What Do You Know?

The effects of psychoanalysis can be registered in the realm of knowledge, but they are less about knowledge gained than they are about a change in the way of knowing. The direct imparting of knowledge from the analyst to the analysis and has long been recognized as a useless gesture in terms of clinical effects. Indeed, even the knowledge gained by the analysis and’s painstaking discovery, recollecting and remembering, plays only a small part in the benefits of psychoanalytic work. The benefit comes instead through finding a new way of knowing, already generally familiar to the analyst and gradually discovered by the analysis and, always in unique and particular ways. This distinct form of knowing is at the core of the psychoanalytic act and at the heart of what psychoanalysis has contributed to clinical science and to culture in general.

It is a knowing how rather than a knowing that. The particular know-how that develops in a successful psychoanalytic treatment, with its deeply affective and imaginative character, is a fundamental and defining feature of clinical psychoanalysis. In fact, psychoanalysis has never been simply about the removal of symptoms or the reduction of neurotic suffering, but rather about the development of a psychic resource for life after the treatment. Since the transmission of this personal know-how is the effect of a successful treatment, articulating the qualities of this way of knowing enables us to identify a distinct feature of psychoanalysis among clinical psychotherapeutic practices and to call attention to an outcome that is not often appreciated nor measured by those who empirically compare clinical interventions. For while other approaches may stumble upon something similar now and then, it is only the field of psychoanalysis that has comprehensively studied this dimension of human experience—the personal knowledge of one’s desire—debated its key features, and focused upon the clinical methods that facilitate it, over the last hundred years of work, dispute, and refinement.

One key feature of this psychoanalytic know-how is that it operates in the gaps in one’s conscious life. Through psychoanalysis, one comes to locate knowing precisely where before it had been impossible to know: in errors, blocks, unwitting actions, dreams, and symptoms. It is a knowing through slips and failures rather than through positive certainties and affirmations. A great misconception is that it is the aim of psychoanalysis to conquer these gaps and slips, to get rid of them for the sake of a more efficient and orderly life. In fact, the aim is to learn how better to live with them, indeed how to make use of them, how to know one’s thoughts and feelings through the gaps in conscious thought. The aim is not to entirely eliminate the mystery of dreams or the mystifying missteps of everyday life, as though one could, but to know how to think with the logic of myth and mystery that dreams and symptoms are made of, a know-how of the unknowable.

There is a wonderful wordplay in French that Lacan used to capture this first principle of psychoanalytic know-how: l’insucces (failure) is pronounced the same as l’insu-que-sait (the unknown that knows).

A second feature of this know-how is that it is a way of knowing based upon the irreducible dimension of affect and intention in the act of knowing. It is a know-how about and with one’s desire and hence one’s fears and angst. It is always a personal knowledge. It concerns the subject’s unique history, attachments, separations, accomplishments, and losses and thus the full range of emotional meanings that accompany that history. As with the mystery of dreams, the aim of psychoanalysis is not to overcome emotions and their disruptive effect, as if that too were possible, but to know better how to live with them, indeed how to utilize the emotion that is an irreducible presence in this act of knowing, a know-how of desire.

A third dimension of this know-how is that it is a knowing based upon an irreducible alterity, an otherness, in the subject of knowledge, that is, in the one who knows. Knowing is no longer viewed as the act of a solitary self-contained thinker but rather of a divided subject always engaged in an expressive encounter with an other. An other who may indeed at times be represented by another person, but may also be imagined or indeed be an implicit presence. It is always in relation to an other that all such psychoanalytic knowing comes into being. Alterity is an inherent condition of speech and language: if one speaks, it is to an other. And if one speaks, it is thanks to language and the cultural history inscribed therein. Psychoanalysis, the talking cure, is based upon the speech act as a vehicle for knowing and language as context of being.

The relational character of psychoanalytic knowing is therefore determined in part by the fact that speech is its method. It is also predicated on the inevitable difference and dependence that arises in the relation between speaker and listener, a difference that is not erased by the occasional replies and interpretative responses of the listener. There is dependence because a speaker depends upon a listener and in this relationship all of the prior experiences of support and nurturance are evoked, and because both speaker and listener are dependent upon a social and cultural framework for their encounter in language.

Otherness in the self, as it were, as a fundamental feature of this new way of knowing is no more overcome through psychoanalysis than are gaps in conscious thought or the irreducible presence of emotion in knowing. The aim of psychoanalysis is to better get along with this otherness, not to eliminate it. The relational dyad of the psychoanalytic setting allows for the possibility of a sustained encounter with this alterity, but it does not dissolve it in an experience of union, a know-how of the other.

In the encounter with difference in the act of speaking, affect and desire inevitably arise. One’s fears and angst, gratifications and disappointments make themselves known. Likewise one soon discovers that the alterity in knowing is also predicated on the lapses and surprises that occur in coming to see that one can never fully know what one is saying. In other words, all three of the fundamental features of psychoanalytic know-how appear together: the unknown as the gaps in conscious thought, affect and emotion, and the otherness at the core of the knowing subject. Taken together, these principles underlie the other way of knowing that is at the heart of psychoanalytic work.

It is not simply that one comes to know things that one didn’t know before. Although that might be the case, as there is often some salutary gain in substantive self-knowledge in psychoanalysis, a far more important effect is that there is a change in what it means to know, in the experience of knowing, and this new way of knowing is discovered in relation to knowing oneself. Because psychoanalysis involves a new way of knowing, linking the ancient credo “know thyself” to the psychoanalytic endeavor is far more complex than it may first appear to be. One does not come to know oneself substantively but rather tacitly. Tacit knowing is revealed by its effects rather than by its articulated content (Polanyi,1958). In coming to tacitly know oneself in new ways, one encounters another self, as it were, that lives in a different place from the one where it seemed to be.

Coming to appreciate this way of knowing is not only the benefit of treatment but also the path to becoming a psychoanalyst. This is why the fundamental process of psychoanalytic transmission is through a personal analysis. Aside from notions of apprenticeship, of the reduction of one’s personal neurotic symptoms, of a more successful social adaptation, it is really the profound experience with this other way of knowing that makes it possible to subsequently support another person’s encounter with that event. It is the facility with this new way of knowing that makes one a psychoanalyst.

The occasion for these remarks is the persistent question about the relationship between psychoanalysis as a discipline and the other disciplines in the human, social, clinical, and natural sciences. In order for psychoanalysis to stand as a separate and independent discipline, the conditions of its disciplinary integrity and authority should be clearly delineated. The question is not only what makes it an independent discipline but also what supports its claims to validity.

One way to address this question is to look at the relationship between psychoanalysis and other disciplines. Joseph Masling’s review of Robert Holt’s work, Ben Kafka’s piece on psychoanalysis and history, and Olga Pugachevsky’s on translation and interpretation, all in this issue of D/R, are instances of this endeavor, which will be an ongoing theme of this review in issues to come.

Psychoanalysis has discovered and refined a unique way of knowing through the study of and reflection upon what takes place in the clinical psychoanalytic encounter. There is no reason why other disciplines cannot make use of this discovery, and indeed many have. Nor is there any reason why psychoanalysts cannot press into service notions that have been developed in other disciplines as a way to better understand the discovery of a unique know-how that defines our field. However, the authority of that discovery, and the principles of its validity based upon the case literature, the collective experience of supervision, case conferences, and the personal observations of generations of analysts, should not be viewed as a weak idea in critical need of support from behavioral research or neurological science. It has shown itself to be a profound and enduring discovery, one that has had a significant impact on our intellectual and cultural history, and the conditions for its discovery and refinement should be respected as reliable methods of research in their own right. Psychoanalytic knowhow should not be dismissed as intuition or a vaguely defined clinical judgment. It is a definable and replicable way of knowing with profound implications for clinical psychotherapy.

Since there is a particular character to psychoanalytic know-how, then the conditions for scientific validity claims such as replicability (or falsifiability) by an objective observer or demonstrable measures of clinical outcome must be sufficiently developed to reflect the conditions that prevail in this distinct domain. To be effective methods for psychoanalytic research, they must be able to capture what is distinct and fundamental to the action of psychoanalysis. This is the project of adequately defining what can be valid and reliable methods of psychoanalytic research, methods that while acceptable to a broadly defined scientific view of knowing are at the same time cognizant of the specificity of psychoanalytic knowing. The effective bridges between these two epistemological perspectives have not yet been completed.

In the meantime, institutional and academic pressures as well as the social and political conditions affecting clinical mental health services should not be used to justify a dilution of psychoanalytic principles. There is no victory in having psychoanalysis survive at the expense of its fundamental contributions to knowledge.

References

Polanyi, M. (1958). Personal Knowledge. London: Routledge & Kegan Paul, Ltd.