The long disruptions of Covid-19 lockdowns together with the gathering pace of political and social global unrest provide fertile ground for catching up with cross-disciplinary literature, informing contemporary psychoanalytic thought. Notable at a time when news cycles crackle with the multiple infractions of United Nations member-states to the United Nations’(1948) Universal Declaration of Human Rights, Martha C. Nussbaum’s clean and Spartan presentation in Creating Capabilities. The Human Development Approach (2011) speaks directly to headline imperatives across political, social, economic, and psychological domains, as human destructiveness degrades not only our relations with one another but also our relations to the biological and geological structures upon which we depend in this Anthropocene age.

Ethics scholar Martha Nussbaum is no stranger to psychoanalysis. In conversation with American Journal of Psychoanalysis Associate Editor, Benjamin Kilborne, she emphasizes

that psychoanalysis can help us, as nothing else can, to understand what it is to live the life of an incomplete being who relies on others. And, understanding that is the central task of ethics. To see how, beginning from an utter solipsism and narcissism, a human personality can acquire the capacity for concern, for responsibility, and for mutuality in love, gives ethics essential information, without which its normative proposals are incomplete (Nussbaum, in Kilborne, 2009, p. 270).

Her timely perspective is rooted in a globalized world influenced by American values, including

reductive anti-humanistic views that portray the human being as a mere mechanism. These views are very attractive to many Americans because they make life seem easier than it is. Americans like quick fixes, and they want to feel content. So, the psychoanalytic imperative to a painful difficult sort of self-knowledge is one that most Americans would rather dismiss. I regard psychoanalysis as a noble humanistic discipline that gets at the questions of life and limitation at the right level of depth. For that reason, it is bound to be unfashionable (Nussbaum, in Kilborne, 2009, p. 269).

It is this linkage, of the “incomplete human being who relies on others,” and who through such reliable dependency develops the capability for the integration of feeling and imagination with practical reason and productive, socially beneficial action, that informs Nussbaum’s capability approach, “a close relative of the international human rights movement” (Nussbaum, 2011, p. 102). Nussbaum synthesizes this approach from her disciplinary orientation in philosophy together with developmental economics (She has developed this approach in collaborative thinking with Amartya Sen and James J. Heckman, [pp. 193–201]), and political theory (Jonathan Wolff and Avner deShalit contribute the contrast between “fertile capability” and “corrosive disadvantage,” [pp. 42–45, 98–100]), aligning broadly with aspirationally humanistic psychoanalytic ideas and ideals (Fromm, 1968a; Reid, 1955; Weiss, 1952).

Mobilized toward human development in the contexts of social justice and expanding democracy, Nussbaum observes that

The earliest and still most common use of the Capabilities Approach is to supply a new account of the right way to compare and rank development achievements. When nations or regions compete with one another for ranking in the global development “marketplace”, trying to show that they offer a better quality of life than other nations do, or than they themselves used to do, the Capabilities Approach provides a new account of the right way to make such comparisons: instead of looking at GDP alone, we must look at a group of central human capabilities (2011, p. 69).

Nussbaum’s framework aspires politically toward the development of equality in human agency capable of thinking through responsible actions necessary both for sustainable progress and for every citizen’s scope for cultivation of human potential. Just as in observation of multiple, conflictual aspects within psychological determinism, Nussbaum’s argument recognizes that for each positive aspiration, there is the ghostly shadow of its negative. Beginning with life, the functioning of the body, and the maintenance of bodily integrity, Nussbaum addresses destructive force, neglect, and abuse, the powerful destructiveness which has led to nonbeing, chronicled in the Western canon since the epics of Homer (McCarthy & Weill, 1965), and threatening humanity itself since the atomic bomb (Fromm, 1973). Her second bloc of considerations, including sensation, imagination, emotional experience and practical rationality, together with affiliative relatedness, addresses object-related thinking and action, elaborately embroidered within our field from its early modern articulation by Spinoza (1964b; Fromm, 1964a; Reid, 1955; Tigner, 1985; Weiss, 1952) to its contemporary presence in the best-seller list of the “PEP” web, our contemporary and comprehensive digital library (Bion, 1962).

Nussbaum’s third bloc of considerations extends her object-related affiliative concern for others to other species sharing our planet. Her psychological scope parallels Ludwig Binswanger’s typology of Eigenwelt, Mitwelt, and Umwelt2 (Needleman, 1963), extending from capabilities within self-experience to experience of the interpersonal world to experience of ourselves within nature. The consequences of human psychology and action strongly affect not only other humans, but also planetary viability. This little-explored psychoanalytic horizon strongly shapes our future (Bellamy, 2019; Melmed, 2020; Searles, 1972).

Two other domains complete Nussbaum’s framework. The first, is the capability for pleasurable, creative play. Here, a synthesis of the necessity for pleasurable experience meets both economic considerations of leisure and more familiar to psychoanalysts, Winnicottian recognition of creativity and play as fundamental within human functioning (Winnicott, 1953). Together with this necessity, often subsumed under the Freudian desideratum, “where It was, I shall be”, is the capacity for material and political control of our lives, also reflected in psychological social learning theory (Bandura, 1977).

Taken together, Nussbaum presents an exciting, comprehensive synthesis of concepts familiar to practicing psychotherapists. What may be immediately foreign to clinical readers is the political and legislative orientation of this work. This explicit exploration of “moral philosophy into development economics” (2011, p. 77) addresses our situated human lifespace (Lewin, 1951) inclusive of individual, social, political, and cultural domains and elements, in which all psychotherapies occur. Nussbaum’s own borrowed dichotomy of overcoming trauma (corrosive disadvantage) and productive extension of potential capabilities (fertile functioning) describe the doubled psychological tasks of ensuring “freedom from,” which Karen Horney attributes to Freudian intervention, together with “freedom to,” characteristic of contemporary humanistic psychoanalytic inquiry (Horney, 1942, pp. 21–22).

This is not a book explicitly focused upon psychology/psychotherapy; but rather, about what psychology and psychoanalysis have contributed to the social sciences and humanities, and what remains reciprocally open to furthering psychological appreciation: therein lies its illuminative beauty. Nussbaum’s approach will be familiar to clinical readers, mirroring a familiar algorithmic methodology, conjoining multiple conceptual elements with their salient and changing forms over time; and historically significant in parsing expressive human process (Miller & Sweet, 2018). The manner of Nussbaum’s synoptic observation parallels W. R. Bion’s demonstrated thinking: what differs is application to an adjacent field of inquiry where

The aim is to find a stable fit between judgments and theoretical principles. Nothing is held fixed: an initially compelling judgment may be modified because it conflicts with the deliverances of a theory that has many other advantages; and an initially attractive theory may be rejected because it fails to preserve enough of the most basic judgments. Equilibrium may never be finally achieved, since new theories may remain to be considered. Over time, however, one may hope to have deepened and made more adequate the overall understanding of justice, even if that understanding remains incomplete (Nussbaum, 2011, p. 78).

Alfred Korzybski long ago observed that the “map is not the territory” (Korzybski, 1933, p. 58). At roughly the same historical moment, Karen Horney would compare therapists to mountaineers in possessing a general knowledge of their craft, however encountering the specifically unknown, whether of individual patients or newly met terrains, makes the patient’s mental activity and productivity all the more desirable. The analyst’s competence–which must include an ability to own uncertainty–coupled with the patient’s participation, determines the nature of treatment (Horney, 1942, p. 14). This remains sound advice. Applied to psychanalytic psychotherapy from elements themselves familiar to clinical psychoanalysts, Martha Nussbaum’s ten-point capabilities approach suggests a powerful grid for clinical practice: describing the territories presented clinically in psychoanalytic psychotherapy reflecting domains of trauma and growth potential.

What makes a book written a decade past, so critically important? Synthesized and thought through in a fusion of aspirational philosophy and the social sciences, its message and method address exactly those headline issues we will read tomorrow: of oppressions and abuses, of contempt, denigration and violation; of hatred for clear and scientifically valid thinking; of malignant narcissistic effect upon citizens and nations; of rejection of the needy. Unlike the prophetic form of jeremiad, Nussbaum’s compressed, well-argued reckoning with capabilities—their denigration and fouling as well as their support and creative growth—provides us with a baseline that is anchored in postwar necessity and sufficiency.

Nussbaum references the long roots of “humanistic disciplines such as clinical psychology, psychoanalysis, history, and literature” both in narrative and experimental forms, in providing the considerations that structure her ten-point framework. She reminds us of the imperative

to use insights from the humanistic and interpretive disciplines in a flexible and nondogmatic way, trying to offer our fellow citizens multiple avenues into the account (Nussbaum, 2011, p. 183).

Beginning with “freedom from,” while pointing toward “freedom to,” Creating Capability offers nothing less than a contemporary framework for humanistic psychoanalysis. Its ten essential points remind us that we are all incomplete, requiring others’ recognition, response, witness, and clarifying presence. Despite life’s ample beneficial offerings, life’s limitations impede our human potential; and that a psychoanalysis informed both by attention to process and by attention to the minima necessitated as rights in human development, can compassionately address

The hardships that life forces upon us—a necessity to leave one’s country, organic illness, periods of solitude—and also its gifts—a good friendship, even a mere contact with a truly good and valuable human being, co-operative work in groups- all such factors can help us reach our full potential. Unfortunately, the assistance thus offered has certain disadvantages: the beneficent factors do not always come at the time we need them; the hardships may not only be a challenge to our activity and courage but surpass our available strength and merely crush us; finally, we may be too entangled in psychic difficulties to be able to utilize the help offered by life (Horney, 1942. p. 9).


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    Dr. Ian S. Miller is Associate Editor of the American Journal of Psychoanalysis as well as a Member of the Irish Forum for Psychoanalytic Psychotherapy. 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). Dr. Miller is a clinical psychologist/psychoanalyst, practicing and writing in Dublin, Ireland.

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    Binswanger (1942), both a psychoanalyst and a philosopher, wishes to understand how the person exists and relates to others in the world—and concludes that this can only be achieved through a situated understanding of the person in his or her life-world. “Using an approach that combines elements from phenomenology and hermeneutics, Binswanger sees the person not as an object, but as fundamentally immersed in a world of human relating” (Frie, 2013, p. 168). Binswanger’s Modes of Existence are the Eigenwelt (self world, the person’s own subjective experience), the Mitwelt (social dimension, the interpersonal world) and the Umwelt (physical dimension, the world around us) [N.B. In German all nouns are capitalized].