Tuesday, January 2, 2018
An Integrated View of Depth Psychotherapy
The unfortunately often-warring, disparate practitioners of depth psychotherapy actually share more commonality in models of mind and practice than you might think.
I have been pursuing these commonalities for nearly 40 years.
I share a few of the most important similarities here.
Beginning with methods of practice, all depth psychotherapists—whether Freudian, Jungian, Kleinian, Fairbairnian, Inter-subjective, Relational, or whatever—work in three basic, similar ways:
- They frame the professional relationships by creating proper boundaries as well as an environment inviting personal transformation;
- They bring their presence to their patients through their empathy, care, attention, interest, and curiosity, and;
- They engage their patients in forms of dialogue—conscious and unconscious, verbal and nonverbal—intended to facilitate transformation and increase autonomy and freedom.
Psychoanalysts have gathered into groups and schools, fighting for the real truth. When it comes to how they actually work, however, they all practice in these three ways.
Although some practitioners cling to one particular model, most utilize the one-hundred years of psychoanalytic writings for its “plethora of theoretical metaphors,” as Robert Wallerstein called it.
Regarding theory of mind, Jon Mills, who integrates multiple psychoanalytic schools with Hegel’s philosophy, offers a sweeping overview of similarities between different depth psychotherapy models.
Hegel’s philosophy, much like trends in Western and Eastern philosophy centuries before him, emphasizes process.
In other words, all things are in motion, including structures and functions of mind.
Mills boldly, and accurately, asserted that Hegel:
provides a logic and truth to the unconscious that is internally consistent and coherent, thus capable of withstanding philosophic criticism when empirical limitations are encountered. Hegel can bring philosophical and logical rigor to psychoanalytic theory, and through his dialectical method shows that the unconscious is the foundation of the human psyche (p. 192).
Here is a quick background useful in understanding Hegel’s integration-offering ideas:
First, philosophers as disparate as Heraclitus, Whitehead, and Hegel agree that dynamism, transmutation, and metamorphosis underlie everything. The mind, like physical or any conceivable reality, is in motion, a dynamic flux of transposition and generation.
Simply put, and as Heraclitus wrote:
Second, although incorrectly attributed to Hegel (it really came from Fichte), three words organize such dynamism:
Thesis, antithesis, and synthesis.
In other words, a trend or theme develops, another opposes it, and a third moves forward in the form of a synthesis.
Third, and crucially, this three-part movement requires an understanding of the idea of sublation—a process of both negating while at the same time maintaining what went before. Synthesis requires sublation. It incorporates some of the earlier trends while expanding them in a different direction.
Easier to understand than it sounds, sublation accounts for the fact, for example, that you maintain certain aspects of infancy, i.e. the capacity for terror or emotional disintegration, even as you grow into toddlerhood, childhood, adolescence, and adulthood.
The applications of Hegel-Fichte’s tripartite concept are literally infinite. They include the history of psychoanalysis itself, psychological development, and even various psychoanalytic metaphors for the structure of mind.
Psychoanalysis began with Freud and his dual-drive theory. It has been subjected to multiple antitheses and syntheses, resulting in more complex understandings of motivation.
I just referred to psychological development, but many further applications exist. Think of how the passion and tumult of adolescence transcends into more stable adulthood but hopefully without too much loss of passion and energy.
The same ubiquity applies to theories of mind. Heinz Kohut’s Self-Psychology, along with Ronald Fairbairn’s similar work, may be considered an antithesis to the early one-person psychologies of Freud, Jung, and Klein. Freud’s Ego, Id, and Superego offered only a limited understanding of interpersonal processes. Kohut and the British middle school theorists offered antitheses. An ongoing syntheses exists in the contemporary Intersubjective and Relational models.
Searching for ways to organize humans ever since I was fired for union organizing at The Gap at age 19, I bring the same desire for unity to my colleagues in the depth psychotherapy profession.
On the one hand, such fragmentation into argumentative tribes seems endemic to human nature. According to Steven Pinker, the Harvard-based evolutionary psychologist, we humans will always be prone to forming us versus them dichotomies.
On the other hand—and note how thesis, antithesis, and synthesis even applies here—we humans can and do find ways to work together.
Depth psychotherapy will remain a highly personal, individualized way of helping people suffer less pain and enjoy more freedom. However, it need not consist of angry groups sporting unfounded and unnecessary antipathies towards one another.
Submitted with hopefulness for the New Year!
Fichte, J. (1800/1987). The vocation of man. (Trans. P. Preuss). Indianapolis: Hackett Publishing Company.
Karbelnig, A. (2018). Addressing Psychoanalysis’ Post-Tower of Babel Challenge: A Proposal for a Cross-Theoretical, Clinical Nomenclature. Contemporary Psychoanalysis. (Manuscript Accepted for Publication, 12/16/17).
Mills, J. (2002). The unconscious abyss: Hegel’s anticipation of psychoanalysis. Albany: University of New York Press.
Wallerstein, R. (2013). Metaphor in psychoanalysis and clinical data. In S. Montana (Ed.), Metaphor and field: Common ground, common language, and the future of psychoanalysis. New York: Routledge, pp 22-38.
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Alan Karbelnig, PhD, ABPP