1 Why Now?: a Social-Historical Inquiry Into the Ascent of Relational

Why Now?: A Social-Historical Inquiry Into the Ascent of Relational Theory

Ilene Philipson, PhD, PhD Institute of Contemporary Psychoanalysis

In a recent issue of the IARPP Newsletter (Vol. 8, No. 1), IARPP President Jeremy Safran writes that “the development of relational analysis was initially influenced by many factors that are particularly American: for example a sense of optimism, individualism, a tendency to challenge social hierarchy and the type of pluralistic perspective associated with the tradition of American philosophical pragmatism” (p. 12).

While undoubtedly there is truth to this assertion, I think Safran’s analysis serves as a good example of what Elizabeth Young-Bruehl has noted as the lack of historicity in psychoanalysis, that is, our lack of reflection upon the historical changes in our field (2009). By tying the development of relational psychoanalysis to a fixed and uniform notion of American character, Safran inserts a timeless quality to what I see as a highly dynamic history, and a recent, rather sudden paradigm shift in psychoanalytic thought and practice. If relational analysis is an expression of American character, why did it emerge in the 1980s and not before? Where did the particularly American tendency to challenge social hierarchy reside during the seven decades of classical Freudian hegemony in this country? And why until only recently did our psychoanalytic institutes reject any kind of pluralism associated with the tradition of American philosophical pragmatism?

Safran’s linking of American character to changes in theory stands out because we typically connect the rise of the relational model only to the development of ideas and the work of particular theorists. An excellent and parsimonious example of this general way of thinking is Stephen Mitchell and Lew Aron’s preface to Relational Psychoanalysis: The Emergence of a Tradition. In that edited volume they state that “[o]ver the past two decades, a distinctly new tradition, generally associated with the term relational psychoanalysis has emerged within American psychoanalysis through a convergence of a number of important factors.” They delineate those factors as interpersonal psychoanalysis (Sullivan, Fromm and Thompson); object relations theory (Guntrip, Fairbairn, Winnicott and Bowlby); self psychology (Kohut), and “[f]inally, . . . a distinctly American brand of psychoanalytic feminism” (Dinnerstein, Chodorow, Gilligan, Benjamin, Goldner, Harris and Dimen) (1999, pp. x-xi). Thus it is exclusively the work of individual minds that accounts for the emergence of the relational model as Mitchell and Aron see it.

1 What has interested me for a long time (see Philipson, 1993) is that so many of the ideas and theorists who are credited with the development of relational thinking have existed in the psychoanalytic canon for decades (cf Fairbairn, Guntrip, Winnicott, Bowlby, Sullivan), but it is not until 1983 that Greenberg and Mitchell denote a “relational model” as such. It is in Object Relations in Psychoanalytic Theory, that, according to Aron and Harris: “relational theory was a description of a group of theorists who had neither defined themselves as relational nor seen their own work as related to that of others or to any movement or trend that would later be regarded as relational. It was only Greenberg and Mitchell, as historians and scholars of the development of psychoanalytic theory, who categorized them retrospectively as belonging to the relational turn in psychoanalysis” (2005, p. xv).

What I am interested in examining in this article is the issue of what allowed Greenberg and Mitchell to make these connections, to create this new category of “the relational.” What space had opened up historically allowing them to see something previously unseen? And, crucially, why did their new category, and Mitchell’s subsequent elaboration of the relational turn (1988), capture clinicians’ attention? Clearly without these ideas finding resonance among psychodynamic practitioners, the name Stephen Mitchell could have remained part of the large pantheon of extremely bright and relatively obscure psychoanalytic writers.

This dimension, the psychoanalytic audience that co-constructs theory through being drawn to certain authors and ideas and not others, is largely overlooked when we think about paradigm shifts. As intersubjectivists or contextualists, I think it should be impossible for us to look at the history of ideas without looking at the audience for those ideas, the question of why those ideas become salient at a particular point in time for a particular group of people. The material realities of which books and journals are purchased and which conferences and seminars are attended, shape theoretical shifts. In keeping with this understanding, we can contemplate the question of why Mitchell’s---and Kohut’s, and Winnicott’s, and Bowlby’s---ideas have such impact, speak with such force and seem so true starting in the 1980s and 90s.

Too often I think we answer this question with the belief that these ideas are, well, simply better than what came before. After all they reject ahistoric drives, or are anti-Cartesian, or see people as fundamentally object seeking, or constituted by a lifelong need for selfobjects, or attachment, or mutual recognition, etc. But this way of thinking begs the question. Why now, at this particular historical moment, do we think that these ideas are better? If we take seriously our rejection of objective truths, how do we end up claiming that relational thinking is better than classical? Greenberg and Mitchell tell us that “the evaluation of psychoanalytic theories is a matter of personal choice. The theory stands or falls on how compelling it appears to be, on its underlying vision of human life. Does the theory speak to you? Does it seem to account for your deepest needs, longings, fears? In your clinical work does it provide a

2 convincing account of your patients which corresponds with your own experience of them? (1983, p. 407).”

I would argue that this view may tell us something about how individuals evaluate theory for themselves or why there might be differences among us at any one point in time, but it does not address the issue of why there are historical shifts in our theoretical understanding, why certain ideas become salient and even hegemonic, and, most importantly, why our collective “underlying vision of human life” seems to have changed.

Further, Greenberg and Mitchell’s emphasis on “personal choice” does not take into account the social-historical construction of what we experience as free choice. A more hermeneutic or social-constructivist perspective holds that while “we are constituted by our self-interpretations, for the most part, these interpretations are not freely chosen or consciously recognized, since they are so deeply embedded in culture, history, and bodily being, and since they are so pervasive as to be nearly invisible. One implication of this is that self- understanding cannot be obtained by studying individual subjectivity alone; it requires an understanding of culture, of language and of history” (Woolfolk, et al, 1988, p. 16).

Ingredient in the relational paradigm is a commitment to seeing people as embedded in contexts that they both shape and are shaped by. The idea of an isolated mind or encapsulated self that exists outside of an intersubjective field belongs to a Cartesian, modernist myth of autonomy. While applying such postmodern thinking to the relationship between analyst and patient is taken for granted by relationalists, rarely is such consideration brought to bear in understanding how the contexts of our therapeutic practice shape our ideas and theories

In what follows I would like to offer some ideas as to why relational psychoanalysis and its underlying vision of human life have ascended since the 1980s. As a sociologist, I ground these ideas in the specific socio-historic context in which we practice. And as a contemporary psychoanalytic clinician, I view theory as socially constructed through the interplay between theorist and audience. Ideas do not fall from the sky; they are fashioned out of the day-to-day clinical work of practitioners who buy the books, read the articles and attend the conferences that allow certain theories to flourish and others to die.

There are, of course, a multiplicity of ways to understand the relational turn.* For the purposes of this article, I would like to focus in on two specific transformations in our clinical practice that I believe dialectically inform the creation of relational theory. If we believe our contemporary theories are somehow better than what came before, I argue that they are so perceived, to some degree, because they offer a

* For the best, and one of the only overviews of the development of relational theory that takes into account its social and historical contexts see Lewis Aron’s A Meeting of Minds (1996), chpt. 1.

3 better fit with the conditions of our contemporary practice and hence with the needs and interests of the current psychoanalytic audience.

The Demise of Psychoanalytic Authority

Over the course of the past three decades, psychoanalytic practice has been undergoing a process of feminization, decreasing status and remuneration, and increased competition. Besieged by managed care, the escalating influence of pharmaceutical interventions, and quick fixes such as EMDR, the world of psychoanalysis has responded, however inadvertently, by graduating increasing numbers of practitioners who find themselves with no one seeking their psychoanalytic services. In one of the few empirical studies of actual psychoanalytic practice, Sabrina Cherry and her colleagues discovered that very few analytic graduates actually practice psychoanalysis: “We found that in New York City, at the Columbia Center for Psychoanalytic Training and Research, strikingly little four-times-weekly psychoanalysis is being conducted among analysts who graduated within the last fifteen years. Graduates who . . .have not become training analysts (78% of our sample) conduct almost no four-times-weekly analysis once their control cases terminate. Finally, and contrary to our hypothesis, graduates were found to practice very little twice-weekly analytic therapy. On average they work about 30 hours a week in the office (less if they have another job), with two patients in twice weekly treatment and zero or one patient in treatment conducted at greater frequency” (pp. 861-2). These findings were consistent with the American Psychoanalytic Association’s most recent survey of its membership with a sizable response rate. In that 1996 assessment “the most common mode of treatment among respondents was once-a-week psychotherapy” (Cherry et al, p. 861).

With the 1988 settlement of the lawsuit that allowed non-MDs to become psychoanalysts without seeking waivers, a flood of psychologists and masters level clinicians sought analytic training. Many institutes opened, in part, in response to this demand, resulting in a vast oversupply of practitioners relative to the market for traditional psychoanalysis. And while some may argue that this process has reduced an elitism that has been detrimental to our field, it is also possible to argue that it diminishes the status, and hence authority of psychoanalysis in general.

When I invited one of my psychotherapy patients to begin an analysis, explaining to her that I was now a candidate, training to become a psychoanalyst, she, a non- clinician in Berkeley, CA, remarked: “what is it with you therapists? Everyone I know has become a psychoanalyst. They’re a dime a dozen. Are there really enough people for you to see?”

And of course, as we all know, the answer is no, there are not. The democratization of psychoanalytic training in the context of the larger cultural devaluation of psychoanalysis has resulted in a perception among many that we are “a dime a

4 dozen,” a devalued profession. As Elliot Jurist, editor of Psychoanalytic Psychology, asserts, “we must face that our place within the world of mental health has become increasingly marginalized” (2010). And as Lew Aron tells us: “the best students, and the students from the best known universities, with the best grades from those universities, are choosing to go into fields which are much more lucrative. There was a time when psychoanalysis was tied to medicine and practitioners could expect to make a better professional-class living, a middle- class living. That’s getting harder and harder to do as a therapist, and so there’s a real question about who is going to be drawn to this field when it has less status, less prestige, and where it’s harder and harder to earn a living” (Safran, 2009, p. 104).

It is important to point out, however, that the devaluation of our profession has unfolded against the backdrop of all forms of authority being scrutinized and challenged. The social and cultural transformations of the 1960s revolutionized our willingness to accept universal truths and grand narratives. Authority figures from politicians to priests, professors to journalists, all labor under the suspicion of bias and the unfair use of power to suppress, manipulate, exploit. This postmodern anti-authoritarinism has fundamentally challenged the expertise of the classical Freudian metanarrative. As Donnel Stern notes, “since the 1960s there has been a broad shift in our culture regarding our relations to authority. . . Because people are different today in this way, the kind of psychoanalysis that was practiced prior to the 1960s is simply no longer appropriate. People today are much less likely than they used to be to put up with analysts who feel that their patients must believe that the doctor knows the truth about them” (2010, pp. 198-199).

The tradition of abstinence, detachment, and objectivity as methods of eliciting frustration, anxiety and insight was founded in an authority relationship between analyst and analysand. The therapist was the unquestioned authority figure who cured by reason of his prestigious training and superior insight. This configuration is a far cry from the mutuality, empathic immersion, and collaborative enterprise that we value today. While I recognize my preference for this latter form and believe in its superiority, I also recognize that I am a socially constructed, historically embedded clinician whose preferences may reflect the historical diminution of my own authority as an analytic clinician.

In order for a psychoanalyst to be accepted as a blank screen who cures through abstinence and interpretation alone, the analyst must be regarded as an authority whose expertise remains relatively unquestioned. If the public perceives psychoanalysis as an occupation that suffers from an oversupply of practitioners, that is continually under siege by new discoveries in biological psychiatry, managed care, and a culture that values quick fixes, then it is possible that when that public approaches a psychoanalytic clinician’s office, it may not be with deference. While many of us may think that this is a good thing in so far as it repudiates elitism, my project here is to simply illuminate the shifting material conditions that may

5 underlie contemporary theory and suggest that the relational turn can be seen, in part, as tacitly incorporating the historic decline of psychoanalytic authority. Similarly, our current interest in neuroscience on the one hand, and phenomenological and hermeneutic philosophy on the other, may speak to the ongoing need to discover other sources of authority outside the psychoanalytic canon to underpin our project.

In essence I find it interesting that just as psychoanalysis is losing its authority in the culture in general and relative to other forms of mental health practice, contemporary theories begin to focus on mutuality and subject-to-subject relating. Just as women become the majority of practitioners, the relationship between analyst and patient rather than the well-timed interpretation becomes mutative.* Thus the space that seemed to open up, allowing Greenberg and Mitchell to see the connections among disparate theorists and in so doing label a new paradigm in 1983, reflects, to some degree, a decline of our authority. And by that I mean both the larger cultural decline of all forms of authority and the specific decline of psychoanalytic authority. While we celebrate the greater egalitarianism, inclusion, fallibilism, pluralism and sensitivity to difference of our contemporary frameworks, these achievements also may reflect our reduced circumstances and the decline of our field.

From Autonomy to Relationality

The ascent of relational analysis not only offers a new way of being in the consulting room but a new way of conceptualizing mental health. The classical Freudian and ego psychology goal of autonomy has been replaced by relationality, mutual recognition, and the holding of both agency and communion. Again, while these goals strike us as inherently better, I think they too accord a better fit with our current historical circumstances.

What was critically important to Freud and ego psychologists who followed him were issues of autonomy and individuation. Throughout the late 19th and early parts of the 20th centuries, people were defined by their contexts: their extended families, communities, religions, social class. Even their very households (think of the circumstances in which Freud grew up) circumscribed people’s capacity to be alone, to be autonomous, to be recognized for who they were apart from their family, religion or class. It is in this social context that the goal of psychoanalysis became autonomous functioning, individuation, being one’s own person. It might even be suggested that drive theory, with its understanding of human nature based in forces emanating from outside of social experience, was one way Freud had of resisting the suffocating, historically determined circumstances he inhabited.

* As I pointed out in my 1993 book on the feminization of psychotherapy, I do not wish to suggest that I believe the relational model speaks to some essentialist conceptualization of femininity. I believe that what is regarded as feminine (e.g., being empathic and nurturant) is socially constructed and that the relational model speaks to these constructs.

Today, we practice within very different historical contexts. Family and community no longer offer a sense of place, order, security or permanence. Instead of overbearing intrusion into our lives that diminishes our capacity to be alone, we are more likely to face denuded landscapes of dislocation, weak ties and an absence of support. Our autonomy is assumed as each of us faces a market that offers indifference and, increasingly, risk and uncertainty.

It only has been in approximately the last 40 years that Americans’ isolation from one another has accelerated at a rate hitherto unseen. As Robert Putnam asserts in his now classic Bowling Alone: The Collapse of American Community: “For the first two-thirds of the twentieth century a powerful tide bore Americans into ever deeper engagement in the life of their communities, but a few decades ago that tide reversed and we were overtaken by a treacherous rip current. Without at first noticing, we have been pulled apart from one another and from our communities over the last third of the century” (2000, p. 27).

The General Social Survey of 2004 revealed that “Americans are far more socially isolated today than they were two decades ago, and a growing number of people say they have no one in whom they can confide. . . [I]ntimate social ties---once seen as an integral part of daily life and associated with a host of psychological and civic benefits---are shrinking or nonexistent. In bad times, far more people appear to suffer alone” (Smith-Lovin, 2006).

According to numerous accounts, social capital, that is, connections among individuals that reinforce norms of reciprocity, trustworthiness, good will, fellowship, sympathy and mutual interdependence, has declined precipitously in the recent past (see Putnam (2000), Hochschild (1997), Sennett (2000), Wallulis(1998)). The reasons for this are vast: changes in family, work, and community life, globalization, and the ideology of neoliberalism that promotes self- interest and autonomy, that conflates consumerism with citizenship, and that characterizes any kind of dependence as shameful (see Philipson, 2002). As the indifferent and nonbinding relationships of the market seep into all aspects of our lives, our personal commitments to one another can begin to resemble market transactions. And with the decline of family, neighborhood, and community, we become a “society without institutional shelters,” as Richard Sennett has observed (2000, p. 66). We have less of a means for anchoring ourselves and evaluating our circumstances and experiences. As we live more of our lives outside of institutional shelters where we are long-term witnesses to each other’s lives, where we experience a shared history and a collective memory, we lack reference points for understanding ourselves and what goes on around us. And it is my belief that in these denuded landscapes, we are more prone to experience events as traumatic often due to living in a society where so many people literally have no one to turn to. If in 2004 “a quarter of Americans admit that they have no one with whom they can discuss personal troubles, more than double the number who were similarly isolated in 1985” (Smith-Lovin, 2006), it is unsurprising that many of these isolated

7 people would seek out therapy with someone who offers connection and mutuality as both technique and therapeutic goal.

I believe it is in this context that the importance of relationality and mutual recognition becomes salient. As the achievement of autonomy and individuation were problematic for Freud, so the achievement of connection and recognition is for us today. It is what we increasingly hunger for and, I think, hear in so many of our patients’ narratives. If there are simply fewer people we can turn to for comfort and care, if we live in a society that denigrates any form of dependence, and if we are filled with shame when we can’t make it on our own---emotionally or economically---we are more likely to turn to our therapists in an effort to find what Robert Stolorow has called a “relational home” (2007). That is, we search for an environment where painful affects can be held, where we can find connection in a world that celebrates social networking sites online rather than true subject-to- subject relating between human beings inhabiting the same physical space. If the analytic consulting room of the first half of the twentieth century offered a means to find autonomy away from overbearing social circumstances, our offices today may provide the only means of finding connection in a world requiring self-reliance and offering weak and transient ties.

Conclusion

Donnel Stern points out that we have the choice of studying the history of “psychoanalysis and psychotherapy in different ways. “One can define them as procedures composed of processes belonging to the natural world; or one can take the position that the processes that compose them, as well as the treatments themselves, are inventions of our culture that will change over time and may even disappear. . . [O]ne can think of the people who practice psychotherapy and psychoanalysis and the people who come to them for the service they provide as human beings who are pretty much the same as human beings in any place or at any time; or one can think of patients and their therapists as human beings of a particular time and place, shaped according to the possibilities afforded them by the cultures into which they are born” (2010, p. 198).

I believe that by locating relational thought in its social-historical context, we can move away from seeing theory as “natural” or universal and exclusively the product of individual minds. I am arguing that the relational turn is situated in a dialectical interplay between the cultural and social circumstances of clinical practice on the one hand, and theorists’ ideas that develop out of that practice that recursively transforms what we do in our consulting rooms. If we truly seek to be contextualists, our understanding of the contexts that define us and our theories cannot be confined to our offices and the analytic dyad. We do not stand outside the societies we inhabit. Therefore, regardless of how much we subjectively experience relational theories as better, they are better in part due to their ability to speak to our shifting social circumstances, to our own historically specific needs

8 as clinicians and to those of our patients living in a postmodern world unimagined by Freud and his adherents.

Bibliography

Aron, L. (1996), A Meeting of Minds. Hillsdale, NJ: The Analytic Press.

Aron, L. & Harris, A. (eds), (2005), Relational Psychoanalysis Vol. II

Cherry, S., et al (2004), Psychoanalytic Practice in the Early Postgraduate Years. Journal of the American Psychoanalytic Association, 52:851-871.

Greenberg, J. & Mitchell, S. (1983), Object Relations in Psychoanalytic Theory. Cambridge, MA: Harvard University Press.

Hochschild, A. (1997), The Time Bind. New York: Metropolitan Books.

Jurist, E. (2010), From the Editor. Psychoanalytic Psychology,27,1: 1.

Mitchell, S. (1988), Relational Concepts in Psychoanalysis. Cambridge, MA: Harvard University Press.

Mitchell, S. & Aron, L. (1999), Relational Psychoanalysis: the Emergence of a Tradition. Hillsdale, NJ: The Analytic Press.

Philipson, I. (1993), On the Shoulders of Women: The Feminization of Psychotherapy. New York: Guilford Press.

Philipson, I. (2002), Married to The Job. New York: Free Press.

Putnam, R. (2000), Bowling Alone: The Collapse of American Community. New York: Simon & Schuster.

Safran, J. (2009), Interview with Lewis Aron. Psychoanalytic Psychology, 26, 2, 99- 116.

Sennett, R. (2000), The New Political Economy and its Culture. The Hedgehog Review, 2(1); 55-71.

Smith-Lovin, L. (2006, June 23), Social Isolation Growing in U.S. The Washington Post, p. A-3.

Stern, D. (2010), Partners in Thought. New York: Routledge.

Stolorow, R. (2007), Trauma and Human Existence. New York: The Analytic Press.

Wallulis, J. (1998), The New Insecurity. Albany, NY: State University of New York Press.

Woolfolk, R., Sass, L., Messer, S. (1988), Hermeneutics and Psychological Theory.

Young-Bruehl, E. (2009), remarks given at Division of Psychoanalysis (39) 29th Annual Spring Meeting, San Antonio, TX.