An Incomplete Education
Page 50
And so along came Kohut (the aforementioned president of the distinguished APA) and his “disorders of the self,” by which he meant defects in the sense of inner cohesion and continuity. In his 1971 volume The Analysis of the Self, Kohut straddled two positions: On the one hand, he maintained his allegiance to Freud by holding to the instinctual drive theory and to the conviction that Oedipal issues were central in tracing the origins of the structural neuroses; on the other, he established a parallel path of narcissistic development that allowed him to concentrate on the relationships established in earlier stages of human evolution. In the system that Kohut eventually constructed, man’s search became a struggle to develop a cohesive and integrated self.
With Kohut, we are confronted once again with a baby in need of empathic response, but in this theory, parental figures are referred to as self-objects, signifying that the child is not yet able to differentiate himself from other objects in his world. Like Sullivan, but using different terminology, Kohut saw the child as experiencing the feeling states of these self-objects. The way that self and self-objects interrelate determines whether a cohesive or a fragmented self will emerge.
What the child requires of these self-objects is the mirroring of his capacities; he needs to sense that the self-objects can enjoy his exhibitionistic displays and are present as continuous, nurturing, empathic, and respectful figures. In addition, the growing child needs to be able to idealize at least one of his parents, to feel that the self-object that he’s tightly tied up with is a swell human being. Although it seems simplistic in light of the complexity of interfamily relationships, Kohut sees the self as based on these two polarities of experience—admiring and being admired. Failure to develop at least one aspect, either mirroring or idealization, ultimately leads to a defective sense of self and the inability to maintain a consistent sense of self-esteem, that is, to narcissistic pathology.
Thus Self Psychology began with an effort to bring the narcissistic disorders within the purview of psychoanalysis. This widening of the net yielded a different set of data, largely concerned with relational issues and, since the self-systems of these patients were more primitively organized, a different series of transference and countertransference reactions to deal with. Kohut never completely dispensed with drive theory, although he waffled quite a bit on the subject. But his system, unlike Freud’s and Klein’s, does not rest on a conflict model. Even the Oedipal conflict, the heart of the Freudian matter, is avoidable if the parent-child interaction is a salutary one. Furthermore, Kohut viewed the Oedipal period not in terms of a triad of sexuality, hateful jealousy, and guilt, but as a growth stage in which the child derives joy from exercising new capacities and mastering new challenges. Where Freud saw Guilty Man who fears castration as a consequence of sexual rivalries, Kohut saw Tragic Man whose anxiety lies in the threat of annihilation.
In working with patients who present narcissistic pathology, the analyst initially acts as a self-object, providing the empathic responses that were missing in the patient’s early life, and presents him- or herself as a person who can be, and who will allow himself to be, idealized. Like small children preening before their mothers, these patients look to their analysts as one looks in a mirror in order to see one’s reflection and to bask in a sense of specialness. Or they may adore and experience themselves as merged with these exalted beings, feeling strong and secure as long as this bonding is maintained. Growth occurs largely through experiencing a relationship that supplies what the parents failed to supply, rather than through the power of verbal interpretation. Ultimately, because an analyst is as flawed and as short-tempered as anyone else, the patient begins to view the deity in a more realistic light and correspondingly sees himself and his own capacities more clearly.
The encouragement of mirroring and idealizing transferences sets Kohutians apart from classical theorists, particularly right-wing Freudians who regard the model as far too supportive and nurturant. Although some of Kohut’s theoretical positions resemble Sullivan’s (e.g., the emphasis on the self and on early one-on-one patterns of relationships), his definition of the analytic stance differs markedly from that of the Interpersonalists. The latter are far more likely to address themselves to (and sometimes to trample on) the weeds and flowers that are clearly visible in the garden, rather than the fragile shoots that are only beginning to emerge from the ground. Jacques Lacan (1901-1981): Enfant Terrible
What do you do with the Écrits of Jacques Lacan when you’ve got three years of college French at best and a vocabulary maintained largely from reruns of Breathless? While Lacan’s confrères nudge one another in the ribs and roll their eyes over such Gallic ticklers as his extended verbal play on “Le Nom du Père” (alternatively, God the Father, the father as definer of law, or modestly, Lacan himself as definer of psychoanalysis), its homophone, “le non du père” (the father’s “No!” or the absent father) and its extension, “les nonnes du père” (Lacan’s singularly devoted female disciples), you, mon pauvre petit, stand outside the charmed circles feeling alienated and perplexed.
Reading Lacan requires, along with your degree in the language, familiarity with Freud, Heidegger, Hegel, Sartre, the structural linguists, and the structural anthropologists. And that’s just to read him. Understanding requires a good deal more. It is disheartening, however, after wading through his Stade de Miroir, ferreting out the true meaning of the Other (not at all what you’d suppose), and distinguishing full from empty speech, to learn from Stuart Schneiderman that since Lacan has emphasized the centrality of the spoken word in the analytic cure, his theories cannot be transmitted through the written one. “The only way to learn the correct application of Lacan’s theories to psychoanalysis is through supervision by a member of the Freudian School of Paris” (italics his). So it looks like you’ll also need an airplane ticket.
Basic to Lacan’s theories is his insistence that the unconscious is structured like a language. What exactly Lacan means by this is rather obscure, and his intention is clearly (and this is the only clear thing about Lacan) to keep things that way. It takes a certain amount of chutzpah to take a hypothetical construct and authoritatively define its structure, but Lacan was never famous for diffidence. Any man who can begin the following sentence with the phrase “to put it in a nutshell” is not going to let you off easy:
To put it in a nutshell, nowhere does it appear more clearly that man’s desire finds its meaning in the desire of the other, not so much because the other holds the key to the object desired, as because the first object of desire is to be recognized by the other.
Through his style, Lacan explicates his thesis; that is, through enigmas within conundrums inside rebuses, he demonstrates the quirkiness of the unconscious. Or maybe not.
Lacan highlights the fact, that regardless of the metapsychology of the practitioner, “psychoanalysis has only a single intermediary: the patient’s Word.” He believes Freud’s greatest contribution was an understanding of the way language is structured and a recognition that the unconscious can be reached through the process of free association. But for Lacan, the unconscious is the structure hidden behind the patient’s discourse, since in the process of speaking he moves further away from himself. In the act of describing how you think or feel, you no longer experience what you are describing. The unconscious cannot, therefore, be revealed through conscious speech, but can be tapped into only through “gaps” in discourse: forgetting, misuse of words, slips of the tongue, puns, dreams, etc. Lacan returns to the Freud of The Psychopathology of Everyday Life and The Interpretation of Dreams for the bedrock of his theories.
More poetically, in the words of a follower:
The unconscious is not the ground which has been prepared to give more sparkle and depth to the painted composition: it is the earlier sketch which has been covered over before the canvas is used for another picture. If we use a comparison of a musical order, the unconscious is not the counterpoint of a fugue or the harmonics of a melodic li
ne: it is the jazz one hears despite oneself behind the Haydn quartet when the radio is badly tuned or not sufficiently selective. The unconscious is not the message, not even the strange or coded message one strives to read on an old parchment: it is another text written underneath and which must be read by illuminating it from behind or with the help of a developer.
But what has intrigued Americans about Lacan is not his theoretical formulations, which approach incomprehensibility, but his waiting room, which had something of the flavor of a dentist’s. Also of Grand Central Station. Not for Lacan the ordered fifty-minute schedule of the modern psychoanalyst; his practice was of a whimsical character. He was known to throw a patient out after a few minutes of idle associations, to extend a session according to his fancy, or to keep a patient hanging around all day if this seemed appropriate. A depressed patient might be treated with the consulting room door open (so that the man might remain in contact with the other sufferers in the corridor) for ten-minute sessions at intervals spread out over the day until his despair lifted. Lacanians defend their erratic ways in terms of “logical punctuations,” that is, sessions defined by the needs of any given analysand on any given day. It makes sense, but it’s a hell of a way to run a railroad. CRUMBS FROM THE MASTER’S TABLE:
QUOTATIONS FROM THE WRITINGS
OF SIGMUND FREUD
Analysis almost seems to be the third of those “impossible professions” in which one can be quite sure of unsatisfying results. The other two, much older-established, are the bringing-up of children and the government of nations.
Analysis Terminable and Interminable (1937)
I do not think our successes can compete with those of Lourdes. There are so many more people who believe in the miracles of the Blessed Virgin than in the existence of the unconscious.
New Introductory Lectures on Psychoanalysis (1932)
A culture which leaves unsatisfied and drives to rebelliousness so large a number of its members neither has a prospect of continued existence nor deserves it.
Future of an Illusion (1928)
We believe that civilization has been built up, under the pressure of the struggle for existence, by sacrifices in gratification of the primitive impulses.
Introductory Lectures on Psychoanalysis (1916–1917)
I then made some short observations upon the the psychological differences between the conscious and the unconscious, and upon the fact that everything conscious was subject to a process of wearing-away, while what was unconscious was relatively unchangeable; and I illustrated my remarks by pointing to the antiques standing about in my room. They were, in fact, I said, only objects found in a tomb, and their burial had been their preservation: the destruction of Pompeii was only beginning now that it had been dug up.
Notes Upon a Case of Obsessional Neurosis (1909)
In girls the motive for the demolition of the Oedipus complex is lacking. Castration has already had its effect, which was to force the child into the situation of the Oedipus complex. Thus the Oedipus complex escapes the fate which it meets with in boys: it may be slowly abandoned or dealt with by repression or its effects may persist far into women’s normal mental life. I cannot evade the notion (though I hesitate to give it expression) that for women the level of what is ethically normal is different from what it is in men. Their superego is never so inexorable, so impersonal, so independent of its emotional origins as we require it to be in men. Character-traits which critics of every epoch have brought up against women—that they show less sense of justice than men, that they are more often influenced in their judgments by feelings of affection or hostility—all these would be amply accounted for by the modification in the formation of their superego which we have inferred above.
Some Psychical Consequences of the Anatomical Distinction Between the Sexes
(1925)
A man who has been the indisputable favorite of his mother keeps for life the feeling of a conqueror, that confidence of success that often induces real success.
Life and Works of Sigmund Freud, vol. 1, by Ernest Jones (1953)
One might compare the relation of the ego to the id with that between a rider and his horse. The horse provides the locomotor energy, and the rider has the prerogative of determining the goal and of guiding the movements of his powerful mount toward it. But all too often in the relations between the ego and the id we find a picture of the less ideal situation in which the rider is obliged to guide his horse in the direction in which it itself wants to go.
New Introductory Lectures on Psychoanalysis (1932)
Where id was, there shall ego be.
New Introductory Lectures on Psychoanalysis (1932)
A woman who is very anxious to get children always reads storks instead of stocks.
The Psychopathology of Everyday Life (1901)
Occasionally I have had to admit that the annoying, awkward stepping aside on the street, whereby for some seconds one steps here and there, yet always in the same direction as the other person, until finally both stop facing each other … conceals erotic purposes under the mask of awkwardness.
The Psychopathology of Everyday Life (1901)
When a member of my family complains that he or she has bitten his tongue, bruised her finger, and so on, instead of the expected sympathy I put the question, “Why did you do that?”
The Psychopathology of Everyday Life (1901) FRUITS OF THE MASTER’S LABORS:
FIVE FAMOUS FLIPPED-OUT CASES
ANNA O.: A compendium of hysterical symptoms from paralysis to hydrophobia, famous within the profession as a study in the pitfalls of countertransference, the thing that happens when your shrink starts reacting neurotically to you. Actually, Anna began as the patient not of Freud, but of his colleague Josef Breuer, who abruptly terminated treatment when his wife became jealous, suspecting that the twenty-one-year-old girl was experiencing more than just catharsis on the couch. Breuer was called to Anna’s bedside that same night to find her thrashing about in the throes of false labor, convinced she was pregnant with his child. The next day, Frau Breuer whisked away her guilty, overinvested husband for some extended R &R in New York. Freud later picked up on the “cathartic method” Breuer had been using—more or less successfully—with Anna, and Anna herself went on to become Germany’s first social worker (although no one is quite sure what that fact has to do with her treatment).
LITTLE HANS: A five-year-old who wouldn’t go out of doors for fear a horse would bite him. The case is remarkable because Freud saw Little Hans only once, and treated the boy by proxy through his father. The trouble had started when Hans was three and a half and his mother tried to discourage him from masturbating by warning him—as mothers did in those days—that if he didn’t keep his hands where they belonged she’d send for the doctor to “cut off your widdler and then what will you widdle with?” Little Hans, who was developing quite a fascination with widdlers in general, had not failed to notice that horses had great big widdlers and that his mother had none. Before you knew it, horses, Mommy, and the possibility of castration were all mixed up with his fears of competing with his father. Guided by Freud, Little Hans’ father reassured the boy and was eventually able to help him overcome his phobia, thereby becoming, himself, simultaneously part of the problem and part of the solution. What’s more, Little Hans grew up to be a musician, just like his dad.
DORA: One of Freud’s most famous cases—and reads like a soap opera. Dora, a teenager in the “first blossom of youth,” was sent by her father to Dr. Freud for treatment of various hysterical symptoms linked to a dastardly proposition made to her by a neighbor, Herr K., whose wife, it just so happened, was having an affair with Dora’s father. To complicate matters further, Dora looked to Frau K. as a surrogate mother, since her own mother was too preoccupied with scrubbing and cleaning to pay attention to her family. Dora’s father asked Freud to “bring Dora to reason,” by which he meant keep her quiet. Dora, a spirited eighteen-year-old, listened to a lot of talk about he
r shameful sexual feelings and none whatsoever about the web of deceit she was caught in. After eleven weeks of analysis and two famous dreams, she quit treatment, seriously hurting Freud’s feelings. Still, much later, he realized he’d learned two important lessons from the case, namely, that hysterics tended to reveal an awful lot through dreams and free association and that it paid to mistrust what he labeled the patient’s “flight into health,” a speedy but only temporary improvement in the early stages of analysis. Dora, on the other hand, got considerably less out of her treatment; she grew up to hate men.
THE RAT MAN: Not a sci-ficharacter, head of rat, body of man, but an army officer who became violently agitated when he heard a fellow officer describing an exotic form of punishment in which a pot of rats was overturned on a man’s naked buttocks and left to gnaw their way through the anus. The officer immediately began to imagine this happening to either his father or the woman he loved, and soon he developed a complicated obsessional system to prevent it, despite the fact that his father had been dead for several years and his lady friend was safe at home darning socks. The dénouement of the case involved a lot of wrong turns by both patient and analyst and a good deal of linguistic play on the word “rat,” but eventually Freud helped restore the man to health, in time for him to be killed a year later in World War I. Freud used the case to illustrate the mechanism of displacement and the sadistic anal eroticism that he believed underlay most cases of obsessional neurosis.