Abstract
Is it ethical to offer education in psychoanalysis? The inescapable implication to be drawn from a reading of Kate Schechter’s Illusions of a Future is that it is not, at least in Chicago. She reports that psychoanalytic practice there has been dead since the 1970s, maintained for a while in a zombie-like state through the smoke-and-mirrors administrative and financial machinations of George Pollock. The recent Chicago Institute graduates she interviews have few or no patients in analysis, though each clings to an image of analysis—in each case a different image. Such allegiance to an absent entity she characterizes as “fetishization,” and the analysts she presents do come across as pathetic in their devotion to, and invocation of, an illusion.
Schechter’s message is somewhat obscured by her ambitions, when setting out on this book, to provide a braided account of “several modes of analysis at once: a textual analysis of the place of crisis in professional discourse; a structural account of psychoanalysis’s difficult history of institutional reproduction in the United States; an ethnographic and historical reading of a group of psychoanalysts’ attempts to define their practices in positive terms; and a political-philosophical analysis of the ‘resistances’ of psychoanalysis that make it so seemingly impossible for psychoanalysts to organize collectively to resist health-care industrialization” (pp. 5–6). If this seems an impossible burden for one volume, it is. Strands of thought begin, but then are never conclusively brought into contact with the subject matter, or else confusingly shift their meanings without warning.
Schechter, trained in anthropology and social work, tells us the “ethnographic research consisted of participant observation in the Chicago psychoanalytic community over three years,” including a period during which she herself underwent training in psychoanalysis (p. 14). Like all ethnography, her report is an inescapably subjective description of the world in which she immersed herself for a time as a participant observer. She hints at her perspective in the introduction, where she puts “classical” psychoanalysts in quotes and says one of them opined that she’d ultimately have to choose between anthropology and psychoanalysis, a choice so far not thrust upon her. And it is true that she writes as someone who has been in, but not of, the psychoanalytic community. One is surprised, then, to learn that she not only completed a full training but describes herself as a psychoanalyst and serves on the faculty of the Chicago Institute, a career path that clearly has taken more than three years. This is a simple example of the jarring moments the reader experiences throughout the first part of the book, of apparent inconsistencies, broken threads of thought, and the like, all of which may reflect the author’s debt to Derrida and his development of the notion of “aporia.”
The best-written parts of this book are to be found in its second half and include a clear if tendentious history of the unique, rich, theoretically and technically diverse, yet problematic organization that is the Chicago Institute. Schechter succinctly describes the split between Alexander (and later Grinker), who stressed technical innovation and flexibility, and Blitzen (and later Gitelson), who defended classical technique. Along the way she gives a clear if partial outline of Alexander’s perspective and of the paradox in his pursuit of an academic research organization with a carefully selected faculty but an ill-defined technical base, as against Blitzen’s insistence on rigorous technique but apparent disinterest in research or a carefully selected faculty. Schechter’s sympathies clearly incline toward Alexander and toward psychodynamic psychotherapy as opposed to psychoanalysis per se. In her view, those promoting classical analysis show rigidity and blindness toward broader scientific horizons, while those favoring flexibility and extraanalytic research show impatience with graduates’ maintenance of narrowly analytic attitudes.
The story naturally unfolds through George Pollock’s tenure, his defense of ego psychology overshadowed by the revelation of his exploitation of a wealthy elderly patient and by a patronage system that led one colleague to describe the institute during that time as Chicago’s “Fifty-first Ward.” In contrast to most institutes, teaching, research, supervising, and even committee work were “well remunerated” (p. 125).
The analyst’s ongoing self-analysis, which many of us see as both opportunity and responsibility, is called an “interminable askesis” in none too approving a tone (p. 115); despite this, the author gives a thoughtful, clear, and sympathetic reading of Kohut’s work, including of course the paper now thought to have been based largely on his self-analysis, “The Two Analyses of Mr. Z.” (Kohut 1979). Indeed, Schechter’s account of self psychology is as clear and succinct an effort as one will find. Reactions to and against Kohut are less carefully rendered; for instance, it is not at all clear that Gitelson’s 1962 reference to a “diatrophic function”—the idea that some patients need preparation for analysis by a preliminary, nourishing bit of psychotherapy—was initially a reaction to self psychology.
Another clearly drawn chapter is based on repeated interviews with several younger analysts, who appear in a field of stark pathos. Each of them is described as taking part in “a collective project of mourning an unattainable ideal” (p. 63). Each in her or his own way evokes “psychoanalysis” as a term, whether to justify a diffuse set of techniques aimed at keeping patients indefinitely in treatment, or to mourn the disappearance of suitable cases, or to cast aspersions on someone else’s technique. In the end they seem united only by wishes to maintain their practices, to be helpful in some way, and to hold aloft the banner of a shared but empty allegiance. Schechter is convincing in her claim that the analysts she describes have come to stress relational views in both their definitions and their practices of psychoanalysis in an attempt to maintain patient caseloads. There is of course another basis for such a shift in emphasis: her interviewees see few or, in some cases, no patients on a daily basis on the couch, and lower frequency and face-to-face treatment naturally provide material for the understanding of past and present couched in interpersonal and relational terms (Carlson 2002). Puzzlingly, Schechter asserts that daily sessions were justified by drive theory, as if to dismiss any empirical basis for them or any historical approach to psychoanalysis.
Apart from these chapters on Chicago psychoanalytic history and her interviews with graduates, this book unfortunately illustrates the decline of serious editing, even at a well-regarded university press. In earlier times a largely extraneous and poorly elaborated foray into poststructuralist philosophy might either have been stripped away or have been expanded into something more explicitly and convincingly related to psychoanalysis, perhaps elaborated into a volume of its own. As it is, the relevance of the many philosophical references in this book is left unstated. Yet another volume might more successfully have become a straightforward polemic expressing the author’s views on the development and (dim) prospects of psychoanalysis. Some of the discussion promised in the introduction never appears: there isn’t much attention paid to “psychoanalysis’s difficult history of institutional reproduction in the United States,” and the broad impact of neoliberal economic policies on psychoanalytic practice merits far more consideration (e.g., lower marginal tax rates and limitations on medical expense deductions have greatly increased the after-tax cost of analysis, which once was far more affordable to upper- and middle-income families, with or without insurance).
Some of the clearer statements in the book are questionable. Schechter writes as if the broadening scope of psychoanalysis had developed only over the last thirty years, in part because lay therapists, excluded from training in APsaA institutes, had shown that psychotic and borderline patients are treatable. This ignores a massive psychiatric/psychoanalytic literature dating back more than eighty-five years (Simmel 1929; Federn 1934) and greatly elaborated by others in the U.S. and elsewhere in the 1940s and 1950s. She characterizes certification by APsaA as a “grueling ordeal,” apparently conflating it with the lengthier procedures institutes use to evaluate training and supervising analysts. She also says that before the 1990s certification and hence the ability to be considered for training analyst appointment merely attested one’s graduation from an institute. In fact, of course, APsaA membership had been granted only after a committee of the Board on Professional Standards had reviewed in some detail a candidate’s training; certification per se was devised in the 1970s, partly in response to complaints from some institutes that too few of their graduates had been accepted for membership. Certification then became a requirement for membership and hence for training analyst appointment. What changed in the 1990s was that APsaA membership became automatic upon graduation from an institute: in effect, instead of needing to apply and pass a review to become a member, one was granted membership by default. For the first time, then, there came to be many members who had chosen not to submit their work to review.
The pivot of Schechter’s argument is obscured by a cloud of references to Derrida and use of the term “aporia.” Most of us would agree that psychoanalysis has been first and foremost a procedure, and that there are limits to the practices that can be considered psychoanalytic, even though, as she notes, we may differ on which procedures one or another of us might include. Derrida insisted that texts and terms are ultimately undecidable, and here many of us will agree that interpretation is capable of extension and variety as wide as the web of association. But Schechter dismisses the possibility not only of definitive content interpretation but also of any specification of technique. It is as if Derrida, French though he was, had eschewed any set procedure for making an omelet. If one denies there can be an operational definition of psychoanalysis, it follows that the word itself denotes an illusion or, as Schechter says, is a fetish that obscures the absence of a reality. She maintains that the reality that doesn’t exist is both the possibility of recruiting patients in the current climate and, far more broadly, the possibility of any delineation of our discipline.
That psychoanalysis and its practice are in crisis most will agree. The spotty scholarship and confusing exposition of this book is a dispiriting accompaniment to that crisis.