The Future of Psychoanalysis

1. What is Psychoanalysis?

Psychoanalysis can have a scientific foundation, and does have a future, even if it is a procedure in which the investigator has an indissoluble influence on what is being investigated, and the possibility of replication is deeply compromised by the uniqueness of the relationship. Psychoanalytic notions do not readily lend themselves to empirical validation. Yet it has been increasingly recognized in contemporary philosophy of science that these problems are general to all scientific inquiry and they represent the limitations of all science. The fact that it is very difficult to validate psychoanalytic hypotheses is not restricted only to psychoanalysis as a science; witness the plethora of contemporary theories and arguments in such traditional sciences as physics and astrophysics about quantum theory, about the so-called “cosmological constant” and whether it is necessary to postulate an inflationary phase in the origin of the universe, and the curious difficulty of locating proton decay, determining the mass of neutrinos, and finding gravitational waves predicted by the various theories but so far not possible to convincingly demonstrate empirically. Some very elaborate hypotheses such as “string theory” have never produced a single testable prediction . The whole conception of science in the twentieth century has shifted, but it does not follow from this that the data of psychoanalysis any more than the data of any other field, are nothing but the current product of an interaction or a dialogue between patient and analyst. This is true in spite of the current fashion as expressed, for example, by the popularity of Bakhtin’s (Emerson 1997) postmodern concepts of dialogue, polyphony, and unfinalizability. This so-called postmodern stance may or may not be valid but it is far from generally accepted and the whole current fashion of postmodernism and hermeneutics remains very poorly defined and highly polemical. 1 1 What is Psychoanalysis? Psychoanalytic theories are not idolized today as they once were, because we now know that all theories tend to filter awareness and promote countertransference . On the other hand we need theories, for in any science, as Kuhn (1962) in his famous work explained it, there has to be a “stable paradigmatic corpus of notions,” a group of core defining ideas. Progress in science involves departures from the prevailing paradigm, but just as science is dead without innovations, so it is lost without its traditions and fundamental body of acquired knowledge. For us, this has been and should continue to be provided by the work of Freud and the psychoanalytic pioneers as summarized in Fenichel’s (1945) classic textbook and brought up to date by others. Much of the recent psychoanalytic literature, however, attempts not to modify and correct Freud’s paradigm as of course it ought to be done on the basis of new research findings, but to replace it entirely in the name of either making psychoanalysis more of a traditional science or of making it a relationship therapy or a purely hermeneutic exercise. This is a major mistake and, contrary to current fashion, we should retain Freud’s basic ideas as our central paradigm and starting point. I strongly disagree with the claim that we are now close to solving the so-called “hard problem” challenge of the mind-brain problem, the problem of how to get from neuronal firings to the qualia of consciousness. This is exactly what stymied Freud, causing him to abandon his “Project for a Scientific Psychology” and develop his metapsychology. The only way I know of to establish scientific knowledge is by consensual validation from a series of investigators. Indeed, there has been a serious effort by prominent psychoanalysts, especially in last twenty years to establish some areas of confluence. For example, Gabbard (1995) published an important paper delineating the gradual migration in our field away from extreme positions and toward some generally accepted principles, and Wallerstein’s (1988) seminal paper “One Psychoanalysis or Many?” was a central topic of discussion at the 1989 International Psychoanalytical Congress. It is easy to criticize psychoanalytic institutions and bureaucracies and many authors (e.g., Gedo 1997) have done so; nobody would disagree that such organizations should fear dogma more than freedom of inquiry, but it is very difficult, human narcissism and group psychology being what it is, to keep such organizations from becoming a conservative force. At the same time, there is a wealth of clinical knowledge and useful theoretical ideas to be found in Freud’s pellucid writings that are of foundational value even today. When Kohut was asked what to...