Psychoanalysts without a Specific Professional Identity: A Utopian Dream?

Abstract

The subject matter of identity belongs to the orthodox psychoanalytic movement. For about the last 15 years, the International Psychoanalytic Association (IPA) has successfully tried to facilitate research and to promote projects. If the resistance of influential analysts against empirical investigation decreases further, “psychoanalytic movement” and its unfavourable concomitants will be a thing of the past. The development to a scientific community will no longer be hampered by controversies over professional identity.

To the memory of Alexander Mitscherlich.

 The psychosocial dimension and its normative implications put the concept of identity into question. Instead the author suggests that we speak of a psychoanalytic attitude. This professional self is closely connected to the personal self. It is however, necessary to separate the method from the person. For a long time the genealogy of the training analyst determined the membership in the ever‐growing family of psychoanalysts. There have been black sheep right from the beginning. Dissidents, therefore, belong to the history of Psychoanalysis. The official acceptance of pluralism within the IPA invites comparisons between the various schools according to scientific criteria. The methodology of modern psychoanalytic process and outcome research provides principles for writing treatment reports. Group identities in their dogmatic aspects are detrimental for the future of psychoanalysis. The message of the paper is to express the hope that a critical eclecticism might replace psychoanalytic schools.

Keywords:

• identity
• orthodoxy
• psychoanalytic movement
• research
• therapy

Acknowledgement

I am grateful to my English colleague Neil Cheshire (Clinical Psychologist) for his helpful comment on an earlier draft of this paper, which not only made it read better in English, but also improved the content in some places. I take this opportunity to record my appreciation of a working partnership and personal friendship that goes back nearly three decades now. It included joint projects both in my former department at the University of Ulm and also as Rockefeller Foundations Scholars at Belaggio in Italy (196, 197).

Summaries in German and Spanish

Thomä H. Psychoanalytiker ohne berufliche Identität

Das Thema der Identität der Psychoanalyse gehört in den Bereich der von Natur aus orthodoxen psychoanalytischen Bewegung. Seit etwa 15 Jahren, wird in der Internationalen Psychoanalytischen Vereinigung (IPV) erfolgreich versucht, wissenschaftlichen Untersuchungen der Boden zu ebenen und Projekte zu fördern. Solle sich der Widerstand einflussreicher Analytiker gegen die empirische Forschung weiter abschwächen, werden die psychoanalytische Bewegung und ihre ungünstigen Begleiterscheinungen der Vergangenheit angehören. Je selbstkritischer Analytiker praktisch handeln, desto normaler wird ihr Beruf werden. Die Entwicklung zu einer “scientific community” wird dann nicht mehr durch Kontroversen über die Identität erschwert werden.

 Die normativen Implikationen die mit der Verleihung einer besondere Identität einhergehen, machen den Begriff fragwürdig. Stattdessen empfiehlt der Autor, von „psychoanalytischer Haltung“ zu sprechen. Dieses berufliche Selbst geht mit dem persönlichen Selbst eine enge Verbindung ein, kann und muss aber von der Person des Analytikers unterschieden werden.

 Die Genealogie der Lehranalytiker bestimmte lange Zeit die Zugehörigkeit zur immer größer werdenden Familie der Psychoanalytiker. Lange Zeit wurden familiäre Konflikte durch Ausschluss aus der IPV erledigt. Die Dissidenz gehörte zur Geschichte der Psychoanalyse. Mir der offiziellen Anerkennung des Pluralismus innerhalb der IPV werden Vergleiche zwischen den Schulen nach wissenschaftlichen Kriterien unerlässlich. Die moderne Verlaufs‐ und Ergebnisforschung enthält Gesichtspunkte, die auch für die klinische Darstellung von Behandlungsberichten vorbildlich werden könnte.

Thomä H. Psicoanalistas sin una identidad especifica: Un sueño utópico?

La cuestión principal de la identidad pertenece al movimiento psicoanalítico ortodoxo. Al menos los últimos 15 años bajo la presidencia de J. Sandler, la Sociedad Psicoanalítica Internacional(IPA) ha tratado con éxito de facilitar la investigación y promoción de proyectos. Si la resistencia de analistas influyentes contra la investigación empírica decrece más, el “movimiento psicoanalítico” y sus desfavorables concomitancias serán cosa del pasado. El desarrollo de una comunidad científica no se verá perturbada por controversias en cuanto a la identidad profesional. La cuestión de la identidad fue dominada por la idea del llamado psicoanálisis estricto y no tendencioso. Nunca existió ni pudo materializarse, fue una ficción. La dimensión psicosocial y sus implicaciones normativas cuestionan el concepto de identidad, en cambio es recomendable hablar de la actitud psicoanalítica, que debe probar su valor terapéutico. Este segundo (profesional) self está frecuentemente conectado con el primer (personal)self. Es necesario y posible separar el método de la persona para objetivar cambios en el paciente a pesar de que ocurran en un intersubjetivo espacio relacional. Durante muchos años Freud definió lo que es el psicoanálisis y quien se llama a si mismo psicoanalista. Más adelante el movimiento psicoanalítico y el sistema de la formación institucionalizada realizaron este rol. El análisis de formación había sido siempre el centro de todos los curriculums. La genealogía del analista docente determinó la calidad de miembro en la siempre creciente familia. Había habido ovejas negras desde el principio. Los disidentes, por tanto, pertenecen a la historia del psicoanálisis. La aceptación oficial del pluralismo entre la IPA invita a comparar entre las diferentes escuelas de acuerdo con el criterio científico. La metodología del proceso psicoanalítico moderno y el resultado en la investigación proveen principios para escribir los informes de los tratamientos. Las identidades de grupo en sus aspectos dogmáticos son perjudiciales para el futuro del psicoanálisis, como ejemplo se discute el fundamentalismo Kleiniano. El mensaje de este trabajo es expresar la esperanza de que un eclecticismo critico que puede devolver a su sitio las escuchas psicoanalíticas.

Notes

To the memory of Alexander Mitscherlich.

I quote from the English Edition (1985/1987) and will speak of the Ulm Textbook (UT vol. 1 or 2 (8)) whenever I refer to the two books written by Thomä & Kächele.

Thomä H. (2004): Comparative psychoanalysis on the basis of a new form of treatment. Report, unv. Vortrag, IPV‐Kongress New Orleans, 2004.

M. Boss (45), for example, referred to those concepts and remained a member of the IPA even though his Daseinsanalyse constitutes a “dissident” school whose adherents have no access to the IPA (cf. 46, as well as the chapter on “Existential Analysis and Anorexia Nervosa” in Thomä, 47).”

Jaspers' polemics against pschoanalysis, and the psychiatrist Kurt Schneider's resistance to the founding of a department of psychotherapy outside his house, as a compromise an independent psychosomatic department was founded. This department was led by Alexander Mitscherlich under the patronage of Viktor von Weizsäcker and financially backed by the Rockefeller Foundation.

If I had stayed in Stuttgart I would have probably become a member of the Psychoanalytic Institute “Stuttgarter Group”, which belongs to the 16 DGPT institutes that are not affiliated with the IPA.

I was the first West German president after C. Müller‐Braunschweig, G. Scheunert und H.‐E. Richter from Berlin. Seven of the 13 presidents so far have been directly related to Alexander Mitscherlich. Beland was the only DPV president from Berlin after Richter.

Indeed we plead to restore the original Eitingon‐Freud German University model of unity of teaching, research and treatment which was the basis of the Berlin Institute. It degenerated to the tripartite system of personal analysis, seminars and supervision, as Balint (52; 53) shortly after the second world war has criticesed. Wallerstein (54:175) called it the „hallowed tripartite model“ of training analysis, course work, and supervision (cf. 55). Amati‐Mehler, (see 56:148), ascribed to Thomä and Kächele, that we proposed “eliminating the personal analysis except for a very brief experience” and “she added that the empirical research at the centre of this model is not what most psychoanalysts think of as psychoanalytic research”. In order to make such ‘misunderstandings’ more difficult we gave up the suggested compromise altogether. With regard to our understanding of psychoanalytic research we refer to our publications and our agreement with Kernberg's position discussed below (p. 20).

At the beginning of the 20th century Abraham Flexner conducted research into medical training in the US. His recommendations in 1910 abolished the training institutes that registered doctors operated. Medicine was instead accomodated in universites and thus enabled medicine's rise in the US.

I would like to thank Frau Ilse Grubrich‐Simitis for a personal communication about that translation.

It is possible to form such a monstrous compound in German. It means ‘uniform pathogenesis’ and implies using the same causal elements to explain very many phenomena.

Thomä H. Zeitlosigkeit und Vergänglichkeit (in) der Psychoanalyse. Unveröffentlichter Vortrag bei der Jahrestagung der Deutschen Psychoanalytischen Gesellschaft (DPG) in Regensburg, 2000.

The topic of Willick's paper was recently in the centre of a controversy between Lucas (166) and Michels (167) and between Willick (168), Frattaroli (169), Robbins (170) and Gottdiener (171). As I had professional experiences with psychotic patients only for 4 years my competence in this area is very limited. I still feel capable of evaluating arguments. Lucas does not invalidate the quoted statement of Willick. He replies only that Bion had seen schizophrenic patients analytically, something that Willick had not denied. Insofar well documented cases by representative Kleinians are still missing. Lucas completely neglects Willick's critique about Searles’ use of the countertransference in the analysis of schizophrenics. On the contrary, he states without any further ado: “If dreams are the royal road to the unconscious in neurosis, then the countertransference is the ‘via regia’ to understanding in psychosis (Rosenfeld, 1992).” It will be no surprise that I agree with Michels' well‐balanced reply to Lucas.

For personal reasons I would have preferred to illustrate the influence of school‐related identities on the problems of validation by reference to some other Kleinian analysts as prominent as H. Beland. Unfortunately, I was unable to find a German or Anglo‐American author who has produced an equally subtle and comprehensive description of therapeutic dialogues in which transference and counter‐transference were stressed so much. Since Beland has also writen on the functions of psychoanalytic identity and the future of our field, he is more closely linked to the topic of this paper than anyone else. Following our controversy on psychoanalytic training, and especially on the status of the training analysis, we are advocates of opposite opinions (51, 173; 174). We disagree on a matter close to our hearts. Still, our controversy arises from genuine problems.