[Paper presented on June 10, 1995, at the Annual Meeting of the Rapaport-Klein Study Group]
Although I believe that psychoanalysis never achieved the scientific status that Kuhn (1962) suggested warrants the label of a paradigm, I nonetheless use the concept of paradigm and paradigm shift in a broad sense. I wish to encompass changes in clinical technique and a change in a philosophical outlook, both of which have increasingly garnered attention in the psychoanalytic community. To the extent that we are willing to loosely use the term paradigm change in psychoanalysis, Merton Gill was in the forefront of this shift at least in these two arenas. As I hope to demonstrate, I think his underlying assumptions are less clear, at times even inconsistent; however, Gill would have been the first to acknowledge that he had not tackled the philosophical issues in any systematic way.
He believed (Gill, 1994b) that the philosophical orientation for psychoanalysis should be social constructivism, and because psychoanalysis addresses a discourse of personal meanings, it is a hermeneutic science. Very little of his intellectual energies addressed these philosophical issues. I certainly understand his reluctance. To step into the complex philosophical hermeneutic literature - a literature, by the way, in which I am a novice - is to confront embattled positions, arguments of differences, and the insistence on the part of many hermeneuticists of the importance of logical discourse, reasoned argument, and the aesthetics of meaningful, coherent, and persuasive treatises (e.g., Habermas, as discussed by Bernstein, 1983; McGowan, 1991, and especially Norris, 1990; Gadamer, 1960). For a discussion of current philosophical views in psychoanalysis, their complex and subtle different nuances, and their influence on the clinical process, see Silverman (1999, 2000).
There is, of course, the other side, more dominated by Jacques Derridas (1982; also Norris, 1990) deconstructionist position or what some think of as a postmodern viewpoint. It is an outlook that at times challenges the use of rational criteria, reasoned argument, truth claims, and standards of validity. Philosophers such as Richard Rorty (1989, 1991, 1993) may belong here, as well may the early Frankfurt school, the social philosopher Michel Foucault (1977), and, in the literary arena, the critic: Stanley Fish (1989). For Derrida, the leading deconstructionist, all texts are contextualized, with meaning indeterminate in any given, case. There is always infinite "free play" (quoted in Norris, 1990, p. 38), an open-ended contextualized account, which Derrida calls "unlimited semiosis" (p. 58). Clearly this is not the position toward which Gill inclined. He was too much of a reasoned empiricist. His last book (Gill, 1994), for example, raises questions concerning issues that have been asserted and assumed as gospel in our field. He challenged many of these positions, offered his own counter-arguments, and in the end insisted, in effect, that it is an empirical question.
I believe there is much that Gill (1982) valued in traditional psychoanalysis. However, he saw serious limitations in its practice. His focus was on the transference-countertransference experience and his view that these were co-constructed. That is, he maintained that the dyad was unique. Each participant brought to the therapeutic experience a complex cultural, sociohistorical, conscious, and unconscious personal context. These characteristic factors for each participant interacted in ways unique to this couple. The need to bridge communication between the two forged an intersubjective field, co-created by both participants. (With the use of the term intersubjectivity, I am stressing a shift from the patient as subject and the analyst as object - the latter as an independent, autonomous, external observer - to the concept of two interacting subjectivities.)
Gill (1992, 1993, 1994b) agreed with the idea of two subjectivities, believing that each of the participants were shaped and shaping each other's psyche in this setting. He referred to this interaction as a two-person psychology, and he maintained as well that there was simultaneously a one-person psychology. By the latter he meant the private psychic life of an individual, fashioned by significant external factors that were internalized, and that these factors interacted with endogenous drives and thereby organized psychic life. (It is a difficult balancing act when you are describing and developing one aspect of a one- and two-person dialectic. When focusing on one perspective, there is a temporary obliteration of the other.)
Gill's (1987, 1994a, 1994b) insistence on a one-person psychology permitted the retention of the concept of unconscious fantasy: a private, intrapsychic experience that the patient brought to the potential intersubjective field. Gill's position on unconscious fantasy was that it was not a discovery, something innate waiting to emerge, but rather a construction. Nonetheless, I believe he did not abandon the original idea of "the innate" or the idea that fantasy could be rediscovered. This is reflected in his view that innate drives have developmental priority over the social interaction in the infant. The innate drives were, as Gill (1982) wrote, the "biological givens, in their psychological representation [which] enter into development as independent factors…" (p. 41). Although he indicated that these biological givens interact with the environment, the privileging of these innate, independent factors divides the mind from its social context and biases his theoretical ideas in the direction of a one-person psychology.
Advocating a view of development as intersubjective, Gill favored a major shift away from Freud's and Rapaport's views about the contributions to conflict, neither accepting Freud's (1905) complemental series, nor what he called Rapaport's (1951) additive position (Gill, 1994b). Nonetheless, a commitment to the concept of the priority of the innate drives more readily lends itself to the greater shaping influence of unconscious fantasies that are derivatives of drives. It leads more systematically to a particular view of the patient's mind as more autonomous and that the patients unconscious fantasies shape perceptions. Such a vantage point is more consistent with Brenner's (1976) position, for example, when he offered that the real aspects of the analyst are "a stimulus to the patients mental activity like any other" (p. 126). For Brenner the focus is on the mind of the patient. This then permits Brenner to think that the specific personality characteristics and behavior of the analyst are grist for the patient's unconscious fantasies, fueled by the patient's drive mill. Challenging such a view, Gill did not believe in the spontaneous unfolding of the analytic process characteristic of a one-person psychology; nonetheless, he insisted that the same major problems of the patient will be exposed by any competent analyst (Gill, 1994, p. 149). This position seems close to denying his own two-person psychology by positing a significantly greater role to the unfolding of endogenously organized experience governing the process than he has spelled out in his clinical work.
The tenor of his writings, especially in his final book (Gill, 1994b), is consistent with what I have been describing. He offered the idea that drives organize fantasy meanings and that these meanings retain their original compelling power. Therefore it is not clear whether this aspect of his theory is really a one- and two-person psychology, the only perspective he thought tenable. However, if his point of view reflected a two-person psychology, Gill would have needed to elaborate on ways unconscious fantasy would emerge as a unique construction co-created by this dyad. Further, the coloration and flowering of the fantasy in the analytic setting would need to be somewhat differently shaded by the analysts contributions than in any other dyadic setting. One might consider as well that the analytic duo might lend itself to the emergence of certain unconscious fantasies and not others. It would be reasonable to argue from a two-person psychology construction that either for the patient or for the analyst or together, particular theory-organized or unconscious conflictual ideas (or both) would be foreclosed, whereas others might be encouraged. Such considerations, I suggest, are more consistent with an intersubjective position.
However, as I have indicated, Gill's one- and two-person psychology at times seems to rest more in the one-person psychology camp, at least when he was presenting his integrative theoretical ideas in contrast to his clinical technique. Thus I believe there is some tension in bridging his theory and clinical process. I have addressed this in some detail because many relationalists have taken up his banner and energetically wave it, believing that Gill's position reflected greater intersubjectivity than I think is inherent in his theoretical position.
On the other hand, his clinical objective is more consistent with his two-person psychology and the more typical relational position. Whereas his secondary view of treatment is the emphasis on the patient's psychopathology, Gill's (1983, 1987, 1992, 1994b) overriding clinical considerations shift from a traditional Freudian one that focuses on the workings of the patient's more endogenously organized mind, to his announced goal of understanding the nature of the patients relationships, starting with the analytic one. This has led many Freudians to assume that Gill bad given up the exploration of unconscious fantasy and opted for what many traditionalists consider a more superficial interpersonal analysis. (See, for example, the special section in Psychoanalytic Psychology: Sugarman & Wilson, 1995). They consider it superficial in that it deals with the actual relationship between the patient and the therapist and treatment that is typically associated with the interpersonalist position.
Whereas I think this is often a caricature of the interpersonalist position, I think Gill (1983, 1994b) also lumped together the interpersonal and the relational perspective too readily. (Because the differences between these two orientations are not my focus in this essay, I shall only comment that I believe there are distinguishing theoretical features and clinical emphases of each perspective and that their linkage obscures these.)
I wish to discuss the concept of unconscious fantasy further because I am aware that it is around this issue that clinicians experience an important divide. It is a central pursuit in traditional analysis, and classical analysts maintain it is downgraded by those who emphasize the relevance of a two-person psychology and pursue its implications in the clinical interaction.
There are, no doubt, differences among clinicians in the frequency of interventions they permit themselves (i.e., seeing where the patient's mind goes spontaneously vs. intervening), traditionalists being less inclined to intervene. One cannot have it both ways. In the noninterventionist camp, the idea is that the unencumbered flow of associations are likely to offer unconscious fantasy derivatives. For Gill (1994b) though, the interruptions were clinically relevant and were consistent with his two-person psychology orientation. In the traditional position the encouragement of free associations, so the theory goes, offered the opportunity for a more regressive primary-process domination of the patient's productions. This was an untenable position for Gill (1994b), who insisted on compromise formation in mental life, that is, that defense and resistance are a continuing accompaniment of the free association process. In addition, he thought that associations are chronically influenced by the analyst, who was a constant even if only a background part of the patient's productions. Thus, for Gill, unless the analyst pointed to the defensive components, including the transference, there would be no deepening of the analytic process, including the emergence of unconscious fantasies.
When evaluating a focus on either unconscious fantasies or on the interactive process, traditionalists - who may be guided in their thinking by a dichotomization - value the former and often describe the latter as typically stressing manifest content and a superficial interpersonal orientation. Setting aside the denigrations, traditional analysts have no real grounds for insisting that an intersubjectively organized view precludes a concept of a private conscious and unconscious self. Such a view is not necessarily an outgrowth of the hermeneutic: position. Gadamer (1960), for example, emphasized the goal of increasing self-knowledge, although he recognized its interactive, contextual, and historical nature. Neither do traditionalists have any basis for arguing that unconscious fantasy is unretrievable via a transference focus that is understood as intersubjectively organized and is clinically pursued. That is an empirical question.
On a number of occasions, Gill (1992, 1994b) described how his own personal analyses led to reconsiderations of transference and, by extension, countertransference. It is in the transference domain that he offered "a radically new perspective." Thus, Gill's emphasis on the pursuit of the transference and the therapist's acknowledgment of the plausible aspects of the patient's experience and perceptions shifts the nature of the encounter for both participants. His vantage point challenged the hierarchical nature of the analytic dyad. Although he acknowledged that most analysts have abandoned the myth of the neutral analyst, he explicitly maintained that the analysand knows considerably more about the analyst than is recognized and that such knowledge shapes transference. While trying to maintain even relative neutrality, he would offer Freud's words that, "our secrets ooze out of every pore" (Gill, 1994b, p. 71). Therefore, in acknowledging the patient's plausible views, the tacit assumption is that it is not exclusively the analyst who knows about material reality. Furthermore, his vantage point challenges the idea that it is only the analyst who understands unconscious psychic reality for both the patient and the analyst. Gill addressed the prejudgments, prejudices, and limitations along with the recognized facilitating and healing aspect the analyst brings to the experience.
By highlighting the patients plausible views of the transference, Gill extended and ultimately influenced novel conceptions about countertransference. A continuum of positions now exists among contemporary Freudians, and tradition-challenging ideas are under consideration by those utilizing a two-person psychology framework.
A blank-screen model has been abandoned in principle by most Freudian analysts, and the history of the concept of countertransference, like transference, has altered from viewing it as a resistance to acknowledging it as a potential facilitator of the analytic work. However, there remains considerable prohibition against self-revelation, countertransference actions, and enactments. The more traditional view holds that the patient's transferences readily stir the analyst's own conflictual issues and a countertransferential reaction occurs, which is a unidirectional, one-person psychology point of view. In addition, the analyst maintains relative neutrality by simultaneously attending to his or her psychic reverberations, and in this manner analysts catch countertransference reactions and thereby eliminate actions. For some contemporary Freudians there is greater acceptance of the analysts contribution - limited, however, by certain constraints. This is reflected in the concept of enactment. Here is Chused's (1991, p. 629) definition: "Enactments occur when an attempt to actualize a transference fantasy elicits a countertransference reaction." Although she talks about "symbolic interactions between analyst and patient which have unconscious meanings to both" (Chused, 1991 p. 615), the thrust of her ideas remains more unidirectional: the patient initiates transference pulls to fulfill fantasy wishes to which the analyst unintentionally responds. Sandler's (1976) idea of role responsiveness which preceded the concept of enactment is similar. He too acknowledges the inevitability of the analysts response to the patients needs and that actions on the analyst's part are unavoidable. Thus, a shift has taken place from the initial view of countertransference as maladaptive, to recognizing it but reducing it to a zero effect, then to acknowledging its value in highlighting patients' neurotic transference wishes and to the more contemporary idea of the inevitability of the analyst's enactment. However, Gill (1992, 1994b) did not believe that even the more modern views of countertransference fully engaged the actualities of the analytic two-person psychology experience. His interest in Racker's ideas more closely supported his paradigm and it seems to me readily lends itself to viewing enactments as co-constructed.
Racker (1960) maintained that the analyst was not a dispassionate, objective listener decoding derivatives but was one who also struggled with internally generated, powerful peremptory wishes, anxieties, guilt, and defensive, resistant reactions, as well as induced ones. Freudians such as Bird (1972) also prepared the way for a potentially more interactive view. He described the powerful emotional immersion of both participants when a meaningful analytic experience is in progress, even suggesting that "the analyst's own transference involvement is necessary" (p. 235). In a more current article, Boesky (1990) offered these complementary ideas: "transference as resistance in any specific case is unique and would never and could never have developed in the identical manner, form, or sequence with any other analyst and that the manifest form of the resistance is ... unconsciously negotiated by both patient and analyst." Thus "there can be no treatment conducted by an analyst without counterresistance or countertransference" (Boesky 1990, pp. 572-573). These ideas propose that both analyst and patient experience potent transferences that involve enactments.
Such considerations suggest that enactments are not only inevitable, but a constant accompaniment of the treatment. As an analyst becomes consciously aware of an enactment and attempts to derail it, it may unconsciously invoke an alternative enactment. However, even this point of view would be an insufficient conceptualization for Gill, because of the unidirectional one-person psychology orientation it implies. Here I quote Gill (1994): "A truly interactive concept is one in which both parties are contributing to the interaction, not one in which one party is merely responding to the other" (p. 103). Thus, transferences and countertransferences are bidirectional and co-created. The danger of such a point of view is that we may be in an infinite regress and feel that we are frequently in the dark about our own and our patient's motivations. However, conceding the inevitability of multiple enactments can inform our work. Useful as well is the acknowledgment of the sometimes slow, confusing, and evolutionary nature of advancing knowledge. In addition, I offer the views of the philosopher Bernstein (1983), who, in talking about the scientific endeavor, argued that in the pursuit of science our future views may reflect modifications of the "standards, reasons and practices" (p. 69) we associate with our discipline. "Such a modified view of scientific standards should not lead to skepticism, but to the acceptance of human fallibility and the limitations of human rationality" (p. 69).
In the uneasy struggle to integrate one- and two-person psychologies, positions are frequent biased in one or the other direction, and I have tried to demonstrate this aspect in Gills thinking. However, I suggest that such biases are inevitable as we are in the formative stages of a new paradigm. In addition, there is no experimental data to solidify either position. Some of the difficulty in this current controversy, as I read the literature, is suggested by each side arguing that the other misunderstands their views. What is required is extensive clinical documentation. We need to establish whether there are significant differences between a one and one- and two-person perspective. If so, can the clinical implications be demonstrated, and, finally, will such distinctions offer outcome differences? Gill would undoubtedly concur with the need for such documentation. He was a passionate promoter of clinical research. With his death, we will miss his powerful voice and compelling advocacy as well as much more.
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[Note: This paper later appeared in D.K. Silverman & D.L. Wolitzky, editors, Changing Conceptions of Psychoanalysis: The Legacy of Merton M. Gill, Hillsdale, NJ: The Analytic Press, 2000, Chapter 9, pp. 188-196; European distributor: Eurospan. We thank for the permission]
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