The Analyst's Analyst Within (Book Review)

Author:  Tessman, Lora Heims
Publisher: Hillsdale, NJ
Reviewed By: Howard Covitz, Summer 2004, pp. 77-80

Thirty years ago when I came to training in psychoanalysis, the mainstream had already broadened to include the likes of Anna Freud and Margaret Mahler. The 1970’s, however, was not the decade in which American psychoanalysis would open its doors. Theoretically, the judges were still out on inter alia: the object relationists (e.g., Middle School folk); feminist thinkers (assuredly those who rejected that penis envy was caput nili for neuroses in women); and those who viewed the vicissitudes of the drive for attachment (Bowlby, Ainsworth, etc.) as central to understanding both human emotional pain and the processes for resolving such pain. In addition, the American Psychoanalytic institutes were officially closed to a sizable percentage of those analysts whose ilk now add to their pools of candidates and faculty. And finally, the Training Analyst system in both IPA institutes and those that existed independently was unshakable. Whether these analysts were “reporting” (i.e., could influence the candidate’s training) or “non reporting,” their authority in their respective institutes was unquestionable—their hegemony more or less complete.

Such were the conditions under which many of us, still practicing today, trained. It may be argued, furthermore, that these three exclusionary practices (exclusion by theory, by membership, and by the narrow locus of decision making authority) could only be perpetuated if there was indeed a vehicle that carried these practices seamlessly from one generation of power-brokers to the next, at both a local society level and beyond. While it is difficult to isolate the dynamics that perpetuated this system, one significant constituent-part for such a carrier-of-the-culture may well have been the Training Analyst system, itself. I suspect that many of the readers of this review recall choosing their training analysts, at least in part, due to the perceived political clout which they wielded in their community—the imprimatur of the chosen one. However chosen, the imprinting of the hand and mind of the training analyst, beyond the therapeutic benefits that may have accrued from this experience, remained and remains upon us as certainly as do the influences of parents from decades past. For some, like Thomas Szasz (1965, p. 118) the impact of the training analysis was “like a fetus deformed by a field of heavy ionizing radiation;” for me it was, indeed, different. When occasionally, I find that I have just wished a patient good-bye with my training analyst’s robustly-spoken “good-days,” I feel comforted and my harmless identification with him reminds me of what must be far more profound inheritances that remain some 18 years after his death and nearly 30 years after finishing our work, together. I find no inclination to ignore the homologies in our attitudes (my analyst’s and my own) towards the fee, towards affiliation with the institute at which we both taught, and much more. How could it be otherwise but that we are impacted by these experiences on the couch that move us to become who we are behind it?

In a successful effort designed to describe this experience of The Analyst’s Analyst Within, Lora Heims Tessman interviewed some 3 dozen analysts from the Boston Psychoanalytic. “Selections were based on the intent to represent the range of decades, the four possible gender combinations, and the inclusion of both training and non-training analysts” (p. 323). Their analyses had been carried out between 1945 and 1995 (roughly half before 1975 and half since) with 22 men and 13 women chosen to fill the sample. “Of the 34 Participants, 28 compared their experience with two or more analysts, whereas in six instances ... two Participants had shared an analyst” (ibid.). While quantitative statistics are presented to describe the sample and review of quantitative literature is distributed throughout, this is a qualitative research study, a method which was well-chosen to the task of understanding such complex interactions as those that obtain within the analyst-analysand field of interaction. And while her conclusions are consistent with those of Curtis’ (Curtis et al., 2004) more quantitative study at William Alanson White and the Oslo Institutt for Psykoterapi of “What 75 psychoanalysts found helpful and hurtful in their own analyses,” Tessman’s study, by presenting verbatim vignettes from
her interviews, offers depth and perspective to the conclusion that both draw: broadly speaking, the relationship—its genuine aspects—are central to the training analysand’s experience of success or failure, of what was helpful or hurtful in their treatments.

Tessman evaluated more than a dozen constituent parts of the analytic endeavor, including the gendering of the analytic couple, how the analysis intercalated with training issues and theories of technique, the manner in which termination was planned and executed and the memories of the analyst. With each such variable, Tessman gave selections from the interviews dividing up respondents into those who were deeply satisfied, those who were moderately satisfied and those who were dissatisfied with their experiences. Care was taken to sculpt the sample so as to provide examples of multiple analysands with the same analyst and individual analysands with multiple analysts. It should be noted that this study was not designed to determine how successful analyses were in resolving neurotic or character pathology but stayed within its defined boundaries of evaluating how satisfying these treatments were to each analysand and how the legacy of the analyst or analysis was apparent to each analysand at this point post-termination.

As noted, this is a qualitative study and little gain would accrue from reviewing a portion of the hundreds of vignettes that Tessman chose for inclusion in this work; the richness of a qualitative study does not lend itself to redaction. Suffice it to say, that the memories thus offered-up — and this was so whether the analysis in question was deemed deeply satisfying, moderately satisfying, or dissatisfying—by Tessman’s vignettes present a portrait of analysands and analysts as quintessentially human. No excuses are made. No whitewashing is attempted. Indeed, as I listened to the accounts of the good, the so-so and the “oh, my Gods,” I came to think of “The Analyst’s Analyst Within” as an Old Testament version of who analysts are. Like the patriarchs, one Abraham (actually, it was a female analyst) might lie about who made the stink in the office or demand compliance on some altar of theory, an envious Sarah might try to discourage mastery and competition (actually, it was a male analyst that comes to mind) and others might show genuine caring and empathy, recognition of similarity and love beyond the requisites of any cool surgical model of treatment (like a forgiving older Esau bringing brother Jacob out of his fear of filial retaliation), This study demonstrates the essential humanity of the analytic endeavor. Of the 64 (training and non-training) analyses that were brought to the interviews, 39% of analysands were deeply satisfied with their experience, 39% moderately satisfied, and 22% were frankly dissatisfied. I will, instead of detailing the accounts of the Participants, turn to Dr. Tessman’s conclusions with a call and a recommendation to all who are interested in the history of psychoanalysis and their own very personal history in psychoanalysis (inter alia Adlerians, Freudians, Jungians, Object Relationists, Relational Analysts, Self Psychologists) to visit Tessman’s work.

Tessman is throughout modest in drawing conclusions but towards the close of the volume does offer up her views of the analytic dyad and how they changed during her study; several of these conclusions shall be noted along with some brief comments.Throughout the work, there may be heard a resounding message spoken by the Participants and echoed in Tessman’s voice that the actuality of the analyst matters deeply in whether the analysis was to later be viewed as deeply satisfying, moderately so, or dissatisfying:

Such differences included the Participants’ experience of freedom, within the analysis, to love and to hate, to be authentically themselves rather than automatically adaptive, to feel understood rather than unseen for who they were, to feel cared about, even loved, rather than shamed or unworthy of wanting to have some personal significance to the analyst. (p.307)

And while, as Tessman notes, this already appears in the literature as early as Fenichel’s little book on Technique (1941), anecdotal evidence and the 22% of Tessman’s Participants who were dissatisfied testify to the likelihood that at least some training analysts are further from this caring stance and closer to Chargaff’s (1977) portrait of the university committee chair who, akin to a minotaur, survives off the blood of the doctoral candidate!

This need for a genuinely caring relationship having been recognized, it is perhaps expectable that Tessman would seek to depathologize the wish for continued post-termination contact between analyst and analysand. If there is indeed a beyond-the-transference relationship that exists between these two subjects, post-termination contact ought not be cavalierly confounded with concerns over whether the analysis was complete or not. She notes: “The more satisfying the analysis had been, the more likely that the analyst’s inner presence remains vivid. Post-termination contact accrues positive or negative meaning as it further elaborates the image of the analyst ... It seems important to revise the prevailing bias that if the analysand continues to desire some kind of connection with the analyst, post-termination, that it signifies an incompleteness in the analysis or a failing in the analysand” (p.318).

While Tessman does not speculate about the sources for this “prevailing bias” (above), it is tempting to fascinate about whether it mirrors other biases, the one that privileges the burial of taboo sexual-oedipal urges over what many may view as a pressing and requisite need to maintain the strivings of the sacred dyad (e.g., Loewald, 1979) or some trenchant cultural trend in the direction of schizoid withdrawal. On a personal note, I feel blessed to have spent some five years sitting with my ex-training analyst and discussing our difficult cases on a bi-weekly basis before his death (though I have not yet rendered this a tradition by doing the same with my own analysands). He and I disagreed on much. He was still suspicious of the ego psychologists and I had begun speaking of a relational underbelly to the oedipal. I and a number of his other students and analysands helped posthumously publish his last words, much as he had uniformly encouraged me to publish my perfidies and take my “comeuppance like a man.” Psychoanalysis was—I dare to speak for him as well as myself—a set of profoundly human experiences that exist somewhere beyond differentiation and along the vital and winding road to emotional object constancy!

Tessman does note discrepant levels of satisfaction with different gender combinations and with the different decades during which the analyses were carried out. Such group statistics are of dubious value and Tessman maintains an appropriately skeptical view of them. Still, it may well be of future interest to researchers that while the ratio of deeply satisfied to dissatisfied was nearly 10:1 in the 1985-1995 cohort of Participants (67% were deeply satisfied while 7% were dissatisfied), in the 1965-1975 cohort the ratio was nearly 5:1 in the opposite direction (59% of the Participants were dissatisfied with 12% expressing deep satisfaction). Analysands with different gendered analysts expressed deep satisfaction approximately 50% more often than with same gendered analysts. As to the decade-dependent statistics, one can but fascinate about whether the social upheaval in the late Sixties in the United States or the first signs of a weakening of the unilateral authority of an ego psychological point of view or some other dynamic might be implicated in this statistic. Such descriptive statistics as Tessman presents are fascinating but without more studied researches cannot be interpreted.

Finally, Tessman presents what she thinks of as a surprise result: “One of the unexpected signifiers of satisfying analyses turned out to be the Participant’s experience of the analyst as a ‘complete other,’ a person in his or her own right, with a good life of his own” (p.313). Tessman notes that this acceptance of the otherness of the analyst was particularly surprising “for we have only fairly recently moved in the direction of acknowledging the power of empathic attunement, of ‘moments of meeting’ emotionally to amplify the possibilities of a shared and cared about psychic reality between analysand and analyst.” Tessman goes on to suggest (p. 313) that the views of these Participants, in this manner, runs counter to “Bion’s (1967) advice to the analyst to ‘banish memory and desire.’”

For those of us who have come to accept that (e.g., Covitz, 1997 p. 340) “emotional well-being or health are measured in one’s capacity to relate intersubjectively” such results are hardly surprising. Herein, intersubjectivity refers to accepting the otherness of others, i.e., embracing their subjectivity, their inner worlds and their relationships to still others. Wasn’t this, after all, at the core of the toddler’s dilemma: to accept or rather to recoil from the acceptance that mother and father had a right to a relationship with each other beyond their responsibility to raise and nurture their young OEdipus. Some years later (Covitz, 2002):

I came to recast, as well, my understanding of the curative factors in psychoanalytic treatment. No more was it specifically either where Unconscious was let there be Conscious or where Es-It-Id was let there be Ich-I-Ego! Instead, I saw the treatment process as one in which two protagonists—one locked into relating unwittingly on the basis of their relational history and another equally locked into both relational history and theoretical specificity—came to slowly abandon these self-referenced pinions and to work to cherish each others’ inner worlds and to accept each other as unique others, as subjects, each in their own right.

With such assumptions, if one such as I were to be surprised by the response of Tessman’s participants, it would be more in the spirit of being pleasantly surprised. If health, indeed, is correlated with such experiences of intersubjectivity that transcend the need to recoil from a recognition of other subjects with the introduction of (either alloplastic or autoplastic) symptoms, the awareness of such correlations in analysands did not begin when theory changed. And as to the matter of Bion’s proscription against memory and desire (above), I would suggest, contrary to Tessman’s view, that Bion’s call for the temporary banishment of memory and desire (propensities intrinsic to the monad) lead canonically to transcendent intersubjective moments.

Throughout the work, Tessman is consistent in placing high value on the types of variables that are generally connected with relational paradigms. Such characteristics of the analyst as genuineness and a sense of caring for the other are, in Tessman’s writing, inseparable from the potential for a sanguine analytic dyad. Still, on the matter of self-analysis, Tessman (p. 258ff) would appear to continue to view the analytic introject in terms of its functional aspects in the comfort and ability to render appropriate understanding to the analysand’s post-analytic psychic productions.

I suspect Tessman would agree that what is optimally introjected has more to do with the style of this analysis than with its correctness or completeness. This would presumably relate to the manner in which “the I relates to the Me” and parri passu how the earlier analytic dyad serves as a template for the manner in which “The I relates to The Other.” In cases in which Tessman reports that the analysand retained an unsatisfying sense of the analyst/analysis it would appear that the remembered and oft-continued suffering had less to do with a failure to communicate correctly or completely as it did with the sense that these interventions failed from an intersubjective point of view, one in which the analyst failed to view the other, their analysand, as a subject in their own right.

A colleague recently confided that in his training analysis some 33 years ago, while the analyst was quite willing to offer suggestions about what his analysand’s wife might do or with this or that Œdipal or preŒdipal matter, he consistently failed to intrude on self-destructive behaviors in the analysand, himself. “Why,” he wondered sadly after these many years, “hadn’t a single good word been so-offered.” And in a public setting some years before his death, Spurgeon English complained about his training analysis with Willhelm Reich—not mind you about the incorrectness of this or that interpretation but on why Reich never hinted at the fact that they shared a love of music. Here, I agree with Tessman and the empirical studies that she presents, that mourning in the post-analytic period is most often not for the good-enough analyst who is no longer consistently available but relates to memories of the withdrawn analyst, the one who could not tolerate the quintessential humanness of the psychoanalytic endeavor. If self-analysis is to be helpful, it has, perchance, more to do with the manner in which the I and the Me have come to relate to each other intersubjectively.

I leave Tessman’s work thankful for much. She has established a path and research agenda for further investigating the curative factors in psychoanalysis with training analyses serving as a model for clinical analyses. She has done so in a welcoming manner that invites the psychoanalytic reader back into his or her journeyman days. And, finally, as I close by returning to my opening comments, Tessman has quietly cracked another window, one which lets fresh air inside and into the history of the first very schismatic and exclusionary century of the psychoanalytic movement by examining the vehicle by which the psychoanalytic method and ethos are carried forth into the future.

References

Chargaff, E. ( 1977). Voices in the labyrinth. New York: Seabury Press,
Covitz, H. (1997). Œdipal paradigms in collision: a centennial emendation of a piece of freudian canon. New York: Peter Lang Publishers.
Covitz, H. (2002) If there were no Œdipus, someone would have to invent one: report on a personal journey. Presentation to Philadelphia Society of Psychoanalytic Psychologists, 5 May 2002.
Curtis, R., Field, C., Knaan-Kostman, I., & Mannix, K. (2004) What 75 psychoanalysts found helpful and hurtful in their own analyses. Psychoanalytic Psychology, 21, 183-202.
Fenichel, O. (1941). Problems of psychoanalytic technique. New York: The Psychoanalytic Quarterly.
Loewald, H. (1979). The waning of the Oedipus complex. Journal of the American Psychoanalytic Association, 27, 751-775.
Szasz, T. (1965). The ethics of psychoanalysis. New York: Basic Books.

Reviewer Note

Howard H. Covitz is a clinical psychologist in private analytic practice in Melrose Park, PA. He was for many years on the faculty and Director (1986-1998) of the Institute for Psychoanalytic Psychotherapies and is visiting faculty at Temple University. His book, Œdipal Paradigms in Collision, was nominated for the Gradiva Book of the Year Award 1998.

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