What’s up with psychoanalysis lately? I’m not all that involved any more in organized psychoanalysis, but I do hear and read a fair amount about what’s going on in my own and others’ local analytic communities. And what I’ve been increasingly hearing about are the ways that patients being presented in case conferences or to visiting experts are invariably deemed sicker than the presenting analyst thought or than appears to meet the eye. At least in some psychoanalytic communities, there is an increasing emphasis on the psychotic aspects of the patient (and sometimes the analyst). Whether an analysis seems to be going well or not, the trick seems to be to locate some difficulty in unrecognized aggression or primitivity in the patient.
I doubt very much that people—our patients—are actually getting more aggressive or crazy over time, so this is likely a turn in theory and not in the patients coming to us for analysis. I also doubt very much that these newer “interpretations” about patients attacking their analysts’ minds, or not really having minds capable of symbolic thinking, or otherwise functioning at primitive levels has actually increased the efficacy of analysis, something that might be expected were our understanding of our patients actually any more accurate.
So, what we likely have, instead, is a turn in theory, reflecting, at best, a new appreciation of hitherto underemphasized aspects of mental life, and, at worst, a new language and conceptual apparatus for the same old things that analysts have always seen and worked with. Either way, while possibly of some intellectual interest, I have my doubts about whether such a trend reflects an advance in analytic theory or in its therapeutic efficacy.
My own view is that the emergence of new languages and paradigms like this might be explored more fruitfully from the point of view of the sociology of knowledge. That is, what is happening inside and outside our profession that might make this theoretical turn seem more “correct” and compelling to its practitioners? Professions (notoriously) don’t do very well at looking at themselves as historical or social actors and psychoanalysis is no exception.
So, here are some of my (admittedly speculative) inferences about the sources of the appeal of this renewed interest in the primitivity of mental functioning among some psychoanalysts:
Or let’s not… but why get darker or crazier than Freud?