The Other French Psychoanalysis (Book Review)

Author:  Birksted-Breen, Dana, Flanders, Sara and Gibeault, Alain (Editors)
Publisher: Routledge, 2010
Reviewed By: Ruth, Richard, PhD and Kahn, Idith, PsyD, January 2011, pp. 817

I. The fields of psychoanalytic psychology and psychoanalysis are in a period of remarkably vigorous development, change, debate, and ferment. (Welcome, indeed, DIVISION/Review!). Whether or not we personally embrace multi-theoretical models of work, we live knowing there are diverse and divergent psychoanalytic schools. At least from time to time, we become aware that each of these schools is developing new theory and new applications. When we are challenged or stuck, many of us search among conceptual and technical models, wondering what might be most helpful, what might work best.

Our education and training do not necessarily prepare us well for this task. Despite the fact that (or because?) there are more—and more diverse—psychoanalytically oriented training programs than ever before (Downing, 2010), few of us are trained, comprehensively and in depth, in the variety of models of analytically informed clinical work currently being practiced. We have to make our own maps and forge our own, independent ways in our professional lives.

This task takes one set of parameters if we consider only the schools of psychoanalytic thinking predominant in the United States, and a very different one if we take a more global frame. There are schools of thinking—Kleinian and Lacanian, most notably—that have their centers of gravity elsewhere. While we are perhaps more open to their ideas than earlier generations of US psychoanalysts and psychoanalytic psychologists, it is an uneven and unevenly informed openness.

The volume under reverie/review is a useful tool for US psychologists and psychoanalysts eager for a stimulating encounter with the work of our French colleagues. Indeed, this rich and beautifully edited compendium is that, and even more, but with a twist: It is an encyclopedic sourcebook, and tremendously useful summary and synthesis, of the history of psychoanalysis in France, but not the French psychoanalysis most US readers will expect. Produced by two members of the British Psychoanalytical Society and one member of the Paris Psychoanalytical Association, it reviews the seminal, brilliant thinking—much of which will be new to most US readers—of those schools of French psychoanalysis that have remained part of the International Psychoanalytic Association, and not the others. Thus, a Lacanian-free zone.

II. Well, not quite. There is an early paper by Lacan, before he was expelled from the IPA; and one reading of this volume is that many of the writers write in response to Lacan, and to the thinking and work of the Lacanian school. That, in itself, feels remarkably French—a kind of psychoanalytic Salon des Refuses.

In the history of painting, of course, it was the Impressionists whose work was at the core of the famous Salon. But, not so many years later, the revolutionaries became the orthodoxy, and so everything old became new again, literally—the newer figurative painters reacted not only to the Impressionists, but to the earlier court painters as well. So, perhaps, in French psychoanalysis: rebellion and orthodoxy define one another.

Many aspects of the work of the French IPA members represented here will represent radical departures from any US notion of psychoanalytic orthodoxy. In form, many of our French colleagues see their patients three days a week. In technique, they are more likely than analysts in Britain and the US to focus on the role of language in their patients' material—how they represent, as well as how they symbolize—and to maintain a largely silent posture (to their thinking, so as not to interfere with the workings of the patient's unconscious and ego by offering words that could skew the trajectory of the associational flow). They are more likely to maintain active links to academic life—and, thus, to be in active dialogue with natural and social sciences, philosophy, and linguistics—and they are far more present in institutional mental health settings than is common for Anglophone analysts. These differences in approach are discussed in a masterfully and accessibly written introductory chapter, prepared by the British editors.

But the editors take us a step further by linking these changes in technique, setting, and context to more historical and theoretical differences. Psychoanalysis evolved in France through the prism of the almost unfathomable destruction that came in the wake of the First and then the Second World Wars, which both necessitated and resonated with the French desire to develop an independent medical tradition. Later in its development, French psychoanalysis was shaped by its fertile interactions with surrealism, communism, and Catholicism, very different from the history of psychoanalysis in the US. Making the differences more interesting still, the development of Freudian psychoanalysis in France traces a straighter lineage to the Freudian text, and its careful reading and re-reading, than is typically the case in the US, where our understanding of Freud, regardless of our own theoretical leanings, tends to be refracted through the historical influence of ego psychology.

Thus, the inclusion of the early Lacan in the volume is a comfortable inclusion. In Lacan's 1936 discussion of the mirror stage—stunningly erudite, remarkably fresh—he parallels the Kleinian re-positioning of the oedipal phase at a point much earlier in development, and posits that the earliest development of ego—an ego far less wedded to adaptation and mastery than "our" ego—takes place in the toddler's confrontation with its own image. In that confrontation, the image appears organized and whole, and thus radically different from the toddler's much more chaotic subjective lived experience. Much in the cognitive architecture of French psychoanalysis derives from this relocation—a greater concern with the experience of subject and Other (and, thus, of alienation and its vicissitudes) and a corresponding de-emphasis on interpersonal object relations, for example.

The editors' approach to the US and British reader's predictable difficulty taking in and metabolizing such ideas is ingenious. We are asked to read skillfully translated versions of original papers (several appear here for the first time in English), carefully selected to allow us to trace the historical flow and developmental construction of large ideas, with each reading preceded by brief but substantive and contextualizing introductory essays. Where terms are likely to take on a different connotation in their French usage (trauma, for instance, tends to refer here to normal, but intense and extreme, developmental processes), we are supplied useful editorial footnotes and definitions, but we are invited to appreciate how the usage developed by reading directly from the sources.

In this way, the French development of psychoanalysis is recapitulated in the structure as well as the content of the volume—return to the source text, and through its careful reading come to experience and understand the position of the Other. This is not an exercise for the faint-hearted—the volume is both dense and oversized—but the potential rewards are substantial. In taking a closer look at the portions of the book that examine drives and children, we aim to demonstrate.

III. Drives (in French pulsions—more faithful to [also different from] Freud's German Tríebe than the English homonym) are especially important for French psychoanalysts—according to Gibeault, fundamental because of their role in infantile sexuality (p.436). Our French colleagues note a number of contradictions in Freud's theory of drives; central among them, Freud is seen as defining drives at times as biological processes (this, our colleagues argue persuasively, seems to be his main connotative intent when he refers to "instincts") and at other times as metapsychological representations of somatic processes (for instance when he speaks of drives as "represented in the mind by psychical representatives") (Gibeault, p.436).

In French psychoanalytic thinking, this distinction is seen as an essential wellspring of the development of the different psychoanalytic approaches. Kleinian thought is read as emphasizing the biological basis of the drives and as describing a continuous process from drive to object. The metapsychological construction of the drives is seen as lying at the core of the notion of the "topography of the unconscious in terms of representations," viewed as central to Lacanian thinking. Seemingly dissatisfied with both of these framings—finding neither true enough to Freud's more variegated, "both/and" view of the drives—the subsequent theoretical elaborations offered here differ from both Kleinian and Lacanian notions.

Marty and de M'Uzan describe several concepts essential in understanding psychosomatic economics—operational thinking (thought delinked from fantasy but capable of generating action), essential depression (libidinal depletion absent economic function), progressive reorganization (through the experience, seemingly more than the interpretations, of the treatment). These concepts are further illustrated in a case study by Aisenstein of a psychotherapy patient brought back from a "psychosomatic solution." Anzieu describes the nine functions of the "skin ego," to include a negative function: that of self-destruction of the skin and the ego. Green uses the idea of a self-destructive function to discuss the salience of the death drive. Rosenberg undertakes a critical analysis of Freud's erotogenic masochism as the binding of the death drive by the life drive. In debate concerning the death drive, Roussillon suggests adopting a metapsychological view to reconcile those in favor of drive theory with those who favor a theory of object relations. He uses Derrida's idea of différance to describe this movement. Diatkine speaks of Freud's "narcissism of minor differences" and employs this concept to explain the narcissism that compels members of a group to treat members of other groups with excessive violence and sadism.

The problems these thinker-clinicians take up—with depth, elegance, and practicality—will not be unfamiliar to US readers: the patient who is present but absent and difficult to engage; the somatizing patient whose dynamics seem so clear to us and so opaque and static to the sufferer. What differs, and differs radically, is both explanatory architecture and technical approach. The pleasure, then, and the challenge, is reading about familiar terrain defined in an utterly unfamiliar way.

IV. Even as one grows accustomed to the theories, one can rely upon one of the French authors to use concepts that at first feel familiar in novel ways. An example: Lebovici's theory of the development of object relations. He describes four stages.

In the first, a Freudian reading of narcissism introduces a helpless being that has to be cared for. The infant is indiscriminate at this stage. The external world is not yet an object and only serves to meet internal needs. Yet, the environment conditions the infant's responses, when it resonates with an ungratified drive.

In Lebovici's anaclitic stage, the object is not yet recognized; proto-object relations remain, based on need. As Lebovici reads Spitz (and departs from Winnicott), this stage is marked by the infant's smiling-response when the face of the mother is offered to the infant. A bond is then established during nursing and the presentation of the human face. Although the breast is the first object, Lebovici (differing from Klein) contends that it is not the first object perceived. The affect triggered by need is the basis of the organization, which—departing from Klein once again—sets the stage for cognitive processes. The infant gradually begins to integrate perceptions and cognition, "thinking in images" (p.291). This stage is still largely characterized by helplessness, but the infant is now able to organize the object by means of the smiling-response, generating relationships that are transitive, pending the development of language.

The object stage coincides with the maturing infant whose motricity and perceptions have now greatly increased. This is the stage of eight-month anxiety—the infant can recognize mother and distinguish her from displeasure-evoking others. This, Lebovici says, is truly the beginning of an object relationship. Contributing to this development are increases in comprehension, in line with advances in neural-function integration (p.294). The object phase is also the beginning of the formation of the ego and the Anna Freudian defense mechanisms. Lebovici also locates the beginning of fantasy life in this stage. The infant is only now capable of "hallucinating" the object when it is absent.

In the final stage of differentiated object relations, perception and action develop rapidly. In the second year of life, the child is now able to walk, talk, and take hold of objects. The child can communicate and use projective identification or identification with the aggressor/frustrator. "Oedipification" emerges in this stage, for Lebovici, with the triangulation of object relations—different from its earlier location by Klein and its later location by Anna Freud. Toward the end of the second year, the child asserts his autonomy and can say, "I want." "The ego is now fully differentiated from the id—that is, from the ensemble of the drives whose expression it works to control—and from the superego, which acquires its structure through the process of identification that will allow the Oedipal conflict to be overcome (p.296).

Is all this true? We are in France; the criteria for truth are different, in no small part because the legitimacy of a psychoanalytic vantage point seems less questioned, at least in the space for thinking Lebovici and his colleagues claim. The current pressure to seek extra-analytic data and "empirical" study to bolster the experience-nearer truths that emerge from work with patients is off having its lunch at McDonald's and isn't seen at this bistro. Our minds are elsewhere.

V. A rich intellectual encounter resists summarization, invites reflection, and is honored by questions.

Psychoanalysis has a history, neither proud nor innocent, of championing freedom of thought, and expression—sort of. Within our field, in the United States, there are forces that work toward inclusivity, diversity, and open-mindedness, and forces that resist such impulses in our organizational and intellectual life as dangerous to our identity. Most working analysts, complex creatures that we are, have parts of ourselves that feel queasy about this wrinkle in our professional culture—we know, at least, that it is not one of our finer contributions—and, at the same time, are bound up in our histories, experiences, loyalties, and never fully analyzed blind spots

Thus, it is not without some sympathy, but also not without some disquiet, that we observe that the freedom of thought that makes this volume such a generative pleasure stops with a more substantive and direct encounter with Lacanian thinking. There is something to be gained, certainly, by telling a part of a story well; but there is something essential that can become lost—or, more curiously at times, lost in plain sight. The editors argue, with some merit, that their difficulty including Lacanian thinking is that non-IPA French psychoanalysis has become "fragmented" after the death of Lacan. But, at times, this volume has a feel similar to a history of music in the United States that chooses to exclude jazz, the blues, and rock and roll; one hears the other melody, inflection, and rhythm, at points, breaking through, though without the satisfaction of self-determined articulation. At minimum, we hunger for a companion volume that allows the English-speaking analytic reader a similar kind of encyclopedic access to the richness of the development and practice of French Lacanian thought. But even more, our desire is for a reading of the authors included here more grounded in the value of dialog—that is, grounded in dialog not just with Anglophone psychoanalysis, as it is so successfully here, but more directly engaged with Lacanian thinking as well. Perhaps, a tripartite model?

A similar concern extends to the almost global lack of a multicultural perspective in this volume. France is in some ways like the United States—its dominant intellectual currents once conceived of its society as culturally homogeneous; that has never been true, or fair, or a zone of the operation of relatively conflict-free ego; and the notion of cultural homogeneity is less true, and less widely shared, today in France, than ever before. The evolution has been intensely conflictual, but exciting and informative. Again parallel to the psychoanalytic experience in this country, there has been in France a dominant analytic discourse that has turned away from examination of cultural (and class) themes, in part by limiting space for minority voices; and there is a critique and another discourse—in France and the Francophone world, represented prominently by Fanon (in his intellectual origins, a Lacanian) and his intellectual descendants, as well as by voices within the French IPA world.

It is not an easy thing for psychoanalysis, or any intellectual discipline, to turn around this deep vein of our history. But (as the Talmud puts it), while it is not our task to change the world, neither are we free of the responsibility to try. Many would argue that our reading of Freud is enriched, not corrupted, by an appreciation of his (often unconscious and conflictual) struggle with his Jewish identity. Contemporary psychoanalysis in France—in different manners, perhaps, inside and outside the IPA societies and institutes represented here—is, and is becoming, a multicultural, class-conscious psychoanalysis. Some echo of, and, again, dialog with contributions from these emerging perspectives could have found a way into, and enriched, this volume.

Finally, the French analytic world bridges a gap Anglophone analysts have largely failed to bridge, and collaborates actively and fruitfully with the institutional and academic mental health worlds. The editors acknowledge this difference, but more of a sense of how the writers represented here theorize this realm of practice would have been welcome. We struggle in this country, for instance, to understand how our willingness or refusal to accept health insurance reimbursements influences not just our economic viability but the ways in which we conceptualize our work. A deeper understanding of the very different ways our French colleagues have handled an analogous problem would have potential to energize our debate and expand the range of options we can imagine. An unfair request of an 817-ge volume? Perhaps we are all guilty of the temptation to make fruitful analysis interminable. But we can dream, and imagine future dreams worth dreaming.

When important ideas find effective expression, nothing is ever the same again—a touchstone of belief in our work. Thus the pleasure of introducing colleagues to this volume is considerable, a disruptive and impassioned desire.

Downing, D. (2010). Psychoanalytic-friendly universities and programs.

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