Psychoanalysis and its critics.

Abstract

This article discusses the question of the basis of changes in psychoanalytic concepts, theory, and treatment. Illustrative examples discussed include the “widening scope” of the use of “parameters” in psychoanalytic treatment; the rejection of the “Enlightenment Vision” and the concomitant de-emphasis on the role of insight; the concept of “narrative truth”; and the “totalistic” reconceptualization of the meaning of countertransferase. I then discuss the relationship between research and clinical practice and argue that if it is to grow, psychoanalysis must be open to and attempt to integrate findings from other related disciplines. I begin with a distinction between criticisms and critics of psychoanalysis from without and from within. Serious criticism should always be thoughtfully considered, wherever the critic is situated. However, there is an understandable tendency for those within psychoanalysis to rush to its defense when it is criticized from without, particularly when the outside critic launches what is perceived as an unfair attack. It is somewhat like finding it acceptable to criticize one’s wife or husband but rushing to his or her defense in the face of outside criticism. Thus, although I have written many articles critical of certain aspects of psychoanalysis, I wrote to the New York Review of Books defending its contributions in response to Frederick Crews’ wholesale condemnation of psychoanalysis. Our understandable reactions to the unfairness and indiscriminateness of some criticisms from without should not, however, blind us to the need for sustained self-criticisms from within, from those who have a broad sympathy with an overall psychoanalytic perspective but take issue with specific claims or practices. The internal critic is often in a better position to offer challenges and criticisms of specific elements within psychoanalytic theory and practice, because his or her thinking is informed by an intimate knowledge of and commitment to the field. I hope that what follows will be perceived as such. A frequent—I think the most frequent—response from the psychoanalytic community