A Lot Lower Than the Angels

By R.Z. Sheppard

PSYCHOANALYSIS: THE IMPOSSIBLE PROFESSION by Janet Malcolm; Knopf; 174 pages; $9.95

When Sigmund Freud, his apostles and apostates jumped down the rabbit hole of the unconscious, they found a world that had as much to do with myth, religion and art as it did with science. Psychoanalysis is hardly an objective discipline. Physical scientists must cope with the fact that even inert nature can be altered by the act of observation. The assumption that one active mind can know another is staggering in its implications--like playing three-dimensional chess in a maze of mirrors.

Nevertheless, the men and women who laid the foundations of "the talking cure," as an early analysand called it, had to think of themselves as neutral observers of clinical evidence. Software like the id, the ego and the Oedipus complex became hardware; schools of thought grew into academies of dogma; schisms appeared; colleagues turned into cultists; and Wilhelm Reich, confusing metaphor with reality, saw space invaders.

For these reasons alone, one would have to agree with Janet Malcolm, a staff writer for The New Yorker, that psychoanalysis is "the impossible profession." Her artful, illuminating survey of the field suggests an even stronger reason. After decades of popularizations and spinoffs, the talking cure appears to have trivialized the majesty of the unconscious. People once said that they were "in" psychoanalysis, meaning that they were committed to a long immersion. In a sense, they were writing their autobiographies. Now, people "go for" psychotherapy as they would go for a haircut, a walk in the park or Chinese food. The mind and soul are felt to be more casually accessible than they once were. In addition, the acquisition of self-awareness should not be too laborious, time-consuming or unpleasant.

It is a hard time for purists, especially traditional Freudians who believe that the psychoanalyst should keep a chilly distance. Free association and the transfer of buried memories to the doctor-patient relationship, they believe, work better in an uncongenial atmosphere. This is not a popular notion especially at a time when people fear being stuffy if they do not establish an immediate first-name relationship with their muggers. Says Aaron Green, the pseudonymous New York analyst whose good-natured fatalism forms the tough core of Malcolm's book: "No one likes to hurt people--to cause them pain, to stand silently by as they suffer . . . That's where the real wear and tear of analysis lies--in this chronic struggle to keep oneself from doing the things that decent people naturally and spontaneously do."

Ideologically and temperamentally, Green is a pessimist who echoes Freud's fundamentally tragic view: humankind's animal instincts limit the realization of its ideals. Such a bleak belief is, of course, a wellspring of humor. Freud did not promise a rose garden, only that the aim of treatment was "transforming your hysterical misery into common unhappiness." Green informs and amuses Malcolm with seriocomic tales about the infantile needs of himself and other psychoanalysts: their sharp clothes, boring talk of summer real estate, erotic entanglements with patients and strivings for position and prestige. Green's own analysis, he confesses, revealed a strong ambition to be a beautiful woman.

In a field that has frequently equated money with excrement, the subject of fees is provocative. Malcolm notes that Freud established the concept of paying by the hour and holding the patient financially responsible for missed sessions. "Nothing," he wrote, "brings home to one so strongly the significance of the psychogenic factor in the daily life of men, the frequency of malingering, and the nonexistence of chance as a few years' practice of psychoanalysis on the strict principle of leasing by the hour." Green tells of one patient so obsessed with his bill that the doctor did not get paid for eight months.

What drives a psychoanalyst? Says Green, citing cowardice and selfishness: "It's a situation of very comfortable abstinence. A situation of not getting involved with the other person, of not taking responsibility for the other person's behavior, but only for one's own."

Self-deprecation is often a pre-emptive strike to steal a detractor's thunder. At times, the reader half hopes that Janet Malcolm will tell Green that he is too hard on himself, that he really is an intelligent, sympathetic man who is defending the faith in an age of pill popping and package deals. But she maintains an orthodox silence with rewarding results. Eventually Green's faults and peeves make his good qualities even more believable. Technically, he also serves as a vital navigational point in the author's explorations. She discusses a number of analytic approaches and comes to the sensible conclusion that the clinical skills needed to get a patient to talk and the doctor to listen are as important as variations on theory. In the final analysis, talking and listening began the revolution that--like heliocentricism and evolution--placed man a lot lower than the angels.

Excerpt

" If you try to understand the patient in the overwhelming fullness of his individuality and idiosyncrasy, you will not have the easy time of it. . .You will feel discouraged, guilt-ridden, depressed, lost, confused, and deluged by the quantity of data and by its ambiguity and complexity. You will suffer back pain, indigestion, headache, fatigue. . .because of the guilt you constantly feel about not understanding the data. And this isn't even to speak of the other kind of guilt that analyst feel over the pain and frustration they regularly inflict on the people they analyze. Analysts keep having to pick away at the scab that patient tries to form between himself and the analyst to cover over his wound. That's what the patient keeps tryping to do--it's what's called resistance. . . The analyst keeps picking away at the scab. He keeps the surface raw, so that the wound will heal properly."

--By R.Z. Sheppard

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