Creating an Analytic Mind
Some discussion on Twitter this week with Jonathan Shedler and others about what we hope patients will be left with after therapy is over put me in mind two books I often find myself returning to. (Shedler deals handily and powerfully with the old and tiresome slanders that psychoanalytic/dynamic therapy are somehow less effective and less "evidence-based" than the CBT methods seemingly so beloved by governments and insurance companies today. See the invaluable articles at his website above, but also see this new book which I am looking forward to reading.)
The first is by Adam Phillips, who, like Shedler, is always worth reading. I have read all but one of Phillips' books, and would be hard-pressed to rank them, but if I had to, then On Kissing, Tickling, and Being Bored: Psychoanalytic Essays on the Unexamined Life would probably be in my top three, if only for its essay "Psychoanalysis and Idolatry," which I drew on in my own recent book on the sex abuse crisis in the Catholic Church.
Anyway, Phillips has a lovely little aphorism in this book: "The cure can begin only after the treatment has ended." One can certainly debate that, but I have found it very true in my own life. As Luis Izcovich has recently argued, psychoanalysis leaves lasting "marks" in certain often distinguishable ways--a point stated even more dramatically by François Roustang almost forty years ago now.
The second book that came back to mind this week is by Fred Busch. I read it several years ago, but it pays re-reading. He argues very much in favour of the idea that psychoanalysis and analytic therapy should leave the person with a re-structured mind as a permanent and positive after-effect: Creating a Psychoanalytic Mind: A Psychoanalytic Method and Theory (Routledge, 2013).
Busch writes in a low-key manner with a refreshing lack of ideological rigidity, jargon, or hubris. He interpolates passages from well-known literary works with short case-studies from his own practice to illustrate what he means. This is a rewarding book that pays re-reading.
As he recounts in the introduction to this book, Busch is something of a pioneer in psychoanalytic technique and training, being one of the first clinical psychologists to be admitted in the 1970s to psychoanalytic training at an American institute. (This restriction has never made any sense to me. I grew in Canada, underwent analysis there, and planned to finish a doctorate in the humanities and then embark on a training analysis at the Institute in Montreal. I was able to do this because unlike American institutes, those in Canada, the UK, and parts of Europe and elsewhere, generally have had no problem following Freud's recommendations in The Question of Lay Analysis.)
As he looks over the course of an analysis, Busch understands it to consist of three phases:
1) The first phase is when the patient comes to be familiar with his own inhibitions and restrictions that keep him from living: until the patient can wonder about his lack of wondering, wondering is not possible. This phase, later in the book, is called one of self-observation.
2) The middle phase of an analysis is the beginning of a "psychoanalytic mind," that is, learning to observe one's own mind and its sequence of free associations. Such a psychoanalytic mind is necessary if the analysis is to bear long-term sustainable fruits in one's life. It is necessary, that is, if the patient is to be freed from the "slavery of repetition compulsion" and instead freed to "think about thinking." Later in the book Busch calls this phase one of self-reflection. (In my experience this ability to "think about thinking" has remained a constant and constantly valuable gift bequeathed by analysis.)
3) The terminal phase of an analysis consists of a deeper psychoanalytic mind more completely free from deceptions in understanding one's associations with greater veracity. Here the analysand can "play, muse, reflect, and interpret her own associations." This phase Busch later calls self-inquiry.
Classically, it was thought by some that the main goal of an analysis was insight into the contents of the unconscious. But for Bush, "the process of knowing is as important as what is known." Here Busch pioneers a different goal for analysis, giving greater emphasis to the patient gaining an understanding of how his mind works and how it affects him. Busch suggests the freedom of a psychoanalytic mind, with a process of knowing in addition to what is known, may be of greater long-term benefit.
This, it seems to me, is a very noble goal for a clinician to work towards: not merely to leave a patient with certain tips or techniques that may come in handy in some future struggle, but to help in the creation of a mind that can now think much differently. And one thing that newly recreated mind will likely have--dare we say should have?--is an awareness of its ongoing need for the help of others. Here I would return to Freud in noting that the creation, and nourishing, of such a mind is never going to be complete, but will require perhaps ongoing or perhaps periodic work. As he says in his "Analysis Terminable and Interminable": "Every analyst ought periodically himself to submit to analysis, at intervals of, say, five years, without any feeling of shame in so doing. This is as much as to say that not only the patient's analysis but that of the analyst himself is a task which is never finished."
In conclusion, I would simply note that Busch has a new book coming out in November which I am looking forward to reading. The publisher tells us this about it:
The first is by Adam Phillips, who, like Shedler, is always worth reading. I have read all but one of Phillips' books, and would be hard-pressed to rank them, but if I had to, then On Kissing, Tickling, and Being Bored: Psychoanalytic Essays on the Unexamined Life would probably be in my top three, if only for its essay "Psychoanalysis and Idolatry," which I drew on in my own recent book on the sex abuse crisis in the Catholic Church.
Anyway, Phillips has a lovely little aphorism in this book: "The cure can begin only after the treatment has ended." One can certainly debate that, but I have found it very true in my own life. As Luis Izcovich has recently argued, psychoanalysis leaves lasting "marks" in certain often distinguishable ways--a point stated even more dramatically by François Roustang almost forty years ago now.
The second book that came back to mind this week is by Fred Busch. I read it several years ago, but it pays re-reading. He argues very much in favour of the idea that psychoanalysis and analytic therapy should leave the person with a re-structured mind as a permanent and positive after-effect: Creating a Psychoanalytic Mind: A Psychoanalytic Method and Theory (Routledge, 2013).
Busch writes in a low-key manner with a refreshing lack of ideological rigidity, jargon, or hubris. He interpolates passages from well-known literary works with short case-studies from his own practice to illustrate what he means. This is a rewarding book that pays re-reading.
As he recounts in the introduction to this book, Busch is something of a pioneer in psychoanalytic technique and training, being one of the first clinical psychologists to be admitted in the 1970s to psychoanalytic training at an American institute. (This restriction has never made any sense to me. I grew in Canada, underwent analysis there, and planned to finish a doctorate in the humanities and then embark on a training analysis at the Institute in Montreal. I was able to do this because unlike American institutes, those in Canada, the UK, and parts of Europe and elsewhere, generally have had no problem following Freud's recommendations in The Question of Lay Analysis.)
As he looks over the course of an analysis, Busch understands it to consist of three phases:
1) The first phase is when the patient comes to be familiar with his own inhibitions and restrictions that keep him from living: until the patient can wonder about his lack of wondering, wondering is not possible. This phase, later in the book, is called one of self-observation.
2) The middle phase of an analysis is the beginning of a "psychoanalytic mind," that is, learning to observe one's own mind and its sequence of free associations. Such a psychoanalytic mind is necessary if the analysis is to bear long-term sustainable fruits in one's life. It is necessary, that is, if the patient is to be freed from the "slavery of repetition compulsion" and instead freed to "think about thinking." Later in the book Busch calls this phase one of self-reflection. (In my experience this ability to "think about thinking" has remained a constant and constantly valuable gift bequeathed by analysis.)
3) The terminal phase of an analysis consists of a deeper psychoanalytic mind more completely free from deceptions in understanding one's associations with greater veracity. Here the analysand can "play, muse, reflect, and interpret her own associations." This phase Busch later calls self-inquiry.
Classically, it was thought by some that the main goal of an analysis was insight into the contents of the unconscious. But for Bush, "the process of knowing is as important as what is known." Here Busch pioneers a different goal for analysis, giving greater emphasis to the patient gaining an understanding of how his mind works and how it affects him. Busch suggests the freedom of a psychoanalytic mind, with a process of knowing in addition to what is known, may be of greater long-term benefit.
This, it seems to me, is a very noble goal for a clinician to work towards: not merely to leave a patient with certain tips or techniques that may come in handy in some future struggle, but to help in the creation of a mind that can now think much differently. And one thing that newly recreated mind will likely have--dare we say should have?--is an awareness of its ongoing need for the help of others. Here I would return to Freud in noting that the creation, and nourishing, of such a mind is never going to be complete, but will require perhaps ongoing or perhaps periodic work. As he says in his "Analysis Terminable and Interminable": "Every analyst ought periodically himself to submit to analysis, at intervals of, say, five years, without any feeling of shame in so doing. This is as much as to say that not only the patient's analysis but that of the analyst himself is a task which is never finished."
In conclusion, I would simply note that Busch has a new book coming out in November which I am looking forward to reading. The publisher tells us this about it:
In this first-of-kind book, senior psychoanalysts from around the world offer personal reflections on their own training, what it was like to become a psychoanalyst, and what they would like most to convey to the candidate of today.
With forty-five personal letters to candidates, this edited collection helps analysts in training and those recently entering the profession to reflect upon what it means to be a psychoanalytic candidate and enter the profession. Letters tackle the anxieties, ambiguities, complications, and pleasures faced in these tasks. From these reflections, the book serves as a guide through this highly personal, complex and meaningful experience and helps readers consider the many different meanings of being a candidate in a Psychanalytic Institute.
Perfect for candidates and psychoanalytic educators, this book inspires analysts at all levels to think, once again, about this impossible but fascinating profession and to consider their own psychoanalytic development.
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