A Conversation with
Q: How did you come to psychoanalysis? Are you Viennese-born?
Yes I was born in Vienna. I first studied Latin and German and became a gymnasium teacher. I liked teaching children very much. Then I started to study psychology because I needed background to approach psychoanalysis. I was already sure from what I had read and from my own experiences that I would like to be a psychoanalyst. I had wanted to study medicine too but it was more realistic to chose psychology because I had to earn money with my profession. Some psychoanalysts also told me that I would never really come close to the essence of psychoanalysis by studying medicine. Psychoanalysis is a topic of its own.
Q: What age range of patients do you treat now?
I work with adolescents but also with parents and grownups. I like to have the mixed experience between young people and grownups. After my psychoanalytic training I established a small practice that grew and grew and left me less time for school teaching. So I slowly gave up teaching. I also became more and more involved in the Vienna Psychoanalytic Society.
Q: So you are a nonmedical analyst - what Freud called a “lay analyst.” You know in the US how much, despite Freud’s endorsement, they are frowned on by psychiatrists.
Yes. There are now more psychologists than medical doctors as psychoanalysts in Vienna. It’s nearly two thirds, which doesn’t make our medical colleagues very happy. They are encouraging students in medical schools to be interested in psychoanalysis. But it was already the trend when I began my studies to have more non-medical analysts. As for who makes the better analyst, in my own experience I found it was really a matter, after ascertaining their talent, of how avidly one is engaged in the topic: Has this candidate the makings of an analyst who can make a contribution, or not? Maybe my medical colleagues wouldn’t so much agree.
Q: One project that spun out of the Vienna Society was your new book Freud in the Press, which examines how Austrian newspapers treated psychoanalysis from 1895 until the Anschluss.
The project was supposed to take two years. But even with my historian colleague co-writer we still needed ten years to complete it. In the beginning we had wanted to compare analysis then with the present time but we had to give it up as too ambitious. But I was surprised to find that most of the anti-Freud arguments that now circulate were around since 1895 when Freud and Breuer published Studies in Hysteria. I was surprised to see how little these arguments changed.
Q: Are you saying the arguments against analysis then were exactly the same kind as those deployed in today’s “Freud Wars”?
I wouldn’t say it was quite the same. There was a shift in some arguments. For instance, physicians read with much interest that this Doctor Freud had found a new idea with which to deal with difficult cases. There was a lot of interest among Viennese colleagues, which is documented in the Vienna Medical Journal and Vienna Cllinical Journal (Wiener Klinische Wochenschrift und Wiener Medizinische Wochenschrift) from 1895 until psychoanalysis was expelled by the Nazis. They keenly felt their own restrictions, compared to what Freud was doing. Some doctors, for example, said that a gynecologist was allowed to ask any intimate question to find a diagnosis but that an ordinary doctor – a nonspecialist - is not even allowed to ask about sexuality. An ordinary doctor had to worry about his reputation if he asks about their sexuality.
Q: But sexuality was not the only concern, was it?
It is not the main concern today. Another argument against analysis was that it is not scientific enough. This is the main argument now, and, what’s worse, the effort to be ‘scientific” it is so even among some analysts the greatest concern. These attacks have always existed. The shift in contemporary criticism is that the reputation of the doctor is no longer at stake but it is more a concern about scientific aspects - whether one can repeat or prove results by statistics, and so on. This objection was always there. What is amusing is that they were saying from the start that psychoanalysis was dead and buried from the beginning, more than a hundred years ago.
Take for a famous example, an assistant at the Vienna University Clinic, Emil Raimann, who for decades followed Freud with an extremely ambivalent interest. When he got to know a bit about psychoanalysis he decided to write a book about it. Another skeptic at his clinic even told him he needn’t bother reading The Interpretation of Dreams - it’s not worthwhile. So Raimann attended Freud’s lectures but already was writing critically about psychoanalysis before getting to know it. So one day he asked Freud if he could accompany him after the lecture and then confessed that he – this is mentioned in one of Freud’s lectures - now would write much differently about psychoanalysis because he had a better idea of it. Nevertheless he continued to write critical reviews, somewhat attacking Freud but even more so even attacking Freud’s pupils, his followers.
Q: Who were more vulnerable?
Yes. This is a split which is very interesting. Freud was excused for working so long in relative isolation. One important commentator of the time said a genius is allowed to be alone because he needs solitude to carry on his work. But this dispensation does not apply to pupils. So this tactic of attacking the followers instead was one way of displaying ambivalence toward Freud and his findings. Like Emil Raimann they couldn’t stop it. They neither wanted to go into details of analytical work nor did they want to risk being drawn into analysis itself.
Q: That may be the key difference between earlier generations of critics and the current generation of critics. This acute ambivalence - because ambivalence means you really are attracted to the insights and explanatory power of the thing you are attacking. But for most critics, like Frederick Crews, today there is nothing whatever to be gained by examining psychoanalysis. It is a pure negative, a deadweight.
They say it but nonetheless many of them are attracted to some other form of psychotherapy based on psychoanalysis. These therapies must be serious, deal with sexuality, and so on. I am sure there is a secret attraction to psychoanalysis even now. And I think it was true also in earlier times. I think that if some psychoanalytic topic catches an unconscious conflict in the reader, it brings them some short period of relief because it is a lifting of repression which is experienced as pleasure. This, in my view, is the source of the secret attraction. This is an ambivalence where one can rail against analysis and at the same time enjoy it.
Q: Crews had a tremendous early interest in psychoanalysis before he rejected it and began what looks like a vendetta. Partly, the attack on analysis today is aided by the usually realistic view that it is too expensive to be available to the ordinary person.
It is a problem. In Vienna, even from the time of Freud, there was an outpatient clinic established through the very hard work of some colleagues who in the beginning struggled against other analysts who said we don’t; need it and we don’t care. As long as you don’t send patients to us we are not interested in it. But through this outpatient clinic we are even in contact with insurance companies now so that it is possible in Vienna to have the whole analysis even without any money because insurance will pay it.
Q: The American private insurance system is extremely reluctant to fund ‘talking cures.”
Even the insurance companies have found that psychoanalysis is serous. It lasts a long time and it costs a lot of money but in the long term it might be cheaper if a patient -- for instance a psychosomatic patient who is always in the hospital – no longer needs hospitalization or drugs. One can prove cases of patients with many stays in hospital who after they started psychoanalysis had none. So even the insurance companies realize that psychoanalysis might be a good thing. There is some appreciation of the therapeutic power of psychoanalysis even among those people who have no idea about it. One eminent colleague, for example, has achieved a certain success in talking seriously to insurance firms and showing them how psychoanalysis differs from other therapies. It is important to understand the view of people from the insurance firms while at the same time preserving the essential precepts of analysis
Q: The battle is proving to insurance companies that psychoanalysis can be what they call bottom-line ‘efficient.’
Yes, that psychoanalysis is cheaper in the long term if it is really indicated. There are studies which prove that psychotherapy can be much more effective, such as that in Germany by Joachim F. Dankwardt and Ekkehard Gattig.
Q: The current “Freud wars” continue. How do you assess them after your study of Freud’s reception at the turn of the 20th century?
At a European Psychoanalytic Institute conference in Helsinki recently a colleague I met in a lift turned to me and said, “What would we talk about if we didn’t have the [Freud Wars] crisis?” He meant it was not a real problem but a pretend problem. He shared my opinion that there will always be a struggle between repression and insight. I don’t think the outside world is more hostile to psychoanalysis than it was in the beginning. I think resistance is a natural reaction that Freud had already foreseen and experienced. When he was confronted with this powerful ambivalence, he explained it as the difference between a flirtation with psychoanalysis and a marriage with it, with all its difficulties and duties. Other psychotherapies have always promised to be able to do the same as analysis, only quicker and less expensively. That is a flirtation, I think. But we should also realize there are situations where other short term therapies are necessary. it must not always be a full-fledged great analysis but also there can be, if indicated, short term therapies
Q: Studies show that analysis works but so do other therapies, under differing circumstances.
It is difficult. I think it is often impossible to foresee what the person will do with his new possibilities after analysis. It can go very well and go awry. It’s not so easy to criticize any particular therapy.
Q: What are the most frustrating aspects of dealing with the press and the public today?
I think we analysts are not used to dealing with ordinary everyday questions, We are not prepared for it. We are too specialized in our thinking. We are prepared for sitting behind the couch, not how to speak with a journalist who wants short clear answers.
I think analysts and journalists both have much to learn, I think we analysts are surprised that we often don’t recognize what the journalists are writing. It is sometimes nothing to do with what we have said. They write something quite different, and then we have a problem. But there is an international effort among analyst to make themselves aware of what the journalists need. And they need clear answers. We don’t give clear answers. (Laughing), They want answers quickly. We don’t act quickly. We are even proud not to do so. We have to learn to make compromises.
Our outreach program analyst Franciska Ylander invited a top journalist who told us what she would need from the analyst. There are, of course, some journalists who have some idea what analysis is like. The first thing I learned was, If you don’t have the time to prepare yourself, don’t give the interview. If you are asked to do it nevertheless, then say no a second time. A journalist interview is not a place for free association. One really has to think over what one is doing - and what we did until now was a bit arrogant, to feel we can answer everything every time. We cannot. We can with a topic with which we are well acquainted. Maybe we can pick out an important aspect of a certain problem so that the journalists can use it, but it is not so in every case. I think that we should listen – something we should already know from our profession – to journalists. And maybe also listen to their fears, which we might detect when they are speaking. Maybe also take into consideration what pressures they are under. In Italy a group of colleagues took time once a month to speak with journalists about ongoing topics, about whether psychoanalysis have something to say or not about it. So they provide a space where journalists and psychoanalysts can meet and become acquainted with each other.
Q: Does analysis still mirror the standard New Yorker cartoon of the analyist scribbling notes behind a babbling patient on a couch?
I don’t think so. Some will take notes and I understand that. I sometime do this myself. [Donald] Winnicott said he could concentrate much better when taking notes. On the other hand, the notebook is something placed between the patient and oneself. We have learned to watch carefully our own counter-transference [personal feelings aroused in the analytical situation]. So some analysts prefer to concentrate on these feelings and not on the writing. I know also of a European colleague who conducts analysis while the patient is sitting on a chairs across from the analyst. So it is not possible to take notes. There are good reasons why the analyst can think it is important for patients to see the analyst and get a picture of him and his reactions.
Q: I know people using psychoanalytic techniques in group therapy.
I know people using psychoanalytic techniques in group therapy. There regrettably is a reluctance among analysts to address group processes and treatments It would be useful if we could all be more open to what group analysts have found. But I am not very hopeful in this regard. There are not usually very good relationships between analysts and group analysts because the latter often have not had such a long and careful individual training as the analysts
Q: So group psychoanalysis is possible.
I am sure that it is possible but there is also a lot of resistance against it, including among analysts. There are fields too where psychoanalysis can be a help, such as in forensics. . I took part in supervision sessions about hardened and disturbed young criminals in prison and I was deeply impressed at how the fate of a young person can be decided, how treatment can help. But it is a question of how one can persuade the public to spend money to help in research and so on.
Q: Let’s talk about your book on Freud and the Press. You found that Freud’s self-presentation of his early years of analytical exploration were not really a time of splendid isolation, as he portrayed it.
It is interesting that Freud exaggerated the period of loneliness. But I think everyone can understand why. Here was a new science and he had to protect it from threats outside and from inside. He also wasn’t sure about his new science, and he could not be. Then there also were his expectations. If you think about his letters to his fiancé. He was very much taken with the myth of the hero and to a hero it is necessary always to be in danger. And so he felt more in danger than he often was
Q: He needed to feel that way
It was certainly not always in accord with the facts. But even contemporaries recognized that a genius had to separate himself, and feel alone to perform the work. He later wrote in Moses and Monotheism that a new idea takes at least one generation to be established.
Q: Werner Heisenberg and Thomas Kuhn later said much the same thing about the history of Physics.
And Freud said this very clearly too. He used the examples of Darwin and others. On the other hand, he did not correct what he said about psychoanalysis, which took less than a generation to succeed. He published in 1895 Studies in Hysteria and by 1908 the Viennese Psychoanalytic Society was founded and the first International Congress took place. In 1910 the International Psychoanalytic Association was established. So 15 years is certainly less than a generation. I think the reason for the short time was that analysis often touches something important in people - something repressed that is relieved by a psychoanalytic idea at least for a short time. And this relief can be experienced as pleasure. . But there will be resistance because it is necessary for us to repress some things. So we never have an easy context. in analysis. In History of Psychoanalytic Movement Freud does say that analysis has established itself as a research method and as a clinical instrument --so he did see that there was not only rejection.
Q: There is a notion that Freud out of pride failed to make use of important contacts in Austria, and that if he made more efforts he would have gained notice and honors earlier.
I think one cannot overlook the Jewish problem, which still matters. It lasted a long time, but in Austria everything lasts a bit longer.
Q: Too true. What was your overall sense of his treatment in press,? It wasn’t all positive.
Press coverage was highly ambivalent - a blend of interest and criticism. The constant criticisms were about the open approach to sexuality, about not being scientific enough, and that the analysts would exclude others and were too arrogant. The newspapers denigrated Freud’s arguments about sexuality. The writers expressed concern that children should be troubled about sexual matters. One wrote that every healthy youngster undergoes this development and never made a fuss about it and now Freud comes along and makes a fuss about it. It is a complaint that has not changed
Q: What about Jeffrey Masson’s charge that Freud abandoned the seduction theory for fantasy not on the basis of evidence but out of sheer cowardice?
In seduction theory everything is outside, the threat comes outside the person. Seduction from outside is indeed a possibility. The seduction can be fantasy or it can be reality. It has to be decided case to case. We have to have our eyes open, and not be closed to anything. Freud helped to open our eyes in this respect but had to balance it again. Something which impressed me is that Freud took reactions of his colleagues seriously Maybe I expected him to be more arrogant than he was but he really thought about criticisms. He considered if he made a mistake. He thought it was quite astonishing that suddenly he found everywhere there was a seduction at the root of neurosis - until he found part of it was in the head of the patients. It was not always outside.He found too that the so-called seducers conveyed something in their unconscious, a feeling which was interpreted by the patient in a way which was experienced as a seduction But nevertheless there were also real seductions too.
Q: Freud never said otherwise.
When we are attending to reasons and causes outside ourselves which overwhelm us. It is a way of pushing our inner life away again, and, when we do so, we lose a lot of possibilities by doing that.
Q: By doing so we deny our own small but vital part of responsibility in what happens, or reacting to what happens.
Yes, exactly. In crisis intervention and so-called trauma therapy they say okay you are a poor victim and harm was done to you. Come to me and I will help. This is making a promise that an analyst would not make because he would guide the person so as to see what part was one’s own contribution to the problem he suffers from.
Q: And thereby establish some control over the problem by establishing control over oneself.
Persons who feel under severe pressure like to hear that they are not guilty of anything. So there is a silence about what is inside them. The analyst will not promise to prove all the bad is outside. He will not be able to sanction this.
Q: The Freud Wars critics first blamed Freud for concealing the level of real abuse and then when many ‘memories of abuse turned out to be false the same critics smartly turned around to say that this too was all the fault of Freud because of his concept of repression, which they said was an active repression much like amnesia.
So one has to keep both possibilities in mind - fantasy and reality - and treat them with great care. Repression is very important but it is not the only thing. Some authors are so rigid in the way they write about repression that they have only one trait they follow. I think this is what is picked up by the public. Such work should be checked by analysts who knows the dangers and who can understand why a person tries to guide the concept in one direction that can do more harm than good.
Q: In great traumas – life-endangering accidents, battlefields, catastrophes and so - it seems a conscious act to repress memory.
So that only in hypnosis or in therapy can one begin to recover it, however untrustworthy the recalled memory may be. I think there is some awareness that one tries to push away and to repress things that are unbearable. But that also gives one a lot of hope that something can be solved later, if not now. This unfortunately is not my original idea but comes from Winnicott who says repression can be healthy, it can be a useful delay enabling [therapeutic] work later which cannot be done now. But it is interesting that you mention hypnosis because this was also a way to bring memories out, done by somebody from outside So one should question these methods. Hypnosis can in some situations be helpful but it is not the end of the journey. Even if by hypnosis some person were able to see something out which cannot come out in some other way, the person still would have slowly to integrate what has happened.
Q: So repression must be handled with the great care.
A lifting of repression can be really shocking. It is one thing to lift one’s own repression and another to go utside the consulting room to damage the repression of a lot of other persons who have not asked for analysis and not asked for a lifting of repression A lot of harm can be done. Maybe that process is in the direction of health but maybe it is a developing catastrophe. Because when people are suddenly confronted with the truth of material they have repressed themselves they would need help. I behind my couch cannot do anything.
Q: The accusation may not be true either
Yes. Given these deep feelings of the person it is sometime not clear whether it true or not.
Q: Critics point out that some analysts too readily regard any criticism as ‘resistance” – sometime it probably is, but certainly sometimes it is not.
I think it would be helpful if we restricted the term resistance mainly to the consulting room, clinical situations and theoretical discussions.
Q: What of politics. Does analysis have any role to play in politics? Psychoanalysis is fundamentally a very subversive science. It’s not there to stabilize, or underpin any society. Since Freud’s time analysts have operated at every point in the political spectrum.
Like any science it should try to keep out of partisan politics. If it is used for only one partisan side, it is not good either for analysis nor for the side it takes. Nevertheless there are moments when we might have the ability to make some things clear, such as the role of projections and so on in the policies we see. I think we can provide knowledge but we shouldn’t peddle ourselves in politics.
Q: What about the question of testability, testing the effectiveness of analysis? What is going on in that realm?
It is a very, very difficult situation because it would be easy if one could concentrate on typical symptoms which one might manage. Some of them might be managed by different types of therapy, but psychoanalysis often turns upside down the whole personality. So it is also a question of how the whole personality develops, which is not easy for the usual scientific methods to gauge Psychoanalysis is much more than only a treatment.
Q: Say more about that.
I like very much a remark by a colleague Michael Parsons who says that a person who starts psychoanalysis must not yet know why he needs it. In some ways it is easier if the person is very disturbed. But it is difficult when a person is not happy and does not even know if he or she is allowed to be happy. After five years of analysis he might be quite a different person who worked through old feelings and wishes and thoughts. All this may have changed. I am not very much in favor of testability because I think it is like in art: how do you show the development of the artist? It’s not easy to do. You have ideas about it but it is nothing you can test. Nonetheless I respect colleagues who try to make links to the positivist science and to test progress. One can test the absence of symptoms. One can even test how great a measure an impression is by projective tests. One can do some things. And, of course, we sometimes need to look up from our methods to have a new view on them, to see more. But it is my view that the possibility to test psychoanalysis is very limited.
Q: The Victorian climate of prudishness is gone. If so, people say the types and sources of neurosis have changed too
I think this view is suspect. In making sexuality seemingly so public the impression is generated that sexual satisfaction is so much easier to get. It is simply not true. We are again confronted maybe not so much with inhibitions from the outside but with the anxieties of the parents and so on. I think there is a return of Puritanism, What concerns me even more is that analysts often share this Puritanism in their selection of theories. These theories are much more concerned with security, and with abuse and trauma and anything which originates from outside. But they are also focused on the union between the mother and child, omitting the sexual life of the mother. The Mother is primarily the fusion with the child but where is the mother who is a woman with desires?
Q: Madonna-whore again?
Rather Madonna without the whore. I think there has been less change than was advertised. I think we again have split off the mother who is a sexually mature woman with her own desires with regard to the father. There is a lot of denial. We have a relatively uninhibited sexual culture on the surface but inside it a lot of split-offs, which is evident even if one concentrates on baby observation. In this splitting off of the woman of desire from the mother of fusion the issue of destructiveness arises, the antagonist of love. There is the little girl who hates the mother when the mother disturbs her desire for the father. And then her guilt feelings regarding her antagonism to the mother, and so on.
As Freud said – quoting our Viennese poet Johan Nestroy - progress always is half as big as it appears to be. So I think things seem to have changed more than they really have because repressed material always comes through the back door. We can’t avoid it and we shouldn’t take the surface as everything.
Q: What are you currently
Q: Did you say m-a-l-a-d-y or m-e-l-o-d-y of separation?
Melody, as in a song. It sounds romantic. But actually I think it is only our defense as analysts against separation which can be experienced as terror. It is tremendous fear of being separated. In analysis separation anxiety plays an important role. It mirrors earlier failures in the environment. In analysis every nonresponse of the parents can turn up, which itself was a kind of separation.
Q: You’ve also written about Harry Potter, rather famously separated from his parents.
There is a total split-off of the ideal parents – a magic couple - who died and lost Harry. They cannot do anything wrong to Harry anymore and they are still helpful from heaven or wherever they are. So there are these idealized parents and then there are the split-off silly parents. Terribly silly people. So every young person has a choice in this split-off and can remake his family as he pleases, falling in love again with idealized parents and know the bad ones are those from whom a separation is necessary.
The books, of course, also appeal to magical thinking .which is full of pleasure. – a special quality of the books is the mixture of fantasy and reality.
Q: Is Hagrid a father figure or another adolescent?
Hagrid is a very powerful figure but at the same time very uncertain of himself. This is very useful for every youth; their uncertainty is projected onto Hagrid. So young people can take it or leave it to identify with him. The books are a kind of treatment they can chose for themselves, how and whom they identify with.
Q: What about Hermione who is so self-confident and commanding?
And she wins the love of Harry by being a ‘chap.’ So her role of sexual identity is not fixed yet, which makes their relationship easier. She slowly comes into the role of a girl. There is a lot of sexuality in this book. It can be a pleasure without becoming conscious.
Q: The game of quidditch?
There are a lot of masturbation fantasies in there. Zooming around on those broomsticks. It’s a bit out of control, a bit of pleasure, a bit of fighting. But neither the parents nor the teachers recognize it.
Q: What happens when Harry and his friends grow up?
They will find real ways to satisfaction and not rely so much on magic thinking. Not long ago an Italian colleague Andreas Giannakoulas elaqborated that all our pleasure as grownups has to have some connection with infantile pleasures and experiences. We can only hope that Harry Potter as a grownup finds his way back to infantile, but controlled, pleasures, controlled in order to keep them longer
Q: I’m turning from witches brews to pharmacology, to the degree there’s any difference. We live in an age of intensively advertised ‘better living through chemistry.” Magic pills will suppress, if not cure, what ails you, and that’s enough. Does drugging people make them more amenable to psychotherapy? Can those who are too violent or too depressive or too passive now have better therapy?
I am not sure about this because one main requirement to do analysis is that people make their own decision to do it. So to stop violence by killing somebody’s vitality, how should it make him more accessible for psychoanalysis ? I am not sure about it. Maybe the very first time it will give the person a break from being out of their mind totally, but it is not enough for analysis, I think.
I know that there are serious efforts to combine the two. But the few cases where I had patients who were also with a psychiatrist who thought it necessary to give them medication, it did not last long. They wanted to have a clearer mind and to work unaided. They felt they could be more themselves without drugs. By choice they decided to leave it. On the other hand when I am on vacation sometimes they go back to it.
Q. Any thoughts on measures that will improve the contribution of psychoanalysts?
Freud suggested that working in analysis there are many dangers for analysts and they should return every fifth year for their own analyses. We don’t know how often this happen because the colleagues who take charge of it are confidential, which is very correct. I think the possibility is not used enough. I also think that an analyst cannot acquire his capacity once and forever: he has to brush up now and again.- and in some way our patients help us with this because we have to watch ourselves. But there are also a lot of blind spots where we need the help of colleagues to regain our capacities.