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Book Forum: PSYCHOANALYSIS   |    
Understanding Dissidence and Controversy in the History of Psychoanalysis
RICHARD D. CHESSICK, M.D., Ph.D.
Am J Psychiatry 2005;162:824-826. doi:10.1176/appi.ajp.162.4.824
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Edited by Martin S. Bergmann. New York, Other Press, 2004, 396 pp., $28.00 (paper).

We are very indebted to Martin Bergmann and the Other Press for the second in a series of conferences sponsored by the Psychoanalytic Research and Development Fund of New York. The first of these was titled The Hartmann Era(1), and the new one is of just as high a quality. What makes it even more remarkable is that although Bergmann presents a long and clear expository essay at the beginning and runs the symposium that follows later with a firm hand, this meeting was held on his 90th birthday!

The book itself is divided into four parts and is well done. The first part reviews a whole series of famous dissidents in the history of psychoanalysis, including Adler, Jung, Rank, Ferenczi, Horney, Reich, Rado, Klein, Fromm, Lacan, Kohut, Fairbairn, Winnicott, Bowlby, and other important individuals and symposia where controversy flared up. Bergmann manages to do this in 109 pages.

The second part contains contributions prepared by a number of prominent psychoanalysts, some of them my favorite authors. The contributions vary in quality and often contain a great deal of high-level speculation. Some authors write directly to the point, while others digress. There are seven prepared contributions, plus yet another article by Bergmann.

The third part consists of an open meeting held on February 14, 2003, Bergmann’s 90th birthday. In this section the individuals who offered prepared contributions in the second section discuss with each other the problems of dissidence and controversy in the history of psychoanalysis. This discussion was apparently taped and edited and is presented here.

The book remains good to the very end because there is a fourth section that consists of an essay by Wallerstein, who could not attend the meeting because of a sudden illness in his family. He was allowed to see the transcript of part 3 and asked to make a response to the symposium.

There is so much material packed into this book on the subject of psychoanalysis, both theory and practice, that it almost constitutes a complete textbook on current and previous important issues in the field. The audience for the book would consist primarily of psychoanalysts and psychoanalysts in training as well as any psychiatrists who are interested in the history of psychoanalysis or in the many conflicting psychoanalytic theories that prevail today.

Bergmann asks, "Can we learn something about the nature of psychoanalysis itself from the dissidents?" (p. 3), and he hopes that this set of papers and the subsequent discussion will be helpful to students who have to "deal with the fact that psychoanalysis is no longer a monolithic movement" (p. 3). Bergmann points out that especially the early dissidents were told that they simply had "resistance" and, "It gave the psychoanalytic group a sense of coherence and contempt for the dissidents" (p. 5). He then devotes the rest of his opening essay to a review of the story of each of the dissidents. He believes that they were all charismatic, "because the capacity to surround oneself with admiring students is a sine qua non for a successful dissident" (p. 65), and he relates how the dissident theories gradually developed a greater and greater rejection of Freud’s entire edifice.

He claims that except for Jung’s psychology, "no other school of psychoanalysis represents as radical a break from Freud’s theory, philosophy, and technique of treatment as does Heinz Kohut’s self psychology" (p. 73). He sees an important root of dissidence in a training analysis when "the hostility toward one’s own analyst, projected on Freud, is greater than the gratitude for what the analyst, with all her or his shortcomings, did achieve" (p. 78), and usually this appears after the training analysis is finished and a self-analysis is carried on. The prime examples of this, according to Bergmann, are the two so-called analyses of Mr. Z: the first is a report of Kohut’s analysis and the second is a report of Kohut’s subsequent self-analysis. It is clear, as Bergmann points out, that "classical psychoanalysis came to an end with World War II" (p. 92). There are no more classical analysts, and papers in the current literature that tend to attack the so-called classical analyst are setting up a straw person.

There is a lot of discussion in the prepared presentations in part 2 about the multiple conceptions of psychoanalysis, the plurality of theories, and whether this is an acceptable situation or one that needs to be transcended. Green presents a very nice review of why psychoanalysis has fragmented. He concludes that the compromise in the field today, a "pretense of tolerance, search for willy-nilly common sharings that are not very convincing and appear as life jackets to avoid sinking" (p. 126), prevents the collapse of the entire field. Kernberg, one of the most active participants in the meeting, repeats his already published arguments that psychoanalysis has created a serious problem for itself "by accepting, indeed enacting, its reputation as isolationist, elitist, and biased against empirical research" (p. 136). Scharff maintains that there is a major difference between the theory of Melanie Klein and British object relations theory, although they are frequently lumped together. Wallerstein brings up the book review by Bachant and Richards (2) in which they divided what they called "psychoanalytic metatheories" into five groups of adherents: 1) those who wish for a common ground, 2) those who advocate a multimodal approach to the phenomena of psychoanalysis, 3) those who want one total composite psychoanalytic theory, 4) a group that wishes to throw out metapsychology altogether, and 5) those who see the variant metapsychologies as falling into either drive-structural theory or object relational theory. This latter constitutes a dichotomy that contrasts the human ego as a pleasure-seeking organ with that of the human ego as an object-seeking organ, pursuing human relatedness.

The issue of whether psychoanalysis is a one-person psychology and, more recently, a two-person psychology is discussed by a number of the authors. The more recent two-person psychology approach focuses on the interactional and intersubjective quality of the analytic encounter. Bergmann, in his prepared presentation in part 2, concludes that dissidence is so unwelcome because it affects "the idealization of psychoanalysis that many need to continue the profession" (p. 251).

Part 3 is probably the most long-winded and somewhat repetitive section of the book, but the topics covered are extremely important to anyone interested in psychoanalysis. There is a great deal of discussion about the vehemence with which dissidents are attacked, ostracized, and, often, asked to leave. There is a lot of discussion of Ferenczi, who is often called the mother of psychoanalysis just as Freud was the father. Blum points out, "It was Ferenczi who really began a new focus on the analyst’s mind, the analyst influencing the analytic process with bilateral, unconscious communications" (p. 296). Ferenczi’s views are being taken increasingly seriously at the present time, although when they were first put forward he was ostracized and even accused of being mentally and physically ill.

Several of the participants point out that the attempt to do psychoanalytic treatment with the now ubiquitous borderline patient has forced analysts to reconsider their theories and has itself by necessity spawned a number of new theoretical and technical ideas modifying the standard techniques. Blum warns,

We have a kind of fragmentation or dissolution of psychoanalysis with all kinds of burgeoning theories and "every flower should blossom." Every theory can be viewed as potentially valid or equally valid. And that’s a danger on the other side of monolithic orthodoxy. (p. 340)

This is not theoretical pluralism with awareness and investigation of differences but is what is now known as eclecticism, a stance that all of the authors oppose.

Kernberg warns of the danger of oversimplification and reductionism every time some new discovery in neurobiology is brought into psychoanalytic theory, even though psychoanalysts are good friends with neuroscientists. Blum points out that "institutes are spending less and less time teaching Freud—reading Freud’s papers, discussing those papers, speaking of the core of psychoanalysis" (p. 348), and the participants agree. Green labels as a core concept of psychoanalysis that the unconscious leads us to the drives and is a product of them. He concludes that dissidents can be identified in the things that they refuse: "We can refuse it massively like Adler and Jung—or subtly with object relationships, even more with attachment theory, and even more with intersubjective theory" (p. 354).

In the final, short section of the book, Wallerstein depicts the core of psychoanalysis as the concepts of the unconscious—hidden workings of the mind that powerfully mold our thoughts, feelings, and behaviors—and of psychic determinism—"What comes before helping determine what comes after" (p. 363). He points out that the various theories are not yet amenable to scientific testing and argues that clinical experience will never lead to definitive answers. He makes a strong plea for empirical psychoanalytic research.

Bergmann MS (ed): The Hartmann Era. New York, Other Press, 2000
 
Bachant J, Richards A: Book review, SA Mitchell: Relational Concepts in Psychoanalysis: An Integration. Psychoanalytic Dialogue  1993; 3:431–460
[CrossRef]
 
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References

Bergmann MS (ed): The Hartmann Era. New York, Other Press, 2000
 
Bachant J, Richards A: Book review, SA Mitchell: Relational Concepts in Psychoanalysis: An Integration. Psychoanalytic Dialogue  1993; 3:431–460
[CrossRef]
 
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