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Publications: Book Reviews
Review of Toward a Psychology of Uncertainty: Trauma-Centered Psychoanalysis

Title: Toward a Psychology of Uncertainty: Trauma-Centered Psychoanalysis
Author: Brothers, Doris
Publisher: The Analytic Press, 2008
Reviewed By: Kathryn White, Vol. XXIX, No. 1, Winter 2009, pp. 15-18

“’Ink-a-bink-a-bottle-of-ink …’ A little girl, seated at her grandmother’s dining room table, taps her finger in rhythm with her chant on each of a carefully arranged assortment of candies.” With these words, Doris Brothers begins the preface to her book Toward a Psychology of Uncertainty: Trauma-Centered Psychoanalysis. Is this memory, or story? In either case, it is personal.
In writing from a personal perspective, Dr. Brothers formed a pivot for this short and compelling book of important ideas. This pivot solves the difficulty that while some things can be analyzed clearly, other aspects cannot be said directly and must be pictured or enacted, perhaps as poetry or story that can generate a resonating experience. A psychology of uncertainty would be poorly served with simple intellectual clarity. So Dr. Brothers weaves intellectual clarity with the evocative power of words. She creates a rhythm beneath the surface, not only in clinical vignette and personal example, but indirectly in the way she constructs and develops her arguments.
It is not easy to present a careful exposition, a thought out analysis, and at the same time evoke something of the subject at hand, but I think that Dr. Brothers has accomplished this. I think it is possible to read this book and enjoy and respect it from a purely ideational perspective; it is logical and clearly argued. But it seems to me to be richer with its evocation of our own experiences of uncertainty.

I have delayed in finishing this review, which I started writing months ago, out of a suspicion that I could not be objective. Perhaps, I wondered, I am more sensitive to this invocation of the undertone of memory because I am writing this review from a personal place of great uncertainty and upheaval—a transition time and space in my private life, in a “sabbatical house” in a small shoreline community. At the same time, I felt that my attempts at a rational ideational cleansing of my words missed communicating something about the quality of Dr. Brothers’ writing. I have never met Dr. Brothers. Yet, it seemed to me she elicited a relationship with her readers and therefore with me. I felt it would be obtuse of me to respond to that unexpected relationship with only an analytic and impersonal critique. Her evocation of the shadow of relatedness between author and reader awakens our implicit understanding of how the relationship in the therapy room lives alongside unsaid experiences outside the room. This dark understanding supports the brighter clarity of her analysis.

This book, about trauma and the discomfort we have with uncertainty, is grounded by case examples and personal perspective that bring her thinking alive with the experience of insight and empathic resonance. In saying that, I do not mean to imply that this book is primarily personal narrative. It is not. Dr Brother’s balanced style of personal narrative and analytic thinking creates a layered exposition of her thesis. Fundamentally, her book is a clear discourse and analysis of three things: the nature of uncertainly related to reality and experience, the tendency of human understanding to withdraw from uncertainty into frozen certainty, and psychoanalysis as a method, discipline and theory that creates an openness, a tolerance for the discomfort of states of uncertainty. “Making the unbearable bearable.” Psychoanalysis can, she argues even welcome the sometimes feared and seemingly dangerous position where “the unique nature of each psychoanalytic relationship is celebrated.” (p. 3)

In short, she believes that it is time to “cultivate a psychology of uncertainty.” To bring psychoanalysis to this new psychology, we must loosen our anxious hold on “all attempts to find authoritative, irreducible, transcendent explanations.” Referring to similar critiques made by others, she restates the need to move more courageously into our own abilities to tolerate uncertainty and to relinquish our faith in the universality of the psychoanalytic theory of technique. As she notes:

Since we are profoundly dependent upon others for our experience of differentiated selfhood, but we cannot fully know them, or ourselves for that matter, experiences of uncertainty are an inescapable feature of human experience. (p. x)

Creating this new psychology involves incorporating two elements that are inevitably known to the psyche: the experience of relational systems and the experience of trauma. Both are aspects of the same thing—the tension and shock that we feel knowing that both the world and the psyches in the world are essentially “other” and also “us.” Dr Brothers tells us that her book’s central premise is that “experiences of existential uncertainty emerge from, and are continually transformed within, relational systems.”

The psychoanalyst, committed to see and hold what arises in each analysis, cannot escape facing the “unique” and “irreducible” nature of psychoanalytic relationship. So, Dr. Brothers would argue, psychoanalytic thought must either develop ways to discuss and understand uncertainty or find itself frozen, cut off from what is the basis of motion and change. She weaves her discourse with history, beginning with Freud’s “positivist paradigm with its glorification of scientific certainty,” proceeding to relational theory which forms the grounding of her psychology of uncertainty. Throughout her historical review, she does not hide her gentle, persistent nudge disrupting all the ways psychoanalysis reaches towards the reassurance of certainty, even though we know that certainty is not possible. Dr. Brothers discusses the tensions we feel as we struggle with complexity and uncertainty, how in our reasonable attempts to understand them we reach for simplification, but ultimately lose completeness because in longing for clarity we run toward illusions of sure knowledge.

As she lays out the relatively recent history of self, intersubjective and relational theory, Dr. Brothers uses the historical arguments to compel us to not only tolerate, but cultivate the discomfort of uncertainty in the face of powerful impulses to reduce complexity. She asks us to fight our impulse to feel secure in a “correct” theory, to avoid reification in favor of experience. She tells us to distrust any theoretical belief that “is believed to occur, without exception, at a predictable moment in development.” She asks us to accept that all understandings “emerge and evolve” and to relinquish our wish for eternal and solid rules that become codified, reified, and essentially close down growth. Dr. Brothers notes that we tend to feel anxious that things that are not fixed are formless – but she points out that the lack of certainty does not mean a lack of form, rather that dynamic systems form in evolving ways holding the tension between certainty and uncertainty.

Most importantly to her thesis, this work has the potential to deepen our exploration of the experience of trauma and our responses to it within relational systems.
Trauma as a relational, complex phenomenon involving both shattered self and efforts at its restoration goes hand in hand with dissociation and the loss of integrated awareness. We become caught in trying to categorize and separate overwhelming experience into fixed understandings, living a “desperate search for experiences of sameness and difference.”

There is a refreshing and honest quality to her writing that allows the mind to open, freed from the necessity to argue to reach a fixed point within the logical, historical, and philosophical layers of discourse. With this book one can allow analytic criticism to exist side by side with personal and clinical evocations. For instance, I find that as I read, I was struck by certain phrases that reflect concepts for which I have a flexible but not fixed understanding. With such encounters, I stopped and wondered as to my understanding and the author’s use. “What do we mean when we say certain things that we take for granted everyone will understand?’
Let me give an example. When discussing the central role of intense emotional experience she notes, using a common phrase, that “In the absence of intense experiences of this sort, certainty about the likelihood of psychological survival may diminish.” I found myself wondering, what really do we mean by “psychological survival” or “annihilation?” I have my own sense. Many people use these phrases and we seem to find them just right to describe what we hope for and fear during certain kinds of intense, emotionally traumatic pain. But we usually don’t mean it quite literally. If after a car accident we say, “I was afraid that I would not survive,” we mean it literally. When we say someone feared “psychological annihilation” what do we mean? Sometimes there is a specific sense of “I was afraid I was going crazy.” Sometimes maybe we mean a kind of “soul murder.” Sometimes perhaps we mean something like what a person with dissociative disorder does experience: the death of a coherent ego identity and the birth of a new divided one. But mostly, I think, we do not really know exactly what we mean. And yet, we all understand something about what each of us might mean.

In the last chapters, as the triad of faith, hope and death is developed, the psychology of uncertainty takes a clearer but still dynamic form. Faith and hope coexist with doubt and insecurity as they arise out of uncertainty and trauma. We see how our fear of psychological annihilation reflects a loss of faith in knowing anything at all. In the traumatic explosion of established context, we experience the chaotic side of the paradox of chaos/form that is uncertainty. If form remains opposed to chaos, it is split and dead, and we have no way to move on into an emerging reality of uncertain future. Healing requires openness to uncertainty, which allows in hope and faith. The paradox of uncertainty includes both chaos and form, without the walling apart of dichotomy. Faith, Dr Brothers notes, is not a static object, but is instead the experience that essentially one’s soul or spirit is not in jeopardy. Hope, she points out, arises out of uncertainty and healing is a normative developmental process.

In trauma we are exiled from our illusion of certainty and in multiple ways we face the experience of annihilation and death. Death is unknown, yet ultimately certain, both fearful and attractive. Dr Brothers escorts us into the dilemma—how what seem to be opposites also seem to be intrinsically connected, and, like the magnetic poles of the earth, liable to flip and be perceived in reversed positions. We dichotomize, create opposing concepts, so as to create order, only to discover that our concepts seem now to move on their own, turning over their meaning and refusing to sit still for us just when we think we have a secure understanding. Is it Eros, or is it Thanatos? In our experiences of death—death, symbolic death, desire and fear—we can see and feel how our experiences are not really so fixed. Even the models we construct to bring us clarity reveal unintentional duality and nuance, plunging us again into the uncertainty we are trying to escape. This paradox is the aliveness that underlies our attempts to secure our concepts. It is the place which refuses to stay where it is supposed to be, refuses to follow the outlines of our carefully laid out theories, and frequently reallocates the attributes we’ve assigned to each side.

As she concludes with a case study involving burnout, analytic error, chance, and the meaning of a shrug, Dr.Brothers ends as she begins, reminding us of all the small accidental disasters that liberate us to painful truths that we have warded off, to disruptions in how we understand ourselves and how we work, and the “uncanny” accidents of chance or grace that can bring healing and hope in the precariousness of uncertainty.

Kathryn G. White, PhD
New Haven, CT

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