Book Review

The Future of Psychoanalysis

N Engl J Med 2007; 356:1791-1792April 26, 2007

Article

The Future of Psychoanalysis
By Richard D. Chessick. 265 pp. Albany, State University of New York Press, 2007. $70. ISBN: 978-0-7914-6895-1

Psychoanalysis was for its founder, Sigmund Freud, three things — a form of psychotherapy, a theory of the mind, and a method of psychological inquiry. Today we might add a fourth — a profession with thousands of members around the world. Now in its second century, the field has undergone important transformations, particularly in terms of theory but also in the way therapy is practiced and in the method of inquiry. At the same time, the profession has experienced the growing pains and crises common to all professions: how large should it be; what are the appropriate standards for membership; how should its curricula be organized; what is the optimal balance among practice, teaching, and research; how can its activities be funded; and what is the best way to resolve conflicts concerning the answers to these questions? As a title, The Future of Psychoanalysis suggests that these issues will be discussed and that we will be offered a glimpse of some possible future scenarios.

But that is not what this book is about. Instead, it largely consists of papers previously published in The Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry. The book's editor, Richard Chessick, is a senior analyst at the Center for Psychoanalytic Study in Chicago and a serious scholar of philosophy and the humanities. After Freud, the most extensive discussions in the book are about Dante Alighieri, Georg Hegel, Martin Heidegger, and the associations that, in Chessick's view, link them to psychoanalysis.

Chessick has strong beliefs and tastes. He feels that the contemporary enthusiasm for pluralism in psychoanalytic theory is dangerous (he terms it “widespread dispersion and dilution”) and that although object-relations, interpersonal, and self-psychology approaches have something to offer, the basis of practice should be, as Jacques Lacan wrote, “a return to Freud,” with the analyst in the key role of observer and interpreter rather than equal participant. Chessick is aware that others have advocated this view but argues that theirs is only a “circumscribed” Freud, whereas his is the real thing. He is anti-eclectic: “The worst mistake a beginner can make at this point in the development of psychoanalytic theory is to assume that in some fashion these . . . various standpoints can be blended or melded into some supraordinate theory.” He does not discuss how he might convince, or even challenge, an advocate of one of the alternative psychoanalytic schools, nor does he even mention the possibility of using empirical tests or traditional scientific strategies for selecting among alternative hypotheses. He is particularly alarmed by those who would seek to link psychoanalysis to neuroscience, stating that “psychoanalysis must lead the way in the task of liberation from reductive materialism.” He is more interested in the relationship between psychoanalytic notions and the broader culture — philosophy, literature, art, music, and the general climate of social opinion. He likes modern art but not modern music, prefers Heidegger to Ludwig Wittgenstein, hates managed care, and in general is not too happy with the social and cultural changes of the past few decades: “The entire field of psychoanalysis is in crisis in our increasingly barbarous, violent, and declining culture.” He is concerned about the future — not only of psychoanalysis but of society as a whole — and conveys the feeling that he would be much happier if it looked more like the past. Chessick describes himself as a feinschmecker — a “discerning person or gourmet.”

According to Chessick, if psychoanalysis survives, it will be as part of the survival and resurgence of core humanist values — subjective experience, philosophy, literature, and the arts. For many, probably the majority of younger psychoanalysts, the future of psychoanalysis is both more optimistic and more modest. Philosophy and the humanities seem less relevant than science, and the science that studies the therapy, its process, and its results is more central than brain science. However, these perspectives on the future of psychoanalysis are not discussed by Chessick; his concern is with the core values that informed the culture that gave birth to psychoanalysis. He believes that their preservation is required for its survival.

Robert Michels, M.D.
Cornell University, New York, NY 10021
rmichels@med.cornell.edu