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Review of Changing Conceptions of Psychoanalysis: The Legacy of Merton M. Gill
Title: Changing Conceptions of Psychoanalysis: The Legacy of Merton M. Gill
Author: Silverman, Doris K. and David L Wolitzky
Publisher: Hillsdale, NJ: Analytic Press; 2000
Reviewed By: Brian Stagner, Winter 2005, pp. 42-44
Constructing The One From The Two
The straightforward title of this book is tellingly apt. The second half of the twentieth century was a period of intellectual ferment in psychoanalysis on many fronts and the extraordinary career of Merton Gill intersected many of the most fundamental problems in the discipline. This collection of papers in his honor may serve as overview, homage, and launching point for new areas of debate and inquiry. As such, it will be useful to students, scholars, and practitioners, serving to chronicle Gillís influence, to place his work in the context of the development of contemporary psychoanalytic debate, and to highlight the new investigations implied in his work.
Contemporary readers will be most familiar with Gillís more recent contributions on the analysis of transference. The editorsí introductory chapter in this volume helps place that work in the larger context of his efforts to investigate psychoanalysis at both the level of metapsychology and the level of clinical data. In the following section, the development of his ideas is illuminated by several personal reminiscences and by illustrating the significance of his ideas for many debates that remain lively in contemporary psychoanalytic thinking.
Merton Gill was born in Chicago in 1914 and he died there in 1994. He studied and worked at many prominent centers of critical thinking, including the University of Chicago, the Menninger Clinic, Austen Riggs Center, Yale, Berkeley, Downstate Medical Center (SUNY), and the Chicago Institute for Psychoanalysis. His path led him to his primary mentor, David Rappaport, as well as to many colleagues whose contributions defined psychoanalytic thinking of his era, including: Margaret Brenman, George Klein, Robert Holt, Robert Knight, Timothy Leary, Karl Pribram, Leo Goldberger, Philip Holzman, Robert Wallerstein, and Roy Schafer. The present book includes several accounts of Gill as scholar, friend, and challenging thinker from Wallerstein, Holt, Holzman, Lawrence Friedman, and Henry Smith. From these personal reminiscences, Gill emerges as an incisive thinker who welcomedóand gaveócomplex challenges in the service of improving big ideas. Contributors speak as a chorus recalling Gill as tenacious, provocative, mentally tough, razor sharp, and unfailingly pursuing the deep truths. From his earliest professional work, he both dazzled and intimidated others with cogent critiques delivered with keen, eloquent wit. New acquaintances may have found him difficult to approach, but his close colleagues speak tenderly of warmth and sentimentality, which was reluctantly expressed yet deeply felt. They also recall his sometimes heroic struggles with episodes of profound despair and depression; even at these times he is recalled as a keen thinker who never lost sight of his intellectual goals.
These goals were many, but they are connected by a pragmatic desire to understand and improve treatment. Skeptical of abstractions, he was in the vanguard of thinkers who seek to push back reified and ill-defined constructs in order to focus our attention on what happens in the interactions between patient and analyst. Papers by Friedman, Smith, and Hoffman describe the various paths Gill followed in this effort. He viewed psychic structure as a continuum of impulse/defense, and argued that much of the metapsychology was a mistaken effort to cloak treatment in pseudo-biology. He became steadily more single-minded in advocating for the importance and centrality of transference as the key to treatment, moving away from the notion of blank-screen neutrality as he moved from metapsychology to immediate clinical data. The culmination of this development was his final efforts (with Irwin Hoffman) to examine the ways in which the transference is a joint creation of the patient and analyst.
A chapter by Hoffman provides a thorough review of the developments of Gillís thinking. He highlights three aspects of Gillís work: the renunciation or disregard of many aspects of metapsychology, his concern with technique, and his attitudes toward research. The remaining contributors return repeatedly to these themes as they outline their own agreements and departures from Gillís thinking. It is a particular strength of this collection that so many contributors honor his memory by continuing the debates and discussions that flourished in any discussion with Gill.
While much of his early work (often with Margaret Brenman) explored hypnosis in therapy, Gill began, as early as 1954, to consider problems with metapsychology that were becoming the focus of debate within psychoanalysis. He rejected much of the natural science trappings of Freudís metapsychology; he came to believe that concepts such as force, energy, and even biological determinism were not congruent with the domain of psychoanalytic inquiry. As several contributors note, this led Gill to champion psychoanalysis as an interpretive or hermeneutic science more concerned with meanings than with linkages to the methods, theories, or findings of natural science. The hermeneutic position presented philosophical problems that Gill never fully resolved. For example, Holt quotes an interesting letter to Adolph Grunbaum in which Gill appears to repudiate true hermeneutics as anti-scientific, although Gill continued to invoke the concept later in his career (with perhaps a more circumscribed meaning). Contributions by Holt and Morris Eagle observe that Gill did not resolve the difficult philosophical problems raised by the notion that psychoanalysis is a form of social constructivism (and, because it deals with personal meanings, necessarily hermeneutic). Holt notes that Gill tried to avoid wholesale rejection of positivism by espousing a weak version of constructivism, rather than a more radical one, but in Holtís view, the problem remains. Echoing this, Eagle suggests that Gill threw the baby out with the bathwater when he rejected the natural science constructs of metapsychology and sought to supplant the epistemology as well.
Concluding this section, Lawrence Friedman reminds us that rejection of the metapsychology paved the way for a fuller recognition of the subjectivity of the analyst, but he laments that no place is left for objectivity. While the mutual subjectivity of patient and analyst provide opportunity for essential interpretation and exploration, this is ultimately in the service of promoting autonomy and self-understanding that (one hopes) leads to a less defensive, more objective self-understanding.
Several contributors note Gillís engagement of the tension between one-person vs. two-person psychology in psychoanalysis. Gill felt that everything that happens must be understood as being shaped by conscious and unconsious dynamics in both the therapist and the patient as they try to understand each other. Theodore Jacobs agrees with Gill that psychoanalysis can never be entirely based on a one-person understanding. The therapist cannot be entirely objective; the treatment is influenced by enactments that are a product of the conscious and unconscious perceptions of both therapist and patient. Where Gill sees these enactments pervading the therapy, Jacobs argues that such enactments arise only when the patientís dynamics activate an unrecognized conflict in the analyst. This position seems to reflect the classical view of countertransference; Gill was concerned that this position places constraints on the analystís ability to fully understand the therapeutic interaction.
Silverman clarifies this: Gill believed in unconscious fantasy and in the importance of drives in understanding psychological developmentócertainly a one-person psychology. She reminds us that, while Gill was a tenacious advocate for a two-person understanding of what happens in therapy, he never completely abandoned the one-person psychology, and never successfully integrated these perspectives.
Gillís focus on the interactions between patient and therapistóhis appreciation for the interpersonalóleads us to consider the question of the distinctions between psychoanalysis and other interpersonally focused treatments. Three contributors address implications of Gillís shift, later in his career, away from a bright distinction between psychoanalysis and psychotherapy. Robert Wallerstein recounts several exchanges he had with Gill attempting to clarify their respective positions on this distinction. Wallerstein accepts that psychoanalysis is interactional. While he therefore agrees that aspects of the two modalities are overlapping, he differs with Gill in that he believes that there are still sufficient technical bases for distinguishing psychoanalysis (relying principally on interpretation and analysis) from psychodynamic therapy augmented by supportive or expressive techniques. Paolo Migone suggests that much of the controversy arises from whether extrinsic or intrinsic criteria are used to distinguish psychoanalysis from psychotherapy. He reminds the reader that Freud considered that psychoanalysis had three, inseparable aspects: research method, clinical technique, and theory of the mind. Migone suggests that during early development of the institutes these functions became separated, resulting in the doctrinaire definition of psychoanalysis by external manifestations (number of sessions, use of the couch, formal distancing of analyst, etc) rather that by the patientís experience. John Gedo argues against the notion that one technique will be suitable for clients at all levels of ego development. He suggests that the emphasis on transference is not inevitably particularly useful and may even be detrimental with some patients dominated by pre-oedipal pathology.
As Kernberg notes, Gillís contributions on transference in The Analysis of Transference (with Hoffman), represent a significant attempt to integrate the transference models of ego psychology, the British and American object relations approaches, mainstream French psychoanalysis, and the interpersonal self-psychology approach. While he commends both Gillís ideas and his research methods, Kernberg argues that there are several gaps in his understanding of transference and countertransference. Echoing comments in Gedoís contribution, he regrets that Gill did not give more consideration to how the patientís observing ego (or lack thereof) will enable the patient to experience the positive elements of transference, allowing treatment to go forward. Further, and in a more fundamental departure with Gill, Kernberg argues that the analytic situation works because the analyst is able to divide between an experiencing part that enters into transference/countertransference enactments and a split off observing part that contains the analystís technical skills, expert knowledge, and interest in the patient. For Kernberg, the analystís ability to be immersed in the dyadic experience while simultaneously being an objective observer is the essential condition of effective treatment. He implies that this is the essential position of any caregiver who must engage participatively while maintaining objectivity to disentangle distorted material. Gill might disagree, both that the clientís experience is a distortion and that the therapist is necessarily more objective.
Wolitzkyís review provides a careful and very scholarly summary of Gillís arguments that transference is not distortion, but must rather be understood as the patientís experience of the analyst, grounded at least in part in the reality of the interaction. This perspective moves the analyst away from the authoritarian, sometimes manipulative, positivist stance that appears to have been normative in the 1950s and toward a more constructivist view of the patient and the treatment. Some, including Mitchell and Hoffman, are ardent champions of the constructivist position, but Wolitzky notes that Gill began to move away from a purely constructivist position in the face of aforementioned epistemological problems with this hermeneutic approach. The result was a pragmatic, but somewhat fuzzy compromise. The constructivist view is essential to understanding what happens in the dyad but the underlying hermeneutic epistemology may be untenable because it elevates a coherence notion of truth. This takes the field away from the correspondence theory of truth that informs natural science. His compromise was to view the dyad through constructivist spectacles, but operate as if correspondence-based knowledge is achievable.
Cooperís paper neatly integrates Gillís work on transference interpretation with a contemporary controversy on the role of different sorts of regression in analysis. Gillís emphasis on here and now awareness of the analyst as a stimulus and his advocacy of early interpretation of transference both challenge us to re-examine many phenomena that are observed in treatment. For example, how does early interpretation relate and illuminate questions about the role of regression in analysis? As analysts are concerned about the in vivo interaction, the opportunity to regress may be preempted. Cooper answers those who would criticize ďtoo earlyĒ interpretation by noting, as Gill did, that regression is a double-edged sword. While regression may be essential to understanding, it also carries a potential for iatrogenic transference problems that are detrimental to treatment. This issue is certainly ripe for further investigation.
Over his career, Gill advanced both the constructivist notion of the mind and the two-person understanding of transference. Some have observed that the philosophical underpinnings of his ideas were not always fully worked out, but there is no disagreement that he was doggedly pursuing a richer understanding of what happens in treatment. In the process, he defined debate and elaborated technique in ways that will continue to stimulate controversy and new ideas. His legacy may not yet be fully realized; the present volume serves very well to keep his thinking alive.
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