Credo: I Believe in What, Exactly?

I'm going to let you in on a couple of secrets from my previous life that bear directly on this book I shall be reviewing.

First, those of us with some scholarly background in religious studies and theology (especially its Christian variants) tend to hear the word credo and immediately have a set of fairly specific and rather clearly defined associations and connotations come to mind. In typical usage, a credo ("I believe" in Latin) is a very succinct and often dense statement comprised of propositions establishing belief on frequently contested points of doctrine. In some versions, after laying out the positive claims, a series of anathemas follow, establishing what beliefs are to be explicitly rejected as heterodox. 

In the book under review we have almost none of this at all. Given that we are talking about psychoanalysis and the authors are all analytically trained, it would be rather queer to find such statements being proffered too categorically for psychoanalysis, of course, seeks always to question definitive claims and probe what lies beneath the lust for certainty. 

While there are, as the eminent historian Jaroslav Pelikan and others demonstrated, many versions of such creedal statements within just Christianity, the most common example still in use today is the Nicene Creed, as it is usually called, though its fuller title is the Niceno-Constantinopolitan Symbol of Faith, reflecting the fact that the statement begun at Nicaea I in 325 was amended and added to at the first council of Constantinople in 381. Unlike the word "creed" and cognates, "symbol" in Greek is less a carefully and cogently constructed series of propositions but instead often translated as that which is thrown together.

I'm going to suggest straightaway that had the editor or contributors to this volume, Psychoanalytic Credos: Personal and Professional Journeys of Psychoanalysts, ed. Jill Salberg (Routledge, 2022) been aware of the etymological history I've just so roughly sketched, they would have called their volume Psychoanalytic Symbols of Faith or something along those lines instead of using the word credos, which promises a type of statement, and a corresponding level of certainty in its propositions, very nearly entirely absent from this volume. That is not a fatal flaw but merely a rather minor mismatch between title and contents. (Perhaps, they might reply, the subtitle, especially with its use of the word journeys, gives cover here, as indeed it does, for many authors seem to have written not tight compact creedal essays, but meandering autobiographical sketches, many of them quite banal and of very limited interest.) 

The second secret I shall let you in on also comes from my scholarly life organizing international conferences, editing two academic journals, and also being editor of scholarly collections and proceedings, several of which I have published. In every case, one often begins with a dream list of contributors, but then has to settle for those who actually say yes and show up. Roughly 15% will say yes and then drop off the face of the earth; roughly 35% will say yes and hold you hostage while they wickedly blow past all deadlines and may eventually get their submission to you months or even years after deadline; and the rest will usually be professional and accommodating in working with you to submit decent materials on time. The resulting collection, of course, is invariably going to be very uneven and even the most ruthless editing I could provide could never totally smooth it out entirely. Such is the fate of all collections. 

Sometimes it is fairly well accepted (though should not be) that especially "big names" may agree to give a paper or make a submission to your journal or book, but it will be some paper they've recycled four times already and couldn't be bothered publishing, or the paper was not really top-drawer stuff, but because of their status in the field they can pawn off second-rate materials and people will gladly take them because, of course, you want their name in your publication, and they know you want their name. Thus they send you some such material--not their best stuff because it may be incomplete, or the sources haven't been updated since they first gave the paper in 1998, or they wrote in sloppy haste--and you accept it even though it doesn't quite fit your focus. 

Similarly, if the "big name" really should be in your book or conference program--else people will sneer How could you publish on gravity without asking Newton for an essay?--but does not want to write something original, or finds you insufficiently important enough to think of writing something fresh for your focus, they may condescend to let you have a paper previously published that, they think after two seconds, clearly fits your focus (but doesn't really). Again, being glad to have this person, you will snatch up the previously published paper and include it in your collection even though it doesn't quite fit your focus.

There are, then, a number of prominent people in Psychoanalytic Credos who fit into this category. These essays, if not previosuly encountered, may be profitably and perhaps even enjoyably read here. I shall not name names nor pay them any attention in what follows.  

Rather, I am content to highlight a half-dozen chapters that offered some excellent insights. 

The first of these--it will come as no surprise--is Nancy McWilliams' chapter "Credo: Psychoanalysis as a Wisdom Tradition." I am, of course, greatly indebted to McWilliams, as I showed here. If I were the editor here, I'd have sent her chapter around to other contributors as a model of what to write: she begins with some autobiographical reflections and then, in a section labelled Credo, tells us how she believes psychoanalysis to be a wisdom tradition, and what that means. 

A central feature of her article, not encountered much elsewhere in the book or the wider literature, is that "much of the healing in analytic treatment seems to me to be essentially a grieving process...and deep acceptance of what cannot be changed" (p.74). What she does not say on this point, but clearly implies, is that such grieving can be a conduit to greater liberation and even to some change not possible until and unless grief happens first and is really worked through. 

The very next chapter is by the British analyst Michael Parsons. He gives us two gifts. The first is to remind us that "to be an analyst...is to lay oneself continually on the line," that is, clinicians (if they are to do what he calls "transformative" work) must "have their own psychic life at stake in an analysis." Only, he says, if you can tolerate this will you have the potential to be both changed and to help your patient change. (This theme is taken up in a later chapter by Lewis Aron, who suggests "the biggest thing getting in our way is that we're afraid to be bad objects, we're afraid to just let ourselves out.")

Parsons ends his chapter with a very striking suggestion: what if we conducted supervision or case consultation in a freely associative manner? How might this help the supervisor, supervisee, and patient? 

Jessica Benjamin (about whom I wrote a bit here) has a wonderful chapter which opens with the ringing declaration that "if psychoanalysis were a religion, I would be not only a practitioner but also a theologian"! She launches into a discussion about Winnicott on uses of an object, and the non-retaliatory stance of the clinician whose failures of the patient and ruptures in the alliance can be "developmentally necessary." 

She also draws on Emmanuel Ghent's celebrated distinction between submission and surrender to note that if the patient has to surrender to the clinical process, so too does the clinician, and the latter's surrendering first is a salutary model for the anxious patient to see that they are not alone (even if the level of surrender is, she notes, assymetrical).

To my mind, the best chapter in the book is, by far, Steven Cooper's "Credo: Playing and Becoming in Psychoanalysis." There is a refreshing candor in what he reports of how he talks to patients with great modesty:

"I have faith in your ability to grow even if I don't always know how to facilitate that. I believe that there is something unique about this setting and the two of us trying that can be useful. I would like to become useful in helping you with the process of becoming who you are." 

Cooper says that the key way he attempts to help patients is through play, which he learned from Winnicott, and about which published a book last year, Playing and Becoming in Psychoanalysis. 

Therapeutic play, Cooper argues, should help the patient to develop "elasticity," a term he borrows from Ferenczi. None of this should be thought easy; we cannot be seduced by the word 'play' into thinking of it as something facile. Instead Cooper says that "finding new forms of play is immensely messy and challenging" (p.106). Some of the challenge comes from patients who "hold on to bad, sometimes persecutory objects rather than feel alone or helpless." Only if they can play with you can they perhaps come to surrender those objects.

Echoing McWilliams, Cooper says that "the play of mourning" is crucial: "limit and mourning are just as constitutive of play as more frequently described forms." Mournful play, though, can facilitate movement "from the chains binding the self to an internal object toward new experiences with self and other" (109). 

Play is ultimately a form of love, Cooper briefly notes, quoting Hannah Arendt (who was herself writing about Augustine of Hippo) who said that love consists in saying "I want you to be." Play is useful here insofar as it expresses "the wish to appreciate the patient as he or she is." 

The last chapter I will note here is from Ken Corbett, "Credo: So Our Lives Glide On." He foregrounds the importance of freedom, drawing here on Freud (and not, as I expected, on Fromm) in several striking ways. Part of the freedom of the clinician, he suggests, is to not know, to not intrude with one's knowing too soon, and certainly to not talk too much: "too much talking is akin to wind drag, and slows the patient down" (p.162). 

He then links his discussion of freedom to "the eroticism of coming into existence" through periods and experiences of "libidinal turbulence." These striking phrases are not developed in any depth, alas, no doubt reflecting the limitations of a word count in a volume such as this. 

There are a few gems in almost every chapter of Psychoanalytic Credos, but I will not drag this on with more talking! 

Overcoming the Super-Ego, Ego Ideals, and Blind Spots

I reviewed a manuscript for Routledge in July, and as always took my payment in the form of books, two of which have now reached me. I hope to finish the second book, Psychoanalytic Credos, and post longer thoughts on the weekend. 

I will offer just a brief note on the first of these, Vic Sedlak, The Psychoanalyst's Superegos, Ego Ideals, and Blind Spots (Routledge, 2019). My brevity is largely dictated by the fact that my academic year begins next Monday and thus my time is becoming severely compressed; but also because this particular book has a rather meandering style (which is quite charming and works well with the content) and largely covers some (to me) fairly well-known territory. So in lieu of a lengthy discussion I shall give you a summary in Four Theses:

1) Avoid Moralization: 

Those of us trained with some notion of "neutrality" or "abstinence" (as Freud sometimes called it) are familiar with the idea of not proferring opinions on controverted moral questions or on most aspects of a patient's life, and of not giving advice on, say, whether to marry or divorce or change careers. But Sedlak advocates going beyond this to say that while we all have moral views, and these are natural, we must do a better job of preventing them from sneaking in to the therapeutic relationship in order to judge, say, a patient's marital situation or sexual fantasies or other choices. The patient's unconscious can pick up on these judgments even if you feel yourself to be sedulous about keeping them out of open discussion. (As someone who works with adolescent and adult sexual offenders, as well as those plagued by sadomasochistic fantasies, I found this a salutary reminder and challenge.)

Moralization is the result of an untamed super-ego, and much of this book's burden is to call for the therapist to work not on the patient's super-ego in the first instance, but on their own, replacing some of its harsh moralizing with what Hanna Segal called kindness and respect. In doing so, Sedlak says, you will end up helping the patient moderate their super-ego as well. 

This is especially important when it comes to failures--our own, and those of the patient. Here Sedlak openly says we have to challenge ourselves to find a way of discussing such things--including therapeutic ruptures and mistakes--"without writing a morality play" (p. 64). We also--here and elsewhere--have to keep in mind that none of us is ever permanently free from the "daemonic power that can fuel one's sadism" (p.68).

2) Avoid Colluding to Exclude Hatred:

In a chapter with the striking title "Contemplating Analytic Failure," and later in another chapter "Hostility Terminable and Interminable," Sedlak, with commendable and not frequently encountered candor in other clinicians, tells us of a case which he regards as a significant failure on his part. It was a huge blind spot for him. (The theme of blind spots does not come up as often as I wished in this book.) In essence he colluded with a patient to keep anger and hatred out of the treatment, and to that extent failed the patient. He challenges us not to make his mistake. (He does not give much by way of practical detail on how to do this, alas.) 

He prefaces this by wondering aloud as to how successful Winnicott was in really tolerating the hatred in his patients that he is sometimes credited with doing. I also ventured some doubts about DWW on this very point nearly a year ago now. 

Here he cites familiar but disturbing data (from Linda Hopkins' invaluable scholarship) on how Winnicott failed to deal with hatred and aggression in Masud Khan, his sometime analysand and editor. (F.R. Rodman's biography of Winnicott, which in my view is far and away the best of the biographies of DWW extant, is even more critical of DWW's handling of the Khan scandal.) Perhaps if DWW had dealt more forthrightly with Khan, the latter's abuses of his patients could have been avoided. DWW seems to have also avoided treating hostility with two other well-known patients: Harry Guntrip, and Margaret Little whose treatments have been written about extensively in the literature.

Sedlak is under no idealistic illusions about handling anger, hatred, and hostility. He says it will require constant maintenance and monitoring by the clinician, and you should have no ego ideals about your own ability easily to do this, or about the patient's willingness to give up hostile or unhealthy attacks on you, himself, or the treatment. 

This brings us to our third thesis:

3) Always Examine and Restrain Your Ideals about 'Cure':

One of the things I first learned from the great Nina Coltart is that you really have to ride ruthlessly on your ideals and hopes about "cure." 

Coltart was also--more than Sedlak is in this book--quite open about advocating that you not only allow for aggression to emerge, but that you figure out a way to draw on your own aggression and use it productively. In this I think she goes somewhat beyond both Sedlak and before him Winnicott. I wrote about this here. 

Sedlak says that completely giving up ideals about curing your patient is not only impossible but also at least partly inadvisable. You may need them to keep you motivated during a tough slog. So you need your ideals, but you need to not be ruled by them. If you are, he warns in several places, your patient may pick up on this and hold you and the treatment hostage by refusing to get better. Negative therapeutic reation, he says, may come from a patient denying you the power to "make" them better. In other words, the patient will want from you a demonstration that you love them unconditionally--without them getting better first--and only if they obtain that will they then allow treatment to proceed. 

Quoting a 1978 article from D Widlöcher, Sedlak warns of how unexamined ideals can ensnare therapist and patient alike, leading to treatment collapse:

the more the psychoanalyst's ego is dependent on his own ego ideal, the more dependent he is on his patient, and conversely the more dependent on the patient he feels, the more he accentuates his dependence in relation to his ego ideal and reinforces his own superego demands in order to detach himself from this dependence--a genuine vicious circle which introduces the problems of narcissism into the...countertransference. 

4) To Suffer the Illness Rather than Suffer From:

With, it seems to me, Bion in the background, Sedlak several times says that one of the aims of treatment is to help the patient suffer the illness rather than suffer from it. He's not entirely clear on this point, but what seems clear enough is that you do this by accompanying the patient so that, as Bion noted, the painful and horrifying--and thus often psychotically warded off thoughts and memories--can now be endured ("suffered") precisely because there is another there to help you do so, thereby preventing you from being alone and suffering from the malady entirely on your own. "Suffering from," in other words, is solitary and miserable; "suffering" is with another, and to that extent potentially very powerful. (To be alone in the presence of another person, as Winnicott so memorably taught us, is an enormous developmental achievement and never to be taken for granted.)