Textes & livres
NOTES DE LECTURES
Serge Frisch (ed.) (2001)
London: Karnac, ISBN 1-8555-266-2, 154 pages, price: £19.99
A border dispute between parent and child
When I was asked to review the book Psychoanalysis and psychotherapy I hoped that the dispute between psychoanalysis and psychoanalytic psychotherapy would not be battled out exclusively on the basis of Freud's 'gold' versus 'brass' metaphor. From this compilation by ten well-known authors it is evident that there is far more to be said on the matter.
In his foreword Wallerstein maps out the post-war history of the relationship between psychoanalysis and psychoanalytic psychotherapy in the United States. This history can be traced in terms of the rise and fall of the ego-psychological paradigm put forward by Hartmann cum suis. Its rise resulted in the so-called 'classical' analysis model, which was the sole norm for a long time. This paradigm started to waver when work by authors like Sullivan, Klein, Kohut and Kernberg was published. Furthermore, it was influenced by the application of psychoanalytical therapy. Wallerstein's publications (Forty-two lives in treatment, 1986; The talking cures, 1995) played an important role in the discussion as well. Similar streams arose in North-West Europe at the same time as in the United States. The present collection, with six of the ten contributions by writers from the Romanic language area, illustrates that reflecting on the relationship between psychoanalysis and psychoanalytical psychotherapy has filtered through to Southern Europe and to Latin America.
Frisch (Luxemburg) points out in his introduction that a number of psychoanalysts
showed an interest in psychotherapy from the very start, namely Adler,
Stekel, Jung, Rank, Ferenczi, Alexander and Fromm-Reichmann. They were
usually interested in using it for patients who, in psychoanalysis, ran
the risk of falling into a deep regression. The demand for psychoanalytical
psychotherapy, or modified versions of it, increased enormously in the
period running from the end of the second World War to the oil crisis
in the seventies. This development got underway because medical insurance
policies started to include psychotherapy in their cover; and because
the first psychoanalytic psychotherapy associations were founded, making
it possible to be trained elsewhere instead of only at recognised psychoanalytical
training institutes. Since the oil crisis the controversy has acquired
an institutional, political and financial dimension in addition to the
initial scholarly debate.
Gauthier (French-speaking Belgium) in his philosophically-tinged essay looks into the implicit assumptions made about the time dimension involved. Often the distinction between psychoanalysis and psychoanalytic psychotherapy is brought about by the pressures of time. He wonders whether the principle of an unlimited period of time for psychoanalysis is not based on unfounded idealism. Gauthier fears that the debate about psychoanalysis versus psychotherapy is more like a crusade than a scholarly exchange. For him empirical research is the only solution.
The contribution made by Coles (England), traces her own development
as a psychoanalytic psychotherapist. It is a factual account of trial
and error, of persevering despite the low status this work has in the
psychoanalytical community. She reverses the order of 'gold' and 'brass'.
Brass is stronger and can be used in a greater number of ways than gold.
There are practical reasons for opting for greater frequency. Who, for
example, can keep track of thirty-five patients when they only see them
once a week? Psychoanalytical psychotherapy once a week feels different
from more intensive therapy: more outside events are brought in. At the
start of her career she dearly missed separate training in this sort of
therapy and makes a powerful case for its introduction. In so doing she
offers a counterbalance to Aisenstein's arguments.
When reading Golse's contribution I thought about the fact that the historical
marginalisation of child analysis is somewhat reminiscent of the harsh
way in which psychoanalytic psychotherapy has been treated. Golse thinks
that the problems child analysis are wrestling with may generate new and
fruitful developments for psychoanalysis in general. In answer to the
question as to who should be trained to become a child therapist, he opts
for a pragmatic approach: the need for good therapists must be met, even
if they are not completely trained psychoanalysts. Suman and Brignone
(Italy) attempt to understand why the demand for psychoanalytical psychotherapy
is so much greater than for psychoanalysis. In a postmodern culture people
put absolute truths, ideology and religion into perspective. Scientific
theories can also be added to this list. There are a great number of meaningful
stories and truths all vying with one another for precedence. The postmodern
man is frightened lest the psychoanalyst should be given too much influence
and finds a single weekly session more democratic. If psychoanalysis can
be characterised as 'free-floating' then psychoanalytical psychotherapy
is more selective in its choice of focus - which may in fact change at
each session. This satisfies the expectations of the present-day patient.
I greatly enjoyed reading this interesting book in which a topical theme has been approached from many angles. The contributions are accessible and clearly written. The fact that they sometimes overlap and are based on identical sources in no way detracts from their quality, as this makes it all the more clear to what extent viewpoints converge and diverge. It struck me that characteristic new developments within psychoanalysis, like validation of the support factor, the influence of the analyst as a real-life person, the interactive character of two-person psychology, the active emphasis on the importance of affect, are all elements that have been a matter of course in psychoanalytical psychotherapy practice for quite some time!
Certainly for those involved with setting up joint courses for the various psychoanalytical associations this book is to be highly recommended.
A. de Klerk, is a clinical psychologist and psychoanalyst with his own practice.
last modified: 2004-03-18