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Dale Boesky’s “Psychoanalytic Disagreements in Context”

by Michael Shulman, Ph.D.

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Some have referred to an earlier era of psychoanalysis as an “era of certainty” in regard to psychoanalysts’ understanding of their patients. Such an era has given way to one dominated by uncertainty and by an embrace of the value of multiple perspectives as tools to challenge the potentially illusory certainties of the psychoanalyst. Amidst this vision of psychoanalysis’s complexity and analysts’ diminished certainty, the idea that, perhaps, there is no enduring truth to be discovered within a person which determines his or her responses in free associations, save one created now, in the new relationship of patient to psychoanalyst, has gained a certain traction.

Psychoanalytic Disagreements in Context is a book written by Dale Boesky, whose psychoanalytic writing has contributed importantly to the downfall of the earlier era of certainty. His seminal 1990 paper “The psychoanalytic process and its components” leaves its reader with an impression of the rich ambiguity of indicators of movement for a patient who is changing over the long course of intimate intensities which is a psychoanalysis. That paper contributed to an appreciation of the ineluctable complexities introduced by “two-person” conceptualizations of psychoanalysis (its conception as a process in which the effects of the unconscious of the analyst on the process can never be removed, entirely controlled or known in advance or in “real time”). As a result of an increasing interest in two-person conceptualizations of psychoanalysis, some analysts have proposed that the truths of the patient’s unconscious mind cannot ever be discovered, but can only be “co-created.” Taken to its current extreme, it might be said of these analysts that they propose there is no real past of the patient’s alive in the present. To paraphrase Gertrude Stein, it is as if “there isn’t any there there” of a patient’s mind and past; there is only a “here now.”

Such a trend of thought is deeply disturbing to Boesky and to others, but Boesky is ahead of many in articulating the grounds of this disturbance. Here, he joins Charles Hanly in proposing that a critical realist view of reality and truth is the only one sensible as a psychoanalytic view. Critical realists hold that there is a distinct and knowable past of the patient’s alive in the present, rather than a never-knowable past, or one the “knowledge” of which can never be extricated from the analyst’s or therapist’s theories. Boesky proposes that critical realism is the only sensible one for a psychoanalyst because it is the one philosophically presupposed as the basis for understanding the meaningfulness of an individual patient’s unfolding associations. For Boesky, a core problem over the course of psychoanalytic history is that different meanings, perhaps sometimes almost any meaning, can be made of groups of such associations. Through chapters in this book in which he discusses two published clinical discussions of analysts’ work, he shows that debates about understanding patients and making interpretations often arise because different analysts fail to identify the specific assumptions (called by Boesky here “contextualizing criteria”) that guide their listening and understanding of individual psychoanalytic sessions.

To see these discussions of clinical material unfold is to share with Boesky a view into the sometimes ludicrous nature of clinical arguments. His reader is shown, first, the astonishing variety of formulations of meaning which can emerge from discussing the same clinical material and, second, the lack of attention to the details of what patients actually say and do, which, from a critical realist’s view, ought to helpfully constrain what can otherwise become the arbitrariness of these ways of making meaning. Boesky’s discussion of a published case from the Boston Change Process Study Group, a group of analysts exploring the possibilities of applying ideas from chaos theory, dynamic systems theories and theories of indeterminacy to an understanding of change in the psychoanalytic process (chapter 3 of the book), illustrates vividly both a loss of clarity in concepts evident in the group’s written work, a loss which has progressed to such an extent as to abrogate essential psychoanalytic assumptions about mind, and a frightening inattention to the details of the clinical material being discussed.

These chapters reviewing clinical materials could serve as a sort of etudes for psychoanalysts, in particular as studies for their use of evidence. They open a window onto the world of a searching and passionate psychoanalyst at work as he thinks about the details of associations and about how to select from competing contextual frameworks in which to understand them. This book is also a decisive prolegomena to psychoanalysis as it enters a second century, one in which the largest issue for psychoanalysts is looking less like “will the ideal psychoanalysis please stand up?” than it is “how can we understand, and compare, the inevitable differences which occur in the psychoanalyses different psychoanalysts conduct?”

In this new century, a burning question has become, at the micro-level of psychoanalytic process, how do we understand psychoanalytic disagreements other than as a revelation of psychoanalytic errors, in which one formulation is ‘right’, the other ‘wrong’? Related questions include: what are the limits of differences that do not constitute errors? and how can one begin to conceptualize non-error-based differences in the thought processes of analysts within interactive, unfolding processes as complex as psychoanalytic ones? These questions engage age-old difficulties in the consideration of the nature of complex interactive processes, and the complexity (perhaps an impossible one) of modeling how different individuals (i.e., different psychoanalysts) could be understood to interact with another individual who is changing, and will change differentially in sequences of interactions with different others. Boesky’s work here helps analysts to discipline their listening, as a result of which debates in the nascent field of comparative psychoanalysis, over time and in the slow forge of psychoanalytic history, might reach their most productive settlements.