PSYCHOANALYSIS IN TRANSITION PSYCHOANALYSIS IN TRANSITION A Personal View Merton M. Gill ~ THE ANALYTIC PRESS 1994 Hillsdale, NJ London Copyright 1994 by The Analytic Press, Inc. All rights reserved. No part of this book may be reproduced in any form: by photostat, microform, electronic retrieval system, or any other means, without the prior written permission of the publisher. First paperback edition 2000 Published by The Analytic Press, Inc. 101 West Street, Hillsdale, NJ 07642 www.analyticpress.com Library of Congress Cataloging-in-Publication Data Gill, Merton Max Psychoanalysis in transition: a personal view I Merton M. Gill p. em. Includes bibliographic references and index. ISBN 0-88163-335-6 1. Psychoanalysis I. Title BF173.G496 1994 150.19'5-dc20 94-17701 CIP Printed in the United State of America 10 9 8 7 6 5 4 3 2 1 To Ilse Contents Preface ix Chapter I I Constructivism and Hermeneutics I Chapter 2 I The Internal and the External IS Chapter 3 I One-Person and T we-Person Psychology 33 Chapter 4 I Neutrality 49 Chapter S I Psychoanalysis and Psychotherapy 6I Chapter 6 I Free Association and the Analytic Process 79 Chapter 7 I What Analysts Say and Do 101 Chapter 8 I Theory and Technique 12S Chapter 9 I The Body in Psychoanalysis 139 Chapter IO I Conclusion ISS References 1S9 Index I69 vii Preface I have long believed that if an author explained how a book came to be, it would be useful to the reader. So, herewith how this book came to be. Some years ago, more than I care to remember, I decided to write a textbook of psychoanalytic theory and practice. I was very dissatisfied with the available texts, especially one of the most popular ones, which I consider to be a catechism rather than a textbook. I wanted to write one that would stress the controversies in psychoanal- ysis and that would be of interest to experienced analysts and to beginners in the psychological therapies. For me, this includes anyone doing dynamic psychotherapy, by which I mean in this context an antonym to behavior therapy. Somewhere I had heard that a sophisticated primer should be an introduction to a field and would encompass it in a way that would be enlightening to the expert as well as to the beginner. That is the kind of book I wanted to write. Not surprisingly, with such an aim, I got bogged down time and again and would abandon the project for some time. Finally I achieved a manuscript of several hundred pages and sent it to Paul Stepansky, Editor-in-Chief of The Analytic Press, asking him to give me an opinion and perspective. With his usual acuity, he told me at once that I had not decided on my audience. He also suggested that the book needed to be brightened up and in particular that I give it a more personal slant. He did not realize that he had hit a nerve. When I was a junior staff member at the Menninger Clinic in the early 40s, my turn came to present at one of our regular staff meetings. I was assigned the task of reviewing Grinker and Spiegel's War Neuroses in North Africa, which details their vivid experiences with the traumatic neuroses of war and their treatment, often by abreaction under sodium pentothal. When I ix X PREFACE finished, the late Karl Menninger, who ran those meetings, declared with an acerbity that was not entirely uncharacteristic of him, "Mer- ton, I have never known anyone else with your capacity to make something intrinsically so lively and exciting so dull and boring." Of course he was right, and I have been struggling against that propensity ever since. I hope the reader will feel I have made some progress. So, back to the book. I began to rewrite in a more sprightly fashion, even including an anecdote from my professional life here and there, like the one about me and Dr. Karl. We called him that because there was also Dr. Will. But I still had not decided on my two audiences. The beginner should know something about the metapsychological points of view, for example, even though I essentially reject them, at least in their classical Freudian guise. But their recital would bore someone experienced in the field. How could I make the metapsychological points of view sprightly? If I could thunder them with Rapaportian excitement, that might have been interesting to a live audience, but on paper ... So I considered various other possibilities. Why not two books, one for the experienced and one for the beginner? But I wanted to set forth my views on the controversies for both audiences. It was not really two separate books I had in mind. I considered writing the book largely from the point of view of the experienced clinician but putting various sections, like the metapsychological points of view and the defense mechanisms, in appendices for the beginner. But that would make a big book. Years ago, when I told someone of my plan to write a textbook, he said, "For God's sake, keep it short, if you want anyone to read it." As I reviewed various drafts, I found that one was written as though for a beginner and another for experienced therapists. My overriding interest for some years has been in technique in the context of general theory. So I decided on two books. One for the experienced and indeed essentially on technique in the context of general theory. The other would be an introductory text, including what is already familiar ground for the experienced, and therefore not in the first book, but taking up the same issues of technique, albeit in less detail. There would be overlap, of course, especially because of a common central theme of both books. The reason for the commonality between the two books is, as will become evident to the reader, that I believe that the classical analytic PREFACE xi situation, with frequent sessions and couch, and the situation con- fronting a resident doing his first case of psychological therapy should each aim to promote something similar, which I call the "psychoana- lytic situation." I believe that situation should be the goal in both psychoanalysis proper-that is, with the standard extrinsic criteria of couch, frequent sessions, duration, and the like-and in a psycholog- ical therapy that employs analytic technique but with different ex- trinsic dimensions, like sitting up, lesser frequency, shorter duration, and the like. I will later discuss in detail the difference between this latter kind of therapy and what is usually called dynamic psychother- apy, or psychoanalytic psychotherapy, or psychoanalytically oriented psychotherapy. I considered symbolizing the kind of therapy I am describing by writing it as "psycho-analytic therapy" with a hyphen, but I concluded that the hyphen was too gimmicky and wouldn't catch on anyhow. I considered using the term psychoanalytic therapy, but I was afraid that it would be understood to be the kind of therapy that Franz Alexander described under that term. But that was so long ago that I decided I could give the term a new meaning. Although the term psychoanalytic psychotherapy is usually used in contrast to psychoanalysis, I mean by psychoanalytic therapy something different from what is usually called psychoanalytic psychotherapy. Of course, the much discussed issue of the difference between psychoanalysis and psychotherapy is involved. In my detailed discus- sion I will give my rationale for including psychoanalysis with and without the usual extrinsic criteria of psychoanalysis proper under the broad heading psychoanalytic therapy, which aims to develop a "psychoanalytic situation." One more word about terminology. "Psy- choanalytic situation" is ordinarily used in connection with psycho- analysis proper, but I am proposing that one should also aim toward it in what I am calling psychoanalytic therapy. Some would argue that the term psychoanalytic situation should be confined to psychoanal- ysis proper, because it is so entrenched and that perhaps a term like psychoanalytic dialogue should be used instead, since dialogue is a major aspect of a central shift I will be discussing in the understanding of psychoanalytic therapy as well as in psychoanalysis proper. The term psychoanalytic dialogue is, of course, the same as the new journal Psychoanalytic Dialogues, which was founded by an offshoot of inter- personal psychoanalysts who call themselves relationists. I decided against "dialogue" because my view of the analytic situation is broader xii PREFACE than relational, as I shall discuss in terms of one-person and two- person psychologies. To keep the volumes shorter, I decided that instead of interlarding examples in the text as is usually done, I would write a third volume of examples intended for both the beginner and the experienced. I had done the same in my monographs on transference, of which this work is a continuation. I faced another difficult problem in deciding what book to write. I have become convinced that, in addition to the matter of dialogue, another new perspective is developing in psychoanalysis, of which Irwin Hoffman is a principal architect, among others of course. He has named it social constructivism. Hoffman (1991) has made clear that social constructivism involves two antinomies or axes, an important distinction. One is the drive- relational antinomy, and the other is the objectivist-constructivist antinomy. Both antinomies have important implications for tech- nique. This volume is largely confined to issues in the drive-relational antinomy, with only a brief discussion of the objectivist-constructivist antinomy. Hoffman has already discussed the latter in a number of papers (1983, 1987, 1991, 1992a, b, 1993, 1994, in press-a, b), and has a book in preparation integrating issues in the social-constructivist paradigm. I return to the question of my two books. What do I think the reader has in hand? Although I have written a number of chapters that would be suitable for a textbook, they are not here. This is surely not a textbook. Whether I will ever carry out the plan of presenting a book with those chapters, together with some version of the present work, that might be more suitable for beginners, I don't know. Do I feel, then, that beginners cannot usefully read this book? The encomia on book jackets in our field often say that the work will be enlight- ening to experienced practioners and beginners alike. I confess that I feel that way about this book. It is about what interests me the most- a basic perspective on the nature of psychological therapy informed by psychoanalytic concepts. Another word about a textbook. Surveys of psychoanalytic theory and practice often take the form of a chronological review of Freud's work. There are several reasons for this in addition to the fact that it is easier to give a chronological account than to attempt to systematize