some conscious recognition from the subject. Freud’s tendency to find an acceptable meaning for unconsciousness made him think of it differently based on the context its mentioned. He specified three domains for the unconscious to be activated: topographic, dynamic, and systemic (1915). This classification was not recognized as of significance by the psychoanalysts, but it showed that unconsciousness exists in every aspect of psychical life. We can talk about the degrees of unconsciousness (Cs, Pcs, Usc)., or topographically as in (Ego-Id-Super-Ego), and dynamically as (repressed, transformed, sublimated, etc.).

Learning the unconscious has to start with Freud’s first distinction between the primary processes the and the secondary processes as in primary narcissism and secondary narcissism. He also distinguished between the primal of an issue and the issue itself (primal repression and repression proper). The ‘primary’ is the earliest while its evolution(s) generate its secondary and more elaborate forms. The primary processes are expressed in our language in the double format of metaphors and metonymies, in speech or messaging. Consciously we use, and literature the primary process is a style of speech, but psychologically it is the earliest way of using language (It takes long months for a child to recognize that mother person who has a special function).  The primary process in psychoanalysis is the means by which the unconscious would use the formats of metonymy and metaphor in moving from the cognitive to the thoughtful and from specific to general. In the Irma dream the gathering of the physicians was metonymy of the medical profession while the patient’s reluctance to open her mouth to be examine was a metaphor of her resistance to cooperate. The unconscious is an amalgam of primary and secondary process, and primal states of psychical entities. Being such a complex psychical function, it is ‘a must’ study subject in psychoanalysis because without knowing how the unconscious penetrate all our conscious life will make consciousness most difficult to comprehend. We do not only need to know it well, but we also have to know how to respond to it, which is another issue.

Learning and Training in Psychoanalysis:

As a psychoanalyst myself who got his formation as analyst in the old days (early1960), a formation that is still ongoing system of training I know well that what I have presented till now and what I am proposing is quite foreign to the minds of the contemporary analysts. In spite of all that it is a duty to use experience to improve psychoanalysis. There is a great deal of new and better understandings of the vocabulary of psychoanalysis, but unexpectedly are done by none-analysts. I mean by the vocabulary of psychoanalysis is the establish ideas, conceptions, practices and modalities of training. It was acceptable- till maybe the mid-seventies- to use the old IPA model of forming the new psychoanalysts via its training modality of the tripartite, but now, with all what we knew and know, and the changes in the sphere of the formation of analysts that happened, that model is not quite enough. we should consider learning psychoanalysis has to replace training in psychoanalysis. The difference is make studying psychoanalysis and teaching it under a strict system of academic education the way to go and look into the aspect of psychotherapy separately. If there is going to be transmission of knowledge from senior teachers to junior candidate it should be done via extensive supervision and not personal analysis. Supervision could be wider in scopes and more enriching to groups of candidates, and maybe some of the personal blindness to the unconscious be better discussed that a personal analysis. However, students of psychoanalysis who want o work in the field of therapy might consider a period of personal analysis as part of training.

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Psychoanalysis was training in doing psychotherapy based on whatever was learned about it, which was much less that what should have been. Whatever was learned in psychotherapy was confined to limited knowledge about psychical mechanisms, dynamics, processes, wrapped in few terminologies that sounded as carrying meanings beyond their ordinary meanings. There was also a lot of reliance on the basic clinical education of the candidate. Despite the gradual deterioration of that narrow scope of background, it seemed that the notion of reviewing the whole scope of psychoanalysis did not get enough attention to seek its revision.  It is our duty as psychoanalyst to encourage and work on moving the learning of psychoanalysis to academic institutions. We should let the specialists in philosophy, linguistics, child development, cognitive psychology, history of civilization, psychiatric issues, and several other issues pertaining to the human subject be the basis of a new psychoanalysis.