Personality and Psychopathology: Critical Dialogues with David Shapiro (Book Review)

Book: Personality and Psychopathology: Critical Dialogues with David Shapiro
Edited by:  Craig Piers
Publisher: Springer, 2010
Reviewed By: Louis Rothschild, Spring 2012, 292 pp.

In dialogue with David Shapiro, Craig Piers has successfully edited a most interesting volume whose focus is Shapiro’s contribution to psychoanalytic psychology. The title of this book is apt. The book is comprised of papers from several scholars who take up the relevance and implications of Shapiro’s work.

Many contributors, including Paul Wachtel and Sidney Blatt, are central to the contemporary endeavor of psychoanalytic psychology, whereas others, such as Louis Sass and Mardi Horowitz, may be considered to have a wider compass that includes phenomenology in literature and psychiatric diagnosis respectively. In addition to such variety, Piers and Shapiro opted for a conversational format that situates the work in a lively manner. This format leads to such knotty problems as self-deception and intentionality being addressed in real time. This is further accomplished by the fact that in addition to responses by Shapiro to each of the twelve focal chapters, nine of the twelve interlocuters afford additional critique via a rejoinder to Shapiro’s response. Such multiplicity affords a chance for the reader to think alongside the book itself.

That such difference, not idolatry, is essential to this endeavor calls to mind the spirit of Bion as described by Grotstein (1987, in Mitchell, 1993). Grotstein writes:

Among many of his followers in Los Angeles, and especially among many analysts all over South America, Bion’s worst fears seem to have been realized: “I was so loaded down with honors that I nearly sank without a trace!” That is, he became “known” and “understood” through his works. His words became litanical on their way to becoming liturgical.

I have long puzzled over his style of presentation. My “understanding” of it began in an analysis with him. On one occasion he gave me a lengthy but cogent interpretation, to which I unsuspectingly answered, “I think I follow you.” His reply was as follows: “Yes, I was afraid of that!” (1987, p.61)

Fortunately the voices found in the volume under review privilege breaking rank over following and disagreement over understanding. Pace Shapiro’s historical connection to the Frankfurt school, such a choice might also be connected to Arendt’s (1958) idea that plurality “is the condition of human action” (p.8). Fortunately, such plurality is balanced by a critical attitude that avoids the danger of rewarding all points of view (Meehl, 1973).

In his autobiographical notes that precede the first chapter, Shapiro writes that prior to beginning work at the Austen Riggs Center in 1952, he had become involved in the student left while an undergraduate at UCLA. He spent 1946 engaged in translation for the Institute for Social Research. Supported by the G. I. Bill, he soon began a career in psychology, where his Marxist orientation sparked an interest in the work of Wilhelm Reich. In this regard, Shapiro writes of Robert Knight (his boss at Riggs) supporting him in his refusal to provide information to FBI agents during the Red Scare. Both the nation and psychoanalysis were different then. Shapiro also writes on the manner in which Hellmuth Kaiser, who had given a talk at Riggs after he left the Menninger Clinic and was establishing a practice in Connecticut, influenced him by a simplicity of style in communicating with patients that in some manner was connected to Kaiser’s having been an early student of Wilhelm Reich.

With the influences of Kaiser as an extension of ego psychology, and his own Marxist leanings, comes a fascinating engagement with the place of autonomy in society that stands in stark contrast to Jacoby’s (1975) observation and critique of much post-Freudian psychoanalysis in the United States: that it had become a handmaiden to a society that is repressing autonomous mind and thought. This distinction on Shapiro’s part is notable and relates to another of Jacoby’s observations: Fenichel’s critique of Ferenczi’s link between money and feces, namely, that Ferenczi was situating a psyche that was ahistorical due to his overlooking the manner by which a particular society shapes drives ( Jacoby, 1975). The link that I wish to emphasize in addition to the relevance of society found in the work of the Frankfurt School is the limit of a drive theory that privileges the past over the present. Here, Shapiro is in good company. Another worthy comparison is with noted ego psychologist Edith Jacobson, who broke with Freud’s dualistic essentialist drive theory that situates all motivation as arising from sexuality and aggression because of its inability to comprehensively take account of the human condition (in Greenberg & Mitchell, 1983). Such identification has led some (Moore, 1999) to consider Shapiro to fit within a constructivist school of thought. The papers found in the volume under review shed additional light on these points, and it is there I now turn.

The lead chapter is fittingly awarded to Herbert Schlesinger, who, when director of the clinical program at the New School for Social Research, invited Shapiro to teach there. Schlesinger had met Kaiser while at Menninger’s, and that each knew Kaiser was interestingly not explicit until the writing of this book. I count myself among the fortunate who shared student life at the New School while Shapiro and Schlesinger were active there. As I write this I can hear Schlesinger’s “Walk around the room in your mind,” Shapiro’s “Come on, think like psychologists.” Each implored us to attend to what was happening in the room in the present. As psychology or psychologies are present—defenses, character(s) whose dynamics are certainly a part of early family dynamics, etc.—but, as Schlesinger and Shapiro point out, are also certainly of a character that has developed over time. Schlesinger makes clear that the idea of a patient repeating something that happened before with a therapist is not news. However, what happens when we consider character to be a composite of many experiences, and repetition to be self-deceptive speech that is a product of the individual’s style?

Paul Wachtel notes that with Shapiro, consciousness may be considered a royal road to the personality. Wachtel considers Shapiro’s emphasis that thought sustains the neurotic process, and compares this attention to persistence, along with Horney’s question as to why some childhood attitudes persist into adulthood. And as Piers comments in a footnote, such persistence may be structured by dynamically reinforcing cycles. Shapiro calls these cycles, attitudes or styles. Following an interpersonal line of thought, Wachtel wonders what happens once character is contextualized. Shapiro makes clear in response to Wachtel that despite agreement on a focus on the here and now, in his opinion, the relational school has overshot the mark.

Following Shapiro’s reference to Piaget’s comment that psychoanalysis was too much a science of the permanent, E. Virginia Demos brings a developmental focus in her argument that threats to coherence may negatively impact one’s trajectory, in a manner consistent with Winnicott’s false self. Discussion of these themes affords Shapiro an opportunity to write on his rejection of the concept of regression, which he counters with the conception of a restricted autonomy due to excessively rule-bound or impressionistic defenses. The debate between them regarding volition in childhood and states of anxiety that include trauma is worthy of attention in its own right, but adequate treatment of this debate goes beyond the scope of this review.

Links can be made between Shapiro’s focus on those who are excessively rule-bound or impressionistic and Sidney Blatt’s anaclitic versus introjective distinction. The common ground and discontinuity between Blatt and Shapiro is found not only in the fourth chapter, but also in an appendix of the book. What Shapiro calls a passive-reactive mode (impressionistic style) is compared to Blatt’s anaclitic, whereas Shapiro’s rigid mode (rule-bound) is compared to Blatt’s introjective. Whereas Blatt maintains that the anaclitic and introjective are exaggerations of the need for relationship and self-definition, Shapiro highlights the manner in which each is an exaggerated mode that diminishes personal agency. The degree and extent to which Shapiro’s rule-bound diverges from Blatt’s self-definition is challenging and central to any adequate psychoanalytic understanding of assertiveness. The two also diverge over what Blatt considers Shapiro’s concern that an etiological focus detracts from phenomenology. Whereas Blatt considers such a focus to enrich the present, Shapiro’s concern is that a focus on historical narrative will occlude the present character that has revived historical modes and given them significance in order to forestall anxiety. He credits Philip Rieff for providing him with the phrase that “oak trees are not acornish.”

The centrality of the concept that rigid defensive styles eclipse personal agency is continued in Shapiro’s discourse with Louis Sass, who considers Shapiro’s conception of agency or intentionality to be the “richest and clearest of which I am aware in clinical psychology or psychiatry” (p.99). However, Sass finds that Shapiro fails to distinguish between distorted and diminished autonomy, and utilizes the case of Antonin Artaud’s uncompromising quality as one example to get at the idea that, in line with Blatt and Freud, autonomy needs to be embedded in an integrated context of dependence. Shapiro in this regard agrees with the view that favors integration, and that Artaud would be a case of impaired autonomy that is characteristic of a rigid character. In contrast to the estrangement found in rigid character structure, Morris Eagle uses the term personal avowal. In a clinical climate in which disavowal is found as consistently as daily bread, to read of avowal is refreshing.

In contrast to Wachtel’s observation that Shapiro’s focus is consciousness, Eagle points out that Shapiro views defenses as something people do, and not as subpersonal mechanisms. In regard to gradations of consciousness, both Eagle and Wachtel find links in Shapiro’s work to Donnel Stern’s (1983) work on unformulated experience, which Eagle also links to Sartre’s bad faith and James’ critique of the unconscious. Shapiro works with Eagle’s idea that intellectual self-knowledge may be considered a form of self-estrangement in a manner that is consistent with Reich’s thesis that insight affords little if no change in structure. This is also consistent with Stern’s (1994) conception of change.

Clinical chapters include specific focus on trauma, addiction, and hypomania. In regard to trauma, Mardi Horowitz addresses the manner in which defense may be both situational and characterological. Like Eagle, Horowitz addresses the distinction between internal conflict and external trauma. In response, Shapiro finds his own method of working, consistent in its ability to address symptoms of trauma. Shapiro makes the point, however, that it is a person not the condition that is being addressed. This stands in stark contrast to the trend of manualized psychotherapy as the therapist engages whatever material is found in the here and now, and this material is unique to each person’s psychology. Mindy Greenstein discusses craving as a conditioned response whose attempt in the case of addiction is to adapt to adverse stimuli. Although drawing from Shapiro’s argument, she illustrates the manner in which intentionality is impaired in an impulsive character in cases of addiction. This is to say that craving is an unrecognized decision to act. Greenstein provides analysis of Thematic Apperception Test data showing that substance abusers are more likely to omit required story elements, thereby supporting the idea that addicts avoid deliberation. Shapiro suggests that this illustrates the self-regulatory nature of neurotic styles, in that becoming more rigid (impulsive in this case) is the reaction to discomfort. Following a theme of rigid impulsivity, Andreas Evdokas and Ali Khadivi examine data of Rorschach tests that were administered in speed-pressure conditions to address what Shapiro’s contribution is to an understanding of hypomania. An interesting link here is that bipolar patients are more likely to use drugs when manic as opposed to depressed. Evdokas and Khadivi find that when self-reflection is experimentally restricted, self-criticism is suspended and the cognitive process is sped up. Here, as in the case of addiction, a deliberately uncritical drivenness is portrayed. While reading these chapters, I was reminded of Ehrenberg’s (1992) argument that the traditional approach is inadequate when treating patients who deny desire and are deliberately uncritical. The argument is that a core experience of deadness motivates a search for aliveness in intense sensation, often found in bizarre behavior such as mania, both as a protest against what may be considered a false compliant self, and an effort to reintegrate a fragmenting world (Stolorow, Atwood, & Orange, 2002). Shapiro’s point is that such understanding need not be reserved for special cases but is applicable to all aspects of psychopathology.

What is similar in method across divergent presentations is the engagement of self-estrangement with the goal of relaxing a rigid character structure. To this end, Michael Schober’s and Peter Glick’s offering on self-deceptive speech is helpful, as it comes from the area of cognitive science called psycholinguistics. Their starting point is Kaiser’s idea that a patient is trying to convince himself of something to counteract an experience of insecurity. One characteristic of such speech is repetition. The other listener (the therapist, for example) may feel irrelevant or as though they are simply a mirror—intently engaged but also irrelevant in regard to differentiation and distinctiveness. The psycholinguistic view sees this as a failure to adjust to the social circumstances of a Wittgensteinian game. One explanation that the authors offer is that trying to convince oneself of something that is not really believed creates a high cognitive load. In addition, Shapiro adds, the speaker is unaware of the active quest for reassurance. Shapiro, like Kaiser before him, is calling attention to the fact that this stress and subsequent estrangement are displayed in session and constitute the central dynamics of character neurosis.

Lawrence Josephs considers the manner in which a listener is feeling irrelevant may not be consistent with projective identification. In addition, he considers if the internally stressful states described above could have an adaptive function. Concealment is thus considered a strategy of tactical deception that prevents the ego from being flooded by anxiety. His argument that a false self may be socially adaptive is critiqued by Shapiro, as Shapiro asks Josephs to consider if such aspects of human cognition might be considered to be related to maladaptive spandrels. This debate gets at qualities central to the place of evolutionary psychology within psychoanalysis. Josephs finds agreement in Shapiro’s critique of the archeological model, whose quest is to unearth “an ‘inner baby’ frozen in time” (p.207). There is ample evidence to suggest that this quest for origins has yet to be fully understood, much less departed from, within psychoanalysis (Brickman, 2003).

That positions from psycholinguistic cognitive science and evolutionary psychology should find themselves shoulder to shoulder with developmental theory and clinical psychology come as no surprise when one considers Craig Piers’s contribution on complex systems theory. Such diversity is a real strength of this book, in that it shows that psychoanalytic psychology does have a significant contribution to make in the realm of cognitive science. For his own part as a contributor, Piers turns to computer models that seek to portray dynamic systems honed by evolution to understand self-organizing differentiated functioning in a fluctuating environment. In his utilization of these models to understand Shapiro’s work, Piers argues that Shapiro’s view of character is nonreductive and self-regulating, and that a goal of therapy is to help a patient notice the manner in which such a system may lead to an active engagement that diminishes agency when rigid.

The importance of this book is highlighted for me as other work (e.g., Medina, 2011) on exaggerated suffering, notable on its own and falling within the spirit of Shapiro’s understanding that mind determines a drive, fails to make note of Shapiro’s contribution. This, I think, is not due to a failure to research the literature on the part of the author, but to the wild and wooly nature of psychoanalytic literature. That some contemporary writers and students of psychoanalysis who would resonate with his work have not been fortunate to discover it more than justifies the publication of this volume, which affords the opportunity for discovery, and, to that end, I highly recommend it.

Arendt, H. (1958). The human condition. Chicago, IL: University of Chicago Press.

Brickman, C. (2003). Aboriginal populations in the mind: Race and primitivity in psychoanalysis. New York, NY: Columbia University Press.

Ehrenberg, D. B. (1992). The intimate edge: Extending the reach of psychoanalytic interaction. New York, NY: W. W. Norton.

Greenberg, J. R., & Mitchell, S. A. (1983). Object relations in psychoanalytic theory. Cambridge, MA: Harvard University Press.

Grotstein, J. (1987). Making the best of a bad deal: A discussion of Boris’s “Bion Revisited.” Contemporary Psychoanalysis, 23(1), 60–76. Jacoby, R. (1975). Social Amnesia: A critique of contemporary psychology from Adler to Laing. Boston, MA: Beacon Press.

Meehl, P. (1973). Why I do not attend case conferences. In Psychodiagnosis: Selected papers (pp. 225–304). New York, NY: W. W. Norton.

Medina, M. (2011). Physical and psychic imprisonment and the curative function of self-cutting. Psychoanalytic Psychology, 28(1), 2–12.

Mitchell, S. A. (1993). Hope and dread in psychoanalysis. New York, NY: Basic Books.

Moore, R. (1999). The creation of reality in psychoanalysis: A view of the contributions of Donald Spence, Roy Schafer, Robert Stolorow, Iriwn Z. Hoffman, and beyond. Hillsdale, NJ: Analytic Press.

Stern, D. B. (1983). Unformulated experience—From familiar chaos to creative disorder. Contemporary Psychoanalysis, 19, 71–99.

Stern, D. B. (1994). Empathy is interpretation (And who ever said it wasn’t?): Commentary on papers by Hayes, Kiersky, and Beebe, and Feiner and Kiersky. Psychoanalytic Dialogues, 4, 441–471.

Stolorow, R. D., Atwood, G. E., & Orange, D. M. (2002). Worlds of experience: Interweaving philosophical and clinical dimensions in psychoanalysis. New York, NY: Basic Books.

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