Book Review: Structures of Subjectivity: Explorations in Psychoanalytic Phenomenology

Structures of Subjectivity: Explorations in Psychoanalytic Phenomenology by George E. Atwood & Robert D. Stolorow, The Analytic Press, New Jersey (1984) 132 pp. (Distributed by Lawrence Erlbaum, London).

Psychoanalytic Treatment: An Intersubjective Approach by Robert D. Stolorow, Bernard Brandschaft & George E. Atwood The Analytic Press, New Jersey (1987). (Distributed by Lawrence Erlbaum, London).

Can there be such a thing as "psychoanalytic phenomenology"? Freud would not have thought so. In his "Introductory Lectures" he defined the place of "phenomena" in his conception of psychic processes quite clearly: "The phenomena perceived must yield in importance to the trends that are only hypothetical". Phenomena may be points of departure - Freud was, of course, a most acute observer - but it is "the trends that are only hypothetical", the invisible forces "behind" them, which deserve our foremost attention. It is this emphasis on the interplay of "unconscious" conflicting forces which has been at the centre of the psychoanalytic project.

However, there is a group of American psychoanalysis, followers of Heinz Kohut, who have broken away from this view. Kohut's ideas, with their great concern for actual relational ties, are for them a springboard for a radical re-evaluation of psychoanalytic theory and practice.

In the earlier (and more theoretical) of the books under review Atwood, and Stolorow define their intentions: "...our thesis... is that psychoanalysis seeks to illuminate phenomena that emerge within a specific psychological field constituted by the intersection of two subjectivities - that of the patient and that of the analyst. In this conceptualization, psychoanalysis is not seen as a science of the intrapsychic, focused on events presumed to occur within one isolated 'mental apparatus'."

The emphasis on intersubjectivity and the rejection of an intrapsychic apparatus shows a close affinity with the existential-phenomenological approaches to psychotherapy of writers like Boss and Binswanger. In an introductory chapter on the "philosophical context" of their presentation, Stolorow and Atwood mention hermeneutics, existential phenomenology and structuralism as the three movements of thought on which the "psychoanalytic phenomenology" draws. However, in the main body of their exposition there is no direct reference to philosophers or psychoanalysis of an existential-phenomenological orientation. The authors express some reservations about "a tendency uncritically to import

into psychoanalytic theory philosophical concepts not genuinely grounded in clinical observation". This ambivalent attitude towards what they after all describe as their "philosophical context" seems in my view, due to their problematic decision to retain a psychoanalytic framework.

The consequences of this shift from an intra-psychic to an intersubjective perspective is explored in great detail in Structures of Subjectivity and the later Psychoanalytic Treatment where Atwood and Stolorow are joined by B. Brandschaft. The shift calls for a re-definition of psychological development and disturbance as well as for a radical new look at what happens in therapy.

Psychological development is seen entirely as the outcome of the interaction between child and care-giver "Trauma is viewed here not as an event...overwhelming an ill-equipped apparatus. Rather, the tendency for affective experiences to create a disorganized self-state is seen to originate from early faulty affect-attunement, with a lack of mutual sharing." This insistence on the importance of the actual contact between care-giver and child, which does not involve the internalization of images or the projection of unconscious phantasies, is an intersubjective elaboration of Kohut's still quite psychoanalytic theory of "self-object relationships".

Even more fundamental is the influence of mis intersubjective approach on the understanding of the therapeutic process. At the centre of this understanding is a reformulation of the concept of "transference". This is no longer "a regression to or a displacement from the past, but rather an expression of the continuing influence of organizing principles and imagery that crystallized out of the patient's early formative experiences".

The therapist cannot be neutral "Indeed, relentless abstinence on the part of the analyst can decisively skew the therapeutic dialogue, provoking tempestuous conflicts that are more an artifact of the therapist's stance than a genuine manifestation of the patient's primary psychopathology". The contribution of the therapist, in this view, is one of "sustained empathic enquiry - an attitude that consistently seeks to comprehend the meaning of the patient's expression from a perspective within, rather than outside, the patient's subjective frame of reference.' The therapist needs to understand the patient's "pathological" manifestations as attempts to survive the consequences of early traumatic experiences.

The authors propose a new approach to "resistance". "In resistance, the patient's experience of the therapeutic relationship is organized by expectations or fears that his emerging emotional states and needs will meet with the same traumatogenic responses from the analyst that they

received from the original caregivers. "Resistance must always be seen in its intersubjective context, and the therapist needs to face the extent to which it is evoked by insufficient empathy. Unempathic "analysis" may present a threat of disintegration.

This rather summary account of some of the authors' ideas shows, I hope, that there is indeed a strong affinity with an existential-phenomenological approach to psychotherapy. The rejection of a "psychic apparatus", the emphasis on intersubjectivity and the contribution of the therapist who can both evoke and ease signs of disturbance offer common ground. The books are lucidly and elegantly written and rich in instructive illustrations

However, we are left with our original question: can there be such a thing as "psychoanalytic phenomenology"? It seems to me that the authors' inability to free themselves from their psychoanalytic origins has created an ambiguity in their presentation.

It is interesting that the later book contains a critique of Kohut which shows that the authors are not unaware of the difficulty of introducing intersubjective perspectives into a psychoanalytic model. They disagree with Kohut when he proposes that a theory of the self - which they define as an "organization of experience"- and a mental-apparatus theory could be complementary. But in view of this criticism it seems strange that they still present "case" histories and call one of their books "Psychoanalytic Treatment". The "treatment" of "cases" recalls a most inappropriate model!

Also, when the meeting of patient and therapist is seen as the meeting between two "structured subjectivities", is it really possible to go on talking about "transference" and "countertransference" as the authors consistently do? What is here "transferred", and by whom? As they criticize Kohut's use of the term "self-object" (with its obvious association with object relations theory) and re-define it as the "function of the relation with a significant person, why do they keep using this term? Some people may feel that these are strictly semantic questions, and that there is no harm in extending the meaning of "psycho-analysis". I believe that we cannot separate what we do from how we name it. If we no longer believe that there is a "psyche" to be "analysed", how can we call what we are doing "psycho-analysis"?

Hans W. Cohn