Approaching Psychoanalysis: An Introductory Course (Book Review)

Author:  Smith, David L.
Publisher:  London: Karnac Books, 1999
Reviewed By:  Gemma Ainslie, Winter 2001, pp. 30-31

In Approaching Psychoanalysis: An Introductory Course, David L. Smith exceeds his goal of writing “an accessible, non-doctrinaire, critical textbook...to capture the dialectic of the development of psychoanalysis.” His book offers a perspective on how history - both within and outside of our field - is woven into theory, elucidating parallels as well as the more commonly noted differences in the field within the United States and abroad. Perhaps most worthy of appreciation is Smith’s style: at times he employs a free and playful quality - especially in the metaphors he chooses and the quotes from many disciplines with which he introduces each chapter, moving this “introductory course” far from the arid chronicling to which other endeavors of this nature fall prey.

Dividing his work into two parts - The Work of Sigmund Freud and Psychoanalysis after Freud - Smith surveys critical nodal points in Freud’s theory formation, including shifts and corrections, and covers six post-Freudian viewpoints. The chapters are well organized and chronologically ordered; comparisons are informative, thoughtful, and clearly delineated, and, with one openly acknowledged exception - his chapter on Robert Langs - non-polemical. Evidenced throughout is Smith’s scholarly commitment to mastering his topic as well as his capacity to engage himself and the reader in appreciation of the people whose work and quirks provide the rich chorus of voices that all practicing psychoanalysts must hear in the back of our minds as we listen to our patients’ stories.

In the eight chapters devoted to the work of Sigmund Freud, Smith traces the development of Freud’s thinking from his earliest training through the positing of the structural model. The early chapters in this sequence cover core topics of hysteria, catharsis, and the actual neuroses and psychoneuroses. In general these issues are presented in a way that well-informed lay audiences would find informative, however from the point at which he begins to outline the seduction theory Smith’s work is geared more to the student of psychoanalysis. Nonetheless, it remains a lively exposition, peppered with intelligently chosen and well-developed metaphors, such as those of various kinds of maps, and illustrations, such as his interpretation of one of his own dreams. The centerpiece of Part I of the book in my opinion is the sixth chapter, “Sex from the Inside: Freud’s Theory of Sexuality.” Beginning with the opening quote from Confucius -”By nature, men are nearly alike; by practice, they get to be wide apart.” - Smith offers a fascinating historical overview of nineteenth century beliefs and mores regarding sexual behavior, and contrasts these with medical facts. His review of the psychosexual stages of development and of perversion is also excellent, engaging chief themes in theoretical and political, nature vs. nurture debates regarding feminism and homosexuality. In the last two chapters on Freud’s work, the same clear explanatory style continues and is applied to transference, technique, Freud’s ego psychology, and defenses; best in these chapters are his well-thought out comments on countertransference

The six chapters Smith devotes to post-Freudians are equally engaging. In “Enfant terrible: Wilhelm Reich in Vienna,” Smith offers rich detail regarding Reich’s appreciation of the encompassing quality of sexual engagement, his political activism, and his systemization of theory and technique in the areas of character analysis, analysis of resistance ad negative transference. Having divulged in the Introduction that he has “very strong reservations about her work,” Smith comments with equanimity on Melanie Klein’s contribution, emphasizing her two stage developmental model, splitting, envy, and projective identification, and giving her credit for the notion of the internal world of objects and part objects; indeed I am hard-pressed to see bias in his exposition. With informative and interesting asides into Ferenczi’s work on infantile omnipotence as background, the chapter on Winnicott and the British Independent School discusses central conceptualizations such as primary maternal preoccupation, holding, impingements, illusion, good-enough mothering, transitional objects, imaginative play, and the false self. Smith cogently offers that “Klein and Winnicott occupy extreme positions on a psychoanalytic continuum between emphasis on the environment and emphasis on the internal make-up of the individual when explaining psychopathology” (p.155). Smith’s segue from these chapters into the next is not only apt but also illustrative of the integrative thinking that is evident throughout this book: “The chief architect of the American assimilation of Klein was Otto Kernberg. At about the same time as this, America’s own version of Winnicott appeared. His name was Heinz Kohut” (p. 159).

In “Self and Object in America: the American Object Relations School and Self Psychology” Smith leads with a brief but powerful indictment of the isolationism that marked at least the early history of psychoanalysis in the United States, “[t]he American analysts had successfully defied Freud’s ...edict that the psychoanalytic profession should remain separate from that of medicine” (p161). He moves on to review Hartmann, Jacobson and Mahler, before covering in more detail both Kernberg and Kohut. My strongest differences with Smith relate to his exposition of Mahler’s work on separation-individuation. He strikes me as uncharacteristically concrete in his view that Mahler views separation as “... the process of establishing physical autonomy (acquiring mobility, co-ordination, etc.)” (p. 165-66). Indeed, I am certain that Mahler’s work, while based in infant and toddler observation, is focussed on the child’s internal, psychological development and for Mahler separation, like individuation, is an intrapsychic achievement. Perhaps Smith’s reading of Mahler is filtered through his training in England.

In any case, he returns to a straightforward and sound reading of both Otto Kernberg and Heinz Kohut later in this chapter, crediting to Kernberg our understanding of borderline states, noting Kohut’s oft-cited tendency to “ignore” contribution of others, positing that self psychology is in the end an American phenomenon, and referring briefly to the intersubjective school.

A chapter on the world of Adolf Grunbaum, subtitled “Criticism from the Philosophy of Science,” begins with an overview of logical positivists and logical empiricists, moves through a consideration of Grunbaum’s chief critique - the tally argument, a pragmatic “it’s true if it works” position regarding the efficacy of psychoanalysis and the explanatory power of psychoanalytic theory, and ends by positing that “psychoanalytic claims are more like articles of faith than scientific hypotheses” (p. 186).

Having alerted the reader very early to two major biases in his work - the exclusion of Lacanian psychoanalysis because “I have so little sympathy with the approach that I cannot even criticize it properly” (p. 6). and the positive bias towards Robert Langs’ work, of which he is “an advocate..and therefore I danger of being insufficiently critical” (p. 6) - Smith devotes his last chapter to Langs’s communicative psychoanalysis. In his presentation of Langs’s position, he emphasizes the two forms of verbal communication within an analysis - narrative and non-narrative, and the mutually agreed upon, secured frame, as a basis for the communication of unconscious. Smith also underscores his belief that communicative psychoanalysis offers the possibility for testing psychoanalytic hypotheses. While I agree that Langs’ emphasis is a solid contribution to our clinical understanding of the analytic encounter - one that is consistent with aspects of the interpersonal and relational schools’ understandings - I believe the rule of thumb to listen to what our analysands verbalize after we make an intervention is an old one, albeit perhaps not elaborated to the extent or as intentionally and single-mindedly as Langs’ does.

A book with the far-reaching agenda of Smith’s is in some ways difficult to review. He excluded some of my own analytic icons from his list of very important theorists, and he has both misinterpreted a central feature of Mahler’s work and overemphasized the importance of Langs’ contribution in my opinion. However, Approaching Psychoanalysis remains a very fine book in my estimation, one that would serve very well its intended use as a text for “an introductory course,” and one that is well-written, well-considered, and generally balanced.

In a Coda Smith comments: “During the century of its existence, psychoanalysis has not so much developed as it has expanded...it has given rise to the co-existence of rival schools of thought...However emotionally appealing, such ecumenism breeds intellectual stagnation… If psychoanalysis is to have the future that it deserves, this option of lazy ignorance must not be chosen. We must get down to the task of exploring in earnest the vastness of mental space” (pp.207-08, 210).

I agree. More importantly, I believe David L. Smith’s Approaching Psychoanalysis is a contribution in correction to the first century’s threatened calcification.

Gemma Ainslie is a Member-at-Large of the Division Board, on the faculty of the Houston-Galveston Psychoanalytic Institute, and in private practice in Austin, Texas.

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