The 2011 national meeting of APsaA in New York City was my first APsaA event. I had a wonderful experience. I was struck by the diversity, the theoretical sophistication and the analytic richness of the panels I have been part of. Before getting into some of the things that I’ve learned, let me describe my experience first.
To be honest, my expectations were shaped by an image of an organization that has troubles putting itself together (of course, these expectations are not shaped my own issues [!]). I go through some of my expectations and see that I was anticipating a different experience. I thought I was going to see a defensive Association, which tries to protect a golden heritage by desperately looking for confirmations from outside. That is, I thought the Association would be heavily inner-focused and would crave for attention from media and advertising. On the one hand, “fortress psychoanalysis” is a powerful stereotype. It is generated by movies, as well as by how critics take apart psychoanalysis’ own defenses. Because of the confidentiality of the practice and its risks, psychoanalysis is desired and reviled. On the other hand, I expected a sort of a struggle for attention, as sometimes kids who are deprived of love secretly desire to become Hollywood stars. I expected a good dose of pathological narcissism. Both attitudes are risks that any organization face. I was expecting them to play a big role in my experience in New York City.
Well, I found a very vigorous and professional body of clinicians deeply invested in the discipline. The clinical work and theoretical debates felt alive and strong. I was surprised to see how many insights from neuroscience, philosophy, postmodernism, and literary studies were part of theoretical approaches to therapy. Intersubjectivists sat at the same table with dissociation scholars, theorists of gender with practicians of sadomasochism, film scholars with professors of English, and feminist historians with philosophers of causality. I loved the panel on Freud’s legacy where the debate was on what to keep from classical theory and what to consider obsolete. I loved the former’s president speech on the citizen psychoanalyst. I think it communicated a powerful message that psychoanalysis has to be felt in the social world, and it has to say things that considerate and true.
In many ways, psychoanalysis has to deal with the legacy of keeping itself out of the world. The very structure of the psychoanalytic encounter makes privacy and confidentiality key for analysis. The private life of an analyst has to be kept out of the public eye for analytical gains. However, these concerns need not to become obstacles for mental health practitioners in addressing social issues. As Prudence Gourguechon pointed out, the time when the analyst is in his / her ivory tower had passed. Psychoanalysis needs to decisively orient itself toward social world, or it is going to disappear. Psychoanalysis learned how to take some risks, and many steps were taken to re-orient psychoanalysis toward the social issues. The influx of psychologists into the Association, and particularly female psychologists, was important. The expensive costs associated with health care insurance companies – and the bureaucratic demands – changed the practices of analysis. The focus on short-term therapy and drugs became a major problem for psychoanalysts who cannot prescribe drugs and who traditionally offer long-term therapies. I believe these elements fundamentally changed the conditions of practicing psychoanalysis.
I generally felt that the Association knows how to navigate the dangers of schizoid withdrawal and narcisstic overexposure. It struck me how open and interdisciplinary the work in psychoanalysis is today. My feeling was that the executive bodies of association are aware that they need to build bridges to academia and general public if they want to survive. At the same time, these bridges did not feel as merely a response to a crisis of credibility, but more importantly, they feel as a part of growing body of psychoanalytic thought.
What would my friends back in Bucharest learn from my observations? I am aware that any advice coming from my position may smell of colonialism. With that risk on my mind, I believe that a few observations are important. First, I particularly liked the feeling of contained environment. By that, I mean that participants could generally express what they experience without being punished for their openness. American psychoanalysis has many factions — and rivalries are part of any national meeting. However, feelings were taking into account, and disagreements were openly displayed. The conflicts seemed to be contained without being resolved or hidden in the closet. For clinical or applied psychoanalysis in Romania, this is an important lesson. The gains of good analysis – the openness, creativity, and capacity to realistically assess one’s own emotions – are psychoanalysis’ critical advantages. They need to be put to work. I remember how struck I was as a member of AIPsA (Asociaţia Interdisciplinară de Psihanaliză Aplicată) by how I felt understood and creative in the association’s meetings. I felt the same way in NYC and I believe this is a major institutional resource.
Second, the other feeling that I had is that psychoanalysis moved from a discipline oriented toward interpretation to a discipline interested in the quality of experience. What do I mean by this? In my first two days as a participant to the clinical sessions, I did not notice an overwhelming emphasis on interpretation in the analytical setting. To the contrary, I felt that the patient and his experience is the most important focus of therapy. In other words, clinicians’ reports of cases were less interested in detailing the relations between the ego, the id and the super-ego, let’s say, and more interested in how patients felt in therapy and what type of relationship they were forming with the therapist. The interpersonal part of the analytic encounter seemed to become at least as important as the focus on the intra-psychic components of therapy. In this regard, the effectiveness of interpretation is supplemented, and even seriously challenged by the quality of listening and the new experiences that the patient / client have.
In terms of theoretical gains, there were two important changes to me. The Freudian mind as a deposit of our unconscious was a revolutionary discovery for science in the XX century. Contemporary psychoanalysis today, I believe, is less interested in the unconscious as a structure of instinctual drives, and more as a relational matrix. Because the theoretical focus changed toward intersubjectivity, mutuality, and the relational features of analysis, the mind is seen as a complex organization of object-relations patterns. A concept such as dissociation explains why the unconscious is not seen as being determined by repression, but rather by phenomena that take place at the level of consciousness. In this new model, dissociated elements are no longer sent to the unconscious, because dissociative self-states act as disruptions in consciousness. The mind itself is organized by dissociative activities, and that leads to thinking about unconscious as a continuous and permanent feature of our relational engagement with the world.
At the same time, a new focus on the analyst’s reactions to the patient / client shows how psychoanalysis moved towards an intersubjective theory. If both sides construct the therapeutic field, then the task of the analyst is to understand one’s own role, as well as his / her participation to the relationship. What does the analyst feel? Who is the analyst among the many roles that the patient chooses for him / her? What are the conflicts as they are experienced in the here-and-now of analysis? What is the function of listening in therapy? The structure of the interpersonal dynamic is, however, not dissociated from the social world. What is the role of gender and class in therapy? How are power dynamics shaping the analytic field? These questions become vital for understanding the patient and for imagining possibilities of an efficient therapeutic intervention.
I want to conclude by making a few observations. Of course, psychoanalysis in Romania faces different challenges and has distinct concerns. It needs to become institutionalized. It struggles with lack of social recognition. It is poorly funded. It is not strongly connected to the flux of theoretical innovation. It struggles to achieve a stronger identity. However, these are also exciting opportunities. To me, the most important lesson is that a re-configuration of theoretical possibilities change the meaning of what psychoanalysis is. It does matter if the analyst is seen as citizen psychoanalyst, part of world from which he / she cannot be removed from. It does matter if a person who produces unconscious dynamics, and not just observing them, does the analysis of the unconscious. It does matter if the patient and the analytic relationship become sometime more important than the rules themselves. It does matter if creativity and spontaneity are the outcomes of the therapeutic alliance. It does matter if trauma is not only worked through by reconstructing events from the past, but also by a good analysis of enactments and interchanges. In other words, what I want to say is that a re-thinking of the psychoanalytic potential leads to important changes in what psychoanalysis actually is. For practitioners in Romania, this is an important thing they need to be aware of.
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Cafe Gradiva - Cultură, societate, psihoterapie este un magazin online de psihologie, psihoterapie, psihanaliză şi psihiatrie şi cu deschidere spre sfera artistică şi culturală, educaţională, socială şi a proiectelor comunitare.
Cafe Gradiva - Cultură, societate, psihoterapie este o revistă magazin online de psihoterapie, psihanaliză, psihologie şi psihiatrie, cu interese în sfera culturală şi artistică, socială, educaţională şi comunitară.