Psychoanalytic Theories: Perspectives from Developmental Psychopathology (Book Review)

Author:  Fonagy, Peter and Mary Target
Publisher:  New York: Brunner Routlege 2003
Reviewed By:  Johanna Krout Tabin, Spring 2005, p.55

This book reminds me of an old joke. It is the one about blind scholars surrounding an elephant and describing it separately according to the part each one touches. Fonagy and Target count over 400 psychoanalytic theoreticians who tried to describe, define and explain psychoanalytically the intricacies of human personality. In a marvelously organized and conceptualized volume, they selected 27, (six of whom are grouped together): Freud (three stages of theory), Hartmann, Erikson, Spitz, Jacobson, Loewald, Anna Freud, Mahler, Sandler, Green, Klein, Bion, Rosenfeld, Independent British School (Fairbairn, Winnicott, Guntrip, Khan, Bollas, and Klauber), Kohut, Kernberg, Sullivan, Mitchell, Bowlby, Horowitz, Ryle, and themselves. Jung and Adler get short shrift, together, on a single page. Significant among present day theorists is the omission of Beebe and Lachmann, Weiss and Sampson, McWilliams, Auerbach, Donnel Stern, and Stolorow. The authors’ treatment of Lacan is interesting. The say that his ideas are too complicated for this presentation; but they do devote two pages (pp. 16-17) to reasons why feminists considered Lacan helpful for their ideas. Freud might have been tickled at such appreciation of work that was so blatantly phallocentric, but the authors prefer clearly logical explanations.

The mission of this book seems to be to bring a strong logical sense to psychoanalytic thought. They see psychoanalysis as a field in peril. So far, our theoreticians are inspired by anecdotal material, which supports whatever theoretical constructions, they may favor. Fonagy and Target urge starting with clinical data and deducing from these what may be sound theoretical understanding. The problem remains, of course, that investigators, as in the joke, are blinded by their preconceptions when they generalize from the available data. Furthermore, as the authors point out, the nature of clinical data is subjective.

The authors rigorously examine each of the theories they explore, giving the reader a chance to evaluate the strengths and weaknesses of each one. It is noteworthy that they apply the same standards to their own contributions.

This task turns the book into a kind of highly sophisticated Cliff’s Notes, with 75 pages of bibliography. On almost every page, there are at least five references to literature that they refer to in substantiating their statements. The splendid scholarship and historical integration of various developments of thought make it valuable, though hardly a book to read through at a sitting. For every theorist, the table of contents lists not only the chapter number but the sections and page numbers for an overview of the model, its characteristics, relevance to particular diagnostic groups, and criticism and evaluation. These qualities create an ideal source for quickly grasping the contributions of some of the most influential psychoanalytic theorists.

The general tone of the discussions is respectful toward each thinker. It is a quality that makes the sections of criticism palatable. Fonagy and Target earnestly try to extract what is useful from each and to be constructive in underscoring deficiencies, as they see them. One is left with an impression of the difficulty that faces us in truly defending our propositions.

An important section of the book, inserted where they consider their own ideas, is “Psychodynamic clinical practice is not logically deducible from any psychoanalytic clinical theory.” They find the tendency to disguise the “loose coupling of theory to practice by rhetoric is pernicious because it actually closes the door on imaginative clinical exploration, by fostering an illusion of theory-based certainty” (p. 285). This is a theme that they illustrate throughout the text. A second thread that runs through the book is the importance of biological, familial and cultural factors in the formation of personality. In a typical instance, they prepare the reader for a future finding “that factors outside of psychoanalysis may suggest better or complementary ways of understanding the data” (p. 311).

Fonagy and Target do not simply require caution on our part. They outline sensible ways in which we might approach more effective theorizing. Reflecting on the particular strengths of psychoanalytic models, they urge our use of modern data-gathering tools from social and biological science. My favorite of their suggestions is to “unpack overarching concepts such as object relationships” (p. 311), and become specific in our formulations of how effects upon personality may be derived. Their detailing the principles of sound research follow upon an excellent section in which they review significant research to date that tests psychoanalytic beliefs. We psychologist clinicians are in a better position for the work ahead than art lovers who simply know what they like. We may sigh with Fonagy and Target, but we can share their optimism at length over what is possible to learn, to establish firmly the meaning of psychoanalytic understanding.

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