Psychoanalytic
Approach: An Introduction
Introductory
Lecture
Freud’s discovery of the basic model of psychoanalysis can be considered to be akin
to Bion’s concept of a thought awaiting a thinker. It emerged as a distinctive form of understanding of human subjectivity
and relations relevant to the scientific and cultural developments and disasters of the times. It remains unique as a form
of understanding and clinical practise at an individual and a social/group level.
Wilfred Bion is of interest partly because
his life experience involved extreme experiences as suffering at an individual and social levels, which he was able to use
to inform his understanding of social and individual life. Bion’s initial focus of study was borne out of his life as
a soldier, his study of shellshock amongst troops and their behaviour in war situations preceded his study of the individual
and her internal world.
It was traumatic, external necessity that thus led his interest in psychoanalysis,
in relation to his experience of having to manage his reaction to terrifying circumstances. He had since school been very
concerned to manage his own anxiety, and terror in war made this a preoccupation in which he studied what it is that allows
an individual in a group situation to survive and remain able to carry on and lead men. His pre-analytic
answer came through a study of groups, his theory of Basic Assumptions. This knowledge of how individuals
reacted to situations, shaped his interaction with psychoanalysis, bringing his attention to the function of communication,
as well as its content, and to the necessity for an adequate response from the outside to allieviate unbearable internal experience.
He was led then, in both interest and life history from an external focus in relation to early life emotional deprivation,
through extreme and prolonged war trauma, to the internal, and so to Freud and Klein through training with the British Psychoanalytical
Society. We will be exploring different aspects of his experience and discovery in our lectures concerning these different
periods of life experience and discovery, internal and external.
My own training and experience as developed
by the British Psychoanalytical Society, was not very different from what Bion would have recognised; as
it continues to rely on three central strands, personal psychoanalysis of five times a week, theoretical and clinical seminars.
British psychoanalysis had been shaped by the refugees from Europe entering the UK before the second world war, creating
a diverse society which quickly reflected both the creative coming together and stimulation of new ideas, with the contrary
processes of more destructive conflict which resulted in heated discussions known as the ‘Controversial Discussions”.
These were debates
between the main proponents of Klein and Anna Freud and the middle uncommitted group between 1940-1945; during in fact the
years of the second world war.
These helped delineate the approaches and techniques of three schools of psychoanalytic
practise and theory in Britain, The Freudian (Contemporary); Kleinian and Independent Groups. The Groups were in their different
ways all influenced in scientific and personal exchange with European psychoanalysts and societies and informed by the refugees-
including Freud. French psychoanalysis in particular influenced British psychoanalysis in the post war period, particularly
Jacques Lacan and Andre Green, as well as the French School of Psychosomatics.
Current senior psychoanalysts in the Society continue to have international recognition as leading theoretical
and clinical psychoanalysts, including Rosine Perelberg, Gregorio Kohon , Ron Britton, John Steiner, Roger Kennedy, Jonathan
Sklar and many others. Although the Society is no longer divided formally into seperate organised groups for the Training,
most psychoanalysts continue to belong to and identify with the Contemporary Freudian, Independent and Kleinian Groups. These
identifications and specialised understandings and approaches continue to be important identities for psychoanalysts and their
praxis. Schematically, these groups could be said to be approaching the subject of psychoanalysis from different vertices;
Love, Individuation and Hate.
The
groups in the British Society are divided by very real theoretical and clinical difference. The debates centred around the
legacy of Sigmund Freud, and the nature of early development, Drive and Object relation theory. Our Society then does represent
cohesive developed psychoanalytic understanding and techniques; while offering distinct models. Kate and myself are from different
groups, Kleinian and independent/Freudian. However, while we will bring theory from differing traditions; there are certain
essentials -What Bion will try refer to as ‘invarients’-about our positions which you will notice.
These concern aspects of psychoanalytic attitude and approach
in regard to fundamental issues such as the importance of a stable regular setting, the centrality to the relationship of
the analyst and their patient; and attention to how that relationship brings alive the internal world of the patient which
can be understood as it unfolds in relation to the analyst who is taken as an internal object. This process requires the analyst
to be sparing in their personal presence, intervention and behaviour or the internal world of the patient will remain obscured
and lack analysis.
Another aspect of common
ground is the need to commit oneself as an essential participant in the psychoanalytic process, necessitating personal analysis.
Some differences would
concern the operation and understanding of drives, the understanding of the dynamic unconscious in relation to unconscious
phantasy, the centrality of pre-oedipal to oedipal in clinical work, the primacy of aggression, the role of inborn preconceptions
in the infant, and the role of the external world for the psyche.
Of course, we are not able to help you with the central work of a personal psychoanalysis, but we are clear
that it is only within an analytic process that a developed ability to work with unconscious process can be fully achieved.
Supervision and theoretical learning are other strands in establishing a working analytic mind, and continuing to grow, that
are essential elements to being a psychoanalytic clinician.
Being able to reflect on and know about oneself is at the heart of any attempt to understand
ourselves and the world we live in; how we might understand what Freud called the normality of ‘ordinary human unhappiness’,
and how we might help ourselves and others in pathological suffering.
It is human suffering- our own, which brings most of us to develop an initial interest in psychoanalysis. Why
after all would we otherwise find resonance with a complex and often unpopular set of practises and theories which demands
so much of us?
And here we find a key
attitude in clinical psychoanalysis; that discovery and development for humans is about work, work demanded of our minds.
To put it another way, our experience as individuals is one of conflict, between what we want and can have, between what we
want to be and who we are, between inner and outer life.
Psychoanalysis accepts a reality about human life; that it involves suffering and struggle and we learn about
ourselves and others by how we respond to the challenges of life, internal and external. There is no ‘cure’ to
life, but it helps if we can be curious about it and ourselves. This self-understanding helps develop resilience and empathy
for ourselves and others. When the work goes well, it can even result in structural changes within us which can be the difference
between an ordinary unhappy life and a path of misery and despair. Psychoanalysis is not a method of passivity in the face
of struggle, or acceptance through renouncing the bod/desire as in Buddism. Rather, by engaging in struggle with our own wishes,
desires and conflicts, as they become manifest in relation to others, we find our growing awareness makes us the parent of
an unruly child within, more than enacting unknowingly the outcome of rigid compromise with which we keep desire at bay. This
in turn may allow us to accept a new compromise which does not rely on renouncing our desire.
One of the reasons it is so difficult to know about ourselves, is that it brings
us into contact with painful feelings and experiences, including of unmet desire. It also confronts us with the realisation
that our conscious mind is only one aspect of our reality, and that we are in fact alive and subject to internal process which
remain unconscious and have much more to do with our conscious decisions than we find it comfortable to think.
Our lectures will focus on key aspects of the individual’s journey to engaging in life, leading to an
ability to develop a confirmed identity, sexuality and engagement with reality.
The Origins of Psychoanalysis
To take a step back, In societal terms,
this step of self-discovery which Freud’s discovery of the unconscious represents was only possible in certain circumstances.
If psychoanalysis was a thought awaiting a thinker: it was an idea
and new way of understanding ourselves which was pregnant in the culture of
19c Europe and its Judeo - Christian culture and Greek origins. The idea of an individual in conflict with himself,
and then with an external world in society would have had no resonance in societies such as the early Greeks, who did not
have a word or social concept for an individual.
The deposing of religion as the sole
authority for human endevour combined with the massive changes wrought by industrialization had led to
increasing room and possibilities for original and radical thinkers
making great leaps of understanding; individuals representing new ideas who Bion called genius’s or Mystics. Changes in society stimulated advances in thinking which could
link and make sense of the new belief in our control of our external
destinies with internal and intra-subjective reflection on the nature and human drive which exists within and shapes our societies.
Freud did not start with such a grand frame;
he sought to establish himself as a successful medical practitioner with his studies into Hysteria, However, it was indeed
an individual experience of conflictual social forces which led him towards his ‘troublesome’
discovery of the unconscious and psychoanalysis when as a Jew, he was unable to gain professional positions in German society.
In Freud’s time, like Bion’s, that
culture was going through a period of intense social and cultural upheaval. That he could create the foundations of a radical
way of thinking and treating mental disturbance was not despite but because of upheaval which meant that a Jew who shortly
before would not have been allowed to practice medicine, was able to free himself from unconscious assumptions about social
life and the reality of his internal life.
Into this moment in time, place and history of thought, Freud was able to embark on a process of clinical discovery
and work with mentally disordered patients by the application of a process of self-discovery in and through himself and his
patients. His first discovery was to allow himself to listen to patients, what they were really saying to him, without imposing
his supposed medical expertise. It is this curiosity about ‘An-Other’ which Bion was later to see as one of the
most important drivers of mental life; curiosity and the search for a truth emerging out of an investigation into the meaning
of thoughts and actions. For Freud, its greatest fruit was the Unconscious.
We shall see in the lectures on Freud how his understanding developed.
To zoom back in to Freud’s theory;
‘In early Freud, the Unconscious is a
repository of representations engendered by the dynamic conflict between the sexual drive and its repression. The ongoing accretion of displaced and distorted
wishes and impulses inadmissible to consciousness
(both excessive and transgressive).p.77 J. Cohen .
The baby is dominated by the pleasure principle- the need to find representation and discharge
tension arising from bodily based drives. In early infancy, this is a narcissistic and omnipotent
state, where she controls and creates the breast and object of her satisfaction. Memory traces
of pleasure/unpleasure expressed in relation to mother become representatives of the drives/instinctual somatic based wishes
attached to growing realisation about the Other.
When the baby needs
the breast, she hallucinates it. It is only where the hallucination of the satisfaction of desire fails that sufficient demand
is made on the mind to start to experience the absence of the breast/mother and need to wait.
The absence is the true start of the growth of consciousness and the psyche.
The baby hence starts what Andre Green referred to in terms of psychoanalysis as the “Work
of the Negative’, managing the experience of I not I, inside
outside, conscious unconscious, dream/awake.
The growing realisation of the child about the existence of a
relationship to both mother and father, and to the prohibition of her most deeply desired wishes, leads to fears of reprisal,
castration fears, and consequently repression of wishes resulting in the creation of a dynamic unconscious, structuring infantile
sexuality, early expressions après coup- retrospective understanding.
An Unconscious formed in and through the body “The first ego
is the body ego” Freud.
We shall see how, in later Freud,
(the structural model) he recognized that
the unconscious does not coincide with the repressed. The unconscious is made up of both descriptive
unconscious and dynamic unconscious. Ordinary unconscious is being currently unaware of something
and can be ego based. The dynamic unconscious is formed as a result of the conflict
of wishes and desires acting under the pleasure principle coming into conflict with the reality principle- the encounter with social reality
and risk of loss of love. This conflict demands ‘work’
by the mind, structuring the psyche (Id/Ego/Super-ego).
The Unconscious of Freud then is the location of the priemieval chaos out of which unconscious
desires constantly seek expression as
the child develops a mind, building up a picture of satisfaction and memory traces in relationship at first
to Mother.
As these desires approach consciousness and hence become more
disguised and hidden with compromises, they form distinct and individual phantasies, linked to
inherited ‘primal phantasies’ underlying and expressed through object relations. These phantasies become organised and fixed in the
mind as repressed infantile sexuality following the Oedipus complex about the age of four.
The search for pleasure/discharge increasingly comes into conflict with self-preservative
needs of the individual, and the necessity of restraint to obtain
satisfaction from another. Eventually this
requires a major process of repression of infantile sexuality through
the Oedipal phase. The world of ‘His
Majesty The Baby’, with its unrestrained desire gives way to a child able to perceive the needs and existence of m/another,
so allowing the child to recognize realities
of life such as differences of sex, generational difference and loss.
To put this in another way, the infant experiences intense passions, feelings and needs which arise from somatic locations in the body. These drives make themselves
felt as states of tension and unpleasure, which seek expression and discharge and experience pleasure in that relaxation of
tension. The most obvious initial evidence for us of this process is the baby beginning to experience a state of distress before her first feed. She moves her body, searches
with her lips, seeks something.
In Bion’s later terms, a pre-conception
is seeking a realisation through sense impressions. The mouth finds it with the nipple and flow of milk. The feelings of hunger and distress give way to the satisfaction and discharge
of want in the experience of feeding. At a mental level, the drive needs within the body have registered the experience as
traces of memory, associating a path between
certain bodily feelings and feeding. These experiences and building up of mental representations begins to populate an internal understanding and perception of self and other.
Freud’s story of the game of Fort-Da also represents this experience;
where the child throws away a cotton reel (Mother) saying ‘Gone’, and retrieves it saying There’. Gregorio
Kohon takes this moment as the start of every psychoanalysis when the patient first lies down with the analyst out of sight
of her. It is only then that the analyst dissapears
as an external other and becomes present in the patients mind. By disappearing from conscious
perception, the patient is allowed room to elaborate unconscious and internal phantasies about the analyst as an internal
object.
The period of original discovery of the mother/other/ideal completeness of satisfaction is never
repeated. It is an original experience of the Other which from then on the baby seeks to return
to, but from now on which she does not fully experience as appearing and being complete satisfaction.
From the original moment on, we become in the presence of the lost object of love.
These demands on the mind
are of two kinds, both the need to represent unconscious drives to achieve satisfaction and growing ego requirements to interact
with an experience of an external world which makes its own demand for the baby to wait, modify its pleasure demands and interact
with another. For Freud, the external world is hated by the infant as Other.
The first years of life
to Freud are the building up of the representations and increasingly complex internal world and experiences dominated by the
pleasure principle in relation to the
reality principle.
The child, emerging from primary narcissism, becomes gradually more
aware of mother, then others, including father who as
paternal third object who in the pre-oedipal stage mediates the relationship with mother, and to whom a separate awareness is developed towards the Oedipal stage.
In Freud’s
case study of Little Hans we find the
young child who is master of his world, with access to desires and curiousity , exhibiting what in an adult might be seen
as complete polymorphous perversity in which the aims of his libidinal
drives have no fixed object- anything goes if it brings pleasure (adult sexual forepleasure is
consequently a return to
the world of infantile polymorphous sexuality where desire is transgressive
since it is linked to what has been repressed in the Oedipal phase.).
However, the demands of
the Oedipal family and social life now impress closely on Hans experience. His wish to know, own and have mum is conflicted
with his love for and the authority for his father, which in consequence exposes him to experiences of hate for his father.
Castration anxiety, as a fear of the father’s punishment for the Oedipal crime of wanting to take mother initiates
the Oedipal crisis for the boy. With the girl, it is the realization of castration that turns the girl from her mother. The
castration or loss experienced here is about the original assumptions that all children have of being the same, of having
the ‘thing’ which mother wants. For social, cultural and biological sex reasons, this is represented for children
in the actual possession of a penis, although what that represents is not a penis. For both sexes, it is not a question of
one being inferior or superior, rather that of difference; neither truly had the ‘phallus’- the object of the
Other’s desire. Both sexes relate to an absence, a lack, an inability to be the ‘thing’ that mother desires
which goes beyond them. (G. Kohon)
The Oedipal situation then, which remains at the heart of Freudian
psychoanalysis, is the moment of the coming together of internal libidinal life and drives, the
culmination of developments under the pleasure principle, the experience of satisfaction and desires which are unrestrained
by external reality. It is the individuals path through that profound experience
of having to accept limitations and the full arrival of reality which structures the mind and
produces the dynamic unconscious.. It is now that this structuring
demands of the child choices and the fixing of object choices, as male and female, hetro or homosexual,
accepting the differentiation of generations. (R. Perelberg)
The dynamic unconscious is the result of the structuring of the
mind which , Apres Coup, or retrospectively structures the bodily
experiences of drive representation. It is formed by the repression of unacceptable and life threatening impulse and desire;
ensuring that the dynamic unconscious is composed of infantile sexuality or repressed desire.
This means that from now on, desire will be linked to transgression, and unfullfillment as the child gives up some libidinal
demand to accept civilization.
In Freudian theory, This great divide of retrospective structuring
means that the pre -oedipal baby is not
open to direct expression. It is only accessible through its re-construction in the transference
which form a retrospective meaning.
The
original experience of the object is a fact of life; if an adult has not had a good experience of a maternal early object,
she will not be able to create that experience or
be re-parented in analysis, rather that that loss and its consequent meaning for her development and life are what will be
worked with, with retrospective structuring able to make changes which help in the managing beyond the early lost object.
Freudian theory then remains
a theory with psycho-sexuality and the dynamic infantile sexuality
of the unconscious and its later representation in phantasies of transgressive
repressed object relations in the internal
world that are at the heart of its understanding and clinical practise.
The father, or paternal third is present and central to the Oedipus complex. Transference emerges as a repetition and emergence of dynamic fixation, trauma under the repetition compulsion. The primary experiences with both parents have formed the
internal world and it is the psychosexual fixations with aspects of these relationships which
are returned to in the transference relationship with the analyst, who is experienced as the threatening father or perhaps the seductive frightening
mother.
These are central difference
from Bion, and Klein, whose world is that of psychotic and primary experience, pre-oedipal and infantile where an initial
differentiation of self and other is assumed to be an existing preconception. With Bion’s development, the primary,
terrifying infant world develops and is ameliorated by the receptiveness of mother, setting the scene for an internal world
of phantasy which determines the infant’s subsequent perception.
Psychoanalysis is a process of discovery with a psychoanalyst which can help people to
become more completely who they are, with greater freedom to make choices and so to manage their lives more effectively.
It offers a way to understand and address problems through an encounter and focus with unconscious as well as conscious process
within the therapeutic relationship. The process develops increasing awareness of the way the inner world is experienced as
reality and forms the assumptions and repetitions behind every day behaviour.
Alone, it can feel that it is only possible to manage problems, intense anxiety and external and internal relationships
by keeping awareness of the difficulties and how much conflict and disturbance they create out of mind, often in such a familiar
way that it is not perceived as a partial perception. This may give some short term relief, but in the long term where familiar
defences and ways of being have become rooted in misrecognition, they continue to have an important effect on feelings and
behaviour, and lead to repeated destructive ways of being in personal relationships and creative life.
The Psychoanalytic approach is based on the understanding that our minds are formed in and through
early experiences and responses to internal wishes and in how our present struggles in turn shape our understanding and perception
of our histories and relationships, much of this working outside of our consciousness.
The relationship with the psychoanalyst develops within a structure allowing both conscious and unconscious thoughts
and wishes to be expressed within the safety, privacy and confidentiality of the analytic setting. Awareness of how unconscious
life and inner beliefs keeps determining our lives emerges in a live way with the psychoanalyst in a way in which they can
be understood, bringing real change.
Key Concepts
The Dynamic Unconscious:
Freud's model of the mind in which primary unconscious wishes and phantasy exist and are maintained in repression
apart from conscious thinking and self perception.
The Negative: The impression of the arms of
mother on the infant in her absence; the role of lack, absence, other
Drive: The life instinct,
expressed primarily in and through the body and expressed in sexualityand creativity
The
death Drive: experienced in its derivatives and tendency to turn away from life and sexuality and creativity.
The Body: The first self is a Body Self; drive, the mind is a physical reality
The
Environment: There is a constant exchange between inner and outer. The work of psychoanalysis concerns and invokes primarily
the inner world, but never in ignorance of the world in which it is experienced.
Representation:
The language of the internal world and the body and its representation in movement and thought
Journal Papers: W. Gibson
Journal of the AmericanPsychoanalytical Association:
'Candidates Experience of Training: Between Creativity and Paranoia"
International Journal
of Psychoanalysis: 'Independent Psychoanalysis" Review
International Journal of Psychoanalysis:
'Reading Bion" Review