Identity or Regression in

American Psychoanalysis?
ROY R. GRINKER, SR, MD, CHICAGO

Introduction In this "debate" I shall orient my discussion

I N MAY 1964, Dr. Maxwell Gitelson ad¬ as closely as possible, but not exactly, to Gitel-
son's format and, therefore, divide it in accord¬
dressed The American Psychoanalytic Associa¬
ance with the numerical system he uses. I must
tion on the subject of "The Identity Crisis in
Psychoanalysis" and very soon thereafter his apologize for the frequent use of quotations
from my own writings in order to correct Gitel-
paper was published in the Journal of the
son's distortions.
American Psychoanalytic Association.1 It is
concerned with the formal relations between
psychoanalysis on the one hand and psychiatry, In this section Gitelson quotes Schilling 5 to
psychodynamics, and psychodynamic therapy on the effect that science has the qualities of a so¬
the other. As Rado et al2 have stated before, cial enterprise in that it involves interaction,
what happens in the psychoanalytic field and in
its official societies and, as well, the pronounce¬
cooperation, and sharing—". its own creeds
. .

and beliefs, orthodoxies and heresies. . ." Al¬

.

ments of its spokesmen are still of some sig¬

nificance to American psychiatry. Much of what
though Schilling wrote about physics, Gitelson
states he could be talking about the psychoana¬
Gitelson writes has been said before, by him¬
self 4 as well. Nevertheless his current recom¬
lytic "movement."
mendations are so at variance with the goals and Despite the recognized interdigitation be¬
tween science and culture, Gitelson wrote else¬
standards of psychiatry and psychoanalysis that
where °: "Adaptation to a culture has no place
these recommendations, if nothing else, require in psychoanalysis which needs to be free of the
answering. gravitational pull of a specific culture." He also
In the body of the paper the word "debate" lamented that teaching and education in psycho¬
is used several times, but it is not explicit whom
analysis have not been "authoritarian" enough
Gitelson is debating or challenging to debate. and implicitly advised intensification of the pol¬
This in spite of his previous statement: "It icy of dogma and self-serving regimentation.2·6
would seem that the wisest procedure would be There seems to be no doubt according to the
to avoid outright debate or other open encoun¬ historians of science 10 that the nature of the
ter with the organized proponents of so-called contemporary culture and society, the social dis¬
liberalism." It may be assumed, since he criti¬ tresses, conflicts, and ways of viewing the
cally quotes and misrepresents the meanings of world—the Zeitgeist—contribute to the appear¬
my writings, that he is debating with me3 al¬ ance of men of greatness and their closely-knit

though he avoids using my name except in the interacting colleagues. Science is closely related
with' its cultural environment because it is a
bibliography. It is, therefore, incumbent upon
me to answer on behalf of psychiatry the study of interbehaviors (Kantor u).
statements made by an individual who as¬ According to Mead 12 : "The most distinctive
characteristic of an evolutionary cluster is the
sumes spokesmanship for International Psycho¬
presence in it of at least one irreplaceable indi¬
analysis. vidual, someone with such special gifts and
Submitted for publication Nov 11, 1964. imagination and thought that without him the
Renrint requests to 29th St and Ellis Ave, Chicago, cluster would assume an entirely different char¬
111 60616. acter." This kind of person is called a genius.

Downloaded From: by a Tulane University User on 01/21/2019

 But "the effectiveness of a genius appears to be my observations indicate that there is less re¬
highly dependent only
not the state of the
on sistance from nonanalysts but more valid scien¬
culture and the period in which such an indi¬ tific criticism from within by some progressive
vidual is born but also on the exact position in analysts and pressure for more communication
the social structure which he occupies and the and cooperative research with representatives
exact composition of the cooperative face-to- of other sciences. The qualities of a social en¬
face group within which he acts." terprise need to be revived and intensified rather
One can hardly imagine a psychoanalysis, than suppressed.
which furnishes the raw data of psychoanalytic Unfortunately the opposing withdrawal and
science, without the analyst living as an ade¬ "movement" qualities are most evidenced in the
quate and integral part of his contemporary training institutes where they do most harm.
society, culture, and reality in order to under¬ Questioning, doubting, and critical discussion
stand the patient and to help him unlearn his by students with curiosity are often silenced
neurotic and unrealistic patterns of living. Cer¬ with explicit and implicit threats that this repre¬
tainly the process of analysis cannot be con¬ sents nonconformity, "return of the repressed,"
ducted in gravitationally free outer space, nor and indicates a need for "more analysis."
can intrapsychic processes be understood apart
from behavior in life. II
Early in its development a science organizes In my paper which Gitelson criticized
3
for action against inertia and resistance within by
means of distortions I wrote:
the cultural environment. Faith in the "great
Our current view of the world of man and his
man" is the impetus for the beginning of a
problems is under the influence of the revolution be¬
"movement." It is also responsible for exclu¬ gun by Freud. His paradigms have been applied to
sion of nonbelievers, as Freud's Vienna group psychosomatic, psychiatric, social, cultural, and educa¬
forced him to do to some members of the Swiss tional approaches. Many hitches, however, have been
observed in the last decade, and increasing evidences
psychoanalytic society, over Bleuler's protests, of rigidity are at hand. Stereotypes are rampant, theory
and which caused that great psychiatrist to is reiterated, and proof is attributed to repetition of
withdraw his support of the psychoanalytic hypotheses.
movement.13 It is responsible for Freud's writ¬ But a revolution or what we call a "breakthrough"
ing to Ferenczi not to be troubled with other has not yet appeared. Where and how will this occur?
theories for, "We possess the truth." 14 It is As members of a contemporary scientific culture
bound to our paradigms, we cannot predict when and
questionable whether any other young science how a view of man's problems in humanness will
even as an early movement was as cultist, as
appear. Perhaps it has already begun and is not recog¬
self-contained, and as mystically oriented. nized. All we can say is that some of us know that
Granted that the psychoanalytic "movement" it is overdue.
was a of development, it would be ex¬
phase If, however,
.

we continue to believe unlike

. .

pected by now that these characteristics would Kuhn 1ß that progress is slow and moves by ac¬
have been outgrown especially in view of the cumulation of verified knowledge, we then
wide acceptance of psychoanalysis in the United should be convinced that thorough grounding
States. But even today some societies do what in contemporary science is necessary for prog¬
Bleuler objected to—at times exclude nonmem- ress. Then we should modify our
concepts of
bers from its scientific meetings. Or, as Mead 12 teaching in every field related to human behav¬
states : ior. Broad education must take the place of
. the methods of Freudian analysis have been narrow technical training.
preserved
.
and transmitted in an apprenticeship situ¬
.

If we consider the final physical evolution of man as

ation, but expensively, by the establishment of a cult a resultant of countless mutations and slow natural
atmosphere and with a very low level of communica¬ selection, appropriate analogies may be made between
tion between the psychoanalytic theoretician and the
rest of the human sciences. genetic mutations and scientific revolutions or genera¬
tive ideas (Langer17) and between natural selection and
Those like Gitelson who advise continued iso¬ the rigorous scientific testing of hypotheses.
lation and more withdrawal are said to fear Other than a scientific revolution, which is unpre¬
emotional opposition from their nonanalytic dictable, our only current alternative, if we do not
professional environments. To the contrary, choose to fall back on philosophy or the supernatural,

Downloaded From: by a Tulane University User on 01/21/2019

 is to educate disciplined investigators who are com¬
theory and modifications are interspersed with
mitted to rigorous testing and searching. reaffirmations of old concepts, confused by
Kuhn believes that a science which has passed
metaphors and circular reasoning, and embodied
through its preliminary phases of observation in poetic literary style; out of this conglomera¬
and description and becomes systematically or¬
tion, it is difficult to develop precise declarative
dered develops a paradigm which defines the sentences suitable for the development of test¬
problems and methods used to solve them. Then able hypothesis.18 In fact, it is difficult to for¬
follows a period of "normal science" which per¬ mulate the "essence" of psychoanalytic theory,
sists until something goes wrong and novelty even if one uses Freud's four contingencies of :
emerges again to create a new paradigm by unconscious mental processes, resistance and
revolution. According to Kuhn normal science
repression, sexuality, and the Oedipus conflict.
often suppresses fundamental novelties because Gitelson states:
they are necessarily subversive of its basic com¬ Though currently there has appeared an inclina¬
mitment. Some scientists do not aim to develop tion to invalidate even these (basic science of psycho-
new theories and are often intolerant of those dynamics and its offspring, dynamic psychiatry and
invented by others. The paradigm must account psychotherapy) ; nevertheless they require our atten¬
tion since they are the basis for the view—though not
for everything. Through an esoteric vocabulary
stated in these terms—that a scientific revolution is in
and ultrarefinement of concepts there is less process in psychoanalysis.
resemblance to common sense. The scientists' Actually I wrote :
vision is restricted, and resistance to change in Unfortunately contemporary psychiatry has almost
the paradigm increases. Then something hap¬ completely adopted the psychoanalytic or psychody-
namic model. Psychodynamics is purported to be
pens and novelty emerges again and the resist¬ the basic science of psychiatry. It is frequently stated
ance increases; hence anomalies stand out more and written that the core process in psychiatry is a
strikingly and prepare the way for change. dyadic "depth" relationship in which diagnosis, prog¬
Paradoxical new findings result in support¬ nosis, therapy, and research are processed. There is no
need to differentiate whether so-called "depth" is
ing splintered movements, but I do not believe achieved with reference
that these are necessarily antagonistic to each to psychoanalytic, transac¬
tional, or information theory; the basic technique is
other. Putting aside the Jungian and Adlerian utilized by a participant-observer of uncertain relia¬
psychology, the schisms in modern psychoana¬ bility.
lytic societies have been precipitated over dis¬ Gitelson states:
agreements about methods and contents of There is an inclination to declare the existing psy¬
training. In my opinion the splintering within choanalytic paradigm defunct or rapidly expiring.
the American Psychoanalytic Association has I actually wrote:
The professional view held by psychiatrists is today
centered around liberality and conservatism mixed and confused. Psychoanalysis, for which many
(orthodoxy) in the training program. The neo- have sacrificed so much, has not become the thera¬
freudians emphasized social factors in the peutic answer ; it seems to be mired in a theoretical
causal matrix of neuroses and the Academy of rut vigilantly guarded by the orthodox and,
except
for relatively few examples, prevented from commin¬
Psychoanalysis is not a new movement but an gling with science. The great breakthrough promised by
attempt to furnish a more liberal * forum for the modern psychosomatic approach, with its con¬
any psychoanalytic or related research. These cepts of specificity of psychological etiology of de¬
then are not based on paradoxical new findings generative diseases, has succumbed to the hard facts
but are evidences that the freuclian paradigm of multiple causation and critical phases of develop¬
ment. Small wonder that with these disappointments a
is not viewed by every analyst as entirely
fertile soil has been created for new therapies—
crystallized. pharmacological, psychological and social—each one
Unfortunately one cannot speak of explicit rapidly exploited as a panacea.
psychoanalytic theory unless it is dated, since Gitelson states:
psychoanalysis, though actually operating as
.

* Gitelson views liberalism destructive and like a

as "normal science," has been declared bankrupt ;
. .

a new
true reactionary casts aspersious on "liberalization" synthesis which will clarify everything is thought to
whereas Webster's dictionary defines "liberal" as free, be already here or visible on the horizon.
not literal or restricted, not narrow or bigoted, and I wrote :
favoring reform or progress and greater freedom of In my opinion we should approach living human
thought or action. beings as if they existed in a total field of multiple

Downloaded From: by a Tulane University User on 01/21/2019

 transactions without connotations of significance, In the meantime during the war many Ameri¬
hierarchical importance, or conceptual devices called
levels. Thereby we avoid the dichotomies of nature vs
can psychoanalysts treated war neuroses and
nurture, organic vs functional, lower vs higher, or taught countless general medical officers using
reduction vs extension. Furthermore, we can opera¬ psychoanalytic theoretical constructs. The re¬
tionally behave in dealing with multivariable problems sult was a rapidly increasing interest in psycho¬
as if we really believed in multicausality of both
analytic training. Psychosomatic approaches
healthy and disordered function. This is transactiona- based on psychoanalytic theory and psycho¬
lism in a total field whose constituents range from
physicochemical to symbolic foci. analytic treatment became household words.
The intelligent public clamored for treatment,
Ill and young psychiatrists pounded on the doors
of training institutes to become "first-class
Gitelson contends that psychoanalysis was no citizens."
longer a movement but had reached the stage of Although our experiences which were so salu¬
"normal science" by the time the European po¬
litical chaos forced many analysts to migrate to tary during the war did not include actual psy¬
the United States. Here they met another choanalytic techniques, our post-war work and
our teaching as typified by that at Michael
"movement" which latched on to psycho¬ Reese Hospital and other new major psychiat¬
analysis: ric training centers were largely based on psy¬
For it the wishful humanism of the Mental
was
Hygiene Movement and the need for a scientific choanalytic theory which has acquired the
foundation by a psychiatry whose barrenness dimin¬ euphemism "psychodynamic theory." Because
ished its professional stature which, together pro¬ of this and other related factors, students en¬
jected on psychoanalysis their own extravagant social tered into the specialty of psychiatry with the
hopes and ambitions, and fell in love with the image. goal of becoming analysts. These two fields
This statement, poetic though it may sound, were so interlocked in our own minds that we
unfortunately is not
historically correct. The originally chose our psychiatric residents simul¬
early migrating analysts in the 1930's were not taneously with our local analytic institute, and
readily accepted by American psychiatry; they a resident entering
training was, therefore, a
came with no cohesive paradigm but struggled preliminary candidate for psychoanalytic train¬
bitterly against each other and the early Ameri¬ ing. In those days, then, we graduated people
can students who had returned from abroad, who we hoped were general psychiatrists but
and as Europeans attempted and succeeded for who became analysts and restricted their pri¬
a time to concentrate organizational power in vate activities, as many graduate analysts do, to
their own hands. Clinical practice was difficult the office practice of psychoanalysis. However,
to obtain, fees were low, and students scarce. many of them also remained on our staff as
Actually American psychiatry became imbued teachers in the role of supervisors of residents'
with interest and gradual acceptance of psycho¬ psychotherapy in a one-to-one relationship. As
a result, the pedagogical
analysis, except for the early efforts in New point of view not only
York and Boston, during and after World War maintained its psychodynamic purity but in¬
II. Profound social, economic, and emotional creased in intensity to the relative exclusion of
upheaval led the public to search for the security consideration of other forms of treatment.
it could not find in disorganized family life, in Many analysts who ascribe to the separateness
of psychoanalysis from psychotherapy are the
religion, or government. The new psychology
same people who teach and supervise psycho¬
seemed a hope as long as the rampant free anx¬
ieties were attributed to past experiences (ge¬ therapy as if it were a modified form of psycho¬
netic factors) yielding current internal conflicts analysis. We, like so many other institutions,
became recognized as proponents of psycho¬
(dynamic). On the other hand the neofreudians analytic psychiatry.
ascribed more external or social causes to the We have realized for some time that limita¬
anxieties, and finally the existentialists entered tion of the psychoanalytic point of view and
with an old philosophical concept of anxiety to that the rigidity and the circumscribed nature
which they applied therapeutic techniques of a training program based exclusively on in¬
which are difficult to understand. ternal dynamics, conflicted with out attempt to

Downloaded From: by a Tulane University User on 01/21/2019

 develop teachers and investigators and seri¬ Indeed psychiatry is not barren, but it lacks
ously impeded our attempts to add the teaching a unified theory although some have been sug¬
of milieu therapy, group therapy, family dy¬ gested.20 But where is such a unified theory to
namics, family therapy, basic principles of bi¬ be found ? Psychoanalysis is in no better shape,
ology including genetics, and social psychiatry although some contend it has a unified theory
to the training program. It was not that we capable of explaining all of psychological life
wished to dismiss psychodynamic principles nor and all of behavior. Its theories are precisely
reject psychotherapy based on these principles. focused on intrapsychic processes—they cannot
We did, however, desire to add to the sum total be applied in toto to constitution, biogenetics,
of knowledge, basic principles of an extended learning, society, culture, or reality at large, all
and expanded psychiatric field without sacrific¬ components of an extended field of which intra¬
ing the dynamic point of view. Indeed this psychic processes are but a part.
created resistances of an almost insurmountable
nature and brought us into a struggle for what IV
I should call, for want of a better name, Gitelson criticized the wide variety of names
eclecticism.19 related to, but not standing for, psychoanalysis
It is not the group of analysts who were edu¬ including "interpersonal" and "transactional,"
cated since the war who are disappointed in the meaning of which he obviously does not
the therapeutic efficacy of psychoanalysis—it is understand. He contends that their only sub¬
the older group which is disillusioned, as was stance "is to be found in the survival in them
Freud himself, and they are not the ones who of the pale shadow of existing psychoanalytic
openly question psychoanalytic theory. Criticism concepts." Animal experimentation, says Gitel¬
arises from the more scientific sophisticated son, is the degradation of the problem of the
group within the psychoanalytic organization human mind, and derivative psychotherapies
(cf later). Yet here Gitelson makes his first represent insufficient sensitiveness to the mean¬
gratuitous psychoanalytic interpretation which ing of unconscious processes. Then Lustman 21
has no place in a rational debate. "None of us is quoted to the effect that critics represent anti-
can say that we are not disillusioned. Unfor¬ theoretical 19th century criteria of science.
tunately many have also been bitterly disap¬ This is leading some research analysts to abandon
pointed. The difference is between insight and the analytic method for the comparative methodological
transference reaction." Those who criticize safety of laboratory research. Experimental sophis¬
.

have transference reactions, and in the next tication and scientific sophistication are not synon¬
. .

ymous. It prevents or should prevent analysts from

section he says: "Paradoxically, but not in¬
distorting and diluting their area of study through the
comprehensible to psychoanalysts, the child has use of available experimental techniques developed by
turned against the father while accepting its neighborhood disciplines.
birthright." Contrary to Lustman's idea that the labora¬
There can be question that psychoanalysis
no tory of research is safe, any research worthy of
has its own paradigm which is but a part of total the name is hard and frustrating in contrast with
psychiatry. Psychoanalysis, as long as it in¬ the pale cast of abstract theorizing for which
volves a special method applicable to people mo¬ there is no negation. We need not search di¬
tivated for relief of suffering, whether the rectly for unified theory but for as much theory
analyst has research interests in addition to his as we can, step by step, as we accumulate solid
commitment as a therapist or not, is a part of data and broaden our concepts.
psychiatry. It cannot withdraw without ad¬ Analysts who have strayed across the fixed
mitting failure as a therapeutic technique. boundaries of the psychoanalytic method are in¬
Psychiatry as a science is a composite field deed numerous and comprise some of the most
in which several disciplines using various meth¬ gifted people in the field. Just to name a few
ods from appropriate frames of reference are they include : Alexander, Benedek, French,
concerned with transactions (reciprocal modi¬ Kubie, Knapp, Stein, Mirsky, Colby, Marmor,
fying interrelationships). Each frame of ref¬ Masserman, Kaufman, Kris, Margolin, Pum-
erence and method is based on theoretical pian-Mindlin, Anthony, Engel, Fisher, Kepecs,
constructs somewhat different from all others. Lidz, Rado, Seitz, Sklansky, P. Solomon,

Downloaded From: by a Tulane University User on 01/21/2019

Stanton, Tidd, Wallerstein—and these are not recorded, and controlled. They may include the
all. This is an impressive group to accuse of use tape-recorders and multiple observers.
of
being antitheoretical and refugees into labora¬ However, experimental observation remains an
tory safety. Researches on sleep and dreams, undeveloped aspect of psychoanalysis. Colby
new results from electrical stimulation of the further states that theoretical biases have main¬
human cerebral cortex evoking memories, tained the f reudian dual instinct theory as well
handling of infantile animals leading to altera¬ as unrecorded observations, lack of quantifica¬
tions in subsequent learning, psychophysio¬ tion, lack of experimentation, lack of controls,
logical studies on the menstrual cycle, lack of follow-up, lack of cooperative research,
experimental neuroses, and the ego psychology lack of predictive statements, lack of interpretive
of academic psychologists all are contributing to ruses and obscurantist language.
modification of psychoanalytic theory. Rapaport 2B states, despite the fact that Freud
Let us now turn to what others have written said that psychoanalytic theory can be validated
about "dilution." Kubie, who is highly critical, only by the psychoanalytic method (and he says
states that "other sciences will clarify what is it has), that independent confirmation is needed
confused and muddy in psychoanalytic theory, by direct observation on infants and children.
concepts and terminology and will furnish mate¬ Psychoanalysis has no learning theory of its
rial for critical self-examination." Sandford f own. The field is beginning to extract valid
believes that "other methods besides the psycho¬ contributions from theories of the neofreudian
analytic one are useful for testing psycho¬ schools. These are statements from a leading
analytic hypotheses and that these hypotheses psychoanalytic theoretician.
are no less psychoanalytic for being tested out¬
Finally :
side the consulting room." Stanton $ advocates The Editors (of Psychological Issues, cf, especially
using methods not characteristically psycho¬ vol 4, No. 1, 'The Influence of Freud on Ameri¬
can Psychology' by David Shakow and David Rapa¬
analytic. Pumpian-Mindlin J stated that psy¬ port) believe that relevant contributions can come
choanalysis as a model is a closed system which from experimental studies as well as from clinical
blocks certain observations. Hartman § admits ones, from controlled developmental studies as well
that distortions of self-observation as well as of as from genetic explorations of psychoanalytic
observations of others may occur. Bellak J like¬ therapy, and that investigations carried out without
wise critically states that psychoanalysts are ap¬ any concern for psychoanalysis may nevertheless con¬
tribute to the theory.
plied scientists, professionals, or therapists and
.

While psychoanalytic psychiatry which fo¬

. .

as such are sometimes ambivalent in their at¬

titude toward theory, poorly trained in scientific cuses on internal dynamics attempts to recover
the libidinal experiences and the vicissitudes of
methods, concept formation, or other rigors of the instincts in reconstructions of childhood ex¬
thought taught to graduate students of science.
As Bellak states, clinicians generally and psy¬ periences within the therapeutic transference,
choanalysts particularly are wary of the aca¬ Piaget2ß has attempted to observe, describe, and
demic approach. classify actual childhood behavior in the process
of development. Psychoanalysis because it has
Colby24 states that psychoanalysis is a not developed a learning theory, instead, leans
branch of science still trying to "develop
scientific methods appropriate to its data and heavily on vaguely expressed concepts of con¬
problems." It proposes a system of theory and ditioning.27 Piaget has stimulated the develop¬
observations about human behavior. The train¬ ment of research in child development to the

ing of psychoanalysts has been limited for the point where it is becoming an independent
most part to the transmission of this system discipline. Mother-child transactions in infancy
in natural homes, foundling homes, and hos¬
without encouragement of original work. Low-
level observational statements refer to what per¬ pitals have been studied by several investigators.
sons actually say or do in the psychoanalytic Engel and Reichsman,28 especially, have been
situation. Observations should be systematic, able to observe in a child with a gastrostomy
opening, changes in behavior and gastric acidity
t See Hook.22 on approach and departure of friendly or
Í See Whitelock.23
§ See Hook.22 strange adults. The field of child development

Downloaded From: by a Tulane University User on 01/21/2019

will become basic to our understanding of nor¬ represent "a return of the repressed in the form
mal and pathological personality development of the wish to reverse history by expunging the
and extend beyond the "reconstructive" effects that psychoanalysis has had and still
anthropomorphizing about infantile fantasies. exerts on psychiatry. .". .

Finally studies of "health" and "normality" are Actually I stated:

beginning ^to refute the psychoanalytic concepts These "dynamic" approaches within a dyad have
of Eissler and Gitelson || that "normality" can superseded and even resulted in a depreciation of the
basic psychiatric techniques through which so much
be characterized simply as a defense.
progress was made in the nineteenth century. These
Critics of psychoanalysis receive from Gitel¬ are the methods of careful unbiased and controlled
son analytic interpretations among which are observations and accurate descriptions of behavior over
included : the return of the repressed, anti-in¬ time including verbalizations but not limited to them.
Observation of behavior rather than inferences about
tellectual trends, atavistic, antitheoretical, etc.
feelings is the keystone of psychiatric research. Be¬
Helen Tartakoff 30 asks whether the Academy havior represents in actuality functions allocated to an
of Psychoanalysis is "concerned with psycho¬ hypothetical ego which filters perceptions on the one
analytic education or with relating psycho¬ hand and actions on the other, which expresses re-
analysis to other disciplines by which eventually portable motivations, affects, defenses, and com¬
it is to be replaced"? Gitelson believes that co¬ promises, which employs symptoms and sublima¬
tions and demonstrates integrative capacities and
operation with other sciences is an intellectual disintegrative trends. About any of these there need
flight from the unconscious; that psychoanalysts be few inferences or interpretations. As observa¬
moving out into research using other than psy¬ tional material they can be coded and rated, re¬
choanalytic methods are concerned with prestige peated and replicated, and tracked through time. These
basic living data can then be interpreted according to
and with secondary gain of government financial fruitful theory and placed in juxtaposition to any
support; that social anxiety leads them to action hypothesis. Information gained from "depth" inter¬
to counteract this feeling; and that objectifying views in addition may account more adequately for
techniques (such as observations and recording déviances and inter-individual variability, but the be¬
of sessions) introduce new variables—as if haviors of the participant-observer and of the subject
whose "internal behaviors" are being observed as in
living in the world did not. psychoanalytic sessions require adequate systems of
In a 1963 paper about psychoanalysis in 1911- recording of data and their subsequent analysis. I
1912 I pointed out that little progress has been contend that the acquisition and validity-testing of
made in even beginning to investigate: "The behavioral data are the core operations of psychiatry
as a science.
same questions arise over and over again and
cannot be answered by affirmation, but only by
In short, behavior in interrelations is the sub¬
ject matter of all psychologies—human behavior
persistent solid research too long absent in the ultimately.
psychoanalytic discipline." Rather than being For the last 100 years psychiatry has been
an evidence of some horrendous neurotic trends,
considered as a specialty of medicine defined as
criticisms are not destructive. To the contrary,
the medical practice or applied science of treat¬
they are constructive, ie, future oriented. I ing and preventing mental diseases or disorders
stated :
of the mind. However, today Masserman's 32
The critics today are not overwhelmed by tradition,
definition is more appropriate : "Psychiatry can
worship or adulation of the originators of the method.
They hope to move forward, leaving behind what is be broadly defined as a science which deals with
disproved or unconfirmed, and to make a "science of the determining factors of human behavior, its
psychoanalysis" more than an easily mouthed phrase.51 variations and viscissitudes, the methods of its
analysis, and the means that may be employed
to align behavior with optimal personal and so¬
In this section the search of psychiatry for a cial goals." The disparity between these two
scientific foundation is emphasized. Here again definitions indicates the profound changes that
Gitelson extracts selected partial sentences from have taken place in psychiatry during the last
my paper; excerpts that, he says, repudiate psy¬ century.
Then Gitelson indicates that as rebels with¬
choanalysis in the name of "big science" and out a cause, critics like myself advocate a return
See Mead.12 to scientific atavism—a "naturalistic state of

Downloaded From: by a Tulane University User on 01/21/2019

 science in which human phenomenology is de¬ garding the freeness of free or the contingencies
hydrated. ." In contrast, I stated:
.
on which it depends. It is the only way, but
Behavior as the central theoretical focus of psychi¬
.

surely, if it is the keystone of psychoanalysis,

atric research is not a simple-minded fractionation of much research should have been expended on its
man as a totality isolated from his environment of
dimensions. "But no such studies of the human
things, people, and symbols. It does not ignore his
nervous, circulatory, and endocrine systems, his vis¬ personality will have their necessary scientific
ceral and somatic organs, and their constituent cells sophistication, no matter how refined their 'de¬
and fluids. We often find ourselves involved in con¬ sign' unless they are governed by the psycho¬
troversy with the reductionists who hope to explain analytic experience," says Gitelson.
man's behavior on a physicochemical or cellular basis, These are broad statements for which there is
or the extentionists or humanists who focus on society
a core of validity. Freud established the prin¬
and culture. These are futile arguments based on the
seemingly interminable resurrection of the either/ ciple that psychological processes should be
or and single cause concepts. The neurological or social studied by psychological methods. Even though
sciences cannot explain behavior, nor can the psychi¬ the data may be difficult to verify and historical
atric behaviorist do without them. How should we
consider the operational relationship of these other
anecdotes may lead to invalid inferences, Freud
approaches of bordering fields to our own? Do these did develop a paradigm suitable to man as an
many techniques study hierarchical series of levels animal capable of symbolic transformation
each with its own system or variables? Do we "bor¬ which in essence was a scientific revolution. But
row" information from other sciences or extrapolate then what? Do not the methods and results re¬
from them by analogy? Or is there a more fruitful
way of viewing relationships?
quire research and modifications ? No scientist
can consider that they represent the final
It is indeed unfortunate that this formulation
"truths." No science can live by reaffirmations
of field theory and transactionalism should be
alone.
termed atavistic by orthodox analysts, for it
Gitelson states, quoting from Hartman, that,
represents an expression of modern sophistica¬
tion such as is embodied in general systems when nonanalytic methods are used to examine
theory. It certainly is an antidote to the other psychoanalytic generalizations, none has been
aristotalian linearity of cause and effect, frag¬ than confirmatory. Rapaport25 has written
on this point. He states that an investigator is
mentation of frames of reference and either
reductionism or extensionism. usually the captive of his method. Theory can
Again, I wrote: predict only those phenomena elicited by the
All this should be known and understood by students method ; what is not amenable to study ceases to
of psychoanalysis, yet they and those in other discip¬ influence theory. In turn, all theories whose
lines should not be tempted to throw out what is methods do not apply to the phenomena are
valuable in this psychology. Until we resolve the mind- considered wrong. If tested at all it is by meth¬
body problem with the help of a unified theory, we ods alien to them and so are
shall have to deal with correlative relationships be¬ obviously wrong.
tween structure and function with causes and effects This verbal maneuvering certainly attempts to
taking either direction. We may use analogies for some put psychoanalytic research in a double-bind.
time yet; fruitful if we do not fall into the trap of
thinking they represent advances in knowledge. We methods of
Psychoanalysis, I believe, can utilize scientific
will have to maintain hypothetical constructs for the operating without sacrificing its con¬
invisible and give them names just as do the physicists ceptual domain. There is a great need for it to
and geneticists, as long as we do not reify them. We become an open system with freer exchange
shall have to continue to infer and make interpretations
through its boundaries. Progressive evolution
of verbal, motor, visceral and total behavior, but only does not occur in isolation but
as hypotheses to be tested.#
only through
partial isolation and by transaction with other
VI groups.33
VII
In his sixth section Gitelson states that free
Throughout his paper Gitelson insists that a
association in the analytic situation "is ex¬
paradigm cannot be relinquished until another
quisitely suited for confronting nature"— This available paradigm is compared and found bet¬
is held to be a fact with no doubts expressed re-
ter. Where is the alternative paradigm for ex¬
# See Bailey.3 plicit comparison ? 22 he repeatedly asks. Earlier

Downloaded From: by a Tulane University User on 01/21/2019

in this paper I have corrected the assumption In the ensuing 35 years there have been many
erroneously made by Gitelson that I propose discussions involving the definition of science,
abandoning the paradigm but this does not mean its methods and its students, involving psycho¬
that it should be maintained in its entirety as an analysis as well. Philosophers of science in in¬
ultimate truth or stand alone. creasing numbers in modern times have
In the second place the word paradigm which attempted formulations of science and the sci¬
Gitelson uses so vaguely, represents a conglom¬ entific method allocating to each a wide and
eration or cluster of theories, hypotheses, and "permissible" range, and some like Kuhn have
methodologies having in common some special outlined the stages of evolution of particular
way of viewing the world. Science may progress sciences.
by modifying any part of the paradigm, without Feigl,35 for example, states that scientists
seek descriptions, explanation, and predictions
destroying the whole, as the result of certain
anomalies or "hitches." Unfortunately this has which are as adequate and accurate as possible.
been disappointingly slow in psychoanalysis be¬ The most important regulative ideas are inter-
cause many orthodox analysts like Gitelson subjective testability, reliability, or a sufficient
maintain the "all or none" concept. degree of confirmation, definiteness and preci¬
sion, coherence or systematic structure, compre¬
Finally it seems to me that Kuhn's specula¬ hensiveness or scope of knowledge. Finally:
tions are based on the history of the physical
"Instead of presenting a finished account of the
sciences in which revolutions are easily possible
by the shift of a single basic assumption, ie, world, the genuine scientist keeps his unifying
hypotheses open to revision and is always ready
relativity. It does not seem likely that such a
thoroughgoing overhauling of psychoanalytic to modify or abandon them if evidence should
render them doubtful." Feigl's basic assumption
theory as indicated by the term revolution could is that
occur. Rather one would hope that slowly evo¬ empirical science is an unending quest
for knowledge and that its claims to truth are
lutionary processes derived from rigorous re¬ never but always held open to correc¬
search could alter what is needed to change. Not absolute,
to countenance change without a revolution, to tion, verification, or disproof, and, therefore,

insist on the established, to advocate withdrawal scientific truths differ only in degree from
from the world of psychiatry (and science) knowledge accumulated throughout the ages by
sound common sense. The quest for scientific
this is a backward movement.
—

truth which gives it a unique character is regu¬

VIII lated by certain standards or criteria which are
best formulated as ideals to be approximated
Psychiatry is not a science—psychoanalysis is rather than as goals ever fully attained. Accord¬
a basic science of individual psychology. These
ing to Feigl it is a sign of maturity to be able to
are strong phrases used by Gitelson, denying live with an unfinished world view.
the scientific basis of psychiatry and allocating
Kaplan 3e states that the behavioral sciences
to psychoanalysis the position of being basic. are overloaded by theories and their prolifera¬
There is a turn-about nature to this declaration, tion. A
good theory is one worth being acted on
since for decades the criticism has been leveled in contexts of
inquiry or of other action. Theory
that psychoanalysis is not a science. For ex¬ is true if it fits the facts—if
predictions made on
ample, in the 1930 edition of the Encyclopedia the basis of theory are in fact fulfilled but not if
of the Social Sciences Horace Kalian * wrote the facts are wholly constituted by the theory
that psychoanalysis has no quantities, meaning
they are adduced to support—if they lack an
systems of measurement, and could never be a operational core. The value of a theory is not
science. He stated that inferences were em¬
only in the answers it gives but in new questions
ployed as agents in their own verification and it raises.
that psychoanalysis is a faith and a dogma ;
Nagel % wrote that it must be possible to de¬
psychoanalysts are judges of their own truth duce determinate consequences from the as¬
and of criteria of their own validity.
sumptions of theory, if the theory is to be
*
See Seligman and Johnson/ i See Hook.2:

Downloaded From: by a Tulane University User on 01/21/2019

 capable of empirical validation. Some theory happy neurotic patients who are motivated to
must be tied down to fairly definite specified undergo therapy. Therefore, therapeutic versa¬
observable materials by way of rules of proce¬ tility (I would say experimentation) is the basic
dure. Finally a credible theory must be capable source of empirical data and not only compatible
of being negated by evidence. but necessary for scientific rigor. This means
Sidney Hook22 also says with specific experimentation, not rigid adherence to the
reference to Psychoanalysis : classical technique and the exclusion of "param¬
A subject is usually regarded as unscientific if in eters" in Eissler's sense. Scientific data can only
principle no observable state of affairs could falsify its be derived from a variety of controlled condi¬
claims, so that by ad hoc modifications its assertions
tions, interferences, relationships, etc.
can be made compatible with any state of affairs what¬
soever. Rapaport25 stated that the subject matter of
It is obvious from these brief excerpts that psychoanalysis is behavior (including the latent
forms) and that these data are subjected to three
the philosophers of science are not agreed on a
definition of science. Each seems to demand levels of analysis: biological, intrapsychic, and
real. For all of these we need more empirical
varying degrees of rigor in accepting evidence. data. Waelder,34 in a carefully conceived answer
The question of prediction vs explanation is
not resolved, and the historical method so im¬
to critics of psychoanalysis, demonstrated levels
of science as exemplified in this field. These are:
portant to psychoanalysis is not universally ac¬
level of observation, level of clinical interpreta¬
cepted as a scientific method. It needs better
validation. tion, level of clinical generalization, level of
IX clinical theory (repression, defenses, return of
the repressed, regression, etc), level of meta-
Gitelson insists that the basic theories and
methods of psychoanalysis have not and need not
psychology (cathexis, psychic energy, instincts,
be questioned. He puts it as follows: "How¬
etc), and finally the level of philosophy ( faith in
reason) which is most known by the intelligent
ever, this debate is not concerned with the public.
scientific substance of psychoanalysis but with The basic foundation is at the level of ob¬
the social and psychological issues surrounding servation in which humans are viewed from a
that substance." In other words, the problems
special frame of reference based on analytic
that the field of psychoanalysis is experiencing
theory. As in all sciences there must be a
today are projected by Gitelson onto its environ¬ transactional relationship between data and
ment. This is an easy escape hatch. To the
theory each by feedback reciprocally modifying
contrary, I believe that, if there be a crisis, it is each other.
in the utilization of theory and methods by
As Mirsky § said to Ostow, "I'd like to see the
psychoanalysts. data," but there is a paucity of data in psycho¬
We would all agree that there has been no
analytic writings. Freud's writings after the
breakthrough of radically new insights in the 1920's contained little of his empirical observa¬
recent American engineering sense, but has
tions. Careful perusal of the literature reveals
there been enough "spadework of normal sci¬ to the
a too frequent jump metapsychological
ence" and "quiet ferment" of progress? Here level, and many times I have heard the criticism
is where disagreement is acute. The issue is that the observations do "not fit into our meta-
joined in Gitelson's statement : "Therapeutic psychology." Conclusions of one author are re¬
versatility and scientific rigor are incompatible." stated as facts, and verbal innovations are
Yet it has been frequently stated that psycho¬
quickly adopted without proof. As Mendelson 38
analytic theories and hypotheses can only be stated in a thorough review of the psycho¬
confirmed or disproved by the use of the psycho¬
analytic literature on depression—it is a great
analytic method. Although I have already dis¬ debate, not a great investigation.
agreed with this statement, let us suppose that it The need for improvement was recognized by
is correct. What this means is that psycho¬ no less an analyst than Ernest Jones, who in his
analytic theory needs empirical data derived Presidential Statement in May, 1936, said:
from the use of the psychoanalytic method which
can be utilized in actual practice only on un- § See Whitelock*

Downloaded From: by a Tulane University User on 01/21/2019

 In the field of Theory, on the other hand (in
psychoanalytic situation is not psychoanalytic
contradistinction to technique), I am inclined to antici¬ research. Data derived from laboratory experi¬
pate very considerable changes in the course of the
ments on animals and humans, and from the
next twenty years or so. The scaffolding, as he
modestly called it, that Freud has erected, has stood social and psychological sciences are not sig¬
much rough weather extraordinarily well, though he nificant. Therefore, any psychoanalytic research
has had to repair and strengthen it from time to time. demands work in human patients who suffer
But it would be counter to all our knowledge of the from illness—the healthy cannot be motivated
history and essential nature of science to suppose that for treatment. So we now have the suggestion
it will not be extensively modified with the passage of
time. The preconceptions from the world of con¬ that nonmedicai persons "humanly qualified"
temporary scientific thought . with which Freud shall work with patients.
approached his studies had a visible influence on his
. .

Gitelson's suggestion to train nonmedicai per¬

theoretical structure, and they necessarily bear the
sons as investigators in psychoanalysis only re¬
mark of a given period. We must expect that other
workers, schooled by different disciplines than his, peats Freud's 39 statements on lay analysis, the
will be able to effect fresh orientations, to formulate suggestions in which were repudiated by
fresh correlations. In spite of our natural piety we American psychoanalysts. The Council of the
must brace ourselves to welcome some changes, forti¬
Association for Psychoanalytic Medicine re¬
fying ourselves with the reflection that to face new
truth and to hold truth above all other consideration affirms this stand in the following statement :
had been Freud's greatest lesson to us and his most It is one matter to offer training in psychoanalysis to
precious legacy to psychological science. promising qualified research specialists from other
Also, Glover called attention to the lack of disciplines to deepen their research in their own fields
scientific controls and to what we have indicated as well as to qualify them for a research career in

as "the increasing tendency not to apply to the psychoanalysis itself. This should not be equated with
data of observation or to the methods of in¬ embarking on programs leading to the unrestricted
terpretation such scientific controls as are avail¬ training of non-medical psychoanalysts for practice.
able. The consequence is that a great deal of The former may indeed develop the intrinsic scien¬
tific possibilities of psychoanalysis. The latter serves to
what passes as attented theory is little more than revise the operational relationship existing between
speculation, varying widely in plausibility." 2 medicine and psychiatry and psychoanalysis.
The sum and substance of my attitude toward We certainly permit and welcome psychiatric
the contents of this section is that the serious social workers and psychologists to work with
critic does not suffer from "existential anxiety" patients under some supervision. But that super¬
(at least not in this context) nor from "return vision immediately complicates the research
of the repressed," but he is painfully aware that aspects of the field by adding another and sig¬
the capacities of psychoanalytic theory and nificant bias. Although PhD graduates of the
method are being prostituted in the name of social sciences, psychology, and the humanities
"differentiation and functional adjustment" in may be well trained in scientific rigor, if psycho¬
the back street of scientific life. analytic concepts are to be used in research con¬
ducted within their own fields, they should
X understand psychoanalytic theory well.
Gitelson in this section suggests abrogating Gitelson terms his withdrawal and backward
what the American Psychoanalytic Association look, not as a policy of isolation but as "differ¬
has stood for in upholding its medical standards. entiation and functional adjustment." These
Gitelson states that psychiatry is mental healing words indicate a return to the "movement" phase
and not a science but that psychoanalysis is a of Freud's days of "splendid isolation." Today
separate scientific discipline, "whose practition¬ analysts are psychiatrists and part of the field,
ers can be various kinds of intellectually quali¬ and they are in it to stay. As Booker T. Wash¬
fied persons who are humanly qualified for the ington said about the American Negro, "You
human experiment which is the psychoanalytic can build a wall to keep the Negroes away from
situation." "Perhaps it is necessary to cast a the whites, but seven walls ten feet high can't
wider net for students of psychoanalysis." keep the whites away from the Negro." And so
In Gitelson's view the application of psycho¬ it is with psychoanalysts who cannot and should
analytic theory in any other manner except in the not be kept away from psychiatry.

Downloaded From: by a Tulane University User on 01/21/2019

 XI 2. Rado, S. ; Grinker, R. R., Sr. ; and Alexander,
F.: editorial, Arch Gen Psychiat 8:527, 1963.
In his final section Gitelson denies that there 3. Grinker, R. R., Sr. : Psychiatry Rides Madly in
is acrisis in psychoanalysis but by the very na¬ All Directions, Arch Gen Psychiat 10:228, 1964.
ture of man the return of the repressed with 4. Gitelson, M. : On Present Scientific and Social
subsequent "efforts at re-repression are taking Position of Psychoanalysis, Int J Psychoanal 44:521,
the form of dilution or denial of what we know." 1963.
No possibility is entertained that the crisis repre¬ 5. Schilling, H. K. : Human Enterprise, Science 127 :
sents legitimate and rational doubts. Again 1324, 1958.
Gitelson states that psychoanalysis is caught in 6. Gitelson, M. : Communication from President
About Neoanalytic Movement, Int J Psychoanal 43 :
an identity conflict between psychiatry which is
373, 1962.
a therapeutic specialty of medicine (no smidgon
7. Gitelson, M. : Analysis of "Normal" Candidate,
of science admitted here) and psychoanalysis Int J Psychoanal 35:174, 1954.
which is a basic science. 8. Gitelson, M. : Problems of Psychoanalytic Train¬
I reaffirm what Percival Bailey has critically ing, Psychoanal Quart 17:206, 1948.
stated about me—I, and many others, have faith 9. Gitelson, M. : Emotional Position of Analyst in
that out of psychoanalytic theory could come Psychoanalytic Situation : Part L, Int J Psychoanal
fruitful and testable hypotheses instead of the 33:1-10, 1952.
10. Boring, E. G. : Cognitive Dissonance : Its Use
worn-out hackneyed reiterations and reformula¬
in Science, Science 145 :680, 1964.
tions and the stultifying stereotypes stated as 11. Kantor, J. R. : Scientific Evolution of Psychol¬
positive facts, based only on inferences. Either ogy : I., Granville, Ohio : Principia Press, Inc., 1963.
psychoanalysis will move into a scientific posi¬ 12. Mead, M. : Continuities in Cultural Evolution,
tion using scientific methods and not rest on the New Haven : Yale University Press, 1964.
boastful statements of "our science," or it will 13. Alexander, F., and Selesnick, S. T. : Freud-
give way to a new paradigm. There are forces Bleuler Correspondence, Arch Gen Psychiat 12:1, 1965.
14. Bailey, P. : Great Psychiatric Revolution, Amer
moving in each direction. The most potent push J Psychiat 113:387, 1956.
for the extinction of what is good comes from
15. Bailey, P. : Sigmund the Unserene—Tragedy in
the "faithful" who maintain organizational
Three Acts, Harris Lectures, 1963, to be published.
boundaries as barriers against the free flow of 16. Kuhn, T. S. : Structure of Scientific Revolutions,
people and ideas. The most significant progres¬ Chicago: University of Chicago Press, 1962.
sive trend, I believe, is expressed by those who 17. Langer, S. : Philosophy in New Key, Cambridge,
recommend bringing psychoanalytic institutes Mass : Harvard University Press, 1942.
into the universities. 18. Madison, P. : Freud's Concepts of Repression
and Defense : Its Theoretical and Observational Lan¬
For me, trained and experienced in jacksonian
guage, Minneapolis : University of Minnesota Press,
neurology and in psychoanalysis, and seeing 1961.
much in psychoanalysis which can be under¬ 19. Grinker, R. R., Sr. : Struggle for Eclecticism,
stood in terms of physiological processes, I hope Amer J Psychiat 121:451, 1964.
that what is fruitful can be extracted by serious 20. Grinker, R. R., Sr., ed. : Toward Unified Theory
scientists who can doubt as well as speculate, of Human Behavior, New York : Basic Books, Inc.,
who can critically observe and experiment as 1956.
21. Lustman, S. L. : Some Issues in Contemporary
well as infer.14
Psychoanalytic Research, Psychoanal Stud Child 18:
Eventually this will happen for as Boring 10 51, 1963.
recently wrote: 22. Hook, S., ed. : Psychoanalysis, Scientific Method
At any rate, though scientific progress may be and Philosophy, New York : Grove Press, Inc., 1960.
hindered by dissonance, it is not necessarily blocked, 23. Whitelock, O. V., Sr., ed. : Conceptual and
for there is always waiting off in the future that most
Methodological Problems in Psychoanalysis, Ann NY
objective of critics, posterity, as well as posterity's Acad Med 76:791, 1959.
posterity.
24. Colby, K. M. : Introduction to Psychoanalytic
REFERENCES Research, New York : Basic Books, Inc., 1960.
1. Gitelson, M. : On Identity Crisis in American 25. Rapaport, D. : "Structure of Psychoanalytic
Psychoanalysis, J Amer Psychoanal Ass 12:451, 1964. Theory : Systematizing Attempt," in Koch, S., ed. :

Downloaded From: by a Tulane University User on 01/21/2019

Psychology : Study of Science, New York : McGraw- 32. Masserman, J. H. : Principles of Dj'namic Psy¬
Hill Book Company, Inc., 1959, vol 3. chiatry, ed 2, New York : W. B. Saunders Co., 1961.
26. Piaget, J. : Child's Conception of World, New 33. Grinker, R. R., Sr. : Philosophical Appraisal of
York : Harcourt Brace, 1929. Psychoanalysis, Sci Psychoanal 1:126, 1958.
27. Pavlov, I. P. : Experimental Psychiatry and 34. Seligman, E. R. ., and Johnson, . : Encyclo¬
Other Essays, New York : Philosophical Library, pedia of Social Sciences, New York : Macmillan Co.,
1951. 1930-1938.
28. Engel, G., and Reichsman, F. : Spontaneous and 35. Feigl, H., and Brodbeck, M., ed. : Readings in
Experimentally Induced Depressions in Infant With Philosophy of Science, New York : Appleton-Century
Gastric Fistula : Contribution to Problem of Depres¬ Crofts, Inc., 1953.
36. Kaplan, A. : Conduct of Inquiry, San Francisco :
sion, J Amer Psychoanal Ass 4:428, 1956. Chandler Publishing Company, 1964.
29. Eissler, K. R. : Notes on Psychoanalytic Con¬ 37. Waelder, R. : Psychoanalysis, Scientific Method
cept of Cure, Psychoanal Stud Child 18:424, 1963. and Philosophy, J Amer Psychoanal Ass 10:617, 1962.
30. Tartakoff, H. : Science and Psychoanalysis, vol 38. Mendelson, M. : Psychoanalytic Concepts of De¬
5, book review, Psychoanal Quart 33:437, 1964. pression : Springfield, 111 : Charles C Thomas, 1960.
31. Grinker, R. R., Sr. : Psychoanalytical Historical 39. Freud, S. : Question of Lay Analysis With 1927
Island in Chicago (1911-1912), Arch Gen Psychiat Postscript, James Strachey, trans., New York :
8:392, 1963. Anchor Books, Doubleday & Co., Inc., 1964.

Downloaded From: by a Tulane University User on 01/21/2019