by Judy Jones
Originally, Freud postulated a life-preserving instinct and a sexual instinct. After World War I, he turned his attention more fully to the problem of repressed aggression. This gave rise to his second instinct theory, the conflict between Eros, the life-preserving instinct, and Thanatos, the death force. Both aggression and the compulsion to repeat events are, in complicated ways, related to the death instinct. Since man strives for a homeostasis in which tension is minimal, death would be the ultimate relief of this tension.
Today, while Freud’s biomechanical view of human functioning has been seriously (and continually) questioned, his method of psychoanalytic inquiry, his concepts of transference, repetition, and resistance, and his theory of unconscious experience remain the cornerstones of the analytic process. FIVE FOLLOWERS
Psychoanalysis was—and is—a rigorous undertaking, but its rigors are not exactly what they used to be. Freud saw the same twelve patients every day, six days a week (and then wrote late into the night); present-day psychoanalysts, more pleasure-seeking and self-preservative, will see a patient only three to five times a week (and then sit down to dinner). On the other hand, analyses were more compact in those days, extending from six to twelve months, rather than six to twelve years, perhaps because the array of symptoms, from hysteria to obsessional neurosis to phobia, were more amenable to treatment than today’s vague anxieties, characterological issues, and “disorders of the self.”
Then there are differences that now exist between analytical schools; between, say, the Interpersonalists, who maintain that they contact the “unique individual” rather than the Freudians’ “Oedipal cliché,” and the Freudians, who accuse the Interpersonalists of not dealing with unconscious experience. To add to the tension, there are even theorists who point out that only a masochist, a social isolate, or a nut would accept a stranger’s invitation to lie down on his couch, turn your back to him, and spill your guts while the stranger says nothing in response.
There’s nothing new about such dissension; it’s known in science as pluralism, and it’s been characteristic of the psychoanalytic movement ever since Alfred Adler challenged Freud in 1910 over the relative importance of the sexual drives. Adler viewed the core problem as man’s struggle to overcome feelings of inferiority (he coined the phrase “inferiority complex”) and saw the “wish to be a complete man”—in the face of physical handicaps and environmental conflicts—as the guiding fiction behind every neurosis. Moreover, unlike Freud, who regarded society as a limitation on the individual, Adler came to see social interaction as essential to mental health. Freud, never one to take kindly to dissent, showed Adler the door (and would later refer to him cuttingly as “Dr. Alfred Adler, who was formerly an analyst”).
Next to exit was Carl Jung, who also objected to Freud’s heavy emphasis on sex. He saw man as influenced by higher forces (in his emphasis on a collective unconscious and his heavy use of symbolism, Jung could get pretty mystical), which conflict with his animal nature. Libido was regarded as a general life force, sexual in origin, but no longer reducible, in adulthood, to its sexual components. Jung developed a theory of character based on two fundamental personality types: the introvert who is absorbed in his inner world, and the extrovert who turns outward at the expense of private experience. For Jung, the overriding goal was always the achieving of a harmony between the conscious and the unconscious; that alone could make a person one and whole. Moreover, he argued that neurotic symptoms were not always the residue of an unhappy childhood, as Freud maintained, but were often attempts on the part of the mind to correct its own disequilibrium, and therefore could serve as pointers to a more satisfactory synthesis.
And that was just the first generation. The following pages concentrate on subsequent generations of rebellious, argumentative, and lapsed Freudians who, together, have effectively challenged the Master’s view of what psychoanalysis is and what it ought to (and can) accomplish. Melanie Klein (1882-1960): Hypothesis on Hypothesis
If prospective parents were to read Melanie Klein instead of Benjamin Spock, there would be a lot fewer babies. Klein’s writings, if understood, would probably rival the pill as the most effective form of birth control yet devised. For to bear a “Kleinian baby” is to bring a potential cauldron of destructiveness and hate into the nursery, a child whose fantasies rival, in greed, malevolence and envy, those of Stephen King, Edgar Allan Poe, and the Marquis de Sade.
Briefly, Klein subdivided the first year of life into two phases; the paranoid-schizoid, in which the infant relates to anatomical parts of persons, chiefly the breast and penis; and the depressive, in which the mother is recognized as a whole person who can therefore be destroyed by the child’s own hatefulness. In essence, the infant is capable of constructing elaborate phantasies (Kleinians use the ph spelling to express their extension of the term to the imaginings of the infant) about the good breast, which nourishes and is loved, and the bad breast, which deprives and is consequently destroyed. Don’t even ask about bottle-fed babies; things are complicated enough already. Under the impact of anxiety and frustration, the child’s desires and phantasies extend to the mother’s entire body, which is seen as containing all kinds of goodies, including the father’s penis, incorporated during intercourse. Klein writes, “The dominant aim [of the baby] is to possess himself of the contents of the mother’s body and to destroy her by means of every weapon which sadism can command.”
Meanwhile, the infant tries to incorporate enough good objects and substances to neutralize the bad objects and substances in his own body. There is a Jungian, as well as a Dracula-like, feeling to all this, an acceptance of some primordial, racial unconscious. The newborn enters the world with an innate sense of the existence of the mother and the contents of her body. Klein’s babies live in a doggie-eat-doggie world in which punishments for destroying the bad breast or emptying the good one are anxiously anticipated. To survive in this jungle, the child wards off the dangers of the bad objects and feelings by “splitting” or separating their images from the good objects and feelings. As if this weren’t bad enough, even the “good” is contaminated by primitive forces of envy, stirred up by the fact that the appearance and disappearance of the milk-laden good breast is controlled by the mother and not by the child. To add insult to injury, bad objects seem even more malevolent because of the hatred projected onto them by the rageful, greedy child whose needs are insatiable.
This takes us up to the second half of the first year (although it might seem that a lifetime has already been lived) when, if all has gone well, the paranoid-schizoid position is superseded by the depressive position. The outstanding feature of this position is the unification of the mother; no longer safely split into good and bad entities, she becomes a single person with both good and bad features. Integration, naturally enough, brings with it despair, since the good features of the mother are now no longer protected from the child’s destructiveness.
Klein took Freud’s death instinct and his theories of aggression and ran with them, adding her own view of envy as a biological given. The environment contributes little, but, like a mirror, reflects the baby’s own conflicts back on him. Klein did not concern herself with parental defects and sufferings; she concentrated solely on the child’s destructive urges and regrets. In this, she differed from Sullivan, Karen Horney, Erich Fromm, and Erik Erikson in America, as well as from W. R. D. Fairbairn and Donald Winnicott in England. What she accomplished was to focus attention on the earliest stage of human development, before the Oedipal conflict comes into play Although she retained Freud’s drive model and his id-ego-superego terminology and regarded herself as fundamentally orthodox in approach, there is little of Freud’s psychophysiology in her schema. Instead of regarding drives as discrete quantities of energy, she redefined them as passionate feelings of love and hate. She saw human life as an intense dramatic tragedy that has its roots in the infant’s constitutional makeup. In this framework, the Oedipal conflict becomes more a wrestling for pow
er and destruction than a struggle with libidinous impulses. Anxiety and guilt stem from aggressive phantasies and fear of retaliation.
Klein’s work split the British Psychoanalytic Society into two factions, one loyal to her, the other to Anna Freud. Others, like Winnicott, formed a third, nonaligned group. Although Klein’s views are unverifiable, the recent emphasis on the importance of pre-Oedipal life in the understanding of borderline and narcissistic disorders has lent more credence to her theories. Harry Stack Sullivan (1892-1949):
Things Are Often What They Seem
After all this meta-messing, Harry Stack Sullivan, a native American of the what-you-see-is-what-you-get school, comes as a relief. For Sullivan, what you see (and get) is all bound up with how you participate: We can know another person only in terms of how we interact with him. Where Freud concentrated on what went on within the psyche of the individual, Sullivan focused on his relationships with others.
For Sullivan, the data of psychoanalysis—the behavior of the analysand and the analyst’s public and private reactions to what the patient says and does—are there to be directly observed; excluded are all hypothetical events occurring in some never-never land “inside” the patient, not to mention the unconscious as an explanatory concept. Thus Sullivan, along with Clara Thompson, Karen Horney, Erich Fromm, and Frieda Fromm-Reichmann, spawned a new psychiatric movement in America, based on how a person makes sense of and responds to what is going on around him, rather than on the biological-drive that is the pillar of Freudian theory. In other words, to understand the individual, one must understand the network of relationships in which he is enmeshed; one must pay attention to the “interactional” rather than the “intrapsychic.”
What really interested Sullivan was why people failed so badly at living productive and creative lives and, instead, stereotypically repeated the same unsatisfying actions. Perhaps influenced by the insecurities and privations of the Depression, Sullivan pared down his motivational system to two basic needs: satisfaction (both biological and emotional) and security (which he viewed as the avoidance of anxiety). The search for satisfaction inevitably propels a person toward involvement with others; Sullivan thought loneliness was the most painful of human experiences.
Like Klein’s child, Sullivan’s develops notions of “good” and “bad,” but Sullivan saw these impressions as linked to the actual responses of the mother, not as derivatives of the fantasy life of the child. Sullivan’s good mother is the nonanxious mother; his bad is a nervous or timid soul who empathically communicates her distress to the child, who then gradually learns to modify his behavior in order to modulate Mommy’s anxiety. Of the child’s introduction to the world of malevolence and mystification, Sullivan wrote, “Once upon a time everything was lovely, but that was before I had to deal with people.”
Sullivan came up with the Self System, that configuration of traits that have been reinforced by the affirmation of the significant persons in the child’s life, and the security operations the child develops in order to avoid anxiety and threats to self-esteem. Three areas are delineated: the “good me” (Mommy’s smiling and not all wigged out and I feel pretty good too); the “bad me” (Mommy’s feeling anxious and cross and I’m not feeling too cool either); and the “not me” (she’s flipping her lid and I’m shaking from head to toe). If Sullivan had raised children instead of cocker spaniels, he might have added the category “who me,” as in “Did you glue all your underwear together?” “Who, me?” But he didn’t. And he didn’t.
The Self System acts as a steering mechanism directing the child toward experiences that are associated with parental approval and freedom from anxiety, and away from ones that have met with disapproval and are subsequently blocked out of awareness. From all of this arises a pattern of I-You interlocking behaviors: If I act weak and helpless, then You, like my parents, must be solicitous and care-taking. If I am adorable, You must be admiring, and so on. Sullivan labeled these pairings “parataxic integrations”: They become rigidified and dominate adult life, sometimes almost completely overlaying one’s perceptions of the real people in one’s life, who, stripped of their individuality, are seen as echoes and shadows of parental figures. Donald W. Winnicott (1896-1971):
The “Good-Enough Mother” of the Year
Winnicott is every reader’s fantasy (with an f) of all that a good mother should be. Few practitioners could engage the heart and mind of a child so directly, poignantly, and emphatically as this psychoanalyst, who had spent forty years as a pediatrician. (This nourishing holds true for grown-up children as well.) As for the mystique of psychoanalysis, Winnicott once wrote, “In doing psychoanalysis, I aim at:
Keeping alive
Keeping well
Keeping awake
I aim at being myself and behaving myself.” Good advice in any ballpark. Like Spencer Tracy, he knew his lines and didn’t bump into the furniture.
From Winnicott’s perspective, man’s core problem lies in his struggle to arrive at an existence which is his and his alone but which, at the same time, allows for intimate contact with others. Intimacy, however, is an inherently limited affair. “At the center of each person is an incommunicado element, and this is sacred and most worthy of preservation. This core never communicates with or is influenced by the external world.”
Life begins not with the infant but with the infant-mother pair, with the crucial developmental factor being the currents of empathic understanding that flow between caretaker and fledgling. It is the responsibility of the former to mediate between the inner world of the child and the environment about him. In plain language, she’s got to help him to feel safe, for whether or not the child develops a real self will profoundly affect the nature and state of every problem the adult experiences. The mother must initially be exquisitely attuned to the physical and emotional needs of the infant as if an invisible band stretched between the two of them. She must respond when called and refrain from impinging when not needed. In such an environment, offered continuous nurturance, the infant enjoys a seemingly omnipotent position, in which whatever he imagines for himself is followed by the mother’s presentation of the desired object. He is the source of all creation and can, through the magic of hallucinating what he wants, will his own satisfactions. Given this sunlit enchantment, he gradually becomes able to tolerate longer and longer separations from the mother without experiencing the terror of annihilation. Ultimately, he develops the capacity to be alone. Later comes the capacity for concern. Concomitantly, the mother awakens from a period of “maternal preoccupation” and begins to note with some astonishment that the world continues to function beyond the walls of the nursery. Bliss has ended.
Motherhood in this framework of empathic bonding is a hard row to hoe. Myriad pitfalls exist, predominantly linked to failure to respond to the infant’s hallucinatory experiences (need to nurse, be caressed, be comforted, etc.) or to too much interference or overstimulation when the child would prefer to be alone, staring at the ceiling. The mother must be able to contain both the child’s dependency and the aggressiveness that is an inevitable accompaniment to the process of separation, without becoming overwhelmed or fighting back. She must also be able to respond to his need to play.
In the worst-case scenario, the infant becomes compulsively attuned to the needs of others, primarily the mother, and in order to survive, develops what Winnicott terms a “false self.” The “false self” contacts and complies with the directives of others, while his “true self” becomes dissociated, goes underground, and protects itself by remaining hidden. The psychoanalyst must provide what the parents failed to offer, a holding environment that is durable, attentive, and responsive, a symbolic re-creation of early mother-child interaction but not an actual regression to the patient’s early years. And, like the “good” mother, he must be able to survive the inevitable assaults of the analysand without being annihilated. In this safety, the patient’s true self can emerge. Heinz Kohut (1913-1981):
Over and over the wheel must be invented. Although it is obvious that psychoanalytic theories overlap, they are promulgated as if they have sprung fullblown from the heads of their creators, products of parthenogenesis and not of union.
So it is with the concept of empathy, pretty much derided when touted by Carl Rogers (nondirective counseling) or Franz Alexander (corrective emotional experience). It was viewed then as a surface phenomenon, secondary in the therapeutic bag of tricks, soothing and supportive but hardly such stuff as psychoanalyses are made of. But in the last decade, empathy has had quite a revival; given clout and respectability by a former president of the American Psychoanalytic Association, it now gets star billing.
What has created all this furor is the spread of borderline and narcissistic personality disturbances. Modern patients suffer from wounded self-esteem, shift rapidly from adoration to abhorrence and from grandiosity to despair, and are far more fragmented and eruptive than the hysterics and obsessives for whom the psychoanalytic method was devised. Until recently, they were considered to be beyond the pale of insight-oriented psychoanalytic treatment. But lately there has been a rush to modify technique to embrace this more disturbed population; you can hardly find a conference that does not focus on the problems of treating the “difficult” patient. Cynics might remark that the psychoanalyst had either to widen his scope or take down his shingle since the popularity of other forms of treatment (psychotherapy, behavior modification, encounter groups, and medication—not to mention step aerobics and video rentals) has made the intensity, duration, and cost of psychoanalysis far less appealing. Where psychiatry was once a highly regarded medical specialty, it is now far down on the preference lists of medical students.
