Crawling out of the wreckage of psychoanalysis; triumphantly?

There are so many well catalogued reasons to disparage psychoanalytic theory and practice that one might wonder whether those who still defend them are charlatans or fools. If you peruse some recent issues of psychoanalytic journals, you’ll come upon some of the most self-serving dogma you are likely to find outside of fundamentalist religion. In the academic world, most who favor psychoanalysis seem to delight in willful obscurantism. Yet some of the defenders of psychoanalysis are very smart and critical thinkers, who risk professional ridicule by even considering what others take to be a dead and worthless approach to the mind. (Jonathan Lear’s philosophical interpretation of Freud in Love and Its Place in Nature: A Philosophical Interpretation of Freudian Psychoanalysis 1990, comes to mind.) This leads me to hesitate before dismissing psychoanalysis as of only historical interest. Stephen Mitchell’s recent book should give other readers some reasons to also reconsider the virtues of psychoanalysis. Although it has been out for a few years, it seems to have gained little attention, so it is still worth reviewing it now.

Mitchell integrates two views for which others have independently argued. First, there is the empirical side. Many psychoanalysts have moved from traditional drive theory to object relations theory, which emphases the importance of the very early years of the child, and the quality of the relationship of the child with its primary caregiver, (who is generally referred to as “the mother”). Object relations theory has close connections with attachment theory and the integrative work of John Bowlby, in his three volume Attachment, Separation, and Loss . This work has a distinct advantage over other psychoanalytic theory since it is strongly confirmed by empirical studies. Mitchell is also ready to acknowledge the innate differences between babies, which can do much to explain how some people are more resilient to life’s difficulties than others.

Second, there is metatheory, or what Freud called metapsychology. Other psychoanalysts have argued that Freud’s theories need to be reformulated, moving away from his “positivistic” framework inherited from nineteenth century science. Roy Schafer and Donald Spence have argued that psychoanalysis provides narratives, and that these are quite different from scientific theories. The adoption of psychoanalysis in English Departments of universities also helped this move towards hermeneutics, where Freud’s approaches are thought to provide an interpretive device, rather than measurable truth. Once this move is made, complaints about the empirical basis of psychoanalysis (or the lack of such a basis) have less bite. It makes psychoanalysis more defensible, although I also think it makes it less interesting. Maybe it’s the “inner positivist” in me speaking, but I want to find the truth, not more ways to spin out our ignorance. Yet even I have to admit it has been very hard to come up with clear and convincing proof of interesting psychological theories, and until we have such proof, it is worth being open to other approaches.

Mitchell’s enterprise in this book is to combine these two revolutions in psychoanalysis, and look at the consequences. He devotes the central portion of the book to views of the self, multiples selves, true selves, and the sources of aggression. He thinks his approach defuses several debates about the nature of the self which have been founded on mistaken assumptions. Are we intrinsically unified or multiple? Is our aggression innate, or does it only arise as a result of inadequate parenting? Is our behavior authentic or inauthentic? Mitchell doesn’t accept the either/or structure of these questions, and proposes alternative ways to approach these issues. His writing is sophisticated and provocative, and although he couldn’t possibly hope to adequately address in the space of a single book all the previous philosophical and psychiatric literature on these issues, he does at least cover a good number of important psychoanalytic theorists. I know that in the future I’ll return to this philosophically rich part of the book to consider his ideas in greater detail.

The book ends with an examination of the relevance of the first two parts for the treatment of patients. In our era of psychopharmacology, limited session psychotherapy, and questioning of the benefit of long-term therapy, Mitchell’s concerns here seem almost to belong to an earlier period of psychiatry, when there was more time for therapists to analyse the minutiae of their clients’ minds. If one takes seriously the theory, however, one should also take its application seriously. The kind of knowledge it provides does seem distinctively philosophical, and it is hard for me to imagine that the subtleties would make much difference to a client’s overall happiness. But I don’t measure the value of philosophy in its ability to make people more cheerful, so there is still room for Mitchell’s approach to be valuable even in therapy.

It would be too much to say that Mitchell’s book signals the return of psychoanalysis. It’s an institution that is on the way out, but it may yet leave a worthwhile legacy. Some might say that Mitchell has watered down so much in psychoanalysis that it is no longer distinguishable from the ragbag of approaches used by most psychotherapists today. However, his book does draw on a distinctively psychoanalytic tradition, which is not a matter of empirical claims or metatheory, but of sensitivity to conceptual and philosophical issues concerning the self. The psychoanalytic tradition, for all its faults, is richer in its philosophical sophistication than any other approach in clinical psychology. That’s why it continues to hold my attention.

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