Like Dr. Prall I was struck by Dr. Bernardi’s comment that “the core ideas of psychoanalytic approaches are certainly immune from controversies.” When I began this exchange I suggested that it was precisely the core ideas, most notably the question of the nature or status of the unconscious, and certainly also the transference, just for starters, that are most open to controversy. My reflections on Dr. Bernardi’s contention, and further comments by Dr. Bernardi and Dr. Prall, happen to coincide with a quick re-reading—for reasons entirely unrelated to our conversation—of a review I wrote several years ago of a book that intended to overcome the differences between Freud and Jung by proposing a new paradigm for psychoanalysis. Much of my review dealt with a clarification of Kuhn’s concept of scientific paradigms, as I had found the book’s author being rather promiscuous and ill informed in his use of the term. One of the conclusions I drew at that time, based on Kuhn’s own comments on the concept subsequent to The Structure of Scientific Revolutions, was that psychoanalysis, broadly construed, was really in what Kuhn calls a “proto-paradigm” state, where indeed it is the status of fundamental elements of the science that remain in dispute. Normal science, another way of talking about paradigms, only really gets underway once these fundamental elements arrive at a point of consensual definition. My own point of view on psychoanalysis is that we are nowhere near this consensual definition, and therefore are at best in a proto-paradigmatic state. Note that this is not a question of competing paradigms. By definition, you do not have competing paradigms within a paradigmatic science. You may have alternative paradigms among different sciences, such as between biology and physics, but the alternatives in this case are not mutually exclusive. Perhaps that is the case where versions of some general undertaking called psychoanalysis are concerned, but either there is a psychoanalytic paradigm or there isn’t, and I would suggest that since the days of Freud and Jung we have never been able to define a singular paradigmatic version of the field.
This state of affairs raises some interesting questions about the relationship of psychoanalytic theory to the natural sciences on the one hand, and hermeneutics on the other, to take off from an important point of Dr. Prall’s comments. One of the pleasures of this discussion, for me at least, has been my felt need to return to my own philosophical roots in hermeneutics and phenomenology. To that end, I have been re-reading Karl-Otto Apel’s Understanding and Explanation (Die Erklären-Verstehen-Kontroverse in Transzendental-Pragmatisher Sicht), which is itself about controversy in the human sciences. It seems to me that his distinction between understanding and explanation is useful for our discussion. Clearly, from a clinical point of view, understanding is critical to the process—although Jung once remarked that the worst thing you can do to a patient is understand them—but at the same time theory demands that some explanation of the observed phenomena be offered. As I noted in an earlier communication, Freud’s problem with his metapsychology, or at least the problem his immediate followers eventually had with it, was that he had relied too heavily on the findings of mid 19th century sciences to underwrite many of his conclusions. As these sciences began to radically revise their conclusions in the early to mid 20th century they ceased to serve as foundational concepts for psychoanalysis, and we have in consequence a more dramatic turn toward the hermeneutical. In other words, the notion that a psychoanalytic paradigm could be established in the early years of the movement came to grief on changes taking place in other fields. This is important today because it seems to me that one of the metaprojects of all the versions of psychoanalysis remains one of trying to ground an explanation for psychoanalytic phenomena in some other field. Some of the major candidates for such a theory-grounding project at this time include cognitive neuroscience, evolutionary psychology and complex dynamic systems theory.
A note here on mirror neurons that may help illustrate the larger point: I would agree with Dr. Prall that there is some confusion around the question of mirror neurons and empathy. However, the principle researchers in the mirror neuron field, such as Vittorio Gallese, do talk in terms of mirror neurons possibly being the basis of empathy. However, I would suggest that as this notion gets moved into the psychoanalytic world it is our understanding of empathy that requires refinement. I take it that empathy in say a Kohutian sense is a form of introspection wherein the analyst seeks to connect with elements of his or her own experiences that offer avenues to mirror or otherwise relate to the experiences of the patient—“I know what it is like to experience X.” Empathy as discussed in the mirror neuron literature is much more an immediate experience of the affective state of an observed other, just as mirror neurons respond to motor actions and may even play a role in language learning by responding as the caregiver’s mouth shapes words. This immediate affective response comes closer to a neurocognitive explanation of what is often discussed as mind reading, and, I would suggest, gives a hint of what is going on in projective identification. To the degree that this latter point is correct we come closer, I believe, to an explanation of mechanisms at work in projective identification than we get with more traditional terms such as splitting, although I would also say that the psychoanalytic terminology remains useful for purposes of understanding and interpretation. It is also the case that these approaches to explanation involve a variety of controversies as well, with the complex dynamic systems theorists cutting decisively across the arguments of the evolutionary psychologists, to take one example.
I will conclude this contribution with a comment on the use of the clinical side of the discussion. To put it in simple terms, I seriously question whether discrete clinical discussions, as outlined by Dr. Bernardi, will yield anything like evidence for assessing the various formulations of theory that make up the controversies we are discussing. Clearly, outcome data in the aggregate has contributed to our understanding of how “talking cures” generally relate to pharmacological treatment, but case by case outcomes would, I suspect vary greatly, and would not demonstrate real measurable distinctions between psychoanalytic schools. One thing that might yield some interesting data would be to assess cases where the analysand made a change from an analyst in one school to a distinctly different school. But the conclusions drawn might be more that patients should work with different modalities, not that one or another is in general superior. I base this on two cases with which I am familiar. In my own practice I once had a patient who had spent years with a distinguished Freudian analyst, from whom, as he reported, he had learned a great deal, but the original presenting problem persisted. The issues involved immediately suggested a transpersonal or archetypal interpretation to me and as we explored this approach to the presenting issue significant movement was almost immediate. The other case, which has been published, is of a Jungian analyst who had been in analysis with a very senior Jungian for years, doing almost entirely archetypal work. When that analyst unexpectedly died the analyst-analysand experienced a major crisis, but due to the dynamics of the analytic community sought out a non-Jungian analyst, whereupon she was astonished to find how much of her reaction to the death of her Jungian analyst was tied up in her personal life story, with no archetypal elements. In both of these cases much was gained in the initial analysis, but the work was incomplete, absent the rather radical shift in perspective occasioned by movement between Jungian and neo-Freudian models. I suspect something similar would be possible if a person worked first with a Kleinian and then a Lacanian, and I would be curious if anyone has experience with such a move in treatment.
It is also the case that exploring along these lines might be a way in which greater resolution of assumptions about the basic constituent elements of psychoanalytic theory could be explored, if not fully resolved. Single case reports are clearly not sufficient, but they are suggestive.
Enough for now. I look forward to the next round of comments, and to meeting in London
Best regards,
George