Discerning Theoretical Differences
The multiple theories in psychoanalysis and their entanglement have always been a major, troubling issue for apprentices; combined with unclear psychoanalytic terminology, making clear arguments is difficult: sorry, Freud considered sublimation a defense mechanism, but Loewald didn't see it that way; idealization and idealization aren't the same thing... It's also something that "pains supporters and pleases critics," giving critics of psychoanalysis one more reason to attack, which isn't a big deal.
As mentioned before, my psychoanalytic alma mater is the Chicago Psychoanalytic Institute (CPI), where the integrative model was my foundational perspective. At Tavistock, however, the Freudian-Kleinian approach dominated, giving me a taste of the split position.
But this is nothing new in psychoanalysis. At the Los Angeles Institute for Contemporary Psychoanalysis (ICPLA), our professors often review in history class the devastating conflict in Los Angeles when Bion's arrival sparked a battle between Bionians/Kleinianians and American native Freudians/Ego Psychologists.
What's really at the root of this? The professor hit the nail on the head: the conflict between schools is ultimately an identity struggle, reflecting narcissistic injury, splitting, pathology, and intergenerational trauma within psychoanalysis itself. —One can only guess how deep Freud's psychological shadow was as a Jewish person marginalized by universities, with psychoanalysis completely pushed to the periphery.
Using psychoanalytic listening, the splitting within psychoanalytic theory itself seems to indicate that this group isn't as developmentally healthy as they imagine. Many bad things happen within this group, filled with competition and violence, while psychoanalysis often maintains silence on important topics. This isn't a new topic either; books like "Psychoanalysis: A Perspective on Collective Thought" have discussed this. And a theory seems to need to stand at the opposite extreme of other theories to be heard; it's also like a form of patricide.
But everything has a "forward edge"—what self psychology would call the healthy, developmental part. Different theories also demonstrate psychoanalysis's courage to question itself and its vitality in constant renewal. —Going back to the founding father: didn't Freud often disagree with himself in his footnotes?
The Emergence of Different Theories
Let's think together about why, in practical terms, psychoanalysis has so many theories.
Personal History of Theorists
The proposal of theories is often inseparable from the personal experiences of theorists. We often joke that Kohut himself was "narcissistic," which led him to create self psychology; "The Analysis of Mr. Z" is nearly autobiographical, a widely known secret. When criticizing Klein, we also say the old lady was uncomfortable herself and couldn't stand seeing others comfortable, always forcing people to face the "truth." Though crude, this is a very common phenomenon in theoretical development. We always begin understanding the world from our own experiences.
Types of Patients
The complexity of human nature cannot be summed up by a single theory. In fact, the development of different theories seems related to different types of patients. One problem with psychoanalysis is that since we're all doing long-term cases, each analyst faces an extremely limited sample size, making it difficult to develop overly general conclusions. Freud was initially criticized largely because the case study method itself is questionable. For example, some believe that the very different understandings and working methods of Kohut and Kernberg regarding narcissistic personality are related to their working environments and the types of patients they encountered—essentially, they were trying to understand fundamentally different types of patients. This is why Kohut focused more on self psychology, emphasizing patients' self-experience and emotional regulation, while Kernberg emphasized object relations theory, focusing on patients' internal conflicts and defense mechanisms—they weren't talking about the same thing to begin with.
As analysts, we are shaped by our own analysts and supervisors, but more importantly, we are shaped by our patients. From this perspective, the diversity of psychoanalytic theories is somewhat similar to the blind men touching the elephant. Each theory starts from a specific angle to help analysts understand and address their patients' problems.
Cultural Influences
This part comes more from my personal observations and conjectures: Each theory is a unique story, reflecting different cultural origins and developmental trajectories. For instance, American ego psychology embodies pragmatic values and social adaptation, aligning with the pragmatic character of American culture. This theory emphasizes individual functioning and adaptability in society, focusing on practical effects and personal development. For a long time, American psychoanalysis was dominated by ego psychology.
Additionally, the later development of self psychology and relational schools in America also reflects cultural and social changes. Their emphasis on empathy and the belief that the relationship between therapist and patient is a key factor in treatment reflects contemporary society's emphasis on equality, interaction, and cooperation.
The British psychoanalytic tradition is deeply influenced by Klein. Klein's theory emphasizes early childhood development and unconscious fantasies; her work particularly focuses on how children express inner conflicts and emotions through play and symbolic behavior. This theory found deep roots in British culture because the British psychological community has long been interested in child psychological development. Concepts in Klein's theory such as projective identification, splitting, and projection provide profound methods for understanding defense mechanisms in children and adults. The calm and rational traits in British culture resonate with the Kleinian detailed analysis of subtle psychological mechanisms.
The French Lacanian approach emphasizes weakening the ego and highlighting subjectivity, echoing the existentialist currents in French philosophical tradition. Lacan's theory is deeply influenced by French philosophy, especially existentialism and structuralism. He emphasizes the profound influence of language and symbolic systems on individual psychology. Lacan's theory, in the French cultural context, exhibits a profound skepticism about subject identity and an exploration of the complexities of the unconscious.
Furthermore, psychoanalytic theories from other countries and regions also reflect their unique cultural backgrounds. For example, the German psychoanalytic school, after Freud, developed a series of theories focusing more on philosophical foundations and the essence of human existence, such as Erich Fromm's social psychology and Hans Cornelius's phenomenological psychoanalysis. These theories, while exploring individual psychological mechanisms, also deeply studied the influence of social structures and cultural factors on individual psychology.
Changing Times
Additionally, the development of psychoanalytic theory itself is a process of constantly expanding territories and catering to patients' needs. Different eras have different zeitgeist diseases, and the development of psychoanalytic theory is a response to these changes. For example, Kohut's transition from guilt-based to tragedy-based humanity, giving rise to self psychology, better addresses the increasing number of patients with narcissistic personality disorders. At the same time, Klein and her successors have been dedicated to developing methods for borderline and psychotic patients.
Furthermore, the contemporary development of psychoanalytic theory is closely related to academic trends worldwide. Contemporary emphasis on relationship orientation, equality, and reflection are reflected in the relational schools of psychoanalysis. The relational school, deeply influenced by feminism and other movements, advocates for equal relationships between analysts and clients, abandoning the authoritative "looking down" approach of the past, thus achieving true therapeutic empathy.
At the same time, contemporary academia also emphasizes reflection and deconstruction of past theories. From this perspective, some of Freud's outdated views and practices, such as viewing women as "deficient" men, will be questioned and criticized. The arrogant attitude in Kleinian technique will also be challenged under the new concept of equality.
Contemporary psychoanalysis also emphasizes interdisciplinary integration, absorbing the latest research findings from psychology, sociology, philosophy, and other fields. The development of the relational school is a typical example, influenced not only by feminism but also drawing on social constructionism and systems theory.
Further Reflection
Applicable Range and Stages
As discussed in the Chicago foundational program's integrative model, different theories have their unique applicability in different situations. Besides different types of patients as mentioned earlier, different techniques need to be chosen at different stages of treatment. For example, in the early stages of treatment, self psychology emphasizes warmth and support to establish a safe therapeutic environment and a solid therapeutic relationship. In the later stages of treatment, Kleinian interpretive methods might be more suitable, helping patients face and integrate repressed emotions and conflicts.
Shadows of Theories
Each theory may have its shadow aspects in application. For example, are Kleinian interpretations truly aimed at helping patients face reality and explore their unconscious fantasies, or are they projections of the analyst's own anxiety and aggression? When self psychologists constantly empathize and meet patients' needs, are they truly providing corrective emotional experiences, or is the analyst's own masochism and rescue complex at play? These questions need continuous reflection and vigilance in theoretical application.
Transference to Theory
The phenomenon of therapists' transference to theory is also an interesting topic. For instance, Kleinian therapists tend to be more aggressive, while self psychologists tend to be "nice guys." This is related not only to therapists' understanding of the theory but also closely related to their personal traits. To avoid becoming fanatical fans or believers of a theory, therapists need to maintain reflection and awareness, and deeply consider theoretical transference.
How to Use Theory Is Most Important
The theory itself is not important; what's important is how people use the theory. Only through the correct use of theory can we avoid its shadow aspects and truly focus on the patient's well-being. For example, the Kleinian theory learned from Chicago has not only hate but also love, understanding unconscious fantasies, but more importantly, showing empathy when dealing with real mental pain.
Always maintain awareness of yourself: and what should be done in the present moment, when to give transference interpretations. Lynn also says, whether it's play or trauma, what's important is whether the current discussion and use is for control or becomes an overly stimulating, overwhelming experience—listen to the signals from your body, listen to what is happening in the present.
Real People Are Important
When applied to specific clinical situations, the conflict between schools is actually more like a "myth" and stereotype. A good analyst is not defined by school but will handle situations flexibly based on various factors, with the most important thing being "learning from the patient." One of my teachers, Stern, says he is a completely different analyst with different patients. I think any good analyst should be like this. We also often find that the practical operations of analysts from different schools in clinical situations are not as different as imagined, further proving that everyone emphasizes differences when discussing theory for identity struggle purposes. The desire among apprentices to find an analyst of a particular school is itself more like an initial transference, and we certainly know that exploring the fantasies within is more important.
Chinese Psychoanalytic Practice
As analysts and therapists in China, we face a client group with some more specific needs and backgrounds. These specific cultural backgrounds and social environments influence the psychological development and problem presentation of clients. Similar to the previously mentioned "transference to theory" and "cultural and era influences," Chinese therapists' choice and application of theories are also due to similar reasons, all to address problems encountered in actual work.
Thus, in China, self psychology has widespread followers because it can help handle individual narcissistic injuries in complex social environments. At the same time, Kleinian theory is also very popular in China, especially in dealing with early trauma and borderline personality disorders. Additionally, more and more Chinese therapists have recently begun focusing on relational schools and intersubjective theory in response to equality and reflection. All these concerns share the same starting point, just with different paths.
The Necessity of Integrative Theory
All the institutes where I've trained so far emphasize "forming your own voice"; I ultimately chose ICPLA to receive more contemporary and diverse theoretical training. As an institute indeed characterized by self, relational, and intersubjective approaches, we also have Freudian, Bionian, and Kleinian professors who often argue: just as I was preparing to publish this article, they were still very actively arguing in the email group. This is also an important factor that truly helped me overcome my dissatisfaction with Tavistock's dominance; in such an open environment, I can truly appreciate the theories of the British tradition.