Journal of the American Psychoanalytic Association最新文献

At a time when many questions are arising about the nexus between psychoanalysis and social justice, the writings of Hans Loewald open an avenue for broadened conceptualizations of psychoanalytic activity and the role of interpretation within it. The pursuit of social justice, it is argued, is integral to psychoanalytic ethics, and the relation between activists and society can be formulated in Loewaldian terms. Using Loewald, and considering case examples from social justice informed advocacy, direct action, and protest speech in AIDS activism, social justice activism can be understood as a spontaneously emergent psychoanalytic interpretation delivered by activists to their social surround, effectively accomplishing multiple forms of therapeutic action. The therapeutic action includes a working through in two phases of the negative social transference, a concept proposed here to elaborate a mechanism for the transformation, through the interpretive aspects of activism, of psychic material directed toward marginalized subjects and those expressing marginalized subjective positions. Resistance to social justice activism is examined using the forms of resistance identified by Freud.

The act of interpretation in psychoanalysis has a distinct character due to the discursive structure of the psychoanalytic setting. The discourse that issues from the interplay of the fundamental rule and evenly suspended attention is a reflection on reflection. The result is that interpretation instead of being a device for inquiry is itself the object of inquiry. Psychoanalysis does not use interpretation. It is about interpretation itself. This perspective sheds a certain light on longstanding questions about the form and effects of psychoanalytic interpretation.

Interpretation of the latent meaning of manifest content is the core of the traditional approach to psychoanalytic treatment. The main purpose of such interpretation is to enhance the patient's self-knowledge, in particular his or her awareness of unconscious wishes and their embeddedness in inner conflicts. An assumption of classical psychoanalysis is that veridical interpretations-as Freud put it, interpretations that tally with what is real in the patient-will be especially effective therapeutically. These basic assumptions have been called into question, as reflected in such concepts as "narrative truth" and the overriding importance of the patient's "assured conviction" regarding interpretations. Also called into question is the therapeutic value of "deep" interpretations intended to uncover repressed impulses. To an important extent, these have been replaced by interpretations of defensive processes just below the surface of consciousness, and interpretations that make connections among different experiences, both of which are intended to help the patient understand how his or her mind works. There is also an increased emphasis on nonsemantic aspects of interpretation, as well as some degree of skepticism toward the therapeutic value of interpretation itself, along with an increased emphasis on the implicit interpretive aspects of the therapeutic relationship. Finally, representative research is presented on the relation between transference interpretation and therapeutic outcome.

Analysts seem spellbound by language when it comes to the word interpretation, a word so idealized and grand, so laden with fantasy, that the term itself continues to hold a magical sense that defies us to think about it. Called upon to do far too much explanatory work in psychoanalysis, it is accorded a variety of meanings. It is employed for varied uses, often simultaneously, making it hard to know what analysts mean when referring to "interpretation" and what uses they intend for it. Approaches to interpretation may be heuristically separated into those having to do with the content of the unconscious and those attempting to "use" interpretation in a manner still not divorced from content. What it means to attempt to interpret what is by definition uninterpretable is yet another area to be explored. Accordingly, issues of construction, co-construction, and transformation are examined. Every interpretation is at once a concealment, every inscription a negation, every representation a re-presentation of something unrepresentable. Despite this, the concept of interpretation, even if theoretically unsupportable in large measure, retains its clinical utility.

Two distinct spaces can be seen as operating in a session-a private one in the analyst's mind, where formulations take shape, and one shared between patient and analyst, in which interpretations are offered. By maintaining a focus on the here and now in the latter space, taking care to protect it from intrusions from the analyst's theory except as hypotheses (in the form of interpretations derived from those formulations) aimed at eliciting unconscious responses that further the analytic inquiry, a basis for analytic work is established that aligns with ordinary scientific processes: theory is generated in the mind of the researcher, and hypotheses derived from it are tested systematically in a laboratory setting. Self-understanding that develops out of such an arrangement can then be seen as based on evidence, minimizing the role of suggestion. This line of thinking is illustrated with excerpts from the beginning of the analysis of a depressed patient. In developing areas of theory, when reliable evidence is particularly important, this way of working holds promise. In this case evidence was systematically gathered that led to the formulation of a model of internal racism.

Interpretation remains relevant in contemporary psychoanalysis and serves a crucial linking function between patient and analyst. Interpretation provides an important link with temporalities: the time of the analytic hour and the time of the patient's history as it unfolds in the present. Analysis, it is argued, is bounded by time and loss. Two case vignettes, presented from a Kleinian perspective, exemplify these propositions.