Psychoanalytic Theory, Therapy and the Self

Harry Y. Guntrip

• Publisher: Routledge
• Year: 2018
• ISBN:
  9780429918117
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Psychoanalytic Theory, Therapy and the Self presents, in a readily accessible form, the overall theoretical position adopted by the author in his two earlier books Personality Structure and Human Interaction (1961) and Schizoid Phenomena, Object Relations and the Self (1968). Part One, addressing itself to theoretical issues in psychoanalysis, traces the changes which have occurred in psychodynamic thought since Freud's early conjectures, reflecting the physicality mode of scientific thought in which he had been trained and typified by the theory of instincts have been largely modified or superseded by the contributions of object-relations theory. Part Two, based on a series of seminars devoted to the structure and treatment of the schizoid personality, puts the theoretical issues discussed in Part One into perspective of therapeutic practice.

Part
I
Theory

Chapter 1
Seeing Freud in Perspective

Quoting Freud in psychoanalysis is beginning at last to be like quoting Newton in physics. Both men are assured of that permanent place in the history of thought that belongs to the genuine pioneer. It is not the function of the pioneer to say the last word but to say the first word. That is the most difficult step. All the pioneer has to begin with is a problem, which has always been there, but hitherto no one has looked at that phenomenon in this particular way. The pioneer suddenly asks a new kind of question. Once the all-important start has been made along some new line of investigation, those who come after have only to faithfully follow up every possible line of inquiry it suggests. Some of these will be false trails, others will lead somewhere, but all have to be explored.

Freud started on the path of the pioneer when, because of the necessity to earn a living, he turned from his laboratory to clinical work. No doubt he was not the first neurologist to feel skeptical about the efficacy of the cures of that era for neurotic symptoms, but no one else reacted as Freud did. The investigations of Charcot and the French hypnotists were certainly a help, but it was Freud’s insight that led him to cast hypnosis aside and begin to formulate the creative idea that the symptoms of neurosis had a meaning that could be explained in terms of the patient’s life history. Hitherto medical symptoms had been simply cold physical facts (which most of them still are), but Freud found that some were different. Some psychoneuroses involve physical symptoms that are connected more with the patient’s personal relationships in family life, than with biochemistry or organic disease. Freud found that at least with hysteric neuroses the symptoms could disappear when the patient felt secure with the physician, and reappear if that relationship was disturbed. Thus, slowly, a whole new area of facts began to come to light, not only concerning some types of physical symptom, but also concerning states of mind and modes of behavior.

This area of investigation has demanded intensive study ever since. But it is a striking fact that, at any rate in Britain, those who criticize psychoanalysis rarely show firsthand knowledge of events in the field later than the Freud of about 1908, when his paper on “Civilized Sexual Morality and Modern Nervousness” was written.

This presented in an uncompromising way the classic psychoanalytical “Instinct Theory” that all our troubles are due to the repression of instincts, and that since sublimation (or diverting instinctive energies to socially approved goals) is so hard, most of us are doomed to be either neurotic or criminal, that is, antisocial. Dr. Martin James describes how gradually Freud’s early ideas came to influence progressive thinkers in education and child-rearing and

created confusion about Freud’s ideas because of the paradox that the patron saint adopted for revolutionary propositions was Freud, and Freud was not consulted. He was a proper, conventional moral man and would have rejected much of what was done in his name.… The cathartic movement began early in the twentieth century and had the motto “no repressions,”… the do-as-you-please school and the slogan of “Freedom.”… The response of psychoanalysts to this state of affairs was to stress an opposite side of the story.… They have over the last twenty years been at pains to explain the need for repression and that symptom-formation is even the sign of a strong ego.¹

This premature attempt to make popular use of Freud’s new work seems to have had the result of fixating the meaning of psychoanalysis in the general mind as standing only for Freud’s early views. Thus, a Cambridge psychologist, Dr. Max Hammerton, writes:

I am an experimental psychologist.… but most of the people I meet seem to imagine that my stock in trade consists of a couch and a lot of verbiage about libido and id and what not. Sometimes I heartily wish that Dr. Freud had never been born.²

Dr. Hammerton and many similar critics, of whom the behaviorist psychologists have been the most vocal, show little sign of being acquainted at firsthand with the far-reaching changes that have occurred in psychoanalytic theory and practice since Freud’s early days.

Today the question to ask is not so much “What did Freud say?” but “What has Freud’s work led on to?” It is all that Freud started that becomes increasingly important. Psychoanalysis can no longer be simply identified with the original, classic psychobiology. Freud himself began the first major move beyond that starting point, when in the 1920s he turned his attention to the analysis of the “ego.” A Professor of Psychiatry whose interests are mainly biochemical once said to me “Freud is the easiest writer to make contradict himself.” In fact this was a tribute to a fearless thinker whose mind was ever on the move, exploring the little understood ways of the human mind. He was a pioneer who opened up an entirely new field of systematic inquiry into the inner workings of human experience.

This field had traditionally been explored in literature, religion, and in the symbolism of art, but no one before Freud had attempted, in the particularly personal way that he did, a systematic examination of the emotional disturbances of human beings that find expression in mental illness, disturbed behavior, and so on. Such an infinitely complex inquiry could not possibly have been completed and exhausted by Freud; and where his work is now leading becomes ever more important than where it began. At this point it becomes important to draw a distinction between Freud’s clinical experiences, the psychic phenomena with which he was confronted in his patients, and the theories he formulated to coordinate and, if possible, explain them. This distinction is not always easy to make, because psychic phenomena are not visible on tangible “things” obviously existing in relative isolation from other “things.” They are subjective experiences which different people verbalize in different ways. Nevertheless, the description of certain common experiences by people of extremely different types are found to have a cumulative consistency. The psychoanalyst, being himself human, can recognize the meaning of what they say by reference to his own experience. Moreover, what is in this sense clinically observable is found to imply the existence of other subjective experiences which have to be inferred to make sense of what is more directly known. Thus, the unconscious is both a clinical fact and an inference, or hypothesis. To illustrate this point concretely, a male patient dreamed furiously every night but could remember nothing of it in the morning. So he took a pencil and paper up to bed to write the dreams down in the night, only to find that he did not dream. After four nights he concluded that he had ceased to dream and did not take up his pencil and paper. As before, he dreamed furiously and remembered nothing in the morning. The inference is inescapable that he was determined not to allow his dreams to become conscious (probably because his waking self was too afraid to know how disturbed he felt deep down and why), but he was quite unconscious of this determination, for all that it was a powerfully operative fact in his experience of himself. Having made this discovery, he did then begin slowly to remember some of his troubled dream-life. All this kind of experience that Freud steadily accumulated, I shall call the “clinical facts he discovered,” and distinguish them from “the theories he formulated to explain them.” Broadly, Freud’s observations of matters of psychic fact have proved to be more lasting than his theories, even though we cannot draw an absolute distinction between them. In his theory making Freud was bound to be primarily influenced by his scientific education and by the ideas generally accepted in the cultural era in which he began his work. His factual discoveries were among the new influences that have led to further cultural change. This is how it is with all creative minds; their original work drives them beyond the boundaries of their own educational inheritance. What I have sought to do in this short series of lectures is to trace the changes that have gone on and are now going on, in psychoanalytical theory, from the starting point Freud provided as long ago as the 1890s.

I have stated that much of Freud’s clincal observation of psychic experiences as verifiable matters of fact, turning up again and again in the widest variety of persons, has proved to be of permanent validity and importance. To illustrate this we can refer to such experiences as the various forms of fear and anxiety, love and sexual desire, anger, hate, jealousy and aggression, and the conflicts that ensue between these experiences when they occur, as they often do, simultaneously in the same person. We can also refer to evidence relating to the ways in which such conflicts often result in the repression of some of the conflicting emotions, which nevertheless do not thereby cease to be felt, but continue to be experienced albeit unconsciously, with highly disturbing effects on conscious experience and behavior. Out of this inwardly suppressed mental turbulence, there arise the various symptoms of psychoneurosis, both physical and mental. This disturbance is not confined to illness, but in some cases is acted out as antisocial or even criminal behavior. This repressed psychic experience finds yet a third outlet in dreams by night and in daydreams or fantasies by day. This type of psychic experience lends itself in a unique way to being understood as having meanings that are intelligible in terms of the person’s life history. Dreams can even contain disguised or plain and undisguised memories of past traumatic events; but, furthermore, dreams are largely, if not entirely, a reliving during sleep of all the unresolved emotional problems in human relationships of our entire past life, if it has been a disturbed past. Thus if a person makes a dream the starting point for talking out a free flow of thought, he will steadily find that he is exploring anew all that he has been unable to deal with satisfactorily in the past, and that this buried, disturbed experience can and usually does, in time, lead back to surprisingly early childhood. It becomes apparent that we do not by any means entirely grow out of our childhood experiences, and that, in so far as they are a source of acute anxiety and insecurity and angers, a great deal of all this is buried in the unconscious while our conscious self of everyday living develops on either a conformity or a rebellion basis, or more usually a mixture of the two. Our conscious self has to develop ego-defences against the uprush of subtle intrusion of the turbulent unconscious conflicts. When these defences weaken or fail, the buried legacy of a too disturbed past erupts into consciousness to result in all degrees of mental or personal malfunctioning, ranging from mild anxiety symptoms to severe or, for the time being, total breakdown of adult mental functioning. All this inevitably puts great stress on the enormous importance of the formative experiences of early childhood. It was Freud who first acted on the assumption that prevention is better than cure for adults by treating a phobia of horses in a five-year-old boy, as long ago as 1909. Today child guidance clinics have proliferated everywhere.

Freud further discovered that one of the things that happens to repressed experiences in childhood is that later in life the emotions involved find an outlet by transference onto some roughly analogous figure in the present day. This phenomenon of “transference”—so prolific a cause of disruption in friendships, marriages, and adult partnerships of all kinds—inevitably erupts, unrecognized by the person in the treatment situation. The therapist, then, gets a chance to help the patient gradually to recognize and grow out of these survivals of past experience and to become free to relate in emotionally realistic and appropriate ways to people in the present day. Freud discovered that in the end, the main method of helping people to outgrow their buried emotional past and to free themselves for a new development of personality towards friendly, spontaneous, and creative living in the present, was simply to leave the person entirely free to talk out whatever occurred to him. This is not as easy as it sounds, for sooner or later it involves the free voicing of what has for a lifetime been held to be prohibited. But, slowly, as the patient finds that he does not lose the analyst’s respect, and is taken entirely seriously, he is helped to understand and accept much that has always puzzled him about himself. Then, in spite of periods of severe strain, the over-all effect of this process is an increasing sense of liberation and reality in oneself. The patient begins to understand how human living, always dependent on the quality of the human relationships we have the good or bad fortune to encounter, can be recreated in the freeing and security-giving new relationship offered by the therapist. Reliability, sympathetic objectivity, and the genuine understanding offered by the analyst, enables the emotionally disturbed person slowly to acquire the confidence to “free associate,” i.e., to talk his way freely out of the emotional mire of past unhappiness in which he has been bogged down. And this enables him to make realistic and appropriate relationships with all the people, beginning with his therapist, with whom he must deal in his present day living. Among other things, he learns to recognize and not to rationalize his own motives and to understand other people better, because he now understands himself. All this and more could be cited as exemplifying the ■factual clinical discoveries made by Freud which hold good permanently, because they are recognizable human experiences, capable of being observed in all of us.

As an example of the more subtle and penetrating insightful discoveries made by Freud, I will give a single instance. Freud observed that “Identification is a substitute for a lost human relationship,” or indeed for one that was urgently needed and unobtainable. Thus a child who finds that he cannot get any satisfactory kind of relationship with a parent who is too cold and aloof, or too aggressive, or too authoritarian tends to make up for his sense of apartness and isolation by identifying with, or growing like, that parent, as if this were a way of possessing the needed person within oneself. Freud’s writings abound with such searching insights. It is this body of factual observation of human experience that constitutes the permanent contribution of Freud. It is this that theories seek to explain and systematize in a coherent body of synthesized understanding of human nature. Freud, naturally, made his own attempts at theoretical explanation, and here we have to say that though his theories, which he himself was always changing and developing, proved to be a most stimulating starting point, they were of necessity lacking in the permanence of his factual discoveries. All theories, especially those about human nature, are conditioned by the cultural era, the prevailing intellectual climate, and the dominant ideas of the time in which they are developed. Freud’s theorizing was of necessity highly determined from the start by the scientific education in physics, chemistry, physiology, neurology, and general medicine and also by the prevailing ideas in academic psychology, philosophy, and social studies then prevalent. It was part of Freud’s fate, which involved him in no little mental pain, that his own developing insights into human nature compelled him so often to clash with the legacy of his own educational heritage and the thinking of his contemporaries.

It is the far-reaching changes in theory construction since Freud began that I have endeavored to sketch, as clearly as possible, within the limited space of this small book. Few people, outside of those whose special professional concern it is to keep their data up-to-date, are aware how much the original theory has changed. Even the most important contributors are far too numerous for any but a small number of them to be mentioned and their work assessed here. I have chosen, therefore, to select what seemed to me the most important single line of central and consistent development and to illustrate that by dealing with the few leading psychodynamic thinkers most closely related to it.

This basic theme arises, as I see it, from a study of Freud’s own work. Beginning as a highly trained physical science laboratory worker, Freud was slowly pushed by his experiences with patients beyond the physical into the study of the dynamically disturbed psychological, emotional, highly individual, and meaningful life of human beings as persons in their most important relationships with one another, beginning with that of the parent and child. People with otherwise healthy constitutions can become ill because of sheer distress in the basic relations of life. This fact was well known among family doctors, but Freud was the first to investigate it on a purely psychodynamic level. Here was his personal paradox. He was trained to be a physical scientist but was destined to become the creator of a new psychodynamic science. All through his work, two strands of thought were interwoven, the physical and the psychological, or personal. Very slowly the personalistic thinking emerged to the forefront, taking precedence over the physicalistic thinking.

It will suffice at this point to indicate the general nature...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• FOREWORD
• PREFACE
• CONTENTS
• PART I Theory
• PART II Therapy
• INDEX