Dr. Stephen L. Salter

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Psychoanalysis Today

Therapy in Context: "Being in the World"

I wouldn't be the first to say that the field psychoanalysis has got a bad rap. In fact, many psychoanalytically oriented practitioners may evade the very word simply to soften an off-putting impression. Euphemisms can include "psychodynamic psychotherapy", "insight-oriented therapy", "depth psychotherapy" and there are various other ways to "soften" it. Generally speaking, it is the great, controversial, and certainly flawed originator that today we so often find distasteful.

Freud himself can hardly be pinned down to believing one thing or another. To his credit, he changed his views throughout the course of his life, modeling a spirit of evolution for psychoanalysis. Still, maintaining Freud as the founder carries a heavy price in public relations, even after a century of progression.

The list of wrong turns in the tradition is extensive and profound. For one, Freud adhered religiously to the prevailing scientific paradigm of the Enlightenment era. There has been a serious cost, a human cost as history continues to demonstrate, in attempting to account for the most deeply personal phenomena from a scientific vantage point.

Fortunately leading American analysts of our era (Stolorow 1993, 1994, 2002; Atwood 1993, 1994, 2002; Brandchaft, 1994 2010, Orange 2002) have propelled the evolution of psychoanalysis by responding quite carefully to it's criticism. Contemporary analytic therapists understand that they cannot separate themselves from the therapeutic encounter as say, a biologist would attempt to from his or her object of study. After all, the human being is not an object. Our minds are not archeological sites (to use Freud's metaphor) -the unconscious awaiting excavation. We are subjects. And we cannot be separated from the therapist's own subjectivity. That is, the tradition now takes into account that the therapist is more a participant than an observer.

Contemporary psychoanalysts (Stolorow, Atwood, and Orange, 2002), are far more focused on the patients' Worlds of Experience than they are on "what lies beneath," or outside of awareness. This transformation amounts to no less than a paradigm shift in the field. It is a shift that makes the world of difference when a patient enters the therapist's consulting room. The experience feels more "natural," not so awkward and impersonal as it may have in the previous era. Because the contemporary therapist is more accountable and more studied with regard to his or her influence in the room; they are free to be more at ease and when appropriate, reveal more about himself or herself and his or her thinking to the patients. The therapist is no longer a wizard behind the mysterious theoretical veil.

In terms of theory, the need grew for a way to think about the therapist's role as a participant rather than as a mere objective observer. The therapist's ideal attitude could no longer be seen as one of moral neutrality, but instead perhaps as one of intent empathy, concern, humility, even love. The therapist and patient are now understood to influence one another. In this newer intersubjective (a term coined by Atwood and Stolorow) system, the way a patient acts toward the therapist may have everything to do with the therapist's demeanor. Their two psychologies are inextricably connected to one another. Conversely, any intervention the therapist might make might reflect their particular subjective reaction to the patient. The mutual subjectivity between therapist and patient does not mean that learning, understanding, is not possible. On the contrary, unmasking the veil of certainty opens the opportunity for mutual exploration. The more equitable setting is more attuned to the patient's need to feel safely vulnerable.

Contemporary psychoanalysis now embraces attitudes of equity, naturalness, mutuality, and authenticity. These dispositions have a more "human" feel to them. However, it would be a mistake to believe that the field is any less rigorous because it has removed itself from an ivory tower. The field has evolved dialogically, which means that it has taken pains to retain the hard earned insight of its predecessors by way of dialogue. Psychoanalysis today is still in dialogue with Freud, Jung, Lacan, and many of the early greats. Even more, it has expanded to utilize the entire Western tradition (from Hegel to Nietzsche to Heidegger to Levinas...) to address questions that are becoming ever-more complex.