The Pain of Getting Close and the Chill of Living Apart

One of course often encounters such a lot of nonsense of Twitter and other platforms, but the former has more than earned its worth in my mind for introducing me to the work of Jonathan Shedler and a few others like Allen Frances. From the former I recently read a recommendation to read Deborah Anna Luepnitz's 2002 book Schopenhauer's Porcupines: Intimacy and Its Dilemmas, and I'm very glad I did. In fact, so delightful is this book that I read it in one day, and then immediately set to trying to figure out which courses I can assign the book in. 

The book is a collection of five case studies of patients Luepnitz has treated over the years. I have been reading case studies for many years now, and vanishingly few clinicians have enough literary skill to present them with the felicity and fluidity that Luepnitz does. Too often they are rendered tendentiously, with tiny bits of the person's life farced between leaden dollops of whichever theory is being served up. Freud rightly won the Goethe Prize for his prose, and his case studies even in English often read very well. If that is the standard we should congratulate Luepnitz for surpassing it so splendidly.

In any event, the book is off to a rollicking start by recounting the author's trek to Freud's last residence in London. I have not been there, but hope to some day; I have, however, made my own pilgrimage to Bergasse 19 when I was giving a paper at the University of Vienna in 2016. I wrote briefly about that experience elsewhere. 

Then it moves on to telling how Freud loved the story of Schopenhauer's porcupines, and used it in his Group Psychology and the Analysis of the Ego. Buy the book just for her profitable retelling of this tale. 

From here the book moves into a brief discussion about ambivalence (well treated in this book) and then the role of hatred in all our loves. Here, of course, Luepnitz cites a paper I have so often turned to in the last three years: Winnicott's "Hate in the Counter-Transference." Luepnitz sums up Winnicott's lengthy paper by quoting the poet Molly Peacock, "there must be room in love for hate." 

From here, the rest of the book simply allows the five stories to unfold, with the barest of theoretical commentary on the cases, and this along familiar lines--pointing out examples of projective identification, of "resistance" and its often salutary uses (which clinician and patient alike may not take seriously enough), and again the ambivalence that obtains in therapy: "Everyone who seeks therapy brings a desire for and a resistance to change--a yes and a no" (p.78). I will give away no more of its riches but encourage you to read the whole thing. 

In its final pages, Luepnitz's book returns again and briefly to Winnicott on how to understand termination in therapy. In his famous discussion on transitional objects (whose possible theological applications I discussed here), he notes that there will come a time when the blanket is neither destroyed nor eaten, but simply set aside as no longer necessary. 

How May We Say that Psychoanalytic Therapy Changes Us?

I freely admit that I've struggled for twenty years to read Lacan with any profit--nearly the same period as I've sought to discern the effects of my own psychoanalysis, which ran for seven years four times a week on the couch. So I am glad, finally, to have been exposed to enough of his writings to find some insightful and useful ideas therein for understanding my own experience as an analysand. 

At the same time, though, I am aware of violating my own practice of always seeking to read primary literature rather than secondary sources, which I have done in this case in the form of Luis Izcovich's recent book The Marks of a Psychoanalysis, trans. E. Faye and S. Schwartz (Karnac, 2017). Izcovich is a psychiatrist, psychoanalyst, and academic teaching and practicing in Paris, where he is a founding member of the School of Psychoanalysis of the Forums of the Lacanian Field. He has written several other books, most of which have not been translated into English. He quotes Lacan lavishly, especially in the latter half of the book, which was far and away the more valuable part to me. 

Part of the accessibility of this book, for me, was that it does not confine itself only to Lacanian thought. Chapter 10 takes me into deeply familiar territory: England, where Izcovich reviews the work of Winnicott and Guntrip. The latter was especially interested in the question at the heart of this book: how much change can anyone expect to experience after having been analyzed? 

Guntrip was first analyzed by the unjustly neglected Scottish analyst W.R.D. Fairbairn (about whom John Sutherland wrote an interesting if incomplete book, Fairbairn's Journey into the Interior) toward the end of the latter's life. Fairbairn--to the extent he is known at all today--is invariably introduced as a solitary Scottish analyst practicing in isolation in Edinburgh where he kept out of the Controversial Discussions and turmoil in the Klein-Freud feud around the English psychoanalytic scene down in London in the 1940s. Fairbarin, even in relative obscurity, remains, to my mind, important for his early and still valuable work on the schizoid personality type which others--Guntrip most notably--have expanded upon considerably. 

Guntrip felt there was still more work to be done, and so embarked upon a second analysis with Winnicott. He would recount details of both analyses later in writing, showing that he received different gifts from each analyst, but that Winnicott was able to take him farther than Fairbairn, but neither could go as far as Guntrip hoped and wanted. 

If neither analyst was able to effect the comprehensive cure that Guntrip seems to have wanted, he would nonetheless be led to ask a crucial question (which is also Izcovich's question): "How complete a result does psychoanalytic therapy achieve?" 

In one of his last essays, "Analysis Terminable and Interminable" (1937), Freud answered this question in a pessimistic way. Here Freud recognizes that almost all analyses will be incomplete in some way for diverse reasons. In some cases it may be that the analysis was broken off too soon; but in in others an analysis may have been successful, allowing for the patient to have a long period of health and freedom which may then be unexpectedly replaced by a return of old habits, or fresh suffering, requiring new therapeutic attention. Sometimes the analysis did all that it could, and new trauma, which nobody could anticipate, emerges, requiring new therapy. This is also true in a well analyzed analyst's life, leading Freud here to give his famous--and welcome--counsel that "every analyst should periodically--at intervals of five years or so--submit himself to analysis once more, without feeling ashamed of taking this step." 

Izcovich goes beyond Guntrip to ask additional questions: What are the marks of a successful and completed analysis? Can we see them clearly? 

When he finally and fully turns to these questions, Izcovich offers an attractively straightforward answer, at least for me: "without doubt the most salient (marquant) indicator of analytic progress is a very clear change in the intellectual inhibition that preceded the analysis" (121). This, he notes later on, does not have to be immediate and is not always calculable. 

A little later Izcovich writes in what seems to me reminiscent not only of Winnicott, but even more of Adam Phillips (whom he does not cite) when Izcovich notes that "one aspect of psychoanalysis is anti-identity" (135). As Dodi Goldman (inter alia) has mentioned, one of the most attractive aspects of Winnicott was his thwarting of ideology and identity in their essentialist guises, his refusal to be dogmatic about these and other matters. 

That, it seems to me, is an especially rare and important gift today--to be freed of the need to have have questions of "identity" solved in a clear and unambiguous way. At the same time, however, such freedom comes at a cost, which was well captured in Auden's haunting panegyric poem for Freud where he notes that "To be free/is often to be lonely." 

The answer to these questions--about the ends and marks of psychoanalysis--is not automatic, and Izcovich shows that Lacan would want us to remind us that the "crucial question concerns what use is made of the effects of an analysis" (213). It should not be assumed, he continues, that one effect is for the analysand to become an analyst "but rather it is what analysis changes in the way someone lives his life" (215). Such changes, however, do not result in having everything resolved sensibly and in understanding everything. Rather there is "discontinuity" at the end of the analytic journey, which leaves one--here Izcovich and Lacan quote Melanie Klein--with a renewed capacity for "solitude" (which is well treated in the contemporary English psychiatrist Anthony Storr's book Solitude: A Return to the Self.)   

In the end, then, Izcovich says that for Lacan "therapeutic analysis should clear the way, via a freedom in relation to the symptom, and, as a consequence, open up the most direct path in life to the realization of one's desire" (239) insofar as this can be known and accepted (for some people do not want what they desire, or do not want to desire at all!). In some cases, one's desire, after an analysis, has been re-directed: "libidinal redistribution implies the withdrawal of libido from certain partners in life in order that it be invested in new ones" (243). 

Izcovich's book did not offer all the answers I may have expected when I first picked it up, but it was and is a useful reminder (especially when joined to the chorus of others whom I love, particularly Nina Coltart but also Michael Eigen) that analysis begins and ends in mystery. 

Adam Phillips and Leo Bersani on Intimacies

Some day I might write that very long review essay about Adam Phillips, almost all of whose books I have read and re-read.

One that had hitherto escaped my attention is a slender volume co-authored with Leo Bersani in 2008: Intimacies. Herewith just a few thoughts from it.

The book is characterized by an anti-historical approach which is surprising to find in psychoanalysis. By that I mean they begin by asking whether or not "psychoanalysis has misled us into believing, in its quest for normative life stories, that knowledge of oneself is conducive to intimacy" (vii).

More strongly still, the authors assert that "There are other satisfactions than the satisfactions of personal history" (3). This is not to say that history is irrelevant or can--or should be--escaped. But it is to take up again a theme developed across many of Phillips' books: the danger of imprisonment in the past, in the stories of our past which presume to determine who we are, what we are and are not allowed to think about ourselves.  

This is a danger which can in fact drive some people to analysis and therapy, but even there sometimes certain stories get reinforced if, e.g., one is especially wedded to a diagnostic history. It requires careful clinical discernment to know when to set aside diagnostic history and labels because they end up doing more harm than good, forcing people to believe something that may not work to their total good.

This becomes clear towards the end of the book when the authors note that "as a clinical practice, psychoanalysis is committed to the unsettling of the individual's hard-won (i.e., defensive) self-knowledge" (93). 

Another theme common in much of Phillips' writings--but here expressed in a more explicitly Lacanian vein--is the fear we have of being too much for ourselves. In this book, both Bersani and Phillips recognize "the fear of jouissance, despite and because of the longing for it,...is not to be underestimated" (97). 

Finally, perhaps the most interesting question raised by and in the book is this: must we understand ourselves in order to be happy? The authors do not quite put it this way, but instead note the assumption of most standard analytic therapy is that "whatever is strange about myself I must make familiar; recognition must replace bewilderment" (99). This they take to be the gist of Freud's famous (and famously mistranslated) "where id was, there shall ego be." 

But why? One of the things Phillips has helped me to see over the years is that a certain degree of self-forgetfulness is very much to be welcomed. Put in concrete terms, I have realized--never more so than during this pandemic--that one way to even temporarily lift one's mood is to go do something concrete for someone else, forgetting about your own struggles for a time. Make soup for someone in a shelter, or help shovel the driveway of your elderly neighbor. Such seemingly "banal" things can in their own way be therapeutic.