Understanding the crisis: Five core issues in contemporary psychoanalysis

Abstract

The psychoanalytic movement is experiencing a serious crisis: its scientific consensus, social standing, and impact on practice in mental health have all been steadily declining over the last decades. This unfortunate process has been variously explained in terms of prevailing hedonistic social values, the political influence of drug companies, and cuts in health-related expenditures. Following a suggestion by Garza Guerrero, we rather believe that the sources of the contemporary crisis in psychoanalysis are to be searched for within its own development and current social and cultural life. Specifically, we think psychoanalysis has failed to bring the revolutionary contribution of interpersonal and intersubjective paradigms to its fuller consequences. Here, we review five core dimensions in which such failure is particularly apparent: (1) an unwitting reliance on the medical model of mental illness; (2) an ontological, concrete understanding of unconscious processes; (3) a manifest failure to fully appreciate the role of extratransference relationships in the patient’s life; (4) a naive and idealized view of the psychoanalyst’s person and role; and (5) a marginal awareness of the impact of group-level unconscious phenomena on the social life of psychoanalytic institutions.

Key words:

• crisis of psychoanalysis
• psychoanalysis and psychiatry
• psychoanalytic institution
• countertransference
• repression
• bipersonal field

ORCiD

Paolo Azzone http://orcid.org/0000-0002-4388-1288

Additional information

Notes on contributors

Paolo Azzone

Author

Paolo Azzone, MD, is a psychiatrist and a psychoanalyst. He works at the G. Salvini Hospital in Milan, Italy. Azzone substantially contributed to the establishment of a psychotherapy research tradition in Italy, with empirical studies on the psychotherapy process and on dreams. His current interests include the psychoanalytic treatment of depression and the intersections between psychoanalysis and philosophy, history, and religious experience. He is co-editor of La mente dell’anima (The Mind of Soul), 2008 and author of Depression as a Psychoanalytic Problem, 2012.