Abstract
Over the past six months, the world has moved at a dizzying tilt and psychoanalysis has lurched into a new technological era. Before Covid-19, would we ever have imagined that we’d be discussing, via teleconference, what to say—or not say—when a patient climbs into the bathtub / closet / pantry / car seat, seeking privacy for a Zoom call? Just a few months ago—as the pandemic took hold—could we have pictured marches and demonstrations pouring out onto our streets in support of racial equality, social justice, and calls to defund the police and dismantle our prison system? Could we have anticipated the federal response to these largely peaceful protests—the presence of military troops in some of our cities?
Living and practicing in urban areas, we see up close how the pandemic and a dangerously simmering political climate, here and abroad, affect patients’ moods, actions, and sense of well-being. Every day, patients express feeling isolated by Covid-19. They fear getting sick. They are inundated by a daily barrage of news that is disturbing and often contradictory. Events in the outside world erode a sense of security and undermine long-held beliefs, ethics, and ideals. Patients describe helplessness; despair; existential dread; profound concern for children already born; and reluctance to bring new ones into the world.
We are right there with our patients, no less vulnerable than they. As analysts, we too must change our footing if we are to remain standing as the ground shifts beneath us; and we must acknowledge that some of our beliefs and practices—now patently unsustainable—never were in the best interest of all we aim to serve. As analysts, we must free ourselves from outdated ways of thinking about human experience, and deeply examine aspects of our profession that over the years have been exclusionary and discouraged participation by many groups. The moment calls for psychoanalysts to think—and act—in partnership with colleagues in adjacent disciplines, to understand how we have arrived at a singularly difficult moment in human history and to work toward a sustainable future.
In the months to come, we will bring to these pages books on topics that demand our attention, including racism and climate change; books by authors who challenge our assumptions, require that we reckon with our painfully chauvinistic history, and call upon us to open our hearts and minds to the present moment.
Psychoanalysis and Contemporary Imperatives
We are pleased to open 68/4 with two book essays, each of which addresses a contemporary concern from a perspective that is at once psychoanalytic and interdisciplinary. We launch this discussion with Allen Dyer’s richly constructed and timely book essay, “Evolution of the ‘Goldwater Rule’: Professionalism, Politics, and Paranoia.” Dyer draws on four books: John Martin-Joy’s Diagnosing from a Distance: Debates of Libel Law, Media and Psychiatric Ethics from Barry Goldwater to Donald Trump; Bandy Lee’s The Dangerous Case of Donald Trump; Allen Frances’s Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump; and Jerrold Post and Stephanie Doucette’s Dangerous Charisma: The Political Psychology of Donald Trump and His Followers. Dyer, a psychiatrist who has written extensively on ethics and served for many years on the American Psychiatric Association’s Ethics Committee, takes up the much-debated question of the “Goldwater Rule,” which—as we learn in this essay—is not a rule at all, but rather a “principle” affirming that physicians do indeed have an obligation to society, “a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.” This seemingly small, subtle distinction leads to a significant reimagination of the role of mental health professionals in speaking out publicly when sound governmental leadership is at risk. To say that a warning may be ethically correct, Dyer cautions, is not the same as a presumptive “duty to warn.” He suggests that though “ethical principles remain constant, they may need interpretation in light of circumstances unanticipated when they were first articulated.” Dyer explores the question of what mental health professionals—and particularly psychoanalysts—can offer in terms of addressing directly the ills of the current administration.
In a book essay titled “Personal Meaning: Anthropology, Psychoanalysis, and ‘Individuology,’” Robert Paul employs a coinage (“individuology”) appreciatively drawn from Nancy Chodorow’s The Psychoanalytic Ear and the Sociological Eye: Toward an American Independent Tradition. Echoing Chodorow, Paul notes “that while psychoanalysts themselves take a great interest in the humanities, the arts, and the sciences—especially neuroscience—there is hardly any input from or outreach to the social sciences.” However, he writes, “This wasn’t always so,” and he offers an example of intermingling among psychoanalysts and social scientists: “in . . . the now defunct Department of Social Relations at Harvard, [Erik] Erikson taught alongside anthropologists and sociologists, all of whom were expected to undergo personal analyses.” Paul joins Chodorow in calling for renewed cross-pollination between psychoanalysis and adjacent fields, and both know of what they speak: Paul, a practicing psychoanalyst, continues to work as well in his original discipline, anthropology; and Chodorow—also a practicing analyst—first trained, worked, and in The Reproduction of Mothering (1978) made a seminal contribution as a sociologist. In his essay, Paul presents three contemporary ethnographies as exemplars of “individuology”—works in which psychoanalytic and social science perspectives join to illuminate the subjective experience of the individual-in-society: Katherine Pratt Ewing’s Arguing Sainthood: Modernity, Psychoanalysis, and Islam; Andrea Chiovenda’s Crafting Masculine Selves: Culture, War, and Psychodynamics in Afghanistan; and Stefania Pandolfo’s Knot of the Soul: Madness, Psychoanalysis, Islam. The four books reviewed in this essay, writes Paul, speak to the present moment, “when psychoanalysts are taking more and more interest in seeing psychoanalysis in its social and political dimensions.”
Separation Theory Revisited
In her review of Catherine Chabert’s Maintenant, Il faut se quitter (Now We Have to Part), Laura Kleinerman closely reviews the author’s subtle analysis of various forms of separation throughout life. In this book Chabert, an eminent French psychoanalyst and author of numerous books and articles, broadens the process of separation beyond the developmental stage that Anna Freud and Margaret Mahler described. Chabert analyzes the “meaning of separation in the contexts of anxiety, the oedipal situation, mourning, sadness, depression, and the death drive,” employing a deep immersion in Freud’s theory and lively clinical examples to illuminate psychic situations of separation in the clinical encounter. Kleinerman emphasizes that separation and individuation are for Chabert “a motor, a driving force forward” in development; and that the Il faut of Chabert’s title (which translates, roughly, as “it is necessary”) implies the internal conflict, the pull to stay small and not alone that, throughout life, counters the drive “to construct a separate self.”
The Psychoanalyst as Memoirist
In his delightful review of Joan Wheelis’s The Known, the Secret, the Forgotten: A Memoir, Salman Akhtar muses on the question of why a psychoanalyst might write a memoir: though as analysts we long for the coherence and explication of the whole of one’s life story, the work of memoir is not the same as that of analysis. “We remind ourselves,” Akhtar notes, “that writing a memoir is not akin to free associating on a couch. Writing a memoir has its own formalities, its intrinsic etiquette and demands. Literary parsimony is not synonymous with psychological guardedness. The creative writer is not a patient.” Thus, he points us to Wheelis’s exquisite eye for detail, her love of nature, the spare elegance and parsimony of her writing. She tells the story of growing up in a loving, intellectually rich, affluent, and stable home with two psychoanalyst parents. Akhtar cannot help but imagine a peek behind the scenes at experiences Wheelis chooses not to address in the memoir. Yet, he tells us, the power of this memoir allowed his curiosity to give way to the “economy of motion” that characterizes Wheelis’s delicately spun prose.
Psychoanalysis and Fashion
A patient once referred to the attire of the therapists she knew as “shrink-wrap,” poking fun at the earthy tones and comfortable-chic fashions common among female analysts. Of course these days, when we appear to our patients only from the shoulders up, many of us have changed wardrobes. During the first weeks of the stay-at-home orders, some colleagues shared daily photos of quarantine footwear. Gone were heels, boots, and flats; in their stead, slippers, flipflops, or even bare toes curling into the rug. Changing times, changing attire—whether subtle shifts or dramatic sea changes. In Psychoanalysis in Fashion, editors Anita Katz and Arlene Richards bring a psychoanalytic frame to such musings. In her review, Carola Chase tells us that fashion, for our patients, contains meaningful clues about unconscious fantasies, feelings, wishes, and terrors. The book offers an in-depth study of how we adorn ourselves. Chase takes us through a discussion of chapters that examine fashion, jewelry, and rich adornment from the perspectives of family, development, sex, and gender. The psychoanalytic investigation of fashion extends to what we wear on our skin: tattoos are viewed as memorials and scars, memories and aids in the working through of trauma. Chase supports the notion that we should attend closely to this aspect of our patients’ experience, bridging the gap between fashion as an exterior symbol and as an expression of the physical, embodied self that may be overlooked in the work of analysis.
Why I Write: Arlene Richards
It is our great good fortune to be the beneficiaries of Arlene Richards’s wisdom, insights from a productive career and lucid, understated, and complex prose—including her most recent book, edited with Anita Katz, on fashion in psychoanalysis (reviewed in this issue). In her essay “Learning to Write,” Richards tells us how for her as a young girl, reading and writing were inextricably linked. Her favorite characters in books became her constant companions, and brought her close, once again, to the grandfather who raised her as a small child and whose loss affected her deeply. Through reading as a child, she discovered language and the play of words; built a bond with her mother; and heightened her appreciation of sensory experiences such as smell and taste. As a young woman, she learned what it meant to be a woman, a scholar, an analyst, and a thinker. Over time, the joys of writing revealed themselves to Richards. Writing became a means of both discovering and conveying what she knew, allowing her powerful mind a voice of its own, and experiencing the gratification of being read and thus received by a reader.