paper presented at the VII Annual Conference della
EUROPEAN ASSOCIATION FOR PSYCHOTHERAPY (EAP)
La formazione nella psicoterapia: fondamenti comuni e diversità negli approcci
Rome, June 25 - 29, 1997
Greenberg and Mitchell, in Object Relations in Psychoanalytic Theory - their 1983 book which has become a classic - draw a fundamental distinction between drive models and relational models. According to the first group - represented essentially by Freudian psychoanalysis - relations are a means for instinctual gratification, and affective relations are a secondary derivative. According to the second group, relatedness is a primary need. Authors from various schools belong to the second group. Various relational positions can thus be defined.
(a) The author who was most independent from the Freudian matrix was Harry Stack Sullivan, who started the interpersonal school in the United States.The original group included also Karen Horney and Erich Fromm. This is the group to which the term "Neofreudian" has traditionally been applied. The group then split. Horney founded her own school, while Sullivan and Fromm founded the William Alanson White Institute in New York. In more recent years, the interpersonal school has given rise to the relational school. Two outstanding representatives of this school are Greenberg and Mitchell, who are the Editors of the two most important journals in this area, respectively "Contemporary Psychoanalysis" and "Psychoanalytic Dialogues".
(b) Also in America, from within Freudian orthodoxy, Heinz Kohut founded Self Psychology. Even if it formally remains within Freudian organizations, this is actually a relational school.
(c) Last but not least, starting from Melanie Klein, the Object Relations school developed in Britain. Here the primacy of the relation was very clearly upheld. Fairbairn says that the child at birth is "object seeking", is namely seeking for someone to relate to. In my opinion, this position reached its peak with John Bowlby, who applied modern evolutionary biology to psychoanalysis and thus gave it a solid biological foundation, although most psychoanalysts still have not realized it. Bowlby claims that the child's attachment to the mother is a form of innate behaviour which was selected in the course of evolution because of its survival value (in the first place, protection from predators).
The various psychoanalytic schools may be divided into three groups according to the degree of the analyst's participation in the relationship.
(a) According to Freud's papers on technique, the orthodox Freudian position is characterized only by a neutral observation of the patient, with two exceptions: the therapeutic alliance, and countertransference, namely the analyst's emotional reactions, which in this context are regarded as a disturbance to be eliminated.
(b) In the second group, the analyst's emotional participation is viewed as an essential component of the therapeutic process. Sullivan, starting from the model of cultural anthropology, spoke of "participant observation". Kohut claimed that empathic participation was necessary. This position, to which most British authors also belong, is called by Greenberg "participation with".
(c) Finally, there is a third group of authors who, in addition to empathic participation, admit the possibility, or, better, the inevitability, of "mistakes" on the part of the analyst, who reproduces in the therapeutic relationship the behaviour of figures from the patient's past. This position is called by Greenberg "participation in". The first to realize the inevitability of "mistakes" and to use this term was Ferenczi. It is well known that for various years after his death Ferenczi was ostracized by the Freudian orthodoxy. He exercized a hidden and indirect influence on the Kleinians. Paula Heimann and Racker reappraised countertransference, which was no longer regarded as a disturbance to be eliminated, but, on the contrary, as a valuable source of information about the patient. In the United States, instead, Ferenczi's influence was openly acknowledged and developed, at first in the interpersonal school, then in the relational school. There were two sources of this influence: Clara Thompson, who had been sent by Sullivan to Budapest to be analyzed by Ferenczi, and Erich Fromm, who was a staunch admirer and defender of Ferenczi. Thus, as early as 1972, Edgar Levenson said that sooner or later we have to fall into the patient's trap, then work our way out of it. More recently, Merton Gill, a Freudian who adopted the interpersonal paradigm, expressed this idea with his third principle of technique, according to which "the analyst will inevitably to a greater or lesser degree fall in with the patient's prior expectations". Some examples of this situation, which in more recent years has been called "enactment", will be given in my workshop. The therapeutic effect of enactment consists in the fact that, after having unintentionally impersonated a figure from the patient's past, the analyst admits it and tries to make amends. The emotional corrective experience (to use Alexander's old term) has maximal impact because it is based on maximal contrast between past and present.
From the technical point of view I identify with the most advanced relational position, represented by the third group described above. However, in my opinion, the American relational school has two serious limitations: it fails to acknowledge the importance both of evolutionary biology and of culture, and it has recently fallen into the relativistic position of radical constructivism, which is also criticized in this country by Giovanni Liotti. But corrective influences are to be found within the relational position itself. As regards evolutionary biology, I have already mentioned that Bowlby has potentially placed psychoanalysis onto a secure biological foundation. As regards culture, Erich Fromm has pointed out, through the concept of "social filters", the unconscious conditioning exercized by society, and he has carried out a severe critique of modern society. I believe that these two authors can be integrated and can provide psychoanalysis with an alternative theoretical framework, based on the dialectics of biological and cultural evolution. In my opinion, cultural evolution, starting from advanced agricultural societies, has given rise to a social and physical environment which often frustrates certain basic innate needs and thus gives rise to psychopathology. This is the position of modern evolutionary psychiatry, as exemplified by Evolutionary Psychiatry, by Stevens and Price, a very recent publication of September 1996.
Bacciagaluppi, M. (1993), Ferenczi's influence on Fromm, in Aron, L. and Harris, A., Eds., The Legacy of Sandor Ferenczi, The Analytic Press, Hillside, NJ and London, England.
Greenberg, J.R. and Mitchell, S.A. (1983), Object Relations in Psychoanalytic Theory, Harvard University Press, Cambridge, MA and London, England.
Liotti, G. (1996), Motivazioni innate, relazioni oggettuali e Sé, Psicoter. Sc. Um., 30, 25-46.
Stevens, A. and Price, J. (1996), Evolutionary Psychiatry, Routledge, London and New York.