Conundrums: A Critique of Contemporary Psychoanalysis (Book Review)

Author:  Mills, Jon
Publisher:  New York and Hove: Routledge, 2011 
Reviewed By:  Jeremy Ridenour, Summer 2012, 260 pp.

Jon Mills’s Conundrums is a stimulating work that will enrage and provoke its readers. I found the text both philosophically satisfying and frustratingly misguided. Conundrums is an internal critique of the various theoretical and methodological weaknesses of the relational school of psychoanalysis, offered by a relational analyst. Mills’s additional training as a philosopher makes his insights poignant and his reasoning clear.

In the first chapter, Mills outlines the basic tenets of relational theory. Relational theorists prioritize relatedness and some (e.g., Mitchell) reject the importance of drive. Mills also describes the implicit intersubjective viewpoint of relational psychoanalysis, a belief that commits relational theorists to emphasize intersubjectivity over subjectivity and objectivity. Moreover, this privileging of relatedness calls into question the importance of the unconscious, considering that relatedness is about the conscious interaction of two or more individuals. This radical change in the conception of the unconscious alters Freudian metapsychology and ultimately leads to the view that psychoanalysis does “not require a dynamic unconscious” (p.13). Finally, the relational school conceives of psychoanalysis as a hermeneutic—a method of interpretation— and not as a proper science. Given that Mill self-identifies as a relational analyst, he is very invested in trying to right some of these theoretical wrongs. According to Mills, the problem underlying all these notions is the indiscriminate embrace of postmodern philosophy, which rejects ontology and epistemological frameworks. Mills critiques relational analysts, such as Mitchell, for uncritically adopting postmodern concepts without fully thinking through the contradictions and incoherence of these philosophical positions.

First, Mills critiques the postmodern fascination with linguistics and the belief that meaning is socially constructed. Although language mediates our experiences, Mills suggests that this view of language and meaning “annul[s] metaphysical assertions to truth, objectivity, free will, and agency, among other universals” (p.31). Stolorow claims that objective reality is unknowable, which, Mills argues, leads to relativism and nihilism. Mills raises a significant concern that relational analysts needlessly generate false dichotomies between fact and fiction, subject and object, drive and object, etc. Second, Mills criticizes relational theorists’ failure to address the self as separate from the intersubjective encounter. The relational focus on the intersubjective matrix reifies it as some independent agent, which Mills critiques as conceptually problematical. Third, relational theorists prioritize dissociation as a model of the mind, which implicitly rejects the dynamic unconscious and redefines the unconscious as that which is nonconscious. Lastly, Mills criticizes the rejection of universalism and essentialism. He argues that this rejection is philosophically contradictory and based on uninformed notions of essentialism. Mills recommends a return to modernist philosophy that can account for particularity and universality.

In the third chapter, Mills deftly critiques the relational school’s unfounded attacks on Freudian technique and theory. Mills finds fault with Greenberg’s rejection of drive theory in toto. Also, Greenberg argues that it is unjustified to assume the existence of any pre-experiential construct, most notably the unconscious. Greenberg commits himself to an empiricist, Lockean view of the mind (that of a blank slate), which is at odds with Freud’s (more Kantian) notion that experience is made possible via intrapsychic structures that mediate experience. Mills suggests that Greenberg cannot argue that the unconscious arises from interpersonal (conscious) experience and simultaneously claim that the unconscious organizes (conscious) experience. Mills goes on to defend Freud’s relational model of the mind from Mitchell’s charge that Freud rejected any role of primary relatedness. In actuality, Freud recognized that drives are always embedded in a relational context, because the subject only satisfies the drive by connecting to an object. Moreover, identification, a foundational concept of classical theory, is an emotional attachment to an important object. Mills offers these ideas (among others) as proof that Freud recognized primary relatedness as an important motivation for human beings. Next, Mills defends classical technique as intersubjective. Freud suggested that sympathetic understanding helps create the conditions that allow the patient to forge an attachment (transference), which is the first goal of psychoanalysis. Moreover, Freud was known to be exquisitely sensitive and kind to his patients. In his most damning critique, Mills takes aim at Stolorow, who lambasts Freudian drive psychology as mechanistic and “dehumanizing” (p.93). To quote this extended passage that nicely summarizes Mills frustration with the relational school’s description of Freud:

When people closely examine the secularity of the relational platform, many take a nihilistic critique of classical psychoanalysis based on misinterpretations (and sometimes blatant distortions) of Freud, omitting what he actually said in mature texts—let alone reading them in German and thus erecting a foundation of theoretical novelty based on straw man arguments. Not only is this not accurate scholarship, but it conditions the next generation of students, mental health professionals, and analysts to erroneously conclude that Freud’s views were fundamentally flawed, antiquated, and reductionistic, without having to bother to read Freud’s text directly to decide for themselves— simply because credible authorities dissuade them from doing so. (p.94)

I could not agree more with Mills and his critique. I especially worry that these types of negative portrayals of Freud discourage aspiring clinicians from engaging many of Freud’s useful insights. According to Mills, these unhelpful caricatures of Freud do nothing but invite schism and create unnecessary division between relational and orthodox analysts.

The following two chapters will likely invite the most criticism. Mills engages in a very personal review of the ugly side of psychoanalytic politics and the technical excesses of some relational analysts. Mills begins the fourth chapter advocating for the relational school’s conception of the analytic encounter as a space that creates the conditions for understanding, recognition, and validation of the patient in a holistic context. Contrary to the orthodox Freudians, who consider the interpretation of conflict as paramount, relational analysts emphasize the lived, present interpersonal experience of the patient and the analyst. Mills summarizes his view of analysis as a place for authentic, honest encounter wherein the analyst models a new mode of being that sets the foundation for a new sense of relatedness for the patient. For Mills, “therapy is about forming and being in a relationship, one that is healthier and more genuine than what patients know only too well in their private lives” (p.102).

What sets the conditions for such a sublime relationship? Is it the analyst’s unique personality traits of openness and courage that creates a radically new relationship experience? I would argue that the patient has the opportunity to forge such a relationship with hundreds of people in his or her life outside of the analytic space. Moreover, these nonanalytic relationships seem to potentially offer an even more robust sense of intimacy because they are not stifled by the artificial framework and boundaries that are an inherent aspect of the analytic relationship. I believe that the effective analyst facilitates and enables the patient to recognize various impediments she or he erects in relationships that prevent such emotional honesty and openness. I remain unconvinced that the analytic relationship is ontologically distinct from all other relationships, in terms of health and authenticity.

Following Lacan, I want to privilege the signifier (the word) over the signified (the meaning) and to offer my critique in the Symbolic register. To put it another way, I want to review what Mills actually says and not engage in some speculation about his motivation or intention (Imaginary register). I will argue that it is imperative for analytic thinkers to remain at the level of theory and technique and to stay away from conjecture about the motivation of the analyst.

Throughout the rest of the chapter, Mills criticizes various relational thinkers for analytic narcissism and ethically questionable countertransference self-disclosures (e.g., sexual fantasies and breaking confidentiality). I believe Mills rightly recommends not burdening the patient with the analyst’s inner conflict; after all, the patient is the one paying for services. Mills especially criticizes Davies for sharing her sexual fantasies about her patient with her patient, and he claims that she has a “penchant for confessing erotic desires to her patient” (p.111). Later on in the chapter, Mills tempers his critique of her by claiming that he’s convinced she’s an excellent analyst because of her spontaneity and honesty. In Chapter 5, Mills cites Davies as someone who has been particularly critical of his work. What is gained from such personal criticism? Who is Mills’s audience? Mills’s intention was to criticize some of the foundations for relational theory and practice, but how is this furthered by such biting personal attacks? If the point of criticism is to recruit others to your position (and to disabuse your opponents of their position), then what is the point of such speculation? Also, I wish we could have a discussion of countertransference disclosures that does not fixate on provocative revelations. Are countertransference disclosures helpful in and of themselves? I would have enjoyed hearing an argument about the judicious use of countertransference self-disclosures, a position that Mills would likely advocate.

Mills’s personal criticism is ruthless, and he offers little support for such strong conclusions. In fact, throughout the rest of the chapter he calls Bion “authoritarian” (p.117), Klein “wild” (p.118), and Lacan’s techniques “perverted” (p.119). How does he arrive at these conclusions? He samples a snippet of a case study to justify his critique of Bion and Klein. His criticism of Lacan is even more unsettling, claiming that Lacan was capricious and that his use of the variable-length session and scansion might have been driven by Lacan’s experience of being prematurely cut off by Ernest Jones during a conference. This is based on nothing but speculation, and I would argue that Mills does his argument a disservice with such flippant dismissals. Lacan’s techniques can be criticized, but would it not be more useful to assume Lacan operated in good faith before offering critique?

In Chapter 5, Mills describes the nastiness of psychoanalytic politics. He criticizes historical infighting between different schools before turning the microscope on relational analysis. I will not summarize the majority of this chapter, as it deals with personal fights between Mills and three prominent relational analysts: Altman, Davies, and Hoffman. The chapter is full of a personal letter, discussions about case conferences, and censorship and bullying that Mills reportedly suffered at the hands of these analysts. In one of the sections, titled “Analysts Behaving Badly,” Mills criticizes major relational analysts for ethically questionable behavior. On the one hand, Mills has the right to defend himself and his position. The reader certainly gets the perspective that Mills has been done a great injustice and that these relational analysts are opportunistic and power hungry. On the other hand, I felt that this chapter was entirely unnecessary. It does not advance his argument, and I worry that the text becomes sidetracked from Mills’s earlier arguments. Certainly, this chapter will infuriate many, and I feel that it weakens the book and will unfortunately distract many readers from Mills’s brilliant critique of relational theory.

Theoretically, Mills justifies airing these public and damning critiques of these analysts by claiming that everything is analyzable, even if it seems to be “politically incorrect” (p.145), and that analysts have an ethical duty to defend psychoanalysis’s public reputation from analysts who act unprofessionally. I disagree. As St. Paul would remind us, “all things are lawful, but not all things are profitable” (1 Corinthians 10:23). While certainly everything is analyzable, I worry that making these personal attacks (regardless of their validity) are nothing but a diversion from real problems in technique and theory. It seems much more persuasive to point out the technical and theoretical problems than to critique these analysts on a personal level for their controversial actions or to question their motivations. Mills raises the questions of why analytic behavior should be a taboo discussion in the literature. He suggests that freedom of speech should trump politics, and that we should be free to write about the personalities of other analysts in the literature. I wish Mills had stayed at the level of the Symbolic and critiqued others based on theory and technique. This chapter is a mass distraction and will undoubtedly incense readers and will do nothing but increase defensiveness and resistance to Mill’s position.

The last two chapters include Mills’s defense of psychoanalysis from its philosophical critics and Mills’s reflections about the philosophical and scientific nature of psychoanalysis. The chapter on the defense of psychoanalysis is significant, and he spends the majority of his time critiquing Grünbaum’s attack on the scientifi c status of psychoanalysis. Mills’s major contention is that Grünbaum’s conception of (natural) science is overly rigid and that psychoanalysis could never meet such standards. Grünbaum believes that science must be based on experimentation, and Mills challenges such a narrow view of science and considers psychoanalysis’s relationship with science and hermeneutics in the final chapter.

In the final chapter, Mills offers his view of the consilience between the competing conceptions of psychoanalysis as either a hermeneutic method or a science. Rather than offering a dialectical synthesis, Mills claims he is “concerned with preserving the two methodologies and modes of discourse that have legitimacy within their own frames of reference and perspective purposes” (p.182). Mills acknowledges the importance of hermeneutic conceptions of psychoanalysis, although he recognizes the conundrums of the hermeneutic circle. Mills reviews various philosophical conceptions of psychoanalysis as a phenomenology, and he offers his own dialectical psychoanalysis, influenced by the philosophies of Hegel and Whitehead. His conception attempts to account for the origin of mind and reality via the unconscious abyss, an organizing principle that drives human behavior. Following Continental philosophy, Mills contends that psychoanalysis is a human science that attempts to account for subjectivity, consensus, and interpersonal interactions when making epistemological statements.

There is much to commend in Conundrums, especially Mills’s clear reasoning, philosophical rigor, and excellent grasp of the literature. Some of his proposals are especially useful, and I believe this text certainly challenges and invites relational analysts to revisit and strengthen their theory. On a deeper level, this is a book about ethics: the ethics of academic scholarship, the ethics of public and personal critique, and the ethics of critique itself.

What is ultimately gained or lost through Mills’s public criticisms of the purported bullying tactics in Chapter 5? He tries to justify his actions by claiming that everything deserves analytic scrutiny; however, I remain unconvinced that this sort of public criticism is beneficial. Psychoanalysts would do themselves a favor if they could focus on the theory and clinical data when dispensing critique (which Mills does greatly, at times), because this personal criticism will do nothing but increase defensiveness, and only further drive a wedge and create division in an already fractured field.

Reviewer Note

Jeremy Ridenour, MPsy, is a graduate student in clinical psychology at George Washington University’s PsyD Program. His professional interests include the intersection of Lacanian psychoanalysis and object relations theory. He also has professional interests in the psychodynamic treatment of psychotic disorders.

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