Grasping psychoanalysts’ practice in its own merits

Abstract

The central objective of this presentation is to reflect on the obstacles involved in the task proposed by the Chicago Congress, which is to explore convergences and divergences in psychoanalytic practice. The author discusses two major obstacles. First, the epistemological and methodological problems in relation to the construction of theory in psychoanalysis and especially the inaccessibility, in any reliable way, of what psychoanalysts really do in the intimacy of their practice. He proposes to separate, at least in part, theory from practice in psychoanalysis, in an attempt to grasp psychoanalysts' practice in its own merits. He then outlines a phenomenology of the practice of psychoanalysis, which reveals that, in their work with patients, analysts are guided more by practical reasons than theoretical reasons; that is, their interventions are predictions rather than explanations. Since these practical reasons need to be validated constantly in the analytic relationship based on their effects, he discusses the subject of validation in the clinical context of the core theory of therapeutic change in psychoanalysis, that is, the conditions required for clinical practice to satisfy the thesis of an inseparable union between gaining knowledge and cure. He ends by challenging the core of the psychoanalytic theory of change, arguing that it neither does justice to the practice of psychoanalysts nor to contemporary knowledge of processes and mechanisms of therapeutic change. Finally, he proposes that we detach practice from theory, in order to study the former in its own merits, utilising a plurality of methods ranging from systematic investigation to the recent methodology of the Working Party.

Key words:

• clinical validation
• pluralism
• practical reasons
• psychoanalysis and truth
• psychoanalyst’s mind
• psychoanalytic phenomenology
• psychoanalytic practice
• psychoanalytic theory
• psychoanalytic theory of change
• theoretical reasons
• working party

1.  This paper will be presented as a keynote lecture at the 46th Congress of the International Psychoanalytical Association, Chicago, 29 July – 1 August 2009, under the title ‘Psychoanalytic Practice: Convergences and Divergences’. Registration is available from the IPA’s website at: http://www.ipa.org.uk

1.  This paper will be presented as a keynote lecture at the 46th Congress of the International Psychoanalytical Association, Chicago, 29 July – 1 August 2009, under the title ‘Psychoanalytic Practice: Convergences and Divergences’. Registration is available from the IPA’s website at: http://www.ipa.org.uk

Notes

1.  This paper will be presented as a keynote lecture at the 46th Congress of the International Psychoanalytical Association, Chicago, 29 July – 1 August 2009, under the title ‘Psychoanalytic Practice: Convergences and Divergences’. Registration is available from the IPA’s website at: http://www.ipa.org.uk

2.  For example, Etchegoyen establishes a bi‐univocal relation between theory and practice when he states: “Just as there is a strict correlation between psychoanalytic theory and technique and research, psychoanalysis also relates, and singularly so, technique with ethics” (Etchegoyen, 1986, p. 27, my italics).

3.  Of course, supervising does not necessarily mean seeing someone else’s material from the viewpoint of the official and public theories preferred by the supervisor. Imre Szecsödy, the Hungarian–Swedish psychoanalyst, developed a method of analytic supervision with a strong empirical base; it aims to create a situation of mutative learning in the relation with the supervisee, in which the latter learns to recognise the system of interaction established with the patient (Szecsödy, 1990).

4.  The difference between theoretical reasons and practical reasons is an old philosophical issue dating back to Aristotle. They differ by virtue of the character of their aims; practical reason is stimulated by the object of appetite. The Scholastics followed tradition by differentiating speculative reasons from operative reasons, a difference Kant takes up when he emphasizes that the two reasons, theoretical and practical, are not two different types of reason but the same reason whose application differs (see José Ferrater Mora, 1969).

5.  ‘Implicit use’ refers to a decision‐making process determined by practical reasons that evaluate the value of use or usefulness of explicit theories at a certain moment. In this case, the guiding question is not why but for what purpose.

6.  Peter Fonagy recently expressed similar ideas: “Psychoanalytic theory, like any other theory, unconsciously serves to organize action. The truth of a theory is thus no longer seen as something absolutely entailed within the relation to an external reality. Rather, validity of a theory rests in its capacity to enable action. Knowledge is not an awareness of absolute facts, but the capacity to attain a goal within a specific context or setting” (Fonagy, 2006, p. 83).

7.  “This [&] reconstruction of theory has not yet taken place within the public theory of psychoanalysis. It is held in a somewhat mysterious, unexplored container of knowledge that one might call the implicit psychoanalytic knowledge base” (Fonagy, 2006, p. 83, original italics).

8.  “It is my firm conviction that the investigation of the implicit, private theories of clinical psychoanalysts opens a major new door in psychoanalytic research” (Sandler, 1983, p. 38).