A Psychoanalytic Odyssey

This essay about my professional life is necessarily highly subjective. I have selected and highlighted areas and issues of personal interest and preference. My own theoretical and clinical ideas have evolved over the years. In some areas, experience as well as my own critical reassessment resulted in changing my views of theory and clinical practice. In other areas, I integrated aspects of the newer ideas of others, including some from the non-traditional schools of psychoanalysis. My contemporary perspective thus reflects what I consider the bedrock of psychoanalysis, my personally evolving ideas, and what I have gleaned from continuing developments and new theories. Some of the trenchant controversies in theory, clinical practice, and education, particularly of the last sixty years, will be discussed, but of necessity, briefly. I will touch upon, for example, conflict versus deficit, one or two-person analytic process, interpersonal versus intra-psychic, fantasy versus real trauma, narrative truth versus historical fact, transference object versus new object, feminine psychology, insight versus the analytic relationship, neutrality versus subjectivity, ego psychology versus object relations, and the role of the pre-oedipal period in development and in psychopathology.

When I was in medical school, although impressed as an undergraduate by my reading of Sigmund Freud, I was drawn toward internal medicine. The surgical specialties were of little interest, lacking intellectual challenge, compared to the intricacies of biochemistry, physiology, and the human heart. Only later in the clinical years did I appreciate the complexity of much of surgery and surgical research. Obstetrics had its own fascination with the pregnant body, delivery, and the awe of birth and new life. Thoughts about the new mother’s psychological response to a new phase of life with her infant were associated with my thoughts and feelings about biological and psychological paternity. When I married at the end of my third year of medical school, my perceptive bride knew before I did that I was headed toward psychiatry. Psychosomatic medicine, as at was called, was of definite interest, and my interest in the human mind was ascendant. I was now drawn toward psychiatry and in particular psychoanalysis. The excellent department of psychiatry at the Boston University School of Medicine furthered this interest, just as psychoanalysis at that time dominated many other psychiatry departments both in the U.S. and internationally. Sadly, concomitant with the general loss of prestige of psychoanalysis in academia and elsewhere, this is no longer the situation today. My reflections will be largely limited to the evolution of my own thoughts and of psychoanalysis in the U.S., in which I have been involved even before the beginning of my formal training in 1957. Following my medical internship I spent two years in the U.S. Navy as a general medical officer. During this time, however, I wrote my first psychoanalytic paper, published in American Imago, titled “Van Gogh’s Chairs” (Blum, 1956). I had no clinical training, but I could author a paper on applied analysis.

In contrast to the decade of dissolution and reorganization from 1939 to 1949, major advances in psychoanalytic theory, therapy, and education took place after 1950. Freud’s death in 1939 coincided with the onset of World War II, precluding the mourning of his loss by psychoanalysts. The war and its aftermath were foremost in the world of psychoanalysis and the world in general, and the first years of peace were marked by the process of recovery from the horrors of the war and the Holocaust (1945–1949). The period from 1950 to 1970, which included the years of my training and early years as an analyst, embodied two decades of development and consolidation in psychoanalytic thought and education. The preceding theoretical and clinical formulations were reviewed with a renewal of analytic inspiration and inquiry. Although the war and Holocaust left enduring traumatic sequellae, there was spirited dedication to preserve past accomplishments and expand analytic theory, technique, and education. In the U.S., the pre and post-Second World War arrival of illustrious European analysts transformed American psychoanalysis. As I entered the world of psychoanalysis, the newly published papers of Anna Freud (1965), [End Page 418...