{"id":138249,"date":"2021-04-05T07:52:29","date_gmt":"2021-04-05T15:52:29","guid":{"rendered":"https:\/\/lukeford.net\/blog\/?p=138249"},"modified":"2021-04-07T09:40:26","modified_gmt":"2021-04-07T17:40:26","slug":"psychoanalysis-the-impossible-profession-paperback","status":"publish","type":"post","link":"https:\/\/lukeford.net\/blog\/?p=138249","title":{"rendered":"Psychoanalysis: The Impossible Profession"},"content":{"rendered":"

Janet Malcolm writes in this 1982 book:<\/a><\/p>\n

* THE PHENOMENON OF TRANSFERENCE\u2014HOW WE ALL INVENT each other according to early blueprints\u2014was Freud\u2019s most original and radical discovery. The idea of infant sexuality and of the Oedipus complex can be accepted with a good deal more equanimity than the idea that the most precious and inviolate of entities\u2014personal relations\u2014is actually a messy jangle of misapprehensions, at best an uneasy truce between powerful solitary fantasy systems. Even (or especially) romantic love is fundamentally solitary, and has at its core a profound impersonality. The concept of transference at once destroys faith in personal relations and explains why they are tragic: we cannot know each other. We must grope around for each other through a dense thicket of absent others. We cannot see each other plain. A horrible kind of predestination hovers over each new attachment we form.<\/p>\n

* Freud took up in forthright detail the delicate and weird task of persuading a female patient to regard her love for the analyst both as a normal part of the treatment (\u201cShe must accept falling in love with her doctor as an inescapable fate\u201d) and as something unreal and hallucinatory\u2014an artificial revival of early feelings that has nothing to do with the person of the analyst. Then, in one of those startling and beguiling reversals that characterize his writings, Freud turns on his own argument and says, But isn\u2019t all love like that? Isn\u2019t what we mean by \u201cfalling in love\u201d a kind of sickness and craziness, an illusion, a blindness to what the loved person is really like, a state arising from infantile origins? The only difference between transference-love and \u201cgenuine\u201d love, he concludes, is the context. In the analytic situation, nothing is permitted to come of the patient\u2019s love; it is a situation of renunciation. Both parties must \u201covercome the pleasure principle\u201d and renounce each other for a higher goal\u2014the doctor for the sake of professional ethics and scientific progress, the patient in order to \u201cacquire the extra piece of mental freedom which distinguishes conscious mental activity\u2014in the systematic sense\u2014from unconscious.\u201d Freud describes the temptations for the analyst that are inherent in the situation\u2014especially for \u201cthose who are still youngish and not yet bound by strong ties\u201d\u2014with rueful candor:
\n Sexual love is undoubtedly one of the chief things in life, and the union of mental and bodily satisfaction in the enjoyment of love is one of its culminating peaks. Apart from a few queer fanatics, all the world knows this and conducts its life accordingly; science alone is too delicate to admit it. Again, when a woman sues for love, to reject and refuse is a distressing part for a man to play; and, in spite of neurosis and resistance, there is an incomparable fascination in a woman of high principles who confesses her passion. It is not a patient\u2019s crudely sensual desires which constitute the temptation. These are more likely to repel, and it will call for all the doctor\u2019s tolerance if he is to regard them as a natural phenomenon. It is rather, perhaps, a woman\u2019s subtler and aim-inhibited wishes which bring with them the danger of making a man forget his technique and his medical task for the sake of a fine experience.<\/p>\n

* \u201cUntil Freud\u2019s discovery,\u201d they write, \u201cpsychotherapists had been haunted, whether consciously or not, by the possibility of erotic complications in the relationship. They could thenceforth feel reassured.\u201d That Breuer took Anna\u2019s sexual feelings toward him personally, whereas Freud discovered transference as a result of the importunities of his importuning patient is the difference between ordinary intellect and genius.<\/p>\n

* Freud likens the feat of the patient who suspends his critical faculties and says everything and anything that comes into his mind, regardless of its triviality, irrelevance, or unpleasantness, to that of the poet during the act of creation. He quotes from a letter that Schiller wrote in 1788 in reply to a friend who had complained of meagre literary production: “The ground for your complaint seems to me to lie in the constraint imposed by your reason upon your imagination. I will make my idea more concrete by a simile. It seems a bad thing and detrimental to the creative work of the mind if Reason makes too close an examination of the ideas as they come pouring in\u2014at the very gateway, as it were. Looked at in isolation, a thought may seem very trivial or very fantastic; but it may be made important by another thought that comes after it, and, in conjunction with other thoughts that may seem equally absurd, it may turn out to form a most effective link. Reason cannot form any opinion upon all this unless it retains the thought long enough to look at it in connection with the others. On the other hand, where there is a creative mind, Reason\u2014so it seems to me\u2014relaxes its watch upon the gates, and the ideas rush in pell-mell, and only then does it look them through and examine them in a mass.\u2026 You critics, or whatever else you may call yourselves, are ashamed or frightened of the momentary and transient extravagances which are to be found in all truly creative minds and whose longer or shorter duration distinguishes the thinking artist from the dreamer. You complain of your unfruitfulness because you reject too soon and discriminate too severely.”<\/p>\n

Just as there are few people who can write poems like Schiller, there are few analytic patients who can free-associate easily, if at all. Analysts today don\u2019t expect the free-association process process to take hold until well into the analysis; in fact, some regard the appearance of true free association as a signal to terminate the analysis.<\/p>\n

* Along with free association and dreams, Freud goes on to cite (we are in the third Clark lecture) a third entr\u00e9e into the unconscious: the various small \u201cfaulty actions,\u201d or \u201cpara-praxes\u201d\u2014slips of the tongue, misreadings, the forgetting of names, the losing and breaking of objects, and so on\u2014by which we daily betray ourselves.<\/p>\n

* \u201cSuppose an analyst were to fall asleep during a session, or to forget an appointment with a patient. Should he apologize, explain, and discuss the reasons for his action with his patient?\u201d Brenner asks in his book Psychoanalytic Technique and Psychic Conflict (1976). He gives this rather magnificent answer: “Many analysts would say he should \u2026 and their arguments for doing so are persuasive. Yet I believe the better course to follow is the usual one of encouraging a patient to express his thoughts and feelings about what has happened. Only in that way can one learn whether a patient has taken his analyst\u2019s mistake as a slight that has offended and angered him, or as a sign of weakness that allows him to feel superior and even triumphant, or as a welcome excuse for anger, etc. A conscientious analyst will naturally regret such a mistake, he will certainly try, through self-analysis, to discover his unconscious reasons for having acted as he did, but he will be well advised to maintain an analytic attitude even to such an event, and not to assume what it must mean to his patient without hearing what his patient has to say. It is presumptuous to act the analyst, unbidden, in a social or family situation. It is a technical lapse to be other than an analyst in one\u2019s relation with an analytic patient.”<\/p>\n

* An analysis ends when the patient resolves his transference neurosis\u2014when he finally accepts the fact that the analyst is not, not, not going to fulfill the wishes the patient had as a child toward his parents, that it just isn\u2019t going to happen that way, that he must renounce these wishes toward the analyst and fulfill them in his own life, in his work, in his attachments, through his children. In other words, that he is an adult and must put away childish things. Which is horribly painful.<\/p>\n

* He begins to dare hope that maybe he will , after all, be admitted into the parental bedroom, that he will be treated to the secrets of the parents, that he will find out what they \u2018do\u2019 in there, that he will be able to form alliances with one or another of them.<\/p>\n

* I\u2019ve never felt \u2018in\u2019 anywhere\u2014not in school, not in college, not in medical school, not in psychiatric training\u2014and now I\u2019m playing it out in relation to the analytic community. Everyone\u2019s analysis unearths a central fantasy, and mine is that of an outsider looking into the bedroom: feeling excited and scared, getting aroused, trying to figure out what is going on, but not having to get involved, not having to risk anything. There are many ways of playing out this fantasy. I could have become a Peeping Tom, for one extreme possibility, but I became a scientist instead\u2014a psychoanalyst, a person who gets to know another person very intimately but doesn\u2019t have to get involved with him. I\u2019m very much a Jew\u2014another kind of outsider… I have all kinds of fantasies about what goes on in the inner sanctum, most of which aren\u2019t true.<\/p>\n

* This kind of hierarchy and infantilization exists in every other profession. It\u2019s in law, in business, in science, in education. There are Oedipally significant positions in every profession, and when people are up for them it creates a crisis that infantilizes them\u2014causes grown men to squabble like kids about trivial things.<\/p>\n

* \u201cThe sources of motivation and pleasure are infantile wishes.”<\/p>\n

* \u201cIn both analysis and life, we perceive reality through a veil of unconscious infantile fantasy. Nothing we say or do or think is ever purely \u2018rational\u2019 or \u2018irrational,\u2019 purely \u2018real\u2019 or \u2018transferential.\u2019 It is always a mixture. The difference between analysis and life is that in analysis\u2014in this highly artificial, extreme, bizarre, stressful, in some ways awful situation\u2014these infantile fantasies come into higher relief than they do in life, become accessible to study, as they do not in life. The purpose of analysis isn\u2019t to instruct the patient on the nature of reality but to acquaint him with himself, with the child within him, in all its infantility and its impossible and unrepudiated and unrepudiatable longings and wishes. Terms like \u2018the real relationship\u2019 and \u2018therapeutic alliance\u2019 and \u2018working alliance\u2019 simply obscure and dilute and trivialize the radical nature of this task.\u201d<\/p>\n

* THE SECOND PATIENT A ARON RECEIVED FROM THE T REATMENT Center was a refined, cultivated woman, eager to do the analytic work, appreciative of Aaron, extremely pleasant and interesting to be with, and very good-looking. As he had cursed his luck with the first patient, he couldn\u2019t believe his good fortune in having drawn the second. She was the most gratifying of patients. She made literary allusions, and understood the ones he made. She worked on a magazine and had an impressive-sounding circle of literary acquaintances. As he had dreaded the sessions with the first patient, he looked forward to the ones with the second. He was dazzled by her, a little in love with her. After two years, the analysis ground down to a horrible halt. It was a total failure. \u201cI was blinded and lulled by her charm,\u201d Aaron recalled ruefully. \u201cI fell down badly on the job. Instead of pointing out to her the nasty, harsh things I should have pointed out, I exchanged literary references with her. I didn\u2019t see the trap I had fallen into until it was too late. In the first case, where the patient gave me no pleasure whatever, to put it mildly, I was able to hew to my course and be of some help to her. In the second case, I failed the patient utterly.\u201d<\/p>\n

* “Benvenuto Cellini was casting a statue, and he needed some calcium for his bronze alloy. He couldn\u2019t find any around the studio, so he picked up this little boy and threw him into the pot for the calcium in his bones. What was the life of a little boy to the claim of art?\u201d<\/p>\n

* a clitoral orgasm may be accompanied by feelings in the vagina and thus, properly speaking, can be called a vaginal orgasm.<\/p>\n

* “I did a hatchet job on [Otto] Kernberg. I had done my homework, and I crushed him, and everyone knew I had. After that, I became socially acceptable. People who had dismissed me as a computer nut started being nice to me. All kinds of people started noticing me, inviting me to parties.\u201d<\/p>\n

* \u201cAnd such small edge as analysts have they exercise in only one situation in life\u2014namely, the analytic situation. In that most unnatural, highly artificial, stressful situation, the analyst\u2019s small advantage of self-knowledge and self-control comes into play. But when you take him out of his consultation room, his advantage recedes and he becomes just like everyone else\u2014he begins to act just like other people.\u201d
\n \u201cThis is ironic,\u201d I said. \u201cThe analyst works with his patients to get them to behave more rationally and reflectively, and remains irrational and unreflective himself.\u201d
\n\u201cBut that isn\u2019t what the analyst works to achieve with his patients. This is a popular myth about analysis\u2014that it makes the patient a clearer thinker, that it makes him wise and good, that people who have been analyzed know more than other people do. Analysis isn\u2019t intellectual. It isn\u2019t moral. It isn\u2019t educational. It\u2019s an operation. It rearranges things inside the mind the way surgery rearranges things inside the body\u2014even the way an automobile mechanic rearranges things under the hood of the car. It\u2019s that impersonal and that radical. And the changes achieved are very small. We live our lives according to the repetition compulsion, and analysis can go only so far in freeing us from it. Analysis leaves the patient with more freedom of choice than he had before\u2014but how much more? This much: instead of going straight down the meridian, he will go five degrees, ten degrees\u2014maybe fifteen degrees if you push very hard\u2014to the left or to the right, but no more than that. I myself have changed less than some patients I\u2019ve analyzed. Sometimes I get discouraged about myself. Sometimes I worry about myself. A few weeks ago, I did something that still bothers me and worries me. My wife and I were having dinner with some friends in SoHo. We were lingering at the table, drinking wine and laughing a lot, and the conversation turned to analytic fees. Someone\u2014these friends weren\u2019t analysts\u2014started making jokes about them. Now, fees are a subject that I\u2019m very sensitive about, for a number of reasons. First of all, because the whole subject of money is a charged one for me. I frankly want more money than I have, and I\u2019m envious of analysts who are rich, yet I can\u2019t bring myself to do what\u2019s necessary to increase my income\u2014that is, to beg for referrals. That, at any rate, is how it looks to me\u2014the whole business of younger analysts sidling up to older colleagues at parties and meetings, like mendicants clutching at the robes of the nobility, and saying with apparent nonchalance, \u2018Oh, I have some free hours.\u2019 That\u2019s how it\u2019s done, and it seems degrading to me, and I can\u2019t do it. So I have unfilled hours, and am bitter.”<\/p>\n

* When Kernberg talks about a patient, he talks as if he understood him inside and out, backwards and forwards, with relatively little effort, and he is just dazzling. Dazzling, brilliant, impressive, and\u201d\u2014Aaron paused to bang his fist on the arm of his chair for emphasis\u2014\u201c unconvincing.<\/p>\n

* “If you try to understand the patient in the overwhelming fullness of his individuality and idiosyncrasy, you will not have the easy time of it that Kernberg has had with his schematic methods. You will feel discouraged, guilt-ridden, depressed, lost, confused, and deluged by the quantity of data and by its ambiguity and complexity. You will suffer back pain, indigestion, headache, fatigue\u2014all the afflictions the flesh is heir to\u2014because of the guilt you constantly feel about not understanding the data. And this isn\u2019t even to speak of the other kind of guilt that analysts feel over the pain and frustration they regularly inflict on the people they analyze. Analysts keep having to pick away at the scab that the patient tries to form between himself and the analyst to cover over his wound. That\u2019s what the patient keeps trying to do\u2014it\u2019s what\u2019s called resistance\u2014and what the analyst won\u2019t let him do. The analyst keeps picking away at the scab. He keeps the surface raw, so that the wound will heal properly.\u201d<\/p>\n

* AT OUR NEXT MEETING , I CONFESSED TO AARON THAT I sometimes got tired of hearing him talk\u2014that I rather resented always listening to him and never talking about myself.
\n \u201cThere it is,\u201d Aaron said, with an ironic gesture of his hand.
\n \u201cIs that how you feel with your patients?\u201d I asked.
\n \u201cAnd how!” <\/p>\n

* \u201cI had a patient once who made me horribly sleepy. I couldn\u2019t understand it at first. She was by no means a boring person. She associated well, and she was someone I liked and respected\u2014a very fine, a truly good person. So it just didn\u2019t seem possible that this almost suffocating sleepiness could be a reaction to her personally. I thought it must be the time of day I saw her\u2014but that couldn\u2019t be, because she had different hours on different days. I thought it might be the result of staying up too late, so I drank black coffee. But the sleepiness persisted, and finally it dawned on me what it was all about. I realized that the patient had developed an erotic transference to me and was defending herself against it by making herself uninteresting and dreary\u2014as she had done throughout her childhood with her father, and as she was doing in adult life with the men with whom (for some strange reason) she could never get into any sort of satisfying lasting relationship.\u201d<\/p>\n

* Like a good messiah, he keeps himself further and further away, sequestered from the masses. When he\u2019s invited to speak, he sends his emissaries, his true disciples.<\/p>\n

* “One becomes a psychiatrist by first working with very, very sick patients and only gradually moving on to less sick ones. Then, when one does analysis with a healthy patient, it\u2019s easy, like cutting butter.\u201d
\n\u201cSo analysis is for the healthy?\u201d
\n \u201cIt works better for the healthy. But I haven\u2019t seen anything in general medicine where that wasn\u2019t the case. The healthier the patient, the better the treatment.\u201d<\/p>\n

* Chekhov: Gurov reflects on the double life he is leading and ponders the paradox that “everything that was important, interesting, essential, everything about which he was sincere and did not deceive himself, everything that made up the quintessence of his life, went on in secret, while everything that was a lie, everything that was merely the husk in which he hid himself to conceal the truth, like his work at the bank, for instance, his discussions at the club, his ideas of the lower breed, his going to anniversary functions with his wife\u2014all that happened in the sight of all… He and Anna Sergeyevna loved each other as people who are very dear and near, as man and wife or close friends love each other; they could not help feeling that fate itself had intended them for one another, and they were unable to understand why he should have a wife and she a husband; they were like two migrating birds, male and female, who had been caught and forced to live in separate cages. They had forgiven each other what they had been ashamed of in the past, and forgave each other everything in their present, and felt that this love of theirs had changed them both.<\/p>\n

* In Yalta, after they make love for the first time, the woman weeps with shame for her fall from virtue, and the man sits down at a table and callously cuts himself a slice of watermelon and eats it. It is an absolutely idiosyncratic, banal, and metaphorically perfect action. It is the same thing with patients\u2014their stories are full of just such arrestingly rich detail, as if a gifted writer had composed them.<\/p>\n

* “If someone outside of analysis came up to me and said \u2018I\u2019m desperately in love with you,\u2019 and I responded by saying \u2018What comes to mind about that?\u2019\u2014that would be a horrible thing to say! Just horrible! But when a patient comes in and says \u2018I\u2019m desperately in love with you,\u2019 and I say \u2018What comes to mind about that?\u2019\u2014that\u2019s absolutely appropriate.\u201d
\n \u201cBut what if the patient finds it horrible?\u201d
\n \u201cShe leaves the analysis. There are patients who cannot tolerate the frustration\u2014it calls up too many painful feelings or too much anger\u2014and the analysis breaks off. There are forest fires that get out of control. There are gas mains that blow up. There are buildings that buckle and crumble. There are wars that break out. There are diseases that kill. Sometimes in regular medicine the patient dies . Sometimes in psychoanalysis the analysis doesn\u2019t survive an erotic transference.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Janet Malcolm writes in this 1982 book: * THE PHENOMENON OF TRANSFERENCE\u2014HOW WE ALL INVENT each other according to early blueprints\u2014was Freud\u2019s most original and radical discovery. The idea of infant sexuality and of the Oedipus complex can be accepted … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[29725,17382],"tags":[],"class_list":["post-138249","post","type-post","status-publish","format-standard","hentry","category-psychoanalysis","category-psychology"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t