Excerpts from Must Read Books & Articles on
Mental Health Topics
In a series of dense, tightly reasoned metapsychological essays over the course of three decades, from the 1950s through 1970s, Hans Loewald worked on and worked out certain central, difficult problems that were of great concern to him: the nature of mind, the relationship between actual events and psychical internality, and the revitalization and transformation of the past within current experience. It would not be too reductive to say that Loewald was working on problems of being and time, and putting it that way highlights the impact on Loewald's work of the three years he spent studying philosophy with Heidegger in Freiberg. But if the problems that gripped Loewald were Heideggerian, the conceptual world that he lived in and loved was Freudian.
There are two features of Loewald's commitment to Freud that are particularly striking. First, Loewald believed that the central feature of Freud's contribution was his theory of drive--his uncovering of the instinctual, primitive, "lower" sources of human motivation. Second, Loewald believed that there was something fundamentally wrong with the way drive was understood, both by Freud and by mainstream psychoanalysis.
Despite the interest he shared in "higher" transformations of the human spirit, it was essential to Loewald never to forget the "lower" sources of motivation that Freud's revolution had uncovered, his unmasking of our intricate hypocrisies, and his revelation of the body-based underbelly of all our activities, the body in its full corporeality, in its surfaces, its parts, its excretions. Loewald reads Jung as enjoining us, like the Bishop of Yeats's Crazy Jane poems, to "Love in a heavenly mansion, / Not in some foul sty." But Loewald responds to Jung like Crazy Jane responded to the Bishop:
Yet, despite the extraordinary power of Freud's vision, his blend of fair and foul, there was, for Loewald, something fundamentally off about the way Freud typically thought about drives. This had to do with beginnings, the locus and origination of experience.
In Loewald's view, Freud began to shift from his earlier energicdischarge (Loewald sometimes refers to it facetiously as Freud's "fuel-injection") notion of drive to a relational notion of drive in 1920 with the introduction of the concept of Eros in "Beyond the Pleasure Principle." This shift, however, was never complete, and Freud's relational model of drives remained a secondary, largely undeveloped avenue. But it was central to Loewald's project and recently has been further developed in the contributions on Eros in the writings of Jonathan Lear (1990,1998).
Thus, the term "primary process," Loewald suggests, should be used in reference to the original state of the infant-mother field, in which there is no organization as such, in which all the usual distinctions that make possible our ordinary experience are missing. "The secondary process is secondary insofar as in it duality becomes established, insofar as it differentiates; among these differentiations is the distinction between the perceiver and the perceived" (p. 168).
It is crucial to note here, and we soon take this up in greater depth, that Loewald is taking pains to suggest that objects, in a psychological sense, do not exist independently of the subject. Objects are created by being invested with significance through organizational (objectcathectic) activity out of the "primal density" or primary process.
In object cathexis, one is drawing a boundary around a piece of experience, differentiating something out, and saying, "This is you." In narcissistic or identificatory cathexis, one is drawing a boundary around a piece of experience, differentiating something out, and saying, "This is me."
OBJECT AND OBJECT-RELATING
What is an object? For Freud, objects are other persons, or body parts, or things that have been discovered to be useful in reducing the tension of drives. For Klein, objects are a kind of teleological image wired into drives themselves, like Jungian a priori archetypes toward which desire is inherently directed, which then become psychically intermingled with real others and parts of others in the external world. For Fairbairn, reversing Klein, objects begin as real others in the external world toward which "object-seeking" libido is directed, which may defensively and compensatorily become transformed into internal presences. In all these accounts, objects exist as either real external entities or prewired properties of experience.
Loewald later concludes:
This crucial point may seem abstract and difficult to grasp, but it is actually quite familiar to any interpersonally oriented psychoanalyst or couple or family therapist. Consider the way things work in couples or families. We are all fundamentally conflicted about all the major issues of life: seeking versus regulating pleasure; expressing versus restraining aggression; spending versus conserving money; rededicating versus reopening commitments, and so on. We all contain intense feelings on both sides of all these issues. But as couple and family relationships are often structured, one or the other side of these fundamental universal conflicts is assigned to different persons. One partner wants a commitment and the other evades it; one family member spends recklessly while another patrols expenditures; one child expresses the family outrage while the other is a model of virtue; one partner seems to want sex all the time while the other seems to avoid it. What goes on here? Each participant individually (and collaboratively with other participants) creates his own subjectivity and creates his objects by superimposing on the rich, affective, conflictual density of experience a simplifying scheme, through sorting out and assigning different qualities to different participants. It is just this sort of layering process, Loewald is suggesting, through which secondary process is generated out of primary process.
Loewald envisions mind as a latticework of interactive identifications, simultaneously in different degrees of assimilation on different levels, with a sense of self on one side and a sense of externality on the other. This vision has close connections to contemporary relational notions of multiplicity of self-states and selforganizations (Mitchell, 1991; Davies, 1996, 1998b; Bromberg, 1998).
Loewald's theory of object formation solves what for me was always one of the most interesting unsolved problems in psychoanalytic theorizing. Why are the residues of early object relations so persistent and resistant to change? It is just this feature of human psychology that makes our work so difficult, that necessitates such long stretches of time. Freud could describe it, but he couldn't really explain it. His metapsychological pleasure principle claims that we seek pleasure and avoid pain. Yet, the durability of early traumatic experiences and relationships is probably the most widespread psychological cause of human suffering. Polymorphously perverse libido, in all its plasticity, should be able to discard painful objects and find new ones. Yet the depth of our loyalty to painful early objects (which was the clinical basis for Fairbairn's redefinition of libido as not primarily pleasure-seeking but as object-seeking), which we encounter over and over in analysis and life in general, is staggering. Freud attributed this phenomenon to what he termed the "adhesiveness" of the libido, but threw up his hands at a compelling explanation by attributing it to a mysterious Death Instinct. And Meltzer (1975) used this same word, which I have always found so experientially vivid, in describing "adhesive identifications" in autistic states. What is so marvelous about Loewald's theory is that it dramatically reframes the whole problem. Primary identifications are so adhesive because there is a boundary between me and my objects only on a conscious, secondary process level of organization; on a primary process level, I am my objects, and my objects and I are always, necessarily, inseparable. They can never be expelled. This suggests that what can happen in psychoanalysis, what does happen, is not renunciation or exorcism of bad objects, but a transformation of them.
TIME AND MEMORY
Self and objects are related to each other in Loewald's model of mind through interactions, and interactions are related to each other through time. To approach Loewald's understanding of time, which, like most other things, soon departs from conventional understandings, let us consider what he has to say about the complex, reciprocally generative relationship between perception and memory.
Once again, these distinctions, which sound very abstract, . are extremely rich clinically. Consider the way in which we work with memories in the analytic situation. The patient may associate to an earlier time, his fifth birthday, let us say. That is clearly past, not
We have seen that Loewald believed that self-other and internalexternal are secondary constructions upon a parallel organization in which self-other, inside-outside are undifferentiated. Similarly, he also believed that our experience of time as duration -- past as distinct from present as distinct from future -- is a secondary construction upon a parallel organization in which these temporal categories do not exist. It is only as boundaries between self and other are constructed that past and present are also distinguished: "in a deeper sense, only by virtue of the differentiation of subject from object -- which is the primordial separation -- does memory arise" (Loewald, 1972, p. 160). Yet, just as with the boundary between self and other, the boundary between present and past exists only on a secondary, not a primary process level. Thus, the present and the past, perception and memory always retain their Siamese relationship (see also Grotstein, 1981) with each other, joined on one level and differentiated on another. Perception and memory, Loewald suggests, are bound together, necessarily, in a dialectic of reciprocal influence.
THE ANALYTIC PROCESS
Because Loewald writes about analytic process only in the most abstract terms, and his writing lacks virtually any clinical examples, it is impossible for analytic clinicians who have fallen under the spell of Loewald's extraordinarily rich vision to discern how Loewald himself actually worked. But I am not even sure this matters. As McLaughlin (1996) notes,
For our purposes here, I want to briefly address the implications of Loewald's revisions for the two most basic features of the analytic process: the analytic situation and the analytic relationship.
Loewald views the human psyche in radically interactive terms. Our minds are open systems embedded in an interactive matrix with other minds, and our sense of self is a function of the internalization and continual reproduction and memorialization of those relationships. Loewald (1960) stresses repeatedly "the role that interaction with environment plays in the formation, development, and continued integrity of the psychic apparatus" (p. 221). In traditional terms, as Loewald describes them, the analytic situation is a medium within which the "closed system" of the patient's mind is revealed and interpreted by the analyst operating "as a reflecting mirror ... characterized by scrupulous neutrality" from a vantage point outside that system (p. 223). In Loewald's vision, the analytic situation is an open, interactive matrix, in which the analyst is "a co-actor on the analytic stage" (p. 223). And interaction is the key, previously unexplored feature that Loewald stresses over and over, with the implication that "a better understanding of the therapeutic action of psychoanalysis may lead to changes in technique" (p. 222).
But how open is open when it comes to the analysand's engagement with the analyst as a real person in the analytic situation? And how open is the analyst as a psychic system encountering the patient? There are places where Loewald seems to suggest a radical, mutual openness and engagement indeed, suggestive of the kind of unique intersubjective mix Ogden writes about in connection with his term "the analytic third." " The analyst, Loewald (1977a) suggests,
To return to our earlier analogy, we might say that the analyst joins the patient in the undivided room of primary process, or that the patient and analyst slowly come to find and differentiate themselves and each other collaboratively in an undivided room.
Loewald (1977b) thus portrays the analyst not as solidly, consistently parental, but as straddling levels of organization .7 "The difference between the patient and the analyst is that the former is at the mercy of that primitive level (inundated by it or disavowing it), whereas the analyst is aware of but not given over to it" (p. 379). In the recent psychoanalytic literature, different authors strike different sorts of balances in depicting the contrast between the analyst's surrender to primary process and the analyst's maintenance of at least some foothold in secondary process. Loewald often seems to assume considerable control on the analyst's part over his own participation, although in his final work (1986) he seemed to be stressing increasingly the dangers of rationality as screening out unconscious communication and the sense that the analyst's control is, necessarily, episodically lost and regained.
The patient "hopes" the analyst is more experienced, knowledgeable, and mature in regard to emotional life. In contrast, the patient "makes himself out to be" a child in the "regressive pull" of the analytic situation. Loewald is tracing the ways in which the different roles shape the greatly overlapping experiences of patient and analyst in different ways. The analyst, in his assumption of professional responsibility, also hopes he is more mature and knowledgeable and tries to act that way, much as a parent might with a child with whom he is emotionally enmeshed. The patient does not have to be responsible and organized in this way; in fact, we consider the patient who is trying to be responsible in this way to be resisting the precious opportunity the analytic situation provides for a freedom from conventional accountability, a surrender (Ghent, 1992) to unintegration. Loewald regards as essential for the analytic process the analyst's capacity to bridge primary and secondary process, self and other, past and present, reality and fantasy.
Loewald (1978a) revealed himself somewhat more in his Yale lectures for the general public than in his professional writings. There he said, and I would like to end this chapter on this note, that "one does not have to be a mystic to remain open to the mysteries of human life and human individuality".
Heinrich Racker (1968) wrote what may be described as the "anthem" of contemporary relational psychoanalysis:
The first distortion of truth in "the myth of the analytic situation" is that analysis is an interaction between a sick person and a healthy one. The truth is that it is an interaction between two personalities.... each personality has its internal and external dependencies, anxieties, and pathological defenses; each is also a child with his internal parents; and each of these whole personalities--that of the analysand and that of the analyst--responds to every event of the analytic situation.This is, for very good reason, an often cited quotation, for it sums up much of the essence of the principle of mutuality that is fundamental to the relational model in psychoanalysis. Racker drew our attention to a number of principles here, including that psychoanalysis is an interaction between two people, who each respond to every event in the analytic situation. That is to say, Racker viewed both members of the analytic couple as being participants in the interaction. Furthermore, Racker refers to the mutuality of neurotic interaction between patient and analyst in his insistence that neither is fully healthy, rational, or adult in his or her functioning.
In a less well-known footnote to this famous passage Racker noted:
It is important to be aware of this "equality" because there is otherwise great danger that certain remnants of the "patriarchal order" will contaminate the analytic situation. The dearth of scientific study of countertransference is an expression of a "social inequality" in the analyst-analysand society and points to the need for "social reform"; ....In Racker's prose we can hear the reverberations of the democratization of society and of the emergent feminist critique that has come to play an important role in the development of relational theories. Racker recognized and warned us of the dangers of polarizing the analyst and analysand with respect to their health and their capacities to judge reality. He recognized the issues of power, dominance, and authority that are at play between them. When Racker wrote of "equality" between patient and analyst, I believe that he used quotation marks because he did not really mean equality but, rather, the mutual containment of health and neurosis by both the analyst and the patient. Edgar Levenson, the best known contemporary interpersonal analyst, has stated that Racker's object-relational position and Sullivan's (1953) interpersonal dictum that "we are all more simply human than otherwise" (p. 32) "converge in a concept of psychoanalysis as a mutual, respectful exploration of a joint reality" (Levenson, 1987a, p. 214).
Similarly, McLaughlin (1981), a well-respected and senior Freudian analyst, wrote that the traditional view of transference reinforces a model of psychoanalysis that differentiates sharply between a "patient with psychopathology and a physician with a cure" (p. 642). Psychic reality and objective reality become split; transference, psychic reality, and the infantile are attributed to the patient, and objectivity, external reality, maturity, and health are assigned to the analyst. One can see in this brief sampling of Freudian, interpersonal, and Kleinian thinking how a relational position that emphasizes mutuality can transcend narrow political and theoretical affiliations.
Both the shift from drive theory to relational theory (Greenberg and Mitchell, 1983) and the movement from an epistemology of objectivism to constructivism (Hoffman, 1991) have taken place in the wider context of social, political, and economic changes in our larger society. PreWorld War I, Europe, where psychoanalysis was born, was a far more authoritarian time and place than are the societies in which psychoanalysis is now practiced. Social changes in the past century have increased the likelihood that such authority will be challenged and scrutinized. The notion of an objective, "neutral" observer has been called into question on epistemological grounds. Even in such a hard and exact science as physics, Heisenberg and Einstein demonstrated that the position of the observer and the acts of observation influence the nature of the data gathered.
In the postmodern world, conceptions of truth are under attack everywhere. Poststructuralists, such as Derrida (1978, 1981), see meaning as multiple, unstable, and open to interpretation, relative to particular social, political, and historical contexts, and they thus move away from Grand Theory, which purports to assert universal Truth. Philosophers allied with postmodernism, such as Rorty (1979), criticize their predecessors as "essentialists" who assumed that there were innate essential meanings rather than historically contingent or local meanings. Postmodern psychologists, or social-constructionists, have begun to deconstruct such concepts as personal autonomy and the self
(Cushman, 1991; Gergen, 1991, 1994). Deconstructionists decenter the biases and assumptions of texts and move peripheral and marginalized perspectives to the center. Foucault (1984) reveals that multiple perspectives are erased from texts and suppressed and that those voices which are heard are connected to power and with strategies to maintain power. Feminists, particularly postmodern feminists, have alerted us to how fundamental conceptions such as gender, sexuality, and race are cultural and linguistic conventions that, when deconstructed, reveal hidden relations of authority and power. The presumed fixity of the existing social order is destabilized, and prominence is given to suppressed voices; in the mental health field, for instance, to the cries of women, children, minorities, gays, and patients.
Where does all of this leave analysts in their attempts to be the relatively neutral interpreters of patients' psychic reality? The classical conception of the analytic process is based first and foremost on the historical understanding of transference as a distortion of reality. The analyst is in the position of having to interpret to the patient where, when, and how the patient has distorted or misperceived the analyst, who is, after all, a relatively blank screen. Analysts, protected from emotional overinvolvement by their relative silence, distance, anonymity, and containment, as well as by a presumed thorough training analysis and a capacity for ongoing meticulous self-analysis, are thought to be in a good position to sort out what in patients' perceptions is real and what is error or distortion. The analyst must be in a position to judge what is real and what is not; hence, the distinction between transference and reality, transference and alliance, transference and relationship. But when authority is questioned in all areas of life, when interpretation itself is seen as an operation of power, when truth is seen as relative and context bound, when the dominant perspective is decentered and marginalized voices are moved to the foreground, when meanings are seen as socially constructed, and universal laws are devalued, when the very notions of objectivity, reality, and truth are challenged, when every Grand Theory is attacked--where does that leave the psychoanalyst? How can analysts interpret the transference, perform that fundamental psychoanalytic act, when that act, as it has been traditionally conceptualized, implies that analysts have the authority to distinguish truth from distortion and to assign meaning as if they were not involved in a relationship of power over analysands in and through that very interpretive act?
Our most cherished and fundamental beliefs about psychoanalytic technique are all being questioned. With the abandonment of drive theory, the dimension of frustration and gratification that for so long was the single best guide to the role of the object has been decentered.
Consequently, the rules of abstinence, anonymity, and neutrality have had to be forsaken. We do not take for granted the absolute truths of our metapsychologies; how could we when we have so many of them to choose from? So our interpretations must be based on something other than these foundations. It was inevitable that the postmodern condition would affect psychoanalysis, and it has under a variety of rubrics and schools including social-constructivism, hermeneuticism, narrative approaches, and what I have called relational-perspectivism.
Relational-perspectivism eschews the role of the authoritative analyst, who knows truth and represents reality and therefore health, in favor of a view of the analyst as a coparticipant involved in a mutual if asymmetrical endeavor. The tendency to polarize into dichotomous categories such concepts as analyst-analysand, therapist-patient, observer-observed, health-neurosis, scientist data, experimentersubject, follows from an acceptance of the traditional dichotomy of subject-object that, in turn, has been intricately connected to the dichotomy male-female. Ideas of male-female opposition have been present in both Eastern and Western cultures throughout history. In the West women have been regarded as the repository of all that is not male; women are assigned the role of "other" to men. The objectivist and positivist experimental model of scientific research that we are so painstakingly taught in graduate school is based on these distinctions. In Francis Bacon's scientific model, nature was depicted as female, to be subdued and conquered by the penetrating male gaze (Keller, 1985). Throughout Western history and culture women have been associated with passion and emotion, and men to reason, technology, and civilization.
In Freud's effort to constitute psychoanalysis as a positive science, he portrayed the analyst's functioning in the image of the phallus. The analyst was thought of as the fearless and adventurous male who seeks to uncover, expose, and penetrate the feminine "unconscious." The analyst needs to be sharp and insightful, brave and intrepid, fearless in "his pursuit" of the feminine unconscious. The analyst is to be "objective," and therefore "the subjective factor"--emotion, passion, subjectivity--has to be eliminated. With the shift in emphasis from a one-person to a two-person psychology, with the rise of a relational and intersubjective psychoanalytic theory, with the acknowledgment of the subjectivity of the analyst comes a shift in our view of psychoanalysis from a relatively detached to a personally and emotionally engaged activity. The subjectivity of the analyst, countertransference in its broadest sense, is not to be eliminated, but used, and the patient's experience of the analyst's subjectivity is to be articulated. The distinctions heretofore accepted between observer and observed, analyst and analysand, rational and irrational, male objectivity and female subjectivity, all collapse, and ambiguity, multiplicity, and paradox take over the center where clarity and identity have prevailed.
Does contemporary psychoanalysis advocate that we abandon objectivity? Postmodern theories push in the direction of relativism, and for this and for other reasons postmodern thinking generates intense controversy. At stake are fundamental questions about how we know what we know and whether meaningful progress in knowledge can ever be made. The older, classical, positivist or objectivist model may have had the disadvantages of being somewhat authoritarian and even patriarchical. But at least in that model the analyst had to accept some responsibility! The analyst may have maintained the myth that "he" was healthier, wiser, more rational, and more mature than the patient, at least while he was being the analyst. But with all of this, "he" had to assume the ethical and moral responsibility to conduct the analysis appropriately, maintain appropriate boundaries, secure the analytic frame, interpret correctly and in a timely fashion, distinguish between what was real and what was distortion and what was progressive from what was regressive, and differentiate meaningful and authentic emotional expression from defense and resistance. Once we remove this striking asymmetry from the analysis, what is left to authorize the analyst to make these distinctions and thus guide the process as we would expect any expert to guide a professional undertaking? In short, with the postmodern collapse of the analyst's authority and power, what happens to professional expertise, professional responsibility, and professional ethics?
I want to assert in the strongest possible terms that the abandonment of metapsychological truths and theoretical foundations does not necessitate the surrender of ethical standards, professional responsibility, or clinical judgment. Quite the contrary, in line with what I described in Chapter 1 as an affirmative postmodern sensibility, I believe that an acceptance of the relational-perspectivist approach that has guided my thinking throughout this book leads to the recognition that analysts must accept responsibility for the fact that it is their own personality, their own subjectivity, that underlies their values and beliefs, that infuses their theoretical convictions, and that forms the basis for their technical interventions and clinical judgements. There can be no technical choice or clinical decision that is not imbued with the analyst's subjectivity. I agree with and wish to emphasize Hoffman's (1995) forceful statement that, instead of regarding the countertransference as one factor among many that is to be considered by the analyst in making any intervention, we must recognize "the analyst's subjective, personal, countertransferential experience as the superordi-
nate context in which everything else, including theory, is embedded" (p. 108). Therefore, instead of disclaiming personal responsibility and attributing their understandings to an abstract metapsychology or universal theory, analysts must accept personal responsibility for their interpretive understandings and clinical interventions. Our understanding is always value laden, and, our values are always personal. There can be no neutral understanding or interpretation.
Bernstein (1983) has described how, having been stripped of the possibility for secure knowledge, we have come to suffer from "Cartesian anxiety," the fear that we will be left with nothing but radical relativism. It is because of our Cartesian anxiety that we long for foundational knowledge. Bion (1990) wrote:
When approaching the unconscious--that is, what we do not know, not what we do know--we, patient and analyst alike, are certain to be disturbed. Anyone who is going to see a patient tomorrow should, at some point, experience fear. In every consulting room there ought to be two rather frightened people: the patient and the psychoanalyst. If they are not, one wonders why they are bothering to find out what everyone knows.Being a psychoanalyst, like being an analysand, is no easy matter. It is, and as Bion says, it ought to be, frightening. As analysts, we long for indubitable, foundational knowledge. We want a solid and reliable theory to guide us and relieve our anxieties. But we, like our patients, must struggle without easy solutions. We must continue to make technical choices, to practice in one way rather than in another, to create certain ground rules for ourselves and our patients, to believe in some things and not in others. But we must accept that these choices reflect our own subjectivities; they are personal, and not only technical or theoretical choices. We must choose, but we cannot disclaim our choices as the inevitable outcomes of abstract and universal principles, Rather, we must accept our choices as based on our values, which, in turn, are reflections of who we are.
We might question how we can speak to patients with any sense of conviction if we abandon our beliefs in fundamental truths. Hoffman (1992a, b), Mitchell (1993a), and Stem (1992) have suggested that, paradoxically, within a constructivist approach analysts are freer to speak their minds, because with the elimination of external standards of truth there is more room for spontaneous self-expression and personal conviction. Emphasizing how this approach leads to dialogue rather than to dogmatism, Spezzanno (1993) writes, "To say this is not to give up truth. It is to give up certainty about truth. By giving up certainty we accept endlessness as the most certain thing about our discussions" (p. 29). Since there are no foundations on which to rest, conver-
sation is endless. The analyst cannot end discussion simply by asserting authority; rather, all truths are partial, perspectival, and momentary and need to be questioned and further analyzed.
Advocating that we acknowledge the profound mutuality in clinical psychoanalysis and a greater egalitarianism in our practice as well as in our epistemology does not entail an abandonment of professional expertise or discipline, nor does it require an abandonment of the essential asymmetry between patient and analyst. There is a critical difference between authority and authoritarianism, between conviction and expertise based on experience and training, on one hand, and inflexible certainty on the other. Those psychoanalytic authors (Hoffman, 1991, 1992a, b, c, 1993; Stem, 1992, Mitchell, 1993a) who have most persuasively advocated constructivist approaches have repeatedly pointed out that those approaches do not reduce the need for intellectual and professional discipline and a certain kind of analytic objectivity. But, here again, how can I speak of objectivity? From a perspectivist position, what is meant by analytic objectivity?
In many respects, I have argued in this book that relational psychoanalysis adopts a dialectical approach, attempting to maintain tension between seemingly opposed principles, balancing the intrapsychic and the interpersonal, the intrasubjective and the intersubjective, the individual and the social, autonomy and mutuality. Rather than maintain the polarization of objectivism versus relativism, the philosophical view that has guided my thinking in this book may be referred to as "the dialectical sense of objectivity" (Megill, 1994, p. 7). Positivist principles of absolute objectivity exclude subjectivity, as Freud did, leading to an aperspectival objectivity or a "view from nowhere," a "God's eye view." Objectivity, in the modernist age, was viewed as an unproblematic quality of knowledge. Megill, surveying the current interdisciplinary debate about objectivity, views it as a contingent, varying, and deeply problematic product of cultural practice. He develops the notion of "dialectical objectivity," which "involves a positive attitude toward subjectivity. The defining feature of dialectical objectivity is the claim that subjectivity is indispensable to the constituting of objects" (p. 8). We do not gain anything if our critique of traditional thinking leads us to engage in a simple reversal of classical values. Traditionally, objectivity was prized and subjectivity was disdained. A simple reversal would disparage any attempt at objectivity on the grounds that it was impossible to achieve and would celebrate radical relativity and undisciplined subjectivity. The dialectical sense of objectivity, in contrast, recognizes that the extreme polarization of these concepts is itself an aspect of the problem. Dialectical objectivity is informed by subjectivity and includes within itself reflection on the subjective.
To return to the famous statement with which I began this Coda, Racker (1968) went on to say:
The analyst's objectivity consists mainly in a certain attitude towards his own subjectivity and countertransference.... True objectivity is based upon a form of internal division that enables the analyst to make himself (his own countertransference and subjectivity) the object of his continuous observation and analysis. This position also enables him to be relatively "objective" towards the analysand.Racker's description of relative objectivity, like the rest of his contributions, was well ahead of its time and anticipated the notion of a dialectical sense of objectivity as I have just described it, an objectivity dialectically achieved only by reflexive inclusion, rather than elimination, of one's own subjectivity.
Traditionally, the rationale for analysts to have their own training analyses was so that they would gain "control" of their countertransferences, to know their own "personal equation" well enough so that it could be eliminated from consideration, to be analyzed well enough so as not to act out or participate interactionally with the patient. From the relational point of view being developed here, there is nothing in our training more important than the depth of our own analyses. Since, from the perspective being elaborated here, our subjectivity underlies everything that we do as analysts, and since, within the relational framework that I have described, access to the analyst's affective reactions is critical for his or her effective functioning (whether the analyst chooses to sustain and contain these affects or to express or act on them), the analyst's own analysis remains the most important element of our professional training.
Our analytic expertise does not reside in our being "thoroughly analyzed" and therefore immune to neurosis, healthier than our patients and therefore better able to judge reality. Rather, our expertise resides in our acquiring and honing certain personal, interpersonal, and professional skills. These include the ability to reflect on our own participation in interpersonal relationships while recognizing just how limited that reflectiveness is at any moment; the ability to attend to our own affective experience and to reflect on this experience and symbolize it, along with the recognition that at any moment there is always a great deal that we are not attending to in our own experience; a facility in using an analytic theory or model with enough dexterity, or the capacity to move back and forth between a wide variety of analytic models (Mitchell, 1993a), so as to help patients construct pragmatically useful narratives of their own lives; a proficiency in deconstructing whatever storylines our patients present to us or that we have constructed with them so that we and they do not become rigidly fixated to any one narrative construction; the capacity to tolerate a certain level of anxiety and depression as our patients observe and scrutinize our participation with them and explicitly or implicitly comment to us on the nature of our participation with them, and the capacity to enjoy, celebrate, and take pride in the shared growth, intimacy, and mutual satisfactions inherent in the psychoanalytic process. This is a very short list of some of the numerous skills that are necessary for the clinical practice of psychoanalysis; none of them requires the adoption of fundamentalist notions of truth and reality, and all of them testify to the enormous degree of discipline required for the competent practice of psychoanalysis.
Relational psychoanalysis suggests that it is not truth that patient and analyst pursue, so much as it is meaning that they attempt to construct (Mitchell, 1993a). Meaning is generated relationally and interpersonally, which is to say that meaning is negotiated and coconstructed. Analysts cannot simply construct psychoanalytic narratives or interpret patients' associations any way they please; constraints imposed by the structure of reality limit the possibilities of our plausible constructions. Analytic objectivity is dialectical and dialogical; we rely on our subjectivity, but our subjectivity is shaped and constrained by input from the object of our investigation, who is, after all, a separate subject. A dialectical sense of objectivity includes our subjectivity but does not ignore these constraints. Analytic objectivity is negotiated, relational, and intersubjective. Meaning is arrived at through a meeting of minds.
I want to bring this book to a close by repeating Ferenczi's (1931) statement, for it is as true now as it was then: "Analytical technique has never been, nor is it now, something finally settled" (p. 235). There is no single correct way to do psychoanalysis, although there are many ways that do not work very well for far too many patients. Analysts should not be taught technical prescriptions, although they can be taught ways to think about the process of making informed clinical decisions; and they can be instructed in clinical theory, which will serve them well as a compass with which to navigate the deep and troubled waters of clinical psychoanalysis. Rather than viewing the psychoanalytic theory of technique as a manual dictating certain types of behavior, I prefer to view our theory of technique as a system of signposts that encourage reflection-in-action. Analysts have no choice but to experiment; to innovate; through trial and error to learn what seems to deepen the analytic work for themselves and for their patients; and to interpret and intervene, guided by their own moral and professional convictions and by the ethical standards of their professional community. This view of clinical practice leads to intervening not on the basis of a Grand Theory, a prescriptive theory of technique or a "technical rationality" (Schon, 1983), but on the basis of the analyst's own subjectivity (which includes his or her personal history and professional experience, a knowledge of theory, and clinical wisdom) as it has been shaped in dialogue with the subjectivity of the other, the individual patient. Since communal dialogue and endless conversation is the very basis of this meaning system, one caveat for analysts in their explorations is that they should do nothing with patients that they would not in principle be willing to discuss with colleagues, with the professional community, and with the public.
Bion (1990) taught:
There is a thing known as "classical psycho-analysis": the analyst has an analytic situation in which he practices analysis; he has patients who are suitable patients and gives them suitable, certified-correct interpretations. I have never known that state. The analytic situation is the situation which the particular practitioner finds is adequate for himself
Far from eliminating "the subjective factor," relational psychoanalysis asserts that analytic objectivity is constituted dialectically, rooted in the intersubjective relationship. Psychoanalytic findings may be said to be objective to the extent that they emerge intersubjectively, mutually constructed between analyst and analysand. Psychoanalytic theory, as well as our codes of ethics, may similarly be termed objective in the sense that psychoanalytic knowledge is communal or relational knowledge, socially derived, and based on the negotiated consensus of the psychoanalytic community of practitioners and theorists. That is, it is based on a meeting of minds.