Thinking in the Space Between Winnicott and Lacan: Towards a New Middle Group?*
by Deborah Anna Luepnitz
Following André Green (1986), the author maintains that the two most original psychoanalytic thinkers since Freud were Donald Winnicott and Jacques Lacan. Whereas in the past the two attracted almost non-overlapping audiences, a recent trend shows more analysts making use of both humanist Winnicott and post-humanist Lacan. This paper contrasts their views of the aims of treatment, as well as their organizing tropes of selfhood vs. subjectivity. Gregory Bateson's notion of 'double description' (following C. S. Peirce's construct of 'abductive reasoning') is invoked to theorize the bringing into provocative contact of two radically different paradigms. A clinical vignette is offered to demonstrate crucial concepts from both traditions in practice. The author asks if we are on the brink of a new independent tradition or 'new Middle Group' comparable to the one that emerged in 1940s' London. The benefits and risks of working in the potential space between Lacan and Winnicott are discussed.
'In the same river, we both step and do not step, we are and we are not.'
—Heraclitus, Fragment 49a
'…What we saw and grasped, that we leave behind; but what we did not see and did not grasp, that we bring.'
—Heraclitus, Fragment 56
Following an interview in 1990, British Middle Group analyst Marion Milner showed me her paintings from the 1930s and '40s. Pointing to a medium-sized canvas with two hens tearing each other apart—blood and feathers flying—Mrs. Milner said: 'I like to say it's Anna Freud and Melanie Klein fighting over psychoanalysis.'
She was referring, of course, to the 1940s' battle that derailed careers, ended friendships and nearly destroyed the British Psychoanalytic Society. It culminated in the group's bifurcation into the A and B groups, each member asked to declare allegiance. The person who argued for the importance of both Klein and Anna Freud was Donald Winnicott, whose 'Middle Group' was to have a lasting impact on psychoanalytic thinking the world over. Few contemporary analysts, whether their primary identification be Freudian, Jungian, Kohutian or relational have not been influenced by constructs associated with Winnicott and the Middle Group such as: the transitional object, potential space, borderline states, the squiggle game—and perhaps most importantly—the clinical use of countertransference as a source of information about the analytic process.
Another schism in the psychoanalytic world occurred some 20 years later—this one ending with no comparable entente. I mean the IPA's expulsion of Jacques Lacan in 1963, and his establishment the following year of his own school, the École Française de Psychanalyse which was renamed the École Freudienne de Paris.
Following what Lacan referred to as his 'excommunication' from the IPA, he maintained a strained but professional relationship with Donald Winnicott. Lacan translated Winnicott's paper on the transitional object into French—certainly a sign of respect—but continued for years in his seminar to discount the British 'nurse analyst' who would turn Freud's radical project into a form of 'Samaritan aid' (Lacan, 1977a, p. 36).
Winnicott (1971) for his part, wrote: 'Jacques Lacan's paper Le Stade du Miroir (1949) has certainly influenced me…' (p. 111), but he neither described that influence nor appeared to comprehend Lacan's widely cited piece. Winnicott, who acknowledged in a letter to Ernest Jones 'a neurotic inhibition to reading Freud' (Winnicott, 1987, p. 33), not surprisingly found Lacan's re-reading of Freud incomprehensible.
Many followers of Lacan and of Winnicott perpetuated the non-reading or aggressive misreading of the other man. For example, Middle Group analyst Charles Rycroft wrote: '…I found his [Lacan's] writings a real load of rubbish' (Rycroft, 1985, p. 5).
Conversely, Jacques-Alain Miller argued against what he saw as Winnicott's ascendancy in France as the 'anti-Lacan' (Miller, 1981, p. 38). Miller felt that the preoccupation of Winnicott and the Middle Group with the role of the mother was almost fetishistic, leading inexorably to a perverse course of thought ('une propédeutique pérverse') (Miller, 1981, p. 43). The same position was taken by Laurent (1981).
Following the translation into English of the Écrits, Jacques Lacan developed a following among anglophone academics, and the obverse relationship between Lacan and Winnicott attracted critical interest. Numerous authors undertook to contrast the two psychoanalysts' theoretical positions, in most cases, tendentiously. Some argued against the familiar humanism of Winnicott and the Middle Group in favor of the brilliant, politically edgy Frenchman (Elliot, 1991; Finlay, 1989; Mitchell, 1982; Moi, 1985; Ragland-Sullivan, 1986; Rose, 1982).
Others campaigned instead for the delightfully readable, guileless, environment-sensitive Winnicott over Lacan, the 'narcissist' who rejected the mothering function of the analyst and who may have abused patients (Finlay, 1989; Flax, 1990; Rudnytsky, 1991; Rustin, 1991).
Did no one recognize the importance of studying both Middle Group and Lacanian psychoanalysis? Even in the 1960s, there were a few such people. For example, Maud Mannoni, a member of Lacan's circle, traveled regularly to London for supervision with Winnicott (Boukobza, 1999). And in 1984, Anne Clancier and Jeanne Kalmonovitch published interviews with eight French analysts about the work of Winnicott, eliciting endorsements of many of his ideas (1987 [1984]).
Conversely, interest in Lacan on the part of anglophone analysts continues to grow, as Lacanian training institutes and study groups have arisen in the UK, Australia, and the US. Further evidence is found in volumes such as Lacan in America (Rabaté, 2000) and Jacques Lacan and the new second wave in American psychoanalysis (Gurewich et al., 1999). However, until very recently, the only psychoanalyst on either side of the Winnicott/Lacan divide consistently to build into his own theory elements of both traditions was André Green, who asserted:
After Freud, I see two authors who have pushed their research and coherence very far on the basis of two quite different points of view, and which up to a certain point converge. These two authors are Lacan and Winnicott.
Initially a member of Lacan's circle, Green chose to break ranks:
I had followed Lacan in the name of freedom of thought, and now he was upbraiding me for thinking for myself. It was the end of our collaboration….The more familiar I became with their [Middle Group] frame of mind, the more I had the feeling that this was where I could find what was missing in Lacan's approach, which seemed to me unsatisfactory, even misguided, in its abstraction. (Green, 1986, p. 9)
For Green, constructs such as the pre-oedipal period, the borderline diagnosis, and the use of countertransference—all anathema in Lacan's school—became sine qua non. Green qualified his enthusiasm by adding: 'I am not an unconditional Winnicottian…[A]n analyst who really wants to think about practice cannot dispense with a reflection on language, a reflection that is absent in Winnicott.'
It should be noted that some would object to Green's use of the term 'Winnicottian.' As one admirer put it: 'There can hardly be a school of open-mindedness.'
Similarly, Lacan insisted he himself was not a Lacanian but a Freudian. I will continue to refer to 'Lacanians' and 'Winnicottians' mindful of the limitations of those labels.
Whether consciously following Green's lead or not, a number of analysts in the past decade working independently of one another, have continued building a conceptual bridge between Middle Group and Lacanian theory (Bernstein, 1999; Eigen, 1981; Ireland, 2003; Kirshner, 2004; Lonie, 1990; Luepnitz, 2002; Mathelin, 1999; Rogers, 2006). These practitioners have placed themselves in an intellectual position roughly comparable to that of London's original Middle Group. Engaged by both Lacan and Winnicott, and disinclined to discipleship, they work in the area between two schools of allegedly incompatible thought. It might be useful, in fact, to describe this area with Winnicott's term 'potential space' which, by definition, both separates and joins two people or entities. The goal of these bridge-building authors, I believe, is not a synthesis creating one master discourse. Rather, the aim is to bring two radically different psychoanalytic paradigms into provocative contact.
How exactly does one do this, and to what clinical effect? André Green seems to see Winnicott and Lacan as complementary and mutually limiting. The quotation above shows him turning to Winnicott and the Middle Group as a corrective to Lacanian abstraction, and turning back to Lacan as a corrective to the absence of rigorous reflection on language in Winnicott.
Similarly, Jeanne Wolf Bernstein (1999) uses Lacanian constructs to titrate what she views as the excessive concentration on countertransference in relational psychoanalysis. Bernstein believes that Winnicott and the Middle Group made a vital contribution in turning our attention to the analyst's interiority, but cautions that an overuse of it can simply be a cover for the 'analyst's narcissism.' She writes: 'Although the American relational school has contributed much to humanize the analytic encounter…an overly democratic use of "working in the countertransference" risks trapping the analyst in the glass cabinets of what Lacan calls the imaginary order' (p. 291). Bernstein devotes the remainder of her incisive article to an explication of Lacan's early emphasis on the role of the signifier as a way of limiting what he perceived to be an overemphasis by Winnicott and other British analysts on the role of phantasy and the imaginary.
I will examine two fundamental differences between the theories of Lacan and Winnicott, arguing that much is gained by keeping both in mind in clinical practice. The most elemental difference between Winnicott and Lacan might be described as the question of who shows up for analysis—the self or the subject? The second essential difference concerns the aims of treatment.
Self vs. subject
There is no concept of 'self' in Freud. Freud preferred 'die Seele' which translates 'soul' or 'mind.' Both Rank and Ferenczi had invoked the 'self,' but Winnicott, apparently confident in the transparency of the term, cites no previous usages, nor reflects on its etymology.
According to the Oxford English Dictionary, the word 'self' probably derives from the stem se used to connote sameness or identity. (Latin ipse translates 'itself,' used for emphasis.) But self used as a noun to describe what is really and intrinsically a person does not appear until the Renaissance. By 1595, Spenser is referring to 'myself, my inward selfe…'. And one year later, Shakespeare's Polonius urges 'to thine own self be true.' This semi-autonomous, perfectible entity, born of secular humanism, was not welcomed by everyone. In 1680, Carnock wrote: 'Self is the great Anti-Christ and Anti-God of the world.'
Winnicott wrote of the self's emergence through contact with a good enough mother, and its subsequent 'development,' 'growth' and 'maturation.' Eigen (1981) wrote of helping patients 'to grow a self.' That trope is interesting in light of the use of 'self' as a transitive verb that occurred around 1900, meaning: 'To fertilize by means of pollen from the same plant.' One could thus 'self' a flower. And Middle Group analysts hope to foster the flowering of the self.
It is precisely this collection of gardening metaphors that Lacan rejected. In a harsh critique of developmental models in Anglo-American analysis, Lacan demanded:
Can you really, you analysts, in all honesty, bring me testimonies of these splendid typical developments of the ego of subjects? These are tall stories. We are told how this great tree, man, has such a sumptuous development…A human life is something entirely different. (Lacan, 1988, p. 155)
Lacan's subject is by definition not a natural but a political entity. The first OED definition of the word is 'One who is under the dominion of a monarch.' In the 18th century it became central to philosophical discourse, e.g., Kant's 'thinking subject,' and remained a key word for Hegel. Althusser (1971), who believed that Lacan's work had laid the groundwork for a meeting of psychoanalysis and Marxism, is well known for his aphorism: 'Être un sujet, c'est d'être un sujet.' (That is: to be a subject in the sense of having agency is to be a subject in the sense of being limited by the laws of a culture.)
If one desired to map the Winnicottian self, one might look no farther than his paper on the transitional object, where he draws a mother's breast pointed in the direction of an infant. In the space between them he places arrows indicating their creation together, first of 'illusion' and later of the 'transitional object' (Winnicott, 1953). His aphorism—There is no such thing as a baby—means that where there is self, there is always already mother.
In contrast to this three-point structure, the Lacanian subject is mapped as a quadrature. The Lacanian diagram known as 'Schema L' (Lacan, 1977a) includes the following four points: S, o, o'and O. The S at the top left of the rectangular schema does not stand for 'subject' as is often assumed. 'S' is a pun on the Freudian 'das Es'—the It, which Lacan glosses as our 'ineffable, stupid existence' (p. 193-4). The small 'o'stands for one's objects. The o'stands for the ego and the O for the big Other. Note that the ego is just one of the subject's objects, albeit a privileged one. The subject is defined by movement across these four points; it has no core or center. Subjectivity does include the feeling of immediacy and intimacy ('This is me') designated by o'. But it is marked equally by the opposite—a radical alterity labeled 'O' in the diagram. This big Other refers not to a person but to a place; it is the locus of extreme alterity some associate with God, fate or death itself. Lacan asks poignantly, 'Who then is this Other to whom I am more attached than to myself…?' (1977a, p. 172). It is this second degree of otherness that most clearly marks the difference between Lacanian and non-Lacanian theory. One could say that Lacan's work is the clinical elaboration of Rimbaud's well known 'Je est un autre' ['I' is an other] (Rimbaud, 1966).
The differences between self and subject generate and are reflected in many important differences between the two traditions. For Lacan, the analyst starts out in the position of 'O' not 'o'—the place of the Winnicottian analyst. For Lacan, an interpretation should be 'halfway between a quotation and an enigma'—not a 'good feed.' For Winnicott, the central drama will turn around the infant's loss or feared loss of the breast. For Lacan, while loss is obviously important, something even more profound is at stake—the lack built into subjectivity by the mere existence of the unconscious.
More difficult than describing the theoretical difference between self and subject is conveying to someone trained in Middle Group or American relational ideas how this difference affects practice. The most helpful heuristic I've found thus far is a remark made by novelist Salman Rushdie during a lecture in 2000. Rushdie mentioned in passing that the first line of his novel Midnight's Children originally ran as follows: 'What matters most in your life happens in your absence.' If that seems to be obvious, consider that it runs counter to everything Winnicott taught. For Winnicott, and for the countless analysts influenced by him, what matters—what forms us psychically—is how we were held, fed, loved, and above all recognized as infants. Those early gestures involving touch, listening and seeing call the inchoate self into being. It is a psychoanalysis of presence.
In contrast, Lacan insists that before we are touched and fed by mothers and others—before we speak—we have been spoken about. We are given a name already stuffed with hope, fear, expectation. Our birth was anxiously awaited or dreaded. We come into a world not of our making—into war or peacetime—into a caste or class that will inform everything we do and say. It is a psychoanalysis organized around the knowledge of limits and death, and always in the key of the signifier.
A clinical example will follow a brief discussion of the aims of treatment.
The aims of psychoanalysis: Lacan vs. Winnicott
To contextualize the questions of the aims of psychoanalytic treatment, it is wise to begin with Freud's memorable: lieben und arbeiten—to love and to work. Those simple words were to take a strange turn in the hands of some English-speaking analysts of the 1930s and '40s. For example, in an interview about Freud's work, Karl Menninger replied: 'There are two fundamentals in life. One is the business of making love, the other is the business of making a living.'
Less business-like, but nonetheless problematic was Melanie Klein's view of the goals of analysis. In 'On the criteria for the termination of a psycho-analysis' she included: 'an established potency and heterosexuality' (1975, p. 45). These are sentiments that Freud, obviously, would not have endorsed, and that Lacan spent a career renouncing.
Winnicott wrote: 'Psychotherapy has to do with two people playing together' (1971, p. 38). His notion of the goals of analytic treatment is often understood as: love, work, and play.
In his posthumously published volume Home is where we start from, Winnicott wrote: 'Health here includes the idea of tingling life and the magic of intimacy' (1968, p. 31). Harry Guntrip, analyzed by Winnicott, said he was helped by '…Winnicott entering into the emptiness left by my non-relating mother so that I could experience the security of being myself' (Guntrip, 1975, p. 465). Guntrip here is referring to the True Self, understood by Winnicott as the source of what is authentic in a person. 'The True Self is the body as creative' (Phillips, 1989, p. 135).
In contrast to what Buccino (1993) condemns as the 'commodification of the object in object relations theory,' Winnicottian mothering—whether in the home from which we start or in the analytic home to which we repair—is as much serendipity as commodity. That is: Winnicott insisted that the breast the mother offers is not the one the baby finds. And the breast the infant demands is not the one the mother presents. This paradox presents itself clinically all the time. It accounts for Guntrip's (1975) claim that he had his Fairbairnian analysis with Winnicott and his Winnicottian analysis with Fairbairn. The illusion of harmony arises in the 'potential space'—the area where meaning is created—between baby and mother, or patient and analyst. The matrix of the Winnicottian self, as pointed out above, is not a simple dyad but a three-point structure: mother, baby, area of illusion. Furthermore, as is well known, the mother at a certain point becomes 'good enough' only through failing her infant.
This is one area where one might speak of a correspondence between Winnicott and Lacan, given Lacan's notion, variously stated, that to love is to give what one does not have (Lacan, 1977a). Such convergences, however, should not blind us to the differences in their views of practice. Winnicott felt that the analytic atmosphere should be a 'holding environment'—a place of safety and trust. Just as Winnicott closes many of his articles with a 'summary of major points,' so did he, when asked, generously summarize for a patient the themes of the previous session (e.g., Winnicott, 1972, p. 25). Winnicott, like Lacan, experimented with analytic time, but he did so by extending the hour in order to maximize the patient's experience of safety (Little, 1990).
In contrast, Lacan, like Freud, believed that the analytic atmosphere should be mildly frustrating. Lacan wrote: 'Everybody agrees that I frustrate the speaker, him first, but me, too. Why? If I frustrate him it is because he asks me for something. To answer him, in fact' (1977a, p. 254).
Unlike Freud, Lacan made use of the 'coupure' or cut to end each session. In order to underscore the fact that the ego cannot control the analytic process, and to keep the unconscious open, the analyst stops the session at a propitious moment. The point here is obviously not to soothe the patient or compensate for early losses. Anyone who has experienced the cut can testify that it reinforces the non-mutuality of the analytic relationship. The cut is non-negotiable, non-democratic by design. Many contemporary analysts would feel uncomfortable with the amount of authority implied in this notion of the analyst's role.
For Jacques Lacan, home is not 'where we start from.' Because we are spoken about long before we speak, the subject's origins can be said to lie at a time anterior to the birth of the individual. Furthermore, whereas Winnicott emphasized the patient's capacity to relate more fully to others, to experience the 'magic of intimacy' and to communicate better with the living, Lacan placed equal emphasis on the subject's improved relationships with the dead. Lacan's goal of supporting the truth of the subject, as will be shown, is different from Winnicott's goal of fostering the emergence of the True Self.
In discussing the aims of Lacanian analysis, it's customary to speak of several phases of his work. In the first, Lacan was intent on returning language and the symbolic to their rightful place in psychoanalysis. Thus, he spoke of the goals of treatment in terms of pleine parole—full speech. The purpose of treatment was to turn the subject of suffering into the subject of speech, to lift the requirement—most evident in hysteria—that the body speak for us. This idea is also referred to in terms of le bien dire—the capacity to 'say it well' (Lacan, 1990). There may be no Middle Group equivalent of this idea.
In the second period, Lacan emphasized the mortifying effect of the symbolic on the subject. That is: as much as we experience the empowering effects of language, it is nonetheless the case that we are born into a network of signifiers in which we, in many ways, will remain imbricated. Lacan (1958) gives the example of the Rat Man pointing out that his predicament was, in effect, present before his birth. As a result of the signifier's power over us, we are marked not simply by the loss of objects and by trauma, but also by an irremediable lack that not even ideal mothering and fathering could prevent. There is no hope for the subject without recognition of this constraint. The alternatives lie either in the foreclosure of lack known as psychosis, or in its disavowal, known as perversion.
In the third phase, Lacan became most concerned with the register of the real. (It's crucial to keep in mind that this has nothing to do with the English word 'reality,' but describes an area excluded by the imaginary and the symbolic.) At this time, Lacan was most likely to describe the goals of analysis in terms of 'crossing the fantasy' or 'crossing the plane of identification' (Lacan, 1977b, p. 273). Lacan passionately opposed the idea of the patient identifying with the ego of the analyst. Throughout, he maintained that the analysand must experience the destitution of the analyst as 'subject supposed to know' and see him or her finally as no more nor less than the objet a—the cause of desire.
There is no reason to posit that the best reading of Lacan is a developmental one in which what comes later is assumed to be truer than what came before. And, in fact, most Lacanian analysts move among these three in discussing the goals of their work.
The focus below will be on le bien dire—the capacity to say it well—which suits the clinical fragment to follow. Le bien dire refers not so much to a performance as to an ethic that becomes clearer when refracted through Lacan's retranslation of Freud's 'Wo Es war soll Ich werden.' The Strachey translation of this line is: 'Where id was, there ego shall be.' Most analysts today, thanks to Bettelheim (1983), understand the violence done to the work by the introduction of the Latinate id, ego, superego. French, like German, uses the equivalent of 'it,' 'I,' 'over-I.' Lacan (1955) argued that Freud did not mean: 'Le moi doit déloger le ça' (The ego should displace the id). He pointed out that Freud did not say, 'Wo das Es war, soll das Ich werden' (1966, p. 128).
Lacan retranslates the line several ways, e.g., as 'Là où fut ça, il me faut advenir' (There where it was, I must go) (1966, p. 284). And stronger still: 'Là où c'était c'est mon devoir que je vienne à être' (There where it was, it is my duty to come into being) (1966, p. 227).
Thus does a statement that the ego psychologists took on as their motto become, in Lacanian teaching, an ethical imperative. The 'ça' here refers not only to the drives but also to the 'roll of the dice' at the time of the subject's origins, including everything we place in the register of the symbolic: culture, social class or caste, race, etc.
Instead of an ego determined to master the drives, the retranslations connote a search—a return to a place (Là). To this starting point, the analysand must commit—in the first person singular—to return.
The retranslations are cited often precisely because they evoke so much—from the journey of Oedipus from Corinth to Thebes, to our own impulses to learn or turn away from the truths of our history and pre-history. The Greeks used the word 'até' to refer to the lineal 'curse' or plot. Those who remain ignorant are bound to relive it, unto generations. Seneca, the first century Stoic, observed that there are two choices in life: One can be led by fate, or one can be dragged by fate. What Lacan's work does is to insist on a place for the aspect of our lives that preceded us, the aspect that was always already beyond our control. Winnicott and the Middle Group seem to make no place for it. Six years into an analysis with one patient, Winnicott asks, 'Do you know of mother's early history? Had she childhood difficulties?' (1972, p. 146). It's as though he was so focused on mother and child that a psychology infinitely more complex than dyadic/triadic became inarticulable. Another way to say this is that Winnicott assumed that whatever had occurred to a mother historically could only be passed on to a child through their relationship—through holding, handling, seeing, impinging. Family history might be nothing more than backdrop until enacted through the physicality of the nursing couple.
Lacan took the obverse point of view. That is—long before the adult Oedipus made his ruinous choices, he had carried the name that means 'swollen foot,' a name that he—clever enough to solve the Sphinx's riddle—had never thought to question. Furthermore, as Lacan saw it, simply being born into the House of Labdacus was more determinative for Oedipus than any subsequent act of holding, nursing, abandoning or rescuing could possibly be.
The following case fragment suggests the way in which a treatment oriented towards the truth of the subject was corrective to a previous (and in many ways helpful) therapy that had aimed at strengthening the ego and developing a self.
Case example
Alvareth Stein was a 35 year-old woman referred for depression. She had struggled since adolescence with a death wish and felt 'dead in life' despite 11 years of psychotherapy with Dr. M, a man in his 60s. Like Winnicott, Dr. M reportedly believed that the holding environment for regressed patients includes a certain amount of 'management.' Dr. M often extended the analytic hour and sometimes gave sessions 'on demand.' Alvareth said that although she herself had never been sure she wanted to be a nurse, Dr. M—whom she called 'Matthew'—had coached her through nursing school so that she might be less dependent on her dysfunctional family. For this, the patient was extremely grateful. She said: 'Matthew helped me see how my mother wore down my self esteem, always preferring my brothers. Matthew was the first person who cared about me.' Alvareth was able to get a hospital job, but under pressure, stopped functioning at work, and often failed to show up. When threatened with eviction from her apartment, she had a breakdown and was briefly homeless.
Alvareth was short of stature, obese, and had grey, unkempt hair. Although my feelings in our first moments together were identifiable—frustration, hopelessness and compassion spiked with disdain—they seemed to offer no useful beginning.
I found myself leading with a question my own Lacanian analyst had posed early on: 'What can you tell me about your names?' Alvareth shook her head. At length she said she had been named for her great grandmother, 'But I couldn't tell you why.' She mentioned that she had never known her, and believed she, too, had been a nurse. I asked how she died, and again the patient sat quietly and blinked until replying: 'Starvation probably. She died in a camp.'
The great grandmother who starved to death and for whom she was named had not been mentioned in her previous therapy, nor had the family's holocaust history come up. Questions about family had focused on the parents, and especially on the mother's early failures.
While this patient's story is in some ways extreme, it is the case that Donald Winnicott focused squarely on two generations, and that grandparents are not mentioned in any of his clinical writings (Winnicott, 1971, 1977, 1986). Moreover, Guntrip's (1975) classic article comparing his personal analyses with Winnicott and Fairbairn constitutes an example of treatments spanning two decades that did not touch on the dynamics of the third generation. Nor was a third generation salient in the present author's Middle Group analysis. Even those contemporary analysts who do routinely ask about grandparents don't necessarily ask about great grandparents. Thus, for 11 years, Alvareth's very compassionate Dr. M missed the history hidden in plain view in her name.
This is not to suggest that only someone with Lacanian training could have done this work. Drawing extensive genograms has long been a technique of some family therapists (Bowen, 1978). It is, to some degree, a matter of salience and depth: the Lacanian emphasis on the role of the patient's key signifiers and the impact of what Lacan referred to as the family até means that this material would have likely emerged in what Lacanians (following Freud) refer to as 'preliminary sessions' (Lacan, 1988). Furthermore, it is not clear what family therapists who do not subscribe to a notion of unconscious process are able to do with the genealogical facts they collect.
One sees the importance of the history which precedes the subject in the memoirs of Lacan's analysands (e.g., Haddad, 2002; Rey, 1989). Similarly, exploration of three generations was a central part of the present author's personal Lacanian analysis.
Conversely, while it's easy to see the things that Dr. M missed, one may well ask if this patient would have survived without his Winnicottian holding and management.
Nor was Winnicott's influence on the treatment over. While living in the shelter, Alvareth's personal hygiene suffered, and her clothes reeked of urine. My disgust, my fear of other patients encountering a bad smell in my office would have been less tolerable and more distracting if not for Winnicott's (1949) permission 'objectively to hate' the patient. This particular oxymoron absorbed my aggression towards her and freed me to speculate on the meanings of feeling 'peed on.'
Alvareth noted a difference between my style and that of Dr. M: 'Matthew was more friendly; if there was an awkward silence, he would talk, whereas I notice you don't.' Alvareth wondered if my 'rules' were different. It was at that point that I introduced the fundamental rule of psychoanalysis: Say whatever comes to mind, no matter how pleasurable or unpleasurable. She responded: 'I need to tell you about a big problem I have with food. I don't eat.'
Preparing or buying food felt onerous, so she subsisted all day on coffee. Late at night she would 'shovel' stale pastry, rolls and butter—whatever had been left over in the place she worked. She had never imagined a connection between her own 'not eating' and the starvation of her great grandmother.
One month into the treatment she said: 'There's something more I want to tell you about my last name, Stein, which means "stone".' Two weeks after that, she said, 'I can't believe I forgot to tell you that my parents never called me "Alvareth."' They had used her middle name which begins with the letter '*.' She liked this name because her father's name also began with '*.' Much later she would connect that with the first letter of my name.
Alvareth developed an interest in learning the truth about her father's family, and she felt she would need to travel one day to find the site of the camp. Because she was terrified of flying, the thought of doing so induced panic. I commented that she might feel differently in the future and that in any case, not every journey requires a passport and plane ticket. I was referring to our analytic journey (at that point, three times weekly).
Shortly afterwards, she brought up another troubling symptom—insomnia—which she dated to adolescence, when she was beset by nightmares. At 14, she had dreamed of her beloved piano teacher in bed with her husband. It frightened her so much, she had gone into her parents' room and awakened her mother. She felt she was going crazy and asked to see a doctor. Her mother assured her she was just being dramatic.
Dr. M had replicated the parents' lack of response by saying he 'didn't do much with dreams.' In contrast, Alvareth and I worked for years on this interesting primal scene dream.
Six months into our work, the patient announced she had decided to 'do it.' She was going alone on a train to a certain Holocaust museum and memorial 100 miles from my office. She stated that she felt this was what I had meant by saying: "Not all trips require a passport and plane ticket." While her own family was unable to discuss the past with her, the museum was a font of information. Photographs of those who looked 'dead in life' strained her defenses as never before.
She returned home much sadder than she'd been in her life, crying openly with a face no longer frozen. Only after that trip was she able to contact relatives who had pieces of the story. Her great grandmother was the only family member who had refused to leave Germany, insisting that because she had sent three sons to the Front in World War I, the Reich would protect her.
It took a long time for my patient to metabolize her findings. Near the end of our first year of treatment she said: 'I was named for a woman who couldn't face reality. I've built my own prison out of Alvareth Stein (stone). I can't really imagine life outside it. But at least maybe we've loosened the bars a little bit!'
This didn't mark the end of treatment by any means, but it was an example of le bien dire—something she would elaborate through the course of our work. Her journey to the memorial—not the journey I had in mind—argues for the significance of Lacan's re-rendering of 'Wo Es war, soll Ich werden.' Where it was, it is my duty to come into being. Dr. M's devoted attention had kept Alvareth's nascent self alive and growing. In the relative silence of my consulting room, her desire was understood, excruciatingly, as the desire of the Other, and the subject of suffering could make itself heard. Eventually, this had an effect on her symptom: Where 'shoveling' was, there mourning came to be.
The word 'analysis' comes from the Greek verb analeo, meaning to loosen or untie. Lacan writes: 'Psychoanalysis alone recognizes this knot of imaginary servitude that love must always undo again or sever' (1949, p. 7). For Winnicott and those influenced by the Middle Group, analysis may untie or free the True Self from its moorings in compliance. For Alvareth Stein, psychoanalysis began to 'loosen the bars' in a way that speaks both to the development of the self and to the transformation of subjectivity.
To pull together more closely the potential contributions of both Lacan and Winnicott in this example, we might ask if my impulse to query the patient about her names was in fact driven by my countertransference experience. That is, could it be that my feelings of 'frustration, hopelessness, and compassion spiked with disdain' were actually the responses her family had had to her name—stored in me through projective identification? As she was to mention only later, her parents, for reasons of their own hopelessness and compassion, had chosen to call her by another name—one that did not belong to a Holocaust victim. They had dutifully given her the name of 'Alvareth' but they couldn't say it.
A passage from T.S. Eliot's Four quartets glosses this clinical fragment:
We are born with the dead.
See, they return and bring us with them.
The moment of the rose and the moment of the yew tree
Are of equal duration. A people without history
Is not redeemed from time…(1963, p. 208).
A third way for psychoanalysis
How can we describe the process of bringing into contact obverse theories such as those of Lacan and Winnicott? As noted above, André Green (1986) and others have used the two as mutually limiting, each tradition correcting the excess of the other.
'Double description' is a term used by anthropologist Gregory Bateson—one he admitted extracting from Charles Saunders Peirce's notion of abductive reasoning—which means understanding one system in the terms of another. Bateson pointed out that the right and left eyes provide a slightly different picture of an object to the brain, and that the difference between them is associated with our ability to see depth in the visual field (Bateson, 1979).
Perhaps rather than insisting on selfhood or subjectivity, we could try to view each patient in both terms. Is this possible? Both Luepnitz (2002) and Ireland (2003) have used the analogy of the wave/particle theory of light. That is, it is now a commonplace of Western science that light is both a particle with weight, substance, and is also nothing more than a pattern, like one's pattern of taking tea with lemon. The observer's position alone determines whether light is a thing or the representation of a thing. If we are able to hold in our minds so astounding a paradox when it comes to the electromagnetic spectrum, we might be able also to imagine human beings in terms of both a substantive self, and a structural subject.
In Ireland's elaboration, Winnicott's thinking:…can be depicted more by the metaphor of psyche as …dispersed particles, and treatment as what enables their organization….The Lacanian field is better presented by the metaphor of psyche as embedded within preexisting wave patterns (setting degrees of freedom concerning love, desire, thought, etc.) within which each individual must find/create a place. (2003, p. 6)
In the case of Alvareth, it seems clear that the patient benefited significantly both from what she experienced as her first analyst's Winnicottian devotion, and from her second analyst's preoccupation with the question of desire.
One advantage of teaching Lacan with Winnicott would be a fuller reading of Freud. Many contemporary analysts, influenced by the Middle Group, read Freud the humanist—the Freud whose thoughts about alleviating suffering grew out of Enlightenment ideals. This is the Freud who advocated public clinics where the poor were analyzed free of charge (Danto, 2005)—the Freud who reassured a mother concerned about her son's sexuality, 'If your son is unhappy, neurotic, torn by conflicts…analysis may bring him harmony, peace of mind, full efficiency…' (Freud, 1975, p. 423-24). This humanist Freud, eager to communicate with a large audience, delivered and published his highly accessible 'Introductory Lectures' (1933).
Lacan, in contrast, wrote: 'As for us, we consider ourselves to be at the end of the vein of humanist thought' (Lacan, 1992, p. 273-74). Lacanians read Freud the anti-humanist, or post-humanist. This is the Freud who, from his earliest writings, described a linguistic unconscious (1895), who insisted on the importance of drives, and who believed psychoanalysis could but turn neurotic suffering into 'everyday unhappiness.' This Freud could say to a patient: 'Our discovery is not primarily a heal-all. Our discovery is a basis of a very grave philosophy. There are few who understand this; there are few who are capable of understanding this' (H.D., 1984, p. 18).
Both Lacanian and non-Lacanian analysts, while foregrounding one valid reading of Freud, ignore—even suppress—the other reading. This is something a double description could redress.
Possible risks, possible benefits of a new Middle Group
The obvious risk posed by a new Winnicottian/Lacanian school would be the dilution of both streams of thought. It's not for nothing that Bateson's 'double description' was first called 'abductive reasoning' by Charles Saunders Pierce (Peirce, 1966). Conceived as a third category after induction and deduction, the very word 'abduction' denotes the violence that the process of translation can do to a given set of ideas. 'Abductive reasoning' posts its own warning: Poachers beware! What if a new Middle Group were to lead to just the kind of bowdlerization that Lacan's entire project is written against?
On the other hand, one risks something also in choosing not to titrate Lacan with Winnicott, Winnicott with Lacan. For example, critics have decried the dangers of Lacanian practice, insisting that it lacks the necessary 'environmental provision.' (Correctly or not, many suicides were attributed to Lacan. See Rey, 1989; Roudinesco, 1990.) Lacan's use of the short session had much to do with his IPA expulsion.
Conversely, non-Lacanian analysts, by focusing their work on two generations only, risk blaming parents—and especially mothers—for the patient's every problem. The search to identify abusive and neglectful caretakers in the real or imaginary bypasses the enormous area of the symbolic in which abuse, when it occurs, is universally bequeathed. (This, perhaps, is the lesson of Alvareth.)
Towards a new Middle Group?
Leanh Nguyen who runs psychoanalytic therapy groups for victims of torture, while relying heavily on Middle Group and relational theory, has criticized what she sees as its 'sunny optimism,' a quality she associates with American culture. As a corrective, Nguyen (2004) welcomes Lacan's insistence on language, the symbolic, and death, but is put off, as many have been, by the obscurantism and 'religiosity' of the Lacanian field. She also believes that both anglophone and French traditions have more work to do in theorizing race.
Similarly, critics have pointed out that both Winnicott and Lacan occupy 'patriarchal' positions (e.g., Sprengnether, 1990) and that the project of writing psychoanalysis for feminism remains incomplete. While Lacan never wrote anything as explicitly anti-feminist as Winnicott's (1964) article 'This feminism,' his refusal to engage certain texts and interlocutors cost his theory of feminine sexuality complexity and resonance (Luepnitz, 2003).
I include the issues of race, class and gender to emphasize that a new Middle Group would not simply create psychoanalytic bilinguals—each cognizant of the other's tropes and traditions—but would point to places where both traditions fail, creating a space for new ideas. This openness might allow change not only in theory and clinical practice but in discursive style as well. Better psychoanalytic writing would require some analysts to forego the jouissance of mimicking the master, and others to forego the reckless pleasures of using words as though they had no history.
In conclusion
Adam Limentani (1989) once remarked that psychoanalysis is not only an impossible profession, it is also very difficult. A new Middle Group would not change that reality; indeed, it might make teaching psychoanalysis more difficult. Nor would such a group be invulnerable to the sectarian envy and infighting captured in Mrs. Milner's painting of the two hens.
Aware of at least some of the risks of this undertaking, the present author is committed to working with others towards a psychoanalytic theory and practice that could move between selfhood and subjectivity, humanism and post-humanism, between Winnicott and Lacan, between devotion and desire.
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