Will psychoanalytic pluralism be an enduring state of our discipline?
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Biomedical subjects
Publications and source records attributed to Robert S Wallerstein.
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The roots of ego psychology trace back to Sigmund Freud's The Ego and the Id (1923) and "Inhibitions, Symptoms and Anxiety" (1926), works followed by two additional fundaments, Anna Freud's The Ego and the Mechanisms of Defense (1936) and Heinz Hartmann's Ego Psychology and the Problem of Adaptation (1939). It was brought to full flowering in post-World War II America by Hartmann and his many collaborators, and for over two decades it maintained a monolithic hegemony over American psychoanalysis. Within this framework the conceptions of the psychoanalytic psychotherapies evolved as specific modifications of psychoanalytic technique directed to the clinical needs of the spectrum of patients not amenable to psychoanalysis proper. This American consensus on the ego psychology paradigm and its array of technical implementations fragmented several decades ago, with the rise in America of Kohut's self psychology, geared to the narcissistic disorders, and with the importation from Britain of neo-Kleinian and object-relational perspectives, all coinciding with the rapid growth of the varieties of relational psychoanalysis, with its shift in focus to the two-person, interactive, and co-constructed transference-countertransference matrix. Implications of this intermingled theoretical pluralism (as contrasted with the unity of the once dominant ego psychology paradigm) for the evolution of the American ego psychology are spelled out.
I present an overview of the development to this point of psychoanalysis as a discipline--both as a theory of the mind and a treatment of the disorders of the mind--and offer a prediction concerning evolving development over its (near) future. My focus is on the coherence of psychoanalysis as a theoretical structure, starting with Freud's strenuous endeavours to maintain the psychoanalysis that he had single-handedly created as a unitary and unified theory, tracing then the breakdown of this effort, even in Freud's lifetime, into the burgeoning theoretical diversity or pluralism that characterises worldwide psychoanalysis today, and then going on to the beginning appearance of evidences--not yet widely remarked--of growing convergences from within very disparate and even seemingly very opposed theoretical perspectives, at least at the level of technical interventions and experience-near clinical theory, with implications, however, even for the level of experience-distant general (metapsychological) theory. Such a development, if sustained, as I anticipate, would strengthen the credibility of psychoanalysis as a science of the mind, amenable to growth through empirical research in accord with the canons of scientific method.
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