Where Do We Look? What Do We Look For? (Book Review)

Book:  With Culture in Mind: Psychoanalytic Stories
Edited by:  Muriel Dimen
Publisher:  Routledge: New York and London
Reviewed By:  Donald Moss, Spring 2012, pp. 196

Muriel Dimen's edited collection, With Culture in Mind: Psychoanalytic Stories, has the direct, straightforward tone we encounter when Studs Terkel gives us access to the lives of workers, only in this case the workers are psychoanalysts. These self-portraits of analysts at work provide a refreshingly clear sense of life on the ground—of what it's like, day after day, to try to affect the minds of complex people, more or less in pain, and more or less like ourselves.

And here with that, I think, runs the book's most important thread line: patients are represented as "more or less like ourselves." Throughout the book, psychoanalytic work is portrayed as a two-person project—each person, deeply embedded in particular histories and cultures, contributing to a relationship that, if properly attended to, will positively transform both of them. Looked at this way, I think we can clearly see what might be meant by the subtitle "stories"—workers' stories, in this case—we, patients and analysts, each working and, as such, linked in that work together.

There is no hint of the practice of psychoanalysis as the practice of white-coated "science." The consulting room is not a laboratory here; it's an intensity site, a work site, each worker aspiring toward improved conditions, laboring at the production of both private and shared "stories."

The stories all present clinical moments in which their authors find a powerful convergence of forces: subjective, interpersonal, cultural, historical—a kind of multidimensional entirety, a dense package of meaning and power whose appearance in the clinical setting seems to allow for a radical psychoanalytic understanding, an understanding thicker and fuller—less susceptible to regressive modes of interpretation—than the kind available through earlier conceptual models.

The stories focus on what can be thought of as the intersection, the point of contact, between the ostensibly private zone of individual mind and the clearly supraindividual zone of history and culture. In this sense, then, the book's theory, politics, and clinical technique are all brought to bear at this well-conceptualized "frontier," one mapped by the book's title, With Culture in Mind.

Of this important frontier, this point of contact, Dimen writes in her introduction, "Subjectivity…comes to us from outside, from the top down, from everywhere and anywhere. And without it we would be nowhere" (p.6). Here, I think, is a central orienting theme of the stories and of the book—subjectivity comes to us from the top down. That orientation, I think, contributes to the sense one has in reading the book that, indeed, analysts and patients are more alike than different, each one's subjectivity "coming to them," so to speak, from "the top."

I think this orientation represents the book's central concern and central claim. In locating the most relevant "frontier" at the interface of inside and out, and in locating the source of subjectivity's determining force at the "top," the book challenges two cardinal tenets of the original Freudian project.

For Freud, the primary frontier, the clinical/theoretical focus of psychoanalysis, was not where culture meets mind but rather where body meets mind. And, following from that, subjectivity would "come to us," not from the top down or from the outside in, but rather from the bottom up, from a deeper interiority to a more superficial one.

The phrase "comes to us," of course, refers to a force, a demand. For Freud, this demand—this "drive"—originated in the body. Meeting the demand constituted the formative, and ongoing, work of mind. This, of course, is the cardinal precept of drive theory.

In Dimen's introduction and in the stories themselves, we sense an inversion of the Freudian picture. Force remains a pertinent term, as does demand. Source changes, though, from a primary interiority in the body to "everywhere and anywhere." This inversion provides us with a diffuse circumferential notion of source, impinging, determining, and demanding. These stories emerge, then, from within that circumference.

Freudian "stories," if one can imagine such a thing, will emerge from a different point. Not primarily organized around a circumferential notion of force or drive, they will read more like reports than like stories, more like "science" than like "literature." They will offer a strikingly different picture of psychoanalytic work, of what it's like "on the ground." They will read more like experts' reflections, and therefore more like reports from management than like the voices of labor.

Differences between management and labor are dramatic and irreconcilable. So too, I think, are the differences between this book's orientation and a Freudian one.

Some textual examples—there are a multitude of them—might be useful. Jessica Benjamin, framing her discussion as "Facing Reality Together" writes of the "social third," that "we cannot undo its powerful staging effects because they are the very stuff of which our meanings and intentions are made" (p.49). Eyal Rozmarin writes:

If there is any promise in psychoanalysis, it is in our expanding our attention from the alleged inside of the subject, to what happens between subjects, that is, to the relational…We may, in other words, want to consider a more current version of an old psychoanalytic notion, of an unconscious formed, inherited, and shared in a collective" (pp.38–39).

Orna Guralnik writes that "during this otherworldly session, tears roll as we fiercely talk about living among so many injustices and trying to maintain small islands of genuine mutual respect" (p.48). Lines are drawn, differences marked.

Most marked here, I think, is a different way of looking, one that explicitly turns away from its Freudian predecessor's—a psychoanalytic gaze now aimed at and therefore affirming the cardinal importance of the outside, the collective, the violent forces of history that both form and deform analyst and analysand alike.

The difference, I think, is, in fact, a real one. Freudians do indeed continue to look toward "the alleged inside of the subject" (p.38). They do indeed continue to feel that looking toward that "alleged inside" marks a path most likely to lead toward the ongoing "promise in psychoanalysis." I know that I, for one, a Freudian analyst, often work, speak, and write with little or no explicit reference to the determining power of culture. Although, neither for me, nor, I think, for many of my Freudian colleagues, does this absence necessarily indicate a failure to appreciate culture's determining power. What it does indicate, though, is a belief in the effectiveness of direct work on the internal precipitates—the idiosyncratic images and fantasies—of our patients' formative encounters—frontier encounters, that is—an internal frontier where mind makes contact with a demanding body, and an external frontier where mind makes contact with a demanding culture.

And with that, I think, we can sense, in spite of difference, a point of convergence between these authors and their Freudian counterparts. The convergence appears in the notion of "promise." Like relational psychoanalysis, Freudian psychoanalysis—Freudian "stories"—is premised on the idea of an enormous gap between human possibility and the actual immediate human condition, the condition, that is, that an analyst confronts when a person presents him- or herself for treatment. To a one, I think, psychoanalysts work at both exposing this gap and diminishing it. Freudians, I think, look toward the "alleged inside" in order to find, expose, and diminish the influence of the imaginary yet still effective incarnations of gratuitous brute forces responsible for restricting possibility. Dimen and the galvanized workers whose reports appear here as "stories" certainly look elsewhere, but, like Freudians, they too aim, I think, at finding, exposing, and diminishing the influence of restrictive, gratuitous brute force.

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