Hey! Where’s the Lingo? (Book Review)

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

Psychoanalytic writing is a curious genre in so many ways, but in view of the warmth and intimacy of its founder’s narrative style, what seems especially odd is the cold complexity of its prose style. Especially in American journals, at some point in the 20th century it became standard practice to write in language as surgical and emotionally neutral as an author can make it, and to turn the subject into an adversary that must be surrounded, cornered, lassoed, and defeated in 25 to 50 pages. Occasionally a case history is briefly sketched (and what a relief that is!). But even then, anonymity (the patient’s) and secrecy (the analyst’s) are at a premium. The vignette over, we readers are back to the grindstone, laboring along with the abstracted narrator, in darkness, obfuscation, and theory. What is persistently missing save for a few exceptions is the analyst’s affective response. In the classic version of this genre, what is never missing is the certainty that the patient is sick, defective, resisting, and just plain wrong, and that the analyst is right, right, right, a steadfast scientific puzzle-solver, a master of the evenly hovering attentional style, extraordinarily calm, lucid, superior.

For the beginner in this body of work, it sometimes seems as if the one great consolation is the humor that results from the contrast between the language and the subject matter—that is, the emotional monotone, the polysyllabic words, the odd contortions of syntax indicating redaction, the innumerable disclaimers that purport to circumscribe and neatly tie up and deliver the most human of subject matters, the stuff of love, hate, sex, fear, misery, madness, and hope.

Not only is emotion excluded, but every detail pertaining to the analyst’s own life, personal circumstances, class, race, and age is omitted or covered by a large fig leaf. Of course, some reality does leak out. The address printed at the end of a piece in a journal is often read as evidence of a personal life, even a political attitude. And then, there’s the bibliography, which illustrates a theoretical position, and possibly a loyalty to one institute or another, but one must be fairly advanced to make appropriate inferences there.

Why the fetishized secrecy, why the gratuitous exercise of power? It takes a great deal of assiduous reading to even get to the point of asking, but eventually, it goes without saying, one’s curiosity is unnaturally aroused by the unnatural reticence. Voyeuristic tendencies are titillated and then left high and dry. But, more than that, if one becomes gripped by the ideas, by the possibilities, by the interest and hope of psychoanalysis, one cannot but feel somewhat robbed of a great opportunity. When one is wondering, “Who is this author?” there is something more at stake than voyeuristic curiosity. Asking that question—and having just enough information to imagine an answer—is how we gauge and understand any text, in every realm where the written word conveys knowledge, information, and drama. For a lay reader, even a determined one, this difficult prose style turns out to be the first of many masks dissimulating an individual author’s personality and also, as it turns out, the conceptual framework and method of contemporary psychoanalysis. If one persists, however, one discovers, via the vocabulary and the signs of the genre, a kind of floating world of connections and meaning. Enough to go on. The questions remain, however: Who is the storyteller? And why is the story being told in this way? The lack of answers seems to point to the possibility that the dilemma is a theoretical one. For an analyst, what is the role of the self? The “ordinary” self, that is, the one who lives in the world.

The medical paper, of course, serves many functions, providing both cover and respectability. But, narratively speaking, it seems designed to distance the author (and the reader) from both the patient and the disease. Or let’s say that the medical paper’s tone is intended to clearly indicate its author’s relationship to his subject as one of mastery.

It is not often that one associates psychoanalytic writing with poetry, but the pieces in the recent collection With Culture in Mind, edited by Muriel Dimen, are highly reminiscent of sonnets. Like sonnets, they are focused on the point of contact between subject and object, and evoke the distance between reality and fantasy, the wishes and regrets that swirl around that contact. Like sonnets they are dramatically brief, compressed, constrained by time and formal obligation, and what emerges, therefore, in both instances, is what is essential: powerful emotion originating from a convection of sensibility, subject, and specific circumstances. Or, as Dante Gabriel Rossetti put it, “A Sonnet is a moment’s monument” (Rossetti, 2011). In reading the pieces in With Culture in Mind, we become witnesses to a relationship that took place in real space-time. We are privy to the narrator’s sometimes anguished self-examination, to the clash or blend of narrator and subject. The use of the self in the treatment is illustrated by the use of the self in the narrative, because prose functions, as it should, like a mirror of the writer’s consciousness: sometimes clear, sometimes fascinatingly murky and in need of repair.

And all this despite—or perhaps because of—an exceptional brevity: most of the pieces in With Culture in Mind are a mere fraction of your average psychoanalytic paper. That’s where the sonnet comes in. From the very beginnings of the sonnet, some 800 years ago, self-examination became the central thread of the narrative. Faced with the prospect of confining their thoughts to a mere fourteen lines (the “Sonnet’s scanty plot of ground” (Wordsworth, 2011), as Wordsworth described it), poets were obliged to condense and crystallize their thought—but without sacrificing paradox—to cut out unnecessary praise, description, and self-serving digression, and to get to what matters as quickly as possible. And then, to boot, they had to worry about rhyme schemes or iambic pentameters, octaves or sestets, which drove them to use more figurative language, to evoke, to suggest, to poeticize, to essentialize.

The analysts who were members of Dimen’s writing group didn’t have to worry about abbaabba rhyme schemes or iambic pentameters, and at first their framework was anything but strict. They had been meeting with her for several years, Dimen explains in the introduction, first to read together, then to write, and finally chose as a common goal for their respective essays to capture those clinical moments in which psychic and the social intersect. “The authors,” writes Dimen, “discovered they were as caught up in the cultural dynamics as their patients” (p.4). As they wrote, they continued meeting and discussing their work, and this unusual collective reached a productive theoretical consensus “that psychic life is made equally of inner and outer worlds, and…found ways to talk about it that sacrifices neither dimension. Their novel approach, in turn, dovetails with a changing construal of clinical process” (p.3).

But what happened to transform what would have been an interesting and innovative writing workshop exploration into a radical experiment was that the members of this writing collective were asked to present their essays at the 2007 meeting of the American Psychological Association, Division 39 (Psychoanalysis) and, what’s more, that the presentation of six pieces plus audience discussion was granted a total of 110 minutes. As Dimen tells us, “in addition to tackling the relation between psyche and society, ever a moving target, the authors braved the challenge of distilling their accounts to 12–15 minutes each, that is, writing papers of 6–8 pages each” (p.2).

This process was repeated with three sets of papers, and the collection was put together in three sections, so as to reflect the chronology. All six analysts contribute to each section, and we therefore have the impression that we witness their development over time—or at least the time it took to write this book. Dimen introduces each piece, and every section concludes with an overview written by a well-known analyst/theoretician.

Although each essay deals with one particular patient, these pieces are far, far away from the familiar medical vignette. They are not exercises in prudent exhibition, studded with disclaimers. On the contrary, they are very personal; they reveal important and sometimes shocking circumstances of their authors’ lives, and the even more surprising process of self-observation the analysts undergo in order “to work toward making conscious the unconscious embroilment with social ideology they identified in their patients and themselves,” (p.4) according to Dimen. This is at the heart of each of these pieces. In other words, each one focuses on what it has long been of paramount importance to preclude from the classical clinical vignette: the analyst’s blind spot.

This is a way of thinking that inevitably leads to a new and most urgent necessity for the analyst’s self-examination, in a new realm, in a new tone: not just a strategy but an imperative. Psychoanalysis has many uses for the analyst’s self-examination, and it isn’t as if this imperative has never been alluded to in the literature. But the topic is usually segregated within papers dealing with the subject of countertransference. As anyone who has taken an interest in the increasingly voluminous bibliography of countertransference can attest, what tends to come to mind as one is reading is some variation of Winston Churchill’s 1939 observation about Russian national interest: It is a riddle, wrapped in a mystery, inside an enigma.

The literature that deals with countertransference issues—often focused on the acting out of the analyst’s lust, for example (though it usually goes by the more respectable term, “boundary violation”)—is, again, designed to dominate the problem, to get rid of it even, while, at least recently, it is acknowledged to be unavoidable. If it can be corralled, it can be useful. “There, that’s settled.” On the contrary, it seems that Dimen’s group of analyst-authors sought not to isolate and master, but to expand the inquiry. “With Culture in Mind explores what psychoanalysis is only now starting to get: Culture saturates subjective experience,” (p.4) writes Dimen.

The tone and the modus operandus of the collection are superbly established in the opening piece by Maura Sheehy, “Melissa: Lost in a Fog, or ‘How Difficult Is This MOMMY Stuff, Anyway?’” To describe her initial encounter with this mother of two young children, Sheehy begins with a recollection that brings to mind a kind of resonant detail that fiction writers use: “Melissa began our first session perched on the edge of the couch and turned toward me at an uncomfortable angle, leaving herself both unsupported and off balance”(p.11). Sheehy then settles into what seems at first to be a more traditional vignette—outlining the patient’s family and socioeconomic circumstances, her problems, her conflict, her sense of failure, her incompetence, her helplessness, her fogginess, her chaos. Nothing unusual there. But then the surprises begin, when Sheehy shares her own irritation and her ambivalence about the patient and about the subject matter of motherhood.

Dimly, I was aware that something about this reaction was off. All my own mother chaos, ambivalence, trouble balancing all the desires and needs—my own and my children’s—was disavowed. My confidence wavered. I couldn’t stop wondering if I was reacting to her as a mother or analyst (and what exactly the difference might be), prescribing my own biased cures or meeting her needs. The identifications and disidentifications were disorienting. I was back to work only 4 months since having my second child and felt my mother self to be barely hidden behind a too-shaky hologram of my analyst self…I felt stuck but could not see what I was stuck in. (p.14)

I felt stuck but could not see what I was stuck in. Hey! Where’s the lingo? Where’s the mastery? Where’s the superiority and the Buddhalike calm?

Sheehy’s realization of the commonality serves to jolt her into awareness of the miasmic inexplicability of motherhood and its effects on the mother. What’s wonderful about this piece, and about this collection, is that Sheehy does not proceed to reduce the connection by leaping from projection into even more simplistic identification. Once the author recalls understanding that the “fog” of the title was not only Melissa’s, motherhood can then be seen to morph into many component parts for analyst and patient—a shared experience and consciousness, a source of conflicts that subdivide infinitely, and also a kaleidoscope of roles in regard to one another, created and cocreated by both women in the consulting room.

In other words, when the emotional coldness that has sealed the analyst’s account like an anesthetizing membrane is removed, the complexity stays and grows. What the analyst-author shares with us, then, is a striking account of how the oscillation of focus between self and other serves to inform understanding: “Melissa’s case opened my eyes,” writes Sheehy, to an “even more insidious set of internal obstacles to the development of a maternal subjectivity that includes a sense of agency” (p.15).

This is the trajectory of understanding identified in the pieces of With Culture in Mind. Each time it occurs it seems both dramatic and necessary, even though these analysts and their accounts differ drastically from one another. The point of insertion is usually something the analyst and the client have in common, an overlap in the social discourse, but the circumstances and the desires, and therefore the stories, are extremely varied. Perhaps that was one of the obstacles to this perspective—the fear that there might be too much to consider, defeating the purpose of confining the therapeutic relationship to a dyad. But these analysts seem at ease navigating the multiple layers. Starting on the surface, diving into the abyss. “We are both Jewish Israeli men of a certain generation,” writes Eyal Rozmarin in “Dori: ‘Oh Thou Seer, Go, Flee Thee,’” and he soon thinks “that the familiarity I sensed with Dori and learned later that he felt together with me had to do with the two of us sharing an unconscious: a grand historical third born when god gave Isaac back to Abraham in return for marking him in circumcision—and still going”(p.39).

Stephen Hartman, perhaps the boldest of these author-analysts, plunges in each of his pieces into “questioning how taboo topics help us map the infiltration of social discourse in zones of unconscious ‘personal’ discomfort” (p.129). In the process, he writes amazing monuments to amazing moments in which the connections between himself and his gay patients are revealed and unknotted—and perhaps reknotted, but consciously so this time around.

The third and most surprising of Hartman’s contributions, “Darren Then Harvey: The Incest Taboo Reconsidered, the Collective Unconscious Reprised,” is in part an account of “[wrestling] with a lapse in my capacity to think or speak about an aspect of my patients’ experience that felt threatening to me” (p.129). Hartman remembers “‘Wild’ angst” when his patients recounted, for example, engaging in the practice of combining the use of crystal meth with “barebacking,” unprotected anal sex with multiple partners.

Here is a wonderful paragraph in which he recalls a case he took as a beginning candidate in psychoanalytic training; I will quote it in its entirety for the strength of its writing as well as an example of a conceptual gold mine:

At the time, I considered it my duty as a gay man to fight the scourge of methamphetamine that was afflicting my community. When I look back, my attitude was anything but “analytic”: I had a zero tolerance policy with meth and no sympathy for crystal users. Were I not so green and in need of billable hours, I wonder if I would have agreed to treat people who needed to share an experience that I found unspeakable and that I was unwilling to imagine? The addictions roller-coaster ride is one problem; then there is the incessant greedy sex talk that rarely reaches beyond recitation of who fucked whom. Listening to it, over and over again, feels deadening if not infectious. How many details of unbridled debauchery does the good doctor listen to before fantasizing what it would be like to check out a barebacking party? “No way! Not me!” I shrink viscerally from any incipient identification with quote-unquote uninhibited, self-declared sex pigs. “Countertransference intolerance?” I ask myself? “No,” I just answer, “Just sanity.” “Prudishness about orgiastic erotics?” “No,” I reassure myself, “Just respect for the individual.” In any case, I took an immediate liking to Harvey in whose personal history I saw elements of my own story gone seriously awry. (p.131)

Muriel Dimen, who introduces each of the pieces, frames them theoretically as well. Speaking about Hartman’s piece above, for example, she points out “several concepts valuable for thinking about sex in clinical situations: erotic identification in undifferentiated states, the incest taboo as policing collective erotic identification, and the psychoanalytic insistence on libidinal hotbeds” (p.129). And here it must be said that although there is surely merit to the idea of keeping the introductions short, one would have wished to hear more from Dimen on such subjects as the psychoanalytic insistence on libidinal hotbeds. Similarly, even in the introduction to With Culture in Mind, Dimen allows the members of her writing group to step up to center stage, while she remains almost too discreetly in the background. Dimen, an analyst and theorist herself, whose original training was in anthropology, could surely provide valuable comments on some of the broader implications of the group’s work and its approach to narrative.

Although each of the section overviews written by Jessica Benjamin, Susie Orbach, and Andrew Samuels is illuminating (especially in juxtaposition to one another), all three address the content and theoretical perspective of these pieces, rather than their structure or tone. And yet it may be the radical alteration of form—the collection of compressed, emotion-filled narratives spoken in the analyst’s own voices—that most clearly announces With Culture in Mind as an exciting artifact of transition.

Just as the rise of the sonnet heralded the new spirit of the Renaissance—and is thought by some to have eventually triggered all of modern lyric poetry—this collection undoubtedly functions as a signpost of vast changes in the field of psychoanalysis. We need such signposts, nowadays. Change used to occur in discernable increments. A war, an invention, a movement in the arts could trigger a distinct new era. Now there is so much happening so fast in the world that we cannot even take note of all that is new, let alone dedicate an era to this or that; if we want to orient ourselves toward what is important we need to rely on markers.

With Culture in Mind is just such a marker, pointing to the profound recent changes that have begun to accumulate in thinking about psychoanalysis. In these dynamic views of how analysis really happens, we see how much is born in the analyst’s unknowing—in the very act of palpating himself or herself for understanding. More broadly, many of us, whether we are analysts or not, feel, like Maura Sheehan’s patient Melissa, as if we were “sitting at an uncomfortable angle” in the world, “unsupported and off balance.” It may be that With Culture in Mind’s boldest move is to allow that still undefined vulnerability a life on the page. Paradoxically, that is what finally allows the reader a glimpse at the authentic mysteries of the consulting room and the talking cure.

These stories mirror not only their authors but, of course, their culture as well. By reminding us to look at what is outside as well as inside our relationships and ourselves, and how the two may meet, With Culture in Mind reveals more beneficial general change in our society than one may have imagined. As we gather and solidify the many radical innovations of the last several decades in how we think of ourselves and others, we can begin to pose some of the questions that will preoccupy us in the unforeseen/unforeseeable future.


Rossetti, D. G. (2011). “A sonnet is a moment’s monument.” Columbia Granger’s World of Poetry Online. Retrieved December 7, 2011, from http://www.columbiagrangers.org.

Wordsworth, W. (2011). “Sonnet.” Columbia Granger’s World of Poetry Online. Retrieved December 7, 2011, from http://www.columbiagrangers.org.


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