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When thinking of descriptors or key concepts related to psychoanalysis, I suspect one seldom thinks of love. My guess is that sex, aggression or even hate and envy are more likely to register, these being the emotions most ubiquitous in psychoanalytic writing. However, as infant research has grown more sophisticated and developmental research has given us an increasingly more accurate picture of the impact of care giver on both physical and mental health, something like love is stirring among psychoanalytic circles. Elisabeth Young-Bruehl and Faith Bethelards book Cherishment: A Psychology of The Heart reflects just such a trend.
The book is an attempt to redefine psychoanalytic developmental theory through the lens of the eastern notion of "cherishment," or the expectation to be loved. This eastern construct, according to the authors, has been an accepted part of Japanese child rearing (the Japanese word being amae), at least until recent incursions of western technique. This technique involves nourishment or respect for dependence, meeting the needs of the infant so that he can "grow without needing or asking help." The authors illustrate the nature of cherishment by describing a Japanese girl's realization that, despite the difficulty her diminutive grandmother had in continuing to carry the girl on her back, the grandmother continues until the child decides to carry herself. Patients in psychoanalysis, according to the authors, are often people who were never given such unconditional care and, as a result, seek such contact in treatment. Young-Bruehl and Bethelard cite Takeo Doi, a Japanese psychoanalyst and practitioner of Amae Psychology, as an early pioneer of the use of this notion with patients.
In the beginning of the text, the authors trace connections between psychoanalytic constructs that come close to describing amae, namely Ferenzi's "passive object love" and Michael Balint's notion of the basic fault. The authors then carefully compare and contrast Freudian theory, moving chapter by chapter throughout the lifespan. At each stage, the authors illuminate the need for dependence and argue how western culture's insistence on independence creates complications in development. Young-Bruehl and Bethelard pull liberally from their practices, using examples of clients in there care to stress how lack of "cherishment" has derailed their lives and how its use in a clinical context is necessary for change.
I suspect that psychoanalytic practitioners (the assumed target audience) of many stripes will have trouble with the central concepts of the text. Those who favor the reduction of conflict or a move towards greater autonomy as central to mental health will be off put by the emphasis on passivity. Furthermore, suggestions of needing to directly meet the needs of patients will horrify those practitioners and theorists who insist that the therapist maintain neutrality or distance from client needs. There is certainly an at least implicit suggestion that some level of emotional gratification is necessary for the patent to "get better." Such a suggestion is anathema to old guard psychoanalytic thinkers, smacking of Carl Rogers like blasphemy, and might also be heralded as one more post-modern attempt to water down tried and true psychoanalytic insights in favor of touchy feely, pop psychology. This is, ultimately, for the reader to decide.
There is much to recommend in this text. For example, the book is written in an interesting style. While many texts on development and psychotherapy are dry and jargonistic (psychoanalytic books being the worst offenders), this book is composed with a highly informal (no footnotes or references), conversational style that unfolds much like a novel. The reader is allowed a front row seat in the minds of the writers as they struggle with and grow from the very book they are writing. There is a level of tension, much like a mystery novel or thriller, that is created and sustained as the book's conversational style draws the reader in. All these literary devices would seem superficial or clichéd to the serious reader if not for the authors' obvious clinical competence and theoretical knowledge. Despite straying from standard scholarly text, this is not a superficial book. Above all, the book will move the non-professional to reconsider accepted negative notions of dependency and the psychotherapist to reconsider intervention in light of the need for dependent connection.
Dan L. Rose, Psy.D. is a Clinical Psychologist involved in direct clinical work and training at Columbus State University and in private practice. His interests include psychoanalysis, neuroscience, religion and literature.
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