Kavanaugh - The Quest in Psychoanalysis: Philosophical Underpinnings of Theory and Technique
The Quest in Psychoanalysis:
Philosophical Underpinnings of Theory and Technique ©
by Patrick B. Kavanaugh, Ph.D.
The Quest in Psychoanalysis ... speaks to the philosophic positions of uncritical realism and phenomenalism; their respective influences in establishing the context for the analytic discourse and discovery; and, their respective influences in shaping psychoanalytic theory, concepts, attitude, and objectives. Consideration is given to a series of questions as might be answered from each of these respective positions: How do underlying philosophic assumptions influence how one listens? ... understands? ... and responds? ... in the analytic discourse. A psychological theory of relativity is advanced in which the complexity and uncertainty of everyday life is considered as an integral part of the analytic discourse.
The role of theory in shaping, organizing, and influencing how one might listen and respond to clinical material has been a subject of considerable interest in recent years. Indeed, during these years, the MSPP has sponsored a number of weekend institutes which have provided the opportunity for further inquiry and questioning into the relationship between one's theory and clinical practice. These institutes and programs have included "Images in the Family: Psychoanalytic Perspectives" (Winter Institute '87), "Reality and Trauma in Psychoanalysis" (Summer Institute '88), "Psychic Reality and Historical Truth" (Winter Institute '89), and "The Associative Method" (Winter Institute '90). The focus of many of these institutes has been upon the question, How does one listen? This rather central question was posed in recognition that how the practitioner conceptualizes provides the bases for subsequent and narrower questions such as: What does one hear? and, How does one respond to that clinical material? There seems to be an even larger and more central question, philosophic in nature, which has made its appearance in one form or another during each of these recent institutes and which underlies the question of the role of theory in how one listens: What is the of reality?
There has been an increased recognition of late that the basic philosophical assumptions which are recognized as 'true' within a particular science or discipline determine the context for ensuing discourse and discovery and, also, for the relevancy of those questions which would subsequently arise in debate or direct further inquiry. It is this proposition which relates quite directly to the questions under consideration: What is the nature of reality?, its influence upon "How does one listen"?, and, its determination of the context for ensuing discourse, discovery, debates, and directions in a psychoanalysis?; a four dimensional influence which substantively establishes the parameters for the analysis. The question as to the nature of reality and the philosophical position taken by the therapist i.e. "uncritical realist" or "phenomenalist" underlies one's psychoanalytic perspective and clinical work. Either of these positions adopted by the analytic practitioner leads to equally far reaching and consequential understandings of: theory, motivational causalities for the individual, criteria for entering treatment, the purpose and goals in treatment, subsequent technique and interpretive style, and criteria for termination. Clearly, one's position regarding the nature of reality has a profound impact upon each element of the analytic process: from that which is considered to be clinical material, to how one listens and responds to that material.
As a contribution to the ongoing questioning and inquiry as to "how does one listen" and "respond" to material, this paper considers some of the implications and questions which derive from this underlying question as to the nature of reality. Specifically, consideration will be given to the philosophical position of uncritical realism and to that of phenomenalism; and, from each philosophical position, some of the implications for one's understanding of theory and the subsequent role of theory in shaping and organizing "how one listens and responds" to clinical material in the analytic hour; also, particular consideration will be given to the centrality and role of "transference" from each point of view.
In general, most people in our culture would adhere to that metaphysical point of view believed to have originated in the "common sense" of early man, and which continues today as the "common sense approach" to the world of objects, people, events, and actions: uncritical realism. Most people would find it absurd to even question the "fact" that a real objective world exists. Their response would be to state with certainty that there is, indeed, a real, objective, and knowable world. It would be considered a bit ridiculous to even pose the question. This "common sense" approach is to be found embodied in the logical positivist's view of the world and has come to provide the model for what is considered to be "science" and "scientific". It rests upon the assumption that there is a free standing reality, an independently existent world about which "the truth" will eventually be known through the systematic application of the scientific method. One's ability to arrive at statements of "truth" rests upon accuracy in assessment and measurement and the appropriate mathematical language and expression of those findings. The replication of results provides both public validation as to "the truth" revealed and progressively greater degrees of certitude as to the particular "truth". From this philosophical position, the world is believed to be self-evident: it does, indeed, exist independently of the observer;. and, objects are fixed and stable, and enduring over time and in space. The scientific method provides a way to obtain neutral, objective, and, thus, legitimate knowledge about this world. From this metaphysical position, there are currently real people, real objects, with real events taking place; and, there were real people, real objects with real events having taken place in the past.
This view of the nature of reality as objective and knowable is quite evident in current psychoanalytic theory. In psychoanalytic theory, the understanding of behavior considered to be pathological is modeled after the traumatic neuroses as would be found in the Studies in Hysteria, i.e. "hysterics suffer from reminiscences". A question to be asked is: reminiscences of what? "archaic events" or "archaic experiences". This theory holds that the basic motive of the current pathological behavior is that the individual is attempting to repeat the faulty attunement of the childhood surround in order to master, or to attempt to master through the repetition, a particular "traumatic event" or series of events which impacted upon them in early life, or, that the individual's current pathological behavior is the consequence of arrest at critical developmental junctures and/or stages. The "theoretical truth", in the mind of the therapist, encompasses an actual, objectively occurring series of traumatic events such as traumatic failures of empathic attunement by mother with the patient as a child. As a consequence of these actually and objectively occurring experiences, it is presumed that a disturbed and/or disordered developmental sequence results and that which should have taken place by way of development did not. This lack of development might be conceptualized differently depending on one's theory e.g. the lack of development of certain of the individual's capacities and potentialities in terms of ego functions/strengths, self structures, or through the internalization of certain malignant objects. Independent of the particular theory, that which one would expect to have occurred by way of normal developmental accomplishment and/or acquisition simply does not exist in adult life as the consequence of that which was not encouraged and/or provided within the early environmental surround. More severe pathology would be conceptualized as having resulted from the trauma of "archaic events" having taken place, or not having taken place, at an earlier time along the developmental pathway. The repressed trauma is then repeated representationally (e.g. in the form of symptoms) throughout the individual's later living. In the therapist's mind, the individual, then, who speaks in representational language does so because of real, live people and events which have impacted so heavily, profoundly, and dramatically upon them as children. Subsequent behaviors considered to be pathological are viewed as a consequence of such developmental arrest or developmental anamoly due to objective, real interpersonal events or series of events which happened or did not happen. so long ago in the individual's childhood.
How might this philosophic position influence how one listens and responds in the analysis, in general? There are several considerations regarding the influence of the uncritical realist's view of the nature of reality as to "how one listens". A central and ongoing, organizing and evaluative dimension for listening becomes: How well is a particular individual currently adapting to and negotiating with this objectively knowable world? i.e. Is the individual's thinking about, perceptions of, reactions to, and feelings about this objective world and its events "realistic"---"unrealistic", "appropriate"---"inappropriate". Reality as objective and knowable becomes the therapist's "objective" evaluative background for listening, provides the criteria for this evaluation, comprises the continuum of that considered to be "realistic", and, influences, if not determines, that to be subsequently addressed in treatment. Further, from this understanding as to the nature of reality, the quest in psychoanalysis might be guided and directed by understandings and questions based upon distinctions between: What was reality and what was fantasy "back then"?; How do the current subjective distortions of this objectively knowable world relate to those past events? and/or How might the therapy further developmental growth? or, Assist in getting the individual back on developmental track? "Objective and knowable" in the mind of the therapist can very well lead to the subtle determination of subsequent analytic discourse, discovery, debate, and directions in the analysis by the therapist in the service of fostering and encouraging adaptation to that objective reality of the world "as it really is". Conformity to objectively defined and located standards as to how to see, think about, and feel, much less to interact within that world become presumed objectives around which treatment is organized with that which is understood to be interfering with or dynamically preventing such adaptation and conformity becoming the focal point of "how one listens" and "responds" through subsequent interpretation; and, with the therapist's motivational tendency to respond to the person with the purpose of developing that which is believed to not be there, e.g. ego functions, self structures, new self and/or object representations so that the individual would be better able to adapt to that objectively existing world. It seems that if one assumes an "objective reality" there would follow the inclination, if not the necessity, for the therapist to see themselves as a representative and arbiter of that objective reality in the treatment situation with this "reality" becoming the defining and evaluative standard, and, "reality" as perceived by the therapist becoming the unspoken, but anticipated and hoped for "reality" to be eventually known by the patient. The therapist would be seeking a theoretically anticipated outcome to the treatment with understanding organized around that which might prevent such an outcome.
How might this philosophic position influence how one might listen and respond during any given analytic hour? "Reality" as knowable and objective might lead to listening and hearing material differentially with distinctions in the mind of the therapist being made between "objective reality" and "subjective reality", "actual reality" and "psychic reality"; and, to be listening evaluatively and differentially as to which segments of the hour represent "artifacts of the transference" and "transference reactions" and which segments represent the "real relationship" and/or ‘working alliance" believed to be relatively uninfluenced by the transference and/or unconscious processes. As one proceeds from the philosophic position that there exists some objective and knowable truth, or essence, and that this "truth" has become embodied in one's "theoretical reality", then in the mind of the therapist the individual would be likely to be understood as speaking about that objective "something" by talking about something else " in the metaphor". The "theoretical reality" of the therapist enables the therapist to presume to "know" with certainty that about which the patient is "really" speaking. Interpretation is then seen to function like scientific inquiry itself. It provides a progressively more accurate picture of objective reality for the patient as to what "must" have happened in the actual past, as in reconstructive interpretations, or, what is "really going on" in the present. Thus, the more precisely accurate the articulation and elaboration of an interpretation, then the more progressively accurate the picture of the objective "dynamic reality" of the individual becomes.
As one is guided by an objective and knowable reality and conceptualizes in terms of actual "archaic events", the concepts of the "unconscious" and "transference" occupy a less central role in the analysis. As the person is "heard" and understood as having been impacted and developmentally arrested by the real external world, the focus within treatment turns to the more "relational" in at least two respects: the individual's relationship with this real and external world, and, the individual's "real" relationship with the therapist. With this conceptualization and understanding, a greater emphasis might then be placed upon this relationship with the therapist at times providing advice, consultation, and direction as to how to best deal with situations in life. The focus conceptually moves away from being within the experience of the relationship between therapist and patient. Transference then comes to be understood as a subjective distortion of current objective reality due to the past traumatic events, a conceptualization consistent with Freud's pathogenic memory model. Transference would tend to be seen as being entirely a repetition of that past objective reality distorting the currently objective situation. Transference as simply a repetition of that trauma leads to a conceptualization of transference as a "sometimes occurring" phenomena and its interpretation being in the service of disconfirmation. The distortions of the transference then are "corrected" through the superior perceptions of the therapist with treatment then conceptualized as a "corrective emotional experience". Reconstruction of the of the patient's actual past comes to occupy a very central role in both theory and in treatment with historical accuracy and veracity being criteria for the adequacy of the reconstruction. The individual's experience of self, his/her mind, its structures and contents. are conceptualized by the therapist to be the consequence and product of "objective reality" with causality presumed to be located outside of the individual. The individual has been passively shaped via "reality".
There has been a persistent questioning taking place within the "family of sciences" and other disciplines in recent years . The focus of the questioning has been upon that which had previously been taken to be unquestionable foundational assumptions. The questioning, philosophic in nature, has disturbed what had previously been considered to be foregone conclusions in physics, medicine, theories of linguistics, psychology, and psychoanalysis. The philosophic questions posed have brought into question the prevailing positivist model of science i.e. What is to be considered legitimate "knowledge"?, What is the relationship between knowledge and science? and, What is "truth"?. Questions have addressed the basic propositions of the positivist's model of knowledge as well as questioning from whence came the logic, the defining criteria, and the standards upon which the accepted logic of science rests and proceeds? Revisions and redefinitions of the traditional relationship between science and clinical practice with quite radical implications for education and in psychology have been subsequently proposed. Indeed, to reexamine the basic philosophical assumptions of the "objective and knowable" reality leads to a reconsideration of implications which derive for discourse, discovery, and directionality in analysis. Phenomenalism provides just such an opportunity for reexamination and reconsideration..
The phenomenalist begins with the statement that that which exists is whatever it is that occurs when the senses of the observer experiences; "reality" is in the eye of the beholder. From this phenomenalistic position, all knowledge of the world is contingent upon one's perception of it, and every perception is suspect as every perception is in the service of one's psychic needs. All perception is ideographic . What one perceives is the perception; there is nothing else other than the perception. A question which begins the questioning might be: Why is it necessary to make "objective reality" an element in one's theory? Indeed, to what end and for what purpose? As nothing ever "actually and objectively" transpires independent of one's perception, then the existence of objective reality in the past, or in the present, is questionable. Indeed, it would be necessary and important to not make "objective reality" an element of the psychoanalytic situation, in the mind of the analyst., as all that is needed to be known in the analytic endeavor is the individual's psychic reality i.e. this is what happened or is happening as is perceived by that person. A very significant distinction is made between the position of "subjective reality" as a distorted perception of the objective reality (uncritical realist), and the position that we know the world only through subjective reality (phenomenalist). The phenomenalist takes the position that this is the only world that we know, the only world there is. This is a significant factor in "how one listens and responds", one implication of which would be that the individual's statement of current difficulties are to be understood as the consequence of "archaic experiences" as contrasted to that of "archaic events". If one understands clinical phenomena as a consequence of "archaic experiences" the implication is that we do not know, nor will ever know, what transpired but we do know what the individual perceived and perceives. Psychic reality is the only reality of concern in the analytic endeavor. This view as to the nature of "reality" carries with it implications for one's understanding of theory and transference, and, how one listens and responds to material the analytic hour.
One of the implications for the understanding of theory with this emphasis upon "archaic experiences" is that the therapist is attempting to understand only that which the individual perceives including the conviction/experience that it was real, i.e. "reality" as it was and is perceived, and which perceptions come to define the treatment relationship. Memories of or reports of interactions with family members, childhood events, everyday occurrences, recent and seemingly indifferent incidents are not viewed as "biographical" nor "autobiographical" truths but as psychological narrative truths related to childhood and currently representing and reflecting ongoing sensual mental images/representations in the analysis. From a phenomenalist point of view, one does not have memories of childhood nor of family members in the sense of objective, independently existing events and objects; rather, memories and thoughts are viewed as being related to one's "experiences of childhood", influenced at that time by the way the child perceived "the facts" of their experiences to have been, and later are recalled under the influence of one's current motives, perceptions, and experiences which are viewed as being in the service of suiting the associative purposes of compromise formation and internal conflict resolution. The infant's perception of the world, if the world exists, is never independent of their perception of their world. One's world is actively organized perceptually, cognitively, and experientially in accordance with prevailing, ongoing, internal, dynamically interactive unconscious experiences and fantasies throughout life; throughout life, the individual signifies meaning. The therapist is always and is only listening to psychological narrative truths, aspects of which are experienced by the individual as "objective" and as representing historical truth. These memories, past events, and historical truths are understood as metaphors serving to convey and communicate ongoing experiences in the analysis i.e. transference. Whereas the uncritical realist would maintain that psychic reality takes place within the larger context of actual reality, the phenomenalist would maintain that psychic reality is the larger context, an aspect of which is experienced as external and objective.
How might this philosophical position influence how one listens and responds in the analysis, in general ?
From the position that all reality is "psychic reality", a very deceptively simple response would be: one would listen to all thoughts as mental representations, as associations unconsciously selected, organized, and orchestrated by the individual for the purpose of communicating something about themselves, about their understanding of their world, and of their experiences of that world, and, something about their understanding of what is going on in the present situation with the therapist as being a part of that world. From the point of view of internal conflict and conflict resolution, all conscious thought is "heard" as representational of unconscious thought with the individual speaking in representational language as a consequence of regression to archaic modes of conflict resolution which involve alterations in the internal modes of self representation and object representation, or, as a consequence of dedication to particular and selected forms of communication about one's archaic experiences.
One conceptualizes all behavior, not just those currently considered to be pathological, as being the consequence of conflictually determined "archaic experiences" in the context of self and object representation. One of the most immediate implications regarding treatment would be the purpose of psychoanalysis. Emphasis is upon attempting to understand the uniqueness of the individual and his/her idiosyncratic construction, definition, and experience of the world. Psychoanalysis then is a venture into communication. Indeed, one such definitional understanding of analysis might be: a venture into communication via the associative method within the context of psychic theatre. As part of this understanding, the therapist takes all thoughts, actions, and experiences as being brought to mind by the individual as being part of the communicative process. This philosophical position advances a very narrow and restricted purpose for analysis: to attempt to understand How the individual's world is constructed and experienced by that individual and to attempt to communicate the Why it might be, as is communicated by that person. The therapist has no other therapeutic ambition or intent other than to understand what is with little if any concern with what should be. The therapist, of course, has to trust and respect the person, the associative method and oneself. The quest in analysis is, thus, guided by questions generated by this How? and Why? with uncertainty becoming a necessary element in this psychic theatre of the mind as it is the patient who directs the discourse, and chooses the areas for discovery and debate.
How might this philosophical position influence how one "listens and responds" in the analysis during any given hour? How one listens during any given hour is inextricably linked to the centrality of the unconscious and transference from this perspective. The understanding of the role of transference would profoundly influence how one listens, understands, and responds to clinical material.
The phenomenalist's position is quite compatible with those theorists who would maintain that transference is involved in every relationship, not just that relationship within the psychoanalytic situation. Thus, it is not the transference which defines or distinguishes treatment as being psychoanalytic; it is what is going on in the therapist's mind and how that guides one's listening and interpretation. Phenomenalism as a foundational philosophical position for analysis reads as being absurdly and torturously intellectual, abstract and, unreal; yet, paradoxically, it permits the most concrete, sensory, and human of experiences to be (re)lived in the treatment. If the essence of analysis is the understanding of the individual's sensory experiences as relived in the transference, then it is through the analysis of the transference and the various elements of its compromise formations that analysis proceeds. Transference, then, is conceptualized as being neither simply nor entirely a repetition, possibly distorted, of object relationships "as they were". Rather, the transference is understood as an ongoing reliving, a repetition of archaic trait conflicts. Transference is a representation of a past perceived internalized object representation, and, also a way of representing current aspects/traits of "self". Representations of family members, or other significant object representations, can be viewed as representational of archaic objects as perceived by the individual, and, as representational of trait components within the individual himself/herself. The particular image brought to mind, for example a particular family member such as "father" or "mother", is done so to communicate both perceived archaic object and internal trait components. Also, the particular image e.g. "father" or "mother" could be viewed as having been unconsciously selected to conform with ingrained images of self and others; and, to confirm ingrained images of self and others.
T'he thoughts, actions, feelings and descriptions of an individual might indeed, represent a repetition of archaic of interactions with "father" as were perceived and experienced by that individual. One implication is that the past is known only through the transference; there is no need to assume any other. The same thoughts, actions, feelings, and descriptions represent an opportunity for archaic fantasies about an individual and his/her father to be relived in the treatment relationship. There is something more: the particular images of father are to be viewed as "mental representations", that is, as intrapsychic, idiosyncratic experiencing definitions of father experienced as being external to self. In each thought about "father" which is brought to mind, aspects of "self" are also manifested. The individual is always and is only communicating intrapsychic and intrapersonal aspects of oneself, and, these intrapsychic aspects of "self" are given expression in the form of the therapist becoming the internal mental representation of "father" perceived and experienced as external in concretized form: the reality of fantasy concretized. The particular image(s) brought to mind represent certain traits, certain trait-conflicts, attitudes, and characteristics which reside within the person. As would each character, element, and aspect in a dream be considered to be representational of "self" so too are images in analysis understood to be representational of "self", as representational of attributes within "self" and aspects of "self".
There are some further considerations regarding the understanding of transference from this perspective and its influence on "how one listens" during any given analytic hour. Each time an object representation makes an appearance in the individual's associations, it has to be understood as representational of a particular attribute and/or a particular experience which may be different each and every time it makes its appearance. The meaning of the particular object representation is to be derived from the surrounding associative context. For example, each and every image of "father" would be heard as representational of a particular sensual memory event/experience which, each and every time it made its appearance would have to be understood within the context of the patient's then current associations as to the specific idiosyncratic experiencing definition that it might hold for the person at that particular time in treatment. It becomes a psychological "theory of relativity" in which meaning and significance derives from context; it requires a reconsideration and reexamination of the implications for one's understanding of and relationship to language.
From this philosophical position. all of "reality" is psychic reality and is conceptualized as a product of the individual's mind with the locus of causality understood as being within the psychic theatre of the individual's mind. The individual is understood, in the mind of the therapist, as having been very actively involved in the construction and orchestration of archaic experiences. From this philosophical position, the therapist would tend to see the individual as an active participant in the treatment, in their life, and in decisions regarding their life.
Is reality objective and knowable?, or, Is reality in the eye of the beholder? The quest in psychoanalysis is inextricably linked to these philosophic quest (ions). How these philosophical questions are answered in the mind of each and every therapist determines the context and the parameters for ensuing discourse and discovery in the psychoanalysis they have to offer, and, how they might listen and respond to clinical material within that analysis.
Dr. Kavanaugh received his doctorate in philosophy (psychology) from the University of Windsor in Ontario, Canada. Since the completion of his doctoral studies, he has been active in the academic, organizational, and practice areas of the psychoanalytic-psychological community. In the academic area, he has served as Director of Clinical Training and member of the core teaching and supervisory faculty in the doctoral program in psychoanalytic psychology at the University of Detroit; as a member of the teaching and supervisory faculty in the Program for Advanced Studies in Psychoanalysis in Wyandotte, Michigan, an interdisciplinary program for the study of the analytic discourse; and, as a member of the teaching and supervisory faculty in the pre-and post doctoral educational programs at the Detroit Psychiatric Institute, the Wyandotte General Hospital, and the V.A. Medical Center in Detroit. In the organizational area, he is the founding and current president of the Academy for the Study of the Psychoanalytic Arts; past president of the International Federation for Psychoanalytic Education; the Michigan Psychological Association, and the Michigan Society of Clinical Psychologists. In the practice area, many of his professional interests during the past 35 years are directly related to experiences in the discourses of various residential treatment facilities.
Dr. Kavanaugh is a recipient of The Distinguished Psychologist Award from the Michigan Psychological Association and the Master Lecturer Award from the doctoral students at the University of Detroit.
Currently Dr. Kavanaugh is in the private practice of psychoanalysis in Farmington Hills, Michigan:
Office: 31805 Middlebelt, Suite #305
Farmington Hills, Michigan, USA 48334
Phone: (248) 626-6460
Fax: (248) 626-4808