Psychoanalysis works quite well when applied to another discourse, but it itself is not a discourse. It is not a philosophical system and does not have its own set of values or beliefs. More likely, it is a method of investigating the unconscious. Psychoanalysis was born at the same time within and against the Western discourse. Nowadays we assist the diffusion of the western discourse worldwide, the so called Westernization, which apparently also affects Hong Kong. As shown by Watters (2010), spreading a discourse across society most likely means to also spread psychological symptoms originated within that discourse. Indeed, anorexia is a good example where some Western ideals have been received in the westernization of Hong Kong. If psychoanalysis is a critique to western discourse, and if the western discourse is spreading worldwide, a rather paradoxical consequence that we can expect is that psychoanalysis will also likely gain more interest as long as the western discourse is spread. But, today, as Francois Jullien (2004a) says the Chinese thought shows a general indifference to psychoanalysis. Psychoanalysis is not practiced in Hong Kong.
Despite this, would it be possible to retrace anything of a “psychoanalytic attitude” in the way local counselors operate? A hypothesis is that Chinese thought, which arose on completely different premises than Western discourse, has at least partly developed in the same direction of psychoanalysis. It is possible that even moving from different premises, and proceeding by different ways, psychoanalysis and Chinese thought share some characteristics. More specifically, it is possible that Hong Kong counselors, even though they do not expressly refer to psychoanalysis in their practice, have something of what we would define as a psychoanalytic attitude.
How then, to define a psychoanalytic attitude? Some scholars (Kernberg, 1993, 2001; White, 2001) have tried to describe the convergences and the divergences between schools inside the psychoanalytic movement. Wallerstein (1991) attempted to find “common ground” among different psychoanalytic orientations; however as Green (2005) replied, this is likely to remain a wishful thinking, impossible to realize. Furthermore, the adoption of a theoretical position or the analyst’s knowledge does not guarantee the results of a practice; rather it is dependent on other factors like the transference. Is it possible to describe psychoanalysis not just as a sum of concepts, but as a practice instead? What are the distinctive traits of psychoanalysis; and what are the basic assumptions that lead the analysts to assume a particular attitude or disposition when listening to their clients? While concepts may be specific to one school, if a psychoanalytic attitude exists, it should be inclusive of different schools and orientations while distinguishing psychoanalysis from other disciplines at the same time. Nowadays, it is difficult to say what Psychoanalysis really is. A common theory does not exist among analysts. Instead, a more important question to ask is: what is a psychoanalytic attitude? Attitude refers to several meanings, including position, stance, behavior, conduct, posture, approach, inclination, sensibility, and disposition. Then, beyond all the theoretical differences, it may be possible to see a common attitude. For example, speaking at the Annual Meeting of the Rapaport-Klein Study Group, held in June 2001 in Stockbridge, Massachusetts, Wolff stated that:
“Psychoanalysis is not a technique of psychotherapy in any conventional sense. Yet, it leads those who are willing to make the journey on a path towards greater responsibility for their own miseries and self-destructive behavior and on a path towards emancipation from their personal and social-cultural illusions” (Wolff, 2001)
At the end of his speech, Wolff also cites Barratt (1985) who described the nature of psychoanalysis with these words:
“What remains of psychoanalysis is therefore a unique method of discovery that distances itself from any theoretical superstructure; and that unearths uniquely personal meanings without exploiting and distorting these as raw material for new conceptual schemes or theories” (Barratt cited in Wolff, 2001).
A similar attitude is expressed by Sias (2008), who stresses the fact that psychoanalysis is a practice and not a teaching of knowledge. He assumes the Freudian perspective of psychoanalysis as one of the three impossible professions. Indeed, Freud (1925) first mentioned the joke of the three impossible professions in the preface to the book by August Aichhorn. These were: educating, curing, and governing. Later in “Analysis Terminable and Interminable” (Freud, 1937) he substituted curing with psychoanalyzing:
“It almost looks as if analysis were the third of those ‘impossible’ professions in which one can be sure beforehand of achieving unsatisfying results. The other two, which have been known much longer, are education and government” (p. 248).
The fact that Freud replaced the profession of curing in the original version of the joke with psychoanalysis seems to suggest that he might have considered curing possible and psychoanalysis impossible. This may seem paradoxical, considering that he is the father of psychoanalysis. However, such an ambiguous statement may allude to the ethics of the analyst, who is called to occupy a position that is not always gratifying (as mentioned before Freud assimilated the figure of the analyst to the surgeon whose only concern is for the operation s/he has to execute), and still is determined to hold that position and carry on the analysis. As a consequence, results may be unsatisfactory for the analyst as a person, as s/he might easily be the target of the analysand’s complains, however, this is part of the process, and a possible consequence of the transference. In any case, this is not a good reason for preferring suggestion to psychoanalysis. Psychoanalysis may also be impossible because although the cure may come to an end, the analysis is potentially interminable. As long as one speaks, thinks, and dreams, the speech, and thus the unconscious are at work, so that the analysis is a never ending process.
As Sias (2008) and others have said, psychoanalysis is impossible because the effects of the speech cannot be arrested. Psychoanalysis is the way one is being interrogated by a question that, from the moment it is wedged in a crevice of life, it does not allow that openness to close again. When one holds the position of the psychoanalyst, s/he cannot pretend to be in control over the speech, or over the client; on the contrary, the direction of the cure cannot be superimposed and will emerge within the psychoanalytic process. Thus, psychoanalysis remains an attitude, rather than a defined corpus of knowledge or techniques. Sias (2008) stresses that a psychoanalytic formation does not arise in a school, but comes as effect of the couch, meaning that a psychoanalyst should be first of all an analysand. For Sias the goal of any psychoanalytic school is instead to conserve and transmit a particular theory, so that what is transferred by a school is a particular theory and the language that represents it.
Only few authors (Schafer, 1983; Gorman, 1999, 2002 and 2008; Hansell, 2008) have specifically addressed the question of what constitutes a “psychoanalytic attitude”, while literature about theory and technique of psychoanalysis is copious. Every psychoanalytic orientation and each school of psychoanalysis, analytic association, and analyst has his own theory and distinctions: this is what Freud, in Civilization and Its Discontents, named the narcissism of the small differences. Despite this, can we retrace something common among different psychoanalytic orientations? What do they share in the practice? And how does practicing psychoanalysis shape the way analysts and analysands read the world out of the consultation room? A hypothesis is that apart from the theoretical fragmentation among schools, psychoanalysts share a common attitude toward the word and the speech, which constitutes the core of their practice. These similarities are probably easier to retrace in the practice than in the theory. It is not at the level of the theoretical concepts or the imaginary divisions among schools that we can retrace the effects of a practice. Several authors (Gorman, 1999, 2002, and 2008; Hansell, 2008) tried to address this issue. Schafer (1983) dedicated an entire book to this topic. In his view a psychoanalytic attitude implies that:
- The psychoanalyst is non-judgmental, and neutral.
- The psychoanalyst avoids either-or thinking
- The psychoanalyst analyzes
1) Concerning the first point, Schafer (1983) says:
“The analyst shows appropriate moderation, regulation, and often simply curtailment of any show of activity of a predominantly narcissistic sort. Narcissistic activity both implies and readily makes for disruptive countertransference reactions. It is the sort of activity through which the analyst tries to cure by ‘force of personality’, or to ‘win at analysis’ (as though at war), or to demonstrate analytic ‘genius’ conclusively” (p.6).
It must be said that the term “neutral” raised numerous debates within psychoanalysis. It was proposed first by Freud for describing the position of the analyst toward the speech of the analysand. However, some argue that this was not the exact term chosen by Freud, and that a questionable translation is the cause of many misunderstanding and misinterpretations. For instance, Hoffer (1985) notes that the term “neutral” is an imprecise translation given by Strachey for Freud’s less technical term indifferenz. For Schafer (1983) being non-judgmental and neutral means:
“A desirable degree of subordination of personality will be evident in the analyst’s remaining curious, eager to find out, and open to surprise. It will be evident also in the analyst’s taking nothing for granted (without being cynical about it), and remaining ready to revise conjectures or conclusions already arrived at, tolerate ambiguity or incomplete closure over extended periods of time, accepts alternative point of view of the world, and bear and contain the experiences of helplessness, confusion, and aloneness that not infrequently mark periods of analytic work with each analysand” (p.7).
It is likely Freud intended “indifference” to refer to the manifest meaning conveyed by the telling of the analysand, and not to the person of the analysand. What was more likely an invitation to listening with hovering attention (not judging, not focusing on the explicit meaning or the fine reasoning, but listening to what is not being said) has been instead misinterpreted, and has led some to represent the analyst as a cold, and distant person who refuses to manifest any emotion for the others, and for the analysands in particular. Obviously the latter is just a parody of the analyst, an imaginary representation that results from a misinterpretation of the Freudian words. On the other hand, the image we have of Freud from his letters and the reports from his pupils and analysands is far from that of a cold and distant person (see for example Roazen, 1995).
2) Saying that the psychoanalyst avoids either-or thinking is to simply consider the unconscious. The unconscious is the third non-excluded. It is the third between the “you” and the “I”. It is what breaks up any imaginary symmetry between the inside and outside, reality and fantasy, and between psychoanalyst and analysand. The experience of psychoanalysis highlights precisely the fact that the truth can never really be said completely. Instead, something always remains unsaid. But far from being a limitation of the speech, this is what makes the speech possible. Avoiding either-or thinking means that the analyst prefers to follow the logic of the unconscious, where indeed the third is not excluded, because it is not Aristotelian logic at work. Instead, the paradigm is that of dreams, showing that the unconscious proceeds by mechanisms of condensation and displacement. Finally, this process is continuous and interminable, meaning that there is not a final truth to discover, or reveal. Regarding either-or thinking Schafer (1983) writes that it is:
“Formalized in the principles of overdetermination (multiple meaningfulness of physical phenomena) and multiple function (the interpretive focus on conflict and compromise formation within and among the so-called psychic structures – the id, the ego, and the superego). In another respect, the avoidance of either-or is based on the assumption that some degree of love-hate ambivalence characterizes every important activity and relationship. If one takes seriously these principles of overdetermination, multiple function, and ambivalence, one can only judge it to be a failure of the analytic attitude to encounter an analyst speaking of what something ‘really’ means. […] The fact that one has discerned further meaning, weightier meaning, more disturbing meaning, more archaic meaning, or more carefully disguised meaning than that which first met the eye or the ear does not justify the claim that one has discovered the ultimate truth that lies behind the world of appearances – the ‘real’ world” (p.8).
3) The third point states that the analyst analyzes. This apparently obvious formulation actually serves to underline all that the analyst should not do. The analyst should be concerned to analyze only, and avoid the temptation to do more than that. To this, Schafer (1983) says:
The analyst “does not respond (not meeting love with love or rejection or exploitation; not meeting anger with retaliation or self-justification or appeasement; and not meeting confidences with thanks or with self-revelations of one’s own). The analyst’s ideal is to rely so far as possible on interpretation and careful preparation for interpretation […] This ideal will appear to be inhumanly rigid , exploitative, authoritarian, or unsupportive only to those who reject the general guidelines of psychoanalytic understanding and so do not appreciate the benefits ultimately to be derived from the analyst’s consistently maintaining the analytic attitude. There does exist a stereotype of the Freudian analyst as one who maintains an arid, stiff, utterly impersonal atmosphere in the analytic session. But in fact there is always room in analytic work for courtesy, cordiality, gentleness, sincere and emphatic participation and comment, and other such personal, though not socially intimate, modes of relationship (pp. 10-11).
The analyst should be concerned, first of all, not to interfere with the process of the analysis. As already mentioned, psychoanalysis is possible when a demand (or better, a question) is addressed by the analysand to someone in the position of the psychoanalyst. The analysis is possible because of a particular (analytical) dispositive; but the operator, what makes the analysis possible is the speech, more than the person of the psychoanalyst.
“the analysis should take place in a context of unabashed, unfussy, untheatrical, and unhectoring human relatedness […] The analyst cannot know exactly just when, what, how, and how long to interpret, or, as the case may be, not to interpret but instead to listen or introduce some other type of intervention. As a rule, the meanings and effects of the analyst’s interventions and silences may be adequately formulated only after the fact, if then” (pp. 11-12).
The analyst is not the expert, the master, or the guru. Then, the psychoanalyst should be able enough to hold on this position, without becoming too active, for example; or simply imaging what s/he is supposed to do or say:
“Analyzing is not giving didactic instructions on how to be a ‘good’ or comfortable analysand, nor is it teaching psychoanalytic generalizations about individual development or the way of the world. Certainly it is not giving advice and reassurance or issuing commands or prohibitions. As a rule, acting in any of these ways is neither analyzing nor preparing the way for interpretation. Most likely it is setting limits on what can be worked through later in the analysis. Consequently, such departures from the analytic attitude should be carefully limited. They may only be expressions of analyst’s narcissistically wishing to play guru. And the more the analyst plays guru, the more he or she reinforces the resistance to one important aspect of what remains to be analyzed more fully, namely, the analysand’s presentation of a weak, empty fragmented, ‘castrated’ ego to the analyst in hopes of receiving his or her good ministration. Freud noted long ago that one should never underestimate the human being’s irresolution and craving for authority. One of the analyst’s temptations, much played on by irresolute analysand, is to purvey wisdom when it would be more appropriate to the job at hand to analyze wisely” (p.15).
Greenber (1986) has proposed another summary of the analyst’s neutral position described by Schafer. For Greenber (1986, p.82) there are six main characteristics:
- 1. The analyst allows all conflictual material to be represented, interpreted and worked through. He takes no sides in the consideration of these conflicts.
- 2. The analyst avoids both the imposition of his own values on the patient and an unquestioning acceptance of the patient's values.
- 3. The analyst is unpresumptuous as to the desirability of alternative courses of action which the patient is considering. He does not unilaterally try to make anything happen and does not try to bring about a certain kind of change because he believes in it in principle.
- 4. The analyst is non-judgmental not only with respect to the patient, but also with respect to others in the patient's life.
- 5. The analyst subordinates his personality to the analytic task.
- 6. The analyst totally repudiates any adversarial conception of the analytic relationship.
Another important contribution for orientating our research and understanding of a psychoanalytic attitude comes from a rather different perspective. The “Guiding Principles for Any Psychoanalytic Act” were written by Eric Laurent in 2006. This brief sequence of eight principles aims to define psychoanalysis as an act of speech. This has significant reflections. This list is indeed a particularly powerful tool that sums up in a few words the essential aspects of psychoanalysis. This instrument is particularly effective for guiding this research. The eight guiding principles (Laurent, 2006) are:
1. “Psychoanalysis is a practice of speech. It involves two partners, the analyst and the analysand […] They do not both have the same relation to the unconscious, however, since one has already carried this experience through to the end whereas the other has not”.
2. “A psychoanalytic session is the place in which the most stable identifications by which a subject is attached can come undone”. The analyst “therefore does not identify with any of the roles that his interlocutor wants to make him take on, nor with any place of mastery or ideal that already exists in civilization. In a sense, an analyst is one who cannot be assigned to any other place than the place where desire is in question”.
3. “An analysand will address an analyst. […] when an analysand speaks he wishes, beyond the meaning of what he says, to reach the partner of his expectations, beliefs and desires in the Other. He aims at the partner of his fantasy. A psychoanalyst, enlightened by analytic experience about the nature of his own fantasy, takes this into account. He restrains from acting in the name of this fantasy”.
4. “The transference bond presupposes a locus, the ‘locus of the Other’, which is not ruled by any other in particular. It is the locus in which the unconscious is able to appear with the greatest degree of freedom to speak and, therefore, to experience its lures and difficulties”.
5. “There is no standard treatment, no general procedure by which psychoanalytic treatment is governed”.
6. “The duration of a treatment and the unfolding of sessions cannot be standardized”.
7. “Psychoanalysis cannot decide what is aims are in terms of an adaptation of a subject's singularity to any norms, rules, determinations, or standards of reality”.
8. “Analytic training cannot be reduced to the norms of university training or of the evaluation of what has been acquired in practice. Analytic training, ever since it was established as a discourse, rests on three legs: seminars of theoretical training (para-academic); the psychoanalyst in training's undertaking a psychoanalysis to its endpoint (from which flow the training effects); the pragmatic transmission of practice in supervision (conversations between peers about practice)”.
From this, a psychoanalytic attitude could mean to cultivate the suspicious, and follow the signifier, and not just the meaning. The psychoanalytic attitude is pragmatic: it does not propose rules that should be followed. And, following this, the clinical case is always in the process of being written, and in the form of present continuous. Oppositely, psychopathology is ideological because it is assumed to be universal and definable from the beginning.
The psychoanalyst works with the speech of the analysand, what the analysand brings in analysis in that particular moment. Every session is a new session. So the psychoanalytic attitude is an attitude of openness, of doing what is needed at that precise moment, out of any representations, assumptions, principles, guidelines, or presumed standard protocols. This means that it is possible for the analyst to assume different positions and different behaviors toward different clients, in different moments. There is not a reference code, or a manual to be followed; quite on the contrary, it is the effect that the intervention produces what justifies the intervention itself (this formulation sounds closer to Chinese thought, indeed).
In particular, what has emerged from an accurate literature review is that what is common to the majority of schools of psychoanalysis (and what differs at the same time from all other forms of psychotherapy/counseling), is a peculiar listening disposition. Psychoanalysis was described as a talking cure, but probably it is first of all a listening cure. Listening is probably the term that best sum up and capture the essence of psychoanalysis. At the same time this term allows us to give an operational definition of psychoanalysis (with the advantage that it may overcome all the conceptual differences among psychoanalytic schools) and to distinguish psychoanalysis from all other forms of psychotherapy and counseling. If a theoretical common ground is impossible to be described, at least a psychoanalytic attitude or, better yet, a psychoanalytic listening, can be more pragmatic and can provide us with an easier operational definition.