The Analyst’s “Use” of Theory or Theories: The Play of Theory

What is a Psychoanalytic Theory? Some General Philosophical Underpinnings

Psychoanalytic theory helps the analyst organize and understand how the unconscious is communicated. Theory also helps the analyst with blind spots, even though blind spots are what by definition we cannot see. Without theory, the analyst is indeed in a desultory, unsettled state. Theory helps us stay on a path we hope will be the most workable one, the “best fit” path, if you will. Quite apart from the allure of the very good individual theories we have, I suspect that there is also the allure of a kind of idealized version of theory where there is just that kind of inerrant path.

Theory is our best construction of that workable path (or our best route back to it) and our use of one theory or multiple theories is to some extent the result of our personal, pragmatic discovery about what has been most useful to us in understanding and helping our patients. That “best fit” construction involving one or multiple theories may differ from patient to patient and may shift for particular analysts at different junctions in their career. Many of our most dynamic and creative theorists (e.g., Freud, Klein, Fairbairn, Bion, Winnicott, Guntrip, Balint, Schafer, Gill, Kohut) shifted their theoretical stances during their career, in several instances more than once.

As can be seen, as I begin my argument and refer to Emerson, I have a fairly pragmatic approach to psychoanalytic work. Moreover, I view theory as relatively loose scaffolding. Theories are elegant useful structures that emerge from the analyst qua artist who created them to help understand clinical work. It is our responsibility as individual analysts to work with the art of that theorist to create our own art in understanding our patients. In that sense, whether it is one theory or several, we move from “relating” to theories to “using” theories in our unique way as an analyst.

Einstein (1954) asserted that “every true theoretical physicist is a kind of metaphysicist” (p. 33). Here he was taking a contrarian position against his many contemporaries who thought that science and philosophy should be disentangled. Somewhat similarly, Bertrand Russell (1914) made a substantial case for the interplay between science and metaphysics in “Mysticism and Logic.” Russell does not valorize the mystical, nor does he reject science in the sense of reason and observable fact. Instead he uses the term mysticism to denote a kind of belief that not all discoveries can be explained through empiricism. For Russell mysticism is more related to a function of intuition, a kind of “poetic imagination, not science, little more than a certain intensity and depth of feeling in regard to what is believed about the universe” (p. 3).

Russell was interested in a kind of marriage of the intuitive and the empirical. He suggests that the intuitive holds our moral ideals and that in turn these ideals must be reconciled with the reality in which those ideals are generated. The proof is in the pudding. In psychoanalysis, Nacht (1962) stated, for the patient to change she must feel the analyst’s “inner attitude” as a kind of real presence. The analyst’s inner attitude is the pudding. W. H. Auden (1970) advances a similar ethic for poetry: “a poet must never make a statement simply because it sounds poetically exciting; he must also believe it to be true” (p. 73).

Russell’s description of how to integrate intuition and reason allows us to think about a rational process by which we develop theory through organized hypotheses that we consider validated in clinical work. When implemented, a theory should help us describe and understand clinical phenomena. But in psychoanalysis, theory is also used as a form of belief: the ethical ideals that Russell would associate with mysticism or intuition.

Intuition does not lie outside the unconscious implementation of theory, but clinicians are likely at times to experience themselves as working without the conscious use of theory. These instances may sometimes result in the expansion of theory. Without this development, we lose the generative tension between the empirical and the intuitive that Russell charted.

I am emphasizing Russell’s work here because I believe that in the study of psychoanalytic theory and, if you will, theory about our psychoanalytic theories, it is particularly difficult to disentangle science from philosophy. Theory is held in the name of science, a set of hypotheses based on observations that allow us to create new hypotheses and to describe our patients better to them and to ourselves. But like anything else, theory can also be used defensively to prevent us from intuiting new things, from creating new meanings with our patients and new systems of meaning through new theory.

For example, Bion was especially interested in the living experience of working with patients and in reading psychoanalytic writing (e.g., theory). He was acutely aware of the limitations of K as a means of understanding emotional life. In a certain sense, then, one could say that too much focus on theory (single or multiple) involves too much reliance on learning from nonexperience and diminishes the potential for new learning or being in an experience (O)—in Bion’s words, “learning from experience” (1962a).

Bion (1992) cogently characterized the difficulty and particularity of psychoanalytic theory in trying to understand the mind: “A peculiarity of psychoanalysis is that the scientific deductive system is a series of hypotheses about hypotheses about hypotheses” (p. 46). Bion goes on to equate this state of things with quantum mechanics hypotheses about basic data that are in fact statistical hypotheses.

As Britton (1998, 2011) has pointed out and I have tried to articulate as well (Cooper 1996, 2016), in some ways we are helping analysands develop a better clinical understanding of their relationship to uncertainty and their probabilistic understandings of their elusive, at times foggy, inner life. As theoreticians, and all psychoanalysts are theoreticians, we are trying to find our way with the problem of how to better hold our uncertainty about using a particular theory or multiple theories. The level of uncertainty that we live with as individual analysts and in our groups—for example, our theory groups and institutional groups—is very challenging. We are likely motivated to make things more coherent or organized than they are for purposes of social and political affiliation so that groups may form identities based on who they are and who they claim that they are not. It is conceivable also that our need for affiliation is a factor in our adherence to theories.

This means that we cannot ever clearly differentiate between a psychoanalytic theory and the analyst’s relationship to that theory. The most obvious example of this observation is that analysts differ in how much their theory offers a comprehensive explanation of clinical facts. Some analysts feel that their theory is more prescriptive than descriptive, while others feel less strongly, at least consciously, about the prescriptive technical value of their theory. For that matter, some analysts feel compelled to not belong to a theoretical group at all. We can hold what Bion would deem an “overvalued” theory or an “overvalued” relationship to multiple theories.

Thus, there are many lenses through which to view our relationship to theory, and it is important to identify which lens we might be using and what kinds of bias we hold. For example, an analyst influenced by multiple theories could be seen as theoretically promiscuous, always needing to hedge a bet, or disloyal. In contrast, the same analyst might be viewed as creative, adventurous, or pragmatic. Conversely, a “one-theory” analyst might be seen as loyal and consistent or rigid and prone to idealization.

Multiple Theories Versus a Single Theory: The Maternity/Paternity of Theoretical Tenets

I view each theory as itself a complex combination of various elements of other theories, and this may not always be known by the practitioner using the theory. I also believe that in some sense each person has a different version of Freud, Klein, Bion, Winnicott, Fairbairn, Kohut, Mitchell, and so on down the line. So I begin with some skepticism toward the notion that there is great clarity about the dividing lines between theories.

Because no single theory in psychoanalysis has proved expansive enough to exhaustively explain or understand all clinical phenomena, alternative theories have emerged, sometimes as overcorrections (if you will), to address the limitations in other theories. Individual practitioners make “use” (Winnicott 1969) of psychoanalytic theories in the sense of taking on a theory as the individual analyst they are, rather than relating to it in some generic sense as a collection of abstract tenets. This means that the particular analyst’s tendency toward understanding and misunderstanding various theories is always at play. Then, to complicate matters, we even have divergent interpretations or actual misunderstandings at the institutional level about theory and theoretical concepts. For example, the term transference in North America is used by many analysts to refer primarily to the patient’s conscious allusions and statements to the analyst about the analyst. What is often deemphasized or plain ignored are the patient’s unconscious allusions to the transference or the ways that the unconscious elements of the transference are enacted and repeated before being verbalized.

I tend to think that quite often our discussions of how we integrate theory focus a great deal on the paternity or maternity of ideas and theoretical tenets. Where do they come from and to whom do they belong? But I don’t really think that the maternity or paternity of ideas is what is most important, or even very easy to determine, in further understanding how we use theory. For some of these reasons, it is possible that some of us may be more theoretical mutts in purebred clothing than first meets the eye.

To some extent, I believe that theoretical purity is an unconscious fantasy, as is the notion of an elaborately and consciously conceptualized integrated model. Most of us work in a rough-hewn manner that combines how we are best able to organize affect, clinical information, and unconscious fantasy with how we can best make use of our countertransference.

Part of why I believe there is more theoretical mixing than we are aware of or acknowledge is that particular ideas become associated with a theoretical model (its leading metaphorical construct); that doesn’t mean, however, that the model doesn’t in fact employ other elements of thinking or technique that are associated with other models. For example, if an analyst focuses primarily on unconscious fantasy and internalized object relations, it doesn’t preclude her from interpreting a patient’s shift from one affective state to another, a technique we might associate with ego psychology. Again though, I emphasize this as a self-described theoretical mutt; I do not advocate theoretical integration. I do, however, believe that some analysts hold elements of a number of theories, whether or not this is acknowledged as an important feature of their theorizing.

I believe that analysts should employ a theory or a set of theoretical constructs from a few theories that helps them find the unconscious elements of their patient’s communications. The practice of psychoanalysis is quite dependent on the person of the analyst, including her relative strengths of observation and her capacity to understand her characteristic blind spots. I have been helped with my personal capacities and liabilities as an analyst through using multiple models. I also just find psychoanalytic theories endlessly interesting in terms of how they overlap and differ and how they each have elements of elegant construction and limited applicability.

There are many advantages to the analyst’s employing a single theory. For example, the use of a theory helps the analyst organize meaning and understand the kinds of aberrations in technique that we are all subject to in terms of either creative exploration or enactment (Birksted-Breen 2010).

In addition to questions about the advantages of using a single theory or a few theories, there is also the matter of how concepts become transformed from the progenitor’s original conceptualization and turned to a new and sometimes useful purpose. For example, in the late 1970s, Thomas Ogden brought on a seismic shift in North American psychoanalysis by broadening the projective identification concept to include an interpersonal process of induction in the analyst. These ideas were of course not new. Joseph Sandler (1976) had introduced the notion of role-responsiveness, and interpersonal analysts had long been speaking in another language about the patient’s affective impact on the analyst.

Ogden (1979) took a linchpin concept from Kleinian theory and fashioned it to include elements of his own clinical experience working with psychotic and deeply disturbed patients. From his point of view, something more needed to be said about the communication of unconscious fantasy through projective identification. To be sure, unconscious fantasy was retained as a central part of the process, but in his own way he was suggesting that there is an impact on the analyst that is then, in turn, experienced by the patient. And, I might add, as the uniquely creative analyst that he is, Ogden was not an official part of a theoretical movement. Instead, his work reflected his deep interest in the various strands of British object relations theory.

I like the example of Ogden’s contribution because I believe that something like this process of individual analysts using concepts in their own idiom, their own language, is going on quite often, consciously and unconsciously, as psychoanalysts engage in their daily work. Nowhere is this more visible than the myriad ways the term transference is used, even by people who ascribe to the same theory. This variability is part of why I believe that there is value in thinking of even the psychoanalyst theorist as both a conscious and an unconscious writer-participant in the analytic process.

Clinically, the use of different theories expands the metaphorical language with which we try to make contact with our patient’s unconscious life. These metaphors are generated by different theoretical tenets and surfaces that are themselves embedded in various psychoanalytic theories. As Lakoff and Johnson (1980) have noted, “There is a good reason why our conceptual systems have inconsistent metaphors for a single concept. The reason is that there is no one metaphor that will do. Each one gives a certain comprehension of one aspect of the concept and hides others” (p. 221). It seems to me that psychoanalysis, with its profound understanding of the richness of human thought and language, fits to some extent with Lakoff and Johnson’s claim about our need for multiple metaphorical constructs.

The following vignette involves a selective focus on a lengthy analysis in order to highlight some of the surfaces generated by a few theories.

Clinical Vignette 1: Affective Urgency and a Few Surfaces

Mark, a single man in his early thirties, grew up as an only child with a quite impaired, mildly though chronically psychotic mother and a father who was a kind and decent man but quite distant. His parents divorced when he was eight, and he lived with his father, since his mother intermittently became floridly psychotic and required several hospitalizations. The patient was very bright and highly successful as an academic.

Mark came to see me for analysis because he felt burdened by his constant sense of fretting and thinking about various interpersonal situations at work, with his girlfriend of two years, and with friends. He was continually critical of himself and had a part of his mind that was unable to stop deconstructing what happened in any interpersonal situation, particularly with colleagues and students and to a lesser extent with friends. Mark’s overactively fretful mind was put to better use in his many academic pursuits. He brought to his work a great deal of energy and creative thought and was able to help his students think through complex problems. But he was exhausted by the fretting.

As his analysis developed we began to understand his worrying as a part of his mind developed during childhood that was created to mother himself, to shepherd himself through various complex emotional situations in the absence of adults who might help him metabolize his experience. His father, though highly rational and able to explain the facts of the situation, had very little sense of his son’s anxieties; his mother, of course, was quite ill equipped to help him.

I will selectively summarize the surfaces on which the patient and I worked to try to capture how I made use of a few models in working with him. During the first few years of our work together, Mark pressured me repeatedly with requests to explain to him in intellectualized terms how analysis works. Initially I viewed these requests as strictly consistent with his general tendency to use intellectualizing defenses to mitigate strong affects, particularly related to anxiety and sadness. I tried to draw his attention to what he might be feeling at these times and how he was trying to move away from those feelings. Over time, though, I was struck at certain junctures by the pressure associated with his requests. When they began, I viewed them as an aggressive pressure for me to act in accordance with the parts of his mind that supported the illusion that he was in control and could always figure out how things “were supposed to go.”

As his analysis developed and we spoke about how much he felt compelled to make those around him act as he thought they should, it became more clear to both of us that he was terribly anxious in these moments, and that his tone would change in striking ways. He became more aware of the anxiety driving these questions and of the internal pressure he felt to do away with any ambiguity in interpersonal situations and to pretend to know how things would or should go. It seemed to me that he was unconsciously asking me to explain a world to him involving his mind and the minds of others. I took up with Mark his wishes for someone who knew about that world and could mediate it for him in a way he had not experienced during childhood.

This series of requests had a few variations. One was that Mark would frequently ask to know how and why I became interested in psychoanalysis, which alternated with questions about how analysis works. Fortunately, Mark could be somewhat curious about the meaning and persistence of these concerns. As these questions emerged and the pressure continued, I began to wonder if perhaps Mark was conveying a new capacity in the transference to ask for things that he needed or wanted, rather than submitting to his mother’s abject failure to participate in his life. I suggested that he wanted me to tell him stories and narratives about who I was so that he could find comfort, especially comfort from someone he could trust to help him be a patient in analysis. I also suggested that at times it seemed he wanted to hear me present these narratives as comforting stories as he lay on the couch, bedtime stories as it were. This led him to feel sadness but also relief. He had worried that his pressuring questions were annoying to me, as they sometimes were to his girlfriend; he worried too that he was defensively intellectualizing, a tendency his girlfriend had also experienced with him. My sense was that he felt somewhat relieved at the thought that with the questions he was seeking something comforting, something he had longed for without realizing it.

Through his requests, Mark moved back and forth between, on one side, a search for a good object/mother, or at least an object he could make requests of, and, on the other, a move away from exploring his anxiety about these longings. He felt compelled to enact these wishes. Sometimes I pointed out to him how these requests also reflected his deadening of the analysis, which in a way reflected his experience with his unavailable mother. I tried to show him how at times his asking for explanations destroyed the affectively alive, dangerously uncertain, more spontaneous and libidinous relationship with me. In other words, his questions seemed to repeat and solidify his link to that deadness with his mother and to remove the threatening spontaneity of analysis.

Finally, the questions seemed consistent with the “identificate” self (Sohn 1985) that took over in the face of uncertainty during childhood. The identificate self has much more certainty about what’s going on through an omnipotent incorporation or identification with a failing object (see, e.g., Rosenfeld 1964, 1971; Modell 1975) and pretends at some level to be grown up. In concert with some of these defensive uses of the questions he directed toward me, Mark found that when he was able to relax his worries, even briefly, he was invariably drawn back to intellectually destructive thoughts about our work. I suggested to him that at these times it seemed as if he had to ruin or destroy what we did together as a response to ridding himself of his maternal longings and restoring some of his omnipotent fantasies.

I interpreted this particular request in the analysis in various ways, depending on what I viewed as the point of affective urgency, or the chief affect then present in him, or in me as his analyst. At times I would take up how he was expressing a wish to be comforted or to have me know what he needed without his articulating it. At other times I took up how he was avoiding an experience, damping affect such as anxiety or depression, preserving an old object tie, or probing the possibility of a new object. Sometimes I also moved between pointing out to him shifts from affect to idea, from vitality to deadness. In this mode I might simply comment on his damping an affect, usually anxiety and sadness in various contexts, trying to broaden his observing capacities much as an ego psychologist would.

At still other times I pointed out to him a deeper internalized object relation to his unavailable mother, an attachment and loyalty to a fantasied mother through an identificate self. Sometimes I interpreted projective identification in which I felt I could not think because things seemed so deadened, an experience I believe he had difficulty containing himself. I could not, if you will, dream with the patient (as he wished his mother could have, thereby helping him do so in relation to himself), partly because the patient’s adaptation in the face of maternal absence was to create a mechanical part of his mind that would guide him, a robot mother as it were. At times, the stories he would ask me to tell him regarding my path to becoming an analyst, or about how analysis works, seemed to express his longing for a father or mother who would explain the world to him or have him in mind, while at other times these requests reflected eviscerated, devitalized notions of analysis.

Elements of defense interpretation, a focus on his internalized objects and attachment to them, and an effort to understand the underlying unconscious fantasy are all in play here as I try to translate what Mark is expressing without being aware of it. What guides me along the surfaces I address, surfaces suggested by different theories, is something quite akin to Strachey’s idea of affective urgency I have a methodological approach that guides my attention to different metaphors and surfaces that are the focus of different theories. I seem to be influenced in my focus by where the patient’s point of affective urgency is expressed. The point of urgency is sometimes expressed directly by the patient and sometimes indirectly, through projective identification experienced by me as a projected affect. This point of urgency is where I try to find and translate what might be unconsciously operating slightly outside the patient’s awareness.

When the patient was driven by the wish for me to, in effect, tell him a bedtime story of therapeutic action, I often experienced it to be a wish that he was with a person (an analyst, a parent who was rational) who knew what he or she was doing. He was seeking reassurance that he would not be lost or stuck with a psychotic parent if he trusted in this methodology. In this mode, I was interpreting a wish for an object he didn’t have but wished for and his reliance on a familiar old object (a self-representation that included a facsimile of the missing mother).

Mark would sometimes find meaning in my interpretations that were closer to the surface concerned with mitigating various longings and feelings. I would make these interpretations to try to broaden his observing capacities. He also found a great deal of meaning in the metaphor of his asking for a comforting story. I think he found this plausible and meaningful because he experienced the method of analysis as something in which he sought comfort. Mark also knew, because he was healthy enough and bright enough to understand this, that my construction was a “story,” a plausible but not entirely believable narrative about reality, particularly compared to the pseudo-certainty of his identificate self, the auto-maternal part of himself.

What I can say about my work here is that it would not be meaningful for me as the particular analyst that I am to work with the patient only from the point of view of how he damps and titrates affect. Similarly, it would not be meaningful for me to limit my translations to how he keeps repeating his particular kind of internalized object relation in the analytic context, despite the fact that I am trying to generate interest in these parts of his mental life. Mostly, I have animated his experience with narratives about those who live inside his mind, chiefly a very lonely experience with his mother and a very active relationship with a part of himself that has served as a substitute, though a problematic and burdensome one, for his mother. My patient found meaning in understanding and mourning the loss of his mother and the loss of the identificate self that substituted for her. He also found meaning in the terror he felt without this internalized presence that would tell him what to do and how things should go, even when he knew he was burdened by the relentlessness of demands for certainty and knowledge that go beyond knowing. At times it was even meaningful for me to animate our work together by noting that when he requested stories about how analysis works, I was being asked to answer to the part of himself that was supposed to already know everything about how things should go.

My reliance on different theories here issued from the fact that I was constantly seeking different metaphors related to different surfaces, surfaces that are embedded in various theories, in order to find elements of Mark’s mind.

The Analyst’s Relationship to Psychoanalytic Theory/Theories: More on Usage

If we approach the analyst’s relationship to theory in a certain way, as we would try to understand any object relationship, we might say that it involves partly a self-representation and partly an object relationship. To state matters simply, our relationship to theory helps us know how we think about our patients and how we think about ourselves in relation to our work and other analysts (the self-representation). It also helps us know what we might expect of theory (the object relation).

Our relationship to theory as an object relationship involves a variety of developmental meanings in terms of the analyst as child to theory-parent or analyst as parent to theory-child. The analyst’s relationship to theory, as used or developed, may be characterized as playful, curious, submissive, rebellious, petulant, creative, inhibited, competitive, or collaborative. Some analysts begin with a more passive relationship to theory, sometimes even a compliant one that accepts it as received wisdom, and then gradually develop a more active relationship featuring a more individual, sometimes creative use of theory as an object. I know other analysts, though, who over time were able to corral some of their more “wild” or independent propensities and to work more self-reflectively through a particular theory, one that allowed them to be more disciplined and accountable. In each of these variations, the analyst is “making use” of theory in the analytic process and in the analyst’s unique development. Just as there is a complex relationship between intuition and reason in the history of science, medicine, and art, so there are tensions within each of us as analysts regarding the degree to which we work with intuition (or the fantasy of intuition) and deduction.

In certain ways, I think that Bion animated theory as a kind of presence in the mind of the analyst. His theory of thinking (Bion 1962b) really allows us to consider, in a far richer way, how we theorize. This is one of a few reasons that Bionian theory is becoming popular in places where before it had not had much currency. Bion’s work helps us think about the analyst’s relationship to theory. First, Bion seems to have implicitly understood that the analyst’s relationship to theory is one that is developed and that the analyst must articulate personally. Mitrani (2001) has pointed out that Bion’s work has “provided a source of inspiration for analysts, especially with regard to their efforts to develop, for themselves, models that conceptualize the analytic process” (p. 73).

Bion aimed to stimulate his readers to reflect on how they think about clinical experience and theory. His work along the fault lines of theory, producing concepts such as overvalued ideas and selected facts, essentially encouraged analysts to think about how they think. In this way, his theory moves the reader, listener, and thinker into an active relationship to theory, no longer a mere receiver of theory and wisdom but a creator of theory. Here “use” of the object (Winnicott 1969) is important in terms of theory, when we consider that we learn to make use of theory as we engage in clinical work, and that the work may not fall into a simple, linear relationship to one theory or another. In that sense, whether we are dealing with one theory or several, we move from relating to theory to using theories in our unique ways as analysts.

Following is a clinical example in which I try to make use of multiple theories to understand ongoing work and a shift in my stance as translated through my use of theory. The shift begins as a result of a different experience of the same material expressed by a patient over time. I aim to think through issues related to the merits and debits of theory integration. The vignette begins with my shift.

Clinical Vignette 2: Jason

Jason insisted on not having expectations of his analyst. This insistence suggested a re-creation of his frozen inability to grieve his mother’s chronic debilitating depression and suicide when he was nineteen. He had always felt that he desperately needed his mother and was inconsolable in his sense of loss and depression. Rather than a site of grieving, Jason’s analysis became a chronically repetitive memorial and testimony to his ossified isolation, his inability to let his grief move into mourning. His analysis had become a gathering place for an internalized community of passive observers to inconsolable loss. Jason couldn’t ask things of his mother because of her depressive preoccupation (focused largely on the loss of her father at an early age), which was enacted with me as his analyst. Increasingly I felt consigned as his analyst to the role of being one of many in a passive, internalized community of ineffective observers.

For the first few years of analysis, Jason continually remarked on how he had no expectations of me. I frequently took up this feeling as similar to feelings he expressed about his mother, something that was communicated and enacted with me and that at times I worried would be intractable. Jason agreed that this was a repetition of his internalized relationship with his mother. But after our noting this together, deadness would generally ensue. He would grow quiet and move into a recitation of his activities as an attorney. In this mode, things were tightly packed and Jason was in charge. I often commented on how he was presenting his world of not needing others, including me; he would take care of himself.

One day when Jason voiced the oft-expressed feeling “I am hopeless and have no expectations of you, analysis, or anyone else,” I had a different set of associations. Rather than interpret the repeated object relationship with his mother that he kept including me in through the enacted transference, I began to associate to how perhaps Jason didn’t want me to have any expectations of him. I told him that I thought that not only was he experiencing me as a mother from whom he could ask or expect nothing, but also that perhaps he was a patient from whom I could expect nothing.

Jason replied, “Yes, I don’t want you to have expectations of me because I will and I do disappoint anyone who expects anything of me.” Uncharacteristically, I said: “You learned not to have expectations of your mother and how much you felt that you disappointed her. In fact, I think that you have expectations of me, and me of you, but you don’t want to experience those kinds of feelings.”

I had interpreted very much the same kind of content but in a different register many times. Some of these registers would be familiar as characteristic of various theoretical orientations. I had interpreted his shift from neediness to isolation and self-sufficiency. I had interpreted elements of a repeated maternal object relationship in the transference. But in the shift I have just described, I noted aspects of a role-responsiveness process in the feeling of deadness with his mother that was communicated to me; I felt that like him in relation to his mother, I could have no expectations of him. Here I had shifted into a set of wishes about what he might feel I wished for from him (nothing). Further, I had also shifted surfaces into a statement of the possibility of my wish as his analyst that he could more consciously experience these unconsciously held wishes or parts of himself.

I view my remark as a transference interpretation (the repetition for Jason in the transference of having given up expectations from his mother in order to avoid disappointment) and a defense interpretation (his reflexive move away from disappointment by claiming incompetence on both our parts). This shift in interpretive position might be seen as what Ogden (1994) refers to as an interpretive action—an action taken by the analyst after the repeated failure of interpretation has yielded a stultified atmosphere.

As we consider this moment, we are dealing not only with the fact that different theories suggest different modes of interpretation. We also face the sobering complexity that different theories would construe such a comment in different ways. For example, I wouldn’t fundamentally regard the comment by the analyst as a “personal” register from the analyst. Instead I would view it as a kind of “analyst-disclosure” intended to use the voice of the analyst to feature the patient’s affects that were expressed and defended against as they appear in the transference (Cooper 1998a, b).

I view the process as follows. The patient is attempting to include me in his mental function through transference as a mother who is depressed and unavailable. I am in a sense interpreting aspects of transference by differentiating myself from the patient, who within the transference can expect nothing and from whom nothing can be expected. Thus, I view the use of the analyst’s expressiveness as intended to feature muted affects and wishes as they appear in the transference.

Then, to make matters even more complex, we have the question of whether analysts, whatever their theoretical orientation, employ techniques that are not accounted for in their explicitly held theory. In this sense, our discussion of one theory versus multiple theories might also include “conscious” or “disavowed” theory.

In response to my comment, Jason repeated something similar to what he would often say: that he doesn’t expect anything from analysis other than providing a place to talk. But he continued: “Talking and psychoanalysis can’t help with depression any more than cognitive therapy, right? For example, if you were before a group of psychiatric review board or medical associates explaining what you do, what would you say? You are unable to design a study to demonstrate its effectiveness relative to other therapies, and if psychoanalysis were a new type of therapy such as a drug regimen, it would never receive stage three approval.” I felt strangely uplifted at this moment and said to Jason, “Here you are having a fantasy in which you hold me accountable. You are doing something with me that is different from the absent and hollow presence you feel in which people are not just unassailable, they simply don’t exist. In a certain sense, I’m on trial.”

This comment surprised Jason, and he cracked a smile that I could see from behind the couch. He thought he was presenting an unassailable fantasy in which he prosecuted as factual the case that I was unable to help and that analysis as a form of treatment was also unable to help. He hadn’t considered that the prosecution of his case had expressed a libidinal longing, a fantasy in which someone would once and for all say “case closed” to his wanting things. I suggested to him that this fantasy, encased in dreadful hopelessness, was the only way that any kind of longing could escape his self-punitive system. He said, in a somewhat playful tone, “You are desperate to find hope here, but I appreciate the effort. I do feel that I want you to be right.”

At this point in our work, I didn’t know whether he had smiled because he felt we were on to something or because he could sense that his analyst was going to persist in trying to understand his antilibidinal universe, in which nothing could be wanted. I did feel that he, and we, had a slightly better purchase on his reflexive need to not want anything that would lead to disappointment.

I believe that you can see a particular kind of melding of theoretical orientations here—a strong interest in his internalized object relations (the unavailable mother from whom he wants not to want); interpretation of his unconscious fantasy; and at the same time a contextualized willingness to speak from a slightly more personal register in the service of trying to make these processes more visible to the patient. To my way of thinking, I am understanding as much as possible what Jason is communicating to me about his internalized object relations as enacted with me in the transference.

A potential problem with my intervention here might be summarized as a conscious or unconscious communication of insistence or pressure on the patient to stop pushing away from his wishes and desires. In essence, Jason might have felt that I couldn’t contain his need to not desire. I could counter this argument with a commitment to watch and listen for this kind of reaction from the patient, but that doesn’t necessarily decrease the risk that the patient would feel pressure that eludes the analyst’s awareness.

From a more self-congratulatory perspective, I would like to think of this interchange as involving a form of analytic play with the patient, and perhaps with the theories that I love and hold dear, play in which analyst and patient are trying to understand what is being enacted as they probe the possibilities of the patient’s capacity to integrate new aspects of experience (old and new). Or is it an untethered blend of understanding the patient’s communications from a Kleinian or Independent theory of technique? One person’s “logic of play” (Parsons 1999) is, I suppose, another person’s destruction of technique.

As I think about why I switched interpretive registers with Jason when I did, I wonder if I felt a greater degree of freedom than was usually the case in our daily work. Perhaps some part of me felt pleased that Jason’s harsh self-punitive and depriving system was slightly less prominent in his fantasy of my reporting to a psychiatric review board (paradoxically, a superego setting). Perhaps I felt a pull to respond to that, in essence unconsciously wanting to support his greater degree of freedom to express feelings and wishes. Not surprisingly, however, his internalized regulatory system came into play and shut down his excitement and curiosity. It seems to me that I was employing another model or theory to assist in a level of self-reflection about my unusual response to Jason.

Hazards and Benefits Related to the Use of Single and Multiple Models

A primary hazard of conscious integration of theories is that concepts are embedded in a series of interlocking assumptions that constitute a theory. It is one thing to criticize our field for being too interested in the maternity/paternity of ideas and another to consider that theories do have a measure of internal integrity. We should be respectful of a theory’s internal integrity (Birksted-Breen 2010), but not so much that we avoid using interpretive focuses suggested by other theories.

The main difficulty with conscious use of a single model is that it may be related to an insistent overreliance on theory to organize incoming clinical data. This has very little to do with “use” and much more to do with “relating” to theory. In Bion’s terms (1970), the analyst is at risk of minimizing the difference between being in an experience (O) and thinking about an experience (K). Bion continually addressed the extent to which theory and an overreliance on organizing principles can obstruct taking in new understandings and meanings. But it’s important to note that the use either of one theory or of multiple theories can promote too much reliance on learning from nonexperience.

Winnicott too was quite concerned about the dangers of omniscience, and wished to undermine “the impression that there is a jigsaw of which all the pieces exist” in his observations on theory (letter to Melanie Klein, 1952; in Rodman 1987, p. 35). Winnicott and the Middle Group in general emphasized the crucial functions of gaps and missing pieces between areas of psychic knowing and unknowing in our use of theory in practice.

Among the best things psychoanalytic theorists can do is try to describe and demonstrate how they and the patient work to come to a greater understanding. None of us have ways of really demonstrating that our method is superior to another, though we all surely welcome the possibility that this might be demonstrated. We can listen to and read descriptions of clinical work and psychic phenomena, accounts evoking physicists’ ideals for describing the physical world, and look for plausible and “best fit” explanations. But in the end we each have what we have learned from our own experience.

Having said that, though, I hasten to note that we are all at risk for using theory to justify actions, either in advance or retroactively, fitting them to what we’ve done. This use of theory is what I would term “wild,” though I would soften the charge by saying that we are all subject to elements of this wildness in our writing, teaching, and clinical work. In fact, we should expect this kind of rationalization for what we do, in developing theory as in all things.

Moreover, our sense of a theory provides us a framework for understanding our aberrations in theory or technique, as Birksted-Breen (2010) has suggested. If we “have” a theory, we may be better able to understand various types of enactment, though we must also consider whether “having” a theory may itself be a form of enactment when the theory is stretched beyond recognition. The latter kind of enactment occurs when use of our theory constrains us in our thinking rather than allowing us to expand our thinking by using other theories. As you might see, the way I have stated this as a binary is itself problematic, since we have every reason to believe that any theory may both expand and constrict our thinking (Britton and Steiner 1994; Cooper 1996).

Finally, I want to address the issue of how we speak with one another from divergent points of view. We have learned from detailed studies of people with strong political views that neurological activity is heavily compromised when listening to someone with opposing views (see, e.g., Westen et al. 2006). Psychoanalysts, like other human beings, have tribal instincts, and theoretical groups are always in the process of consolidation even as they try to grow and change.

The biggest problem with which analysts contend in discussing theoretical difference is that psychoanalysis as a form of treatment is so fraught with uncertainty. Irrational forces, often unconscious, drive our wars about theory and contribute to a tendency to create positions of pseudo-certainty.

A recent generation of students of psychoanalysis in North America has been raised learning about multiple models of psychoanalysis in what I have called the era of “post-pluralism” (Cooper 2016). I mean by post-pluralism a world in which the analyst is thinking less about choosing or consciously blending theories and is less preoccupied with the maternity/ paternity of ideas. Instead, psychoanalysts in the wake of learning about several theories are hopefully more able to make use of them naturally, both consciously and unconsciously. I also believe that our theories had more overlap to begin with than was often understood or acknowledged (Cooper 2015).

Psychoanalysts are moving in useful directions to speak at least bilingually, and often as polyglots, in discussing theory with one another. Finding the unconscious in our patients and in ourselves often requires all hands on deck. Canestri (2006) and Jimenez (2009) have suggested that, with this growing competence, analysts work within multiple organizing frames, implicitly constructing a range of inferences that fit the immediate situation. This competence involves drawing on a wide array of intellectual and interpersonal sources.

For many contemporary students of psychoanalysis, pluralism (not the integration of theories) is a fact of life. If younger analysts have not sworn allegiance to a particular model, the pragmatic use of theory comes more naturally and is not something they are necessarily aware of. We may also be becoming better observers of how we form theoretical allegiances and the unique amalgam of theory that makes us each who we are as analysts.