The issue of Our Democracy is not  simply related to self centeredness or regression to naive narcissism.  It is a hasty attempt at dealing with the return of the repressed. What is most evident in the returning of the repressed in this occasion is guilt. In a disguised way Americans are  dealing with old guilts but- displacing it to democracy (Which is not working well). This displacement makes the return of Guilt bearable and also have a good touch of honesty;  We are suffering and wish to correct the past. I believe that if this suggestion is acceptable our American Colleagues could dip in the pool of psychodynamics safely. 

 Why!!

I am not breaking my promise to not write more in my blog. I am just asking people who know how to answer this Question to think about an answer even if not stating the answer in my blog:

Why Americans, and their media in particular, keep adding the adjective-possessive (of our) every time they mention the word Democracy. 

Democracy is a Greek term for a system of governing which they established few centuries ago. Democracy in its modern form is healthy and flourishing in Europe and many other countries- all over the world. Democracy in the USA (now in particular) is going through a serious episode that is revealing many of its shortcomings. In fact, it will take very little time and attention for  American Democracy to require serious revision.

Why is the compulsion to add the adjective-possessive to the term Democracy every time an American mentions it in his country.   Analysts, get working... it is a complex question.   

 This is the Last Posting:

 

2. The Need for a New Psychoanalysis:

The issue I am dealing with in this last posting is my belief that the psychoanalysis that existed for more than a century, and I (we) witnessed its loss of identity has to be replaced by a new psychoanalysis and not by a modified version of the old one. Two reasons for my belief. Old psychoanalysis had a subject matter that does not exist anymore: the study of the human subject that happened to come from his psychotherapy. We are now aware of our nature and psychoanalytic psychotherapy is not effective as it used to be because we are treating ‘a new human subject’. If most of us do not know what I mean by a new patient (new human subject) they only need to consider the quality of the clinical papers that were published in the last twenty years and the criticism of the old system of Neutrality, Anonymity, Abstinence, interpretation\ Construction, and Transference. The second reason for considering a new psychoanalysis is that patients are dealing more with actual and real social and interpersonal issues than the intrapsychic issues of the faulty upbringings that were prevalent in the past.

However, I have to make a short calling to mind about some key features of the past to get to the new. Psychoanalysis started with answering the question Why (the symptom), followed a little later with the question How (repression and unconscious means to satisfy the blocked desire or wish), but did not touch the question of What (what is a symptom, what is an imaginary fulfillment in unconscious acts). Answering the What question required a radical understanding of what is unconscious?

The first two questions pertained to the function of therapy while the third question comes from the existence of language as the means to understanding to make understood. Obsessive-compulsive rituals used to ‘say’ something and imply another thing at the same act [those old symptomatic acts still exist but we are not able anymore to make the nature of the human subject the core of psychotherapy]. Although hypnosis was a very successful beginning it was Freud, and only Freud, who realized that the issue is not resistance to talking about certain matters and overcoming it by hypnosis, but it was the nature of those matters themselves: they were unconscious to the subject because of their nature and their structure (Why a bout of jealousy creates depression or loss of sexual desire). The unconscious is so because it is not amenable to the rules of regular thinking to enter consciousness. It also uses language differently. At that stage in the discovery psychoanalysis, it began a new journey: naming the states of unconsciousness and creating the ‘vocabulary’ of psychoanalysis, i.e., defense mechanism. The Why Question found the answer in the notion of the unconscious and got answers from the vocabulary that was improvised to explain the defenses, such as repression, splitting, projection, etc. But the question of what unconsciousness is was not touched or ‘most’ analysts were unable and uninterested in getting that specific answer. I believe that the disregard of addressing the issue of what is unconsciousness required a different kind of analysts who were not therapists- analysts (those analysts existed but were not permitted to call themselves psychoanalysts). Even the psychoanalysts who showed interest in explaining how splitting or identification happen in the process of the development were not met with enthusiasm (like Bion).  Psychoanalysis was captive of the definition of psychotherapy with a subtle resistance to showing any of its other characteristics.

After more than a century of psychoanalysis it is still neither a theory of the subject whom we treat nor a theory of psychopathology we deal with nor a theory of practice that we claim to be our claim of fame. I could be understood as condescending to psychoanalysis, but the fact is that I am blaming ourselves for the condition of psychoanalysis now.  The evidence is the diversities in hypothesizing in all those three areas without a campus for direction. All the attention in the official circles of training, which also the domain of improving and advancing psychoanalysis is directed to preserving the numbers high!! and   thought saving the practice from vanishing.  I am just mentioning the result of forgetting psychoanalysis and concentrating on psychotherapy and the institutes.

To my astonishment and disappointment when there was a faint response to moving psychoanalysis to academia. However, it was just the notion of changing the addresses of the institutes and their postal code. MOVING PSYCHOANALYSIS TO ACADEMIA IS GETTING RID OF THE TRIPARTITE SYSTEM OF TRAING IN INSTUITES AND INTRODUCING THE ELEMENTS OF PSYCHOANALYSIS (STRUCTURAL PSYCHO ANALYSIS) AS ISSUES OF ACADEMIC STATUS THAT REQUIRE THE INPUT FROM THE DIFFERENT BRANCHES OF THE HUMANRIES.  

The notion of conscious\unconscious (the earliest and most basic tenet of psychoanalysis) demanded two things: A. learning the structure of the unconscious (what is unconsciousness?), B. how a type of ordinary thinking gets affected by repression. To give an example of those two ‘repressed questions that baffled psychoanalysts up till now I will discuss “The Interpretation of Dreams” as the earliest attempt at theorizing an aspect of practice.

Freud was torn between functionality that could provide help to psychotherapy and structuralism which is the means to understanding the human subject. Thus, he managed to get a thread of knowledge from his own dreams and the most well-known is the Irma Dream. From that dream he conjures up the idea that the ‘dream scene’ is a scene of A Wish Fulfilled. He followed that with his book on Parapraxes, which was also regarding the disguised wish fulfilled in a slip of the tongue. But the book on sexuality which follows Three Contributions to the Theory of Sexuality was the first jump to structuralism. He followed the main trend at that time to consider sexuality an instinct, but the made a distinction between the Aim of that instinct and its Object. The significance of that distinction was very intuitive in explaining the richness of sexual life of the human subject. We recognize in that dissection he made that the intrapsychic aspect of the subject (intrapsychic instinct has external objects but is more important is the structural duality of every psychological issue in the human subject.  

This duality indicates a gap that is occupied by our psychological life. Thus, psychoanalysis is the work that reaches that gap, examines, and makes changes based on knowledge of the nature of the gap, and reconstruct the analyzed material. This is far more essential, complicated, involved with several other issues the subject deals with and most of all no IPA training institute could manage with its apprenticeship concept conveying knowledge from one generation to the next.  

Then What?

The thing that requires re-examining and re-thinking: is there a future for contemporary psychoanalysis? Contemporary psychoanalysis is the outcome of a few transformations over the years that make it quite different from it even up till the mid-sixties of last century. It has all the features of an exhausted branch of knowledge in addition to all the features of an obsolete system of treatment of psychoneuroses. In the last two years I had the chance to review the training programs in two institutes: one her in the USA and one in a relatively new European institute. The structure of the traditional tripartite system of apprenticeship was preserved with insignificant additions and eliminations. But, But the obvious thing to notice is that the training body is the source of the strongest resistance to change which means that we psychoanalysts are obstacle in the way of catching up with change. There is something in the psychoanalytic movement that reminds me of the TALIBANS.

 A Theory of Technique?!

Yes, a theory of technique, but only if psychoanalysis is acknowledged as a theory of the human subject first, and not only a psychotherapy. Defining the human subject and concentrating on his most distinguished and distinctive characteristic would lead the psychoanalyst to a theory of psychopathology, and consequently to a theory the technique of psychotherapy. A good definition of the human subject comes from his dual nature: I (subjective)\Me (objective), conscious\unconscious, thought\language, issue\meaning. Our psychical life is a creation of our dualities: thus, it is our successes or failures in bridging those gaps will determine our psychopathologies. Those notions of dualities would directly lead us to where the human subject’s psychical life is, and how it could get affected. The first step and the foundation of becoming a psychoanalyst is learning how dualities emerge and what the caregiver does to help the enfant manage them  This point requires more than just mentioning it in the context of a theory of technique.

The subject’s dualities is the product of our neurological evolution and being the only creature, which has the inclination to uses ‘language’ in communication, not signs and sounds talk (Note a five-month baby making vocal sounds when he  sees or hears something which suggests that he ‘recognizes’) . Language, generally defined, as the link between the intrapsychic and interpersonal, i.e., the link between one pole of the duality and  its counter pole. “Language”, in its core is the main link between the subject and the other. But this point needs an explanation.  I am not sure if we have the inclination to develop a sense of identity before  or after the appearance of our dualities, or visa-versa.  Therefore, I would say that psychoanalysis, and only psychoanalysis has the conception that psychoneuroses exist within the link between the intrapsychic and the interpersonal. In other words, all other psychotherapies deal with either the interpersonal or the intrapsychic while ‘proper’ psychoanalysis deals mainly with the link between the two. The distinction mentioned here is not only a formal distinction but also the distinction that makes psychoanalysis the only psychotherapy that aims at cure, not improvement.

That difference between psychoanalytic therapy and other psychotherapies reflects another important distinction in the training of therapist. The theory of the subject in psychoanalysis is based on the unconscious separation of the intrapsychic from the interpersonal, while in other psychotherapies the emphasis is on the interpersonal  as the seat of the problem. Thus, the psychoanalyst has to know (learn, know amount of knowledge in the works of other  scientists of the humanities and other analysts that needs to be ‘studied’ with academics to understand the formation of the intrapsychic and mostly the unconscious linguistic formations of such link. There is a significant scientific basis for what the analyst has to acquire to apply the analytic technique well. In another clearer way: there is a significant link between the intrapsychic and the interpersonal which requires a wide and deep knowledge of child’s development. This aspect is not a matter of apprenticeship or seminars in a training center: it is a matter of a number of years of systematic education with a clear curriculum and a number of specialists.

This leads us to the sensitive issue of personal analysis in the formation of the psychoanalyst. This item in the IPA tripartite training method was originally the only way to learn how psychoanalysis is done (!!??). It evolved for to make Freud come up with his recommendations of Anonymity, Neutrality, and Abstention. Although other formalities  pertaining to the number of sessions  and some clinical rituals evolved gradually, nothing of substance to their psychoanalytic significance was given to them properly to expose their clinical value. Without that requirement a major, major aspect of psychoanalyzing quietly got disappearing: Transference.  

The Psychoanalytic Technique:

I am not sure if  the two separate brain locations of language created the duality of the subject, or it is the other way around (the last book by Solms)did not address this point.  Therefore, I will carry on with the assumption that duality is  a fundamental feature of  the human subject [Psychoanalysis will lose its identity if this point is not emphasized, in spite of its undeniable contribution to all human sciences]. It is not easy to emphasize that issue because since the early forties of last century  psychoanalytic psychotherapy was turned into a “free for all” kind of field, while a theory of technique could not be formulated within a chaotic line of work .  Moreover, psychoanalysts produced a rich and equally jumbled catalogue  of vocabulary that looked (sounds) like component of a theory when it is not more than using common words in an operational background. A theory of technique should emerge from a thermotical background  of psychopathology. In light of the fundamentality of the subject’s duality the theory of technique should come out the psychoanalytic concept duality.

The duality of the subject and the link between the two poles of the duality are the forming elements of the subject’s intrapsychic structure. It is not difficult to have an idea of what is the basic duality in the subject’s  personality from taking a good history and noticing his speech and the issues of importance that constitute  his mind. A preliminary diagnosis of the intrapsychic would lead to reasonable expectation of the patient’s psychodynamics. Further observations of what does not seem fitting in the clinical picture could also highlight the failure in the link between the two poles of the patient’s dualities (most analysist do most of those things unintentionally,  thus they do not benefit well from them). Yet, those aspects of the initial assessment will influence the technique the analyst might keep in mind while working with the patient. An example will fit here:

A female patient who was less than average in her looks was in a relationship  with  handsome and very well-known poet (in Egypt).  At the same time, she was befriending his wife, who was not aware of that secret relationship. As usually happens,  rumors went around, and the affaire became an open subject for roomers and comments. The wife attempted suicide and my patient did not show any sign of remorse or guilt about that incidence. On the contrary, she was (I was told) enjoying the notoriety of the whole matter her. However, she developed a painful and obvious skin condition. Her brother insisted that she comes to see me for a consultation. In the second interview she was talking about the poet’s wife and made a slip of the tongue: she said competition (Monafasa in Arabic) instead of discussion (Monakasha in Arabic). I did not wait- as I usually do- to tell her that this slip of the tongue is coming from things she did not talk to me about in her first interview. What came out of this intervention was a flood of puzzled dualities of ‘good’ and ‘bad’, honorable, and dishonorable, and several other dualities that pertained to morality and immorality. They  came out in almost a gush associated with pain, shame, and despair. She remembered situations in her early childhood at school when she was not accepted, and promising herself that one day, she will have revenge and harm those kids badly.

Hesitating in telling me more about her reaction to the attitudes that followed the scandal of her love affair convinced me that she has contributed to making the secrete become a scandal. Sure enough,  she confirmed that she enjoyed- to an extent- the notoriety. However, for the rest of that interview she was sad that she was not nice looking like other girls, and that affair boosted her sense value and now it has a negative effect on her. I got the chance then to ask her to talk more about her slip of the tongue. She conceded that she always felt that she is in a competition (Monafsa) with others. Her analysis started later to reveal her confusion in regard to competition: the wish to be admired and to be loved. Some issue regarding aggression cam out revealing a major lack of understanding aggression and being aggressed. To get to the point I started this post to discuss I usually start by exploring the field of the patient’s concerns (the main duality that is in need for clarifying) and based on the psychodynamics of that duality I keep in mind the manner that duality was mismanaged in building the patient’s intrapsychic core. In this way, psychoanalysis will have the flexibility required to do a good job while I still  know what I am dealing whatever the analysis deviates to.

What is meant by that is to listen to the patient’s speech in order to find out what is the duality that had the largest impact on the formation of his intrapsychic structure. This is also useful in having an idea of what the transference will be like. After a while of that free-floating attention the features of the pathological outcome of creating symptoms, as the bridging of the gap in the duality, will emerge. What the analyst will do with that is a separate issue in itself, which I believe is unteachable but mostly it is what make us different. The last thing I would mention here is the formation of symptoms. Symptoms are very useful in giving the diagnosis additional verification the patient’s symptom was a psychosomatic skin flare up. Most of  the literature on that symptom (five old papers with very limited value) and my own experience strongly suggest that those skin condition relate to craving for primitive intimacy and very early deprivation of secure contact with the care giver. Symptoms- even if they are only verbally expressed SAY something that could be even verbalized.

To sum up my thesis I would say that a thorough psychodynamic diagnostic work could deal with the a proper assessment of the intrapsychic issues that are expressed in the patient’s character formation, leading to the main symptom (psychopathology) , and that in itself is most valuable guide to the work of interpretation and reconstructing a better functioning intrapsychic. 

 JUST A MINUTE AGO'S INSIGHT

WHY DOEASN"T THE IPA WORK WITH ANALYSTS AND ACADEMICS ON MOVING PYCHOANALYSIS TO ACADEMIA??

  A Moment of Insight: Psychoanalysis in Academia

This post is based on a personal experience, so it does not have an absolute value but only what is relative to my limitations.

In 1962 I was teaching psychology at Ein-Shams University (Heliopolis University) in Cairo. In the first year the course in general phycology was introducing two main points of view: Cognitive functions (memory, thinking, perception, etc., are psychological processes, and they are subject to experimental work to guarantee their scientific nature). In the second year of psychology, I was teaching Freud's "Introductory Lectures in Psychoanalysis". The students of the first year were fascinated by the effects of some unconscious elements on the common psychological processes. I just asked them to waite till they were in second year to know what the unconscious means.

The students of the second year (who were instructed by a great professor in the first year but not analytically minded) were fully absorbed in the part on dreams.  By the end of teaching that part I was faced with a group question: do wishes create, stimulate, shape, etc., dreams or do dreams call wishes from the unconscious to happen or is it the wish the master of sleep? In 1962 I was as fascinated by psychoanalyses as those smart kids were.

A few years later I was able to get better in understanding the unconscious process and discard the notion of repression. I was first leaning towards the role of other defense mechanisms in creating variety of unconscious conditions. That venture made me realize that psychoanalytic terminologies and vocabulary are not emanating from a theory of psychoanalysis, and they are merely expressions of certain observation. Yet, the unconscious no longer was a noun or an adjective but a new mystery to solve. Freud’s paper on the three categories of unconsciousness was a very new way to approach psychoanalysis. The most amazing thing about the unconscious, which made Freud’s endeavours worthy of its place in human heritage, is link betweenen thinking and language and Speech.

It just happened that Egypt and The Soviet Union  (Russia) were close to each other at that time and there was good cultural exchangesetween the. We were able to read in English the freat works of Marks an listen to the fantastic Moscow Orchestra with very little expense. To me the works of Lauria and Vigotsky (and two other female psychologists) were even better than the great Cassirer and Lang). ALL THOSE THINKERS, PHILOSOPHERS, PSYCHOLOGISTS were exploring the missed point that psychoanalysts were almost considering irrelevant: speaking our thoughts is unconscious and we unconsciously speak without consciously using a language. In other terms when we talk we unconsciously reveal our inner life ‘unconscioulty’.My answer to my student at that time was just listen carefully and you will notice that what is said is two lines of thoughtsare intermingled [dreams and slips of the tong is a language].  

This notion stayed with me all those years and opend my mind to many things pertaing to the nature of psychoanalysis. In a moment of insight that lasted for close to four decades I cam to believe that psychoanalysis as method psychotherapy is no longer convincing, while pschanalysis as epistemology is the right definition of its core. Therefore limiting psychoanalysi to an apprenticeship in psychotherapy has no place in Academia, but as an epistemology and a branch of the human sciences academia is it natural home and it is time to give it that chance.

  The Unyielding Psychoanalysts'

Resistance to Change and its Advantages

 

I firmly believe that there is no psychoanalyst who would not admit that psychoanalysis is in bad shape, even if he would not agree on whether it is its condition as a profession or in its premises and theory (or both). Putting this in a different perspective: psychoanalysis is not what it was before, whether for people, thinkers, patients, practitioners, or aspiring young people. They will differ in their views about what to do with it; revise it, replace it, consider it past its competency to still exists, or analysts are not as competent as the old generations, and we should ameliorate its training. The variations and degrees of disagreements among present-day analysts- in regard to the solution for this quandary is unique in one implicit way. Any suggestion of making genuine and drastic changes in the way training takes place is opposed by the faculty in charge of training or learning, graduating, or has the authority to proffer its professional affiliation based on those changes. Any suggestion of changing the isolation of psychoanalysis and the absence of links between it and other fields of knowledge; any suggestion of making changes in those aspects is resisted implicitly and explicitly too. Analysts want to defend the past and not look to the future.

Being an old analyst who witnessed several major breakdowns in the analytic field, which happened after Adler\Freud and Freud\Young conflicts, I can say that psychoanalysis was never an agreed upon subject: Klein\Anna Freud, Lacan\ French society, Ego\object relations, Latin\Anglo, West\ East and more and still happening out of my present limited engagements. Therefore, it is sensible to say that psychoanalysis is not a tight field of knowledge; it is only a tight field of personal identities. There are psychoanalysts but there no real psychoanalysis.

Does psychoanalysis need to change and become the ‘main issue’ instead of the psychoanalysts with their vague identities? Not really. We are twelve thousand analysts in the entire world. But the resistance to change in the field relates to both issues: analysts do not want psychoanalysis to change as they also resist changing the way they are trained and acquired their cherished title of Psychoanalyst. The resistance to change by ending the IPA professional domination and moving psychoanalysis to academia will require ending the old fashion training of psychoanalysts in poorly supervised institutes.  It will also demand learning new kinds of theoretical fields and exposure to the richness of other fields of the humanities, i.e., taking psychoanalysis seriously, and also taking the discoveries in the other fields in the humanities equally seriously. Put in a clearer way; there is no place for apprenticeship in academic psychoanalysis because if psychoanalysis is not a new branch of the humanities it is a branch of one of the humanities that has more than one applied reach. Analysts resist change because of the ease with which they are trained now. The academic milieu put us in supervised training for a long time. It declares the end of the apprenticeship morality. The issue here is not the length of time required for a good psychoanalyst to become, but the sense that who and what you will be your making as we did with our basic degrees. This is making psychoanalysis more of a respectable academic subject not a side issue in an apprenticeship. We old-fashioned analysts find it difficult or self-injurious to admit the less desirable training we got. Analysts of today would resist the end of apprenticeship and the beginning of an academic psychoanalytic framework for both their sense of independence and false sense of superiority.

The Advantage of Resisting Change:

The resistance to giving up the old-fashioned psychoanalysis has its positive aspect. Psychoanalysis has changed just enough in some parts of the world (USA for example) to still call itself psychoanalysis, based on the classical psychoanalytic model. Although the changes that are made- once in a while- were happening quietly, they were cosmetic changes to allow giving an old system a new appearance. The new trend now is to move training centers that are still IPA to universities, and some are even giving that same training a university degree (name). This is not more than housing training at universities and just changing the ZIP CODE of IPA institute. The system of self-analysis, studying certain theoretical landmarks and supervision of few cases did not enable questioning the apprenticeship concept of learning. The result would be graduating a candidate when he satisfies one or more training analysts’ expectations, and not when he fulfils leanings judged by academic standers and by academicians who have their standers of acquiring objective knowledge.   

The resistance to the demand of progress and insisting on not giving up the old psychoanalysis or at least its training system will in the end go two ways. The end of any psychoanalysis of IPA nature due to its basic and obvious deficiencies, then starting to build a new academic psychoanalysis that is modeled differently (learn, understand, apply, be assessed, and judged by equals). So, the unyielding psychoanalyst will make us get rid of the IPA poor psychoanalysis and keep our minds open to the new human science of psychoanalysis. Th inevitable has to happen and psychoanalysis will find its way to the academic human sciences, will link with several other human sciences like psychology and sociology, and progress to reach the point that it will re-approach psychotherapy from a different point of view.

Academics in the humanities will introduce and integrate psychoanalysis in their programs when and if the are sure the tripartite system of training is disregarded. Psychoanalysis will gradually be accepted as a viable knowledge. Thus, the unrelenting psychoanalysts will help uproot the old-fashioned psychoanalysis and cause it to be ignored.  However, this progress will be founded on to basis:

A.   Reaching out or pulling in the suitable sources of knowledge regarding child development and similar and related topics from other branches of the humanities. Language and psychical functions will be part of the novelty in learning psychoanalysis.

B.    

 Psychopathology of the new fields of studies, which gives life to some neglected or misunderstood phenomenon like psychosomatics, will acquire new identities and the input of the Other (parents, social life, etc.) will be meaningful.

C.   Transference and narcissism will gain new their proper place in psychotherapy and a new system of psychopathology.

The advantage of the rigid and unexplainable insistence on keeping an already dead psychoanalysis is good for te future of psychoanalysis: weeding out the useless system and perspective allowing a new era to start.