A. What is Therapeutic in a Psychoanalytic Interpretation?

          I think the answer to this question could lead to addressing several problems that we encounter in our practices, and our accountability to the patients we treat. Psychoanalysts have the obligation to show that their act of psychotherapy is based on a clear link between interpretation- as the core of psychoanalyzing- and cure. If the analyst takes a different approach in therapy, he still has the responsibility to explain his work. What is professionally disturbing, and alarming is the faint notion that  we initiate cure by bring the unconscious to consciousness via the work of interpretation. Although this formula is the most acceptable among analysts of all walks of practice, it is not the main focus of psychoanalysing-as analysts like to claim.

The basis for saying that is the absence of agreement among analysts on the meaning of  “unconscious”. The unconscious means- in the Freudian vocabulary- something that was once conscious and was rendered sub-conscious, thus it gained a certain new function. After modern thinkers, of whom some analysts were pioneers and worked on that imperfect Freudian notion, the unconscious was regard as a structural system, or a special form of thought that is embedded in every spoked idea (the unconscious is not sub-conscious psychical material). Although analysts agree that the old unconscious is not ‘the repressed’ they still have the notion that the unconscious is something we should get rid of by exposing it within consciousness.  The other challenging issues are agreeing on the meaning of interpretation and what to interpret and from what do get the interpretation. In less words, we have more vague and difficult issues  to deal with than the expression of making the unconscious conscious suggests.   

What this post is emphasizing is that we should know consciously what we do and call ‘interpretation’, which is supposed to be what instigate the change the patient’s come to us to initiate.

A Moral Obligation:

As in all professions a professional is accountable to the person who requests his service. The psychoanalyst is accountable to the patients, the colleagues, and the field of epistemology as a whole and is not just free to practice with just the certification of a private training institute. The analyst should  know what he does to what.  The early analysts were exploring a newly discovered field and it was acceptable to give this  tentative answer of making the unconscious conscious. After Freud and his disciples gave birth to psychoanalysis as a professional discipline, in the nineteen thirties, the few decades that followed  were spent in theorising the substance of therapy and the analytic notions about the psyche. Aa a  new field of knowledge it needed two things that were not yet achieved: validating its claims to being a successful base for psychotherapy, and the prospects of developing it into a human science ( psychotherapy was and  still is considered an off shoot of a medical act). In spite of the absence of both those two conditions since and till now, psychoanalysis thrived without them. There was no proof or evidence provided to support the psychoanalysts claims regarding their descriptions of the  psychical processes or to confirm the effectiveness of psychoanalysis as therapy.

The expanding interest in psychoanalysis required  Freud and his disciples to start  creating a new vocabulary for their new findings. The vocabulary of psychoanalysis came from the common spoken language-like repression and projection- but the words acquired additional and more in-depth meanings. Developing the psychoanalytic vocabulary and its expansion to cover more ordinary issues like love\and hate, sadism, and masochism, etc., made it looked like  a theory. The theory of psychoanalysis was  actually a new and in-depth vocabulary of  certain psychical operations and phenomena, but it lacked a ‘subject-matter’. We can presume  that the human subject was its subject matter, but in this case, we would be reversing the cause/effect relation needed  in theorising. A search to understand the human subject should have created psychoanalysis and not that discovering psychoanalysis led us to discovering the subject. This mistaken start still delays reaching a comfortable answer to the question: what is psychoanalysis? Because it is expected that we will get more than one answer one answer we should just decide on some parameter  for the answers: no hypotheticals to qualify the answers.

  Freud looks as if he discovered psychoanalysis for us to find it. His text (the Standard Edition) is never old to ignore and replace. It is not what he discovered that is  essential in the formation of the analyst; it  his style of  discovering it that counts. As an example of this idea is his work on dreams. Finding out that a dream is a wish fulfilled is not a great break-through in the field of exploring the psyche. But, interpreting the dream- scene as fulfilling a wish, and realising that many important unconscious wishes could be found in the patients’ dreams bring to focus the nature of our work: interpreting in order to affect change- ‘new knowledge is cure’? I would not be surprised if most contemporary psychoanalysts would answer my query by saying that the dream brings the unconscious wish to consciousness. This is not true or satisfactory. The importance of interpreting dreams in analysis is to show the dreamer the workings of the dream-work. Interpreting the dream reverses the process of dreaming  which separates the wish from the dreamwork. It should catch our attention that a reputable physician in the eighteen centuries started a unique career of discoveries in a nonmedical field, by finding a respectable way of understanding dreams.            

Freud’s Gradual Discovery of Psychoanalysis:^[1]

To begin with, I find it very useful to make an early distinction between ‘psychoanalytic discoveries or finds’ like the dream as a wish fulfillment and ‘psychoanalytic thinking’ like the ‘ego’ is negation. Soon after finding that dreams are wish fulfilment Freud demonstrated a new way of thinking without which “dream-work” would not have become our way of listening to patients’ associations regardless of the topic. Freud 'intuitively' realised that the unconscious dream-work (S.E., 6\277-278) has its own structure and is not 'bad thinking'. Freud’s theory of dreams is a discovery of the psychology of dreaming and fantasizing, but it also detailed how a wish could be turned into a dream, a conflict, or a symptom, a childhood experience creating a character formation. Dream- work is a product of  the linguistic facilities of metaphor and metonymy, and a  dream is a statement expressed pictorially as  metaphor and metonymy, thus the wish of the dreamer could find its way to the world of expression, disregarding social conventions. It is not correct to considers an insight just a moment of enlightenment, because as I will show, Freud had an analytic mind that made insights a natural way of making discoveries in simple and common observations.

Freud’s brief experiences with Bernheim, Charcot, and Breuer directed him to something those three pioneers practiced but did not notice or understand: the hysterical patients (later all patients) ‘have two psychological lives’ separated by psychodynamic resistances. This notion came from his observation that consciousness and unconsciousness are only separate when to fit the situation.  In other words, the physician using hypnotism in treating a hysteric has been given a chance to look at the two psychical lives next to each other. But as the history of the splitting of consciousness [the French School] shows, it was a specific Freudian insight that made the whole difference. Freud looked at the outcome of hypnosis to realize that in terms of its content it was psychological material that the patient is rejecting it to be his (the basis of repression). The other finding that Freud realized was that what remains in consciousness is rational (causes and effect) while what split from consciousness is of a different nature and has its own system of functioning. The repressed is not another conscious content that is objectionable; it is consciousness because of its different mental structure. To consider the repressed different and not just objectionable-matters meant that something else or additional was required in order to  move beyond the simple repression of the unacceptable.

Without being aware -at the time- he started psychoanalytic thinking by saying “the hysterics suffer from reminiscences” (1895). He discovered that the split of consciousness into consciousness and sub-consciousness was not caused by something outside that same split psyche. He came to a new way of thinking in regard to psychopathology (and eventually to the human subject) by making the cause of the neurosis part of  the symptom [the patient is hysterical not because her symptoms say so, but  because her hysterical symptoms are her way of trying to get by with her impediment!]. Thus, Freud moved to a new horizon: understand the symptom as an unconscious message. This insight went in the opposite direction of  medical tradition. In the fields of medicine or objective endeavours causes and effects are separated by a ‘process’ not by differences in   their nature. I am emphasizing this difference because Freud’s gifted insight in regard to causes and effects (results) were uncommon and were only part of the dialectics of the Hegelian thinking. This is a point that deserve the attention because  Freud's intuitions have their roots in Western philosophy and are not merely strokes of genius luck.

There is another much more important source of his intuition that got its definition thirty years or more after his stating work . Psychoanalysis, as it was discovered and administered by Freud,  was fundamentally a theory of structures and not a theory of functions. That difference was highlighted in the thirties of last century the advancements in the field of linguistics (F.de-Saussure). De-Saussure made a distinction between functional thinking and structural thinking, or between explaining and interpreting (explaining pertains to motives, while interpreting pertains to structures).The example of Freud’s distinction between explaining and interpreting is obvious in his dream-work formulation that interprets the dream as a wish fulfillment (a structure that is latent in every and any dream) instead of looking for the specifics of each dream to explain its function.  and the old methods that were meant to explain the dream.

Freud’s theory of dreams is a discovery of the psychology of dreaming and fantasizing, but it also detailed what turns a wish into a dream, a conflict into a symptom, and a childhood experience into a character formation. Dream- work is a product of the linguistic facilities of metaphor and metonymy. Thus, a dream is a statement expressed metaphorically and metonymically thus the wish of the dreamer could find its way to the world of expression and disregarding social conventions. It is not correct to considers an insight just a moment of enlightenment, because Freud had an analytic mind that made insights a natural way of making discoveries in simple and common observations.

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1.       The discovery of psychoanalysis is an event created by Freud’s endeavor to follow up on his intuitions regarding hypnotism. There are various ways to choose an approach to that subject which would be based on the most valued findings like the unconscious, identification, projection, etc. My approach in that regard is to underline some of Freud’s insights about common things, which built his way of thinking and created the ‘psychoanalytic way of explaining the new ‘findings’, like repetition compulsion and somatization. The most remarkable thing in that venture is Freud’s natural leaning to to simplicity instead of the appeal of complexity.

  

Freud’s insight was noticing that ordinary speech is made of interwoven conscious and unconscious meanings. This new feature in the functions of the mind opened him to a new mode of thinking: in psychical life it is not the causes and their effect that count but the nature of the link between them. Desiring something strongly could become painful enough to scare the person from attaining it. He was comfortable to live with the notion that the human mind is capable of reversing the link between causes and their results without much consternation, because the conscious and the unconscious coexist in the subject’s mind as a natural feature of our specie’s verbal thinking. Freud continued from that insight to practice thinking, instead of applying it. He accepted the existence of another thinking process alongside regular thinking, which has different means of expression. He also realized that with good attention to the patient’s conscious speech  the unconscious issues revealed themselves, but indirectly.  I believe that Freud was unconsciously searching for the unconscious. His discovery of psychoanalysis- as a new and distinct field of knowledge- started when he established the coexistence of consciousness and unconsciousness and that there was no use for hypnotism to dealing with each separately. This point emphasizes the fact that whatever is said still requires interpretation. 

If we accept those preliminary discoveries (insights) as basics in psychoanalysis we- old generation psychoanalysts and our candidates- should face the fact that psychoanalysis is not going to continue being that unspecific type of work. In more direct ways: psychoanalysis should shed off the old adage of free association, the open ended process of sessions, the rituals that are part of  the exchanges between analyst and patient and be more focused on the two issue that bring a patient to psychoanalyst: the impact of the intrapsychic on the interpersonal (the character formation that was created in the early upbringing and persists in adulthood), and limiting the analytic relation with the analyst to interpretations and reconstruction.

Those three last lines-if accepted- would have a noticeable impact on the -sometimes- distorted process of psychoanalysing.  

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1.       The discovery of psychoanalysis is an event created by Freud’s endeavor to follow up on his intuitions regarding hypnotism. There are various ways to choose an approach to that subject which would be based on the most valued findings like the unconscious, identification, projection, etc. My approach in that regard is to underline some of Freud’s insights about common things, which built his way of thinking and created the ‘psychoanalytic way of explaining the new ‘findings’, like repetition compulsion and somatization. The most remarkable thing in that venture is Freud’s natural leaning to simplicity instead of the appeal of complexity.