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8 Comments on the Development of a Psychoanalytic Technique
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Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Psychoanalytic Inquiry: A Topical Journal for Mental Health Professionals Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/hpsi20 Comments on the Development of a Psychoanalytic Technique Michael Shulman Ph.D. Published online: 05 Jan 2012. To cite this article: Michael Shulman Ph.D. (2012) Comments on the Development of a Psychoanalytic Technique, Psychoanalytic Inquiry: A Topical Journal for Mental Health Professionals, 32:1, 79-86, DOI: 10.1080/07351690.2011.553167 To link to this article: http://dx.doi.org/10.1080/07351690.2011.553167 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the Content) contained in the publications on our platform. 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Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms- and-conditions Psychoanalytic Inquiry, 32:7986, 2012 Copyright Melvin Bornstein, Joseph Lichtenberg, Donald Silver ISSN: 0735-1690 print/1940-9133 online DOI: 10.1080/07351690.2011.553167 Comments on the Development of a Psychoanalytic Technique Michael Shulman, Ph.D. The convergences and divergences in our techniques across analysts are, to me, the most fascinating phenomena in the eld of clinical psychoanalysis. Although I assumed, before my psychoanalytic education, that Id be learning about a standardized and monolithic technique, Ive actually found much more divergence, and so I have become particularly interested in considering the how and why of divergences. THIS TECHNIQUE, THAT TECHNIQUE? There have always been recommendations that seem like guides for technique. Some are old like Fenichels recommendation for the movement of interpretations from surface to depth some newer: Gray, Busch. Has technique evolved into a clear method, though, one that dictates to the analyst how to proceed? I dont think so, and I will say in the following what I think are the good reasons this is never going to happen. But I note at the outset that, in my experience, even if a group of analysts self-identify, along with Busch and Gray, as ego psychological, there is no consensus among them that Buschs and Grays close-process monitoring technique is the only ego psychological version of psychoanalytic technique. The idea of a named techniquethis one, versus that oneto which an analyst subscribes is to my ear an archaism. Although close-process monitoring is an inuence of some prominence and is sufciently delimited to merit being identied as a technique, its more or less the only one with a name these days. Most analysts that I know dont have a name for their technique (unless it were to be everyones private name for what they do as analysts, like The Right Way to Go). I believe that the real underlying problem for our understanding of technique is that, even if we subscribe to similar adjectives to describe our psychoanalytic theoretical orientation or preferred vision of mind, and even if we train in the same institute, we each make different analyses, and we dont have good ways to describe, let alone to model, howand why this happens. In the absence of such ways of describing and modeling difference, at least at my institute and at national meetings, however, analysts within a group go on talking as if they all believed they were trying to do some ideal right thing. In the absence of fuller dialogue about what makes our differences, and in the absence of ways to conceptualize and to model these differences, an imagined unity of technique, the notion of a striving toward an ideal proper technique, seems to exist. Certainly, analysts are known to point to others of different groups, or who they feel have gone astray within their own Dr. Michael Shulman is Faculty, Michigan Psychoanalytic Institute; Department of Psychiatry, University of Michigan and Department of Psychology, Madonna University. D o w n l o a d e d
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80 MICHAEL SHULMAN group, to complain that these enemies, or misguided colleagues, are no longer doing more or less the right thing; but the difculty to which I wish to draw attention here is not this disdain for the Other, for bad analysts, but the power of the illusion of a unity around a presumed proper psychoanalytic technique and its presumed more-or-less identical optimal results. Within groups of analysts, in other words, I have heard a lot of pretending to an identity, a unity, on the score of technique or the common clinical method which does not exist, but is continually assumed to. 1 Glover recognized how much analysts even in the same group dont and cant seem to agree, and this was long ago, when it was still possible for him to write things that seemed to indicate that a general convergence in clinical understanding and, by implication, in technique, might be just around the corner. For example, he could write that, when two analysts dont agree on important points of doctrine, at least one of them is practicing suggestion instead of analyzing his patients (Glover, 1955, p. vii). It sounds as if it was easier to think of right and wrong, erroneous and correct then, than it is now. (Dale Boesky, 2008, has referred to an earlier era of analysis as an Era of Certainty personal communication). In the present, it is my impression that wishing or craving for a certain kind of scienticity, analysts often prefer to imagine the differences from their in-group peers in the analyses of the same patients that they, themselves, would conduct are either matters of veerings off course from a proper method (such as those caused by omissions or commissions based in problem counter- transferences), or are matters of small differences of emphasis, something akin to gradations of color in painting or of spices in restaurant dishes. The notion of real, basic differences between analysts is minimized or brushed aside. Once again, it is presumed that there is a proper way to proceed, a proper ideal course. That is why, I believe, the search has been so devoutly pursued into recent analytic history to describe such things as the analytic surface and ego psychological psychoanalytic technique, a technique that could reliably point to just where in that surface is the moment for intervention. SEEKING THE (CORRECT) TECHNIQUE AND THE ANALYTIC SURFACE Here is a beginning to a description of why that surface 2 will never be located and agreed to. The primary difculty in the notion of a psychoanalytic surface is that it is as if this surface were not one derived from a combination of two individuals minds (as Isakower described in his papers given at the New York Psychoanalytic Institute in the 1960s which detailed the joint creation of the analytic instrument; e.g., Isakower, 1992). This surface is described as if it actually existed entirely noncontingently, as a natural phenomenon, pristinely even, the same way, no matter who the analyst were, so long as she did not disturb this surface and the derivatives emergingso long as she is listening, in other words, and properly. This surface, as it were, is described as if it were somehow free-standing, an assumed-to-be universally-accessible surfaceone that would emerge reliably and fully formed, with any analyst. 1 I do not dispute that groups of analysts often share values, but it is my observation that such shared values do not translate to techniques that are anywhere near the same across a given groups analysts. 2 I am following primarily Buschs (1995) use of surface as I understand it, which I regard as a delimited portion of Paniaguas (1991) broader work on analytic surfaces. D o w n l o a d e d
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DEVELOPMENT OF A PSYCHOANALYTIC TECHNIQUE 81 Over and over, I have seen analysts liking to assume, especially if they like each other, that theyd agree what the surface is in the session, and therefore, what to do technically. However, if I know each of them, as one gets to, for example, as a supervisee or in a study group, I know they really dont. This phenomenon of nonagreement occurs regularly even when the surface is reported verbatim. 3 Why? Because there are too many simultaneous meaning-informing shapes behind a given verbal surface for it ever to be a real stand-alone. When it comes to psychoanalytic data, in other words, there will never be a Sergeant Fridays technique for psychoanalysts, in which the analyst could ask for a properly delimited packet of evidentiary data, as Friday could when hed order, Just the facts, maam. WHY THERE WILL NEVER BE ONE RIGHT TECHNIQUE What has implicitly been learned in the history of psychoanalytic technique, but is only occa- sionally explicitly discussed, is that, although there are certainly many ways to make errors in psychoanalysis, it is also the case that, because of the riches of overdetermination, there are also multiple ways to be right. The very idea of a surface misses the multidimensional nature of a work of art, the psyche, which we each necessarily engage differently. Psychoanalysis, as a body of theory, lacks a way to model difference in clinical psychoanalyses across analysts. Needed is a form of multidimensional modeling that does not yet exist. We may not yet have a consciously available model for this problem, but it is, again, easy to witness when considering the following issue: as with any subject matter one is learning, psychoanalysts all have individual learning curves in getting to know each analytic caseones own way, and pace, of learning; but this is, in our literature, a hardly discussed issue. Instead, the history of psychoanalysis has mostly exemplied analysts preferring to go on imagining a proper technique, and, in recent times, to looking at isolated sessions in detail and at microprocessloving Bions epic, but also overstated, and certainly overquoted, lines on work- ing without memory and desire, and fantasizing that psychoanalysts could validly understand isolated session hours in detail; that they could fairly dispense with knowing all that has come before, the hundreds or thousands of hours. A quixotic dream-goal is embodied in this attention to microprocess: the quest for a Reliable Psychoanalytic Technique, in imagining that all analysts would formulate and intervene the same way, might all see the same surface and experience the same clarity, and surely agree just what the transference is, what the resistance, and where the moment to intervene. And yet, here is the learning curve problem: The issue in the patient that youanother analystmight have discerned clearly by the 400th hour I may not understand until hour 600, but I may have seen in hour 200 what you dont get to until hour 1,000, or never at all! Or vice versa. 3 This point was brought home to me with particular force when I participated in a discussion of one of Boeskys presentations of his work on psychoanalytic disagreements, a paper (now part of his book on this subject; Boesky, 2008) on Ilany Kogans published verbatim case material. In the group discussion that followed his discussing the Kogan, after I had found Boesky compelling in his use of evidence to argue his understanding of the material and I assumed others would similarly, I noted wide disagreement from those in attendance, who were members of his local institute, who heard the identical compelling single session of material quite differently from each other, and applied different rules of understanding in listening to it. D o w n l o a d e d
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82 MICHAEL SHULMAN The learning curve issue is not the same as the issue of countertransference blindspots, as causes of error, and their overcoming; it is an issue of a different order and type, one related to general human processes of coming-to-knowand of insight formation. It is an issue friendly to our modern understanding of the inevitability of enactments, for example, and the analysts guring out only ex post facto much of what shes been participating in unconsciously. The learning curve issue is unfriendly to earlier, to my mind rigid, fantasy-ridden and perfectionist visions of analysis which focused ineluctably, and quite unproductively, on the idea that errors are easy to spot, as violations of an already-given method, one that produced a prescriptive technique characterized by many rules (cf. Boeskys, 2008, discussion of Brenners commentary on Kogan). Why do psychoanalysts continue to discuss each others work in the unproductive, single- session, microprocess way? I dont have a certain answer, but I feel one very good one was implied in something Stephen Mitchell is once reported to have said: Criticizing other peoples clinical work is like shooting sh in a barrel. In discussing clinical material in groups, analysts supervising others work continues to be the easiest thing for themto do, and it is a great challenge to get them to consider others work without supervising it (Tuckett 2008). Its fun for many (so long as a willing presenter, all-too-often a candidate, even at national meetings, is there to serve himself up), and there are always things one can point to that someone else missed, especially if its in the transference. Many continue to enjoy this ancient form of psychoanalytic sporting event. But the spectacle of the sporting event misses the most interesting issue: Why is it, after all, so easy for each of us in listening to anothers material to notice what someone else has missed? In other words: Why did they not see it themselves? Why is it so easy for us to see, and for the other to be blind? The answers to these questions must lie in the direction of a general human epistemological difculty: Each of us can only see just so much of a multidetermined, and multiply functioning, phenomenon at any one time. This trio of questions just asked redescribes what I mean by the learning curve issue. I dont want to be misunderstood on the learning curve issue, or to be heard to be a radical relativist, someone who believes everything that emerges in an analysis is coconstructed (if by coconstructed were meant coinvented) by patient and analyst. A strong coconstructionist position is logically incoherent and in no way follows from an appreciation of the learning curve problem. Even if there is no universal surface, there are, of course, inner forces in the patient continually shaping each present clinical moment. These forces produce in the process something that could be thought of as a stream of data from the patient. This patient is a person with a real history, which we assume in various ways constrains the unfolding of the streamof data within the session (to believe otherwise would be to drop psychoanalysis most basic assumption, that of psychic determinism, the basis of what a psychoanalyst listens for). This patient has a psyche and a structure to this psyche also constraining, in myriad ways, the issues that unfold over the years of the work, though not, I believe, the order of the unfolding of these issues, which will be one of the major differences likely to occur across different analysts. To further clarify my system of beliefs about the psyche: At the core of any given psyche, I believe that different analysts would each encounter, in some form, the same set of organizing unconscious fantasies (I give an example in the following)again, I am no radical relativist. However, all in this paragraph and the previous one said: in my experience listening carefully to hundreds of hours of analysts listening to each other, I have concluded that they simply respond in too many different ways to the same stream of data for the idea of one proper method of tech- nique ever to be useful. Once there is more than a very small sample of material in front of them, D o w n l o a d e d
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DEVELOPMENT OF A PSYCHOANALYTIC TECHNIQUE 83 psychoanalysts begin to hear different structures organizing the material from behind it, com- pellingly in each of their own experiences, but only sometimes, maybe even only occasionally, equally compellingly in others (cf. footnote 3). And, if there were decisively consequential ways to be right and wrong, only a very small number of analysts would be left in the business at all, certainly not enough to have given the eld any public success, or to have kept it going over generations, which raises the subject of the pragmatic. PRAGMATISM AND TECHNIQUE Currently, I have been thinking that, although real, the different analyses we make may not mat- ter that much practically in the end for our patients, and it is a profoundly difcult task, again, without any means to date, of which I am aware, to model the problem, to begin to imagine how to fairly assess comparative outcomes of analysis (I know this view is heretical to some in my own institute, but I have found them strong on conviction and short on argument). Psychoanalysts have no sound, or even agreed-to, methodology for comparison, and in offering opinions of com- parative outcomes, they are on the extremely thin ice of comparing a real outcome they know (i.e., what they have done in the work with their patient) to a hypothetical one (i.e., what they imagine they would/could have done in the work with anothers patient; cf. Mitchells previous comment). I nd much common ground in my views and those of Fonagy in some of his work (e.g., 2003), where he is interested in the pragmatism of psychoanalytic technique and thinks that much of what psychoanalysts have developed in the way of technique does not follow, in any sense of logical deduction, from our developmental and psychopathology theories at all; rather, this technique follows from our experience of what works to further the process and help with the outcome. Pragmatism, our durable American friend, should not be absent from considera- tions of psychoanalytic technique (and interest in pragmatism does not, by any means, commit us to accept such particular and narrow positions on pragmatism as Reniks, 2006, which is one in which multiple dimensions of the unconscious are ablated and in which it appears that psychoanalysis is often sacriced for short-term therapeutic work and outcomes)! Although I think Fonagy (2003) overstated the disconnection of theory from practice, I also believe he is right that much of what is taught us (this is particularly true, in my observation, in clinical supervision) as part of our analytic education in technique was deduced from no partic- ular theory, but is, in fact, only a juxtaposition of multiple habits derived from the more useful portions of the habits of others (supervisors and teachers), passed down, from generation to gen- eration of analysts and, both creatively and uncreatively, identied with and disidentied with, remembered, forgotten, mangled, and recast, with many old useless habits simply dropped and forgotten without memorial along the way. In my experience of supervisors and teachers, I could see that the fate of a great many old convictions regarding technique recommendations, some of them held ercely in earlier times, was to simply fade away. (As just two examples of such erceisms of the past: The giving of any advice in an analysis, other than the recommendation for undertaking analysis, is an error; the patient must be charged for all missed sessions, under any circumstance, or analysis cannot occur). The teaching of psychoanalytic technique, at least where I received my psychoanalytic D o w n l o a d e d
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84 MICHAEL SHULMAN education and I strongly suspect in most institutes, is the least reading-based part of the curricu- lum, the one most subject, in a useful way, to the differences of personality among supervisors and among other inuential teachers. In my experience, these persons often did not so much teach technique, in the sense of talking about basic principles and building specic technique recom- mendations from there, as embody it. Technique was an extension of themselves, which, as we witnessed them in their engagements with our material, their patients, and themselves, we came to feel and to gradually embody in an individual way for ourselves. But again, even in supervision and technique seminars I found that there continued to be a lot of fronting for the existence of unity on the subject of technique that did not, in fact, exist. (I had one supervisor who still referred to something called standard technique among analysts at our institute, though none of this individuals presumably standard colleagues did. The use of the term standard technique had vanished for them). NO NAME FOR MY TECHNIQUE, BUT HERE IS WHAT IS IMPORTANT IN IT I eschew the idea of a formalized technique, because I dont have a name for the one formalized technique I use. I think that the way I listen guides my technique, and that the way I listen has the inuences I describe shortly. I dont think these listening priorities are other than ordinary ones for analysts. I hope and believe, of course, as we all do, that these things to listen for are the most important ones, the best effective distillation of what Ive been taught, but most of us tend to feel weve been well taught, so we risk being overpleased with our individual distillations. These principles also guide the listening I try to teach in supervision. They are listed here in order from most to least central: 1. to listen for anxiety, especially anxieties active in the transference; 2. to listen for affective urgencies: What issue emerges affectively as in-play, as making a claim, in a given session; 3. to listen for what threads are continued from the last (and sometimes other recent) sessions, and which are new; 4. to listen for themes and variations on the theme; and 5. to listen for elements of a particular deep structure, the basic unconscious organizing fantasy(ies) of a patient. I do think of my technique as being guided by my listening. However, I also know I listen in different ways at different times, sometimes because of new learning or a paper I have just heard or read (e.g., after I attended a recent symposium on secrets in analysis, I, of course, was hearing them left and right in my patients material; they seemed to be popping up everywhere, where previously Id missed them everywhere; cf. my earlier discussion of blindness and seeing). Sometimes, I listen accidentally: Because when I have a head-cold I have learned that I listen differently (and not necessarily less effectively, or so I believe), that different-than-usual brain activity on my part seems to be in play. I believe to I sometimes try to listen in new ways is useful, the way that shining lights of different wavelengths, and viewing from differing angles, is useful in the exploration of a work of nature or of art, because we learn of more structures not yet visible to us but operating behind D o w n l o a d e d
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DEVELOPMENT OF A PSYCHOANALYTIC TECHNIQUE 85 the surface in this way. 4 When I particularly incline my neck, either further back, or to the side, in my ofce armchair behind the couch, I know that I am craning for a new view. In trying these days to embrace a greater plurality of views than they used to in our eld, psychoanalysts are collectively craning for new angles to reveal new dimensions to our object of study, our patients. Since I believe the psyche is a work of nature and of art, I know that new angles of view are always of potential use. Thomas Kuhns (1962; 1996) analogue of the process of scientic revolutions to that of the psychology of Gestalt shifts has great, and still largely unexplored, application to listening and the capacity for openness, freshness of hearing and new learning in clinical psychoanalysis. A paper remains to be written: Each psychoanalysis is a problem of sci- entic revolutions (i.e., each one requires major, even radical, repeated exibility of perception over time to allow the analyst the freedom she needs to help her patient achieve maximum under- standing, to allow new ndings to be made even when it seems that everything is known already and all the pieces t). Finally, I think that what most serves to guide my technique is not a listening principle. Rather, it is a desire: to be helpful to another person in understanding their particular lifetime pain and suffering, and the deep unconscious fantasies and internal knots that are continuing to damage him because these fantasies and knots are xed, rigid, and place that person in an impossible, contorted position. For example, one traumatized patient suffered with, and from, the following concatenated fantasies, which emerged piecemeal over a long period, each contributing the more to tangling him into an impossible position: I needed to be a girl to be a person for my parents, but I was born a boy; I am defective goods; I could only ever feel good if I believe I can have xed my parents marriage which ended when I was 5, but because I was born, I caused this marriage to fail, and each of them to be unhappy; and If I were never born, my parents would not have been unhappy; then and only then could I be happy. I am skeptical of some older views of the analyst that seem to describe the analysts technique in terms of his working relentlessly to help the patient experience warded-off affects. As an example of this phenomenon, I have heard an analyst say of a patient, He needs the chance to experience his full rage toward me. Certain others I have heard describe their analytic technique in terms that focus almost exclusively on the patients defenses against mourning and the constant need for analysis of such defenses. One analyst I heard present, and who was taken by this view, seemed to be in love with the idea that mourning, and interpretation of defenses against it, was all of what analysis was about, as if in a good analysis something that needed to be mourned by the patient should be identied by the analyst each analytic day. I nd puzzling and disconcerting the idea that the clinical goals of analytic technique might be dened by these intensive kinds of foci on warded-off affects or mourning work, because I am disturbed by the narrowness and prescriptiveness of these notions. Many people have lots of intense affects with which they have trouble; they dont need awareness for its own sake of additional warded-off ones, as these analysts imply is the universal goal of analytic technique. That would be to mistake something that is at most a feature of analysis (in some cases, for example, with traumatized patients, a potentially treatment-destroying, because it is so easily a 4 I was an amateur astronomer as a boy and learned the usefulness of the expansion of our knowledge that came from ultraviolet and infrared visualization, as well as radio-telescopic mapping, of interstellar objects; how much more of the structure and functioning of a galaxy, for instance, could be learned by such juxtapositions of pictures of radiation, than might come just from pictures based in wavelengths visible to the human eye. D o w n l o a d e d
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86 MICHAEL SHULMAN hope-destroying, feature) for its goal. Or to mistake a part of analysis for the much larger whole of what it offers. Although the following view on my part may change, I dont think it will: Psychoanalysis as a clinical practice is useful to the overcoming of affective misery via increased self-understanding forged in a new experience. Two minds are denitely better than one, because they create new possibilities (and certainly not just because warded-off affects have been reexperienced in the here and now). The patient does, of course, need to work through the effects on themselves of some of the old of their intense defended-against affects; but they need much more than this the new of a jointly built platform from which to come to terms with themselves, providing a basis that can allow the overcoming of destructive and unproductive unconscious emotional reexes causing psychic contortion and imprisonment. I appreciate very much the opportunity offered me by Mel Bornstein to further rene and make explicit my thoughts on psychoanalytic technique in this article. REFERENCES Boesky, D. (2008), Psychoanalytic Disagreements in Context. Lanham, MD: Jason Aronson. Busch, F. (1995), The Ego at the Center of Psychoanalytic Technique. Northvale, NJ: Jason Aronson. Fonagy, P. (2003), Some complexities in the relationship of psychoanalytic theory to technique. Psychoanal. Quart., 72: 1347. Glover, E. (1955), The Technique of Psycho-Analysis. New York: International Universities Press. Isakower, O. (1992), Chapter four: The analyzing instrument: Further thoughts. J. Clin. Psychoanal., 1: 200203. (Paper originally presented in 1963). Kuhn, T. (1962), The Structure of Scientic Revolutions. Chicago: University of Chicago Press. . (1996), The Structure of Scientic Revolutions (3rd ed.). Chicago: University of Chicago Press. Paniagua, C. (1991), Patients surface, clinical surface, and workable surface. J. Amer. Psychoanal. Assn., 35: 669685. Renik, O. (2006), Practical Psychoanalysis for Therapists and Patients. New York: Other Press. Tuckett, D. (2008), Psychoanalysis Comparable and Incomparable. London: Routledge. 117 N. First Street, Suite 113 Ann Arbor, MI 48104 mshulmanphd@gmail.com D o w n l o a d e d
4 On The Asymptotic Distribution of The Transaction Price in A Clock Model of A Multi-Unit, Oral, Ascending-Price Auction Within The Common-Value Paradigm