The Repression of Sexuality in Contemporary American Psychoanalysis

Two weeks ago I had the pleasure of reading Conci’s biography of Harry Stack Sullivan entitled Sullivan Revisited – Life and Work: Harry Stack Sullivan’s Relevance for Contemporary Psychiatry, Psychotherapy and Psychoanalysis. It’s a wonderful work that contextualizes the radical innovation of Sullivan’s contribution to interpersonal psychoanalysis. Sullivan is the grandfather of contemporary American psychoanalysis and Stephen Mitchell recognized his work as foundational to the contemporary movement. Sullivan began his work at Washington DC’s storied St. Elizabeths Hospital. He then went on to work at Sheppard Pratt Hospital, outside of Baltimore. While at Pratt, he began a therapeutic wing for young male psychotics who recently had psychotic breakdowns. He collaborated and influenced Frieda Fromm-Reichmann’s work at Chestnut Lodge, a hospital located in the DC suburbs (in Rockville, MD).

What was interesting about Conci’s story about Sullivan’s theoretical and therapeutic innovations was the ways in which he re-worked psychoanalytic theory. Although he relied heavily on Freud’s notion of transference (which he re-named) and had an appreciation of unconscious processes, Sullivan was innovative in stressing the social nature of human beings. Sullivan (like many other early dissenters such as Fromm, Thompson, Fromm-Reichmann, etc) argued that Freud had overemphasized the sexual in human nature. Sullivan also collaborated with many social scientists, believing that the cultural and political background greatly informs the ways in which society understands mental illness.

Although I greatly appreciate Sullivan’s contribution to the theory and treatment of schizophrenia (along with the other notables in the interpersonalist tradition such as Fromm-Reichmann and Searles), I was astounded to find how quickly these psychoanalysts dropped sexuality from their theory. Continue reading “The Repression of Sexuality in Contemporary American Psychoanalysis”

Repetition and Remembering – Thoughts on the Season Finale of Mad Men

1) The Bar Scene – During this scene, I really worried Don was going to have a conversion experience to Xianity. Instead, he punched the minister for offering him salvation and for damning JFK and MLK (although apparently Don was OK with Nixon). While Weiner draws our attention to another memory of Don’s life with the condemning minister, another idea came to mind. As Don is once again coping with his emptiness through alcohol, this minister attempts to offer him the ultimate escape: the fantasy of a redeemed past. Don rejects this illusion and beats the hell out of him. The past cannot be changed. Dangling the carrot of redemption in front of a broken man is torturous.

2) California – As usual, Don attempts to deal with conflicts and problems by wanting to run away. He hopes to escape the ennui of his existence and his frustration with his marriage and children. Given that he and Megan had good experiences in CA, Don believes he can magically save his marriage and himself through a change of scenery. Perhaps this represents Don’s attempt to reconnect with Dick Whitman who was only ever himself with Anna in CA. Of course, there is no holiday from one’s self. This becomes apparent in Don’s next major scene.

3) Hershey’s – After presenting his typical sentimental pitch to Hershey’s of an imagined childhood that he never experienced, Don begins to have a tremor in his hand. While everyone appeared satisfied with his presentation, Don cannot contain the repressed truth that is demanding to be spoken. He confesses his truth. He was an orphan raised in a whorehouse, neglected by his mother. He only obtained Hershey’s chocolate bars by stealing change from men who rented prostitutes. He then engaged in some ritual wherein he imagined (probably dissociated) having a life where he was wanted and loved. He fantasized about a life where things were sweet rather than bitter.

4) The Final Scene – Now that Don is being given an unspecified holiday, he decides to continue down the path of his own redemption. My friend reminded me earlier tonight that Sally had previously said that to Don, “I know nothing about you.” Don has decided to finally open up to his children about his past. He came from poverty and the “bad side of town”.

Analysis: In these movements of the episode, we see that Don is continuing to confront themes of redemption. In the first scene, Don violently rejects the myth of the redeemed past. He knows this is cheap. As is typical, Don imagines that he can only be saved by fleeing to CA and hiding. This reminded me of Freud’s (1914) beautiful paper “Recollection, Repetition, and Working Through” in which he argues that repetition is a defense against remembering (past traumas). Don’s entire life has been a series of repetitions of the same scenarios: impress, seduce, self-destruct and hide. CA would be another way to repeat the cycle. However, it would simply represent another attempt to avoid remembering, recollecting, and integrating the past traumas. Don’s salvation will only come through remembering and being honest about the horrors and suffering of his childhood. Moreover, Don will only receive grace by coming to terms with his own sins and confessing them to the people he loves, especially his children. No God can save him, however. Only through recollecting and mourning the difficulties of his past can he hope to live a life full of integrity, wholeness and honesty. This final scene represents the first steps of Don trying to be honest. Perhaps he will not survive this exploration of the past (many trauma survivors suicide during this painful phase). The number of repressed memories that resurfaced this season indicates that his unconscious demands to have a voice. The return of the repressed must be dealt with and alcohol cannot silence the truth of his history. Can Don survive the final season?

Balance and imbalance

Which comes first, balance or imbalance? Which is more primordial? Many would have it that balance comes first, that there is a preestablished harmony that is then disturbed, often by human willfulness. In our contemporary world, for instance, many would hold that the market is inherently balanced and is only thrown off by extraneous human interventions — a modern-day notion of the inexplicable intrusion of original sin into God’s perfect creation.

Yet there can be no such thing as a permanent, inherent balance, because balance always presupposes at least two things. If we see something that looks like a balance and is permanent and inherent, then it is only a balance by analogy — really, we are just looking at parts of one thing and noting how they go together. Balancing always means balancing things that are not the same, that are not inherently compatible, that don’t automatically fit together. Balance is always an achievement, and one that must be continually renewed.

This provides us with one way of interpreting Zizek’s claim, based in his reading of Hegel and Lacan, that the gap is primordial, that difference actually generates what seem to be its positive terms. Continue reading “Balance and imbalance”

“I’m not here to tell you about Jesus”: Don Draper and the Death of God

In the first-season episode “The Hobo Code,” which in many ways is the most important of the series, Don Draper is selling Peggy’s copy to a reluctant client. He goes on the offensive, asking them to leave if they aren’t serious about changing their strategy, and along the way he makes an enigmatic statement: “Listen, I’m not here to tell you about Jesus. You already know about Jesus, either he lives in your heart or he doesn’t.” The pitch proves effective, and when Ken Cosgrove mentions how great “the Jesus thing” was (perhaps implicitly asking what it means), Don explains that “sometimes force is actually being requested.” I am probably not alone in finding this explanation, such as it is, less than helpful.

So what does the quote mean? Or better: What role does it play in the episode and the season? Continue reading ““I’m not here to tell you about Jesus”: Don Draper and the Death of God”

Taubes and Zizek

From Jacob Taubes, “Psychoanalysis and Philosophy,” in From Cult to Culture, pp. 323-24:

The analysis of man according to the guideline of history, carried out for example by Hegel and Marx, is replaced around the middle of the nineteenth century by an analysis of man according to the guidleline of psychology…. Freud is positioned within this turn, and his psychoanalysis gives it a particular acuity. And still, the problem of history poses itself anew in Freud…. Psychoanalysis differs from all other variations of psychology as the most radically historical. Its fundamental design is historical. It works with histories of illness and with the biography of the individual as a constitutive part of its therapy…. A reflection on the process of psychoanalytic theraby necessarily encounters the problem of the historical method in general and, as I claim, particularly the problems of the historical-dialectical method. It is the explicit thesis of these reflections that Freud’s psychological writings in general and his metapsychological writings in particular answer questions posed by Hegel’s dialectical method and philosophy of history. That is, sub specie Freud the fundamental problems of Hegel appear in a new light; sub specie Hegel, the fundamental problems of Freud appear in a new light.

A Kleinian Appreciation

Over the last month I’ve been reading through Melanie Klein’s published works in Love, Guilt and Reparation and Other Works 1921-1945. Tonight I had the joy of reading her paper “Symposium on Child-Analysis” (1927) which is a response to Anna Freud’s critique of Klein’s play technique with children. I wanted to describe some of Klein’s intriguing arguments and then describe how Kleinians have a radically different way of approaching analysis for patients from all populations: children, adult neurotics and psychotics.

Continue reading “A Kleinian Appreciation”

Insight and Change in Psychotherapy

In a recent comment on CBT and psychoanalytic therapy, a commenter, Dr. Jason Ramsay offered a familiar criticism levied against psychoanalysis:

I loosed the boundaries of CBT and found myself working from a psychodynamic perspective more and more, because that is what they wanted. What I found was that lots of insight was generated. Some could, some could not. But in the end, insight was rarely enough to help them change years and years of maladaptive behaviour. In the end, I think that what many of my patients in the study wanted was a combination of insight and technique oriented treatment, just for much much longer than the 12 weeks we were able to offer.

There is much to reflect on here, especially in the wake of a paper I recently presented on social adaptation and the goal(s) of psychoanalysis. Psychoanalytic clinicians are consistently critiqued by others in the profession that knowledge and truth are not sufficient to facilitate change. Some go so far to even discourage exploration and view it as a defense against making “real behavioral change.” While I am not absolutely against providing certain patients with skills (particularly in extreme situations such as psychosis) I always wonder a bit about this argument. I should note that I have yet to be trained to provide psychoanalysis just psychotherapy (although the dividing line is questionable as my old Lacanian teacher once told me). One is led to believe that unless certain folks are given skills they will never be able to make lasting changes. Let me try and break this idea down further.

Continue reading “Insight and Change in Psychotherapy”

Saving Freud from himself

I just got through a couple weeks of teaching Freud, which was a lot of fun. It was particularly interesting to do as I’ve been spending so much time with Lacan lately — it seems to me that the basic Lacanian interpretative strategies and emphases really “work” in the classroom setting, though by this I don’t mean much more than highlighting the “linguistic” element. We did a handful of his introductory lectures along with the case of Elizabeth von R. from Studies in Hysteria, and with regard to the latter, I feel like in discussion I stumbled across a really evocative way of putting the problem of hysteria: what kind of beings must we humans be if we can get sick from a pun?

That case study also includes the kind of thing that always disappoints me in Freud, namely, his desire to bring things back to some kind of biological origin. In his concluding reflections on the function of metaphor in hysteria, he brings in Darwin’s theory of the origin of the emotions (also quoted by James, by the way!), and things really fall flat for me at that point. There’s something similar skewing his theory of feminine sexuality, it seems to me — many of my students felt frankly betrayed after reading “Femininity” from the New Introductory Lectures, and I think it’s the gravitational pull of the idea of a “natural” biological outcome that produces all the well-known contradictions and slippages in his argumentation here. (And to their credit, my students engaged more in authentic critique than in extrinsic criticism, as Freud had built up enough good will in their minds in previous readings that they tried to stay with him for as long as they could.)

I know I’m not saying anything original, but it’s striking to see how this unfolds among students approaching Freud for the first time — and to juxtapose it with my current work with Lacan, so that I can see so clearly the ways in which Lacan might, from a certain perspective, be “saving Freud from himself,” bringing forward his most authentic and radical insights and freeing them of the gravitational pull of naturalistic reductionism.

Psychoanalysis and the Social Order

As I’m preparing my conference presentation which I’ve briefly discussed here, I’ve been reading some early papers by Freud. I especially enjoyed “‘Civilized’ Sexual Morality and Modern Nervous Illness” (1908). I found Freud’s observations very prescient and provocative. In this paper he discusses how society’s regressive attitude about sexuality contributed to the high rates of neurosis in both men and women. Freud is critical of the value society placed on abstinence, believing that the amount of energy it required was certain to deplete the individual’s capacity to fully exert himself in other arenas. He argues that men who are abstinent before marriage ultimately do a disservice to themselves and their future wives because it renders them weakling who have irreparably damaged their libido. Freud goes on to claim that women are often promised that marriage will finally satisfy their sexual desires, when, in reality, it will certainly prove to be disappointing and unsatisfying. Freud criticizes those doctors who encouraged “nervous” women to get married, because Freud noted that “the cure for nervous illness arising from marriage would be marital unfaithfulness”. Due to societal repression of their sexual instincts (along with great moralistic coercion), women are forced to find “seek refuge in neurosis” and remain in their hapless marriages. Interesting stuff.

What intrigued me about this paper was that Freud raises larger questions about society and condemns cherished institutions and norms given that they are responsible for individual pathology. Eric Fromm also discussed how society can often have socially patterned defects and that adaptation to a pathological society should not be seen as healthy. Fromm argued quite persuasively that adaptation and conformity to the social order might be a sign of individual pathology. Surprisingly, social adaptation has been upheld as healthy in many psychoanalytic camps as the gold standard for “mental health” especially in the United States (think of Hartmann’s fixation on adaptation and Sullivan’s emphasis on consensual validation). Also, in my clinical experience, I’ve found that many clinicians are liable to label non-normative beliefs and skepticism of major institutions (e.g. marriage) as defenses rather than adult convictions.

Lacan likewise detested these analysts who upheld adaptation and conformity as the aim of psychoanalysis. Of course, for us clinicians in the trenches, things are not always so simple. Psychoanalytic clinicians also uphold neutrality (not taking side in the patient’s conflicts) and abstain from suggestion. Kernberg has written about how analytic neutrality has often served as a mask to obscure the analyst’s prejudices and ideology. My paper will move in the direction of stressing how Lacan’s understanding of the unconscious and desire necessarily require an analysis of the social order.

I think that the rules have to change radically when working with individuals who are suffering from psychosis but that’s another conversation. I’ve never really had much sympathy with the anti-psychiatry movement…

Overheard remarks

In connection the directed reading over Lacan that I’m supervising, I recently read Jonathan Lear’s Freud, which I assigned to make up for the fact that we can’t literally do the ideal thing to prepare for the reading of Lacan, i.e., read all of Freud 14 times in German. Lear spent some time on Freud’s dream of the botanical manuscript, the interpretation of which hinged crucially on something Freud’s father said about him, in his presence, but not to him: “He’ll never amount to anything.” I recalled that Bruce Fink had also reported the importance of overheard parental declarations in psychoanalysis — and the fact that the crucial declaration may not even be about the child himself or herself (for example, if Freud’s father made the same declaration about the neighbor boy, but Freud had misunderstood it as referring to him), an idea that for some reason struck me as deeply tragic and meaningful.

A chain of associations opened up. For instance, once when I was in grade school, I decided that I should become a spy and hid under my parents’ bed and listened to an odd conversation. Continue reading “Overheard remarks”