I am aware, as I write, that I address the reader at a particular moment in time. And I have no doubt that by the time these words find themselves published, that moment may have vanished, transformed into another time with other bundles of concern and fusions of pressing magnitude. Clinically, this contextual issue is framed across today’s psychoanalytic schools through the post-Lewinian lens of field theory (Stern, 2013a, b). Our psychoanalytic situation is not only individual and intra-psychic, but also interpersonally and relationally shaped by the social, political, and societal pressures and times under which each of us lives. How we integrate the fields in which we practice, how we construct our psychoanalytic situations, will, of course, vary subjectively both relative to the individual therapist and patient within the clinical dyad.
We all have witnessed how, over a year’s rough course, a clinical field which once allocated decades to the problem of whether psychoanalysis might be conducted in a chair rather than upon the couch, or whether three weekly sessions were comparable to five, has uniformly shifted to different approaches in technologically-mediated psychotherapy. Some clinicians argue for the use of video-facilitation while some argue for telephonic therapies while others still rail that neither really approximates the feel and tang of the authentic clinical encounter. Yet, fitting what we know of therapeutic forms and activities within the constraints of global lockdowns under the press of coronavirus, differing in length and patterning from country tocountry, mobilizes us all. Colleagues’ informal Zoom meetings now often concern the challenges of treatments mixed between in-person and mediated contacts or the transferential and countertransferential experience of our field’s shift to technological mediation as therapists and patients alike are affected by the limitations placed upon us by social distancing and the anxieties attendant upon the current pandemic. Our field itself has suffered and now contains, the effect of this recent catastrophic change. We have accommodated; and in so doing have effectively acted upon many of the defining categories of clinical practice: the forms of transference, countertransference, anxiety, and the psychoanalytic “third” (Ogden, 1994) constructed of our joint participations with patients.
From the context of this universal shift, the question framing this present issue of the American Journal of Psychoanalysis seems geared to another time, though it was only yesterday. Late in 2019, we asked clinicians practicing in different locations and societies to tell us what was on their minds as they thought about clinical psychoanalysis. Five members of this original cohort assented and were able to attend to this task, despite the sudden onset of Covid-19, disrupting them all. This Journal is thankful to them in persevering with this undertaking within our psychoanalytic thought collective, understanding that preparation of research, once termed “journal science” by Ludwik Fleck (1935), is time consuming and even distractingly speculative under the immediacy of this moment calling for active adaptation as against thoughtful, long reflection.
These five papers represent an array of global practice locations. Annie Reiner practices and writes in California. Barnaby Barratt practices and writes in South Africa. Both Clara Mucci and Anna-Maria Loiacono practice and write in Italy; and Ian Miller practices and writes in Ireland. Together, uncoordinated, this joint effort reflects a recognition of psychoanalysis noted in this Journal sixty-five years ago, that
Psychoanalysis is at least three different things. It is a technical procedure for investigating unconscious mental processes and for treating psychoneuroses; it is a systematic body of fact and theory concerning the relations of conscious and unconscious mental processes; and, it is finally, a philosophy of life, in the sense that it is a way of looking at, of thinking about, and appraising some of our basic habits, attitudes, and beliefs (Reid, 1955, p 115).
The conjunction of these five contributions, taken as a whole against Reid’s standard, suggests an ongoing stability in the evolutionary progress of psychoanalysis as we consider the durability of our therapeutic approach in a time of catastrophic change under Covid-19, compounding the larger markers of the 21st century in facing the socio-political challenges of anti-thinking together with the precarities and technological challenges of contemporary life (see for example, Melmed, 2020; Miller, 2018; Prince, 2018).
Four of our five papers begin in consideration of Reid’s first definitional premise, the technical procedure of psychoanalysis. Annie Reiner’s (2021) Bionian orientation reflects the broad contemporary consensus within our field, both of the wide treatment spectrum of neurotic and psychotic conditions, as well as the evolutionary nature of psychoanalytic concepts and language, our current “vernacular expression” (Miller, 2016). Beginning with the author’s own filiation, her supervisory experience with Bion, Reiner clearly depicts our therapeutic reliance on clarifying the confusions of language and the experience of lived uncertainty. She observes how Freud’s analyses, lasting only a few months, may have satisfied intellectual questions or “cured” symptoms, whereas the scope and length of analysis have expanded in our present moment, touching deeper emotional levels of personality.
By contrast, Barratt (2021) steers closely to early psychoanalytic interest in free association, and bases his definition of psychoanalysis upon this principal fact. Together, these papers reflect the ongoing tension within our field of orthodoxy and heresy (Bergmann, 2004), as what has been seen institutionally as an outlier in one generation becomes amplified in its acceptance by future generations of practice. But the question of whose orthodoxy and whose heresy remains as our contributors argue from different subjective positions, each robust in its relation both to Reid’s criterion of technical procedure and the attendant criterion of facts emergent from our procedures.
Anna-Maria Loiacono (2021) introduces two reality constraints into the mix. Beginning with the nature of institutional training, she focuses on the particular legal definitions of psychotherapeutic practice that shape psychoanalytic training in her country. Similarly, Ian Miller (2021) attends to cultural and historical currents in his locality of practice, in relation to patient characteristics emergent in clinical contact. Together, Loiacono and Miller, from the particularities of their experience, remind us that each of us, in our practice lives, is shaped by cultural and historical factors; and that these have an impact, however implicit, upon the work we do. Only by making such constraints knowable, are we able to engage consciously with them, and so, to exemplify in action, the reflective philosophy of life that Reid recognizes as fundamental within our shared clinical pursuits.
Technique then, as well as the facts that follow from what we do, are approached from multiple clinical perspectives related to the history and development of psychoanalysis as well as the history and cultural contributions from within practice communities. Development within the history of psychoanalytic inquiry, as well as clinicians’ emphases upon various intellectual forebears’ traditions of clinical practice, are also reflected in these papers. Reiner’s primary focus follows from the work of Bion. Barratt’s primary orientation follows from the work of Freud. Clara Mucci’s (2021) focus upon cutting-edge research in the neurosciences, relative to psychoanalysis, reminds us too, of Freud’s early positivist interest in psycho-physical relations, reflected in his “Project for a Scientific Psychology” (Freud, 1895). Mucci signals that the developmental history of psychoanalytic thought is recursive; and that contemporary science addresses questions only dreamed about a century earlier, but which have remained present in observation of the behaviors emergent in the conduct of psychoanalysis.
So it is that our contributors begin with the technical procedures of our joint pursuit, arriving at different fields of consideration relative to the systemic nature of their thinking. The unspoken commonality among these papers is in Reid’s third strand of psychoanalytic definition. In concluding this introduction, this consideration bears repeating, as it links our five writers’ subjectivities, one with the other: “that psychoanalysis is finally, a philosophy of life, in the sense that it is a way of looking at, of thinking about, and appraising some of our basic habits, attitudes, and beliefs” (Reid, 1955, p. 115).
Despite the unknowable trials of the coronavirus pandemic, inconceivable when this project was initiated, the convergence of orientations presented here describes a commitment to learning, articulating, communicating, and making conscious, the language and states of unconscious experience both within the individual and within the societies in which we live, love, and work. We anticipate that occasional further papers from this perspective will be appearing in later issues of this journal.
1. Ian S. Miller, Ph.D., is a clinical psychologist/psychoanalyst, practicing and writing in Dublin, Ireland. Dr. Miller is Associate Editor of the American Journal of Psychoanalysis and Member of the Irish Forum for Psychoanalytic Psychotherapy and a Chartered Psychologist in the Psychological Society of Ireland. He is the author of Defining Psychoanalysis. Achieving a Vernacular Expression (Karnac, 2016), and On Minding and Being Minded (Karnac, 2015). Together with Kay Souter, he is author of Beckett and Bion. The (Im) Patient Voice in Psychotherapy and Literature (Karnac, 2013); and with Alistair Sweet, On the Daily Work of Psychodynamic Psychotherapy (Routledge, 2018).
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Ian S. Miller, Ph.D., Issue Editor, is Associate Editor of the American Journal of Psychoanalysis. Dr. Miller is a Member of the Irish Forum for Psychoanalytic Psychotherapy and a Chartered Psychologist in the Psychological Society of Ireland.
Address correspondence to Ian S. Miller, Ph. D., Kilmainham Congregational Church, 62 Inchicore Rd., Dublin 8, Ireland.
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Miller, I.S. BALANCING THE GENERAL WITH THE PARTICULAR IN PSYCHOANALYSIS.
Am J Psychoanal 81, 1–5 (2021). https://doi.org/10.1057/s11231-021-09280-4