Illusions of a Future

The picture is of Socrates drinking the hemlock by the celebrated French painter, Jacques-Louis David. After reading Kate Schechter’s Illusions of a

SocratesDrinkstheHemlockByDavid

Socrates Drinks the Hemlock – Just Like Psychoanalytic Politics?

Future (2014) one has to wonder if psychoanalytic politics have brought the practice of psychoanalysis to a similar result. Psychoanalysis is and remains an intensely personal undertaking. It can do things and get results that no other method of inquiry or treatment  can touch. This book is not a funeral oration nor a report of the demise of the practice (of which there are already a glut in the market). In all probably psychoanalysis will continue to exist as a method (if a military metaphor may be allowed) rather like elite special forces are to the front line infantry. It will also continue to exist (an anthropological metaphor) like a starving band of indigenous Amazon people to whom anthropologists continue to trek for purposes of oceanic experiences without however the need to use mescal or other psychotropic medications.

To someone such as myself who was an official psychoanalytic candidate for awhile – they had no idea who they let in – the first-hand accounts of the colorful characters is what is most engaging reading. However, there is some risk that much of what Schechter has to offer will hit the merely above-average reader as so much psychobabble. A case in point:

As a form of sociality directly exploitable by capital and a form of governmentality geared to controlling a market by bundling enrollment and problematization, the real relationship creates the social bond itself [….] Insurance did not originally underwrite this shift, but it has taken it on board and adapted it, driving these analysts’ impulse to heights of self-valoriztion though, as I’ve shown, (highly theorized) self-devaluation (Schechter 2014: 181).

Huh? Why not just say that insurance won’t pay for psychoanalysis, and, thus, psychoanalysts struggle with their sense of self-worth and contribution to the community? The reason is that one can make devaluing comments that are so carefully wrapped in academic double talk that no realizes how deeply insulting the book really is to the practitioners and institution.

Kate Schechter’s Illusions of a Future(2014) belongs in the tradition of Janet Malcolm’s Psychoanalysis: The Impossible Profession (1980). Each in its own way covers the theoretical disputes of psychoanalysis, the struggles of individual analysts to understand their own profession, and the politics of organized – or perhaps disorganized – psychoanalysis. However, the thirty five years that have elapsed since Malcolm’s statement have not been kind to psychoanalysis. For example, Peter Kramer’s 1991 Listening to Prozac knocked the knees out of all forms of Talk Therapy, and since psychoanalysis was the jewel in the crown, it arguably had further to fall than most. It has. Unlike Malcolm, who is a journalist, Schechter is a practicing psychoanalyst and a member of the faculty at The Institute for Psychoanalysis, Chicago.

For my money, Schechter’s work is a courageous book from a courageous author. Not only does it speak truth to power, it does so with a humane and intellectual rigor. My take is that the work is getting positive buzz around the Institute for two reasons. As Dale Carnegie famously noted, the barber lathers a man prior to shaving him. Schechter applies the lather in abundance. The engaging accounts of colorful characters at the Institute are appealing to a subtle and not so subtle narcissism of the faculty and Institute leadership. Well-published, celebrity psychoanalysts such as Arnold Goldberg, David Terman, Nat Schlessinger, Arnie Tobin, and other thinly anonymized individuals are engaged by the narratives of their roles in the group dynamics of the organization. That the subtext is called out in the title itself – the Illusions of a Future – is excused or perhaps hidden in plain view (see Jacque Lacan on “the Seminar on the Purloined Letter” or Freud on knowing and not knowing at the same time (Freud 1893: 117ftnt)). Schechter’s title is an inversion of Freud’s celebrated debunking of religion, The Future of an Illusion. In Freud’s essay, the illusion is organized religion, a kind of infantile dependency of humans on the ultimate father figure, the old bearded guy, the father figure in heaven. Freud’s conviction is that mankind needs to grow up, especially under the influence of scientific progress and the insights about man’s wounded humanity provided by psychoanalysis. Humans will simply realize that religion is a bunch of fairy stories, which, however, result in devastating religious wars, ignorance, and intolerance. Many things have changed since Freud’s days, but sadly this is not one of them. Man is still a wolf towards man. The implication is that, in spite of great initial promise and impressive results, psychoanalysis itself has become a kind of religious dogmatism, which, in turn, has contributed to the steep decline of psychoanalysis as a profession. Schechter does not much disagree with Freud, who remains a source of inspiration and admiration, but rather with Freud’s would-be followers who have proven to be human, all-too-human.

A case in point. Patients requesting psychoanalysis as the treatment of choice for their personal issues are few and far between. That is, psychoanalysts actually practicing the method of psychoanalysis on patients are few and far between precisely because there are no patients. Zero. If it were not for candidates in training needing to be psychoanalyzed as part of the process of training, psychoanalysis would simply not be occurring at all. Schechter calls this issue “the reproduction of the profession.” In plain English this is called “no business” – the market for psychoanalytic services is kaput. The profession is challenged to reproduce itself – but cannot do so in the face of zero people requesting psychoanalysis.

What may be unforgiveable. Schechter tells it like it is. One wonders if psychoanalysis once again is its own worse enemy. For example, some psychoanalytic organizations run a low fee clinic that make psychoanalytic treatment available to the general public at a reduced rate, for example, $60 a session instead of $150 a session. But when one plays “secret shopper” and calls the clinic about services, then one finds one is speaking, not to a psychoanalytic intake profession but an Extern. This individual is probably an advanced student at social work or psychology school earning further credits. Nothing wrong with that. However, the issue is this individual is not prepared to enroll the caller in the benefits of psychoanalysis, and that is a problem. This individual, even if using psychodynamic methods, is most familiar with cognitive behavior therapy. To be sure, if the caller escalates and insists, “I request to speak with a psychoanalyst,” then she or he is forwarded to one of the psychoanalytic candidates or even a senior colleague if the prospective patient actually has financial resources and is able to pay. A big “if”. The expectation is that if one called the Institute, one would be told about the benefits of psychoanalytic services as a default. Not so. This is yet another source of Schechter’s powerful point about “failure to reproduce”. Why would the psychoanalytic institute be so shy – so passive – so indifferent – in promoting its services? Turns out that the goal of the clinic is to generate revenue [doing CBT?], not promote or propagate psychoanalysis. Whether this is compatible with the Institute’s mission as a 501c(3) not for profit under the IRS code needs to be made an issue for the regularly authorities, which in this case would be a further issue for the IRS.

Most people do not appreciate that Freud published and lobbied in favor of lay psychoanalysis, that is, Freud was in favor of training a variety of professionals in psychoanalysis, not merely medical doctors. For example, these include a lawyer (Hanns Sachs), a novelist (Lou Andres Salomé), educators (August Aichhorn, Erik Erickson, Anna Freud), Talmudic scholar and sociologist (Erik Fromm), a scholar of comparative literature (Otto Rank). Melanie Klein was studying academically prior to the interruption of her studies and her psychoanalysis with Sándor Ferenczi, but she was not trained medically. An astonishing intellect, Klein proposed the innovation that, given Freud’s interest in infant and childhood sexuality, let’s actually talk to some children about how the children feel in the matter. The results were explosive under any interpretation, including explosive conflict with Anna Freud. But when psychoanalysis got to America one its first proponents and translator of Freud, A.A. Brill, took great pains to be sure that the professional training was restricted to medical doctors. Schechter gives a nice account of these group and political dynamics. A major lawsuit had to be mounted by non medical doctors to force the American Psychoanalytic Association to train social workers and psychologists in the early 1990s. The Committee on Research and Special Topics (CORST), which is tasked with training PhD academics, emerged at about the same time, though the Chicago Institute recently [2014] shut down its program.

Schechter narrates a nice history of the Institute for Psychoanalysis in Chicago with all the colorful characters that contributed to making it what it is today. This arguably falls within the realm of Michel Foucault’s (1978) distinction “biopolitics” – that is, the political struggles for organizational power as it relates to the treatment of those suffering from the disorders for which psychoanalysis was considered suitable. However, in another sense, the biopolitical remains the navel into the unknown since in the work in which Foucault promises to engage with biopolitics, he delays and delays, digressing productively from one topic to another, and never gets around to engaging biopolitics as such.

Meanwhile, Schechter wrappers the main dilemma of psychoanalysis – no business except as part of a professional pyramid whereby analytic candidates are required to be psychoanalyzed themselves – in a framework of neoliberal biopolitics, which explicitly references Derrida and Foucault (which I reread prior to writing this review). This is known as explaining the obscure through the more obscure. I will try to clarify.

In Foucault’s Biopolitics, he promises to relate liberalism to the issues of health and well-being that challenge people such as ourselves, living in late stage capitalist economies with unfavorable demographics (an aging population), intermittent financial meltdowns, and stressed-out systems of social support and security. By “liberalism” Foucault means the liberalism to be found in John Stuart Mill’s On Liberty that argues that government governs best which governs least. Such is virtually the opposite of today’s neo-liberalism that presents something like the welfare state as it has progressed in Germany and France up to the late 1970s when Foucault was lecturing about it. Psychoanalysis is further marginalized financially in our own time since insurance companies, to which the power of the purse has migrated, will not reimburse for it, leaving analysts with an integrity issue as they code the analytic sessions as “four times a week psychotherapy.” Nothing wrong with that as such, but there are contentious arguments in psychoanalysis itself about the difference between the psychotherapy and psychoanalysis. One feels a certain dissatisfaction with the lack of solutions. What to do about it? “But your majesty, the people have no healthcare benefits. Then let them pay cash! And then let them eat cake.”

I am sympathetic to the approach to research that talking to people is a powerful form of research. Dr Schechter, herself a PhD anthropologist from the University of Chicago, reportedly performed some fifty interviews with psychoanalysts about their work and profession. The implication is not without its humorous implications. She is an anthropologist doing field research, as noted, not among a starving group of indigenous Amazon peoples, but among the curious tribe of psychoanalysts. Schechter reports that they graciously agreed to be interviewed, but it is not clear to me to what extent the informants provided their informed consent for the use of the conversations. Did they appreciate that their “contribution” would be featured in a framework that asserted that the future of psychoanalysis was an illusion?

As an advocate of psychoanalytic methods, I am persuaded that Freud’s Interpretation of Dreams is one of the great books of western civilization and provides access to levers and mechanisms of understanding and behavior that were indeed fore-shadowed in the Bible, Plato, Shakespeare, and Dostoyevsky but nowhere else explicitly formulated. What some of Freud’s followers such as Heinz Kohut, the innovator behind self psychology, did with Freud is equally worthy of our engagement. However, as with any human institution – think of the Boy Scouts of America, the Catholic Church, Penn State – the challenge is that humans are providing the organizational leadership – or more specifically, the lack thereof. Lest one think this is rhetorical exaggeration and there have not been abuses of power, the instances of You Must be Dreaming about Jules Masserman (Noël and Watterson, 1992), Jacque Lacan’s sexual liaisons with his female candidates (not a Chicago issue but abuse of power none the less (Roudinesco 1993/1997: 387)), and George Pollock (Schechter 2014: 123-131), are all matters of public record. Not unconditionally a bad man and, for awhile, a dynamic and positive force for innovation and growth, George Pollock’s self-dealing and financial improprieties are chilling reminders of Lord Acton’s famous saying. : “Power tends to corrupt; and absolute power corrupts absolutely.” Not only was Pollock’s fund raising “too creative” (Schechter 2014: 15) – to use Schechter’s euphemism – it was also a financial boundary violation of appalling proportions, involving material conflict of interest, self-dealing, endangering the tax exempt status of the Institute itself (Schechter 2014: 126). How the Institute escaped scrutiny by the IRS – the statue of limitations seems finally to have expired – is evidence of the ability of the Institute leadership to work as a group when their backs were to wall.

If your head is spinning after this go around with Foucault, the encounter with Derrida will not necessarily clarify matters. Here Schechter makes one of the few inaccuracies in her account. She quotes Derrida (1998) as saying, in so many words, that psychoanalysis runs aground, ends, in its own resistance to itself. Perhaps. But this makes Derrida sound stupid. Any analysis, including that of psychoanalysis applied to itself, necessarily encounters resistance in moving beyond one’s comfort zone. A more charitable reading of Derrida is that he accurately reads Freud as saying psychoanalysis begins when resistance shows up. As long as the patient is going along, smoothly talking about the issues in his life, the analyst has nothing to do but listen, reflect back, and be standardly human. But when the patient encounters uncomfortable truths about himself, his inauthenticities, and his responsibilities for his own neurosis, then the work of psychoanalysis begins, which in this case, is the work of interpretation. Interpreting the resistance in relation to the patient’s life, is the key to dissolving and over-coming the resistance and allowing recovery to supervene on illness. The comfort zone for psychoanalysis as a profession is that the more tightly analysts cling to the shrinking piece of the pie that they do possess, the faster the shrinkage occurs. The way out of the impasse requires a level of innovation, creation of possibilities, and contribution to the community, that is not visible from within the profession as Schechter describes it. My association is to the comment by Mark Smaller, President of the American Psychoanalytic Association, to the effect that if you want to build your practice, get out of your office. That is, get out and make a contribution to the community – as has Dr Smaller has done and is doing work applying psychoanalytic methods at a local high school for troubled adolescents. To be sure, easier said than done.

The deep debunking, self-inflicted double binds, and appalling lack of empathy of both the current leadership and rank-and-file who buy the party line, are wrappered by Schechter in a post-modern pseudo-anthropological scientism that left this reader gasping at the boldness of the psychobabble. It is also possible that the work is a caricature of itself – making fun of the post-modern deconstructionist movement the way Alan Sokol (1996) succeeds in publishing a paper that shows that gravity is socially constructed. The force of gravity is not socially constructed and functions everywhere in the known universe, including within black holes. Against the unwritten rule of “no telling tales out of school,” Schechter seems to have succeeded in getting the psychoanalytic cognoscendi to “fess up” to a bold statement of the obvious, namely, that the phone is simply not ringing with individuals interested in being psychoanalyzed.With some 40% of the faculty being 70 years of age or more, the Old Guard, who are rapidly approaching double emeritus status and passing from this life, take the position of King Louis XV of France: “It will last my time.”

Still, the psychoanalytic method is so powerful and the results so dramatically impressive when applied with skill, that it is heartbreaking to experience the ongoing stuckness and decline. Making a strong case that she does not have to choose between psychoanalysis and anthropology, Schechter ends up with neither.

Time-after-time Schechter comes around to the self-deception of practitioners claiming to be psychoanalysts while having no single patient in analysis (p. 55), the sense of shame and failure of being professionally marginalized and dispossessed (p. 49), the crumbling social power of psychoanalysis (p. 126), the failure of psychoanalysis to gain a lasting foothold in the university (p. 80), the implosion of psychoanalytic authority (p. 126). Ben Garber, who was reportedly a child survivor of the Holocaust and contributed professionally to setting up a framework for children mourning the loss of a parent, is quoted by Schechter as saying that the colleagues are anxious about being over-whelmed by too many patients (p. 128). Obviously this quotation was from another time and place. Still, Garber’s is a narrative that would be worth hearing and preserving.

Along the way one gets a nice account of the orthodoxy of ego psychology, with colorful characters Max Gitelson and Roy Grinker going at one another (p. 97), and the disruptive innovations of Kohut’s self psychology (p. 133). But that is not the main point of Schechter’s account, as other presentations of self psychology are less wrappered in the burdensome rhetorical framework of a report on field research of the stressed-out state of the discipline in today’s challenging mental health market. The strong suite remains the back story of the institutional dynamics. Perhaps that is what is meant by “biopolitics” after all, in which case it would have been simpler just to say so and dispense with the psychobabble. But then it would have been plain that what makes this work worth reading is precisely the gossip.

Meaningful censorship does not exist in this community, and anyone can publish whatever they can find a publisher to tidy up editorially and print. But some who published debunking treatises such as this one too early in their career found that they had no career. Dr Schechter is already a member of the faculty and perhaps not that interested in teaching any courses anyway, since she is not likely to be assigned any. This is a blessing in disguise, since the stipend does not even rise to the level of minimum wage. The thing you have to realize is that The Institute is not a real school. It has no accreditation with any education accrediting organization and never likely to get any since it would have to be subject to Title IV and Title IX of the Civil Rights Act, requiring levels of institutional reporting, transparency and disclosure with which the conservative leadership in simply not comfortable. In other words, if they retaliate against a candidate, it is a violation of civil rights, but not under the Federal Legislation of that name. The organization is a 501(c)3 charitable organization under the Internal Revenue (IRS) code.

Once again, the strong point of Schechter’s narrative is engaging with the colorful characters in the history of The Institute for Psychoanalysis, Chicago. A case in point: Lionel Blitzsten, described by Stuart Brent in his autobiography The Seven Stairs as the “man with the golden coach,” a take-off on Nelson Algren’s Man With the Golden Arm. Blitzsten did not publish, unlike the founder of the Institute, Franz Alexander, and so remains a quasi-mythical figure. In contract, Alexander published significantly and so is subject to debunking and at risk of being refused by counter-examples, unable to defend himself against misunderstanding since he has passed away.

Schechter documents what many have long suspected. Whether good Freudians or not, the Blitzstenites were not very nice people. The new wave of self psychology that emerged in the 1970s and proposed to treat people like human beings with human vulnerabilities and a personal psychology leads movingly to Schechter’s account that well-published psychoanalysts such as Ernest Wolf, Marion Tolpin, Jerome Beigler, felt the need to have an authentic psychoanalysis after the ordeal of the training analysis conducted by the likes of Blitzsten, Gitelson, and Shapiro. Meanwhile, Tolpin, Wolf, and Goldberg (and others too numerous to name here) were the individuals who championed and carried forward Kohut’s self psychology: “I was appalled by the contempt and lack of empathy he [Gitelson] showed for his analysands” (E. Wolf quoted by Schechter 2014: 139). Speaking personally, I have found self psychologists in short supply. Marion Tolpin has passed away. Arnold Goldberg is a great teacher, but basically his listening is highly inventive for didactic purposes in response to what one says. Wolf and Terman have retired from practice or teaching or both. It seems like there is never a self psychologist around when you really need one.

References

Jacques Derrida. (1998). Resistances of Psychoanalysis, tr. Peggy Kamuf, Pascale-Anne Brault, Michael Naas. Stanford: Stanford University Press.

Sigmund Freud. (1893). “Miss Lucy R, Case Histories from Studies on Hysteria.” Standard Edition of the Works of Sigmund Freud in Twenty Four Volumes, Volume II: 106-124.

Jacque Lacan. (1956/1966). “Seminar on “The Purloined Letter.” In Ecrits, tr. Bruce Fink with Héloïse Fink and Russell Grigg. New York: W. W. Norton, 2002: 6-48.

Michel Foucault. (1978). The Birth of Biopolitics: Lectures at the Collège de France, 1978-1979, tr. Graham Burchell. New York: Picador, 2008.

Barbara Noël and Kathryn Watterson. (1992). You Must Be Dreaming. New York: Poseidon Press (Simon and Schuster).

Elisabeth Roudinesco. (1993). Jacque Lacan, tr. Barbara Bray. New York: Columbia University Press, 1997.

Kate Schechter. (2014). Illusions of a Future: Psychoanalysis and the Biopolitics of Desire. Durham and London: Duke University Press.

Alan Sokol. (1996). “Transgressing the boundaries: Towards a transformative hermeneutics of quantum gravity,” Social Text, No. 46/47: 217-252.

(C) Lou Agosta, Ph.D. and the Chicago Empathy Project

 

Advertisements


Categories: empathy consulting, historical empathy, Kate Schechter book reviewed

Tags: , , , , , ,

%d bloggers like this: