Revisiting the Debate Between Classical/Commitment and Analytic Therapies

A FUTURE PROJECT OF PSYCHOANALYTIC PSYCHOTHERAPY:

Revisiting the Debate Between Classical/Commitment and Analytic Therapies

Ryan LaMothe, PhD Saint Meinrad Seminary and School of Theology

This article revisits the distinctions between and limitations of classical and analytic therapies with the aims of further clarifying each and, more impor- tantly, proposing a future project for psychoanalytic therapies. More particu- larly, it is argued that psychoanalysis, although not a “commitment” therapy, can offer some patients a safe space to analyze their commitments with the aims of (a) understanding their conscious and unconscious motivations vis-à-vis living a life in common with particular others, (b) exploring their childhood experiences of committed others, (c) assessing the positive and negative consequences of their commitments, and (d) inviting them to consider choosing to live a life in common with a particular good enough community and its traditions. Implicit in this fourth aim is thoughtful attention paid to the criteria vis-à-vis a good enough community.

Keywords: psychoanalysis, classical therapy, analytic therapy, self, freedom, commitment

(T)o be rooted in a community is perhaps the most important and least recognized need of the human soul.

(Simone Weil in Baker, 2009, p. 94)

Phillip Reiff (1987) drew a sharp distinction between classical and analytic therapies. This distinction was not necessarily new. A half century earlier, Sigmund Freud and James Putnam had a friendly disagreement about the theory and aims of psychoanalysis. Putnam, leaning toward commitment therapy for some patients, agreed with Freud that “the physician has no right to impose his own ethical or philosophical opinions on any patient, but must content himself with helping the patient develop in his own way” (Hale, 1971, p. 168). However, Putnam believed the patient’s obligations and loyalties vis-à-vis his or her community were important to explore and understand, largely because Putnam viewed

This article was published Online First June 2, 2014. Correspondence concerning this article should be addressed to Ryan LaMothe, PhD, Professor

of Pastoral Care and Counseling, Saint Meinrad Seminary and School of Theology, 200 Hill Drive, St. Meinrad, IN 47577. E-mail: rlamothe@saintmeinrad.edu

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Psychoanalytic Psychology © 2014 American Psychological Association 2015, Vol. 32, No. 2, 334–351 0736-9735/15/$12.00 DOI: 10.1037/a0035982

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the self as rooted in community. He went on to say that “one ethical consideration that seems to me especially significant in psychoanalytic treatment . . . can be developed without danger, though not with every patient” is the patient’s obligations to or his or her loyalties toward friends, family, community, and so forth (p. 168; emphasis added). Freud responded politely, indicating that this perspective would lead away from analysis and the “great ethical element in psychoanalytic work,” which is truth (p. 171). Nothing resulted from their discussion and, decades later, Reiff (1987) further differentiated between these therapies, arguing that whereas commitment or classical therapies are authoritarian and initiate people into a particular community, analytic therapy is antiauthoritarian and functions as “a counterinitiation, to end the need for initiations” (p. 77).

I believe that Putnam was on to something important, though he did not develop his argument or persuade Freud. In this article, I revisit the distinctions between and limitations of classical or commitment1 therapies and analytic therapies with the aims of further clarifying each and, more importantly, proposing a future project for psychoana- lytic therapies. More particularly, I argue that psychoanalysis, although not a “commit- ment” therapy, can offer some patients a safe space to analyze their commitments with the aims of 1) understanding their conscious and unconscious motivations vis-à-vis living a life in common with particular others, 2) exploring their childhood experiences of committed others, 3) assessing the positive and negative consequences of their commit- ments, and 4) inviting them to consider choosing to live a life in common with a particular good enough community and its traditions. Implicit in this fourth aim is thoughtful attention paid to the criteria vis-à-vis a good enough community.2

Before beginning, I present reasons why this is an important, indeed, a necessary future project for psychoanalysis in Western societies. Many commentators (e.g., Ander- son, 1983; Bellah, Madsen, Sullivan, Swidler, & Tipton, 1985; Cushman, 1995; Lasch, 1979; Lifton, 1993; Zaretsky, 1973, 2004) on Western society have argued that various philosophical, economic and social forces (e.g., capitalism, individualism, narcissism, urbanization and so on) have undermined social cohesion and community. Playwrights such as Arthur Miller (Death of a Salesman) and David Mamet (Glengarry Glen Ross) wrote powerful plays about capitalism and its effects on social and family relationships. In psychotherapy, Cushman (1995) argued, there is an unquestioning, tacit affirmation of a bounded, isolated, empty self, which is enmeshed with a culture of consumption. Similarly, Strenger (2004) addresses the plasticity of identity in a capitalistic and indi- vidualistic society, identifying its benefits and excesses. The point here is not to repeat the arguments and critiques of Western societies, but rather to note that we can no longer take community for granted. Forming and maintaining communities where people commit to

1 Although I explain below what I mean by classical/commitment therapies, I wish to make clear here that my use of the term “commitment” has nothing to do with Acceptance and Commitment Therapy (ACT). In general, ACT uses the term “commitment” in reference to an individual’s motivation to engage in actions/behaviors aimed at changing his/her entrenched thoughts and emotions (Hayes, 2013). My use of the term “commitment” refers to individuals who are motivated to live a life in common with particular others, making use of their attending semiotic systems for organizing and making sense of daily life.

2 John Macmurray (1991/1961), a Scottish philosopher, argued that community comprises “direct relations” of people committed to living a life in common. A community, Macmurray posited, is founded on direct (face-to-face) personal relationships whereby the principle of unity is the personal. That is, the functional, contractual, impersonal realities of human relationships are subordinate to this principle of unity. For a more detailed discussion of community and its relation to the social and intersubjectivity, see LaMothe, 2013.

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living a life in common is, perhaps, more intentional than at any other time in history and more precarious. This leads me to an underlying premise in this article, which is that a good enough community is foundational for the development and support of healthy selves (experiencing a sense of freedom and aliveness in relation to significant others), as well as necessary for healing (cf., Herman, 1992; Holton, 2011) and sustaining people as they deal with chronic suffering (cf., Clebsch & Jaekle, 1994; Redfield-Jamison, 1995; Sass, 1992). Anything that undermines community, then, will contribute to individuals who struggle to feel alive, people who feel alienated and alone, sufferers who experience isolation, and patients who live lives of quiet desperation. This said, I am not suggesting that community is a panacea for Western ailments. Clearly, there are numerous examples of people being harmed in communities, which speak more to the inevitability of human struggles in forming and maintaining committed relationships, whether that is in mar- riages, families or communities, rather than creating substantial argument against com- munity or for the abolishing of this form of human association. Psychology does not seek to rid humanity of these arrangements, but instead to understand them and find ways to help people live a life in common.

Commitment/Classical Therapies: Premises, Attributes, Strengths and Limitations

Freud and Putnam’s friendly exchange can be understood as a liminal or threshold moment in Western psychotherapy—a moment between the dominance of religiously grounded commitment therapies and the mergence and eventual dominance of analytic therapies. For centuries, Western people who were ill sought out religious healers, who understandably made use of the Christian (and other religious) cosmologies to understand illnesses and to develop interventions aimed at alleviating suffering, such that the person could regain his or her participation within the community and with God (cf. Clebsch & Jaekle, 1994). Diverse types of rituals and more informal conversational methods were and continue to be used by religious leaders and healers.3 Any relief from suffering through cure or the discovery of new meaning in one’s suffering was understood theologically and believed to be transformative (Reiff, 1987, p. 76). These classical therapies fall under the heading of the cure of souls tradition. In this tradition, men and women, who were tasked to help people suffering from physical and soul maladies, relied on theological interpretive frameworks for diagnosis and intervention. Many of the more prominent healers developed methods and articulated aims of practice. For instance, Gregory the Great (1978), a 6th-century monk and later pope, wrote a book on pastoral care, outlining a method for sensitively and respectfully conversing with those who suffered from various relational and soul maladies. This talking cure included clear theological analyses of the individual’s predicament and prescriptions for interventions. Other monastics, such as John Cassian, wrote about the suffering that resulted from various vices (or seven deadly sins) and methods for curing them. Centuries later, John of the Cross wrote about the dark night of the soul, a particular painful experience of

3 Ellenberger (1970) and Frank (1961) identify a wide variety of rituals used throughout the world by shamans and other religious healers to respond to different types of human suffering. Although there is variation within Western Christianity, there is, at least, a common text used to support and justify interpretations and interventions.

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alienation from God. A contemporary, Teresa of Avilla, wrote about the travails of the soul’s journey to God.

Similarly, various U.S. Protestant pastors in the 17th and 18th centuries developed and wrote about their talking cures or conversational methods, hoping to teach other pastors appropriate diagnoses and effective methods for responding to soul suffering (Holifield, 1983). Clergy were to be experts in diagnosing the maladies of the soul, and the primary methods for dealing with these maladies were called answering methods.4 Some of these talking cure methods were early forerunners of cognitive–behavioral therapies, relying on rational persuasion vis-à-vis a person’s false religious beliefs, though these healers were interested in change that restored a person’s relationships vis-à-vis God and the commu- nity of faith. There were also interpretive techniques for reframing (theologically) a person’s understanding of his or her illness with the aim of providing a meaning that the person could constructively use. For instance, Reverend Thomas Hooker was called to help a woman tormented by thoughts of guilt and damnation. The previous pastor’s rational method failed to convince the woman that she was not damned. Hooker reframed her alienation by suggesting to her that her suffering was an indication that God had chosen her, and her suffering, therefore, had nothing to do with her guilt or being damned. Reframing the meaning of her suffering from guilt and damnation to God’s presence in the midst of suffering led to a change in the woman’s attitude and mood. That is, this young woman, according to Hooker, was no longer tormented by guilt and was able to find meaning in her suffering. Regardless of what one thinks about the theology manifested in this reframing, it was, to Hooker and the woman’s family, very helpful in relieving her guilt and fear of damnation, and restoring her to her family and the community of faith. Whether this was a cure or simply symptom relief it is difficult to know, but this approach is not uncommon in some current secular therapies (e.g., Frankl, 1969, 1987), though the interpretive frameworks used to reframe the meanings of a patient’s suffering are not theological and the therapeutic aims are different.

These talking cures, as well as other rituals of care, Reiff (1987) placed under the heading of commitment therapies, with which I mostly agree. The healer was recognized by the community to care for his or her people. The healer’s aims were not simply to reduce or eliminate suffering. To be sure, to cure or remove suffering was a good in itself, but the ultimate aim was to restore the person to the community and to God. Suffering, which could be the result of the individual’s sin, possession, or unexplained natural suffering (natural evil), often led to emotional experiences of alienation from the com- munity and God. This is decidedly different from Reiff’s (1987) claim that classical therapists sought to “commit the patient to the symbol system of the community, as best he can and by whatever techniques sanctioned (e.g., ritual or dialectical, magical or rational)” (p. 68). Reiff seems to think that the patient was not using the symbol system, which, in many cases, does not make sense because there were no other symbol systems for the individual to commit to. More importantly, someone who is suffering does not “commit” to a symbol system, though s/he will use it to understand his or her suffering. The sufferer is also not initiated into a community and its beliefs system. Instead, s/he uses the symbol system of her community to derive meaning, solace, and cure vis-à-vis his or her malady. “Classical” soul therapists or commitment therapists used the symbol system to assist in the process of restoring—not initiating—the person to his or her commitments

4 This does not include various rituals of exorcism, which involved casting out demons. Answering methods or talking cures were more common than exorcisms (Holifield, 1983).

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to family and community. When an individual, through no fault of his or her own, could not be restored to family and community, the question became how the community could contain and sustain the person—at least persons who had not through their own sin caused the alienation (Clebsch & Jaekle, 1994). In short, these religious talking cures and other rituals were not necessarily initiation rituals as Reiff (1987) argued. Granted, there are religious rituals for initiation, but these are not the ones identified in the cure of souls tradition in caring for the sick. Instead, healers and sufferers used the religious interpretive framework in providing meaning and to help restore or maintain an individual’s relation- ship with the community and with God.

It is important to note that these classical talking cures addressed two basic sources of suffering. In instances when suffering was the direct result of human actions, classical therapists sought to have the person take accountability (confession) for his or her actions and perform acts of restitution (penance) to repair the relationship with people in the community and God (Ellenberger, 1970, pp. 22–25). Again, this did not mean helping the person to commit to a symbol system, but rather to restore his or her commitments and relationships with others and with God. These rituals of reconciliation contained the premise that part of human suffering results from the decisions we make that contribute to our alienation from other people and God. We might say that this is a moral talking cure or a recommitment therapy. On those occasions when suffering was not the result of an individual’s decisions and actions, the challenge was to cure him/her and, when that was not possible, provide some meaning and purpose within the context of a sustaining community. In both cases, as well as those when the meaninglessness of suffering threatened, the healer and community ideally were to provide sustenance, comfort, and solace. Again, these were collective actions of commitment that aimed to provide emotional support in the face of physical and psychological suffering that were understood to be alienating.

These classical or commitment therapies possessed several underlying and interrelated premises. First, the self or, more properly, person, is inextricably yoked to community. A self, if you will, has its being and life in community (cf., Macmurray, 1993/1949). To be exiled is to die or to experience horrendous suffering, as seen in depictions of hell. This idea that the person has his or her origin and development in community is an ancient theological idea that continues to be an integral part of Christian anthropologies (e.g., Niebuhr, 1989; Volf, 1996; Zizioulas, 1985, 2006). In these theological perspectives, community, then, is not simply for the sake of survival, but for living a meaningful life with others. Indeed, a good enough community ideally provides the possibility of expe- riences of meaningful communion with members (Buber, 1958—I-Thou) and God, whether that is partially achieved in the present (Emmanuel—God with us) or in the belief and hope of being united with God and others in the Kingdom of God. A second key and related premise of classical therapies is the notion of an encumbered self. Human beings make commitments and they depend on the commitments of others for their survival, experiences of communion, purpose, and meaning. This encumbered self is not to be understood as an individual weighed down or onerously confined by communal and family obligations. To be sure, commitments can be difficult, burdensome even, but for classical therapists an encumbered self also means living a meaningful and purposeful life. The religious notion of covenant and its centrality vis-à-vis God and community signify the importance of encumbrance in human life. Keeping the covenant meant life— physically and psychosocially. Conversely, breaking covenantal relationships was repre-

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sented by stories of illness, death, and foreign bondage and oppression.5 Although this may seem like a religious idea, there are numerous examples of nonreligious people choosing to be encumbered and, in doing so, experience communion, meaning and purpose. Good enough parents, for instance, are encumbered by voluntarily being obliged to meet the numerous and intense demands of their baby. Without their commitment to the baby’s physical and psychological well-being, there is little hope that the baby will survive. People who marry decide to encumber themselves to each other. A husband is encumbered by his wife’s illness, finding the alternative untenable, yet also finding meaning and purpose in the shared struggle. A therapist, working with a borderline patient who is suicidal, chooses to be encumbered so that there is the hope and possibility not only of the patient’s survival, but also of a better life. An unencumbered self, in short, was inconceivable for classical therapists, because one’s commitment to family, community and God were foundational to individual and collective survival and life.

This leads to the third related premise, and that is the notion of freedom. For classical therapists, freedom is not to be understood as freedom from the exigencies of living in family and community, at least not entirely. Freedom is experienced in relation to other members of the community and in their mutual commitments (Macmurray, 1993/1949, pp. 31ff). The encumbered self is free by voluntarily committing him/herself to others, to live a life in common—freedom to commit, to take up one’s encumbrances, which, in turn, provide individuals with meaning and purpose. The paradox is that one is free when one voluntarily encumbers him/herself to others.

For classical therapists, then, freedom was not an absolute, as if human beings could live without constraints, encumbrances, limits and so forth. Freedom is conditional; that is, freedom is conditioned by one’s decisions to accept the encumbrances and conse- quences that attend one’s obligations to others. Good enough parents voluntarily encum- ber themselves and, in so doing, make possible the child’s development as a human being who in time will voluntarily commit to his or her family and community. The child, in other words, will learn that freedom involves the experience and decision to live a life in common with particular others. To be free from all commitments, from a classical therapy point of view, would lead to alienation, emptiness, meaninglessness and purposelessness. More to the point, an unencumbered self, for classical therapists, is not free, but a slave to his or her own fears, desires and wishes. Put another way, an unencumbered self, in committing to his or her own desires and needs, experiences alienation, not communion, because s/he is in bondage to his or her passions and needs. In contrast, by voluntarily committing oneself to others, by deciding to be encumbered by others, one recognizes that freedom is experienced in relation to committed others.

Of course, there is also the idea of freedom from commitments or situations that are unjust, oppressive, or destructive. For instance, Israelites were liberated from the Pharaoh and from Babylonian exile. Yet freedom from did not mean an escape from one’s obligations to one’s people or to God. Being free from unjust relations allowed the Jews to be more fully committed to one’s people and to the community’s covenant with God. Ideally, it is a return to an encumbered self who, after being freed from the chains of oppression, freely chooses to commit to his or her people. Classical therapies, then, were

5 One does not have to agree with various theological premises or stories to see that beneath the stories is an anthropology that points to the necessity of committed relationships for survival and flourishing of individuals.

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aimed at freeing the individual from suffering that caused alienation and diminished their ability to engage in committed relationships with others.

So far, I have been focusing on the individual and his or her suffering vis-à-vis the aims and premises of classical therapies. It is necessary to point out that healers also had other concerns and aims, which could undermine care and concern for some sufferers. As representatives of the community and its tradition, healers and religious leaders were also concerned with the security and stability of the community and its tradition, which meant that individuals, at worst, were sacrificed for these aims.6 Identified leaders and healers, in other words, were responsible not only to the “patient,” but also to the community of faith and to God. For instance, St. Paul in his pastoral letters, at times, counsels people within the faith community to seek reparation with certain community members and, if this did not work, to eject the person from the community. Also, we read in Hebrew and Christian scriptures about the marginalization of individuals who suffered from leprosy, fearing they would contaminate others and undermine the health and well-being of the community. And for centuries, for those who suffered from what we now know were most likely mental illnesses, exile or ostracism was the usual communal response.7 In these instances, the survival and putative well-being of the community took precedence.8

There are advantages and disadvantages to commitment therapies. First, relying on the community’s symbol system and rituals, individual sufferers could find meaning and purpose in their struggles within the context of committed relationships, ideally relieving them of the psychological suffering that comes from meaninglessness. Second, classical therapists sought to return a person to the community, where s/he could experience communion, meaning and purpose in his or her commitments to others. Third, when suffering was not going to be relieved or cured, classical therapists, along with the community, ideally helped sustain the patient. That is, commitment therapies reinforced the commitment of the community vis-à-vis the sufferer, which helped attenuate the suffering that comes from alienation. Fourth, the wisdom of classical therapies is the existential, paradoxical recognition that encum- bered selves, in good enough relationships and communities, experience freedom in voluntarily encumbering themselves to others in the family and community.

There are, of course, disadvantages to commitment therapies. Reiff (1987) was partially correct when he stated that commitment therapies are authoritarian. Cer- tainly, they can be authoritarian, imposing meaning and commitment onto people who suffer, or worse, still exiling or killing people who are perceived to threaten the community and society (burning heretics, which is a counterinitiation ritual). It is a mistake, however, to suggest that commitment therapies are, in and of themselves, authoritarian or, by contrast, that analytic therapies cannot be authoritarian. Any

6 Christian history also contains illustrations of horrific practices that rationalized political and religious violence with the ostensible aim of preserving both community and an individual’s soul (see Russell, 1972). That said, I am addressing the ideal aims of classical therapies, which includes their shortcomings.

7 An example of this is seen during the Middle Ages, when deranged people were placed on ships traveling up and down rivers—ship of fools (Porter, 1991). They were sequestered in prisons as well.

8 Lest we too narrowly judge our predecessors, they were limited in being able to understand the physical etiologies of mental illnesses, which translated into limited ways of responding. Let me add that we continue to sequester people who suffer from mental illness, whether that is more formally in prisons and mental hospitals or in less formal settings like inner-city streets (Szasz, 1970).

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cursory reading of clinical cases in psychoanalytic history reveals the presence of authoritarianism vis-à-vis interpretation, at times, which does not mean that psycho- analysis is in and of itself authoritarian. Another disadvantage of commitment therapies is the often-unquestioned interpretive religious framework used in construct- ing diagnoses and interventions. The theological worldview is often taken to be unquestionable, and this may attend an unquestioned acceptance of the community, its traditions, and its way of being in the world. So, in some situations the individual sufferer and healer may not see that suffering results from the community and its tradition. A case from the 17th century illustrates this view (Holifield, 1983). The patient was a young woman whose parents married her off to an older gentleman. Soon after giving birth, this woman began to have visions and thoughts of damnation. It was inconceivable to the parents and the pastor, who was using a talking cure, to consider that this woman’s suffering was related to being forced to encumber herself to a man she did not wish to marry. It was seemingly unquestionable to consider alternative interpretations or interpretations that contradicted dominant religious views about young women and marriage. Another related disadvantage is the tendency to encumber individuals who either do not need to be encumbered because they are already overburdened, or those whose suffering is directly related to their current distorted encumbrances. A painful example of this is a clergyperson telling an abused woman she must work harder at being a good wife. In this situation, the woman’s encumbrance and freedom signify a distortion. She is involuntarily subjected to the abusive husband, largely out of fear and partially out of her belief that her very sense of self depends primarily on this relationship, rather than a self that is situated within and dependent on a wide range of communal relationships of mutual commitment. Moreover, the husband’s (and clergyperson’s) view of encumbrance is faulty, because his freedom is dependent on the subjugation of his wife instead of freedom that arises out of mutual and voluntary encumbrances associated with the religious notion of covenant.

A final limitation of classical therapies is that its helpfulness can be narrow in its reach or effectiveness. Classical therapies emerge out of a particular community and its symbol systems. Generally, those who do not accept the community’s common purpose, commitments, and symbol systems are not subject to or subjects of the rituals for healing or cure. An atheist who is dying of cancer is likely not going to find it meaningful or helpful to have a clergyperson offer prayer and anointing. Commitment or classical therapies, then, can be parochial and, in secular societies, not available or helpful to the wider public or nonbelievers.

In brief, the cure of souls traditions involved commitment therapies that included talking cures. These therapies relied on theological interpretive frameworks for diagnoses, interventions and therapeutic aims. Analysis was part of the diagnosis, but this involved listening for the hidden movements of the soul or occult aspects and sources of evil and sin. The aims of commitment therapies included 1) healing or mitigating the individual’s malady; 2) providing meaning and purpose to one’s suffering; 3) repairing the individual’s relationship with God; 4) restoring a person’s commitment to the community of faith; 5) sustaining and deepening one’s experiences of communion with God and others; 6) providing communal support and solace for those whose suffering was incurable; and 7) ensuring the security, stability and well-being of the community.

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Analytic Therapies: Premises, Attributes, Strengths and Limitations

Echoing de Tocqueville, Reiff (1987) observed that in a “highly differentiated democratic culture, truly, for the first time, there arose the possibility of every man (sic) standing for himself, each at last leading to a truly private life” (p. 70). A consequence of pervasive individualism is that it prevented “commitment therapy from taking full effect” (p. 73). This ushered in the need for a new type of therapy, which Reiff called analytic therapy. Analytic therapies, Reiff remarked, “arise in an historical period concomitant with the rise of democratic individualism [and] are uniquely modern. . . . The therapeutic effort is not primarily transformative but informative” (p. 76). Although Reiff does not confine analytic therapies to psychoanalysis, he clearly recognized that Freud was the chief architect of this new therapy. Freud was the response to Nietzsche’s (1982) question, “Where are the new physicians of the soul?” (p. 33).

The roots of the shift from commitment to analytic therapies, as Reiff points out, were grounded in the Enlightenment, which ushered in the apotheosis of reason and the eventual rise of liberalism. As a result, there was a tectonic shift in how soul suffering was understood and how experts understood and responded to psychic suffering (see, Cush- man, 1995; Ellenberger, 1970). Kantianism and utilitarianism, which hold the premise that human beings are rational creatures, focused on the individual and his or her autonomy, which Tauber (2010) noted is embedded throughout Freud’s theories. Liberalism cele- brates this autonomy and seeks to protect it politically. That is, the state is to provide only those laws that would guard each individual’s attempt to fulfill his or her aims (Miller, 1983; Sandel, 2012). The individual subject was no longer subject to a king and his self-proclaimed good. The good of the individual preempts the common good, especially if the common good is seen to obstruct individuals’ aims. In a liberal society, the individual seeks those relationships that either do not obstruct his or her desires or help achieve his or her desires or his or her self-selected good. As Taylor (1989) noted, “The primacy of self-fulfillment, particularly in its therapeutic variants, generates the notion that the only associations one can identify with are those that are formed voluntarily and which foster self-fulfillment” (p. 508). The individual, then, relying on his or her reason, seeks to determine his or her own good and, against this backdrop, one senses the negative view of the common good that is represented in a community and its traditions. In other words, a community and its traditions are, at best, seen as positive as long as they mirror and aid the good of the individual and, at worst, are seen as onerous and authoritarian whenever they appear to dictate or obstruct a subject’s desires. It is no wonder, then, that Freud, as Reiff (1987) noted, eschewed “interest in creating a doctrine of the good life” (p. 87). The good life is left to the putative free choice of the individual to discover and decide and, ideally, the community and society are either obstacles or supporters of the individual’s self-fulfillment.

This new analytic therapy, then, had a number of premises that differentiated it from classical therapies—premises that emerged from various strands of Enlightenment phi- losophies. One clear difference, as Reiff points out, is the absence of a community that stands behind the analyst. The analyst belongs to an association that relies on an interpretive framework or symbol system and concomitant methods that are not linked to any particular community and its traditions. To be sure, the analyst represents a profes- sional association, but the symbol system, although having its own myths, falls under the heading of the human sciences and, therefore, has no obligation or loyalty to any particular community or society. The analytic therapist, unlike his or her classical counterpart, is, therefore, not a sacralist or an exemplar of a particular community (p. 86). Although s/he

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does not represent the common good or ideal, the analyst certainly represents the values (e.g., self-awareness, maturity, integration and so on) associated with his or her profes- sional association. A second and related difference relates to the understanding of the self. Broadly, analysts hold the premise that human beings are social creatures,9 which means that less attention, if any, is paid to the reality of community vis-à-vis the development of the self. In addition, the notion that human beings are social creatures accompanies a strong claim of the importance of the individual and his or her reason and autonomy. In the West, the self is social, but the self can rationally and freely decide, if not undermined by neurosis, to choose his or her own good—a good not necessarily rooted in society. Indeed, the emergence of individualism and liberalism gave rise to the tendency to view the society in terms of how it limited or obstructed the good of the individual, suggesting the self’s commitment to seeking his or her own good.

Given this general background of the shift between the premises of classical and analytic therapies, I move to the chief architect of analytic therapies to fill out the picture of this analytic therapy vis-à-vis underlying premises, as well as the attending conse- quences.10 First, Freud clearly acknowledged the limits of both reason and freedom. In other words, Freud was no Rousseauean, believing that a return to a natural state represented an idyll freedom. Instead, he consistently argued that there was an antagonism between instinctual life and civilization. Analytic “research,” Freud wrote (1910), “into the neuroses (the various forms of nervous illness with a mental causation) has endeavored to trace their connection with instinctual life and the restrictions imposed on it by the claims of civilization” (p. 252). The growth of civilization required, to some degree, the suppression of instincts (Freud, 1913), and although this may result for some in neuroses, for others the achievement of civilization served as a defense “against the crushingly superior force of nature” (Freud, 1927, p. 21). Some renunciation and sublimation of instincts vis-à-vis civilization keeps human beings from killing each other, provides a

9 Community and the social are related but distinct terms. For Macmurray, social life involves entering into associations where there is a shared purpose and function. In a social group, there are customs and traditions “in which we are enmeshed and which, by more subtle pressure, cuts across individual tendencies and compels us to conform to ways of living which are conventional” (Macmurray, 1991/1961, p. 54). Some degree of conformity is necessary if one is to participate in a social group. “We have to co-operate with one another,” Macmurray wrote, “very often with numbers of people whom we do not know or do not like, for common purposes” (p. 54). A viable social life, where cooperation is necessary to achieve the aims of the group, “depends upon entering into relationship with other people, not with the whole of ourselves but only part of ourselves. It depends on suppressing, for a time at least, the fullness and wholeness of our natures” (p. 55). One might hear echoes of Rousseau’s negative view of society in this formulation, but this would be an incorrect interpretation. Social life, for Macmurray, is necessary for human life, and the fact that we might suppress a part of ourselves is not, in and of itself, damaging. Put differently, in a social group, where there is a shared purpose, loyalty and trust within the group are founded on that purpose, which is distinct from communities that are founded on the unity of the personal. A reason why individuals might withhold “the fullness of [their] natures” is because trust and loyalty are contingent on this purpose and function. That is, consciously or unconsciously, individuals recog- nize that trust and loyalty are conditional and that, once the purpose has been achieved, the existence of the group is in question. Community is prior to the social in Macmurray’s view.

10 Reiff (1987) argued that Jung, Adler, and others developed therapies that were a mixture of commitment and analysis (p. 74). Given the fact that commitment therapies are associated with the care of souls tradition, this view is incorrect. Jungian therapies, for instance, do not seek to initiate patients into a particular community and its traditions. Moreover, these therapies are no less “informative” than Freud’s theories, especially given the critiques regarding Freud’s claim that psychoanalysis is a science (Tauber, 2010).

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collective protection against nature, and enables the collective use of nature in meeting human needs. Given this, one could say that Freud possessed a view of an encumbered self—encumbered by the demands of civilization for the sake of survival. Nevertheless, this encumbered self was an individual who could use reason and self-determination to achieve some degree of self-fulfillment given the demands of civilization.

In one sense, then, Freud’s analytic therapy did not subscribe to more exaggerated forms of individualism or an ideal notion of an unencumbered self. Indeed, the language used to describe the relation between the self and civilization is one of sacrifice. The self must give up some of its desires, if it is to obtain safety and to realize his or her own goals. So, the pursuit of one’s own good is prized and civilization, to some degree, requires a down payment, if one is to obtain sufficient freedom to identify and pursue his or her own good. Freud’s self is partially encumbered by the demands of civilization and, therefore, selves must partially adapt to the demands of society. Thus, freedom, although limited, is located in the individual’s pursuit of his or her own good. Civilization is both an impediment to complete freedom of the unencumbered self, as well as existentially necessary for the self to realize, partially, his or her self-fulfillment.

This is a significant change from classical therapies that claimed that the self is free not despite encumbrances, but because of his or her commitments to community. Freedom and meaning are achieved in community and not despite it. The new physician of the soul, however, focuses on helping the patient realize his or her own good, and this “good” is not necessarily rooted in a particular community or society. Granted, the patient will have to make some adaptation to the demands of the larger society if s/he desires to obtain protection, but more particular commitments and encumbrances are eschewed if they do not clearly relate to the individual’s good or self-fulfillment. In my view, Freud’s analytic therapy acknowledged an encumbered self that was linked to the underlying philosophical premise of individualism, as well as joined to Freud’s tragic vision of humanity (Schafer, 1983).

Freud’s emphasis on psychoanalysis as a science11 and the acceptance of individual- ism were instrumental in leading away from classical therapies’ aim to initiate or reconnect persons to particular communities. Reiff (1987) believed that this new talking cure was “not an initiation but a counterinitiation, to end the need for initiations” (p. 77). Yet, Reiff’s point is a quite curious and paradoxical observation. First, one could say that the analytic talking cure is indeed an initiation, at least into an analytic attitude (Schafer, 1983), as well as an acceptance of an analytic hermeneutic. Analysis is an initiation into a hermeneutics of suspicion that is linked to a particular psychological (and philosophical) tradition and its narratives. There is, as Reiff rightly noted, no initiation into a community or group. The patient does not end up becoming an analyst and joining an analytic group, unless, of course, s/he chooses to do so. Analytic therapy, in being a counterinitiation ritual, paradoxically became an initiation ritual not into a community of faith and its traditions, but to a philosophical liberal tradition of an autonomous, relatively unencum-

11 There have been numerous critiques of Freud’s attempt to argue that psychoanalysis is a science (Grunbaum, 1984; Tauber, 2010). Reiff (1987) appeared to accept psychoanalysis as a human science, which is why he viewed analytic therapies as informative and classical therapies as transformative. This distinction, like that of counter-initiation, is too sharp, especially when one considers the critics of psychoanalysis who argue, like Wittgenstein, that analysis provides an interpretation not an explanation and is, therefore, akin to aesthetics (Tauber, 2010, pp. 71). Analytic interpretations are embedded within and emerge from psychoanalytic theory, which is similar but not identical to classical therapies’ aesthetic interpretations.

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bered self, free to choose whatever “realistic” symbol system that helps him/her achieve his or her aims (Cushman, 1995). The patient, freed from the illusions of previously held symbol systems (e.g., religion), now voluntarily selects the symbol system that provides him/her the best opportunity to achieve his or her ends. As Reiff (1987) remarked, “Freud sought to give men (sic) that power of insight which would increase their power to choose; but, he had no intention of telling them what they ought to choose” (p. 87). This is not entirely true, though. Certainly, Freud, like Putnam, wanted patients to choose what was in their best interests, but clearly Freud was biased about the choice, which is evident in a number of his works (e.g., Totem and Taboo, The Future of an Illusion, Civilization and Its Discontents). I am not suggesting that Freud would necessarily initiate a person into his atheism, but his tendency to view religion as inhibiting human freedom and maturity undoubtedly shaped his followers, the analytic tradition, and the talking cure itself (LaMothe, Arnold, & Crane, 1998; Meissner, 1984). Put another way, Freud’s theories or narratives, which undergirded the psychoanalytic ritual, initiated a person into an attitude about religious commitments and their concomitant narratives.

Adam Phillips (1993) echoed Reiff’s claims, though with greater irony and tragedy. “With the discovery of transference,” Phillips wrote, “Freud evolved what could be called a cure by idolatry; in fact, potentially a cure of idolatry, through idolatry. But the one thing psychoanalysis cannot cure, when it works, is belief in psychoanalysis. And that is a problem” (p. 121).12 A patient initiated into and surrendering to an analytic process discovers, often painfully, the particular idolatries s/he uses to make sense of him/herself and the world. Idolatries, for Phillips, are the transferences upon which we rely in our daily lives, which are supported by the stories we tell to others and ourselves, justifying and rationalizing our inordinate attachments. We hold illusions about ourselves and others, acting as if the Other can redeem some wounds from the past or protect us from the vagaries of life. We cling tenaciously to these illusions, these idolatries, transferring them onto all kinds of objects, activities, and persons. This may include the analyst who, from Phillips’ perspective, helps the patient discover that his beliefs are false, and this is accomplished by believing in and trusting the analytic method and process, which may itself be a problem. In short, the analytic method of inquiry served as the means to free people of wishful illusions, which Phillips quipped, “could, of course, be the most ironic wish of all; a wish that our wishes be correctable” (p. 121).

Freed from idolatry, freed from illusions, the patient is better able to determine and act on those goods linked to his or her relative self-fulfillment, which is distinctly different from a religious cure of idolatry and the return to God and community. Reminiscent of being freed from the darkness of Plato’s cave, the patient can now see reality, which will enable him/her to renounce freely some instinct for the protection of civilization while pursuing his or her own self-fulfillment. Reiff, then, is correct to say that analytic talking cures, since Freud, are significantly different from classical talking cures. One of these differences is that the new talking cure was an initiation into counterinitiation vis-à-vis a particular community and its traditions. That said, it was an initiation into an adoption of

12 What is curious about Phillips’ statement is that he overlooks the Judeo-Christian traditions’ recognition of idolatry in human life and the interventions used to attempt to cure people of idolatries. Put another way, religion can use its interpretive framework to evaluate the kind of attachment a person has vis-à-vis religious and material objects and, if deemed to be idolatrous, provide interventions to “cure” the individual. So perhaps the same could be said for religion: religion itself can be a cure for idolatry, but the one thing that it cannot cure is belief in religion. This said, the aims of psychoanalytic and religious rituals remain distinctly different.

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a counternarrative of individualism and autonomy, replacing the importance of commu- nity and its tradition vis-à-vis the achievement of meaning, purpose and relative freedom.

This new talking cure has advantages and shortcomings. By not having allegiance to any particular community and its tradition, analysts are relatively more free to explore and be critical (hermeneutics of suspicion) toward any community and society. I would add they are psychically more free by not having the added agenda of facilitating the patient’s movement to committing to a particular community and its traditions. Similarly, it frees the analytic space in that the patient is free to discuss, explore, critique and choose (or not to choose) specific communal and social commitments and concomitant narratives and rituals. In addition, because the new physician of the soul is not a sacralist or exemplar, the patient ideally is less likely to feel compelled (transference) to adapt to the demands of a particular community, family or group or adopt its narratives and tradition. Another advantage of analytic therapies is their acknowledgment of the importance of self- awareness—a self-awareness not corralled by the symbol system of a particular commu- nity and its traditions. Exploration of the self can lead to greater accountability for one’s psychic life and behavior, as well as lead to psychic integration and the affirmation of one’s own desires, dreams and so forth. At the same time, accountability includes the patient’s identifying and living out his or her own self-chosen good. The development of a hermeneutics of suspicion, exploration of the unconscious, and self-awareness are key pillars in freeing many patients from the tyranny of socially imposed narratives that overly confine and circumscribe gender roles, as an example.

These advantages are also accompanied by disadvantages. Counterinitiation, which emphasizes the individual’s freedom and self-fulfillment, implies that communities and societies obstruct freedom, even while offering protection. There is also an almost reluctant renunciation of libido vis-à-vis the demands of society in order for the individual to obtain sufficient protection to pursue self-fulfillment. To be sure, some communities and societies can be and have been oppressive, but not all communities are. I would add that, even in more strict religious communities, people can be not only mentally healthy, but also free to find life in this community meaningful and purposeful—in other words, they would not interpret their experiences or commitments as oppressive. The disadvan- tage of this perspective is threefold. First, analytic therapies can undervalue or overlook the role communities play in healing people (Herman, 1992; Holton, 2011; Sass, 1992). Certainly, classical therapies can err on the side of emphasizing the role of community vis-à-vis the self and healing, yet analytic therapies underemphasize it. Community, then, is not just protection against nature and the purveyor of material goods for life. Good enough communities also provide healing and when healing is not possible emotional sustenance. Second, once the patient has gone through this counterinitiation s/he is ostensibly free to pursue his or her self-fulfillment. This is fine, but carried to its extreme leads to a narcissistic emptiness (cf. Cushman, 1995). Freedom from encumbrances, in other words, is not freedom, but bondage to one’s individual notion of self-fulfillment and illusion of a self-chosen good.13 Meaning and purpose in life are achieved not by escaping one’s encumbrances (unless they are oppressive), but by choosing one’s encumbrances. Consider the analyst and the analytic ritual itself as an illustration. The analyst is paid for

13 By illusion, I mean that it is a mistake to believe that the good I am choosing vis-à-vis my self-fulfillment is disconnected from the prevailing goods of the narratives, collective ideas, and practices of a society and community. Perhaps a difference between modern versus classical selection of the good is that the modern individual selects a good for him/herself, rather than selecting a good for the sake of oneself and others.

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his or her work, but some patients cannot pay enough for the psychic energy and care required. Ideally, the analyst chooses to encumber him/herself to the patient and, in so doing, derives meaning and purpose that are more substantive than the annoyances of helping difficult patients. This is a self-fulfillment through choosing to be encumbered and not freedom from the demands and vicissitudes of working with a difficult patient.

Even given the hermeneutics of suspicion, a third shortcoming of analytic therapies is an unwitting collusion with (or initiation into) Western notions of a bounded, atomized self that fits well with the needs of capitalist-driven society and culture (Zaretsky, 1973). As Cushman (1995) argued, “Psychotherapy is permeated by the philosophy of self- contained individualism, exists within the framework of consumerism, speaks the lan- guage of self-liberation, and thereby unknowingly reproduces some of the ills it is responsible for healing” (p. 6). Furthermore, Cushman noted, psychotherapy perpetuates the political status quo (cf. Zaretsky, 2004, p. 164). So, analytic therapies may not be as counterinitiating as Reiff seems to suggest and, perhaps, it is unrealistic to expect a therapy to be free of any tendency to initiate the patient into some value system.

These limitations are not meant to imply that analytic therapies are not valuable or effective in helping people with their psychological struggles. My aim is to identify the underlying premises that shape analytic therapies and how these premises are not only significantly different from the classical approaches, but also how they shape therapeutic aims. Just as classical therapies can be criticized based on their emphases, so, too, can analytic therapies.

A Third Way

Putnam’s belief that psychoanalysis, for some patients, should include attending to the patient’s communal commitments represented a third way—a middle ground between classical therapies of the cure of souls tradition and the new analytic therapies represented by Freud. Putnam was arguing that, for some patients, it was important to explore their past and present commitments, and to consider which community and its traditions the patient would hope to voluntarily commit. Freud mistakenly regarded this as interfering with the patient’s decision to choose his or her own good, but Putnam was not in any way imposing a choice. Certainly, both men necessarily possessed aims or goods that shaped how they thought about psychoanalysis. Putnam’s aim, at least from my understanding, is that freedom is best understood and realized in healthy committed relationships. This is not an imposition vis-à-vis the patient’s freedom, because the patient is free to choose what relationships and traditions are meaningful and life enhancing. I suspect, as well, that Putnam was concerned about not only what others could offer the patient, but also what the patient could contribute to the community and society through his or her commitments. Both men believed in the importance of the patient’s freedom, but the significant difference was the foundation and aim of this freedom and the kind of self connected to it.

I suggest, with modifications, that a future project for psychoanalysis is to reexamine psychoanalytic practice in light of the premises of classical therapies and the importance of community for human life. This in no way means a facile and nostalgic turn to therapies of old, nor a jettisoning of the strengths and advantages of analytic therapies. Rather, it means taking seriously and critically the philosophical and anthropological truths of classical therapies and seeing how this might shape analytic theory and practice. This is

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a large task, which is beyond the scope of this article. However, I wish to identify some of the contours of this future project.

A Putnam type of approach vis-à-vis analysis would mean that it is neither a classical type of talking cure nor fundamentally an initiation into a counterinitiation ritual. Instead, the analytic ritual works through the transference and explores the unconscious with the aim of helping the patient become free of the psychosocial encumbrances that are obstacles to forming commitments that make possible experiences of interpersonal com- munion and freedom. The patient, in a relatively successful analysis, is free to encumber him/herself, to live a life in common with particular others and attending tradition(s). This would include a patient’s (and analyst’s) more conscious, constructively critical, and deliberative assessment of the kind of community and tradition to which the patient is committed (or not) and the one to which s/he intends to commit and contribute to. In saying this, I am not opting for a liberal notion of self that selects a community only to the extent that it meets one’s needs and aims. Rather, the encumbered self that volunteers to commit to a people and its traditions also seeks to contribute to the community. It is not simply that the community is obliged to meet the needs and desires of an individual, but how the individual may meaningfully and purposefully contribute to the life of the community, given his or her capacities and resources.

Implicit in this form of talking cure is the necessary analytic evaluation of communal life. In studying adult neuroses and pathologies, analysts since Freud have sought to understand the developmental and relational or social etiologies of psychic maladies. This necessarily results in overt and tacit criteria regarding healthy parent–child relationships, as well as healthy adult relationships, including more macro social relations. In other words, pathological depictions of human development and adult relationships presuppose some idea of healthy interactions and relationships. If one accepts the importance of community in human life, then community itself becomes an object of analysis—not simply the family, culture or society as evidenced in applied psychoanalysis. What attributes of community contribute to healthy relationships, to meaningful lives? What characteristics of community lead to desiccated selves, to experiences of emptiness and alienation? How does the community shape family life and the parents’ abilities to care for their children? Is there an unconscious aesthetic that attends a particular community, and in what ways does this aesthetic of care and communion contribute to subjective and intersubjective experiences of being alive and real? How does society contribute to or obstruct community, and what are the impacts on mental health?

These questions shift the focus from the infant-parent, therapist-patient dyad, or culture to larger systemic issues vis-à-vis community, complicating the range of analytic inquiry and perhaps requiring alterations in analytic theory and conceptual tools. Granted, this is no easy task and individual analytic-oriented therapists may balk, arguing that this is well beyond the scope of psychoanalysis. Psychoanalysis is more at home with the analytic dyad, but it is clear that the dyad is linked to and dependent on larger systems. We know that analytic researchers study infant-parent interactions and family relation- ships, yet, as Winnicott frequently noted, these good enough parents and families are connected to larger social (and I would argue communal) systems—systems that need to be understood in terms of their influence on the health of parents and families. Analysis can, I argue, broaden the unit of analysis to include various forms of community (not simply social groups) and their effect on psychosocial development. Moreover, analysis may include an assessment of the patient’s present participation in social and communal groups, not simply in the sense of whether the group is oppressive, but the patient’s own commitments and contributions to his or her community. In other words, is the patient in

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a community (or not), and what is the impact of the community vis-à-vis the patient’s symptoms, suffering, and so forth? What is the patient’s participation and commitment to the community, if s/he is actually in one? Will an exploration of his or her current commitments help the individual achieve greater awareness of how his or her participation and commitment contribute to suffering and/or help him/her realize how the community colludes with his neurosis? I stress here that an analysis of the patient’s commitments and how s/he experiences community is not automatically a counterinitiation, but rather an exploration that may lead the patient to make a commitment to a community that is healthier—one in which s/he can experience greater freedom and communion, as well as how s/he may meaningfully contribute to the good of the community.

I wish to emphasize three points. First, Putnam, I believe, was aware of the tendency of classical therapies to “suggest” (proselytize) or coerce individuals into community, which would clearly interfere with their choosing their own good. Putnam’s analytic approach affirms the importance of community in patients’ lives, but the choice of community is, of course, theirs. Freud believed Putnam’s approach would interfere with the patient’s freedom to choose his or her own good, whereas Putnam believed that a patient’s freedom would be preserved by exploring his or her relational commitments. The analyst, in other words, would not steer the patient to a particular community. Second, this analytic approach is not for all patients. Putnam qualified his comments to Freud, arguing that this was suitable for some, but not all, patients. Although I do not know what exactly Putnam had in mind, it seems to me that patients who have lifelong psychological struggles, such as schizophrenia, will not, in my view, benefit from an exploration of their communal commitments, though s/he will surely benefit from a good enough commun- ity’s support (e.g., Sass, 1992). Similarly, exploration of one’s communal commitments may occur much later in therapy because of the degree of childhood trauma. For instance, a child who has been sexually abused, while needing a good enough community to heal (Herman, 1992; Holton, 2011), will not benefit, until near the end of her work, from exploring her communal commitments and the current community in which she shares a common life. Third, exploration of commitments and experiences of communion do not imply an initiation into a particular community, although such an exploration does suggest that community and communion are goods to be pursued. I wish to emphasize that a strength of psychoanalysis is that it is not an initiation into a community. This future project retains that, but does hold the premise that one’s commitments to a particular people and its traditions can be life-enhancing. Finally, classical analysis possesses the aim (and good) of the patient’s increased freedom. I agree, yet with a modification. Psychoanalysis, in general, views freedom in terms of a partially unencumbered self— freedom from the constraints of illusions. My view is that freedom from illusions and from neurosis should lead to a freedom to engage in mutual commitments that are life- enhancing. In other words, a relatively differentiated individual experiences greater communion and freedom when s/he is mutually engaged in communal relationships— voluntary and mutual encumbrances.

In some ways, I do not believe that what Putnam was addressing was so different from psychoanalysis that it would undermine psychoanalytic theory and practice. Indeed, analysts often work with married couples and families—the basic social arrangements that are the building blocks of community—trying to help them strengthen, if possible, their relational commitments to each other. This suggests that there is a hidden premise that our obligations to each other are important for psychological health. A future project for psychoanalytic therapies, however, does mean bringing to the foreground and seriously considering the foundational premises of classical therapies.

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Conclusion

For too long, there has been a sharp division between classical and analytic therapies. Identifying their underlying premises, strengths and shortcomings is a step toward bringing these types of therapies. If Putnam and Freud had continued their dialogue, they may have realized they were not as far apart as they thought. More importantly, if Putnam had been more convincing, analysis may have shifted its analytic anthropology and practice. A future project of psychoanalysis reconsiders the insights of classical therapies and considers how these premises may alter theory and practice.

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351A FUTURE PROJECT OF PSYCHOANALYTIC PSYCHOTHERAPY

  • A FUTURE PROJECT OF PSYCHOANALYTIC PSYCHOTHERAPY
    • Commitment/Classical Therapies: Premises, Attributes, Strengths and Limitations
    • Analytic Therapies: Premises, Attributes, Strengths and Limitations
    • A Third Way
    • Conclusion
    • References