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One of the first wall labels we encounter at the recent Museum of Modern Art show, Magritte: The Mystery of the Ordinary aligns us upon a certain trajectory for thinking about surrealism’s project. The painting, Entr’acte (1927), we are told, vis Magritte, “shows his preoccupation with bodily fragmentation.” And, for sure, there it is scattered all around the galleries of MOMA, a body in pieces; morselized limbs and feet, torsos minus heads, arms as cudgels and orphaned skulls, breasts, legs and feet. The dates of the works in the show range from the late 1920s when Magritte was living and working in Paris, and was at his closest to André Breton and the Paris group of surrealist artists and writers, up through the 1930s when he had returned to the more parochial scene of Brussels. And given those dates there is no doubt the human and psychological detritus of World War 1 foreshadows this “preoccupation” of Magritte’s. Unsurprisingly, it was not a lonely preoccupation. Many a contemporary of his, on either side of the now defunct –but soon to be rehabilitated– Western front would attest in their own work to this same preoccupation. In Germany, Otto Dix cornered the field for rendering “war cripples.” In France the traumatized body surfaces –merely staying within the surrealist group– in photographs by Brassai, and Jacques Andre Boiffard, in the collages of Max Ernst and the assemblages of Hans Bellmer, to name only the most obvious. This same figuration deformed, or is it re-formed, human body executed by many of the most notable of the surrealists including Magritte would later adorn the covers of the surrealist journal Minotaure. And importantly, as our concerns will develop here, within said journal we will find essays by a youthful Lacan; especially one on the notorious crime of the Papin sisters, wherein aforementioned sisters murdered and gruesomely dismembered their employers. Indeed Lacan was attentive to and “inspired” by, as Elizabeth Rudinesco offers (1990, p 26), the “encounter between the Freudian unconscious, language and the decentering of the subject” that he witnessed in his various outings with of the Surrealist group. In short, while war cripples inhabited the paintings and the streets of Europe, it is fair to say that the disorganized body is everywhere in surrealism. For the surrealists this was not mere reportage of the recent hostilities. Indeed, in the shadow of and very much contrary to the nation’s loudly promoted “Return to Order” (Lyford, p7) the Surrealist project sought to disorganize the very social body of the good bourgeoisie of France.The Paris that Magritte found himself in in the interwar years was one of the centers of the European avant-gardes. Dada’s moment of doubt and fame had passed in Zurich. Founder Hugo Ball was already eying a return to Catholicism, co-conspirator Richard Hulsenbeck, back in Berlin as early as 1919, was organizing a Dada cell there while by the 1920s many of the other originals had moved to sundry European cities –and Europe’s North American outpost, New York– to establish the heterodox future of their movement. In Paris Tristan Tzara author of the first published Dada manifesto, (the prior Dada manifesto by Ball had been read out but not published) was eagerly embraced by Breton’s circle. Though Breton allied himself with Tzara and Dada, he also sought to shift the center of gravity toward his own concerns with the legacies of Arthur Rimbaud, and Guilliame Apollinaire. In the former he identified a poetry that most prefigured the surrealist cannon-to-be, while from the latter he borrowed, and rode to apotheosized heights, the word surrealism. Thus, if Breton was to ultimately be in charge, and he surely was –he was dubbed the Pope of Surrealism– the mantle of Dada was to be shared with those of Rimbaud, and Apollinaire.
The missing player in this coalition, thus far, is Freud. As read by Breton and Co., psychoanalysis –its particular version of an unconscious, its techniques of word association– was little short of the muse to all future poetry. It is often said that Freud came late to France. He lacked an invitation on grounds both anti-German and anti-Semitic is the frequent conceit. Roudinesco argues somewhat differently that Freud was there in clinicians’ minds as early as 1914. But he was there less as a clinical technique she argues and more as psychobiograpical tutor, a way of conceptualizing a conflated picture of pathology and personality. (Roudinesco 1990, p12) However, Freud’s most open invitation to France is not medical –though not exactly not clinical (see below)– but literary. Breton and Louis Aragon friends, surrealists in the making and medical students during World War 1, tried their hands at psychoanalytic technique. 1917 finds medical student Breton as an orderly in a psychiatric unit in Saint Dezier. His population is the ‘war cripples’ of many a painting to be. Flush with rudimentary psychoanalytical knowledge Breton interviews the patients, “able” one biographer attests, “to try out experimentally on the patients the process of psychoanalytical investigation.” (Balakian, p27)
We do not know of Breton’s clinical acumen, or indeed true details of his clinical practice. The scene is perhaps most important as a prologue to the fudged boundaries between the clinical and the literary that he is already courting. 1920’s French attitudes toward insanity, despite the efforts of dynamic psychiatry remained hungover with notions of degeneracy. The Freudian unconscious, as Breton et. al read it, was not a withering away from some ideal non-degenerate form of good European, who knew his place in class and nation –and would return to that place in class and nation post- hostilities. It was rather a potential, an access point to The Marvelous: that magical philosopher’s stone of Surrealism where the quotidian abruptly became extraordinary, surreal. Appropriated thusly this theory of the unconscious sanctioned a part of human existence that was neither rational nor constrained by reason. In doing so it undid the whole logic of degeneracy. In 1920s Europe reason itself seemed as a swindle, if nothing else Verdun and the Somme showed that. In this context the Freudian unconscious was neither a moment of pathology, nor a sign of degeneracy; it was rather at work relentlessly undoing the reasoning subject. Though it was neither Bolshevik, nor Spartacist, in Surrealist hands psychoanalysis was certainly not going to be part of France’s return to order. In this manner two largely German accents –Freud and Dada– arrive in Paris via the proto-surrealists.
T.J. Clark has recently offered that, “It is very hard for us . . . to conjure back the feeling of the circumstances in which, for much of the 20th century, modern art got made.” (Clarke, 2000, p.6) A world war round the corner behind them, a world war round the corner ahead of them, incipient or actual fascism afoot, artists across Europe were reimagining a social form as much as the form of the work itself. Dada artists had abandoned national affiliations (albeit temporarily) by reclusing themselves in Zurich. Breton and the other surrealists were busily abandoning the coordinates of their bourgeois caste: Breton ditched medical school, there were relentless public excoriating attacks upon the clergy and the venerated cultural elite and most individual surrealists sought a close affiliation with the communist party. It was as if an identity that would not go along with the low dishonesty of the times was the task of modernism itself. And so, writing with Louis Aragon in 1928, Breton valorized ‘madness’ itself announcing that, “hysteria was the greatest poetic discovery of the latter part of the century.” (Roudinesco 1990, p7) In this embrace of madness Breton et al genuflected before Augustine, Charcot’s young hysteric of much photographic fame from The Salpêtrière. They saw the hysteric’s body as “a supreme vehicle of expression.” (Roudinesco 1990, p6). In its way –Breton fulminated– hysteria was not pathology at all but a form of poetic utterance. And in its way this argument of Breton’s is the struggle of modern art, of modernism; it is the struggle to find the right form. Breton and the poets and painters he gathered around him were struggling to find, through automatism, the right form for a poetry of 1920s Europe. With automatic writing, with free association, with dream imagery it seemed to them that they had learned their lessons from ‘madness’ and from psychoanalysis.
In this image rich history of the Salpêtrière, which was embraced by the surrealists, and with Magritte’s “preoccupation,” we see the infirm and broken body as a nodal point of that struggle. Whatever form it is that the body will deploy, it is not a voluntary body. Rather it is impelled by trauma in its amputations or contortions and by unconscious impulses in its desires. What shall the evolving social subject of a destroyed Europe wear as its outer skin or form? How will the mutileés return to being French men? Split and riven by trauma, by trench warfare or rape, as in the case of many of Charcot’s hysterics, the body, the subject of an evolving European modernity, was in need of renegotiation.
Against this interwar chaos it can be said that Magritte has a style of painting, of rendering, wherein the rendered object is visually clear and recognizable (his style has ungenerously been referred to as a ‘paint by numbers’ style). Yet the dynamic at play within the painting, either between elements within the canvas or in the dynamic of reading set up between canvas and viewer, hinges upon visual or linguistic misrecognition. “This is not a pipe,” Magritte assures us. Neither the image painted nor this word “this” is a pipe. Such semiotic mischief generically undoes representation, but also, and more importantly for our concern here, such images as The Titanic Days(1928) or The Acrobat’s Ideas (1927) present a non-congruent rendering of a human form. A human form not bounded and not delimited, even though at first glance it appears to be so. Imaginary misrecognitions such as these abound in the work, alongside doppelgangers in bourgeois bowler hats and mutilated, wounded human bodies. Formally his painting is bland, unimaginative, pedestrian but the bodies formed and the sense of identity formation that they convey is of the monstrous, the deformed or the un-forming. Notwithstanding the clichéd presence of Magritte posters in sophomore dorm rooms the imaged human forms he deploys are unsettling and disorienting.
Two registers then; the visually seen and the affectively known. I see clearly and I feel haunted. I see clearly, yet I feel an uncanny presence. Magritte is exploiting a certain aspect of rendering, to wit resemblance. Despite their style his paintings never, of course, achieve the status of photographic verisimilitude. And yet their proxy style for realistic rendering toys with and courts a certain truth-value that photography claims as its own. In the inevitable Magritte twist, that truth claim is torqued beyond tolerance. The contract come swindle Magritte’s paintings propose is that what you are seeing exists beyond the canvas’ rectangle in the world. This proposition is not believed exactly, but the viewer’s grasp of what they see toggles back and forth in some imprecise space of knowledge and disavowal.
In appropriating this terrain of rendered visibility –resemblance– the paintings also invoke a quality of the viewer. If there is a coherence to what the viewer sees, is there not surely a coherence to the viewer, a unified coherent form of identity lurking somewhere in the proximity of the spectator. By proposing this and pulling the rug out from under said contract Magritte spikes this imaginary formation of identity. It is here, on the far side of the failed proposition of coherent identity that the affectively known is found.
Rosalind Krauss, in writing about surrealist photography, nails this psychic operation that Magritte is negotiating on the far side of this imaginary contract. After invoking Lacan’s theory of the imaginary constitution of subjectivity, or more accurately his theory of the failure to constitute a coherent subjectivity. (Which is in turn an attempt to rethink Freud’s failed proposition of a coherent ego.), Krauss offers:
“To produce the image of what one fears in order to protect oneself from what one fears is the strategic achievement of anxiety, which arms the subject in advance against the onslaught of trauma, the blow that takes one by surprise.” (Krauss 86)
The blows, the traumas, are many and varied. And indeed Surrealism saw itself, at least in part, as in the business of administering such blows to the French social body already on its knees from WW1. It is Krauss who offers a thread to follow here through the bewildering maze of traumas. Against the modernist quest of finding a form she invokes, in her words, “renegade surrealist Georges Bataille.”(p57) It is Bataille’s motif of the formless or, in Krauss’s rendering the unformed, that is to be mobilized to hold the renegade line. Formless arises in Bataille’s journal Documents. The journal, his “war machine against received ideas,” was published between 1929 and 1930 and was a precursor to the already mentioned, much more well known, more highly produced and far less war-machine like Surrealist journal Minotaur. Over its brief existence Documents was a heterogeneous container of essays and images. Its masthead offered that it contained a formidable grab bag of “Doctrines, Archaeology, Fine Arts, Ethnography.” Contents that ranged from Eli Lotar’s photographs of the Paris slaughter-houses to an essay on S.M. Eisenstein’s films by expelled Surrealist poet Robert Desnos. There were images of Juan Miro’s painting, a photo essay on the Chicago Gang wars of the 1920s, reproductions of lurid covers from detective fiction and a full-page images of the Roman catacombs chock full of human skulls. Bataille’s Formless comes to life as a relatively brief entry in a subset of the journal, The Critical Dictionary. This ‘Dictionary’ was something of a cabinet of intellectual and cultural curiosities even by Documents’ standards, its most frequent contributors were Bataille’s closest circle, ex-Surrealists and writers associated with Paris Dada.
The entry for Formless gives that the word is “a term serving to declassify.” A word to undo the already done because, as Bataille conceived it, “A dictionary would begin when it no longer provided the meanings of words, but their tasks.” And what was to be undone? The “academics’” need for “the universe to take on a form.” Because the “universe resembles nothing at all and is formless, which amounts to saying that the universe is something akin to … a gob of spittle.” Resemblance then, a noted identity between things, or its noted absence, is jettisoned, spat out we might say. Clearly The Dictionary’s entries were not limited to definitions, nor to revealing words’ “tasks.” There was also –the occluded truth of all dictionaries– an ideological battleground to contest. (Bataille, 1985 p31)
Krauss, in her essay on surrealist photography, Amour Fou, allies with Bataille’s Formless to examine the usurpation of photographic verisimilitude; that is, its formal undoing or un-forming. Scanning photographs of the human body shot by Surrealist photographers Man Ray, Brassai, Lotar, or Boiffard –many of which were to be found in Documents– she notes that the body is made strange, “unfamiliar.” Strategies for this vary. Sometimes through what amounts to a system of anamorphosis, where the rotation of the camera’s point of view and a deep plunging sight line, or an extreme foreshortening of the photographed subject, the body appears as a “beast.” Photography, surrealist photography, creates monsters. In this body of work the human body becomes a never fully and stably recognizable form. The human body coheres into view and slips away again. Or, perhaps the body is mis-recognizable; it is a body in-becoming, but becoming what? In this photographic work there is never to be a fully achieved identification. Identification is always unachieved, underachieved or undone.
Anamorphosis sets up a point of view of an‘Other’ within the seen scene. It is as if what I am seeing is seen from another subject-position simultaneously. My authority, my uniqueness, my constitution of and by the scene is brought into question by the possibility of another point of view for whom the scene is organized. Indeed, if we return to Lacan, he goes further. Lacan references, on numerous occasions, Hans Holbein’s painting, The Ambassadors with its famed anamorphic rendering of a deaths-head, asserting that in Holbein anamorphosis guarantees that the “ subject is annihilated”. (Lacan, 1988, p88). Thus, moreover, when the entire image’s point of view is shaped by anamorphosis it is I who is out of place, in the wrong position –annihilated, as Lacan has it. He, who is seeing from the other point of view which, it is implied, is not anamorphic, is seeing the clear organized picture which is organizing him as a subject for whom this scene is clearly laid out. Anamorphosis sacrifices human congruity and uniqueness in much the same way as Magritte does in The Titanic Days or Entr’acte.
And perhaps, in more than a punning association, we could wonder if that word sacrifice, or that word annihilation,have a more resonant tone than they at first signals. As Neil Cox (Ades, p106) has pointed out, though there is no entry in Documents, nor The Critical Dictionary, for sacrifice itself, its presence nonetheless abounds therein. And, throughout his work, Bataille turned his eye, mind and pen toward sacrifice again and again and again. InDocuments, Lotar’s already mentioned images of the Paris slaughterhouses are commissioned to accompany Bataille’s dictionary entry on animal sacrifice, Abattoir. It is Bataille who is most often credited as the author of the polemical attack upon Breton, published as the pamphlet Cadvre, (1930) wherein Breton’s image crowned with thorns, is given as an obituary for the very much still living Surrealist leader. Later, in 1930, Bataille will write of Van Gogh’s severed ear as animist sacrifice. As early as 1926, wearing an ill-fitting anthropologist’s hat, Bataille will write of Aztec sacrificial rituals. Images interpreted by him as depicting Aztec sacrifice, though now said to depict birth, will appear in Documents from Codex Borgia. (Bataille, 1985). Into the 1940s Bataille continues to research and write about the same in Sacrifices and Wars of the Aztecs. (Bataille, 1985). From whence he will move on to Marcel Maus’ theorization of Potlatch, elaborating upon same as the practice of senseless waste, expenditure and sacrifice. And most notoriously, later, in the secret society Acephale, it is rumored that Bataille eagerly planned for this group to actually carry out a human sacrifice. (Bataille, 1985. Pxx)).
Beginning in 1925 and for a little over a year Bataille was in analysis with Adrien Borel. Paths crisscross many times over here, and provenance regarding knowledge, regarding image, becomes hazy. According to Roudinesco, at the beginning of the treatment, Borel handed to Bataille an infamous photograph by Louis Carpeaux. (Roudinesco 1977, p12). The image was of a Chinese man being executed by the, probably apocryphal, process of ‘death by a thousand cuts’, but described by Roudinesco as a man being “cut into a hundred pieces.” Michel Surya, Bataille’s biographer, places Borel himself at the scene of the execution taking the photograph that he later ‘sent’ to Bataille. (p93) The victim of the far from apocryphal actual execution has, it is reported by both writers, been injected with opium to prolong rather than to anesthetize the process. Said opium is presumed to account in part for the presumed ecstatic countenance on the victim’s face.
With Surya the photographs inexplicably become plural and we are told that they “obsessed” Bataille; “he spoke of them often and always kept them.” (p94) For Surya, “The photographs Bataille discovered in 1925 and published a year before his death, in 1961, . . . welled up in his work like one of its essential springs.” (p94) We are perhaps in the presence of a devotional act on Bataille’s behalf. But, there is too an act of interpretation or –and perhaps this is the same thing– empathy. Bataille regards the cuts, the tortured body, but also the face of the victim. He writes of the victim, “The young and seductive Chinese man . . . communicated his pain to me.” (Bataille, 1988 p120) For Bataille, looking into the face of this victim, there is an ecstasy of empathic connection. Bataille’s ecstatic reverie collides with Magritte’s “preoccupation.” And yet Magritte’s undergirding device — resemblance — is ambushed and undone. Bataille reaches out to the sacrificial victim, he strains for resemblance, identification. Yet the body is being literally undone, unformed; literally it is being put asunder. No resemblance, no form, little more than a ‘gob of spittle.’
There is a particular figure, the acephale, which after the mid 1930s comes to be the cypher for Bataille’s thought. And though it is never named as such, this figure is relentlessly at work in Magritte’s oeuvre. Indeed, it is blatantly there in Entr’acte the painting where Magritte’s “preoccupation” is first noted at MOMA. It is there in The Lovers(1928), the painting that is often cited as referencing Magritte’s suicided mother. Indeed this headless or faceless figure recurs again and again throughout Magritte’s career. For Bataille it is Andre Masson’s drawing, published on the cover of the first edition of Bataille’s eponymous magazine, that illustrates the acephale. Masson’s drawing gives a human(ish) figure, based upon Da Vinci’s Vitruvian Man. It is a headless figure, a body minus its locus of rational thought. The head has become a skull and has been displaced southward to become as a fig leaf. The acephale, the headless man, is seen as representing thusly, the end of reason (which is certainly one way to think of the surrealist goal.) This is also perhaps the best proposition of the inter-war years, European social subject coming into being. Lost to reason, not in control of motivations and action, locus of identity banished or displaced, traumatized and scarred, acephalic man is the prototypical, mid-century subject shared by psychoanalysis and Surrealism. Indeed it is at mid century proper –1951-52, a full twenty years after Bataille– that Lacan, in addressing Freud’s Mass Psychology and the analysis of the Ego, will work out his own theory of the polysephalic and ultimately acephalic subject. For Lacan, “If there is an image that could represent for us the Freudian notion of the unconscious, it is indeed that of the acephalic subject” (Lacan 1974, p166)
Whether Lacan’s debt to Bataille is acknowledged or not it is of note that heads, lost, gone, switched and crowned with thorns populate Bataille’s Arcanum –and so too do other body parts. In Documents, Boiffard’s images of the big toe accompany Bataille’s article of the same name. Boiffard’s images offer the body part rising out of its pitch dark, dismembering background; grotesque, anonymous but labeled male and female. Bataille’s essay is littered with a vocabulary of violence and death. Toes are “hideously cadaverous,” they give “shrill expression to the disorder of the human body.” The toe is “always, more or less tainted and humiliating.” (Bataille, 1985 p22). Thus big toes are gendered, poised, loaded and here staged rather melodramatically upon their dark grounds. Bataille ponders the seductiveness of this fetishized part-object. Yet his words arrive at the irreducible base materialism of this particular body part, “with their feet in the mud but their heads somewhat approaching the light, men obstinately imagine a tide that will elevate them . . .” (Encyclopedia Acephalica, p87) The tide is far, far out is Bataille’s conclusion. And if it ever arrives we should expect it to be fouled with our own abject flotsam.
Many of Boiffard’s other images in the magazine drive to the far north of the body. There is a suite of four photographs of anonymous men dressed in regular street clothes but with heads obscured –in their way gone– by grotesque carnival masks. The trickster photographer gives us street clothes that beckon, but the grotesque masks repel all possibility of identity, resemblance or empathy; the soul is missing in action with the head. Masks acephalize their wearer and the unformed body becomes the totemic figure of Surrealism’s historical moment.
Perhaps it is important to acknowledge that there are divergent readings of Freud to be disinterred in surrealist circles. At one remove Lacan is reconstructing Freud according to his own architecture of psychoanalysis. While Breton and Bataille are all but competitively reading Freud hot off the translator’s press.
And it becomes increasingly apparent that each of the latter read Freud through in his own way. Sometimes it feels as if Bataille reads Freud contra Breton almost as part of their ongoing feud. Breton valorizes, in Walter Benjamin’s phrase, the “magical realm of words” (p232). With words Breton can translate trauma. Trauma is legible, transcribable and knowable. The hysteric’s language can be joined. It is an utterance that can be responded to rather than a babble written off as degeneracy. With Bataille trauma is revered, it is all but sacred. In Magritte, as in Dix et al cited at the top of the essay, there is too an ironic reverence for the war injured. But for Bataille trauma is all but an aspirational moment. Bataille, seemingly entranced, genuflects before trauma. He is impaled by a shared ecstasy of the victim. There is a reverence but also a joining with the victim’s body. Breton reads Freud and finds a world of liberated signs. Bataille reads Freud and finds the tortured body. Torn, traumatized and base, but nonetheless a body.
In Bataille’s response to the other’s trauma there is something beyond the moment of empathy that might connect two persons, an analyst and analysand, say. Borel and Bataille, say. There is an experience of communitas. Communitas is to be taken as a moment of vanishing or dissolution of unique identity. Often communitas is achieved around some shared rite of passage. The traumatized body, empathically embraced, is for Bataille that rite of passage. There is a debt owed by Bataille to “the young and seductive Chinese man” in the photograph. His trauma allows Bataille an intense moment of joining with the other’s torn body; like a jump-cut from my point of view to your point of experience. As with the dissolution of identity engendered by the anamorphic point of view the look upon the victim’s face in Borel/Carpeux/Bataille’s photograph seems, for Bataille, to transcend the recognition of an individuated self across the gap between observer and seen.
Ades, D., Baker, S. eds. (2006). Undercover Surrealism: Georges Bataille and DOCUMENTS. Cambridge MIT press
Balakian, A. (1971). Andre Breton, Magus if Surrealism. Oxford University Press. Oxford
Bataille, G. (1985) Visions Of Excess: Selected Writings, 1927-1939.Minnesota. University of Minnesota Press.
Bataille, G. (1988) Inner Experience. SUNY Press. New York
Benjamin, W. (1929). Surrealism: The last Snapshot of the European Intelligentsia. In One Way Street. London. Verso
Clark, T.J. At Tate Modern. The London Review of Books. Vol 36. No1. 2014
Encyclopaedia Acephalica (Atlas Arkhive). (1995). London. Atlas Press
Krauss, R. (1985). L’amour fou: photography and Surrealism. Abbeville press
Lacan, J. (1974). The Seminar of Jacques Lacan: Book two: The Ego in Freud’s Theory and in the Technique of Psychoanalysis, 1954-1955 (Vol. Book II) (The Seminar of Jacques Lacan) New York. W. W. Norton & Company
Lacan, J. (1988). The Seminar of Jacques Lacan: The Four Fundamental Concepts of Psychoanalysis (Vol. Book XI) (The Seminar of Jacques Lacan). New York. W. W. Norton & Company
Lyford A. (2007) Surrealist Masculinities. University of California Press. Berkley
Roudinesco, E. (1977). Jacques Lacan. New York, NY. Columbia University Press
Roudinesco, E. (1990). Jacques Lacan & Co: A History of Psychoanalysis in France, 1925-1985 Chicago. University of Chicago Press
Surya, M. (2002). Georges Bataille: An Intellectual Biography. London. Verso
The following is a sidebar to DIVISION/Review’s interview with Jonathan Shedler
The following is a sidebar to DIVISION/Review’s interview with Jonathan Shedler
In your interview in this edition of DIVISION/Review, you alluded to the widespread misconceptions and negative stereotypes about psychoanalysis. What can the Division do?
Quite a lot, actually. But our challenges are internal as well as external. Psychoanalysis as a profession has a deeply rooted culture of insularity. We tend to occupy ourselves with internecine issues instead of engaging with professional colleagues outside our own circles. This no longer serves us. Actually, it is suicidal.
The perception of psychoanalysis in the eyes of policy makers and the educated public could hardly be worse. Barely a month goes by without an article in a major news outlet saying that manualized, “evidence-based” therapy is superior. Misinformation and disinformation about psychoanalytic treatment abound.
Here’s one concrete example of something the Division could do. In the midst of all the buzz about “evidence-based” therapies, APA actually commissioned a blue-ribbon panel of experts to review the scientific literature. They concluded that the therapies that are being promoted and marketed as “evidence based” are not more effective than other forms of psychotherapy. APA (2013) issued a formal policy resolution saying so. (For more on this, see my blog Bamboozled by Bad Science).
How many Division 39 members even know about this APA resolution? How many are talking about it? If the Division can’t find ways to educate the public, we could at least launch an information campaign to inform our own members. So the next time any Division member talks to a patient who has been told that “evidence-based” therapy is superior—or to a fellow psychologist, or a medical professional, or a student or supervisee, or a journalist, or simply an interested layperson—they could say, “No, actually scientific research does not show that. That is not just my personal opinion. That is the official scientific conclusion of the American Psychological Association.”
If every Division member could have this conversation, it would go a long way to changing the dialog in our profession.
There are many more things the Division could do, but our collective attention seems to be elsewhere. Change begins with self-examination. We need to examine our tendency to retreat into intermural quibbles at the expense of our survival. We need to reflect on why we communicate in arcane jargon, which creates an impenetrable barrier for many students and colleagues who would otherwise be receptive to psychodynamic thought. They are interested and curious, but they find a “not welcome” mat at our door. We need to reflect on how we ourselves have contributed, and continue to contribute, to the misunderstanding and prejudice that threaten what we cherish.
American Psychological Association (2013). Recognition of Psychotherapy Effectiveness. Psychotherapy, 50, 102-109.
Shedler, J. (2013, October 31). Bamboozled by bad science: the first myth about “evidence-based” therapy. Retrieved from http://www.psychologytoday.com/blog/psychologically-minded/201310/bamboozled-bad-science
In recent years, pressures from managed care and the evidence-based movement have led many researchers to demonstrate the efficacy of psychoanalysis and psychodynamic therapy. Jonathan Shedler has been a torchbearer for such research, arguing against the typical public narrative where evidence-based approaches (particularly cognitive-behavioral therapies) enjoy empirical support while analytic/dynamic therapies do not. In his now famous 2010 article “The Efficacy of Psychodynamic Psychotherapy” (PDF), Shedler reviewed meta-analysis research to assert that treatment gains in dynamic therapy are equal to those of other modalities, and that the latter may actually be efficacious due to their use of dynamic techniques.
In the following interview, Shedler discusses his attempt to bridge research and clinical practice, arguing that being a good scientist requires being a skilled clinician. He suggests that the apparent rift between research and psychodynamic therapy is not intrinsic to the two disciplines, but rather a byproduct of scientists lacking clinical experience and clinicians underappreciating the challenge of doing sound scientific research. Regardless of where the reader stands on this enduring debate, Shedler is masterful in highlighting the attitudes and cultures of science and psychoanalysis that have kept the two apart for so long.
Below the jump, the editors of DIVISION/Review interview Jonathan Shedler
What got you interested in psychoanalytic research? What is your research background (grad school, work, etc.)?
I’ve worn two hats from the beginning. I graduated from the personality program at the University of Michigan. I worked with faculty mentors doing research in personality and social psychology. I also took the clinical curriculum. At the time, the Michigan clinical program was basically a psychoanalytic institute. So I lived in two worlds. When I was with the researchers, I was a researcher. When I was with the clinicians, I was a clinician.
My research mentors didn’t understand why I was interested in “all this psychoanalytic stuff.” At various times, I heard it referred to as religion, superstition, and a cult. I also encountered resistance from some of the psychoanalytic faculty, who regarded me as an interloper. What I was trying to do just wasn’t “done.” There is a lot of talk these days about the science-practice schism. I was living the science-practice schism.
This experience shaped my view of the profession. I saw how clinicians and researchers did not talk to each other. I saw first-hand the insularity and arrogance of some of the psychoanalytic clinicians of the time. I also saw how arid, artificial, and fundamentally unpsychological research in psychology could be, and how irrelevant much of it was to the needs of real clinicians and real patients.
A certain amount of psychological research looks to me like a game of “let’s pretend”: let’s pretend we are studying something important while ignoring virtually everything that is psychologically meaningful. For example, too many studies rely on responses to self-report questionnaires. If you believe that unconscious mental life matters, this kind of research can seem silly and superficial. I resolved that my own research would always address unconscious mental life.
Living the schism sounds like a conflictual place to exist. How do you find yourself managing both sides, or have you been able to build an effective “bridge” between?
It has not always been an easy place. I’ve been viewed with suspicion in both camps. There are academic researchers who try to dismiss me as a “psychoanalyst,” which has become a term of derision in certain circles. Some psychoanalysts want to put me in a compartment, as “the researcher”—in other words, not really “one of us.” As if conducting research is somehow a disqualification from being a legitimate psychoanalytic clinician or scholar.
It’s okay, because I’m not looking for “easy.” Easy is overrated. It’s easy for researchers to shape research questions to fit a certain research method, instead of tackling questions that are psychologically meaningful. It’s easy for psychoanalytic clinicians to embrace a certain theoretical model and apply it to every patient, whether it fits or not. Good research and good clinical work are not “easy.” We might benefit—individually and as a profession—from spending more time in “conflictual places.”
That said, I’ve found a number of bridges. One is my work on personality patterns and disorders using the Shedler-Westen Assessment Procedure (SWAP). My collaborator Drew Westen and I designed the SWAP to (among other things) assess the spectrum of psychological processes relevant to psychoanalytic case formulation—for example, characteristic conflicts, defenses, internal and external object relations, self experience, transference propensities, desires, fears, fantasy life, and so on. It’s an assessment instrument completed by clinicians, not patients, and it forces clinicians to consider a patient through multiple theoretical lenses. This research has made me a better clinician and deepened my understanding of psychoanalytic theory. It has helped me understand which theoretical models apply when, where they illuminate and where they obscure, and their practical treatment implications.
Initially, from a quantitative perspective, researching unconscious mental phenomena seems like a difficult process. How do you go about developing such a skill set?
First, you have to be a real clinician. This means devoting time to clinical practice, treating a broad spectrum of patients, and undergoing personal psychotherapy or psychoanalysis. Psychoanalytic concepts are just abstractions unless you experience them first hand, in clinical work and in personal therapy. You can’t really understand the concept of a transference-countertransference enactment, for example, just by reading about it.
Before we try to quantify any clinical concept, we should understand it at a deep level. In his book Outliers, Malcolm Gladwell described the “10,000 hour rule.” Basically, in any area of human endeavor—athletics, music, computer programming, creative writing, psychotherapy, anything—it takes 10,000 hours of focused practice to develop mastery. I believe this. This is one reason why I’m skeptical of “clinical” research conducted by people who lack clinical practice experience.
The other piece of the puzzle, for me, is psychometrics: how to measure psychological phenomena. It sounds boring and people often take it for granted, as if it were something trivial or obvious, but it is not. Psychological phenomena can be extraordinarily difficult to quantify. I worked with Warren Norman at Michigan and Jack Block at Berkeley, two of the greatest psychometric minds of their day. They weren’t clinicians but they understood how to quantify complex, nuanced psychological processes.
Sometimes psychoanalytic clinicians who attempt research get disappointing results, not because their hypotheses are wrong, but because they do not appreciate the psychometric challenges they are tackling. Their measures may not capture the richness and complexity of psychoanalytic concepts, or they may end up with data that contain too much measurement error to be scientifically useful.
This brings us back to the science-practice schism. We have empirical researchers in the business of quantifying things, but they lack clinical experience and do not necessarily understand what is important to quantify. From a psychodynamic perspective, they sometimes end up studying trivia. We have sophisticated clinicians who may have a deep understanding of clinical phenomena, but they don’t know how to translate clinical ideas into researchable concepts. If people with these different skill sets valued one another, communicated, and worked together, great things might happen. But generally, they don’t.
How would you recommend that the profession begin to bridge the schism?
That’s above my pay grade. We’ve been hearing rhetoric about bridging the science-practice schism from the highest levels of APA leadership for as long as I can remember. The rhetoric waxes and wanes with APA election cycles. But it never amounts to anything more than rhetoric.
It might be more helpful to discuss some of the things that exacerbate and perpetuate the schism so we can see it more clearly. From my perspective, the schism is getting worse, not better. One contributing factor is that we have institutionalized the science-practice schism by bifurcating training in clinical research and clinical practice into PhD and PsyD programs, respectively.
There was a time when clinical psychology PhD programs at research universities included faculty members who identified primarily as clinicians and faculty members who identified as researchers. They came into contact with each other and developed some appreciation of one another’s perspectives. Even researchers who had no professional interest in clinical topics developed some understanding of what clinical work is about. This is no longer so.
The demands at research universities to publish and get grants have become extreme. Faculty members cannot devote time to clinical practice; it would be professional suicide for an untenured faculty member to treat patients while others accumulate publications and grants. As clinicians have retired, they have been replaced by “clinical researchers” or “clinical scientists” with little practice experience. The trend is toward APA accredited “clinical” PhD programs without clinicians. Faculty members at these programs may have no idea what good clinical work even looks like.
This is one reason we keep seeing comments in the news media from prominent researchers that are dismissive and denigrating of in-depth psychotherapy. Not long ago, for example, former APA president Alan Kazdin told Time Magazinethat individual psychotherapy is “overrated and outdated” and bemoaned that too few patients receive “evidence-based treatments like cognitive-behavioral therapy.”
I don’t think anyone who knows what good psychodynamic therapy looks like and can accomplish would consider 12 or 16 sessions of manualized CBT to be good psychotherapy. And scientific research does not show that it is more effective (see my blog, Bamboozled by Bad Science). I’m not singling out Professor Kazdin, whose research I respect. His comments reflect prevailing attitudes. Clinical researchers routinely extol the brief, scripted therapies studied in research laboratories and denigrate psychotherapy as most of us understand and practice it. Policy makers and the public are getting a steady diet of misinformation about psychotherapy, coming mostly from people who do not actually practice psychotherapy.
As clinicians have disappeared from research universities, real clinical training has moved increasingly to the professional schools. This bifurcation of the profession has consequences. In research-oriented clinical PhD programs, theory and research develop in isolation from the crucial data of clinical experience. In freestanding professional schools, clinical training can become divorced from the scholarly and intellectual traditions of university life and the critical thinking it fosters. Training in both kinds of institutions suffers, and the science-practice schism grows.
These are structural problems without easy solutions. Research universities now depend on the grant money researchers generate, and they have no incentive to reward or encourage clinical immersion. Many free-standing professional schools have become profit centers, and they will continue to operate as they do so long as it is financially profitable. Both clinical research and clinical training have become industries.
These comments barely scratch the surface. Readers who want a more thorough discussion may want to read my article,Why the Scientist-Practitioner Schism Won’t Go Away (Shedler, 2006).
Can you describe some specific research findings that influence your work with patients, and offer a clinical vignette that illustrates the finding’s applicability?
A question can sometimes reveal more than an answer, and that may be the case here. I know this question was drafted by the Research Committee and reflects a sincere desire to support research and demonstrate its relevance. But the question reflects an assumption about the relation between research and practice that I don’t share. It implies there is or should be a direct relationship between research findings and clinical intervention: “Because this study showed X, I do this or that in psychotherapy.” That is not my understanding of the role of research.
Knowledge is about constructing narratives. A clinical case formulation is a form of narrative. So is a scientific theory. A narrative weaves information together in a way that makes sense of it. It helps us see how the pieces fit and relate to one another. A sound narrative is internally coherent, is consistent with what we can know and observe, accounts for as much relevant information as possible, and helps us anticipate what is likely to come. Our narratives should be dynamic, not static, so we are continually reworking and revising them as new information emerges (like Piaget’s concept of assimilation and accommodation).
For me, empirical findings are one of many streams of information that help shape the narratives that reflect our psychological knowledge and understanding. The narrative transcends the information it incorporates and represents a synthesis of everything we learn from all sources—from our patients, from theory, from teachers and supervisors, from empirical research, from our countertransference responses, from our personal analyses. Everything is in the mix.
From this perspective, asking how a specific research finding influences my work with patients is the wrong question. The direction of influence is not one-directional, from research to clinical work. It is not even quite right to say the influence is reciprocal or dialectical, although that would be better. I would say, rather, that everything plays a role in shaping the narratives or working models that inform my clinical work. (See Shedler, 2004, for more on the relationship between psychoanalysis and research.)
I also don’t draw a sharp distinction between thinking clinically and thinking scientifically. Good science and good psychotherapy require critical thinking. Psychotherapy is, among other things, a shared, collaborative process of observation, hypothesis generation, hypothesis testing, and hypothesis revision. When I do research, I am sharpening my clinical skills. When I treat patients, I am sharpening my research skills.
A psychoanalytic interpretation is really a hypothesis, and we generally present it to the patient as such: as an idea for mutual consideration and reflection. What happens next provides data that help us revise, refine, or elaborate on the hypothesis, or discard it and formulate a different hypothesis.
I don’t mean to give the impression that psychoanalytic work is just an intellectual process. Far from it. We enter the therapy relationship with our whole selves. We immerse ourselves in the relationship and experience it from the inside. We experience it emotionally. Yet we must be able to shift between experiencing and reflecting on what we experience. A therapist who engages primarily on an emotional level, without stepping back to reflect and understand, is either participating in an unwitting enactment or else offering the patient little more than emotional pablum. A therapist who approaches the work in an emotionally distant, intellectualized way will miss everything important. The work requires heart and head, yin and yang. In classical analytic language, we must be able to move fluidly between experiencing ego and observing ego, and we work to develop this capacity in our patients as well.
What is sometimes difficult to convey to people who are not psychoanalytically trained is that the most important data emerge from the therapy process, not just the manifest content of our patients’ words and actions. For example, they emerge in the transference-countertransference enactments that we inevitably find ourselves participating in as we engage with our patients. Our data are not limited to what our patients tell us. They include what they show us through their interactions with us, and the emotional reactions we notice in ourselves as we engage with them, and what they communicate metaphorically or symbolically through their associations.
I know of exactly one book that explicitly discusses psychotherapy in terms of hypothesis generation and hypothesis testing and emphasizes how the therapy process—what happens in the room between patient and therapist—provides the crucial data. The book is Beginnings: The Art and Science of Planning Psychotherapy by Mary Jo Peebles. I recommend it to all my students and supervisees, from first-year graduate students and psychiatry residents to advanced psychoanalytic candidates.
I could, of course, come up with examples of how particular research findings influence my clinical work, but in doing so, I’m afraid we might miss a larger, more important truth.
So will you tell us about a specific research findings that has influenced your work with patients?
Now that I’ve discussed the misconception embedded in your question, yes. There’s still a certain amount of debate about the concept of borderline personality organization. The historical debates between Kernberg and Kohut are legendary, and the topic can stir rancor even now. Some psychoanalysts view the concept of borderline personality as a throwback to a “one-person psychology” that pathologizes the patient for experiences that are co-constructed in the therapy relationship. On the other end of the spectrum, I occasionally hear very classically-oriented psychoanalysts reject the idea that personality can be organized around splitting (versus intrapsychic conflict), and dismiss the model with the ultimate psychoanalytic put-down: “It’s not psychoanalysis.” But there are empirical questions here. There is no use trying to resolve them through philosophical or ideological debate, or by appeal to authority, or through competing clinical case studies selected and crafted to demonstrate whatever a theorist wants them to demonstrate.
The defining hallmarks of borderline personality organization, as Kernberg conceptualized it, include splitting, projective identification, identity diffusion, and affect dysregulation. The Shedler-Westen Assessment Procedure (SWAP; Shedler & Westen, 2010) assesses all these phenomena. The SWAP consists of 200 personality-descriptive statements that a clinician scores according to their relevance to a patient, from “not descriptive” (scored 0) to “most descriptive” (scored 7). The possible combinations and permutations of SWAP items are virtually infinite. They allow a knowledgeable clinician to provide a comprehensive description of a patient’s personality functioning in a way that captures the person’s psychological complexity and uniqueness.
We used the SWAP to study personality in large national samples of patients. In a recent study, 1,201 psychologists and psychiatrists described a patient randomly selected from their practices. We used statistical techniques to identify naturally occurring diagnostic groupings in the patient sample—that is, groupings of patients who share core psychological features in common, that distinguish them from other patients (Westen, Shedler, Bradley, & DeFife, 2012).
In every sample we studied, we found a grouping of patients that unmistakably fit the theoretical description of borderline personality organization. Some analysts may object to the concept on philosophical or ideological grounds, but burning the map does not destroy the territory. The phenomenon exists.
And guess what? The core, defining features of borderline personality organization do include splitting, projective identification, identity diffusion, and affect dysregulation. These are theoretical terms. The actual SWAP items are written in plain English, not theoretical jargon.
SWAP items like the following helped capture the phenomenon of splitting:
When upset, has trouble perceiving both positive and negative qualities in the same person at the same time (e.g., may see others in black or white terms, shift suddenly from seeing someone as caring to seeing him/her as malevolent and intentionally hurtful, etc.).
Expresses contradictory feelings or beliefs without being disturbed by the inconsistency; has little need to reconcile or resolve contradictory ideas.
SWAP items like the following helped capture the phenomenon of projective identification (consider the meaning of the items in combination, not singly):
Tends to see own unacceptable feelings or impulses in other people instead of in him/herself.
Manages to elicit in others feelings similar to those s/he is experiencing (e.g., when angry, acts in such a way as to provoke anger in others; when anxious, acts in such a way as to induce anxiety in others).
Tends to draw others into scenarios, or “pull” them into roles, that feel alien or unfamiliar (e.g., being uncharacteristically insensitive or cruel, feeling like the only person in the world who can help, etc.).
Tends to confuse own thoughts, feelings, or personality traits with those of others (e.g., may use the same words to describe him/herself and another person, believe the two share identical thoughts and feelings, etc.)
These are examples of SWAP items that consistently received high scores for patients in the empirically-identified borderline grouping. They received high scores from clinicians of all theoretical orientations. In other words, it didn’t matter whether or not the clinicians understood or “believed in” the theoretical concepts (or had ever been exposed to them at all). When asked to describe their actual patients using descriptive statements written in plain English, this is what clinicians of all theoretical orientations observed and reported. (For more information about SWAP, visitwww.SWAPassessment.org)
So it turns out that the concept of borderline personality organization, as conceptualized by Kernberg and more recently explicated in Nancy McWilliams’s classic book Psychoanalytic Diagnosis, is empirically sound. Clear treatment strategies follow from this. Among other things, we need to recognize and interpret splitting where it occurs. This means helping a patient hold in mind, at the same time, contradictory attitudes and feelings that he or she is accustomed to compartmentalizing.
For example, I am now treating a patient with narcissistic personality dynamics, organized at a borderline level. He oscillates between feeling superior and feeling inadequate but he doesn’t experience this inner contradiction. When he feels superior, that is what is real to him, and his co-existing feelings of inferiority seem inaccessible and irrelevant. Likewise when he feels inadequate. When he expressed both sets of feelings sequentially during the same session, I had an opportunity to do some work around this. I said, “Sometimes you feel that you are better and smarter than everyone else. And sometimes you feel that everyone else is better and smarter than you.” My comment was aimed at bringing together what my patient had been keeping apart. I will likely be making comments along these lines throughout the treatment. I’m also experiencing splitting in the therapy relationship. At the moment, I’m a good, idealized object. I have little doubt that soon enough, I’ll be a bad, devalued object, and I will be prepared to interpret that too.
Here is an instance where there is convergence between psychoanalytic theory, my subjective experience of my patient in the therapy relationship, and a specific research finding.
Shedler, J. (2013, October 31). Bamboozled by bad science: the first myth about “evidence-based” therapy. Retrieved from http://www.psychologytoday.com/blog/psychologically-minded/201310/bamboozled-bad-science
Shedler, J. (2004). Book Review: Joseph Sandler, Anne-Marie Sandler, & Rosemary Davies (Eds.), Clinical and Observational Psychoanalytic Research: Roots of a Controversy. Journal of the American Psychoanalytic Association, 52, 2.
Shedler, J. (2006). Why the scientist-practitioner schism won’t go away. The General Psychologist, 41, 2, 9-10.
Shedler, J. & Westen, D. (2010). The Shedler-Westen Assessment Procedure: Making personality diagnosis clinically meaningful. In J.F. Clarkin, P. Fonagy, & G.O. Gabbard (Eds.). Psychodynamic Psychotherapy for Personality Disorders: A Clinical Handbook. Washington, DC: American Psychiatric Press.
Westen, D., Shedler, J., Bradley, B., DeFife, J. (2012). An empirically derived taxonomy for personality diagnosis: Bridging science and practice in conceptualizing personality. American Journal of Psychiatry, 169, 273-284.
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