2. A Different Way of Saying the Same Thing

 

C. Training to Practice of Psychoanalysis:

 

The second arm of the formation of  psychoanalysts is ‘training to practice’. This aspect of preparing the new commers to the profession is concentrated in two activities: personal analysis (get analysed) and supervision (get the know[aF1]  how to conduct a psychoanalytic treatment of patients from three ‘training analysts’). Personal analysis is supposed to be ‘experiencing’ the process, or as Freud said it in 1910: “…. and ‘derive’ from it the essence of doing psychoanalysis”(SE, Vol XI). Sadly, this part of training lost its didactic meaning and gradually acquired a therapeutic  meaning. This is sad because we know that analysis as therapy does not work if it is not meant from the beginning to be just for therapy. Therefore, personal analysis is a distorted item in the preparation of the candidates. It is -in fact- detrimental to the process of training if it remains as a therapeutic necessity.

 This change had two very detrimental consequences: The candidate does not pay attention to the process, but very subtly creates another objective to replaces the original one(training). The training analyst takes the attitude of a therapist and the original purpose, thus, distorts the  transference and counter\transference. It is a glaring cause of the  psychodynamics of relationships in psychoanalytic societies. Moreover, personal analysis as part of training becomes another source of good patients for the training analysts; not only this does not serve its basic function, but it also distorts the purpose of becoming a training analyst. This aspect of training was the logical way to do training in the early years of psychoanalysis (Eitington modality)but now and maybe in the last seven- or eight-decades training should have taken a different direction. Personal analysis has to be redefined, or recommended as  therapeutic case by case, or be required a suitable period before engaging in a training program.

When we come to the second aspect of training, i.e., supervision, we have to consider that aspect the most basic and fundamental in the whole process of the formation of the analyst. Most the colleagues I trained with and the candidates I supervised had a strong conviction that psychoanalysis (as a process of therapy) has very limited rules, compared to the spontaneity and the analyst’s’ intuitions, and his ‘free floating attention’. I believe that conception, first of all is wrong. There are rules to listening, discerning the unconscious in the rhetoric, interpreting it, or waiting longer before doing that, etc. Because those aspect of training are important the training analyst should know how to explain them to the candidate, so he would practice something that has a theoretical base (the gap mentioned above). What is meant by that is to explain to the candidate-from the material the patient has delivered- what was unconscious in the conscious rhetoric.

Freud’s Tripartite Recommendations:

I believe and advocates the notion that Freud was intuitive about the very basic and cardinal in psychoanalysis but did not articulate his intuitions properly and many time he did exactly the opposite of his recommendation. The reason- I think- is the analyst’s intolerance of putting his identity on hold to maintain neutrality. If psychoanalysis is a unique way of psychotherapy, it is because of Freud’s tripartite recommendations for practice and the analysis of transference, or the transferiantial elements in the relationship with himself.

Freud’s paper on Wild Psychoanalysis  came two years before his three recommendations or the tripartite rules of practice [I believe that Freud’s poor clinical record is due to not adhering to  his own recommendations). His intuition about psychoanalysing made him recommend: Abstinence, Anonymity, and Neutrality. From the patient side he should create his own ideas, phantasies, collect whatever fact he could get or like to get. From the analyst side he should refrain from denying or confirming to the patient any of those notions he built. As for the analyst his unconfirmed or undenied personal qualities- given to him  by the patient- widen the field of the patient’s transference. Two decades ago, there was major attacks on this protocol, especially in Western US Psychoanalysts. The fallacy of the  reasons given shows in analysts extending those violations of the rules of psychoanalysis-unnecessarily-by sharing with patients their own personal thoughts and feelings. The issue with Freud’s recommendations is the need for good personal analysis and understanding of the process of treatment.

The basic ‘idea’ in psychoanalyzing-therapeutic or didactic- is to limit the factual and encourage the personal and transferiantial. So, the natural thing is to explain to the Candidate the logic of the tripartite recommendation and the notion of wild analysis issue. Conducting analysis that way is didactic in itself, whether in training or just ordinary practice. In training the candidate will make the distinction between therapy and learning about the way material gets it wider meaning by interpretation. A training analyst is not a better psychoanalyst but a psychoanalyst who KNOWS how to link interpretations to free association without being obvious in this didactic work. The candidate is not better than a patient in analysis. However, he has the advantage and the duty to learn how the unconscious keeps forming and changing with its interpretation. This knowledge is what to keep in mind all the time while practicing.

 

The Core Meaning of Training in Psychoanalysis:

Freud said clearly: “It is not enough, therefore, for the physician to know a few of the findings of psycho-analysis; he must also have familiarized himself with its technique if he wishes his medical procedure be guided by a psycho-analytic point of view. This technique cannot yet be learned from books, and certainly cannot be discovered independently without great sacrifices of time, about, and success.”(1910, S.D., Vol. XI, p.226). In a nutshell,  the analytic situation is a patient who knows what he suffers from but does not understand the factors that causes that condition. On the other hand, the analyst knows something about the causation of the complaint but does not know the conditions that led to that complaint. Analytic work is to make and engender knowledge to help the other person in that due understand. Therefore, training in psychoanalysis is to learn how and what is involved in this mutual effort to know what seems to one very baffling while for the other (the analyst it is a slow process building up that knowledge. Training in psychoanalysis is to learn how to mange ‘the unconscious ‘knowledge’ of the patient.

This point is related to the meaning of the unconscious knowledge and how the candidate learn to hear it within the conscious rhetoric.

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2. A Different Way of Saying the Same Thing

B. Learning Psychoanalysis:

The literature of psychoanalysis is immense and claiming that some of it are better than others is a foremost understatement. Nevertheless, I have to say something about that: a training endeavour has to do things: make a good choice of literature that makes it logical and easy for the candidates to fill the gap between theory and practice. It does not make sense to have a syllabus that mixes literature from two clearly different authors, or that has samples of the literature of different schools of psychoanalysis. The other point is making the same deliberate choice of Freud’s works. The really significant in the Freud S.E. is how he coined his terminology and how they were pregnant with the rich meanings that they have now. THIS WHAT I MEANT BY AN ACADEMIC SCRUTINIY OF TERMINOLOGY. Our vocabulary was a marvel when it was used in the psychoanalytic theory…new, revealing, full of a variety of meanings. With time (more than a century) it no longer has those qualities and lost anything that give them that insightful  distinction.

     Learning psychoanalysis is easy to identify as sudyining some foundational theoretical texts, but the important aspect in learning the literature is how the chosen literature is studied. Because psychoanalysis is originally an original way of perceiving and understanding common issues and giving more meaning to regular vocabularies a basic part of learning it is to be exposed to those specifics of psychoanalytic way of thinking. The good example to that distinction I am making about learning analysis is the difference between a thinker like P. Ricoeur’s understanding of ‘interpretation’ and Lacan’s style of interpretation. The difference is something to learn.

Therefore, the efforts to update psychoanalysis, theory and practice requires a serious and sharp attention to the gaps between theory and practice and how the candidate will bridge that gap.

   

 

A Different Way of Saying the Same Thing

 

1.Overlooking a Basic Link in Psychoanalysis:

Saying something more than once when that thing is important and needed emphasis or was not understood well enough to leave it alone. I am repeating a previously emphasized idea that ‘psychoanalysis’ is a term that could connote a body of knowledge, and also a specific modality of psychotherapy, but not both at the same breath. The main issue in that distinction is the link between what is usually named the theory of psychoanalysis and what is considered a technique of psychotherapy. Those are two different things but linked. That link is a most elusive subject to agree on its nature. My view of that link is that if there is a link (which I believe there is) it has to come from a well-defined, verified, clearly articulated theory, so the analyst would not practice psychoanalysis arbitrarily. He has to adhere to his understanding of psychopathology and therapy, and how one determines the other. If the analyst understand psychopathology as the outcome of intrapsychic distortions that were formed during growing up his approach in therapy would be concentrating his work on transference manifestations that will give him the insight about those distortions and what to do[aF2]  the reformulate their structure. If the analyst believes that he can deal with the interpersonal mismanagement of the psychopathology, he then will not bring transference in the work and concentrate on correcting the patient’s views about relationships. Each approach has clear distinctions in terms of what to do and what not to do.

Those two different understandings of psychopathology and its link with psychotherapy goes back to something in the Freud’s dealing with discovering ‘psychoanalysis’. Freud began the notion of psychoanalyzing with-maybe-some general social ideas about sexual frustration as a possible causation of hysteria emanating from common social attitudes and some remarks from physicians who must have encountered issues related to sexuality and morality in their daily medical practices.  Hypnosis showed him that he could make his patients talk about those frustrations in less reservations. However, he was able -due to his special psychological sensitivity- to hear double meanings in what patients were consciously relating to him. Talking did not just revealed ‘the unspoken about’ but also unconscious ideas that were implicit in what is spoken. The rest is our history. Freud was endowed with certain mental gifts in addition of great and advanced psychological familiarity with the neurological foundation of most of his discoveries in in psychotherapy (see the “The Project”, and Holms extrapolations). However, Freud noticed and intuitively knew what should be done with listening to the patients’ free associations. In 1912 he made the clear recommendations of a practice of good psychoanalysis; the three or the four (1910) restriction on practice. Nonetheless, he was the biggest culprit in breaking his rules (analyzing his daughter!!). In other words, Freud discovered the core qualities of the real and true psychoanalyzing but did not follow them. He was not a good clinician, but he discovered clinical work that matches his theory[aF3] . He dropped hypnosis and started ‘psychoanalyzing’ the patients’ speech. The link between what is said and what was ‘not said’ but relayed to Freud created that gap between psychoanalysis and psychoanalyzing.  

  However, the gap is very clear in the huge difference between his building of a body of knowledge about psychopathology and psychodynamics on one side and the technique of psychoanalyzing (practice) on the other. The gap between Freud’s clinical work and his knowledge of the subject of psychoanalysis remained a trademark of psychoanalysis as a whole and its literature, since then. The scarcity of clear and committed literature to how we do psychoanalyzing-practicing it- is the background of all the unresolved issues regarding the so-called theories of psychoanalysis (the schools). It is obvious that all the well-known schools of psychoanalysis that were competing for dominating it were related to its practice and not to new knowledge; with the exception of Kohut’s self-psychology. He killed it early trying to find a new way of practicing his sudden discovery of the duality of the subject.

The link between theory and practice looks important as a major issue in the world of psychoanalysis. But it is a link in every individual practice of psychoanalysis. A psychoanalyst who has his patient on the couch or on a chair in front of him has to keep in mind that he is obligated to keep the distinction between his understanding of what the patient relays to him and his response to it, should bridge that gap properly and in the proper moment. The link between his theory of psychopathology and psychotherapy will determine his response, from silence to reconstruction. This means that the practice of psychoanalyzing should always be based on the link between the two connotations of the term psychoanalysis. In other clearer way: the link between what we know and what we do with what we know is where a clinical psychoanalyst has to keep in mind all the time and readjust his work to make that link a daily obligation.

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 [aF1]

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