Robert S. Wallerstein

The new American psychoanalysis : A commentary

I n her very moving plenary address, in which she describes the intertwining of her own painful life vicissitudes with those of her patient and with the vicissitudes of the treatment, Evelyne Albrecht Schwaber begins with the question, probably rhetorical, “Are we in the midst of a paradigm shift?” Or, as she goes on to ask, “is it the narcissism of each generation that leads us to believe that ours is a truly new and different step?” I think that we collectively agree, those of us who participated in the panels at San Diego, that indeed, at least in America, we have been engaged, over the past fifteen years or so, in a major shift—call it a paradigm shift or not—in our conceptualization of the nature of the psychoanalytic enterprise, both in theory and in practice. It should be said, of course, that this new conceptualization, or reconceptualization, had already occurred elsewhere, over a period of many decades (within, for example, the British object relations school), and had had its forerunners just as long ago in America—in Harry Stack Sullivan’s interpersonal perspective, which at the time was not accepted within the ego psychological mainstream. That shift has of course been characterized in many ways, but generally as a shift away from a natural science, positivistic model anchored in a one-person psychology based on the intrapsychic vicissitudes of the patient’s instinctual strivings and the defenses ranged against them, all of this authoritatively surveyed by an objective, neutral analyst, the privileged arbiter of the patient’s reality, and on the patient’s neurosis as projected onto the analytic blank screen—away from all that to the ramifications of a two-person psychology focused

Psychoanalytic perspectives on the problem of reality.

HE PRIVILEGE ACCORDED THE IhtIhIEDIATE RETIRED PRESIDENT of the Association to address it in plenary session carries with T it a corresponding obligation to select a suitably large topic whose scope warrarits directing your attention to it, in the hope that a dialogue about it initiated or furthered here can lead to theoretical or empirical additions to our scientific understandings. Such a topic, I think, is the one I have chosen today, one relatively neglected or taken for granted in usual psychoanalytic discourse, namely the psychoanalytic study of reality. Although Freud’s theoretical reformulations, in “The Ego and the Id” in 1923 and “Inhibitions, Symptoms and Anxiety” in -1926, into the structural theory that placed the ego at the crossroads where the drive demands of the id, the moral constraints of the superego, and the requirements of the outer reality all met and were mediated, implicitly made reality directly comparable to the intrapsychic instances in its role in mental life, the full implications of this repositioning for our theory have never been adequately remarked or more than rudimentarily developed. Historically this circumstance is readily understandable. In its beginnings and for several decades, psychoanalysis was primarily a drive psychology-the elaboration of the vicissitudes of instinctuality in all their ramifying complexity. Not that the so-called ego

The Goals of Psychoanalysis; A Survey of Analytic Viewpoints

DISCUSSION of the limitations of psychoanalysis as a treatment modality necessarily raises the question of the ideal and of L the practical goals of psychoanalytic treatment against which its inevitable shortcomings are to be measured. Yet the goals of psychoanalysis represent neither a set of simple and agreed-upon concepts nor an easily circumscribed range of delimited considerations. Inextricably interwoven with the question of goals, in fact, are a variety of related considerations that cover the major technical and theoretical issues of psychoanalysis as a therapeutic procedure. These include (i) the theory of technique, how analysis works, by what procedures it achieves its goals, a statement, that is, of the relationship of means to ends, treated at length in the 1936 Marienbad Symposium on the Theory of the Therapeutic Results of Psychoanalysis (30); (ii) the similarities and differences between psychoanalysis and the dynamic psychotherapies, as compared from the viewpoint of different therapeutic goals projected for patients with differing illness pictures set into differing character organizations, determining through these differences the

Development and metapsychology of the defense organization of the ego.

This panel was one of two anniversary panels constituted to commemorate the thirtieth anniversary of The Ego and the Mechanisms of Defense by Anna Freud. Panel B marked the occasion by concerning itself with the implications of this historic landmark for the continuing development of psychoanalysis as technique and as therapy; this panel devoted itself to a reconsideration of the defense organization of the ego from the metapsychological points of view, in the light of the theoretical developments in psychoanalysis in the intervening thirty years. Jacob Arlow opened with a brief historical perspective on The Ego and the Mechanisms of Defense, set in the context of a survey of the concept of defenses and of defense mechanisms in the development of psychoanalytic theory. He stated that Anna Freud’s book was the logical culmination of a long process of reorganization of both psychoanalytic theory and practice that took place in the 1920s and the early 1930s in the publications of Sigmund Frcud. Some, therefore, saw nothing especially new in it. Others, on the contrary, saw this book as a radical and definitive departure from the unremitting psychology of the psychic depths that psychoanalysis had, earlier, monolithically represented. Arlorv read from some of the reviews of this book which appeared in the psychoanalytic journals at the time. Otto Fenichel emphasized that the major contribution of this new book was in its convincing demonstration that psychoanalytic (ego) psychology, even when it investigates the psychic surface, remains nonetheless a depth psychology. I t seeks constantly to study how

Psychoanalysis in the university: a full-time vision.

Psychoanalysis may be unique among scholarly disciplines and professions in having grown as an educational enterprise in a private part‐time setting, outside the university. Freud would have liked it to be otherwise, but in Central Europe, when it was created, university placement was not possible. In America, after World War II, the concept of the medical school department of psychiatry psychoanalytic institute was established in some psychoanalytic training centers but it could only partly overcome the educational and research inadequacies of traditional psychoanalytic training. The possibilities for a true university‐based full‐time training structure are explored.

Reconstruction and mastery in the transference psychosis.

N BOTH CLINICAL and theoretical grounds the transference neurosis has long been established as the central technical and conceptual vehicle of psychoanalysis as a therapy. The usual course of psychoanalysis and of the developmenf of this regressive transference reaction is characterized by the familiar reactivation within the analysis of earlier (i.e., infantile) experiences and also of earlier (i.e., infantile) modes of reacting to and mastering those experiences. At times this reactivation within the analytic transference can (temporarily anyway) sufficiently lose its “as if” quality to become near delusional. Classical analysis is, however, usually protected against such extensive reality distortion by the split, described by Sterba (14) into an observing (introspecting) ego alongside the experiencing ego. It is this observing part of the ego which in its guardian function enables one constantly to maintain distance from, and exert reality mastery over, the transference illusion. It is the purpose of this presentation to describe the circumstances, in two psychoanalyses, under which this guardian function failed and a severe disorganizing and dereistic episode ensued. The following illustrates what is meant. A highly emotional tvoman with a hysterical character structure had been adjudged suitable for psychoanalysis despite her potential for being swept

Psychoanalytic research and the IPA: History, present status and future potential

This paper traces the chequered history of formal psychoanalytic research within the century-long development of psychoanalysis as theory and practice. It describes the official involvement of the American Psychoanalytic Association in the support of psychoanalytic research since 1970, and of the International Psychoanalytical Association since the 1980s. In the IPA, this has consisted of the introduction at the 1987 Montreal Congress of two half-day panels on formal psychoanalytic research; in the creation in 1991 of an annual IPA Research Conference held in March at University College London; and then the creation in 1996 of an annual ten-day IPA Summer School for neophyte psychoanalytic researchers, also at UCL in London. The paper then details the inauguration by the IPA, at the 1997 IPA Congress in Barcelona, of a mechanism for funding psychoanalytic research the Research Advisory Board (RAB), and the overwhelming--and totally unanticipated--worldwide response to the initial call for proposals in the autumn of 1997. Implications of this for psychoanalysis as a discipline are sketched.

Psychoanalysis in the university: The natural home for education and research

Psychoanalysis as a theory of human mental functioning and a derived therapeutic for disturbed functioning would have its natural home in the university, and Freud gave evidence of harboring such an ambition. But the sociopolitical structure of the early 20th century Austro‐Hungarian Empire precluded this, and analysis developed, by default, its part‐time, private practice‐based educational structure. Psychoanalytic penetration of academic psychiatry in the United States after World War II made possible a counter‐educational structure, the department of psychiatry‐affiliated psychoanalytic institute within the country’s medical schools. This paper outlines, beyond these, other more ambitious vistas (David Shakow, Anna Freud, The Menninger Foundation, Emory University [US], APdeBA [Argentina]), conceptions even closer to the ideal (idealized) goal of full‐time placement within the university with strong links to medicine, to the behavioral sciences, and to the humanities.

THE ROLE OF PREDICTION IN THEORY BUILDING IN PSYCHOANALYSIS.

NY DISCUSSION of psychoanalytic methodology invites a wide range of considerations. These vary from a discussion of A theoretical conceptual issues involved in the nature of the relationship among the data, the method, and the theory of psychoanalysis to a discussion of empirical research issues involved in the advancement of systematic knowledge in our field in a manner that is simultaneously loyal, both to the demands for rigor and objectivity in science, and to the complexity and subtlety of the clinical processes under scrutiny. The creation and carrying out of a clinical research into the effectiveness of therapy and the mutative factors in the therapeutic process such as the Psychotherapy Research Project a t The Menninger Foundation necessarily involve one in detailed consideration of just this very same range of issues, from conceptual to empirical, among them the place of prediction (and postdiction) in hypothesis building and validating, the problem of the kind and level of quantification appropriate to the study of qualitative clinical data, the intrusion of value commitments into the empirical assessment of therapeutic change and improvement, the concept of naturalistic research study and the alteration of the natural data by the intrusion of

Psychic Energy Reconsidered

Problems in the theory of psychic energy and the controversies surrounding them were brought into focus by Robert Wallerstein, in his introductory remarks. He reviewed the early development of the energy theory, from Freuds earliest equation of affect and energy through his reconceptualization of it as the energy of the instinctual drives, an energy that ultimately, through the transformations of neutralization, binding, and fusion, provides the power for all the activities of the psychic apparatus. He touched upon differences of opinion that have been expressed concerning the necessity for deriving all energy from drive energy, as well as doubts regarding the suitability of the concept that the energy itself has a quality that is responsible for its effects. Wallerstein also made it clear that, whatever the theoretical considerations are around these somewhat convoluted and at times peripheral issues, certain basic phenomena gave rise to the energy theory as an explanation for them and still represent an important problem to those who challenge energic explanations. He was referring particularly to the subjective feeling of intensity and also to the question of how a particular action occurs as a choice among several if it is not determined as a resultant of conflicting forces of different intensities. In this connection, he criticized those who tend to object to energy theory on the specific ground that it cannot or has not been quantified, and he defended the position that not all sciences, especially clinical ones, need be based on quantitative assessments. Of course the concept of psychic energy is a metaphoric construct and was not intended to be understood literally, although it has nevertheless often been so used. In