Do we know our place? The role of psychoanalysis in public life

ABSTRACT

The contributions to this Psychoanalytic Controversies section explore the question of what psychoanalysis may be able to contribute to thinking about some of the challenges currently confronting humanity and how such communications can be made effectively. This introduction to the section frames the debate with some reflections on anxieties that have been expressed about the application of psychoanalytic ideas beyond the clinical context, the risks of insularity, the need for appropriate humility, and the reality of the embeddedness of analytic practice, in particular social, cultural, and historical contexts. Contributions from Claudia Frank, Sudhir Kakar, Eli Zaretsky, Michael Rustin, Pratyusha Tummala-Narra, Magda Khouri, and Sally Weintrobe are introduced.

KEYWORDS:

• Applied psychoanalysis
• community
• sociocultural context

In the dark days of World War II, on 5 November 1941, Barbara Low read a paper to the British Psychoanalytic Society titled “The Psycho-Analytic Society and the Public”. This paper, now unfortunately lost, addressed what Low and others felt to be the unsatisfactory relation of the British Society to the public. Low’s paper sparked an extremely heated debate over the course of several meetings that ultimately led to the commencement of the Controversial Discussions. The record of those preliminary meetings describes how the normally equable John Rickman lost his temper on 17 December 1941, attacking the officers of the Society for their inability to respond to the needs of the wider community (King and Steiner, 1991, 33–34). It is striking that the British Society’s most extensive exercise in self-examination was precipitated by a paper addressing the question of the relationship between the internal and the external and asking what kind of contribution psychoanalysts could make to the challenges being faced in those difficult days. Over 80 years later, the outlook for humanity is once more looking rather bleak. How can psychoanalysts contribute to thinking through the challenges that we face now? If we think that in principle this might be possible, how can these contributions be communicated effectively? How can we judge whether our efforts have had an impact?

Freud (1926) viewed clinical work as one application of psychoanalytic theory among others, and even suggested that ultimately it might turn out not to be the most important application, but the term “applied psychoanalysis” evokes the distinction between pure and applied mathematics and historically has often been taken to mean the (secondary, incidental and less vital) application of psychoanalytic ideas beyond the clinical context (see Esman 1998 and Gourguechon 2013 for discussion of this tendency). Esman (1998) has questioned the conventional wisdom that psychoanalytic propositions are derived from clinical observations and then applied in other contexts, suggesting that the data on the basis of which Freud developed some of his foundational ideas in The Interpretation of Dreams (1900), The Psychopathology of Everyday Life (1901), Jokes and their Relation to the Unconscious (1905a), and even the Three Essays on Sexuality (1905b; see Sulloway 1989) were for the most part not derived from clinical experience and raising the question of to what degree early clinical observations were shaped by ideas derived from extra-clinical sources. Freud’s first formulation of the Oedipal situation in an 1897 letter to Fliess famously made reference to Oedipus Rex and Hamlet. To what extent did these literary models enable the psychoanalytic formulation? Freud himself was fully aware that observation could not be innocent of preconception, writing in the introduction to “Instincts and their Vicissitudes” (1915) that even at the stage of observation “it is not possible to avoid applying certain abstract ideas to the material in hand, ideas derived from somewhere or other but certainly not from the new observations alone” (117).

While some have felt that the clinic is the home domain of psychoanalysis and it is best for psychoanalysts not to trespass on other territories, both because they do not know enough about other fields and because such activity may have a negative impact on their clinical work (e.g. Kubie 1950), others have expressed concerns about our discipline’s inward-looking tendencies. For example, Otto Kernberg reads a recent Textbook of Applied Psychoanalysis (Akhtar and Twemlow 2020) as “an implicit protest against the inner-directed, isolationist tradition that psychoanalysis as an institution has become”. In 1950, defending his personal reluctance to engage with extra-clinical questions, Kubie wrote, “a conviction that the individual is of prime importance is the cornerstone of our democratic social philosophy and political structure, as opposed to the totalitarian way” (2). Nevertheless, he did also acknowledge that “The clinical analyst develops a bad conscience at turning his back on the world’s agony to live in the ivory tower of individual clinical problems” (2).

In 2024 we are living in circumstances that make it impossible to ignore the impact of social, political, cultural, economic and environmental factors on individual experience (the Covid-19 pandemic and its aftermath, multiple wars, ever-increasing socioeconomic inequality, racism, misogyny, transphobia, the sculpting of our online experience by algorithms, extreme weather, the rise of populism, the displacement of populations and the impact of that displacement on both refugees and hosts). Consequently, it is not surprising that much greater attention is now being paid to social and cultural issues and there is increasing recognition that psychoanalytic investigations in clinical and extra-clinical situations have the potential to inform and enrich each other. As Georg Bruns and James Barron recently wrote, “Our consulting rooms are embedded in multiple communities, which enter in various ways into those private spaces, shaping the intersubjective field” (Bruns and Barron 2022, 109).

Salman Akhtar (2021; Akhtar and Twemlow 2020) has characterised the shift that has taken place as a transition from armchair psychoanalytic anthropology as practised by early psychoanalysts including Freud himself to anthropological psychoanalysis. While the former could be said to involve looking at culture through a psychoanalytic lens without reflection on the “Eurocentric, phallocentric, cis-gendered, monochromatic, and homoethnic” nature of that lens (Akhtar 2021, 443), the latter has involved greater humility and openness to interdisciplinary dialogue that enabled critical reflection on psychoanalytic assumptions. Akhtar suggests that this shift was precipitated by the cataclysmic upheavals of mid-century Europe. There are many contemporary examples of efforts to bring psychoanalytic perspectives to bear on social issues such as community violence (Twemlow and Sacco 1996), terrorism (Lord Alderdice 2017), populism (Loewenstein 2023), racism (Holmes Commission 2023), antisemitism (Perelberg 2022), immigration (Akhtar 1995), and the collective failure to respond adequately to the threat of climate change (Weintrobe 2021). A new magazine, Parapraxis, describes its mission as “To inquire into and uncover the psychosocial dimension of our lives”, offering itself as an aid “to weather today’s difficult realities”. The American Psychoanalytic Association’s long-running magazine, The American Psychoanalyst (TAP), has recently undergone a wholesale rebrand in an effort to appeal to readers beyond the profession. In his first editorial, TAP’s new editor Austin Ratner reflected that in its previous incarnation the magazine had become “outdated and moribund”, unintentionally echoing words rather desperately spoken by John Bowlby at the British Society’s Annual General Meeting on 21 July 1943:

We find ourselves in a rapidly changing world and yet, as a Society, we have done nothing, I repeat nothing, to meet these changes, to influence them or to adapt to them. That is not the reaction of a living organism but of a moribund one. (King and Steiner, 1991, 489–490)

Clearly, while there may not be consensus, there is a growing sense that a turn outwards is required, both because we feel we have valuable perspectives to offer on some of the most challenging problems we face and to ensure the vitality of our discipline. However, as a profession we are relatively new to this job and far less at home outside the clinical frame. So far, the degree of traction that efforts in this direction have gained has been variable both within and beyond psychoanalysis. What are the principles of this new practice? How can we do it well, and what are the potential pitfalls? What impact can we expect it to have? Taken together, the contributions to this issue of Psychoanalytic Controversies offer a multifaceted and thought-provoking set of responses to these questions.

Claudia Frank’s contribution suggests that in their everyday clinical work with patients, analysts cannot avoid engagement with contemporary issues which will often feature in the patient’s associations and may create countertransference challenges, as she describes in the case of her work with a patient who was preoccupied with what he perceived as injustices done to those who others regarded as troublemakers. She develops this example to show how the temptation to identify with a pathological superego figure because this obviates the need to be in touch with painful realities (e.g. one’s own vulnerability) can be observed both in the clinical setting and in manifestations of political extremism, suggesting that the former can helpfully illuminate the latter.

Writing from India, Sudhir Kakar highlights the embeddedness of psychoanalysis in the Western cultural imagination, an issue as invisible as water to the fish that swim in it. By drawing contrasts with Indian myths and culture he shows how psychoanalytic claims about what is natural or healthy are actually highly culturally specific, focusing on our relationship to the nonhuman environment, and our ideas about gender and separation-individuation, and proposes that greater awareness of this and greater openness to diverse cultural perspectives has the potential to reinvigorate our discipline.

Eli Zaretsky underlines that psychoanalysis was born of social and historical changes and that from the beginning the major psychoanalytic thinkers understood it in social and cultural terms. He suggests that the concept of an individual or personal life that can be distinguished from one’s place in the family, in society, and in the division of labour needs to be understood as itself a social and historical product. He highlights the ways in which psychoanalysis undermined the idea that the individual was a rational agent, proposing that it can complement rather than replacing socio-historical analyses, for example by highlighting the ways in which the victims of prejudice mobilise their aggression to internalise those prejudices. On the other hand, psychoanalysis cannot and should not be replaced by analyses focused purely on social reality: provocatively, he suggests that the relational perspective is in danger of scotomising psychic reality and failing to consider the role of aggression turned against the self.

Michael Rustin considers whether and under what conditions psychoanalytic interpretations of political situations can make any difference. It is assumed that political situations are at least in part shaped by unconscious beliefs, but drawing attention to this, while necessary, may not be sufficient to have any impact, given the resistances of which psychoanalysts are all too well aware in their clinical practice. He considers the example of John Maynard Keynes, whose attempts to influence the victorious allies’ decisions about reparations after World War I were informed by psychoanalytic perspectives. These efforts were unsuccessful, but do appear to have had an impact on the approach taken in the aftermath of World War II. Rustin also discusses the influence of the work of Alexander and Margarete Mitscherlich on the German people’s reappraisal of their relationship with the Nazis in the 1960s and 1970s. He suggests that the use of experience-near language, careful assessment of the readiness of the audience to receive the insights on offer, and relationships of trust between the public and those offering psychoanalytic interpretations may all be important factors contributing to the effectiveness of such interventions.

Pratyusha Tummala-Narra’s contribution addresses the question of how psychoanalysis may need to evolve to better serve the wider public. Tummala-Narra, who served as a member of the Holmes Commission on racial equality in American psychoanalysis, emphasises the importance of developing critical engagement with the sociocultural context within training and clinical structures to enable us as a discipline to reflect on troubling phenomena such as polarisation and mutual mistrust rather than reproducing them in our own debates. She also emphasises the humility required to enable us to find out about the needs of the communities in which we are embedded rather than presuming we know what they are. She stresses the nuance that a psychoanalytic perspective can bring to narratives of oppression and victimhood, differing from Zaretsky in seeing the relational perspective as particularly helpful in complicating such narratives.

Magda Khouri reflects on the engagement of psychoanalysts in Latin America with the communities they serve, arguing that psychoanalytic listening can be deployed with powerful effect beyond the traditional clinical setting and that such listening not only provides a valuable support to community members but also has the potential to reinvigorate psychoanalysis. She describes how psychoanalytic listening groups have been used to support individuals engaged in challenging frontline work with people in highly precarious living situations in Latin American cities.

Finally, Sally Weintrobe addresses the question of methodology in non-clinical applications of psychoanalysis, in her reflections on her decades-long work on the psychological roots of the climate crisis. Off the couch, what constitutes data and how do we define the field of study? She describes how immersing herself in other relevant disciplines while still remaining connected to her clinical roots enabled her to detect and characterise a perverse psychic organisation that supports disavowal, omnipotent thinking, and disconnection from unwelcome realities. She also discusses the importance of going beyond identification of this characteristic organisation to understand the phantasies and anxieties driving its formation, which may vary considerably notwithstanding their final common pathway, and the need for careful listening to the responses that interpretations offered may evoke.

We hope that reading the contributions to this controversy will engender an experience of looking at our discipline with fresh eyes. On the one hand, they highlight both the challenges and the possibilities of applying psychoanalytic perspectives beyond the clinical setting. On the other, they underline the ways in which the clinical setting is shaped by different aspects of the socio-cultural environment in which it is embedded, and the need for awareness of this. To conclude with a metaphor, perhaps keeping both sets of challenges in mind is required to enable the binocular vision that psychoanalysts need for true perception of depth. As always, we are very interested in our readers’ responses, and invite your reflections in the form of letters to the editor or longer contributions.

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