Annotated Bibliography and OutlineKirsten VincentRES.docx

Annotated Bibliography and Outline
Kirsten Vincent
RES 802
March 29, 2017
Dr. Millett
Running head: ANNOTATED BIBLIOGRAPHY AND
OUTLINE
1
ANNOTATED BIBLIOGRAPHY AND OUTLINE
6
Annotated Bibliography and Outline
Hall, C. S., & Lindzey, G. (1957). Social psychological
theories: Adler, Fromm, Horney, and Sullivan. In Theories
of personality (pp. 114-156). Hoboken, NJ: John Wiley & Sons
Inc. doi:10.1037/10910-004
https://lopes.idm.oclc.org/login?url=http://search.ebscohos
t.com.lopes.idm.oclc.org/login
.aspx?direct=true&db=pzh&AN=2006-03537-
004&site=ehost-live&scope=site
This article defines and explains the different theories of
personality and social psychological theories. The contributions
of Alfred Adler, Karen Horney, Erich Fromm, and Harry Stack

Sullivan in the development of the ideas are discussed in the
article. These psychologists agreed with previous works of
Freud but incorporated their ideas and theories to develop new
theories. These theories aim at answering questions and
explaining concepts that previous theories could not explain.
Adler developed a theory that had social interest and striving
for superiority as its primary pillars. Horney and Fromm
insisted on the relevance of social psychological variables in the
development of the personality theories. Later, Harry Stack
developed the theory of interpersonal relationships and provided
insight on its relationship with the personality theory. Despite
different assumptions and concepts are shown by the different
theories, some concepts complement each other in explaining
certain behaviors.
Weaver, Y. (2009). Mid-life - A time of crisis or new
possibilities? Existential Analysis, 20(1), 69–78.
.aspx?direct=true&db=a9h&AN=37585685&site=ehost-
live&scope=site
This article offers insight on the different views held by various
psychologists concerning mid-life crises. There are two groups
holding views from the various schools of thought. One group
believes that the cause of the mid-life crisis is rooted in
childhood difficulties that cause disorders of the ego. They
argue that psychoanalysis is the only solution that allows the
disturbed individuals to revisit their childhoods and deal with
issues emanating from the same. The other group views mid-life
as a normal stage of human development. This stage, according
to this panel, is characterized by a time for people to re-
evaluate their achievements and gauge their accomplishments.
This period involves critiquing of one's abilities at this stage is
also a feature of this period. It also entails conflicts between
who an individual is and what they are aiming to be or what
they expected to achieve at their age. These psychologists argue

that these conflicts can occur at any age and are not specifically
characteristic of mid-life.
Axelrod, S. D. (2012). "Self-awareness: At the interface of
executive development and psychoanalytic therapy.
Psychoanalytic Inquiry, 32(4), 340–357.
.aspx?direct=true&db=a9h&AN=77657662&site=ehost-
live&scope=site
This article seeks to define the relationship between effective
leadership development and the process of psychoanalytic
therapy. Both processes employ the same stages in their
actualization. The first concept utilized is self-awareness. In
psychoanalytic therapy, it is the first step applied before an
individual can deal with issues affecting them. This is also a
key aspect of the development of effective executive leadership.
Other common subsequent processes include self-reflection and
self-observation. The understanding of self is essential for both
processes’ success. Both processes involve dealing with one’s
emotions and inner feelings. The processes enable individuals to
maximize their potential after they deal with issues that hinder
them from becoming their best.
Eagle, M. N. (2007). Psychoanalysis and its critics.
Psychoanalytic Psychology, 24(1), 10–24.
.aspx?direct=true&db=pdh&AN=2007-00135-
This article analyses and discusses the changes that occur and
develop in the field of psychoanalysis. It also shows the
relationship between research and clinical studies and practice.
It suggests that the discipline of psychoanalysis be open to
changes emerging in the field of psychology. The role of
clinical studies should be integrated into this field too to

increase its relevance as a treatment option for various
psychological disorders. Changes in the theories that explain
psychoanalytic therapy gear towards widening the scope of
psychoanalysis and making it a considerable option for the
treatment of more conditions and disorders. There must be an
end to the rigidity of the previous theory of psychoanalytic
theory to incorporate new ideas and concepts. Other disciplines
must also be considered when practising psychoanalysis as a
treatment option.
Overskeid, G. (2007). Looking for Skinner and finding Freud.
American Psychologist, 62(6), 590–595.
.aspx?direct=true&db=pdh&AN=2007-13085-
Freud and Skinner are considered opposites in the field of
psychology and propagate different views that are usually
contradictory. This article analyses the insight Freud offered
Skinner in the development of his work and vies in psychology.
The article examines the views of these two people in fields
such as civilization, behaviorism, and conflict and harmony.
The article also explains the contributions of different events in
the development of the views they hold dear. The diverse views
of these people mask any similarities that developed over time
in the field of psychologists.
Skinner, despite his development of contradictory opinions,
cited Freud in a majority of his works and pays credit to him.
Freud was a mentor to Skinner and played a role in the
development of the views the latter holds. They both agreed that
two different systems govern human behavior and that these
systems may contradict each other. Conflict and differences
should not come in the way of appreciating the work and the
lessons provided by people with varied views.
Outline
1. Introduction
Change and challenges are a part of life but the way we prepare

ourselves to brace these changes has an impact on our life.
These articles focus on the difference that self-awareness and
individuation can make to one's personal as well as professional
life.
2. Common themes
a. The first important common theme- Self Awareness and
understanding of self
i. First theme explained- understanding personal motivates,
meanings and desires.
ii. Importance- aiding a person to discover satisfaction and
confidence.
iii. Evidence from all related articles regarding the presence of
this theme
Axelrod (2012) looks at ways in which self awareness among
executives aids the person and the company they work for.
Weaver (2009) discusses the ways in which self-awareness can
lead to a better contentment in life..
b. The second theme- Individualism
i. Explanation- achieving ones dreams.
ii. Importance- support how a person may attain more
satisfiction and confidence. Individualism unifies the psyche.
iii. Evidence from related articles as it relates to the presence of
this theme
Axelrod (2012) looks at ways where individualism assists in the
quest to acheive a deeper meaning of life. Weaver (2009)
explores ways in which a person needs a better development of
self-awareness to achieve more.
3. Conclusion
Looking at all of these articles as a single unit, allows for a
deeper analysis and aids in the conclusions relating to having a
better knowledge of oneself. This allows a person opportunities
to better understand a lot of differences in the way people face
challenges. This level of self knowledge may aid in personal as
well as professional life.

Existential Analysis 20.1: January 2009
Mid-Life – A Time of Crisis or New
Possibilities?
Yana Weaver
Key words
Individuation, will to meaning, personal growth, lifespan
development,
owning experience
Abstract
With age our knowledge, emotions and the way we behave
mature. The
commonly held view of mid-life crisis is that it is an emotional
state of
doubt and anxiety in which a person becomes uncomfortable
with the
realization that life is half over. It is a potentially stressful
period as it
usually involves reflection and re-evaluation of one’s
accomplishments. It
usually occurs between the age of 35 and 50 and lasts between 3

and 10
years. This paper compares and contrasts what might be taken
as Freud’s
view on middle age, Jung’s idea of individuation, Frankl’s idea
of will to
meaning and Rogers’ idea of personal growth: ideas that have
relevance to
middle age. It also reflects on Erikson’s and Peck’s view of
middle age as
a stage in the lifespan development. This paper relates the idea
of middle
life crisis with Yalom’s research on meaning in life and
Spinelli’s idea of
owning experience. It argues that middle age should not
necessarily be
seen as a time of crisis and loss but of growth and new
possibilities.
Psychodynamic view
According to the psychodynamic view, the major psychological
changes
occur during childhood. More specifically, as Freud postulated,
all three
stages of psychosexual development are completed in early
childhood.
Therefore, the argument follows, any crisis occurring in middle
life is
caused by the ‘disorders of ego’ related to the developmental
experiences
in childhood. Thus those suffering from psychogenic neurosis,
caused by
the conflict of different drives and/or clashes between parts of
the psyche
developed in childhood, should be treated in psychoanalysis by

visiting
and resolving those early experiences. The end-goal of all
activity
throughout life is the re-establishment of individual equilibrium
which has
been disordered in childhood (Wood et al. 2002). Adulthood,
according to
Freud, is the ‘product’ of childhood, an end point rather than a
stage for
change in its own right. Freud wrote in 1907 that ‘about the age
of 50 the
elasticity of the mental processes on which treatment depends
is, as a rule,
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Yana Weaver
lacking. Old people are no longer educable’ (as cited in Cohen,
2006, p.1).
Freud, as Cohen noted, was 51 when he wrote this and a great
deal of his
work was completed after his 65th birthday.
Jung’s individuation
While Freudians considered all crises of middle age to be linked
with
childhood, Jung talked about middle life less in terms of crisis
but more in
terms of an important period of growth and maturation.
Furthermore, while
Freudians mostly were dealing with patients suffering from

neurosis
caused by ‘disorders of ego’ and who needed to adjust to social
(‘normal’)
requirements, the majority of Jung’s patients were …’socially
well-adapted
individuals, often of outstanding abilities, to whom
normalization means
nothing’ (Jung, as cited in Storr, 1973, p.82). So ‘crisis’ or
maturation in
middle age was not aimed at achieving equilibrium between the
self and
the requirements of the social world but at deepening the
meaning of
existence for those individuals who have achieved success.
These
individuals, as Jung stated, were suffering from
…’senselessness and
aimlessness of their lives’ (as cited in Storr, 1978, p. 82).
Understanding a
crisis of this nature and subsequent emergence from it would
only have
some meaning to those of middle age. Individuals who have
negotiated
their youth successfully have usually, according to Jung,
developed one
side of themselves. They are intelligent and successful but feel
something
is lacking in their inner life. For example, a good standard of
living was
generally assumed to be something to aim for in twentieth
century Western
Europe and America. But it appeared that more was not
necessarily better
and people continued to search for something else that they
described as
‘quality of life’ (Storr, 1978). Jung’s patients were disenchanted

by their
wealth and prosperity. His idea was that through ‘Individuation’
–
integration of wholeness, serenity and harmony within himself
and
cultivation of the inner self – one overcomes middle life crisis
(Storr,
1978). To be able to reach those aspects of self that have been
neglected,
Jung suggested, one needs (in analytical therapy with the help
of the
analyst) to consider the personal underlying values. All people
have them –
they are influenced by the collective assumptions and the
dominant way of
life of the culture they belong to. Apart from exploration and
re-evaluation
of these values and exploration of dreams and phantasies,
individuation
also means a conscious acceptance of the whole balanced self -
neither
neglecting nor overdeveloping any part of the self. A person
who achieves
this state does not get emotionally puzzled any more and does
not negate
any part of his/her nature. An essential part of this new
integration-of-self
attitude is acceptance and preparation for death. By
understanding and
accepting self, others and most of all by preparing for death,
one accepts
and acknowledges that this awareness is more important than a
good
70

Mid-Life – A Time of Crisis or New Possibilities?
material standard of living. Jung describes it as a ‘religious’
attitude,
although a person who achieved this does not have to belong to
any
religion; it is a spiritual quest (Storr, 1978). Jung did not think
that all
people go through the process of individuation. Only those
whose
consciousness is overdeveloped and who have been detached
from their
unconsciousness can be encouraged in analytical therapy to take
this
journey. Neurotics who suffer from weak ego (typically
Freudian patients)
should not be tempted towards this kind of thinking (Storr,
1978). For the
same reason, individuation does not have much relevance for
young
people. Although Jung’s ideas related to individuation are
generated
through his self-analysis and analysis of his rather particular
group of
patients, some of Jung’s followers would argue that
individuation is a
natural development process which everyone undergoes for the
most part
unconsciously (Storr, 1978).
Some existentialists’ views
Viktor Frankl, the existential therapist, challenged the

psychodynamic
view that a determined end-goal of all activity throughout life is
the re-
establishment of individual equilibrium. Frankl did not see
people as
mainly trying to gratify their drives and satisfy their instincts in
order to
maintain or restore their inner equilibrium. He thought that
people are
oriented towards the world of potential meanings and values
(Frankl,
1967). Frankl, as did Jung, also talked about the existential
emptiness of
people. A cross-sectional survey conducted at a Vienna Hospital
in the
1960s, showed that 55% of those screened (both neurological
and
psychotherapeutic patients) expressed signs of existential
frustration. More
than half of those stated that they had experienced the feeling
that life is
meaningless (Frankl, 1967). This existential vacuum, as he
called it, may
be explained by the instincts and traditions that have been lost
by man in
the process of becoming a truly human being. Some basic
animal
behaviour patterns have been lost for ever and man no longer
relies on
instinctive responses; he has to make choices. More recently,
tradition is
no longer a powerful guide to what he ought to do. Very often
he does not
know what he wishes to do. Instead, as Frankl suggested, he
conforms to
the wishes of others (wishes to do what others do) or behaves in

a
totalitarian manner and does what others tell him to do (Frankl,
1959).
Existential vacuum is usually expressed as boredom with life.
Although in
constant race against time, we see how people lack ideas about
how to add
some spiritual experience in their free time. Technological
progress, the
reduction in the number of working hours and the increase in
leisure time,
Frankl predicted, would create a society in which people would
not know
what to do with their newly acquired free time. As an example
of this,
Frankl mentioned ‘Sunday neurosis’, a type of depression
affecting people
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Yana Weaver
who lack content in their lives when the busy week is over
(Frankl, 1959).
Frankl did not talk about a mid-life crisis as such but by talking
of ‘Sunday
neurosis’, ‘the neurosis of unemployment’ and ‘the
psychological crisis of
retirement and ageing people’ he implied that the search for
meaning
became paramount at a certain level of maturity. Frankl noted
how people
think about their survival only when under immediate threat.
But when

continued survival is not threatened, people look for meaning in
life.
Frankl emphasised the importance for people of the ‘will to
meaning’ or
finding a sense of purpose in life. The sense of purpose in life
must be
constructed by each person on their own at a given moment.
Further, the
meaning of each individual life is not something to be invented
but
discovered in potentialities which are to be found in the world
rather than
within oneself. He emphasised the objectivity of this endeavour
and
responsibility with which each individual should respond to the
questions
of life. He stresses …’that the true meaning of life is to be
discovered in
the world rather than within man or his own psyche…’ (Frankl,
1959,
p.115). One way, suggested by Frankl, in which personal
meaning may be
sought is through actions, in particular creative activity. Other
ways are
through experience of nature, through art or experiencing love.
But the
meaning of existence is not fulfilled by creative activity only.
In a situation
of unavoidable difficulty and tragic circumstances of suffering,
pain and
guilt, meaning may be found in fortitude (Wood et al., 2002).
For those
troubled with noögenic neurosis (caused by an existential
vacuum) Frankl
recommended logo-therapy, a therapy that explores man’s
search for

meaning in which the role of the existential therapist is to be
with the client
on their journey of discovery of their own meaning. As Frankl
put it
…’what matters is not the meaning of man’s life in
general….one can
search only for the concrete meaning of personal existence, a
meaning
which changes from man to man, from day to day, from hour to
hour’
(Frankl, 1967 p.57).
Yalom also emphasised the idea that search for meaning is
intrinsic to
our existence and that it needs to be discovered rather than
given. One of
the reasons why people need meaning is that it creates values
which in
return confirm one’s sense of meaning (Yalom, 1980). Common
values
bind people together and form a shared belief system which
tells
individuals what they ought to do. But the meaning of life is
intertwined
and masked with other existential anxieties about isolation,
freedom and
death. In the case of death anxiety, one of the arguments that
Yalom
follows is that human beings wish to transcend death and leave
something
behind that matters. Like Frankl, Yalom does not say explicitly
that these
concerns are related to middle-aged people only but he
illustrated this
particular idea with a case study of a patient of his – a 55-year-
old

composer whose forthcoming birthday made him contemplate
the meaning
of life – implying that these concerns are more natural at this
stage of life.
72
The notion of ‘self’, whether in the middle or any other stage
of life, as
understood by the existential-phenomenological model is always
constructed through a particular experience (Spinelli, 1994).
Each person
also develops strong (sedimented) beliefs that are the building
blocks of
self. These beliefs are complex: not just personally, but
culturally and
socially derived. They are sometimes irrational and distorted
but always
very strong and it is difficult to change their interpretative
power. Usually
when there is incongruence between the believed and
experienced self, a
person is faced with choice; either to embrace the experience or
to find
some way of alienating it or, as Spinelli put it, ‘disowning’ it
(by for
example ‘forgetting’ it or avoiding reflecting on it). In many
cases in order
to maintain the status quo, preserve the self-construct and
maintain the
position in their social world, people tend to go with the latter
option and

avoid reflection. In the therapeutic setting, in the process of
creating ‘a
new’ self, people sometimes undermine the importance of their
relations to
others. Any changes in fundamental beliefs of any individual
could have
consequences for the relationships of that individual on both a
personal and
social level. If the client does not consider the implications of
changes of
their self-construct for their relationships with others, as
Spinelli
suggested, usually one set of disowned self constructs is
replaced with
another equally ‘disowned’. Examples of this, Spinelli noted,
could be seen
in many cases of ‘mid-life crisis’. Instead of exploring changes
that
brought about this ‘crisis’ and trying to accept them and ‘own’
them, a
client would replace one set of self-constructs with another,
neither being
congruent with his experience (Spinelli, 1994). What Spinelli
suggests, it
seems to me, is that to negotiate a mid-life crisis successfully
does not
require the individual to make changes in order to construct a
new ‘self’
but to face, explore and accept experiences that mid-life brings
and make
an effort in owning them. Reflecting on Spinelli’s presentation
of the self
being constructed through personally and socially developed
sedimented
beliefs, it would be interesting to explore to what extent a
‘crisis’ of

middle age might be viewed as a socio-cultural construct itself
and how
many people ‘feel’ it because it is an idea that has been
internalized by
their culture or society.
Rogers’ personal growth
Similarly to Frankl, Carl Rogers, one of the founders of the
humanistic
approach to psychotherapy, explored some existential questions
that people
ask themselves such as ‘What is my goal in life?’, ‘What am I
striving
for?’ and ‘What is my purpose?’ These are the questions that
every
individual asks himself at one time or another, some calmly and
some in
agonizing uncertainty (Rogers, 1961). Rogers also stated that
each
individual must answer these questions in his own way. In
Rogers’
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Yana Weaver
writings, they were not explicitly linked to middle age, but as
generally
people tend to ask themselves these kinds of questions when
they are free
to choose, it could be taken that they are more common later in
life. Rogers

postulated that people’s behaviour is goal-oriented but instead
of libido
being the driving force, there is a basic tendency towards
developing their
potentials or tendency for ‘personal growth’. From his
counselling
experience, Rogers noted that people embark on the process of
personal
growth not only through action but also by moving away from a
part of
their self with which they are not content. Rogers, as Frankl
did, noted that
many people did not know what they wish to do, but knew that
they
needed to move away from something. Rogers noted that
through client-
centred therapy, people gradually become more aware of their
own
situation, more open to experience and changes, accepting
others and
trusting the self. This process of ‘becoming a person’ is never
completed –
it continues throughout life (Rogers, 1961). Thus it could be
said that
middle age for Rogers represents a stage in the developmental
process
when confronting the existential questions related to personal
growth.
Something positive?
Erik Erikson, a neo-Freudian, also considered that
psychological
development continued throughout life. He suggested that each
stage of a

person’s life requires the resolution of an issue which could be,
if
negotiated properly, turned into a ‘virtue’. Each stage is built
on what has
gone before and becomes a part of that person’s ego
development (Wood
et al. 2002). So crisis is present in the form of a major ‘issue’
that needs to
be resolved in all stages of lifespan development. Erikson
considered
middle adulthood (40-65 years) to be characterized by the
concern about
the legacy one will leave behind and growing awareness of
mortality.
Those who negotiate these concerns in a healthy way are
‘generative’ -
they care about others and issues outside themselves. Those who
do not
negotiate these issues in a healthy way remain focused on their
own needs
and become self-absorbed (Wood et al. 2002). Although
Erikson’s theory
was one of the very few which made explicit the role of
development in
later life, he considered that most developmental changes occur
in
adolescence. The primary concern of middle age is coming to
terms with
death.
Peck (as cited in Wood et al. 2002) argued that this view was
too narrow
to account for all the issues that are of concern in the last forty
years of
life. To address this, Peck attempted to characterize the crisis of
middle life
in more detail. One area of potential crisis is when one values

physical
powers more highly than the wisdom that come with age. There
is the need
to come to terms with a loss of physical strength. But at the
same time
people gain (one hopes) wisdom in dealing with self and others.
According
74
to Peck, it is wrong to deal with life problems by relying on
physical
capability. Another area of crisis could be if one fails to
redefine partners
in terms of their personality rather than viewing them as sexual
partners
only. Another relationship crisis is related to the ability to make
new
emotional bonds when children leave home and parents die. The
fourth and
final crisis of middle age, according to Peck, occurs if people
fail to keep a
flexible and open attitude to life; very often people of middle
age are
closed to new ideas (Wood et al. 2002). All these issues are
viewed as
potential sources of crisis but also, if negotiated well, they can
be seen as
opportunities for satisfaction and personal growth. By looking
at mid-life
issues in more detail, Peck actually viewed later life positively.
Yalom also supports Erikson’s idea of the life developmental

cycle. He
mentioned George Vaillant’s longitudinal study to illustrate
how people’s
concerns from the age of 45 onwards are more long term and
self-
transcending rather than being personal and self-centred,
characteristic of
adolescence and early adulthood.
Cohen (2006) also thinks that growing old could be filled with
positive
experiences. The challenge is to recognise it and nurture it.
Only 10% of
middle aged people, Cohen found in the research he conducted
(2006),
described middle life as a time of crisis. Far more said that they
felt more
secure and eager to follow a new sense of quest and personal
discovery.
They thought that they could use the knowledge and experience
they had
gained to organize their life in a more creative way.
Does culture play a part?
Theories about meaning of life and midlife crisis are culturally
specific
rather than universal. Erikson and Peck’s remarks about life
span
development are based on Western concepts of when people
retire, their
children leave home and when they stop having sex. While there
is
evidence that sexual activity declines with age, some evidence
also
suggests that it could play an important role in people’s

relationships well
into their 70s and beyond (Wood et al, 2002). Further, there is a
vast
difference between western and eastern attitudes to nature and
by
implication to life. Yalom points out that the westerners’ view
is analytical
and objective in contrast to the oriental view which is
subjective and
integrative. While the western world considers past and present
as
preparation for a ‘point’ in the future which is always goal-
oriented, the
eastern world never assumes that there is a problem in life that
needs to be
solved: …’instead, life is a mystery to be lived’ (Yalom, 1980).
Within the
western world, views on the purpose of life have changed a
great deal
through history. The early Christians valued contemplation
above all else,
while the Calvinists, whose theological system has influenced
the West’s
ideas towards the purpose of life ever since, valued hard work.
Those who
75
Yana Weaver
do not fit in feel guilty and worthless (Yalom, 1980). The
differences are
evident within contemporary culture as well. Frankl referred to
a survey

revealing that 25% of his European students said they were to a
degree in
an ‘existential vacuum’, while amongst his American students it
was 60%
(Frankl, 1959). In his book ‘Man’s Search For Meaning’ he
made this
distinction again by saying ‘…to the European, it is a
characteristic of the
American culture that, again and again, one is commanded and
ordered to
‘be happy’’ (Frankl, 1959, p140). But happiness, as Frankl put
it, can not
be pursued but can only be a by-product when a reason to be
happy is
found. It seems that some form of mid-life crisis occurs when
people see
their lives in terms of their expectations and missed
potentialities, but in
this process of reflection, they tend to overlook the valuable
contributions
they made in the past. Frankl mentioned how these ‘realised
values’ in the
past are neglected when ‘measuring’ how useful a person is to
society. As
he put it …’today’s society is characterized by achievement
orientation,
and consequently it adores people who are successful and happy
and in
particular, it adores the young.’ (Frankl, 1959, p. 152). Frankl’s
study of
existential vacuum in the sixties and Cohen’s recent study on
mid-life
crisis have different results. The question is whether this is due
to a general
maturation of western society, or perhaps the same phenomenon
has been

looked at in a different way; Frankl focused on negative
experience of
ageing while Cohen’s survey highlighted positive experience.
Further,
most of the research on this subject has been focused on the
male life cycle
and the results have been generalized to the whole population.
Yalom
referred to a recent feminist study offering an important
corrective of this
view. Middle-aged women, having devoted the first half of their
lives to
their families, have different desires (from their middle-aged
male
counterparts) for the second half of life. While traditionally
men become
more altruistic at this stage of their life, having achieved
success, women
now have their first experience of having time for themselves
since
marriage (Yalom, 1980).
Ageing brings losses and challenges. By accepting inevitable
losses and
embracing challenges one can find ways to reach individual
potential and
in the process maintain physical and mental health. Erikson’s
theory of
lifespan psychological changes and Frankl’s ideas of striving
for deeper
meanings resonate with my own experience of middle age. An
interesting
area for more research would be to investigate the positive
experience of
ageing. Knowledge and experience gained through ageing brings
spiritual
maturity and serenity, which can benefit not just the individual

but also
societies as a whole – ‘happy’ people are productive people.
The
alternative seems to me unproductive and unnecessarily bleak.
76
Conclusion
While most psychodynamic theorists see middle life as a
product of
childhood, some, such as Erikson and Peck, consider it to be a
stage in the
lifespan development. Reflection and re-evaluation of one’s
accomplishments does not have to be seen necessarily as a time
of crisis
and negative experience. Facing existential questions, usually
associated
with the middle stage of life, is not easy; it often entails
conflicts between
what one is and what one should or could be (or between one’s
beliefs and
experience), but it also opens up new possibilities. It could be
said that
growth and maturation underlie existentialist and humanistic
ideas
associated with search for meanings: Jung’s individuation,
Frankl’s will to

meaning and Rogers’ personal growth. But the good things of
middle life
do not just happen; the meanings should be actively searched
for through
creative work, experience of love and fortitude and acceptance
and
‘owning’ of the whole self. In doing so, I believe, one can come
closer to
achieve one’s own individuation, deepen the meaning of one’s
own
existence and continue one’s own process of personal growth.
Yana Weaver has a background in economics and psychology.
She is
currently in the second year of a Doctorate course in
Counselling
Psychology at the School of Psychotherapy and Counselling
Psychology,
Regent's College, London.
An earlier version of this paper was originally submitted as a
course
requirement essay at the School of Psychotherapy and
Counselling
Psychology, Regent's College, London. I am very grateful to
Tony Babarik,
my tutor at the time, for his suggestion to submit the paper for
publication.
References
Cohen, G. (2006). ‘The myth of midlife crisis’ Jan. 16 2006
issue of
Newsweek - the article adapted from ‘The Mature Mind: the
Positive

power of the Aging Brain’, Basic Books, www.msnbc.msn.com/
id/10753221/site/newsweek/ accessed on 23 February 2007.
Frankl, V. (1959). Man’s Search For Meaning. London: The
Random
House.
Frankl, V. (1967). Psychotherapy and Existentialism. New
York: Simon
and Schuster.
Rogers, C.R. (1961). On Becoming a Person. London: Constable
&
Robinson Ltd.
Spinelli, E. (1994). Demystifying Therapy. London: Constable
and
Company Ltd.
Storr, A. (1973). Jung. London, Fontana.
77
http://www.msnbc.msn.com/%20id/10753221/site/newsweek/
http://www.msnbc.msn.com/%20id/10753221/site/newsweek/
Yana Weaver
Wood, C., Littleton, K. and Oates, J. (2002). Lifespan
development. In
Cooper, T. & Roth, I. (eds.) Challenging Psychological Issues.
Milton
Keynes: The Open University.
Yalom, I.D. (1980). Existential Psychotherapy. Library of

Congress
Cataloging in Publication Data.
78
PSYCHOANALYSIS AND ITS CRITICS
Morris N. Eagle, PhD
Adelphi University
This article discusses the question of the basis of changes in
psychoanalytic
concepts, theory, and treatment. Illustrative examples discussed
include the
“widening scope” of the use of “parameters” in psychoanalytic
treatment; the
rejection of the “Enlightenment Vision” and the concomitant de-
emphasis on
the role of insight; the concept of “narrative truth”; and the
“totalistic” re-
conceptualization of the meaning of countertransferase. I then
discuss the
relationship between research and clinical practice and argue
that if it is to grow,
psychoanalysis must be open to and attempt to integrate
findings from other
related disciplines.
I begin with a distinction between criticisms and critics of
psychoanalysis from

without and from within. Serious criticism should always be
thoughtfully considered,
wherever the critic is situated. However, there is an
understandable tendency for those
within psychoanalysis to rush to its defense when it is criticized
from without,
particularly when the outside critic launches what is perceived
as an unfair attack. It
is somewhat like finding it acceptable to criticize one’s wife or
husband but rushing
to his or her defense in the face of outside criticism. Thus,
although I have written
many articles critical of certain aspects of psychoanalysis, I
wrote to the New York
Review of Books defending its contributions in response to
Frederick Crews’ whole-
sale condemnation of psychoanalysis. Our understandable
reactions to the unfairness
and indiscriminateness of some criticisms from without should
not, however, blind us
to the need for sustained self-criticisms from within, from those
who have a broad
sympathy with an overall psychoanalytic perspective but take
issue with specific
claims or practices. The internal critic is often in a better
position to offer challenges
and criticisms of specific elements within psychoanalytic theory
and practice, because
his or her thinking is informed by an intimate knowledge of and
commitment to the
field. I hope that what follows will be perceived as such.
A frequent—I think the most frequent—response from the
psychoanalytic community
to cogent criticisms of traditional psychoanalytic theory (e.g.,
Grünbaum, 1984, 1993) is

some variation of “oh, that might have been true years ago, but
psychoanalysis has
progressed and we don’t think that way anymore. The critics are
beating a dead or at least
This article was based on a paper presented at a Division 39
Panel, New York City, April 16, 2005.
I thank Rita Eagle, Jerome Wakefield, and David Wolitzky for
helpful suggestions and comments.
Correspondence concerning this article should be addressed to
Morris N. Eagle, PhD, Professor
Emeritus, Derner Institute of Advanced Psychological Studies,
Adelphi University, Garden City,
NY 11530. E-mail: [email protected]
Psychoanalytic Psychology Copyright 2007 by the American
Psychological Association
2007, Vol. 24, No. 1, 10 –24 0736-9735/07/$12.00 DOI:
10.1037/0736-9735.24.1.10
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an outdated horse.” This reply tends to be taken as self-
evidently correct, but in fact there
are at least three questions one can pose in regard to this
response: (a) Just how do we now
think? (b) On what grounds, including empirical grounds, are
the changes in how we think
based? and (c) Does how we think now effectively address the
criticisms previously
made?
I want to address mainly the second question in this article,
which is essentially a
question regarding how changes in theory and in therapeutic
approach come about in
psychoanalysis. Some years ago I published a couple of articles
on theory change in
psychoanalysis, and my presentation today is a continuation of
those articles (Eagle 1986,
1993). My main claim is that changes in psychoanalytic theory
and practice are primarily
based not on empirical evidence, including evidence of greater
therapeutic effectiveness—
although I have the personal conviction that certain changes, for
example, the abandon-
ment of the “blank screen” role, could not help but contribute to
greater therapeutic
effectiveness— but instead reflect broad developments and
shifts in cultural, philosoph-
ical, and social– economic conditions.
Consider as a case in point the claim that changes in
contemporary psychoanalytic
theory and practice have yielded a “widening scope” (Stone,
1954, p. 567) of practice that
permits effective psychoanalytic treatment for a wider range of
patients. The term

widening scope implies that new techniques and tools are now
available that can reach
patients who were not treatable by earlier techniques and tools.
It is not at all clear whether
these presumably new techniques and tools are more effective
with more disturbed
patients, and whether the “older” techniques and tools were
ineffective with certain kinds
of patients. One only knows for sure that there are repeated
statements in the literature
referring to a widened scope and its presumed applicability to
more disturbed patients.
In addition to the motivation to help a wider range of patients,
an additional factor in
leading to the so-called widened scope might have been the
need to enlarge the range of
patients who were available for psychoanalytic treatment. The
pool of patients who met
the idealized criteria of appropriateness for psychoanalysis was
shrinking. There were
fewer and fewer patients who were able or willing to spend a
great deal of money and time
and who were likely to be capable of withstanding the rigor of
the classic analytic stance.
The widened scope suddenly made potentially available a large
pool of patients who
would not otherwise have been available.
For many of the wider range of patients, the classical analytic
situation, including the
blank screen role of the analyst, was probably not helpful or
manageable. This meant that
the analytic situation had to be modified so that it would be
more suitable and more likely
to be helpful for these patients. However, it is important to note

that the modifications of
the analytic situation—what Eissler (1953, p. 109) earlier
referred to as “parameters”—to
make it more manageable for a wider range of patients,
including more disturbed patients,
does not necessarily mean that the blank screen stance, although
more readily tolerated by
some, perhaps less disturbed patients, was ever appropriate or
helpful for any patient. It
was not as if there was empirical evidence for the applicability
of traditional methods
within a certain patient population and their inapplicability for
certain others, and then
new evidence emerged that a different approach could help
those others and thus widen
psychoanalysis’s scope. No such evidence was presented. In
fact, at least some of the
modifications of the analytic situation which constituted the so-
called widened scope and
which presumably were generated by the treatment requirements
of more disturbed
patients may well have been modifications appropriate for all
patients, as Stone (1954)
suggests.
This, then, seems not so much a matter of widened scope for a
particular class of
11PSYCHOANALYSIS AND ITS CRITICS
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patients but of general correctives of a stance that, too often,
had become rigidified and
stultified. As Holzman (1976) noted, for some classical analysts
who took ideas such as
blank screen and analytic neutrality too literally, the analytic
stance had become somewhat
of a caricature characterized by aloofness, excessive silence,
and stodginess. Although it
is, of course, an empirical question, it is difficult to believe that
these characteristics would
be therapeutic for any patient.1
Eissler’s (1953, p. 109) concept of “parameters” implies that
although the ideally
desirable analytic stance is a neutral2 and blank screen one,
given, so to speak, extenuating
circumstances (e.g., more disturbed patients), one may have to
introduce modifications,
that is, parameters, to the ideal analytic stance. However,
Eissler cautioned the parameters
should be reduced as soon and as much as possible, should be
interpreted, and one should
not permit an unnecessary transference gratification. In other
words, one should attempt
to return to the ideal analytic stance as soon as possible. But
there was little reason to
believe that the presumed ideal analytic stance was
therapeutically ideal. It was ideal only

in the sense that it was presumably dictated by theory and had
become accepted dogma.
Later modifications of the analytic stance and of analytic
practice included other
features that one might sum up as the increasing
democratization of the analytic situation.
Psychoanalysis became increasingly interactional; transference
was no longer simply
distortion; the analyst was no longer confidently thought to be
in an epistemologically
privileged and expert position, and so on. Also, the
“participant-observer” sensibility of
the quintessentially American Harry Stack Sullivan was
suddenly rediscovered, often with
no explicit acknowledgment. In some quarters, the process of
democratization increas-
ingly blurred distinctions between therapist and patient. I read
recently in one of our
journals—I can’t recall where—that the success of a treatment
should be measured by the
analyst’s transformation, as well as the patient’s.
From his or her earlier position as an opaque blank screen, the
analyst had now
become for many, if not an equal, at least a near-equal
democratic partner in self-
disclosure. The patient self-disclosed, both overtly and
inadvertently, through free asso-
ciation on the couch and the analyst self-disclosed, presumably
mainly advertently, from
behind the couch, through sharing his or her countertransference
reactions, sometimes
including very personal reactions. The question of the analyst’s
self-disclosure is a
controversial one. But my purpose here is not to discuss that but

rather to note the radical
swing of the pendulum and to raise the question of how we got
from one place to the other.
1 One finds in the history of psychoanalysis a particular pattern
of justifying departures from
traditional theory and practice by initially limiting claims of
their applicability only to a particular
class of patients and retaining traditional theory for the other
“usual” patients. As Mitchell (1979)
argues, the division of domains of applicability represents, in
part at least, an attempt to escape the
charge of heresy through a strategy of retaining a “domain for
orthodox concepts” (p. 182) and
designating “a new form of psychopathology to which the
formerly heretical lines now apply” (p.
188). Furthermore, as I (Eagle, 1987) have noted, once these
innovations have been accepted on this
limited basis by the psychoanalytic community, then claims of
applicability are extended to all
patients. A good example of this pattern is the movement from
Kohut’s (1971) early restriction of
the applicability of self-psychology to narcissistic personality
disorders (with traditional drive-
theory continuing to be applicable to “structural neuroses”) to
the more all-encompassing claim that
at the “deepest level” of all disturbances is self pathology
(Kohut, 1984).
2 Although a full discussion of this issue is beyond the scope of
this article, I believe that,
understood in a particular way, a good case can be made for the
therapeutic legitimacy and value
of maintaining a stance of analytic neutrality. However, I do not
believe that a plausible case can
be made to expect that neutrality instantiated as aloofness,

excessive silence, and other related
attitudes and behaviors should have any special therapeutic
value.
12 EAGLE
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On what factors was this swing based? As far as I know, we do
not have the foggiest idea
whether and when self-disclosure is related to therapeutic
outcome. We also have little or
no systematic information on different kinds of self-disclosure.
We have, instead, testi-
monials and seemingly endless debate.
Let me turn now to the relation between other changes in
psychoanalysis and broad
philosophical developments in our culture. How can one
characterize these broader
developments and in what ways are they reflected in changes in
psychoanalytic theory and
practice? It seems to me that a central and significant cultural
and philosophical shift that

marks our era is the repudiation of, or perhaps disillusionment
with, what Searle (1998,
p. 12) calls the “Enlightenment Vision.” Among other things,
this repudiation is charac-
terized by a rejection of and deep skepticism toward the
legitimacy of any concept of a
reality independent of the observer, any notion of universal
truths, and, as expressed by
Rorty (1979, 1985, 1991), of even the usefulness of the notion
of truth. Furthermore, for
those who do allow room for a concept of truth it is only a
local, not a universal, one. It
is a socially constructed truth that is saturated with issues of
power, social practices, and
social status. Again, as expressed by Rorty (1979), in this view,
knowledge is not a matter
of internal representations that reflect or mirror an independent
reality, but rather a matter
of pragmatic usefulness in achieving the practical projects and
goals one is pursuing. One
may recognize my brief description as social constructivism or
postmodernism, but the
label does not matter.
It seems to me that paralleling the broader philosophical shift
briefly described above,
indeed, reflecting it, is the shift from psychoanalysis as a
quintessential representation of
the Enlightenment Vision to a project in which that vision is
repudiated and replaced. As
I have argued elsewhere (Eagle, 2003), for Freud, learning the
truth about oneself—in the
form of lifting repression, for example—was at one and the
same time, a Socratic moral
imperative to know oneself, and the primary means of
therapeutic cure. What a fortunate

and wonderful and perhaps too good to be entirely true
convergence! Gaining self-
knowledge, expanding self-awareness, and being cured were all
part of the same liberating
project, a project that seemed to be a quintessential expression
of the Enlightenment
Vision. Soon, however, doubts were voiced regarding the
curative power of interpretation
and ensuing insight and awareness. An attempt was made to
rescue insight by positing a
distinction between merely intellectual and truly transformative
emotional insight. How-
ever, this discussion and literature soon faded and what
followed was an increasing
de-emphasis of the primary role of insight and awareness and an
increasing emphasis on
the curative powers of the therapeutic relationship.
The increasing emphasis on the therapeutic relationship and the
increasingly interac-
tional conception of the psychoanalytic situation brought other
changes in its wake.
Among many analysts, the patient’s transference reactions were
no longer understood as
distortions or projections on a blank screen analyst, but rather
as plausible interpretations
of cues emitted by the analyst (Gill, 1982, 1994). Also,
although analysis of the trans-
ference had long been a central focus in psychoanalytic
treatment, for many the belief that
only transference interpretations are therapeutically useful has
become virtually axiomatic
in contemporary psychoanalysis. And yet, there is remarkably
little evidence supporting
this claim. It has become an article of faith based on repeated
assertions (see Spence,

1992), despite the fact that the picture is a very complicated one
and that there are at least
some studies that report a negative relationship between
frequency of transference
interpretation and therapeutic outcome (e.g., Ogrodniczuk,
Piper, Joyce, & McCallum,
1999).
Consider also the “totalistic” (Kernberg, 1965)
reconceptualization of countertrans-
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ference and its new place of honor. Gabbard (1995, p. 475)
recently observed that the use
of countertransference as a valuable guide to understanding
what is going on in the
patient’s mind constitutes the “common ground” of
contemporary psychoanalysis, despite
the existence of theoretical differences. However, it should be
noted that there are no
systematic investigations and no systematic evidence indicating

when one’s countertrans-
ference reactions serve as a reliable guide to what is going on in
the patient’s mind and
when they do not.
Although the de-emphasis of insight and awareness does seem
to reflect a disillusion-
ment with the Enlightenment Vision, the concomitant emphasis
on the therapeutic
relationship is not, in itself, antithetical to that vision—it is sort
of orthogonal to it.3 It
reflects a turning to other factors partly as a consequence of the
disillusionment with the
curative role of insight and awareness. Nevertheless, if one
found, on the basis of
systematic and ecologically valid empirical research, that
relationship factors contribute
more to positive therapeutic outcome than interpretation and
insight, there would be no
special anti-Enlightenment or antiscientific implications.
Emphasis on the therapeutic
relationship is not in itself antithetical to the Enlightenment
Vision. It would simply be a
straightforward empirical finding that would present a challenge
to a point of view that
places exclusive emphasis on the therapeutic role of insight and
awareness. And, indeed,
there is some evidence that the quality of the therapeutic
alliance is the single factor most
highly correlated with positive therapeutic outcome (e.g., Blatt
& Zuroff, 2005; Zuroff &
Blatt, 2006).
Some contemporary features and developments in
psychoanalysis, however, go be-
yond merely giving special attention to the therapeutic

importance of the patient–analyst
relationship. And it is these developments that I believe most
clearly reflect broad
philosophical influences and that are most susceptible to
criticisms from within. Perhaps
the most far-reaching conceptual changes in psychoanalysis, the
ones that perhaps most
clearly reflect contemporary philosophical shifts, are those that
seem to call into question
the very ideas that (a) the patient’s mind has an organization
and structure that is
independent of the analyst and the analytic interaction—an
ontological claim; and (b) that
one can gain any objective knowledge of such a mind—an
epistemological claim. Note the
issue here is no longer the question of whether uncovering and
discovering truths about
the patient’s mind are therapeutically effective. It is, rather, the
deeper and more philo-
sophically sweeping question of whether it is in principle even
possible. These ontological
and epistemological skepticisms regarding, respectively, the
separateness and the know-
ability of another’s mind have been expressed in a number of
ways in the psychoanalytic
literature.
Consider Spence’s (1982) concept of “narrative truth” (which if
you read Spence you
will find, has nothing to do with truth, narrative or otherwise,
but entirely with persua-
siveness). In contrasting “narrative truth” and “historical truth,”
Spence makes a modest
and defensible point; namely, that because the analyst (and
patient) does not have reliable
access to historical events in the patient’s life, the best one can

do is formulate narratives
that are persuasive to the patient. Freud (1937) makes a similar
point in his “Constructions
in Analysis” paper when he writes that “if the analysis is carried
out correctly, we produce
[in the patient] an assured conviction of the truth of the
construction which achieves the
same therapeutic result as a recaptured memory” pp. 255–256).
He acknowledges that the
3 Such an emphasis is, however, more congruent with what
Rorty (1985) calls “solidarity” in
opposition to “objectivity”.
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analyst constructs rather than reconstructs the patient’s
history.4 It is unfortunate and
misleading, I believe, to have chosen the term narrative truth,
insofar as it equates at least
one kind of presumed truth with persuasiveness. That is, it
implies that there is a special

kind of truth—narrative truth—that is to be distinguished from
ordinary historical truth by
its special mark of persuasiveness. However, the basic idea that,
as far as the historical
past is concerned, the analyst may have little choice but to
formulate persuasive narrations
is, I repeat, a modest and defensible one. What has happened,
however, is that the concept
of narrative truth has come to be taken by many to be applicable
to all analytic
interpretations, including those that refer not only to the
patient’s historical past, but to his
or her current unconscious mental states. In other words,
narrative truth has been
assimilated into the general position that the analyst does not
and cannot gain objective
knowledge of the patient’s mind, but can only construct (or
coconstruct) new narratives.
On this view, all the analyst can offer is persuasive narratives
that hopefully make sense
to the patient and are useful.
In effect, this view concedes defeat in the battle against
suggestion, which Freud
viewed as the single most devastating criticism of
psychoanalysis. For some, who were
openly inclined toward postmodernism, even this was not
enough. Thus Geha (1984b)
takes Spence to task for being a closet positivist, still, poor
man, naı̈ vely believing that
there is a historical truth that can be distinguished from
constructed narratives and for
being concerned with retaining truth of any kind. According to
Geha (1984a, p. 268),
analysts generate “beautifully wrought” esthetic fictions,
nothing more, nothing less. (For

a further discussion of this issues, including ontological claims
regarding other minds, see
Eagle, 1984; Eagle, Wolitzky, and Wakefield, 2001; Altman &
Davies, 2003; and Eagle,
Wakefield, and Wolitzky, 2003).
Note that these developments in psychoanalysis regarding
knowledge of the internal
world almost completely parallel a currently fashionable
philosophical position regarding
knowledge of the external world. For example, as noted earlier,
Rorty (1979, 1991) tells
us that we should dispense altogether with the concept of truth
and the idea that our
theories and representations mirror an independent reality and
are to be tested against that
independent reality. According to Rorty, animistic tribal myths
about the nature of the
universe have no lesser or weaker epistemological status or
claim to truth than, say,
Einstein’s theory of relativity. One cannot look to an
independent reality to adjudicate
between different accounts. Each story—and each, according to
this view, is nothing but
a story—is designed to serve a particular pragmatic project and
accomplish certain goals
and is to be evaluated only in terms of how well it does that. By
the way, most often we
do not even take this step in psychoanalysis. That is, we
generally do not systematically
determine whether this or that coconstructed story or retelling
or narrative or esthetic
fiction or new perspective accomplishes what it is supposed to
accomplish. We merely
proclaim and assert and tell anecdotes.

So, where does all this lead to and where do we go from here? I
can only give you my
own views for whatever they are worth. I believe that
psychoanalysis cannot be a
self-contained discipline but instead must be open to influence
from and integration with
4 It will be noted that although Freud remarks that the best the
analyst may be able to do is
construct a convincing account of the patient’s past, he does not
claim that the constructed account
somehow possesses some special truth to be distinguished from
ordinary truth. Instead, he focuses
on the therapeutic usefulness of the constructed account.
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findings and theory from other disciplines. Drew Westen’s
work, one example of which
is presented on this Panel, serves as a very good exemplar of
that kind of endeavor.5

I think, however, there is a caution to be sounded. There is the
risk that one will look
to, say, cognitive science and neuroscience only or mainly to
confirm preexisting psy-
choanalytic concepts and formulations. That might be
interesting and personally satisfy-
ing, but it will not necessarily contribute to the growth and
vitality of the field. The greater
challenge is to look to findings from other disciplines that may
suggest a reconceptual-
ization or even elimination of cherished ideas. For example,
there is some fascinating
empirical work in psychology on “repressive style,” the
implications of which both
support certain aspects of Freud’s concept of repression but, at
the same time, point to
important modifications of that concept (see Eagle, 1998).
I believe that attachment theory and research have a great deal
to offer to psychoan-
alytic theory and practice. For example, as Parish and Eagle
(2003) have shown, partic-
ularly in long-term psychoanalytic treatment, the therapist
serves as an attachment figure
for the patient—although in different ways, depending upon the
latter’s attachment
pattern. I think some interesting implications flow from
thinking of the therapist as an
attachment figure, as well as some interesting work to be done
on how the match between
therapist’s and patient’s attachment patterns influence the
course of therapy (see Diamond
et al., 2002, for preliminary work in this area).
There are certain concepts that cut across different theoretical
schools and that are

likely to play a central role in understanding how people
function. Two such related
concepts in my view are defense and affect regulation. As Drew
Westen’s article (2004)
demonstrates, defense has been an extraordinarily robust
concept in psychoanalysis—
although how it is understood needs to be fine tuned in the light
of clinical work and
empirical findings in psychology and neuroscience. The concept
of self-regulation is
integrally linked to defense insofar as from the very beginning,
the primary function of
defense has been understood to be the regulation of affect states
such as anxiety, guilt,
depression, and shame. By the way, work on attachment styles
shows that one can find
evidence of self-regulating defense in infants as young as 1 year
of age. Thus, there is
evidence that a 1-year-old avoidant infant who does not seem to
respond to mother’s
absence and/or who does not turn to mother as a safe haven or
safe base upon reunion in
the Strange Situation nevertheless is responding with
accelerated heart rate and increased
level of cortisol secretion (e.g., Sroufe & Waters, 1977). One
way of interpreting these
findings is that the avoidant pattern serves to spare the infant
the pain of rejection and the
caregiver’s anger. In other words, it serves as a defense.
Although insight and self-awareness are not in much favor these
days, recent attach-
ment research points to their great importance, including the
role of mentalization and
self-reflection in self-regulation. (e.g., Fonagy, Target, Gergely,
& Jurist, 2002). We may

yet find that such old-fashioned ideas as the goal of
strengthening the observing function
of the ego in psychoanalytic treatment may become acceptable
and prominent again.
My strong belief is that one of the places we need go from here
is the abandonment
of different “schools” of psychoanalysis, each with its own
training institutes, its own
associations, and its own loyal band of followers. This sort of
thing is more appropriate
to political parties or religious sects than to a professional or
scientific discipline.
Adherence and loyalty to different schools are associated with a
habit of mind that is
parochial and will, in my view, contribute little to
psychoanalysis. I know that a happy
5 The research reported by Westen on this Panel will appear
elsewhere.
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face is put on so-called psychoanalytic pluralism. It is hailed as
a healthy alternative to
past psychoanalytic orthodoxy and rigidity and the
psychoanalytic version of “let a
thousand flowers bloom.” However, it seems to me to reflect
more a Tower of Babel than
anything else. I have much sympathy with Fonagy’s (2002)
conclusion that “this frag-
mentation and confusing absence of shared assumptions is what
spells, to me, the
inevitable demise of psychoanalysis—more than any of the
external challenges we face”
(p. 12). I am not suggesting (nor, I doubt, is Fonagy suggesting)
a return to a period of
monolithic orthodoxy and dogma. However, I do not believe,
paradoxical as it may seem,
that the existence of different schools constitutes a departure
from orthodoxy and dogma.
Rather, one finds that we now have a varieties of orthodoxies
and dogmas rather than a
simple predominant one.6 Freedom from orthodoxy and dogma,
it seems to me, lies not
in multiplicity of “local” orthodoxies and dogmas, but in an
openness and habit of mind
that is sensitive to evidence and that is antithetical to loyalty to
this or that school. In short,
the current so-called pluralism is not the only alternative to past
psychoanalytic orthodoxy
and dogma. Another alternative is an enduring effort for a truly
integrative theory that is
the product of a relinquishment of quasi-political loyalties and a
genuine openness—and
openness includes a readiness to relinquish cherished ideas—to
relevant empirical find-
ings from a variety of sources.

One will be able to say that the psychoanalytic ethos has
changed when one can write
about the history of psychoanalytic ideas without reference to
“dissidents” or “revision-
ists.” As a former President of Division 39, I have been
especially concerned with the
direction the division has taken. I believed that as an
organization primarily of psychol-
ogists, Division 39 could perhaps better integrate
psychoanalysis with psychology,
broaden its empirical base, and take it in a direction that the
earlier psychoanalytic
establishment could not. However, although there are
exceptions—Drew Westen is a
prime example of such an exception7—for the most part, this
has not occurred. Indeed, in
certain respects, I think the programs of the American
Psychoanalytic Association
meetings perhaps reflect a greater concern with scientific issues
and input from other
disciplines than the programs of Division 39 meetings. I am not
alone in this assessment.
During the course of revising and expanding this article for
publication, I had the
occasion to read an exchange of e-mails on psychodynamic
research on a Listserv that
includes leading clinicians, researchers, and scholars in our
field. It is clear from these
e-mail exchanges that at least some leading people in our field
are dissatisfied and
disillusioned with the substance and content of Division 39
meetings, in particular with the
relative absence of representation and interest in empirical
research at these meetings.

Drew Westen (April 21, 2005, personal communication) writes
that “I mostly go to
Division 39 meetings to see friends. Most of the talks have
titles like the container, the
contained, and the continental breakfast.” I would add an
observation on the hype and
excessive claims one sometimes encounters implied in the titles
of Division 39 workshops.
Westen also notes the tendency of some authors to present
“views about development,
unencumbered by what anyone who has actually studied it has
ever written” and suggests
6 There are exceptions to this state of affairs. For example, Pine
(1990), although not claiming
or attempting theoretical integration, argues convincingly that
the different aspects of psychic
functioning, emphasized by different “schools”— drive, ego,
object, and self— are all likely to be
especially relevant at different points in psychoanalytic
treatment.
7 Others include John Auerbach, Sidney Blatt, Wilma, Bucci,
Hartvig Dahl, Diana Diamond,
Peter Fonagy, Kenneth Levy, Lester Luborsky, Joseph Masling,
Harold Sampson, Robert Waller-
stein, Sherwood Waldron, and Joseph Weiss. Of course, this is
not meant to be an exhaustive list.
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that someone who presents or submits a paper on an issue that
has been empirically
investigated should at least demonstrate that he or she has
carried out a PsycINFO search.
In accord with my own impression noted above, Westen also
notes that “I’m actually
finding that the medical analysts and the American
Psychoanalytic Association and its
institutes are some of the most excited about research. Many in
Division 39 are psychol-
ogists and are dropping the ball rather than pushing it up the
hill.” Again, similar to my
view, Westen writes that “unfortunately, when psychologists
created their own alternative
to the orthodoxy of medical psychoanalysis, they forgot that
alongside learning to interpret
meaning in graduate school (now a disappearing art), they also
learned something else that
could have distinguished a psychologically informed
psychoanalysis: knowledge about
evidence, methodology, and hypothesis testing.”
An interesting and potentially fruitful suggestion made by Larry
Josephs (April 21,
2005, personal communication) in that e-mail exchange is the
scheduling of a regular

Division 39 presentation in which a theory paper, a clinical case
paper, and an empirical
research paper are presented on a given topic or issue. This
approach could serve as a
model for cooperation and interpretation among clinical,
theoretical, and research per-
spectives.
I believe that we need to strive to develop an integrated theory
of mental functioning
that incorporates findings from other disciplines and that does
not neglect or trivialize the
kinds of real-life complex phenomena and properties of the
human mind with which, in
contrast to other approaches, psychoanalysis has been
traditionally concerned. I know of
no current theory other than psychoanalysis that even attempts
to do justice to the depth
and complexity of the human mind. This is what needs to be
preserved. Whether the
integrated theory turns out to bear much resemblance to current
psychoanalytic theories
and schools seems to me of less importance than whether it
constitutes an ecologically
valid and comprehensive explanatory account that does justice
to deep questions regarding
the passions, subtleties, and complexities of the human mind.
It will be noted that I emphasize the need for an integrated
theory of mental
functioning and an explanatory account of the human mind
rather than the need to
demonstrate the effectiveness of psychoanalytic treatment—
although one would hope that
the former would have implications for the latter. Although I
believe that it is important

to carry out outcome and process research on psychoanalytic
treatment, I do not believe
that psychoanalysis’ main claim on posterity will necessarily lie
in its therapeutic effec-
tiveness.8 Indeed, Freud (1933) remarked that although
“psychoanalysis began as a
method of treatment, . . ..I did not want to commend it to your
interest as a method of
treatment but on account of the truths it contains. . .” (p. 155).
He also famously expressed
his need “to feel assured that the therapy will not destroy the
science” (Freud, 1926, p.
254). From the very beginning, the main contribution of
psychoanalysis was that it
presumably constituted both a special means for the
achievement of self-awareness and
self-knowledge, as well as a treatment for neurosis. As I noted
above, from the moment
that Freud focused on lifting repression as the main process
goal of psychoanalytic
treatment, the Socratic imperative to know thyself and the
clinical goal of cure for mental
disorder converged. However, the Zeitgeist no longer permits
the assumption of a
8Although there are studies suggesting that psychodynamic
treatment is effective (e.g., Bate-
man & Fonagy, 2001; Fonagy, 2002; Leichsenring, 2005;
Leichsenring, Fairbairn, & Leibing, 2003;
Sandell et al., 2000, 2001).
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convergence between self-awareness and cure, at least not in
any simple and unproblem-
atic way.
If one can no longer assume a convergence between self-
knowledge and cure, where
does this leave psychoanalysis? We have witnessed many
implicit and explicit answers to
this question, including ones that focus on the therapeutic
relationship, on corrective
emotional experiences, on offering new perspectives, on
constructing narratives, and so
on. An adequate answer to this question could itself take up a
full volume. One can read
Freud’s modesty regarding the therapy as expressing the
concern that in an overemphasis
on the cure aspect of psychoanalysis, its major role as a special
vehicle for self-knowledge
(as well as knowledge of others) would be weakened. Indeed, I
suspect that if Freud was
faced with the possible disjunction between self-knowledge and
therapeutic effectiveness
(the latter defined in a way that did not give a privileged
position to self-knowledge) and
was forced to choose between the two, he would opt for self-

knowledge as the main
mission of psychoanalysis.
One could argue that the emphasis on self-awareness and self-
knowledge is econom-
ically suicidal insofar as such an emphasis would lead to the
disqualification of psycho-
analysis as a treatment modality by health maintenance
organizations (HMOs) and
insurance companies. However, they do so anyway, and it is just
as likely that the claim
that we offer coconstructed narratives, or retellings, or new
perspectives would equally
disqualify psychoanalysis as a treatment modality. It may well
be the case that psycho-
analysis cannot compete as a treatment for mental disorder in an
age of quick fixes and
randomly controlled trials but can honestly offer a unique
opportunity to strengthen one’s
capacity for meaningful self-reflection and a unique experience
in the quest for self-
awareness, self-knowledge, and self-discovery. In a 1997
article, Stone, himself an analyst
and former President of the American Psychiatric Association,
takes the position that
psychoanalytic treatment is not suitable for severe pathology
but is irreplaceable as a
means to self-knowledge. He challengingly writes: “I still
believe that that a traditional
psychoanalytic experience on the couch is the best way to
explore the mysterious
otherness of oneself. But I do not believe that psychoanalysis is
an adequate form of
treatment” (p. 39). He also writes that, contrary to Freud, “when
a patient’s symptoms are
treated, he may then need a psychoanalyst to help him deal with

his ordinary human
suffering. That is the therapeutic domain in which the art of
psychoanalysis will survive”
(p. 39). It might well turn out, however, that the pursuit of self-
knowledge and self-
reflection is not only a worthy aim in itself, but may, in the
long run, constitute the most
reliable means of achieving cure or lessen the need to seek cure
from the more narrowly
focused forms of treatment.
In coming to the end of this article, I want to address briefly
two underlying issue that
run as a red thread through the entire discussion, namely the
“proper” relationship between
clinical work and research and the weight to be given to clinical
experience and to the
cumulative clinical experience of our field in developing
theories of personality and in
clinical practice. Does an emphasis on systematic research
imply that these experiences
are to count for nothing? An adequate examination of this
complex issue requires a
separate article or perhaps a separate volume. However, a few
brief comments are in order.
I recall during my Presidency of Division 39 there would be
periodic flurries of
apparent interest in research generally generated by the urgent
need to demonstrate that
psychoanalytic treatment is effective and could, therefore,
qualify for HMO and insurance
coverage. As noted earlier, there is, in fact, a body of research
that tends to demonstrate
that psychodynamic treatment is effective. However, the sudden
and periodic surges of

interest in research were not motivated by any interest in
information that research might
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provide, but by its public relations value. This, I believe,
continues to be the typical
attitude among many analysts. In a recent e-mail discussion of
evidence-based therapy, a
number of prominent analysts took the position that although we
know that psychoanal-
ysis works, we need the research for public relations purposes.
In a recent article,
articulating a viewpoint similar to the one expressed here,
Schachter (2005) cites as an
example of this attitude, Laufer’s (2004) statement that
universities “can contribute to
systematic research methodology to validate our findings” (p.
16, Schachter’s emphasis
added). Schachter goes on to comment: “she knows that our
finding are correct; university
research would provide a pro forma validation, rather than a test

of them” (p. 484, italics
in original). This attitude toward research limits its usefulness
and purpose to what might
be called its demonstration value. That is, it is intended to
demonstrate what we already
know (or think we know). There is little or no interest in
learning anything new from the
research and little or no expectation that the research findings
will surprise anyone by
calling into question or disconfirming what we think we already
know. Although under-
standable and necessary in particular contexts, the
demonstration function itself is not
likely to lead to new knowledge and to growth of our field.
My strong impression is that if a research finding did contradict
or disconfirm the
clinician’s convictions, it would be ignored or rejected. In an e-
mail discussion of a
Listserv,9 a prominent analyst—let us call him Dr. X—took the
following position: “what
if the findings [of a research study] were that medication
worked just as well as medication
and psychotherapy, but my conviction, based on my own
experience, was that people who
tried with just meds came back later in worse shape and people
who continued with both
therapy and meds did great. Well, I’m the therapist. Shouldn’t
my own experience take
precedence over any study, regardless of the results, in which I
was not the therapist?
What kind of scientist would I be if I let a study in which that
variable was left
uncontrolled decide how I should practice?” One can charitably
interpret these comments
as making the valid point that in this hypothetical study,

because the experience, talent,
and qualifications of the therapist were not taken into account
in comparing the relative
effectiveness of medication and psychotherapy, the results
should be taken with a grain of
salt. Such criticism, taken seriously, would lead to a better-
designed study. However, this
is not the gist of Dr. X’s comments. For even a better-designed
study would still not
include Dr. X who could continue to ask: “Shouldn’t my own
experience take precedence
over any study, regardless of the results in which I was not the
therapist?” Imagine that
every therapist takes a similar position: “I don’t care what the
results of this or that study
show. I was not the therapist in the study. And my clinical
experience is what counts in
how I practice.” This position is, of course, a recipe for
ignoring the findings of any study,
however well designed and however ecologically valid.
What Dr. X does not address is the question of what variables
are being omitted or
ignored by virtue of his not being included in this hypothetical
study. What is it about Dr.
X’s experience that could usefully be included as a factor in an
investigation of psycho-
therapy process and outcome? Is that factor Dr. X the person or
something he understands
and does which, if included in a study, and carried out by
others, would yield processes
and outcomes congruent with Dr. X’s experience? When Dr. X
asks “What kind of
scientist would I be if I let a study in which that variable was
left uncontrolled decide how

9 I understand that Listservs have an ambiguous privacy status.
Hence, although I quote one of
the contributors to the e-mail discussion, I do not identify him
or her. Therefore, I will use the name
“Dr. X”.
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I should practice?” the variable he seems to be referring to is
Dr. X the person or Dr. X
the therapist. But surely, Dr. X knows, that he cannot be
included in every study on
psychotherapy process and outcome—just as every therapist
who takes a similar position
knows. What Dr. X position amounts to, then, is not only a
guaranteed rejection of any
findings that contradict his experience, regardless of how well
the study is designed, but
also silence regarding how his experience might contribute to
better studies which, despite
his not being included as a therapist, he (and others) would find
convincing.

What then is a useful and productive relation between clinical
experience and research
(as well as other) findings? I think it is important to note that in
clinical work (from both
the patient’s and the therapist’s perspective), as well as in
everyday experience, compel-
ling insights may spontaneously emerge that cannot be
controlled or predicted nor dictated
by the use of a therapy manual, but nevertheless have the ring
of truth about them. Meehl
(1991), who has long advocated the importance of rigorous
research data, provides a
striking example of this kind of experience. Most of the time,
these insights are not and
perhaps cannot be validated by systematic research data. I am
not suggesting that,
therefore, one should dismiss or minimize the importance of
these experiences.
It seems to me in doing clinical work one must anchor oneself
in a set of convictions
that are buttressed by background information, commonsense,
personal intuitions, and
cumulative clinical experience. However, although one may
have such convictions—and
I have expressed such convictions throughout this article—it is
necessary. I believe, to
recognize that contrary evidence may come along that will
throw these convictions into
question. All such convictions, then, particularly in the contexts
of theory and professional
practice, have a provisional status, subject to the test of
systematic evidence.
I realize that this is a difficult attitude to maintain. One is

always more comfortable
with certainty and unshakeable convictions. However, there is a
great cost to be paid for
this greater comfort. One of the reasons I believe that loyalty to
this or that psychoanalytic
school is ultimately harmful to the field is that it serves to
crystallize and ossify
convictions on the basis of quasi-ideological affiliation and
renders one’s views more
refractory to contrary evidence.
In the course of working on this article, I read a New York
Times (Kolata, 2006)
article on an extensive and well-controlled 6-year study on the
effects of a low-fat diet on
the incidence of cancer and heart disease in women. The results
showed that the low-fat
diet employed in the study was not a protective factor—
evidence apparently dramatically
contrary to the cumulative clinical wisdom and experience of
the field. I have little doubt
that the clinical wisdom of many, if not all, physicians dictated
the prescription of a
low-fat diet and that they could buttress their conviction with
anecdotal evidence and
self-selected case studies. However, their convictions and
cumulative clinical experiences
seem to be unsupported by systematic evidence. As one
commentator noted, “We, in the
scientific community, often, give strong advice based on flimsy
evidence. That’s why we
have to do experiments” (as quoted in the New York Times, p.
A15).
This study is hardly the last word on the topic. Letters to the
New York Times have

already appeared pointing to flaws in the study and undoubtedly
more systematic critiques
will follow. But cogent critiques will likely lead to better
studies and modifications of the
conclusions suggested by the earlier study. And so it will go. It
is likely that despite the
findings of this study, which like many studies is an imperfect
one, many physicians will
continue to prescribe a low-fat diet. (And, I, personally, will
continue a low-fat diet.)
However, the issue is now open to further systematic
investigation. Any responsible
physician, whatever his or her clinical convictions, will now
have to be sensitive to
relevant findings from future studies. I am reminded of Meehl’s
(1997) observation that
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s
ar
tic
le
is
in
te

nd
ed
s
ol
el
y
fo
r t
he
p
er
so
na
l u
se
o
f t
he
in
di
vi
du
al
u

se
r a
nd
is
n
ot
to
b
e
di
ss
em
in
at
ed
b
ro
ad
ly
.
there is no clinical intervention in human history, including
those that in the course of
time, have turned out to be useless or harmful, that has not been

supported by personal
conviction, clinical experience, testimonies, and anecdotes.
As noted, I am aware that in doing clinical work, one must have
certain convictions
and firm beliefs in order to function effectively. One cannot
constantly keep at the
forefront of one’s mind an attitude of skepticism and an acute
awareness of the fallibility
of one’s convictions. At its extreme, this degenerates into an
obsessive stupor. However,
at the other extreme is the dead end of unshakeable and
dogmatic conviction and the
inability to not know and to be surprised by findings that are
contrary to one’s dogged
beliefs and convictions. I believe that in order for our field to
grow, we must all wear two
hats, one hat operating with some confidence, on the basis of
what one thinks one knows,
and with the other hat operating with an openness to not
knowing, to being surprised, and
to contrary evidence. This is an ideal stance, I believe, not only
in the context of the
relationship between clinical work and research, but also within
clinical work itself. Just
as there is the danger that excessive certainty will shut out
critical information from
external research sources, so there is a similar risk that
excessive adherence to preset
views will shut out critical information from within the clinical
situation, that is, from the
patient.
A final comment: The focus in the above discussion has been on
clinical work and the
relationship between clinical practices and research findings.

However, as noted earlier,
psychoanalysis is not only a treatment approach, but also, and
perhaps most importantly,
a theory of mental functioning and psychopathology. Even if
one questions the relevance
of research findings for clinical practice, can the development
of psychoanalytic theory
afford to ignore relevant research from a variety of other
disciplines? How one answers
this question will reveal one’s vision of psychoanalysis. Is it a
self-sufficient discipline,
content to rely on data exclusively from the clinical situation or
does its future lie in an
openness to and enrichment form a variety of sources, including
disciplined clinical data
and a wide range of research findings? For whatever it is worth,
it should be clear what
my view is. I believe that the former position is a dead end and
that a receptivity to
findings from a variety of disciplines represents the best
opportunity for psychoanalysis to
survive and, perhaps, prosper.10
10 Needless to say, I also believe that other disciplines can
benefit from psychoanalytic insights
(e.g., See Barron, Eagle, & Wolitzky, 1992; Eagle, 1997).
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