Excerpts from Must Read Books & Articles on Mental Health
Articles- Part XXIV
THE GROWTH AND TRANSFORMATION OF AMERICAN EGO PSYCHOLOGY
Robert S. Wallerstein (2002)
The roots of ego psychology trace back to Sigmund
Freud's The Ego and the Id (1923) and "Inhibitions, Symptoms
and Anxiety" (1926), works followed by two additional fundaments,
Anna Freud's The Ego and the Mechanisms of Defense (1936) and
Heinz Hartmann's Ego Psychology and the Problem of Adaptation
(1939). It was brought to full flowering In post-World War II America
by Hartmann and his many collaborators, and for over two decades it
maintained a monolithic hegemony over American psychoanalysis. Within
this framework the conceptions of the psychoanalytic psychotherapies
evolved as specific modifications of psycho-analytic technique directed
to the clinical needs of the spectrum of patients not amenable to
psychoanalysis proper. This American consensus on the ego psychology
paradigm and its array of technical implementations fragmented several
decades ago, with the rise in America of Kohut's self psychology,
geared to the narcissistic disorders, and with the importation from
Britain of neo-Kleinian and object-relational perspectives, all coinciding
with the rapid growth of the varieties of relational psychoanalysis,
with its shift in focus to the two-person, interactive, and co-constructed
transference-countertransference matrix. Implications of this intermingled
theoretical pluralism (as contrasted with the unity of the once dominant
ego psychology paradigm) for the evolution of the American ego psychology
are spelled out.
My intent here is to present an overview of ego psychology, the metapsychological
paradigm developed in the immediate post-World War II period, primarily
in America, by a brilliant cluster of European refugee analysts in their adaptation to the scientific
and intellectual climate of the New World. Actually, of course, the
roots of ego psychology trace back in a direct line to two fundamental
works by Freud: (I) The Ego and the Id (1923), which established
the tripartite structural model--id, ego, superego--as the components
of the psychic apparatus, through the interactions of which human
behavior was to be understood and explained; and (2) "Inhibitions,
Symptoms and Anxiety" (1926), which positioned anxiety, or
the threatened eruption of signal anxiety, as the impetus to the ego's synthesizing and executive
functions of mediating the pressures of the three major forces impinging
on it--the peremptory instinctual drives of the id, the constraining
and channeling moral and value judgments of the superego, and the
adaptational requirements of external reality--and fashioning then
the best behavioral compromise of these disparate, and often conflictual,
Over the remaining years of Freud's
lifetime, two additional fundaments were included in this edifice,
both dealing with the functions of the ego, by then a central focus
of psycho-analytic inquiry. This marked the transition of psychoanalysis
from being primarily an id or drive psychology, focused on the vicissitudes
of the instinctual drives (centrally the libidinal and the aggressive)
as the prime movers of behavior, normal and neurotic, to a period
in which the ego was accorded equal importance and was regarded as
the prime shaper and modulator of behavior, again both normal and
neurotic. In America this came to be called the era of ego psychology.
THE THEORETICAL EDIFICE
The first of these fundaments was Anna Freud's The Ego and the Mechanisms
of Defense, published in German in 1936 as a tribute to her father
on his eightieth birthday and translated into English in America in
1946. (It was also a response to what Viennese analysts considered the extremes to which Wilhelm Reich had carried his theoretical and
technical views on character armor in his 1933 Character Analysis.)
In her monograph, Anna Freud attempted to systematize the array of
defense mechanisms her father had described in various papers, as
well as adding some others to the enumeration. She tried, as best
she could, to link the appearance of particular defense mechanisms
to the stages of psychosexual development in which they presumably
originated, and to the various psychopathological formations in which they were prominent.
The emphasis throughout was on the defensive functions of the ego.
The second fundament to be added was
Heinz Hartmann's Ego Psychology and the Problem of Adaptation,
published in German in 1939. Although it did not appear in its entirety
in English (again in America) until 1958, major sections of it had
been published in 1951 as a chapter in David Rapaport's Organization
and Pathology of Thought. In contrast to Anna Freud's focus on
the defenses of the ego (primarily against the pressures of id and
superego), Hartmann's focus was on the adaptive functions of the ego, as it fitted the
individual's behavior to the requirements of external reality, what
Hartmann called the "average expectable environment." Hartmann's
central conception was of a conflict-free sphere of the ego, a sphere
in which functions of primary autonomy (e.g., perception, motility,
language, thinking) grew not out of conflict between the id and the
outer world, but rather apart from conflict, on an innate maturational
timetable. These conflict-free functions could of course be invaded
secondarily by conflict, as witness hysterical paralyses, speech disorders,
and the like.
In a tribute to Hartmann on his seventieth
birthday, Anna Freud (1966) noted that "in the field of ego psychology
... we appeared almost at the same time, in the 1930s. I came into
it more conventionally, from the side of the ego's defensive activities
against the drives; Hartmann, in a more revolutionary manner, from
the new angle of ego autonomy, which until then had lain outside analytic
study" (p. 18). This was indeed Hartmann's central conception,
critical to the full evolution of the ego psychology paradigm, and
key to its alienation from other theoretical perspectives, including
Kleinian analysis, which was developing in England during the same
period, and Lacanian analysis, which would arise in France somewhat
It was this set of constructs--the tripartite
structural model; the ego, pushed by threatened anxiety, as the mediator
of the conflicting pressures of id, superego, and external reality;
the defensive functions of the ego; and, last, the autonomous functions
in an evolutionarily determined adaptation to reality--that the tide
of Hitler refugees (most from Vienna) carried to the receptive soil
of America, above all to New York. With few exceptions, the group
associated with the full flowering of ego psychology--Hartmann, Kris,
Loewenstein, Jacobson, the Eisslers, Annie Reich, Mahler, Spitz, Waelder,
Fenichel---came to work and teach at the New York Psychoanalytic Institute,
then and now the single largest affiliate of the American Psychoanalytic
It was there, with Hartmann as principal
architect, working with his closest collaborators, Ernst Kris and
Rudolf Loewenstein, that the complex structure of the ego psychology
paradigm was elaborated out of the concepts of autonomy and adaptation.
That structure included, to name only the most salient conceptions,
the undifferentiated phase of development; the growth of the conflict-free
sphere of the ego; primary and secondary ego autonomy (with attendant
change of function); inborn ego apparatuses and autonomous ego development;
the synthesizing and integrating functions of the ego; ego interests
and intrasystemic (as distinct from intersystemic) conflict;
the separation of the ego concept from the self concept; the opposition
of self- and object representations; the equal status of the aggressive
drives alongside the libidinal; the transformation of the concept
of sublimation into deinstinctualization and neutralization; the principle
of multiple appeal; and the concepts of social compliance (analogous
to Freud's somatic compliance) and the average expectable environment.
Rapaport (first at The Menninger Foundation in Topeka and later at
the Austen Riggs Center in Stockbridge, Massachusetts) became the
paradigm's declared systematizer.
For a summary review and explication
of all these terms and concepts, nothing perhaps serves so well as
Rangell's paper of tribute (1965) to Hartmann on his seventieth birthday.
Rangell viewed Hartmann's labors as a Herculean effort to systematize
the "fragments" of ego psychology into a composite whole,
pointing always toward organization, equilibrium, and harmony. He
saw this as Hartmann's effort to make psychoanalysis the fulfillment
of Freud's dream: psychoanalysis, born of the study and treatment
of neurotic illness, of psychopathology, would become a truly general
psychology, fully explanatory of both normal and abnormal mental functioning.
Indeed, Freud had begun this task with his studies of dreams, jokes,
and parapraxes, and of other psychopathologies of everyday life. Rangell
also pointed to the links Hartmann was forging with the child observation
and longitudinal developmental studies of Rene Spitz, Margaret Mahler,
Ernst and Marianne Kris, and John Benjamin.
Roy Schafer's overview (1970) of Hartmann's
contributions to psychoanalysis--written within five years of Rangell's
tribute--placed the emphasis rather on Hartmann's strenuous efforts
to fit psychoanalysis into the framework of natural science. To Schafer
this seemed the fulfillment of yet another aspect of Freud's original
vision: psychoanalysis as the explanation and representation, through
the ego's functions and apparatuses, of humankind's evolutionary biological
adaptation as a successful social animal in a difficult and indifferent
outer world. Schafer emphasized that Hartmann's choice of adaptation
theory as his scientific option was but one of several frameworks
that could have been chosen--a linguistic or hermeneutic one could
as easily have been adopted. Once made, however, Hartmann's choice
was carried to its uttermost possibilities as a theoretical explanatory
system. As Schafer declared, "Hartmann's contributions put an
end to the period when psychoanalytic theorizing was a law unto itself.
He brought psychoanalysis into the world of modern natural science"
(p. 430). But Schafer could also be critical of Hartmann's thinking,
in light of the explanatory paths foreclosed in this theoretical edifice,
built as it was on concepts of structures and functions, forces and
energies. Hartmann's conceptions clearly bypassed the ubiquitous problems
of purpose, intention, and meaning that are the very essence of clinical
psychoanalysis. "The biological language of function," Schafer
noted, "cannot be concerned with meaning" (p. 440).
For those who wish to explore Hartmann's
theorizing more extensively, and in its original form, reference can
be made to two volumes published in 1964. One, Essays on Ego Psychology,
is a collection of twenty theoretical papers written over two decades
(1939-1959); the other, Papers on Psychoanalytic Psychology,
is a monograph comprising six articles written with Kris and Loewenstein.
The effort to create a systematic and hierarchical organization of
the concepts and tenets of ego psychology was undertaken in Rapaport's
1960 monograph, The Structure of Psychoanalytic Theory. Rapaport considered
the task eminently achievable, the creation of an evolutionarily derived,
biologically anchored general psychology, explanatory of the entire
range of human behavior, from the indubitably normal to the flagrantly
aberrant, save for one gap in comprehensiveness: "If we must
single out an outstanding limitation of this theory's claim to comprehensiveness,
then we should choose its lack of a specific learning theory"
(p. 34). Rapaport dedicated the last years of his life to trying to
fill this hiatus through a series of psychoanalytically conceived
experiments in human learning.
A few years after Rapaport's monograph,
his close friend and co-worker Merton Gill (1963) attempted to elaborate
the hierarchical organization of the psychic apparatus by systematically
exploring the continuing need for the topographical point of view,
once considered an essential component of Freud's metapsychology.
Gill's conclusion was that no such need exists. His book was in fact
a quite extended version of a short article he and Rapaport had published
in 1959, detailing five fundamental assumptions and metapsychological
points of view that together were deemed essential to the full psychoanalytic
understanding of any and all behavior. These were the genetic, the
economic, the dynamic, the structural, and the adaptive. Notably,
the topographical had been dropped, all its explanatory capacity said
to be subsumed by the other five perspectives.
TECHNICAL ISSUES AND INSTITUTIONAL HEGEMONY
To this point I have focused on the issues of ego psychology as a
theory, one that aspired to make psychoanalysis both into a general
psychology--though with Rapaport's caveat regarding learning theory--and
into a general science linked to the universe of the biological sciences.
Indeed, it was Hartmann's penchant, and that of many of his colleagues,
to focus on theory--abstract, austere, and, to the extent possible,
elegant and aesthetic.
It fell to Kurt Eissler (1953) to articulate
the implications for clinical work of the ego psychology framework. His famous paper on
"parameters" served for at least two decades as the benchmark
against which the analytic technique of those trained in American
ego psychology would be measured. It too, presented an austere model.
The analytic patient on the couch displayed, via free association,
and in ever more regressive fashion, the full panoply of his or her
transferences, the engrafting of the most salient object relations
(or self-object interactions) from the infantile past upon the neutral,
objective analyst. The latter, from a position outside the transference
display could, through appropriate interpretations, bring to light
and to mutual discussion, the transference-drenched and therefore
distorted representations of the analyst.
This was to be done by a process of
veridical interpretation alone, with of course many variations of
the interpretive process over time, leading finally, by "working
through" the varying but similar interpretations around each
transference theme, to meaningful insight and consequent change, and
ultimately to resolution or "cure." Through a split in the
cooperating patient's ego, first described by Richard Sterba (1934),
whereby the experiencing part of the ego (which reenacted the old interpersonal dramas) and the observing part (in league with the
analyst and the analytic function), the analyst (whose ego was similarly
split, but with the observing part dominant) was able in time, from
the position of outside observer, to unravel the patient's projected
transference distortions and undo the neurotic character formations.
Countertransference, when it reared its complicating head, was to
be properly mastered and controlled, lest it distort the analytic
understanding (A. Reich 1951). Any departure from properly timed and dosed
interpretation, regarded as the only true road to insight and eventual
change, was labeled a "parameter," a deviation from technique,
necessary perhaps in relation to the clinical exigencies of patients
with less than "normal" egos, but to be interpretively resolved
(i.e., totally undone) within the analytic situation in the interest
of analytic thoroughness.
The hallmarks of this analytic posture
were the objectivity, neutrality, abstinence, and relative anonymity
of the analyst; an unremitting focus on the intrapsychic conflicts
in the mind of the patient; extrusion of the personality and potentially
interfering countertransferences of the analyst; and a conception
of the analyst's veridical interpretations, properly reinforced through
the process of working through. Together these were regarded as the
necessary and sufficient road to insight, change, and cure. In recent
years this view of analysis has been called a "one-person psychology"--that
of the patient.
Against this understanding of what constitutes
a proper psychoanalytic process there developed--first on these shores--various
conceptions of psychoanalytically informed psychotherapy. These ranged
along a spectrum from the closest in technique to psychoanalysis,
expressive psychoanalytic psychotherapy, to the farthest, the form
called supportive psychoanalytic psychotherapy, which, though psychoanalytically
conceptualized, introduced the greatest technical departures from
the strictly psychoanalytic method. The line of demarcation (often
blurred) between the two variants was between expressive psychotherapy,
which aimed at the uncovering and resolution of intrapsychic conflict
(though within a range more focused and restricted than the open-ended
exploration of the entire life experience that characterizes psychoanalysis),
and supportive psychotherapy, which aimed through various techniques
to strengthen the embattled ego's capacity to cope with, and often
to cover over, inner conflict.
These psychoanalytic psychotherapies
arose first in the United States--though they subsequently spread,
first to Britain and then to Germany, Holland, and Scandinavia--as
an adaptation of European-grown psychoanalysis appropriate to American
conditions. A hostile social and professional milieu in Europe had
from the start imposed an isolation on Freud and his early followers,
which effectively barred them from access to medical schools and teaching
hospitals, thereby consigning psychoanalysis as a therapy to a private
practice setting, and as a healing discipline to free-standing night
schools, the early psychoanalytic training Institutes of Central Europe.
By contrast, American analysts, strengthened enormously by the influx
of refugee analysts in the 1930s and 1940s, were determined to capture
psychiatric departments in medical schools and teaching hospitals.
Their goal was nothing less than to establish psychoanalytic conceptions
as the predominant psychology and major therapeutic in treating the
gamut of mental illnesses and disorders.
This effort to be fully accepted within
the medical establishment played a significant role in the fierce
opposition of American analysis to the training of nonmedical analysts,
an opposition not fully overcome until the settlement of a major lawsuit
half a century later (see Wallerstein 1998a). That is another story;
the point here is that from the 1940s through the 1960s, as major
chairs in psychiatry, until then in the hands of the Adolf Meyer-trained
psychobiological generation, became vacant, American medical schools
avidly sought psychoanalysts to chair departments of psychiatry. They
sought to introduce psychoanalytic concepts into the understanding
of mental health and illness, and to adopt whatever modification of
classical psychoanalytic techniques might be required to deal with
the psychological disturbances of the far sicker patients encountered
on the inpatient wards and in the outpatient clinics of these medical
school-linked psychiatric treatment centers. This was a population
very different from the private practice neurotic outpatients from
whose treatments the traditional conceptions of psychoanalytic technique
Thus was born the panoply of psychoanalytic
psychotherapies, across the spectrum, from expressive to supportive,
that has characterized American practice for half a century, though
with major shifts in the relationship between these psychotherapies
and their psychoanalytic parentage. The conception of expressive versus
supportive psychoanalytic psychotherapies was delineated most clearly
by Knight (1949, 1952) and Gill (1951, 1954). Most succinctly, expressive
therapies are geared to the expression of intrapsychic conflict, leading
to working through and resolution with insight; supportive therapies
are geared to supporting the ego in its struggle to contain, or repress
intrapsychic conflicts and to suppress their symptomatic expression.
A given therapy, of course, can also be an admixture of both expressive
and supportive techniques. In the 1950s, the similarities and the differences,
as worked out by a host of contributors--Gill, Rangell, Edward Bibring,
Leo Stone, and Anna Freud being the most significant--were clearly
delineated and consensually agreed on, with sharp distinctions in
the aims of the varying therapies, from the most supportive to the
most expressive-analytic, and equally clear distinctions in methods
and technical approaches. The minority who demurred from this consensus,
who sought to blur rather than sharpen the distinction between psychoanalysis
proper and the range of psychoanalytic psychotherapies--Franz Alexander
and his followers, Frieda Fromm-Reichmann and hers--were in the main
ruled out as unanalytic. The debates that raged at the time around
this issue found expression in three panel discussions in an issue
of JAPA (Panels 1954; for a more extended presentation of this
period and these issues, see Wallerstein 1995).
The consensus achieved in the 1950s
on the differences and similarities between psychoanalysis and the
psychoanalytic psychotherapies--the technical implementation of the
precepts of the dominant ego psychology paradigm---has long since
fragmented. But that is getting ahead of my story. What remains to
be stated is that the ambitious Psychotherapy Research Project of'
the Menninger Foundation, launched in 1954 by me and a group of coworkers
(Wallerstein et al. 1956), a wide-ranging, in-depth study of' psychoanalysis
and the psychoanalytic psychotherapies that came to final publication
in my book Forty-two Lives in Treatment (Wallerstein 1986), was conceptualized entirely within the ego psychological framework
then regnant in America, and in which my research colleagues and I
were all trained.
It is difficult to appreciate now, a
full third of a century after the heyday of ego psychology in America--and
in the midst of our current pluralism--just how monolithic was its
hegemony through the 1950s and 1960s, and even into the 1970s. The
ego psychology paradigm was presented in those years as the direct
descendant of, and heir to, the psychoanalysis of Freud, originally
a drive psychology but now immeasurably enhanced as an ego psychology
through the work of Anna Freud and Hartmann, and now prevailing in
America as the legitimate expression of the Freudian heritage. (In
Britain this tendency found expression in the Anna Freud group within
the British Society, and prevailed at the Hampstead Clinic under the
leadership of Anna Freud and Dorothy Burlingham.)
For those trained in American psychoanalytic
institutes in the 1950s, as I was, ego psychology was the total representation
of the proper psychoanalytic world. Institute syllabuses were constructed
around Freud's writings, of course, with some side ventures to Abraham
and Jones (but not Ferenczi, who was to be ignored), and continued
through the line of ego psychological authors I have mentioned. "Safe"
journals numbered but a handful: Psychoanalytic Quarterly; Psychoanalytic
Study of the Child (an Anglo-American but totally "Freudian"
enterprise), and the newly created Journal of the American Psychoanalytic
While there were important articles
to be read in the International Journal, to be sure--notably
those of Sterba and Strachey in 1934--it was also a minefield strewn
with Kleinian articles to be meticulously avoided, interspersed as
well with object-relational articles from the Middle Group, or now
Independent Group, which were to be equally avoided, with but a few
exceptions. I remember two such exceptions, both by Winnicott, his
"Hate in the Countertransference" (1949) and "Transitional
Objects and Transitional Phenomena" (1953). In fact, everything
other than ego psychology was covered in the four-year curriculum
in but one course, of perhaps eight to ten sessions, that would include
Jung, Adler, Rank, the Kleinians, American interpersonalists and culturalists
like Sullivan and Horney, and whoever else the instructor might wish
to pack in. As for Kleinian views, then rapidly developing in England
and spreading to Latin America, they were peremptorily dismissed,
as in Rapaport's well-known footnote to his historical survey of ego
psychology (1959): "The `theory' of object relations evolved
by Melanie Klein and her followers is not an ego psychology but an
id mythology" (p. 11).
But, of course, the psychoanalytic world
has not stood still since the heyday of ego psychology. The paradigm
had been created by emigre analysts from Europe, primarily the Viennese,
with close personal ties to Freud and his immediate circle. It had
been treated as a precious gift, handed down to be preserved and protected
from dilution by nonanalytic pragmatic approaches like the behavioral
therapies emerging within academic psychology; from the Kleinians,
whose ideas about infantile mental states were regarded as totally
speculative and incapable of verification (and therefore unscientific);
and from the British object-relational school, whose approach was
declared superficial and charged with sacrificing a depth-psychological
understanding of the drives and with underplaying the centrality of
infantile sexuality and the oedipus complex as nodal points of neurotic
psychopathology. I separate out, as distinct theoretical tendencies,
the Kleinians (adherents and further developers of the views innovated
by Melanie Klein) and adherents of the British object-relational approach,
the latter a quite diverse group including Fairbaim, Winnicott, Balint,
Bowlby, and Guntrip, who came together in a declared "middle
group," neither (Anna) Freudian nor Kleinian. The Kleinian metapsychology,
though heavily emphasizing internalized object relations, was anchored
in the vicissitudes of the endogenous drives, with a particular focus
on the aggressive drive, regarded as the expression of the death instinct. By contrast, the object-relational middle group's metapsychology
was built around the centrality of object relations--the ego as object-seeking,
not gratification-seeking--with psychopathological outcomes arising
from traumatic and/or deficient developmental experiences, especially
within the earliest caretaker/infant interactional matrix.
Early papers by Paula Heimann (1950)
and Margaret Little (1951) on the ubiquity of the analyst's countertransference
involvements and their potential use in better understanding transference-countertransference
manifestations, thereby placing the analyst within (not outside) the
analytic situation, were responded to with alarm. Annie Reich's 1951
article--which assigned countertransference the status of a frequent
but unwelcome intrusion into the analytic process, to be mastered
and kept from interfering--had the effect of delaying for twenty years
any serious discourse in American psychoanalysis on the topic of countertransference,
except insofar as it was regarded as an ever present potential interference.
CRACKS IN THE MONOLITH
Nonetheless, by the early 1970s cracks had begun to appear in the
ego psychology monolith. Curiously, a major impetus of this development
came from some of Rapaport's closest collaborators. Merton Gill, George
Klein, and Roy Schafer began by collectively attacking the energic hypotheses of the economic point of view, but the critique
rapidly spread to much of the structure outlined by Rapaport and Gill
(1959) in their paper on the points of view and assumptions of metapsychology
(see Klein 1976; Schafer 1976). This assault was carried to its extreme
in Psychology versus Metapsychology (Gill and Holzman, 1976),
a collection of articles written by former students of Rapaport and
dedicated to the memory of their colleague George Klein. The most
notable contribution was Gill's "Metapsychology Is Not Psychology"
(1976), in which he turned his back on a quarter-century of writing.
In a personal communication he told me that he wished he had written
none of his earlier work and that he disavowed every word of it.
At the same time, the interpersonal
psychiatry of Harry Stack Sullivan (quite akin to British object-relational
views) had never died out completely, but had been kept alive in the
Washington area at Chestnut Lodge Sanatorium and the Sheppard and
Enoch Pratt Hospital (see Searles 1979). At the William Alanson White
Institute in New York it began to flower, with Edgar Levenson (1972,
1983) and his many colleagues making significant contributions. Prominent
among these was the groundbreaking Object Relations in Psychoanalytic
Theory, by Jay Greenberg and Stephen Mitchell (1983), which ushered
in an explosive outpouring of contributions, marking the sea change
into what I have called the "new American psychoanalysis"
(Wallerstein 1998b). This is an object-relational, interpersonal,
and social-constructivist theoretical perspective, a "two-person
psychology" (analyst and patient as co-participants in an interactional
relationship, to which they each bring their psychologies and pathologies
as co-creators of the therapeutic situation), that today vies for
pride of place with the continuation, much transformed, of the original
ego psychology, the contemporary expression of a still basically one-person
But the hegemony of the ego psychology
paradigm in America was not really endangered until Heinz Kohut's
self psychology (see Kohut, 1971, 1977, 1984) began to take shape,
a psychoanalytic paradigm built not on conflict and its resolution,
but on deficit and its repair--not on Guilty Man, epitome of the oedipal
drama, but on Tragic Man, carrier of an unintegrated self, subject
under stress to disorganizing and fragmenting pressures. It was Kohut
and his rapid winning of adherents, not only in his own Chicago institute
but in psychoanalytic settings across the country (Cincinnati, St. Louis, Los Angeles, Washington,
Boston), that propelled to the fore an alternative psychoanalytic
paradigm, thereby destroying what to that point had been an unquestioned,
almost total adherence in this country to American ego psychology,
until then accepted as the uncontested and legitimate Freudian legacy,
warranting naturally the epithets "traditional" or "classical."
Kohut himself, in a personal aside to me at one of the early annual
self psychology conferences--he as the charismatic leader of the gathering,
and I as one of the few invited "friendly critics"--confided,
"I'm not sure how enduring my own psychoanalytic contributions
will, in the end, turn out to be, but you'll have to admit that I've
sure shaken up the ego psychology establishment." He was, of
course, correct, and it has never been quite the same since.
Developments in American psychoanalysis
since then--the late 1970s--can be traced along three parallel and
related lines: (I) a growing acknowledgment and acceptance of an increasing
pluralism, with Kohut's self psychology as the first metapsychological
alternative to ego psychology; (2) the burgeoning of an object-relational
or interpersonal paradigm, with a variety of roots (some domestic
and some imported), given its impetus by the 1983 Greenberg and Mitchell
book and effecting (with major recruits from the ego psychology camp)
the sea change that has occurred in American psychoanalysis; and
(3) internal evolutionary changes within ego psychology, which likely remains the majority position in America, though with far-reaching
alterations, centered chiefly around the work of Charles Brenner,
that are truly major modifications, both of the theories advanced
by Hartmann, Rapaport, and their coworkers, and of the austere technical
prescriptions of Eissler and his adherents. I will discuss the historical
changes in American analysis in the last two decades along each of
these three lines.
One can question the bundling together
of the British object-relational perspective, with its roots in Winnicott,
Balint. Fairbairn, and even Bowlby, and the interpersonal perspective
(indigenously American) grounded in Sullivan and his allies (Fromm-Reichmann,
Fromm, Horney, Thompson and others). The distinction would be in
the British object-relational effort to maintain its derivation from,
and linkages to, the Freudian corpus, and the American interpersonal
and culturalist effort to reconstruct psychoanalysis on a different,
non-Freudian theoretical and epistemological foundation. This would
suggest a bifurcation between the object-relational and the interpersonal
approaches traceable in their theoretical conceptualizations, though
with much commonality and various hybrid forms--all represented on
the American scene today. This point bas been emphasized to me by
A GROWING PLURALISM
The first of these, our ever increasing pluralism, was the subject
of my two presidential addresses to the International Psychoanalytical
Association--"One Psychoanalysis or Many?" (Wallerstein
1988), delivered in Montreal in 1987, and "Psychoanalysis: The
Common Ground" (Wallerstein 1990), given in Rome in 1989. Briefly,
my thesis was that Freud failed in his ambition to maintain as a movement,
unitary in its structure and unified in its performance, the science
and therapy he had almost single-handedly brought into existence.
Although Freud was able to extrude early dissidents (Stekel, Adler,
Jung, and, somewhat later, Rank) as proponents of theories deviating
from psychoanalysis as he and his followers defined it, the Freudian
striving for theoretical and clinical unity broke down, even in Freud's
lifetime. In England the Kleinian movement arose in opposition to
the precepts of the Viennese surrounding Freud-- thus pitting a so-called
London School against a so-called Vienna School--with the former refusing
to be cast as outsiders. They in fact declared themselves more loyally
Freudian by virtue of their embracing Freud's hotly contested theory
of a death instinct, whereas most of the Viennese, closer to Freud
personally, took sharp exception to the concept, which they regarded
as biologically dubious and clinically unnecessary.
Eventually the Kleinians became the
largest group within the British Society, and soon their doctrines
spread to continental Europe. During the rapid post-World War II proliferation
of psychoanalysis in Latin America, Kleinian ideas swept that continent.
There then developed--also in Britain--an object-relational theoretical
tendency (called first the Middle Group, situated between the Kleinian
and the Freudian, and today called the Independent Group) that coalesced
around the early contributions of Suttie, Fairbairn, and Guntrip,
and then Balint, Winnicott, and Bowlby. Their rallying cry was Fairbairn's
declaring the ego not a drive-gratification seeking organ, but an
object-seeking and object-relating one. Soon thereafter came Wilfred
Bion's extensions of Kleinian thought in Britain, the rise of the
linguistically based Lacanian perspective in France (which soon spread over much of Romance-language Europe), and the philosophical and hermeneutic
perspectives on psychoanalysis exemplified by Ricoeur and Merleau-Ponty
in France and by Habermas and Gadamer in Germany.
From Freud's death up to the decade
of the 1970s, America alone had been resistant to this spreading diversity,
remaining true over several decades to the founder's vision of a unitary
psychoanalysis. In America the ego psychology descended from Freud
through his daughter and Hartmann had become hegemonic and was called
simply Freudian, traditional, or classical psychoanalysis. (In Britain,
it was called Freudian, or Anna Freudian, in distinction from the
Independent and Kleinian schools.) In the U.S., the exceptions to
this hegemony were a small Kleinian enclave in Los Angeles, established
in the late 1960s and early 1970s, and encouraged by Bion's visit
of several years during that period; a small handful of psychoanalytic
scholars espousing Lacan's views (supported by significant theoretical
interest in those views among academics in university departments
of French, English, and philosophy); and a growing interest in the
object-relational perspective stemming from the work of Sullivan,
Horney, and Fromm, and by their ideological descendants in the William
Alanson White Institute and other independent groups in New York.
Aside from these scattered and at the time not numerous groupings,
up until the advent of Kohut's self psychology, which came into full
flower only in the 1970s, American psychoanalysis, politically organized
within the American Psychoanalytic Association, could see itself still
as the unified and unitary analytic "mainstream."
Since that time, many influences have
conduced to the growing awareness and acknowledgment of our theoretical
diversity, and of the growing allegiance of psychoanalytic workers
to alternative psychoanalytic perspectives once considered deviant.
Indeed, so far has this progressed that Leo Rangell, a powerful advocate
of the evolving ego psychology tradition, has lamented publicly, on
more than one occasion, that the mainstream seems no longer "main."
Foremost among these influences has been the increasingly palpable
presence of the International Psychoanalytical Association in American
consciousness. Growing numbers of U.S. analysts have been attending
the biennial IPA Congresses, where they meet and hear presentations
by colleagues of theoretical persuasions other than the ego psychological.
Increasingly, U.S. analysts serve on IPA committees, often making
site visits to troubled or developing component groups around the
Curricula in American institutes have
been broadened to offer courses on Kleinian and object-relational
perspectives (though Lacanian views are more rarely taught). Visits
by leading Kleinians and object-relational thinkers, mostly from Britain,
and to some extent by representatives from France and its analytic
tradition, both to meetings of the American and to many of its affiliated
institutes, have become almost de rigueur. Kleinian and object-relational
authors have become more widely read in the United States, through
distribution of their books and through the pages of the International
Journal. English translations, particularly of French authors
(notably Green, Chasseguet-Smirgel, McDougall, and Anzieu), as well
as of Germans and Latin Americans (of the latter, Heinrich Racker
stands out as one of the very first), have become widely available,
and there is a growing clamor for more. It was within this increasing
internationalization of American psychoanalytic discourse, and based
on my almost twenty years of involvement in the scientific and administrative
affairs of the IPA, that I felt it appropriate to choose, as the theme
for my 1987 and 1989 presidential addresses, the scientific and political
issue of our growing psychoanalytic diversity and its implications
for what holds us together as adherents of a shared psychoanalytic identity--i.e., our psychoanalytic common ground.
THE RISE OF OBJECT-RELATIONAL THOUGHT
I turn now to the second line of development in American psychoanalysis
over the past two decades, that of an interpersonal or object-relational
paradigm. Its seeds are to be found in the indigenous "interpersonal
psychiatry" of Sullivan and the culturalist emphases brought
to America by Horney and Fromm, ideas originally decried as superficial
social psychology. Adherents to these views either were extruded from
organized American psychoanalysis (as were Horney and Fromm and their
followers) or remained, in part at least, quietly within it (as did
the Sullivanians entrenched in the Washington Psychoanalytic Institute).
Their influence remained small but steady, mostly in the New York
and Washington areas, and mostly in independent institutes and training
centers outside the American Psychoanalytic Association. That influence
grew wider with the publication of Levenson's first books (1972, 1983),
a growth culminating in the major impact on American psychoanalytic
thinking by Greenberg and Mitchell's Object Relations in Psychoanalytic
Theory (1983). This success was followed by the 1991 launching,
under Mitchell's editorship, of Psychoanalytic Dialogues, a
journal of "relational perspectives" that quickly assumed
a major position among American psychoanalytic journals. Mention should
be made here also of Psychoanalytic Inquiry, inaugurated a decade
earlier, in 1981, under the editorship of Joseph Lichtenberg. Taking
a developmental and self psychological perspective, the journal is
broadly sympathetic to the object-relational movement and interrelates
with it in a variety of ways, as does self psychology itself. A 1990
volume by Howard Bacal and Kenneth Newman traces quite convincingly
the precursors of Kohut's self psychology in the contributions of
Balint, Fairbairn, Guntrip, Winnicott, and Bowlby, and even earlier
in those of Ian Suttie. Kohut, who liked to regard his work as a totally
new direction in psychoanalysis, never acknowledged these forebears.
Of current theorists, Robert Stolorow and his collaborators most explicitly
express the links between self psychology and the relational turn
in recent American psychoanalysis (Atwood and Stolorow 1994; Stolorow,
Brandchaft, and Atwood 1987; Stolorow and Atwood 1992).
Since then, of course, these various
object-relational trends, most claiming postmodernist auspices, and
each with distinctive particularities, have swelled into a wide stream
under many rubrics: the interpersonal, the interactional, the intersubjective,
and the perspectivist (or, later, social-constructivist, and now dialectical-constructivist).
Under these designations, major authors have emerged, of whom I will
name a few, at the risk of omitting others, equally worthy of note:
Neil Altman, Lewis Aron, Adrienne Harris, Irwin Hoffman, Donna Orange,
Stuart Pizer, Charles Spezzano, Donnell Stern, and Robert Stolorow;
from a more feminist perspective, Jessica Benjamin and Muriel Dimen;
and from a more Kleinian (or perhaps Bionian and Winnicottian) perspective,
Thomas Ogden. This current is what I have called the New American
Psychoanalysis (Wallerstein 1998b), which vies now with the ego psychology
tradition for recognition as the mainstream.
These various object-relational perspectives
all share what has come to be called a "two-person psychology,"
in contrast to the traditional "one-person" or ego psychology
focused on the intrapsychic conflicts within the patient as
understood and interpreted by an objective analyst through the transference
projections of the patient within the psychoanalytic situation. By
contrast, the two-person psychology is focused on the interpsychic,
or interpersonal, experience within the transference-countertransference matrix, of two interacting personalities
or subjectivities--of patient and analyst--together constructing the
meaning of their shared experience of the interactive process, and
relating their characteristic ways of experiencing that interaction
to the personality structure and life experience of both participants,
primarily of course with the intention of unraveling the genesis and
development of the patient's presenting psychopathology. Unlike the
effort to avoid or to master countertransference involvements as threatening
impediments to the analytic work, which is the usual stance within
ego psychology, within the two-person framework countertransference
is understood as inevitable and ubiquitous, and as an essential ingredient
of the psychoanalytic process, vital to the analyst's understanding
of his or her own participation in co-constructing the meanings of
the psychoanalytic dialogue, and vital also to understanding the patient's
inner psychology through the impact made on the analyst's mental equilibrium.
THE TRANSFORMATION OF EGO PSYCHOLOGY
The third line of development in American psychoanalysis over the
last few decades, the continuing evolution of the ego psychology paradigm,
is the one most central to my concerns. Changes here have been both
conceptual and technical. Elizabeth Zetzel (1956) and Ralph Greenson
(1965) together pioneered the "alliance" concept in American
analysis--actually an elaboration of Freud's remark (1912) that the
"unobjectionable" positive transference, as an aid to the
analytic work, does not require analysis (p. 105). Greenson used the
phrase "working alliance" to focus on the patient's highest-level
secondary process functioning, as it cooperates actively with the
analyzing work of the analyst and stands apart from the fluctuating
vicissitudes of transference manifestations. The alliance thus provides
a framework within which transference oscillations can be safely contained.
Zetzel introduced earlier the phrase "therapeutic alliance,"
to emphasize the role of the alliance in supporting the therapeutic
process. Unlike Greenson, she stressed the archaic and infantile origins
of the alliance in the earliest period of mother-infant interactions,
the period in which, optimally, the child's "basic trust"
is established (Erikson 1950, p. 75).
Whatever its origins (more primitive
or later), and however constituted, the alliance for both Zetzel and
Greenson is essential to the proper conduct of analytic therapy. In
"normal neurotic" patients it can usually be taken for granted,
but in sicker patients whose developmental history has failed in the
proper nurture of this capacity, it often requires special attention
and direct cultivation. The alliance conception has never seemed useful
to adherents of paradigms other than ego psychology, and it has been
sharply attacked even in friendly quarters (see Brenner 1979; Stein
1981) as shielding from analytic scrutiny transference manifestations
that often are highly conflicted and therefore "objectionable."
This is probably because two-person approaches have no need of an
alliance concept, which had emerged within ego psychology specifically
to take account of the "real" interaction with the second
person, the analyst. But whether disputed or embraced, the alliance
conception was a breach in Eissler's austere technical doctrine that
the only proper psychoanalytic activity is unremitting interpretive
attention to the transference manifestations of the patient's intrapsychic
An even larger breach in the rigorous
Eissler model, embedded as it was in the abstract theorizing of Hartmann's
natural science vision of psychoanalysis, occurred during that same
time period with the technical softenings proposed by Leo Stone (1961)
and the conceptual recastings of Hans Loewald (1960). Stone's plea
was for a humanization of the analytic process, a modification of
Eissler's austere ideal, the insertion of a frank and avowedly therapeutic
commitment, what he called the "physicianly" attitude of
explicit concern and care for the feelings and the psychic well-being
of the patient. This attitude could include the simple gratifications
expected in ordinary social and/or professional discourse, as well
as the offering of important information or judicious advice when
clinically indicated, all unnecessary and misguided "parameters"
in Eissler's sense, and all recognitions of the interactional two-person
nature of the analytic situation.
Loewald's precepts were conceptually
more far-reaching and revisionary. Stone's emphasis was on the necessary
"humanness" of the analyst-analysand relationship; Loewald's
was on the analyst's role as a "new object" in the patient's
life, with whom therapeutically productive "integrative experiences"
were to be achieved. Desired resumption of the patient's ego development
consequent to the progressive analytic process was contingent, Loewald
believed, not only on proper analysis of the transference relationship with reawakened old objects,
but equally on the forging of a new relationship with a new object,
the analyst as coactor on the analytic stage, on which the childhood
events that culminated in the patient's infantile neurosis are reactivated
and restaged via crystallization and resolution of the contemporary
In this reconceptualization, which drew
explicit analogies to early mother-child interactions optimally reexperienced
in the therapeutic present with less pathogenic and more adaptive
resolutions, Loewald, though retaining the language of classical ego
psychology, significantly moved it in the direction of a two-person
psychology. It may not be too much to state that it is this stance
by Loewald, developed with increasing specification in a sequence
of papers spanning three decades (Loewald 1980), that was the major
impetus for the gradual movement of many gifted analysts, trained
within the ego psychology tradition (even when it was most demanding
in its technical strictures and unyielding in its theoretical formulations),
toward intellectual fellowship with the object-relational descendants
of Sullivan and Horney. Among those gifted analysts I include such
figures as James McLaughlin, Dale Boesky, Warren Poland, and Judith
Chused, and, perhaps even more fully, Theodore Jacobs, Owen Renik,
and Merton Gill (in the case of Gill, in an extraordinarily fertile
intellectual partnership with Irwin Hoffman). Here again the question
arises whether Loewald's work forges a bridge from classical ego psychology
to the interpersonalist inheritors of Sullivan and Horney (Mitchell,
Aron, and their colleagues), or to a more "Freudian" form
of two-person psychology as elaborated by most of the authors I have
just listed. If such a distinction has significance, I would incline
to the latter view, of a bridge, through Loewald, to those trained
within the ego psychology framework.
Yet another influence may be cited
in the opening up of the American ego psychology paradigm. John Gedo,
first in a book with Arnold Goldberg (1973), and then in several books
of his own--notably, Beyond Interpretation (1979)--developed
a hierarchical and developmental model of the psychic apparatus, and
of technical implementations appropriate to each of the five stages
in this schema. These stages, three drawn explicitly from Freud and
two based on the emerging formulations of Kohut, were (1) the stage
of the reflex arc model of primary narcissism; (2) the stage of the
self-object model, after differentiation of self from object; (3)
the second self-object stage, with its danger of castration and its
central "phallic narcissism"; (4) the stage of the tripartite
structural model, following superego formation; and (5) the mature
stage of the evolved adult psychic apparatus.
The point most relevant here is that
in Gedo's schema interpretation, in the classical Eisslerian sense,
is the appropriate therapeutic intervention only with individuals
functioning at the fourth level, that of the traditional neurotic
disorders. At the other levels, which correspond, in ascending order,
to states of traumatic disorganization, psychoses, narcissistic personality
disorders, and (skipping to the fifth) the highest achievable nonneurotic
adult functioning, other intervention strategies are recommended.
These, again in ascending order, are designated as pacification, unification,
optimal disillusionment, and, at the highest level, thoughtful introspection.
What in Gedo's view is accomplished here is a breaking of the bounds
of the classical ego psychology framework, with a far wider array
of theoretical conceptualizations and technical derivations made available
to the clinician.
These various developments (or, rather,
transformations) in ego psychology have together, I believe, encouraged
a growing acceptance of object-relational thought within American
psychoanalysis, where increasingly it exerts a further influence on
traditional ego psychology. My point is that the contributions of
Kohut, Loewald, and Gedo, as I have outlined them, all bring, with
increasing explicitness, a developmental perspective to ego psychology,
which now directs greater attention to the role of adequate development
in adaptive personality functioning, and of developmental failures
in the formation and evolution of psychopathology (for a similar perspective
from the side of child analysis, see Seligman 1997). Once this ground
was broken, the way was paved for the growing receptivity of traditional
ego psychologists to object-relational, even Kleinian, theoretical
perspectives. To these influences may be added theoretical developments
within child analysis per se, or even the "baby watching"
developmental research of Robert Emde, Louis Sander, Daniel Stern,
and others, all conceptualized within the ego psychological tradition.
These changes--e.g., the elaboration, within the Freudian group in
London, of Anna Freud's conception of developmental lines (1965, pp.
62-91), or Stern's conceptions of the attunement of mother and infant
to each other from the very start of extrauterine life (1985, pp.
207-214)--have each contributed to the internal evolution of ego psychology.
Germane in this context, too, has been
the profound alteration, over recent decades, of the relationship
between psychoanalysis and American academic psychiatry (see Wallerstein
1980, 1983). Briefly, the growth of neuroscience and the rise of biological
psychiatry have displaced psychoanalysis from its earlier, virtually
hegemonic position within academic psychiatry; the result has been
labeled the "remedicalization" of psychiatry. The void caused
by this loss of cultural and political dominance within American psychiatry has in a real sense
been filled by psychologist psychoanalysts, who are indeed the chief
authors of relational analysis, which by and large emerged politically
and has been nurtured within Division 39 of the American Psychological
Association. The concomitant increasing feminization of all the psychotherapeutic
disciplines (Philipson 1993), as well as the breakdown of the exclusionary
policies of the American Psychoanalytic Association against the clinical
training of nonmedical analysts (Wallerstein I998a), have likewise
played their part in the shift in psychoanalysis from a clear hierarchy
of theory and technique within a natural science perspective in which
facts are understood as knowable and fixed (the original ego psychology
one-person paradigm), toward the conception that knowledge is conditional,
contextual, and co-constructed (central tenets of the relational two-person
paradigm). I have not attempted to cover here the impact, on the world
of ego psychology, of relevant critiques brought by disciplines separate
from psychoanalysis: the feminist attack on adaptation theory as actually
a psychology of gender oppression; the neuroscience critique of Freudian
drive theory; and the press by nonanalytic child development research
toward an interactional, two-person psychology. All of these have
also played a role in altering psychoanalytic conceptualizing in ways
that could well be the substance of another paper. (For fuller development
of these views, see Seligman 1996.)
Given, then, the panoply of these internally
developed and externally enhanced enlargements of classical ego psychology--the
alliance conceptions of Zetzel and Greenson, the focus on the quality
and nature of the psychoanalytic relationship by Stone and Loewald,
and the hierarchical schema of Gedo (all of whom, incidentally, always
saw themselves as operating within the ego psychological paradigm,
even while "pushing the envelope")--what corresponding changes
have occurred in the recent transformation of ego psychology by those
who have always been regarded as its staunchest guardians, linked
closest in lineage to the original group around Hartmann? Among these,
Jacob Arlow and Charles Brenner, central figures in the same New York
Psychoanalytic Institute where ego psychology experienced its original
flowering, and frequent collaborators (see, e.g., Arlow and Brenner
1964), have been the most influential voices.
Arlow's special contribution has been
in filling the lacuna left by the demise of one of Freud's (and Hartmann's
and Rapaport's) central metapsychological viewpoints, that of the
economic or energic constructs. Though energic concepts had their
continuing defenders (e.g., Lustman 1969), they had been increasingly
attacked as mischievous and misleading metaphors, with no conceivable
relation to any of the customary scientific meanings of the concept
of physical energy, and also as totally unnecessary to psychoanalytic
explanation. They were attacked first by the original defectors from
Rapaport's systematization of metapsychology--George Klein, Gill,
and Schafer--and then by a host of others. In 1975, I chaired one
of the last panel discussions of this issue in the American Psychoanalytic
Association (Wallerstein 1977), and today Freud's energic constructs,
for all their central importance to his theorizing, no longer have
Instead, as portrayed by Arlow in a
series of articles (for two of the most significant, see Arlow 1969,
1985), the function of the energic constructs in motivating behavior
is replaced by the role of unconscious fantasy in the constitution
of psychic reality and in the motivation of normal and abnormal behavior.
The memories that constitute our life history are created, in Arlow's
conception, through the mingling of external perceptions with unconscious
fantasies, as experienced against the background of the individual's
past development, itself a mingling of earlier perceptions and unconscious
fantasies into encoded memories.
Brenner, accepting Arlow's reformulation
of energic constructs into the unconscious fantasies that motivate
behavior, proceeded to a more total revision of the tripartite structure
of the psychic apparatus. He became a principal spokesman for the
general retreat from Hartmann's (and Rapaport's) vision of psychoanalysis
as a general psychology, explanatory of the entire range of human
mental functioning within a biologically anchored natural science
framework; this entailed the dropping of any central concern with
a structure of autonomous ego apparatuses developing in a conflict-free
sphere. The result was a reversion to Freud's conception of psychoanalysis
as explanatory only of that aspect of mental life born of psychic
conflict. This was stated aphoristically in the 1940s by Ernst Kris,
otherwise Hartmann's closest collaborator, as the conception of psychoanalysis
as nothing but human behavior considered from the point of
view of conflict. And this is the conception that Brenner has systematically
developed to its fullest.
Brenner's The Mind in Conflict
(1982), in which he presented a new, revisionary framework for what
would become contemporary ego psychology, is thus aptly titled. Since
the ego in its manifold functions was so central to the formulations
of ego psychology, Brenner begins with the ego, but with the ego specifically
in its functions in relation to conflict--the classically established
defense mechanisms. His thesis is both sweeping and simple, that there
are no special defense mechanisms, that any aspect of ego functioning
can serve a defensive purpose but can at other times, or at the same
time, serve also as a vehicle for drive gratification, as the expression
of superego pressures, or as an adaptation to the requirements of
external reality. In Brenner's words (1982), "no aspect of ego
functioning, no ego function is a `defense mechanism.' All aspects
of ego function are all-purpose" (p. 80). They can equally well
serve drive gratification, expression or modulation of anxiety or
depressive affect, defensive needs, or superego strictures--simultaneously,
or alternately, or successively, often of course weighted more in
one direction than in another.
How then, does Brenner conceptualize
the play of forces in psychic conflict? It is via compromise formations
as the omnipresent accommodations to mental conflict--and compromise
is declared to be ubiquitous in all neurotically impaired behaviors,
as well as in all (or perhaps almost all) so-called normal behaviors.
And what is it that enters into these compromises? Four elements are
involved: the push of drive expression; the pressures (opposing or
not) of the superego; the ego's defensive need to modulate these expressions
in the interest of adaptation to external requirements; and the ego's
intent to ward off or minimize dysphoric affects. These last are of
two kinds, in Brenner's conception of equal status: anxiety (central
to Freud's thinking), which is the fear of pending risk or danger,
and depressive affect (which Freud denied equal status), which is
the fear or the consequence of a dangerous situation that has already
befallen the victim.
Compromise formation in response to
psychic turmoil becomes then, in Brenner's view, the all-purpose explanatory
principle that marks (and unifies) the structure of this contemporary
ego psychology. Brenner tries to show, through illustrative vignettes
(which incidentally never characterized Hartmann's presentations),
that any thought, speech, wish, plan, fantasy, dream, behavior, neurotic
symptom, joke, or parapraxis can be usefully dissected, to show in
it the four elements noted above, and the compromise formation that
at once represents it and modulates their conflict. Brenner then extends
this way of conceptualizing even more broadly, encompassing what Kris
(1936) called "regression in the service of the ego," at
work in all intellectual and artistic creativity, as well as in public entertainment, religious
thought and activity, support of art, music, sports and games, and
the like. In the final section of his book, Brenner considers, from
the point of view of the compromise formations formed out of human
conflict, such diverse human expressions as normal character traits,
choice of vocation and avocation (hobbies and interests), choice of
sexual/marital partner, folk tales, myths, legends, superstitions,
organized religion, sociopolitical and governmental forms, and the
writing of fiction. And, of course, all object relationships, including
those at play in the transference-countertransference matrix, are
themselves but compromise formations.
It is clear by now that, in Brenner's
words, "conflict and compromise formation are not the hallmarks
of pathological mental functioning. They are equally important in
normal functioning" (p. 115). As for the purpose of it all, "In
their role as executants of the drives and, later, of the superego,
ego functions will grant to both the fullest expression compatible
with a tolerable degree of unpleasure" (p. 116), meaning tolerable
anxiety and depressive affect. Actually, in the fullest extension
of this thinking, Brenner seems to come close again to Hartmann's
vision of psychoanalysis as a general psychology explanatory of all
individual and social behavior--not through reestablishing Hartmann's
biological anchorage, but by extending the reach of his own conceptions
of conflict, with a concomitant deemphasis or neglect of Hartmann's
array of conflict-free ego functions and apparatuses.
Brenner does leave a little room for
these central Hartmannian ideas in his statement of "the proposition
that a dynamic interaction among the components of psychic conflict
underlies much or all of the subjectively conscious and objectively
observable phenomena of adult psychic life and behavior" (p.
214). It is in the phrase I have italicized, "much or all,"
that space is provided for the existence (and relevance) of conflict-free
functions of the ego. To fill out Brenner's new conceptions, it remains
only to delineate his views of superego origins and functions. Put
simply, his view is that the superego is "definable as one of
the consequences of psychic conflict [i.e., a compromise formation
itself] as well as a component of all later conflicts [i.e., after
its formation, one of the conflicted components in all subsequent
compromise formations]" (p. 121). "The compromise formations
that make up the superego form the basis of the moral aspects of psychic
functioning" (p. 123). Thus, superegos can occupy a range from
normal to pathological in their psychic impact; Brenner has no use
for the idea that the superego has defects, or lacunae--rather, it
is more or less normal and adaptive in its functioning, or not.
So much for Brenner's transformation
of ego psychology into what is now a rather widely accepted revision
of that framework. The familiar psychic instances of Hartmann are
all still there--drives, ego, superego, outer reality--but very significantly
altered in function and structure, with a dropping away not only of
the focus on the conflict-free in ego functioning, but also of the
preoccupation with the explanatory interplay of the five metapsychological
points of view accorded such importance in the 1959 Rapaport and Gill
paper. Though all this is at considerable remove from Hartmann's model,
Schafer in a 1995 paper, "In the Wake of Heinz Hartmann,"
has tried to establish, in what I think is a considerably strained
manner, a continuity in the theory of therapeutic action from Hartmann's
era to today's ego psychology. Contra the many efforts at debunking
Hartmann and consigning him to history, his adaptational theory in
general, and his ego psychology in particular, are presented almost
as precursors of the shift to an interactive view of the two-person
Schafer's main thesis in this regard
is that "by theorizing the mature, the rational, the stable,
and the modulated, the ego psychologists have established that primitive
and damaged must be defined by the otherness of the nonprimitive
and the so-called `normal"' (1995, p. 244; emphasis added). And
that otherness relates to "two-ness," whether of the interaction
with the other person, or with a larger, nonpersonal entity (the outer
reality to which the individual adapts). It is this concept of adaptation,
so central to Hartmann's thinking, that Schafer sees as leading inevitably
to modern conceptions of dialogue (and even intersubjectivity), though
Schafer acknowledges that Hartmann never took that step. And even
the conception of identity is declared to depend on difference from
the other. If one says "I am this," it means "I am
not that," though again Schafer acknowledges that the psychoanalysis
of Freud--and of Hartmann, as his interpreter and extender--is not
primarily field-theoretical, as a truly two-person psychology would
have to be.
But then Schafer makes an effort to
link the two main directions into which the once unitary structure
of American ego psychology has now split: on the one hand, its revision
by Arlow, Brenner, and their adherents, and on the other the object-relational
perspectives that have coalesced into what is today an alternative
mainstream. Schafer's point is that epistemologically the two cannot
be disentangled: "For that attempt at complete systematization
[of the dialogic and intersubjective stance] must take for granted
that the speaker or writer on its behalf is an objective observer
who may be relied upon to give a once-and-for-all definitive account
of the patient, the analyst, and the analytic process. In other words,
the systematization necessarily presupposes a privileged protagonist
who is qualified to argue the superiority of the dialogic and intersubjectivist
position. Thus, there is a hidden return to, and dependence on, the
rejected positivism and, by the same token, a new vulnerability to
a critique developed from the standpoint of perspectivism and so on
ad infinitum" (1995, p. 228). Similarly, from a pragmatic
clinical, rather than philosophical, standpoint, Gill, who had long
seen himself as a full-fledged convert to the two-person interactional
perspective, reverted in his final book, Psychoanalysis in Transition
(1994), to a stance in which he upheld the necessity of both the one-
and the two-person psychology. He considered both to be vital, employed
often in successive or interacting ways, to the fullest pursuit of
the clinical requirements of the evolving analytic situation. This
is fully consonant with my belief that though both perspectives (one-person
and two-person) exist within clinical psychoanalysis, and some use
one, some the other, and some both, at this point of uneasy equilibrium
no one can properly claim the epistemological high ground.
Where does all this leave my overview of the current status of American
ego psychology at the turn of the century, as compared with its beginnings
more than half a century earlier? There are those who agree with Greenberg
and Mitchell's categorical statement in 1983 that an irreconcilable
chasm has opened between ego psychology, however evolved since Hartmann's
day, as still clearly a drive/structural perspective embedded in a
one-person psychology and their own object-relational perspective embedded
in a two-person psychology. To them there exist today in the U.S.
two distinct conceptions, fundamentally antithetical, of the nature
and practice of psychoanalytic therapy.
Those on the other side of this divide,
however, regard ego psychology, as currently reformulated, as a sufficient
explanatory framework, and therefore eschew object-relational approaches
as both incompatible with their own and unneeded for clinical work.
As I have indicated, of course, a significant number of prominent
analysts trained in the ego psychological tradition have come to adopt
object-relational perspectives, and so have recast the transference-countertransference
matrix into two-person interactional terms. In varying degrees they
maintain as well the usefulness of ego psychological precepts and
the one-person view.
Perhaps the staunchest advocate of the
continuing explanatory sufficiency of the natural science ego psychology initiated by Freud
and transmitted through the chain of Anna Freud and Hartmann (with
Fenichel included as a major influence) down to Arlow and Brenner,
is Leo Rangell (1988). "My theoretical overview," he has
written, "is the presence and desirability of what I call `total
composite psychoanalytic theory,' including all the metapsychological
points of view, culminating in the structural. I have pointed out
repeatedly that self, object, interpersonal, preoedipal, all elements
which have served as nodal points of alternative theories, are included
in the total unitary theory, whereas the converse is not true: that
other theories of self, or object, or the Kleinian view, eliminate
variable essentials of the developed, cumulative psychoanalytic theory"
(pp. 316-3 17). Clearly this view of the ego psychology paradigm,
as an overarching composite subsuming all other psychoanalytic perspectives
as but partial expressions or offshoots of the whole, would hardly
be accepted by adherents of other theoretical positions. Indeed, in
this era of theoretical pluralism, of increasing acceptance of a diversity
of competing explanatory frameworks, it might meet with little agreement
even among those Rangell would count in his camp.
Another approach to this breach in what
once was the unquestioned hegemony of the ego psychology paradigm
is exemplified by Otto Kernberg and Joseph Sandler. Contra the views
of Greenberg and Mitchell, they have devoted major efforts to reconciling--even
creatively amalgamating--the seemingly disparate metapsychologies
of ego psychology and object relations theory. Kernberg and Sandler
have of course not been alone in this enterprise. As already noted,
so prominent an early ego psychology stalwart, later turned wholeheartedly
relationist, as Merton Gill in his final book (1994) returned to a
plea for a complementary, if not yet integrated, view of both one-
and two-person conceptualizations (theoretical and technical) of the
psychoanalytic process. More recently, Nancy Chodorow (1999) bas developed
an amalgamating path toward a "both-and" synthesis of ego
psychological (one-person) and object-relational (two-person) psychoanalytic
perspectives, with Loewald her declared theoretical forebear. Kernberg's
effort, spelled out in a sequence of books (1975, 1976, 1980), has
been to conceptualize internalized object relations--i.e., sequences
of self- and object representations and the affective valences linking
them, established in the infant's earliest interactions with the ambient
(primarily maternal) world--as primordial motivators of behavior and
building blocks of subsequently crystallizing psychic structures that
culminate, in full personality development, in Freud's tripartite
structuralization of id, ego, and superego.
Sandler's path (1987) originated in
his studies of the logical structure of classical psychoanalytic concepts,
which he examined for their explanatory fit with the data of the psychoanalytic
treatments conducted at the Anna Freud Centre, as discerned through
the descriptions in the Hampstead Child Therapy Clinic index categories.
This led, through an incremental transformation of the traditional
Freudian drive/structural paradigm, based on an economics and dynamics
of drives and energies, to a more object-relational model, an economics
and dynamics of fluctuating feeling states embedded in internalized
object relations, and reflecting the full human feeling range, from
anxiety, depression, and pain to well-being and safety. This was accomplished,
however, without his losing sight of the vital links to issues of
instinctual gratification and frustration, so centrally important
as the ego balances danger and safety, and adaptively regulates its
shifting feeling states.
In this sense, Kernberg and Sandler
have been converging in carefully crafted efforts at the theoretical
amalgamation or integration of paradigms Greenberg and Mitchell had
declared totally distinct and irreconcilable. Perhaps in pursuit of
this agenda, Kernberg in 1993 published an article, titled "Convergences
and Divergences in Contemporary Psychoanalytic Technique," in
which he sought to demonstrate converging trends in clinical technique
across what traditionally had been regarded as totally distinct theoretical
perspectives, from each of which, presumably, a set of clearly differing
technical precepts derives. And though he tried, in an attempt at
evenhandedness, to delineate areas of seeming divergence, these seemed
both less consequential and more alterable than the convergences.
Did he mean this as a forecast (or at least a portent) of a growing
coalescence, the restoration, out of the present congeries of distinct
and competitive theoretical paradigms, of a unified science and praxis
Given this array of differing voices,
we each of us, especially if trained within that earlier unified vision,
have our choices to make at the start of this second century of psychoanalysis.
Should we hold the ego psychology paradigm distinct (or even supreme)
in its modern transformed version? Or should we see it existing alongside,
and in healthy intellectual competition with, all the other psychoanalytic
metapsychologies that have been developed, going back to the Kleinians
in the 1930s? Or should we, as Fred Pine (1990, 1998) suggests, adopt
a pragmatic willingness to employ these systems in shifting explanatory
endeavors in relation to the fluctuating vicissitudes of our patients'
mental processes? Or should we rather embrace the convergences held
out by Kernberg and Sandler? All we can be certain of is that this
is all part of the healthy, creative flux in our psychoanalytic discipline
today, not just concerning ego psychology in its evolution to date,
but challenging all our psychoanalytic thinking at this moment in
time, however stable or uncertain our theoretical allegiances.
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