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The International Journal of Psychoanalysis The latest Psychoanalytic Controversy between Jessica Benjamin and Vic Sedlak, on the the question of whether analysts should at times openly acknowledge to their patients that they have failed them, is now available for discussion. The position papers are available to read at the links below: To submit a contribution to the discussion of these pieces, email ijpa@psychoanalysis.org.uk. Contributions will be posted below and email summaries will be circulated periodically. Contributions received so far: From Bennett Roth (received 14/09/09) From Bennett Roth (received 14/09/09) I found the discussion and the case material quite compelling and interesting; and the formulations quite different from my own although I come closest to Sedlak's position when he offers that Benjamin wasn’t being psychoanalytic. It is at that moment when she becomes an instructive other that the analysis is abandoned in my view. But let me set this up from a position of dialogue. While there is some talk of the “ third position ‘ the basis of the third position is not as simple as portrayed . the surface dialogue ( words) created understanding , responses on various levels in the analyst and the patient. This is, from a linguistic point of view , what is meant by co-creation and for current purposes creates a multidetermined analogic domain. This dynamic domain mediates the interactions between the participants and usually a small part of the process is verbalized through free association as evidenced by the complex dynamic identifications apparent in the discussion : that is there are complex identifications in both the analyst and the patient that are “ currents in the session” . That being briefly noted I have to return to Benjamin’s taking a position in which she enacts one of her own “ third” positions . Benjamin does not simply apologize to the patient for what I understand as her counter transference enactment , in her unqoted text she “suggested she ought not to let me off the hook so readily and apologized for my sharpness." My questions are many. What were the tone of these words? what was actually said? (there are no quotes in this sentence). Am I the only who hears multiple voices in Benjamin’s remark? There are certainly, to my ear, many voices and instructions in that summarized statement. Further, at what point does the analyst attempt to analyze the counter-transference and not ask the patient to respond. For me I am a deep sea fisherman and getting “off the hook” has a surplus of meanings. But again, the more I understand this remark, I must admit I side with Sedlak, That at that moment there is something else going on; that setting up a verbal double bind in such an invitational manner and asking the patient to comment on it as quoted by Benjamin certainly may account for other continuing dynamics. From Zvi Lothane (received 09/09/09) I concur with Jessica Benjamin that by acknowledging a mistake the analyst provides the analysand with what Franz Alexander so aptly defined as a corrective emotional experience AND a heuristic window for emotionally understanding new, hitherto hidden, aspects of the patient's personality and dramas. Since Benjamin uses the terms 'drama' and 'dramatic' I would like to build a bridge between her formulations about enactments and mine in a recently published paper, "Dramatology in life, disorder and psychoanalytic therapy: A further contribution to interpersonal psychoanalysis," International Forum of Psychoanalysis, 18:135-148, 2009). Benjamin writes: "I chose to speak from within this drama, as if it were true, . from a place of protective indignation, as if she really were my own child." Here Benjamin joins the patient not just as a participant OBSERVER of the drama, i.e., as a listener to a narrative, but as participant ACTOR, as a VICARIOUS parent who "lost it." In other words, the analyst, like Alice Through the Looking Glass, entered the dramatic scene via an enactment of a role. Benjamin states she "failed to contain [her] frustration and fell into what Steiner means by interpretive enactment." I agree with Benjamin, Steiner and others about the inevitability of such enactments but go a step further, seeing how they mirror a similar history regarding transference. Initially regarded as a bane of psychoanalytic therapy it became a boon when its heuristic potential was understood with time. The same happened with countertransference: first seen as a hindrance, later as helpful to the analytic process. This is now happening with enactments: rather than seeing enactments as failures, they are play a role as windows of therapeutic opportunity. Such dramatic enactments are fruitful and rewarding, leading to emotional, not just intellectual insight and a greater sense of conviction for the patient. It leads to new memories and a more effective working through of character defenses and identifications. It stimulates growth it the analysand and the analyst. Benjamin describes the dramatic enactment: "My willingness to enact the improvisational role of a protective mother ... helped me to realize and acknowledge how my enactment came from my unformulated identification with the mother .. I actually became as analyst the helpless mother, too 'out of it' to be of use or see what was really going on. I became the shameful mother I was trying to protect." However, contrary to Benjamin, I do not consider this enactment as a failure requiring an admission that a mistake was made. Instead of reacting in a studious manner, Benjamin reacted in a SPONTANEOUS fashion, only seemingly out of control, but actually unconsciously wise and therapeutic. Years ago Theodor Reik wrote about "surprise and the analyst" followed by later elaborations of Isakower on the analyzing instrument. The enactment came as a surprise: "To both our surprise, my shift into acknowledging precisely the role I had played triggered Hannah's switch into re-absorbing her protective daughter role who identifies with mother: exclaiming she felt sorry for this poor mother who can't soothe anyone, she cried out: ''You don' t love her, no one could love her, she is so unlovable!'" Note Benjamin's "the role I had played" - the language might suggest using an artifice of a theatrical performance, but therapy is not a fiction, it is a real-life situation. This was not a fictional role that was played out here, this was real-life dramatic interaction, a psychoanalytic situation drama, psychoanalytic process as dramatic action and reciprocal enactment, leading to mutual discovery and validation for analyst and analysand alike. From Merle Molofsky (received 04/09/09) I found Jessica Benjamin's contribution a useful elucidation of phenomena that psychoanalysts come across daily. She delineates the moral dilemma we face each time we are humanly imperfect, i.e. not fully empathically attuned; not the "subject supposed to know" that Lacan postulates and that Gianmaria Benedetti seems to expect us to embody; not the lost idealized object of fantasy. In March 2007 I published an article in Journal of Religion and Health, Vol. 46, N0. 1, called "Ethics, Ethos, and Dualities: Self and Culture, Talking in Tongues." I questioned the familiar "fundamental rule" of free association, the expectation that the analysand is expected to fully disclose via free association, and offered instead the already established concept of an ethic of self-awareness on the part of the analyst, the necessity of being aware of one's own fantasies in the transference-countertransference matrix. I asked, "what is ethical about neutrality? or relationality?" My musings led to the concept that "We ...have an ethical obligation to acknowledge to ourselves where we fail, as we fail. This is the ethic of acknowledging countertransference." I was not pioneering new ground. But I was exploring that which we constantly need to explore, our "mindfulness" as analysts, as we encounter the going-on-being of human limitation in conjunction with skill, knowledge, and good intention in the psychoanalytic experience. Therefore our professional discourse will include discovery and re-discovery of who we are as clinicians. I admire the courage of Jessica Benjamin in revealing her analytic process. She has the courage of her convictions. Intersubjectivity and relational theory both begin with the philosophical premise of an equality of minds engaged in mutual endeavor. Yes, analysands must "resist," i.e. defend against being overwhelmed by thoughts and feelings. Yes, analysts too must "resist," for the same reasons. Whenever any of us "exposes" our work to our colleagues, in print, in study groups, at conference presentations, we understand that others will glory in seeing what we "could not, would not" see, that others would interpret clinical material much differently, because of different theoretical perspectives, different life experiences, and sometimes just a need to triumph or shine. The psychoanalytic community second guesses everyone, from Freud to Kohut to the next self-revealer. We each may have different ideas of what psychoanalysis is, what a "successful outcome" is. I'll put forth that the outcome of a good enough analysis is integration of self and authenticity of being. For me, this works with a conflict model, an object relations model, a self psychology model, a relational model. If we are not authentic with our analysands, why would they move toward their own authenticity? Acknowledging a mistake does not "intefere" with the transference any more than not acknowledging a mistake does. Transferences stay intact under all sorts of pressures. The intersection of fantasy and reality takes place in the transitional space of the analytic situation, and is addressed by analysand and analyst as a mutual endeavor. From Gianmaria Benedetti (received 02/09/09) Click here to read this contribution in the original Italian. How disappointing that even this discussion has not succeeded in coming to life, after the last one of years ago, if I'm not wrong! Beyond the proposed topic it would be useful perhaps to discuss just what is happening in this avoidance of discussion: have the psychoanalysts or people interested in psychoanalysis lost their interest in discussion? Is everyone closed in their retreats, preferring not to go out unprotected? Are the various psychoanalytic traditions by now only self-referential and busy only with the cultivation of their own isolated small gardens? I must say that I was not well informed about the specific thread of relational psychoanalysis: reading the contributions of Blass, Benjamin and Sedlak was therefore interesting for me as information about this development of psychoanalysis. I want to thank them for that. As a psychiatrist and psychotherapist who uses the psychoanalytic method as a frame of reference in operating in the whole field of mental health, as a guide in many interventions and not only in individual sessions with patients, I did not find anything scandalous in the described approach, but neither did I find anything particularly revolutionary. Although there is no specific reference by the authors, it seems to me that this field was opened by Ferenczi's late works, with their particular attention to reciprocity in the relationship with the patient, something that Freud certainly did not approve. Here perhaps is the heart of the problem: the problem of the existence (or negation, that is the same thing, perhaps…) of an authority which one has to give account to or to rebel against in order to express one's own positions and views in the psychoanalytic field. Nearly the phantom presence of an 'imprimatur' that always remains in the background, an authority that decides what can be approved and what cannot. A problem of siblings that dispute the paternal inheritance and the birthright (evoking the history of Esau and Jacob)? The kernel of the argument touches on the relationship between analyst and patient (a topic that seems to have remained the exclusive concern of psychoanalysis, since the patient-physician relationship does not seem to interest medicine and the other forms of psychotherapy any more in general terms). In effect, what characterizes the psychoanalytic method in my opinion, which can therefore be the trait-d' union between the various psychoanalytic schools and theories, is the specific attention to what happens between doctor and patient, using Freud's terminology when he discovered transference and, then, countertransference phenomena. The universe created by the meeting between two persons in the specific laboratory of the psychoanalytic situation, is the object of a living knowledge enterprise (in the frame of 'learning from experience') that modifies the object, as by now we know also from physics. In this universe a lot of figures and personages do take part, like 'the third' but also like many others, as usually happens in the " other scene" evoked by Freud, where a drama variously composed of personages with and without author is continuously enacted (as in Pirandello's drama). The psychoanalysts progressively left and leave the role of deus ex machina and found themselves engaged in a lot of characters. They would have certainly preferred to maintain the original role of, using Lacan's words , the 'sujet supposé savoir' (that I translate: "subject supposed to know ") that is, in my interpretation, the character invested with Knowledge and Authority, created by the shared fantasy of the two protagonists (close to D. Meltzer's 'mutual idealization'). Perhaps the evolution of psychoanalysis (in its history but also in the history of every psychotherapy) is readable as the more or less easy and slow evolution of this shared fantasy towards a domain where both subjects are on the same level, like associates in a common enterprise, even if they have different tasks, in which the task of the psychoanalyst in particular is creating and maintaining the conditions that enable all this can take place. That seems to remain, in the various evolutions of the theories and the techniques, the hard core of the psychoanalytic building, under the various scaffoldings that cover the intense activities of restructuring continuously. |
