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Critical Psychoanalytic Thinking for Trainee Clinical Psychologists
Transcript of Critical Psychoanalytic Thinking for Trainee Clinical Psychologists
Eigen, M. (2013). Interview here: http://tinyurl.com/pkcfyvo
Fahry, D. (2010) A Psychoanalytic Approach to Race. Podcast: http://tinyurl.com/cok8644
Fink, B. (1997) A Clinical Introduction to Lacanian Psychoanalysis: Theory and Technique, Cambridge. MA-London: Harvard University Press
Leader, D. (2012). What is Madness? Penguin. http://tinyurl.com/kode5jy
Vanheule, S. (2011). A Lacanian perspective on psychotic hallucinations. Theory & Psychology, 21, 86-106. http://tinyurl.com/njxqfjq
Vanheule, S., & Verhaeghe, P. (2009). Identity through a psychoanalytic looking glass. Theory and Psychology, 19, 319-411. http://tinyurl.com/ojxlh96
Watts J. (2013). The Maternal Function in Schizophrenia. Journal of the Centre for Freudian Analysis and Research 22: 48-67. http://tinyurl.com/ofclfy8
Loads of other references and links on paper reference list
Critical Psychoanalytic Thinking for Psychology
The Schools and Radical Approaches
Dr Jay Watts
To have some idea of the terrain of psychoanalytic thinking worldwide
To have an introduction to some Lacanian ideas
To have a space to think how social constructionist and psychoanalytic thinking agree and disagree
To have some resources for your ongoing investigations
Long time campaign with UEL!
Evidence base – therapist allegiance
Recruit people to think more about the psychodynamic/systemic interface!
Why this Lecture?
Luborsky et al (1999) found researcher allegiance accounted for two thirds of variance in outcomes in review of 29 comparative therapy studies (cf Munder et al, 2013). Westen et al (2004) calculated in more than 9 out of 10 instances the results of a comparative trial can be predicted solely on the basis of the therapists’ allegiance = the Dodo Bird Effect http://mentalhealthpros.com/mhp/pdf/Dodo-bird-meta-analys.pdf
If one looks at the data on the comparative efficacy of different modalities, rather than the data establishing efficacy vs TAU, the evidence suggests there is in fact little difference in efficacy (Luborsky et al 2002, Wampold et al 1997, 2001).
Research points to an average difference in effect sizes of 0.2 (a relatively small difference), reducing to .14 or even 0 when allegiance effects are taken into account.
If someone believes in CBT, it will be more likely to work than if you don't. More need to find out what works for you x patient.
What about Evidence Based Practice?
Brief Psychoanalytic Timeline
The Kleinians: Klein, Isaacs, Bick, Britton, Segal, Bion, Ogden. McDougall, Target
The Anna Freudians/Ego Psychology: Anna Freud, Hartmann, Lowenstein, Rapaport, Kris, Fonagy
The Independents: Winnicott, Bowlby, Balint, Symington, Bollas, Casement, Eigen
The Lacanians: Lacan, Miller, Roudinesco, Vergehae, Salecl, Leader, Zizek, Laurent, Parker, Fink.
The Jungians: Jung, Hillman, Papadopoulos, Samuels
The Existential-Psychoanalysts: Sartre, Frankl. Laing, Szasz, Mosher, Lowenthal
The Relational Psychoanalysts: Mitchell, Greenberg, Bromberg, Safran, Benjamin, Orbach
Schools (and some key thinkers)
Critical thinkers: Barthes, Deleuze, Guattari, Derrida, Foucault, Levi Strauss.
Feminist: Irigaray, Kristeva, Mitchell, Rose, Butler
Qualitative Researcher Methodologies: Frosh (psychosocial), Hook (Lacanian), Parker (Lacanian), Holloway (Kleinian), Walkerdine (feminist psychoanalytic)
In UK, Academy=Lacanians, NHS=British School
Organisational dynamics, attacks and paranoid-schizoid position.
Drives versus relationships
To interpret or not: anna freud versus the kleinians
Knowing position versus mystic
Academic versus clinic
English speaking versus non speaking psychoanalytic worlds
Construction versus interpretation
True self versus structurally alienated self
Fantasy or repetition
Pre oedipal object relations versus post oedipal object relations
Lacan wonders humorously “if a desk might not be an ideal patient? For never having had an ego, it would not resist the substitution of someone else's ego for its own” (Sheridan, Ecrits, pp. 135-36)
Klein: "worshiped to the point of dogmatic fanaticism by her disciples, and held in utter contempt by her detractors, some of whom did not hesitate to deny her the analyst title." (Kristeva, 2012).
"Manuals for the use of electronic equipment are always more complicated than self-help books" and that "a human is somehow considered simpler than a stereo" (Leader, 2006).
Very few people in the psychoanalytic world hold the depressive position to other people's models → the Judea People's Front Syndrome.
People's Front of Judea Syndrome
Criticisms of countertransference: Practitioners subjectivity as a/the royal road to the patients psychic reality. But this is effected by socio-cultural positioning, power relations, vested interest in a particular model.
Dora, Mr K. and Mrs K. Freud (1905) tells us that Dora’s refusal to accept his interpretations was “an indication of the strength of her repressed love and sexual desire for her father”. Furthermore, following Dora’s resistance, Freud described her as being “incapable of impartial judgement”, and suggested that her “No” signified “Yes”. Freud contended that part of the reason why Dora ended treatment precipitously was because she had become disturbed and excited by thoughts of wanting to be kissed by him. In a later footnote, he acknowledges she might have had feelings for Mrs K not a complex around Mr K.
Criticisms of Countertransference
Power imbalance and 'resistance': damned if you do, damned if you don’t
Concept of 'Ego strength'
Engagement levels (e.g. Giesen-Bloo et al., 2006)
Lost former focus on fantasy, sexuality, trauma, memory, language etc
All diluted to transference, countertransference
Less interest in the history of a patient (in response to false memory stuff)
Enactment seen as bad thing
Moved too much to focus on two body psychology rather than triangulated (I.e mother not father)
Outcome mature object relations and ‘identification with the analyst’. Mental hygeine?
But therapy without the murkiness of the unconscious, sexuality, aggressivity is just too darn NICE!
Systemic attends to the socio-political but less the body, the murky?
Relational Countertransference (to 11:08)
Hidden in Language?
The Real – the body - ‘pure plenitude’; cannot be talked about. More drive.
The Imaginary – where “human self comes into being through a fundamentally aesthetic recognition” (text 1281); with an identificatory image of its own stability and permanence. More demand (including 'mental hygeine').
The Symbolic – language. More socio-cultural and embedded.
Can we ever understand? Can we ever empathise? Can we cure? What is the role of frustration? Whose well?
Lacan's Three Registers
Structures – neurosis (obsessive, hysteric), psychosis (manic depressive, schizophrenic, paranoia, melancholic), perversion
Different solutions to
the Paternal Function
Experience as a Knot of RSI
The baby (with its fragmentary sense of self) identifies with an external image (of the body in the mirror or through the mother or primary caregiver) to have a sense of self (ideal ego).
The Split Subject: experiences fragmentation; sees wholeness.
Work of analysis to deconstruct identifications and to drain symbolic to find a few remnants connected to a 'fundamental fantasy' (kind of like a unique 'primal scene') of which there will be reverberations in masturbatory fantasies/dreams, etc.
The Mirror Stage, Alienation, Aggression
Objet Petit A is the missing lost object, the unattainable object sought in the other. But not a person and can't be. Rather a part object.
The remnant left over when the Real is inserted into the
Symbolic where is the 'jouissance'.
Analyst position themselves as 'objet petit a'. Rarely interpret the transference as want to be addressee.
Part objects for Lacan are: the breast, faeces, phallus, urinary flow + phoneme, nothing, the voice, the gaze.
Desire and Objet Petit A
Winnicott, Bion and Lacan, as mystics, overlap in emphasizing insufficiency in face of who we are and what we go through:
Winnicott emphasizes unprocessable agony, a sense of agony beyond what we can experience, an agony that drives us mad.
Bion emphasizes shattering, explosive force, whether evil force destroying existence, or force of terrifying truth.
Lacan emphasizes inability and fragmentation we fill with imaginary wholeness. In each case, mystical feeling interlaces with insufficiency-excess (Eigen, 1998).
“I didn’t know then that therapy works on an irreparable fracture. When I was young, I still believed it could be corrected.” Eigen interview.
Keep what want and who one is unknown to the patient. Like chess. Until point of 'subjective destitution'.
The Mystic Position: To Keep Desire Alive
Time and Nachträglicheit (or apres coup/deferred action):
'mode of belated understanding or retroactive attribution of sexual or traumatic meaning to earlier events'
the pathogenic effect of a traumatic event occurring in childhood...[manifesting] retrospectively when the child reaches a subsequent phase of sexual development'.
memory is reprinted, so to speak, in accordance with later experience
“Unconscious structured like a language”
Freud's concepts of 'Condensation', 'Displacement' replaced by Metaphor and Metonymy
But Lacanian Clinic really a 'Clinic of the Real' – what circles around the point where language fails.
Trauma and Language
Interpretation – linguistic, dramaturgical
Position of the analyst
Sinthome – jouissance
A Lacanian Practice?
Lacan described a typical neo-Freudian concept of cure as the analyst's imposition of her or his own Desires and symptoms on the analysand, thereby infusing him with "reality" and making him more capable of tolerating frustration. Such a procedure is meant to "strengthen" a weak ego. What really occurs, from a Lacanian standpoint, is a deepening of the patient's alienation from the truth of his or her being. The moi has already been alienated in the Other(A) and in language. Subjugating an analysand to the analyst's ideals merely pushes the moi farther in the direction that has already led to the subjugation to the Other(A)
So less on imaginary (the two bodied lot), but not just language (the systemic). Rather RSI – real symbolic imaginary – orientation.
Not end of analysis as focus just on Imaginary
The Oedipus complex as the Knot, give up something now (enjoyment of mother) to have it later
Psychosis forecloses having to give this up, so identity more stable as has to invent new knot/sinthome e.g James Joyce's writing
Changes to culture may decrease paternal function
Ian Parker, as an example, sees Asylum radical magazine as a sinthomic one.
Zizek's famous title: “Enjoy your symptom!”
End of analysis as focus on Sinthome
Ecriture feminine: coming from 1970s Kristeva, Irigaray, Cixous. Cixous challenged women to write themselves out of the world men constructed for women. She urged women to put themselves-the unthinkable/unthought-into words.
“Almost everything is yet to be written by women about femininity: about their sexuality, that is, its infinite and mobile complexity; about their eroticization, sudden turn-ons of a certain minuscule-immense area of their bodies; not about destiny, but about the adventure of such and such a drive, about trips, crossings, trudges, abrupt and gradual awakenings, discoveries of a zone at once timorous and soon to be forthright” (Cixous, 1975).
Queer theory rather than LGBT etc. But never imposed from outside.
Sinthome and Difference
How can you form a practice that incorporates the key psychoanalytic principles of the unconscious, sexuality and aggression whilst considering the material-discursive backcloth?
Best psychoanalytic practitioners have a loose relation to 'Big T'?
Explore as far and widely as you can in thinking about the human experience and find your own 'formation'.
And then give that up as each and every patient makes you think anew.
Invitation to Enjoy the World of Psychoanalysis!
Why don't we all go Schema then!
The Big Question Mark
The Terrain and Mainstream
Open this by pressing http://prezi.com/ukmsquesnlf2/super-brief-psychoanalytic-timeline/
Look at Fink (1997) and Verhaeghe (2008)
Fakrhy Davids 'A Psychoanalytic approach to Race and Difference' http://baatn.podomatic.com/entry/2012-06-07T00_45_32-07_00