From Classical to Contemporary Psychoanalysis: A Critique and Integration (Book Review)

Author:  Eagle, Morris N. 
Publisher:  Philadelphia, PA: Routledge, 2011
Reviewed By:  William A. MacGillivray, Fall 2011, 321pp.

Psychoanalysis never lets go: Freud and his (reluctant) followers

Virtually every theoretical difference from Freudian theory since Alfred Adler and Carl Jung, including Fairbairn, Kohut, and relational psychoanalysis takes as its major point of departure the modification of rejection of one or another of these fundamental Freudian ideas (p.3).

This long-awaited text by Dr. Eagle is a masterful summation of Freudian concepts, clearly and succinctly presented. For that alone, this book is a valuable compendium to any reading of Freud, as Eagle discerns the warp and weave of Freud's thinking and brings a conceptual clarity while not overlooking the knotty problems that arise theoretically and clinically in applying Freud's ideas. In the first chapter, Eagle describes how Freud built upon four core principles in his work, and how these principles lay bare the inner logic of Freud's project.

1. the constancy principle,
2. the pathogenic effects of the isolation of mental contents,
3. repression, inner conflict and the dynamic unconscious, and
4. drive theory (p.3).

The constancy principle, or the unpleasure (Unlust) principle as it became, is bedrock to Freud both as a way to tie psychological phenomena to biological and physiochemical processes and also to ultimately link the other three foundational principles into one logical structure. This core assumption is vital to Freud's metapsychology, unifying psyche with soma, reducing all phenomena to the dynamic of the building up and discharge of tension.

Given an assumption that mental life is governed by the constancy principle, Freud was able to construct the etiology of hysteria. Beginning with the assumption that all traumatic experiences cause a build up of affect that typically will be directly expressed, with a resulting discharge of tension. In "normal" situations of trauma, then, the affective "load" dissipates over time. In Freud's evocative phrase, the memory of the trauma enters the "great complex of associations" and gradually diminishes in intensity. Think, for example, of what happens when you narrowly avoid a serious car accident.

In contrast, if the memory of the traumatic event is unacceptable for any reason, the memory is repressed. This is the "seduction hypothesis": a memory of a sexual encounter in childhood is repressed, revived in adolescence, and repressed again, but the affect associated with the trauma continues to seek discharge. Repressed memories cannot enter the "great complex of associations" and, as a result, remain "alive" in the unconscious. This "strangulated affect," according to Freud, is the cause of the hysterical symptom. In addition, repression of traumatic memories, this pathological isolation of mental events, weakens the neurotic, due to both the energy required to repress the memory and contain the affect, but also because the memory and associated forbidden wishes cannot be subjected to reality considerations and become available for emotional growth. Repression, then, is the core of the dynamic unconscious; that is, the memories and associated affects pressing for discharge through symptoms constitute the core of the unconscious.

Finally, we come to the drives, the psychic expression of biological forces operating constantly on the person. The drives, because they are internal in origin, operate with a constant press for satisfaction in a cycle of buildup and release of energy. Although there are a variety of possible drives (and Freud had varying ideas about this), the drives that are subject to depression are uniquely responsible for the dynamic unconscious. Sexual desires, in particular, bring us into conflict with social, cultural, and familial values that result in the repudiation of these impulses. With these four principles, Freud was able to not only build up a view of neurosis, but also account for normal development as well. In other words, repression is more or less successful in most individuals in containing the drive impulses in ways that allow partial satisfaction within the bounds of the reality principle.

Further developments awaited, of course, including abandonment of the seduction hypothesis and role of unconscious anxiety in the development of the symptom. Although never denying the importance of actual seduction, Freud concluded that the crucial element in repression was the fact that the conflict the hysteric faced was primarily inner conflict, that is, conflict between sexual and aggressive urges and societal/cultural/familial prohibitions and barriers.

The second theory of anxiety shifted the locus of the conflict from the system unconscious versus system conscious to the struggle between the ego and the id/superego/reality. However, this did not alter the fundamental position that energy and its vicissitudes determine the formation of the neurotic symptom and provide the mechanism for the cure by undoing the repression and providing a way for the infantile memories/wishes to enter the great complex of associations, coming under the influence of a now more mature ego that can understand the drives and seek adequate substitutions in love and work.

In summary, then, Eagle's point, if I understand it, is that these four principles underlie Freud's thinking regardless of his various shifts and turns over many decades. By tracing these principles through Freud's developing views, Eagle also proposes, as noted above, that challenges to Freudian psychoanalysis is most clearly understood as a challenge to one or more of these four principles.

The next four chapters address conceptions of mind, object relations, psychopathology, and treatment in Freudian theory, followed by four chapters that review how these conceptions are the same or different within contemporary psychoanalysis. Although the boundaries of the conceptions get a little fuzzy at times, Eagle is an excellent guide when the going gets rough. I am going to change the order somewhat and present and contrast the Freudian and contemporary conceptions of object relations, psychopathology, and treatment together, because I think Eagle makes a good case for areas of convergence and integration among theories in these areas. In contrast, I will summarize Freud's conception of mind next and save the contemporary views until later in the review, because Eagle sees the sharpest areas of divergence in the contrasting theories of mind.

Freudian Conception of Mind

One of the salient points Eagle makes is that Freud was primarily interested in developing a theory of mind that was consistent with evolutionary theory and biology, as well as the facts of psychology. "According to Freudian theory, the basic tendency of mind to gratify drives and thereby discharge excitation (i.e., to seek pleasure) initially exists independently of reality considerations, [that is] wishes dominate thinking" (p. 23). Although Freud often uses vivid language and everyday experiences to present his ideas, Eagle firmly insists that Freud's metapsychology is basic to his theorizing. Mind is an "apparatus" in the service of drive gratification." The infant turns from hallucination to action only after determining that the build up of tension from hunger can only be relieved by receiving nourishment. When Freud later comments that hate is older than love, that is what he means. Primary narcissism is abandoned as a strategy as the infant turns to the outside world to obtain the satisfaction it requires: the reality principle in statu nascendi. It is important to take seriously the notion that mind, conscious and unconscious, is determined and subserves biological functioning.

Eagle frequently resorts to the notion of hunger as a drive partly in order to side-step the issue of the status of the sexual and aggressive drives. Indeed, Freud remained remarkably unconcerned about the actual nature of the drives and readily exchanged the contrast between libido and ego drives for the sexual and death drives, without any change in the core assumption that the drives and their intermingling and opposition constituted our existence. In other words, although Freud abandoned the Project for a Scientific Psychology, he never abandoned its core psychobiological assumptions.

Freudian and Contemporary Conceptions of Object Relations

"Freud's theory can be understood as a description of the individual's struggle to reach and relate to the actual object in the real world rather than the fantasied one in an imaginary scenario" (p.61). Eagle outlines the status of objects in Freudian theory, finding that despite positing a "reluctant turn to the object," the infant (and adult) must seek gratification in real relationships and real connections with others in order to survive. Again, Freud's enchanting insistence that "one must love in order not to fall ill" contrasts jarringly with his equivalent statement that "original libidinal cathexis of the ego, is related to the object cathexis much as the body of an ameba is related to the pseudopodia which it puts out." (quoted in Eagle, page 56) Although the infant (and the rest of us) will seek and continue to seek self-gratification through our body and our fantasies, ultimately we must always return to objects, to others, to find real satisfaction.

I think Eagle's chapters on object relations, Freudian and otherwise, are extraordinarily helpful, not only in clarifying the differences between Freud's ideas and Klein's, Bowlby's, Fairbairn's, etc., but in laying bare the central similarities and unresolved tensions that exist in any accounting of object relations. Although there is the salient difference that the Freudian infant only "reluctantly" turns to the object (in contrast to the always already-relating baby of Fairbairn and Winnicott), what is especially important to consider is that neither Freud nor the attachment and object relations theorist can say exactly what is going on: What do babies want? Over the intervening decades, legions of reseachers have poked and prodded them, analyzed micromoments of filmed interactions with caregivers, abandoned and reunited them with parents, and pondered the colored Rorschach of fMRI brain imaging results in an attempt to answer this question.

Freud's narcissistic baby reluctantly seeking food from the mother becomes Fairbairn's joyful object-seeking infant as mediated through Harlow's monkeys. Eagle raises the important question, however, as to if they really are so far off, so determinedly opposed. How different is Bowlby's evolutionary imperative from Freud's biological determinism? Although it is certainly true that Harlow's monkeys sought out the cloth mother who did not provide nourishment as opposed to the wire mother who did, the monkey was still seeking something from the cloth mother, and it wasn't likely an attempt to contemplate the Platonic Ideal Mother. Eagle points out that the tactile comfort that seems to determine the monkey's choice does not exactly demolish Freud's argument, because the monkey is obviously seeking something from the mother; and that something, as later studies have shown, is emotional regulation.

We have progressed far beyond Harlow's rather cruel studies of abandonment and have far greater knowledge of the regulation that goes on between infant and mother from the very beginnings of life. We have far more sophisticated ways of measuring these moment-to-moment regulations (such as the work of Beatrice Beebe), and have certainly expanded our conceptions by including the mother's capacity to also be regulated (or disregulated) by her infant. I was struck by the possibility that Beebe's infant may not be all that different from the Freudian baby, seeking regulation as much as nourishment, with the addition only of the mother's need for regulation (or, more poetically, recognition and mutuality). Eagle concludes that we need objects "in order to be regulated, without them and their regulating function, we become dysregulated and adequate functioning is impaired" (p.163)—in the end, we must love in order not to fall ill.1 Insert Anchor here

Freudian and Contemporary Conceptions of Psychopathology

Certainly a key contrast between Freudian and contemporary conceptions hinges on the question of conflict versus deficit, with modern theories more or less ending up emphasizing the concept of deficit. Eagle states, "Contemporary theories of psychopathology, in one way or another, constitute what may be called environmental failure models" (p. 168,) italics in original). He focuses mainly upon the self-psychology of Kohut, the relational perspective of Mitchell, and the intersubjective position of Stolorow. Eagle draws attention to the problem facing contemporary models that have jettisoned the central roles of drives and inner conflict: how to distinguish a psychoanalytic conception from cognitive theories that posit a similar deficit model origin (e.g., maladaptive self-schemas) for psychopathology. He notes that Kohut and other contemporary theorists have developed alternative ways of conceptualizing the role of the unconscious, psychodynamics, and even conflict, while rejecting more or less in to Freud's formulations. In essence, contemporary theories locate the persistence of maladaptive patterns in the intensity of early relationship patterns, what Fairbairn terms the patient's "obstinate attachment" and Mitchell describes as the "conflictual attachments, to archaic objects." As a result, the "field of battle" that Freud described between the ego struggling against the id and superego is replaced by a new struggle between autonomy and dependence, between separation and intimacy. This new and just as stubborn dynamic conflict replaces the sexual and aggressive drives. As Eagle points out, this shift in focus moves the primary affect state from Oedipal anxiety to guilt from/fear of separation and loss.2 anchor link here

The Freudian child is anxious that his parents will retaliate if he expresses sexual and aggressive strivings. From a contemporary perspective, this child is instead both longing for (and fearful of ) connection and separation. The "relational" child fears not only parental abandonment, but also feels intense guilt over the wish to separate. Obliteration rather than castration awaits the Fairbairnian child. Loss of cohesion is the fate of the Kohutian child. Mitchell's child remains caught between guilt that independence might harm the parent and paralyzing ambivalence over his right to have a life.

One important point Eagle makes, here as elsewhere, is that contemporary perspectives, however much they emphasize differences from Freud's basic conceptions, must find and re-find various ways of accounting for psychopathology. While eschewing the idea of "inner conflict," for example, contemporary theories shift the ground of conflict to the interpersonal, to the moment-to-mo-ment interactions in treatment that reflect either the analysis and's strivings for autonomy or longings for connection, and the various ways that both are undermined in order to safeguard the "archaic objects." While Freud focused on the patient's conflictual wishes and their permutations, Kohut and others have objected that psychopathology is the result of unmet needs.3 Insert Anchor here

The question remains whether the differences so passionately argued are more securely based than Freud's own foundational assumptions.

I have tried to think of it this way. The Freudian child has wishes that necessarily and inevitably conflict, not only with the parents (in all their own pathology) but also with reality broadly considered. Not only will society as a whole seek to curb the child's passions, but the child will also seek to curb its passions in order to be able to seek real gratification in the world. As a result, when the patient says to the Freudian analyst "I want it all," this is seen as part of the human condition. In contrast, the Kohutian child needs empathic mirroring and understanding from his parents and, failing that, seeks false gratification of its needs. As a result, the Kohutian analyst hears the same patient's demands as "break-down products" of the failed provision of needs that must now be met through the analyst's provision of empathic attunement.

Freudian and Contemporary Conceptions of Treatment

It is in the arena of the consulting room that much has been made of the difference between Freud's conception of treatment and contemporary theorists. Eagle insists that certain key concepts of treatment, especially analytic neutrality, have been seriously misunderstood or tendentiously distorted by contemporary theorists, but he also emphasizes that the traditional model of a largely silent analyst relying solely on the interpretation of resistance and defense is based on an accurate understanding of what Freud advised (even if he rarely practiced such restraint). Although Freud acknowledged the importance of the therapeutic relationship (and Ferenczi reproached Freud for failing to account for this importance), the focus of contemporary treatment has shifted from interpretation to engagement and Alexander's "corrective emotional experience" is no longer dreaded as an "unanalyticstance," but instead is seen as a benchmark for what can be accomplished in treatment. As Mitchell famously commented, if we are not doing that, what do we think we are doing?

Eagle points out that the issues of suggestion, gratification, and indoctrination were issues of vital concern to Freud. He wanted at all costs to avoid being charged with "merely" influencing patients to change, dethroning psychoanalysis from a science to social engineering. These concerns remain an important theme as contemporary analysts seek to promote a "softer, kinder" version of analysis that still avoids these very problems. So Kohut, for example, although elevating empathy to a level at least equal to that of interpretation, also recognized that empathy would necessarily fail, and that in fact it was these moments of "optimal frustration" that the patient could utilize for emotional growth. Similarly, although the emphasis on countertransference and projective identification has become for many contemporary theorists the linchpin of the treatment, there remains the need to recognize that the analyst's reactions in the session may more related to the analyst than to the patient. At some point, that is, we are obligated to say something useful to the patient rather than address our own curious mental perturbations. Eagle takes the strongest issue with the role of interpretation and the tendency in contemporary theories to dismiss the importance of interpretation, even to the point of dismissing any need for the analyst's comments to tally with what is real in the patient's life and experience. Although the debates about construction and "narrative truth" rather than interpretative truth have faded somewhat over the years, Eagle insists, for both theoretical and pragmatic reasons, that the analyst's comments must fit what the patient has actually experienced. However fraught with uncertainty, finding what is "real" in the patient's experience is vital, and certainly no patient would be pleased to be told that the analyst's comments were merely useful "narratives" that might or might not fit with the actual events of the patient's life. He points out that interpretation and "truth value" of the analyst's comments are brought in "under the radar" in contemporary theories, unacknowledged yet still central to building and maintaining the very therapeutic alliance that is the primary focus of cure.

He concludes this section, however, with a further observation that many contemporary theorists, regardless of the conceptual axes they grind, have expanded the range of theorizing about what actually happens in treatment. The assumption, for example, that the "blank screen" was the aspirational goal for the analyst to maintain can not only be challenged on theoretical grounds, but also on the more relevant observation that there is no such thing as a blank screen, and analysts are always revealing themselves consciously and unconsciously to the patient. As Eagle alluded to early in the book, Freud the analyst was quite different from the indifferent surgeon of the soul he insisted was his model. Although Freud is frequently cited for his warmth and human compassion with patients, he also indulged in episodes of acting out that might have benefited from a more thoroughgoing recognition of the actual demands of practice discussed by contemporary theorists.

Conclusions

One of the reasons this book is so valuable is Eagle's evenly hovering attention to the similarities and difference between Freudian and contemporary views. At some points in the text he all but has you convinced that the differences between these conceptualizations constitute an unbridgeable gulf, while only a paragraph or two later he is focusing on the essential similarities between the two. He is quite sharp in taking contemporary theorists to task for the gaps in their theorizing, only to also point out that Freud's theories are similarly subject to such criticisms. Finally, he cannot resist pointing out, from time to time, how little these core assumptions have been subjected to empirical research, and that Freudians and others have long remained content to argue their profound differences, seemingly without any need to even agree on what data would constitute validation of their theories. Eagle does have one unbending allegiance, however, and that is to an Enlightenment view that our task in life and analysis is to expand our range of knowledge and experience, to continually test our knowledge rather than rely upon received wisdom, and to help patients uncover the truth about themselves (to bring them to the ecstatic limit of the "Thou are that," as Lacan put it). He locates these fundamental beliefs solidly within the Freudian perspective that increased self-knowledge is the fundamental purpose of psychoanalytic work. He concludes that contemporary theories are fundamentally at odds with this vision:

I would suggest that the contemporary psychoanalytic attitude toward uncovering truths and privileging of the therapeutic relationship—solidarity—over insight, awareness, and self-knowledge—objectivity—is not simply attributable to clinical experience but is also an expression of the cultural philosophical zeitgeist. (p.251)

Before my final comments, a note on the text itself. This book is the 70th volume of the Psychological Issues Book Series, continuing a tradition that stretches back to Erikson, Wolff, and Rapaport. We should be grateful that this series has been revived, and this book contributes to a vital tradition within psychoanalytic psychology. It is also a pleasure to read Eagle's observations of a time in American psychology when psychoanalytic ideas were taken seriously and posed a challenge to former titans of our field, such as Clark Hull and others now consigned to the dustbin of history.

It is hard to ask for more, but I will note that Eagle only covers a narrow range of contemporary psychoanalytic theorists. Although he attends to Fairbairn's and Bowlby's ideas, he is mainly interested in Kohut, Mitchell, and Stolorow, with occasional nods to the work of Weiss and Sampson. I would be interested to see how he would place the contemporary French theorists, as he mentions Laplanche, Green, and Widlocher only in passing and says not a word about Lacan and his followers. Although critiquing the (to me) obvious limits of intersubjective ideas of Stolorow, for example, he gives only slight acknowledgment of the possibility of developing a more philosophically secure basis for pycho analytic theory and thought that is grounded in Husserlian thought. His comments about the failure to empirically evaluate the divergent and competitive elements of psychoanalytic theory and, in particular, the relevance of theory to practice suggest the need for another book. Hopefully we won't have long to wait..

1. In other words, although the Freuds, Anna and Sigmund, at times exclusively focused on the mother's need-satisfying role, they were not always consistent.

2. Again, Freud did recognize fear of loss in his formulation, but contemporary theorists have made this a central or even exclusive theme; for example, Kohut's observation that Oedipal themes represented "breakdown products" of a failure of empathic parenting.

3. This focus on the patient's needs also echoes Freud's earlier and rejected formulations of neurotic symptoms.

Bill MacGillivray, PhD is in private practice in Oak Ridge, Tenn. and adjunct professor at the University of Tennessee, Knoxville. Currently serving as president of the Division of Psychoanalysis, he is the former editor of Psychologist-Psychoanalyst, the Div. 39 newsletter and a contributing editor of DIVISION/ Review.

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