Contemporary Psychodynamic Theory & Practice: Toward a Critical Pluralism (Book Review)

Author:  Borden, William
Publisher:  Lyceum Books
Reviewed By:  Morris N. Eagle, PhD, Fall 2008, XXVIII, No. 4, pp. 58-59

I begin this review with a piece of self-disclosure. Because I have been working on a book that also deals with contemporary psychoanalytic theories, I thought it might be useful for me to review a book on Contemporary Psychodynamic Theory and Practice. However, it soon became clear that the author, William Borden, and I had very different projects in mind.

Borden’s book is a primer, directed primarily to social workers as well as other mental health professionals and “seeks to deepen readers’ understanding of psychoanalytic thought in contemporary psychoanalysis and to demonstrate the relevance of relational perspectives and recent developments in psychodynamic studies for psychosocial interventions” (p. xii). The book covers in 13 chapters of 167 pages of text the work of Freud, Adler, Jung, Ferenczi, Suttie, Klein, Fairbairn, Winnicott, Bowlby, Sullivan, Kohut, and the relational paradigm (mainly the work of Mitchell). Quite a feat! Given the sheer amount of material covered in a modest sized volume, for the most part, the author does an excellent job in providing the reader with a clear and intelligent summary of complex ideas. He does an especially good job on the ideas of Winnicott and Suttie. For those who want to get a broad introduction to some central psychoanalytic ideas and who do not want to grapple with the extensive, complex, and variegated primary sources, this book will serve them well.

The author also manages in this slim volume to present not only a summary of others’ ideas, but also something of his own point of view. He is clearly sympathetic to a “relational paradigm” and adopts a perspective that he labels “critical pluralism.” More about that later.

I could end the review here by simply recommending this book as an excellent choice for an undergraduate and early graduate survey course on basic psychoanalytic ideas. However, I have some concerns about some aspects of the content of the book that go beyond a summary of the work of various theorists.

According to Borden, because “much of Freud’s work is flawed and out of date” and because “very little of what Freud understood as psychoanalysis has remained intact,” critics of psychoanalysis “remain behind the times” (p. xii). I must confess that I always react negatively to this familiar defense of psychoanalysis because it suggests that if critics were aware of contemporary psychoanalytic formulations, they would learn that their criticisms have been adequately addressed or no longer apply. However, if this kind of defense of psychoanalysis is to be taken seriously, one is obligated to a) identify just which aspects of and in which ways Freud’s work is flawed and out of date; b) describe the nature of the criticisms directed to Freudian theory; and c) most important, delineate precisely how contemporary psychoanalytic theories address (and overcome or ameliorate) these criticisms. The author does not tackle any of these tasks.

After telling the reader that “much of Freud’s work is flawed and that “very little of what Freud understood as psychoanalysis has remained intact,” one is then also told some twenty odd pages later that “empirical study in the behavioral and social sciences increasingly provides support for a series of core propositions that Freud advanced in his theoretical systems, including assumptions about the nature of unconscious motivational, affective, and cognitive processes; defensive strategies and self-deception; the origins of personality and social dispositions in childhood; developmental dynamics; and the nature of “psychic reality” and subjectivity” (p. 24). This seems like an awful lot that has remained intact. How does one reconcile these very disparate assessments of the standing of Freud’s ideas?

In citing Greenberg and Mitchell’s (1983) distinction between a drive paradigm and a relational paradigm approvingly, the author contrasts a perspective “which takes relational elements, rather than (my emphasis) biological drives, as the core constituents of human experience” (p. 2). Although I understand the distinction drawn, it would be useful to be reminded that if we have learned anything about human nature, we have learned that “relational elements” are as biologically rooted (e.g., the attachment system) as sexual and aggressive drives.

In adopting James’ pragmatism, the author writes that “what matters is what works, and the practitioner determines the validity of theoretical formulations on the basis of their effectiveness in the particular clinical situation”(p. 9). The relationship among validity, veridicality, and effectiveness is complex, as is the question of whether the practitioner can truly determine the validity of theoretical formulations on the basis of their effectiveness in the particular clinical situation. If one is to do justice to these complex issues, one needs to tackle them in a sustained and serious way. But that is not going to happen in a primer. Perhaps, then, one ought to leave these issues alone in this kind of book. And here is one of the problems with the book. So long as it remains a primer, it does an excellent job. When, however, it goes beyond this limit and attempts to deal with more complex issues, given the nature of the book, it cannot help but deal with them in a superficial way.

Before concluding this review, I want to raise what may seem to be a strange question, namely, what do books like this tell us about the state of our field? What I mean by “books like this” are ones that typically devote a chapter each to the “usual suspects”—Freud, Adler, Jung, Sullivan, Klein, and so on, and also include additional theorists who are current at the time the book is published. Books like this have been around for a while. I am reminded of Ruth Munroe’s Schools of Psychoanalysis, a book widely used during my graduate school days and also of Hall & Lindzey's Theories of Personality, a book not limited to, but including different psychoanalytic theories.

As I suggested earlier, books of this kind can be useful for teaching purposes. And, as I also indicated, Borden does an excellent job in providing such a book. But the question I raise is: What is the image of psychoanalysis that emerges from books of this kind? We get a picture of successive charismatic figures, each one proposing a presumably comprehensive theory to replace previous theories, each figure with a loyal band of followers, and each theory associated with its own training institute. The presentation of psychoanalysis as a succession of different and often warring theorists and theories, followers, and institutes may well be historically accurate. But is this the most useful way to present our discipline, particularly, in a book entitled, Contemporary Psychodynamic Theory and Practice? This sort of presentation does not include much of anything about the evidential base for each theory or any systematic evidence on whether it is associated with greater therapeutic effectiveness. Nor is there much discussion of such issues as possible contradictions among theories, different language for similar constructs, possible differential applicability, or areas of possible convergence and integration.

The above state of affairs is frequently hailed as pluralism, in Borden’s case “critical pluralism.” According to his modest and defensible version of critical pluralism,

“we must master multiple theoretical models, therapeutic languages, and methods of intervention, sorting out the strength and limits of various perspectives. In doing so, we locate ourselves in the broader therapeutic landscape and establish a clinical sensibility that is distinctly our own.” (p. 167)

At another point in the book, however, Borden’s “critical pluralism” seems to entail the position, which he attributes to James, that “there are equally valid descriptions of phenomena that contradict each other . . .”(p. 8). It is difficult to believe that this is an accurate attribution. I suspect the author is confusing different or disjunctive descriptions that may be equally valid with contradictory ones that, insofar as they contradict each other, cannot be equally valid. In any case, the question with which I want to end this review is whether the state of affairs described in Borden’s book should be viewed as a happy pluralism—let a thousand flowers bloom—or whether it urgently suggests that it is time for serious attempts at integration, even if partial integration, and for the careful assessment of the array of different psychoanalytic theories in terms of systematic evidence and therapeutic effectiveness.

Morris Eagle

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