Lacanian Psychoanalysis: Revolutions in Subjectivity – By Ian Parker

Book Reviews

Faith, Theology and Psychoanalysis: The Life and Thought of Harry S.Guntrip by Trevor M. Dobbs. Published by James Clarke, Cambridge,UK, 2010; 185 pp; £19.50.bjp_1238 220..233

Many patients entertain the thought that they will make detailed notes after eachsession of their psychoanalysis, and probably few persist for more than a shorttime. Harry Guntrip, however, really did: he kept a detailed record of both hisanalyses, with Fairbairn and Winnicott, and when he was an old man, and theywere both dead, he wrote them up in his lively and energetic style in a paperwhich he published in the International Review of Psychoanalysis (Guntrip,1975). Charitable, forthright, and carefully avoiding superiority, it gives a vividpicture of these two pioneers at work,Fairbairn the austere,aristocratic purveyorof relentlessly intellectual interpretations, Winnicott informal and humorous,speaking of Guntrip’s babyhood experience with rather astonishing certainty.

In the 1960s and 1970s, Guntrip was well known as a writer on ‘schizoid’phenomena, and his name was often bracketed with that of Fairbairn. He livedin Leeds, worked as a psychoanalyst but never formally trained and was not amember of the British Psychoanalytical Society so, although in one sense well-known, he remained somewhat peripheral. When I first encountered the psy-choanalytic scene in the 1970s, he was mainly viewed, I think, as a sort ofaccessible spokesman for Fairbairn’s ideas. He became critical of Fairbairn’stechnique but it is not unfair to see him in that light: it was Fairbairn’s greatinsight that beneath ‘depressive’ symptoms there is often ‘schizoid’ pathology,which both contributed crucially to the development of Melanie Klein’sthought and also became Guntrip’s central message.

In the present book, Trevor Dobbs, a training analyst in California, hasrevisited Guntrip’s career with a view to putting him in the context of hisreligious background. The comparison of psychoanalytic schools with religiousmovements has often been made, and it is certainly suggestive that all thesepioneers of the British Psychoanalytical Society’s ‘Independent’ group camefrom Christian nonconformist upbringings: Fairbairn from Scottish Presbyteri-anism, Winnicott from Methodism, Guntrip from the Salvation Army andCongregationalism (he was a Congregational minister before becoming a psy-choanalyst). Fairbairn and Winnicott’s personal styles, the intellectuality ofthe one and the warmth of the other, also seem to fit the stereotypes of theirsectarian backgrounds.

Such correlations are rather hard to assess. It would be equally possible tomake links with other social factors, such as class. Both Fairbairn and Winnicottgrew up in prosperous middle-class families, with nannies and maids and a greatdeal of loving attention, whereas Guntrip grew up as an only child (his onesibling died in infancy) in an unhappy lower-middle-class family in SouthLondon. His mother’s drapery shop failed, his father gave up the evangelicalministry he loved to work with no great success in the City. All such factorsmust be hugely influential.

The harshness of Guntrip’s mother is described in lurid terms, no doubtreflecting the origin of the description in Guntrip’s case-notes.After his brother’s

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death (Percy was 16 months old, Harry was 3 and a half years old), Harry becameill for several years with obscure afflictions.When he was 5, his mother dealt withan irritation he felt under his foreskin by‘suddenly’ having him circumcised in thesame room in which he had witnessed his brother’s death. Soon after, she foundhe had been playing some excited game with a little girl and beat him unmerci-fully until he sobbed and clung to her skirts. In his International Review article,Guntrip says he did ‘active battle’ with his mother for four years after Percy’sdeath, but then gave up and ‘grew away from her’. In his self-understanding, thismove – to intellectuality at school and also to the Salvation Army – was a‘schizoid’ splitting-off from unbearable emotions, which he was to spend the restof his life trying to re-contact. Only at the very end of his life, long after both hisanalyses, did he ‘remember’ Percy’s death and the terrible atmosphere in thehouse around that time.

What does all this have to do with religion? Guntrip removed himself fromhis family by joining the Salvation Army while still a child – it taught him manyskills including carpentry, drumming and, later, leadership – and then enteredthe Civil Service when he was 15. By age 19 he was oppressed by the authori-tarian structure of the Salvation Army and left it to study for the Congrega-tional ministry, at the same time becoming a student of philosophy at UniversityCollege London under John Macmurray – for the first time encountering afirst-class and profoundly psychological thinker. Dobbs considers Macmurraythe foundational influence on Guntrip’s mature thought. As a philosopher,Macmurray was unusual, especially so in the 1920s, in emphasizing the personalnature of the self: he addressed very directly what Guntrip would later call theschizoid problem of the separation of thinking from feeling. ‘Only emotionalknowledge’, said Macmurray, can reveal to us the world as it really is.

Macmurray was a Marxist who became a Quaker so this very ‘independent’philosopher is another example of the correlation between independence ofthought and the British nonconformist religious traditions. (Much later, anotherIndependent psychoanalyst, Neville Symington, would also be influenced byMacmurray when he developed his concept of ‘mature religion’, a phrase Mac-murray also uses.) Macmurray’s influence on Guntrip was to steer him towardspsychoanalytic ways of thinking. ‘Personal existence’, said Macmurray, ‘is con-stituted by relations of persons’, and such a philosophical vision clearly antici-pates Fairbairn’s later psychoanalytic shift when he declared that libidinaldrives were less to do with reduction of somatic tension and more in the serviceof object-attachment. Guntrip, so often unlucky as a child, seems to have had aremarkable piece of luck in finding Macmurray.

Dobbs argues that neither of Guntrip’s two analyses really allowed him thedeep dependency that might have altered his ‘schizoid’ pathology. Guntrip’scase-notes are perhaps the evidence: he was unable to give up his control of theanalysis. Winnicott joked: ‘I’ve never had anyone who could tell me so exactlywhat I said last time’, but of course such scholarly remembering can also blockthe mind’s freedom to metabolize and move on. Guntrip recognized theneed for the schizoid person to experience dependency – very parallel, asDobbs points out, to St Paul’s recognition that God’s ‘grace is made perfect

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in weakness’ – but was unable to allow himself to quite do so. ‘You feel you maydie in a gap like Percy,’ said Winnicott, ‘You know about “being active”, but notabout “just growing” . . .’ (Guntrip, 1975, p. 152).

It was only when he received the news of Winnicott’s death that Guntrip hadthe ‘volcanic upheaval’ of the dream-series that took him back to the atmo-sphere of his infancy and, when that settled down, he was left with a mood ofsadness for his damaged and so often hated mother. I am inclined to think thatthat is as good an outcome as could be hoped for (although it is sad that it tookhim so long to reach it); Dobbs, describing it as both a triumph and a tragedy, isperhaps more optimistic about the potentials of psychoanalysis.

As often happens, even when psychoanalysts speak with apparent sympathyof theology, the theology becomes by the end of the day hard to find. Dobbsspeaks of an ‘implicit theology’ in the idea that the weak self ultimately ‘comeshome’ to relationships with others by embracing its own vulnerability. ‘Cominghome’ is of course a common image for religious conversion and I was hopingto see the implicit explicated. But at this point it becomes hard to find anythingto get one’s teeth into. God for Guntrip, says Dobbs, is located ‘within thepersonal relations factor’ (p. 174); Guntrip has an ‘internal theological objectwithin his object relations theorizing’ (p. 175). The acceptance of dependence iscompared to Kierkegaard’s ‘leap of faith’. To my reading, this reduces theologyto the uncontroversial role of providing metaphors for internal object-relationalprocesses.

There is another point at which the technical language of theology is broughtin suggestively, when Dobbs quotes Fairbairn’s idea that the ‘love’ of the analystfor the patient is agape rather than eros. Agape is the Christian technical termfor a love that looks for no reward (God’s love is of this sort), often contrastedwith eros [sensual love] and philia [friendship]. If Fairbairn and Guntrip areright, then the analyst’s love may be linked with divine love. But to use such anotion in a psychoanalytic context requires much more energetic discussionthan it receives here. Leaving aside the fee, and all the many other rewardspsychoanalysts receive from working with their patients, the complex engine ofthe countertransference seems both diminished and idealized when it is trans-lated into agape. Any psychoanalyst, moreover, is bound to ask what could bethe developmental and evolutionary background to a love that seeks no reward;or are we to imagine a different sort of origin altogether? In short (though onecan glimpse possibly fruitful lines of argument hidden in this idea, possibly likesome of those developed by Jonathan Lear [1990]), it awaits a great deal offurther exploration.

I should mention that this interesting book is spoiled by remarkably poorediting. There is no index, and many typos have survived the editing process:‘phenomena’ is repeatedly used as a singular, and amongst others we meetWilford Bion, the Boar War and (I rather liked this one) Blasé Pascal.

David M. BlackBritish Psychoanalytical Society, London

[[email protected]]

222 BRITISH JOURNAL OF PSYCHOTHERAPY (2011) 27(2)

ReferencesGuntrip, H. (1975) My experience of analysis with Fairbairn and Winnicott: How com-

plete a result does psychoanalytic therapy achieve? International Review of Psycho-analysis 2: 145–56.

Lear, J. (1990) Love and Its Place in Nature: A Philosophical Interpretation of FreudianPsychoanalysis. New York, NY: Farrar, Straus & Giroux.

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Lacanian Psychoanalysis: Revolutions in Subjectivity by Ian Parker. Pub-lished by Routledge, London, 2011; 238 pp; £20.99 paperback.

Ian Parker’s obvious passion is engaging but, if you are unfamiliar with Lacan’sideas, you will probably find this book’s style too dense.The series editor (KeithTudor, ‘Advancing Theory in Therapy’ [Routledge]) warns that the book isaimed at professionals and postgraduates. I was surprised to read on page 7:‘I do not assume you are Lacanian’: I think he does. I suspect that anyoneunfamiliar with Lacan’s work would hesitate before reading much of thisinteresting book.

There are two main appeals: the political dimension and the wide-rangingcatalogue of argument, challenges, tensions and contradictions. Sometimesthese two streams are entangled. ‘I want you’, he writes, ‘to accept . . . that thecontradictions that characterize psychoanalysis need to be connected with theother revolutionary emancipatory movements’ (p. 13). But these contradictionsthat ‘characterize’ psychoanalysis are not identified, nor is the reader presentedwith any persuasive arguments for psychoanalysis joining other supposedlyrevolutionary emancipatory movements. There is a third important difficulty –working out exactly what counts as revolutionary; that we will return to.

Ian Parker challenges tensions and contradictions between psychoanalysisand psychiatry, and between the theories and the techniques of diverse psycho-therapeutic schools, against those of Freud and Lacan. Psychology, humanism,spirituality, Marxism and capitalism also figure. Broadly he is as analytical andcritical of the non-Freudian or non-Lacanian therapies, as he is uncriticallyaccepting of Marxism and feminism. Arguments for Marxism and feminism areoften absent, and it is unclear which variety of feminism he favours.

Some of the political analyses attempt a synthesis of Marx’s work withFreud’s or Lacan’s.There is a substantial literature in this tradition preceded byFreud’s New Introductory Essays on Psychoanalysis where Freud (1933) stateshis ignorance when it comes to judging the value of Marxism and its distancefrom psychoanalysis. Since then a contrary stream of books including Osborn’s(1937) Freud and Marx have set out to marry psychoanalysis and Marxism. IanParker’s book is in this tradition: ‘I trace . . . what I take to be the core ofLacanian psychoanalysis . . . from an ideological limbo-world to . . . my owndebt to Marxist and feminist politics’ (p. 11).

This is what makes the book brave. Ian Parker intertwines a particular meta-physics and political worldview with psychoanalysis. Psychoanalysis is neces-sarily without a special worldview. Psychoanalysis is without a comprehensivetheory of the cosmos and everything in it and does not subscribe, for example,

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to Hegelian metaphysics or to Marxist dialectic or Christian theories of spiritand matter. Psychoanalysis is not in need of any such worldview. Instead it usesscientific method to advance itself theoretically. Psychoanalysis insists on endur-ing the ‘ideological limbo-world’ that Ian Parker does not tolerate. Psychoana-lysis is only able to exist by virtue of not possessing a worldview of the sortproduced by religion and philosophy. It is by not knowing that psychoanalysis isable to discover, both theoretically and clinically.Were psychoanalysis to ‘know’and to confidently offer a set of benefits, outcomes or salvation in the style ofmany therapies and religions, then psychoanalysis would not be an idiosyncraticexploration, a unique adventure for each patient. Instead it would be formulaicand rely on fixed meanings, knowable by the analyst in advance. For Freud andLacan, the important meanings for each patient have to be discovered on a caseby case basis via the analyst’s ignorance. An essential part of this ignorance isthe psychoanalyst’s absent commitment to a worldview. Of course each of us,including psychoanalysts in their private lives, has our own worldview. But inanalysis it is, or ought to be, the patient’s idiosyncratic worldview that gets anairing and has a chance of changing. The analyst should not peddle a competit-ive worldview but he ought to leave a space for the patient’s worldview tobecome elaborated.

One consequence of this absent metaphysical commitment, in my view, is aweak paradox regarding outcomes. You might start your analysis complainingabout X. At the end of many years’ successful treatment, you may find that Xstill figures in your life, but now you enjoy X on a voluntary basis rather thanbeing compelled. So there may or may not be a difference before analysis andafterwards in terms of behavioural outcomes. Psychoanalysis does not aim forbehavioural outcomes. It is not revolutionary in this narrow sense.

I suspect that Ian Parker’s commitment to Marxist metaphysics and feministideology is the reason why there is so little discussion of the nature of revolu-tion, a key term in the book’s subtitle. If there had been an analysis of therelative status of revolution in the psychoanalytic clinic, and in Marxism, then Ibelieve that the metaphysical baggage, the Marxist worldview with which theauthor burdens psychoanalysis, would be more obviously surplus. It is by avoid-ing such an analysis of revolution that he is better able to get away with weavingtogether two incompatible things.

A review of the nature of revolutions in a field more open than politics, suchas the history of science, or the history of mathematics, for example, alongsiderevolutions in subjectivity in psychoanalysis, would have done no violence toFreud’s or Lacan’s research programme. But that would have been a differentbook.A relevant text, for example, is Revolutions in Mathematics (Gillies, 1992).

Psychoanalysis certainly has no monopoly in the field of revolutions. Revolu-tions in subjectivity can be brought about by art, love, a poem, a walk, a murderor an analysis. But what is the status of these revolutions? Are they all similar?Are political revolutions different from those observed in the clinic? Are sci-entific revolutions structured in the same way as clinical ones? Might theserevolutions be distinguished? We do not find answers to these questions, or eventhese questions, in this book.


We are though asked to accept four ‘arguments’ (p. 13). Actually they arepropositions or assumptions rather than arguments. There is only space for onehere. We are asked to accept ‘that psychoanalysis is not universally true’ (p. 13).I am not sure that I understand this claim. I suspect that he means that there aresome psychoanalytic statements that are true for some people – or perhaps justone person – but not for others. If this is the correct interpretation then all iswell here: psychoanalysis in the Freudian and Lacanian tradition sets out –amongst other things – to identify or work with truths that are unique andidiosyncratic for each patient. In the clinic sporadic scrabbles for supposedlyuniversal and accessible truths are usually attempts at avoiding a more difficultand obscure individual truth. But psychoanalysis certainly makes universalclaims, at a metapsychological level, for example, regarding theoretical termssuch as drive or libido, hysteria, fantasy or the symptom. If there were no suchuniversal claims to truth then psychoanalysis would not exist, even in the clinic,because every practice is theoretical, even if the theory is remote or obscured.1

Another possible interpretation of this claim is that it is a response to theincredible proclamation that ‘psychoanalysis would benefit everyone’. I do notknow any psychoanalyst who believes this.

If Freud was right and psychoanalysis does not need a worldview besides thatof science, then this book is systematically flawed. It is, though, engaging, livelyand enjoyable, especially if you are attracted to politics and the Lacanian clinic.

Philip HillCentre for Freudian Analysis and Research, Site for Contemporary

Psychoanalysis, London[[email protected]]

Note

1. That is not to say that psychoanalytic theory is infallible. It is consistent to claim thata proposition is true, but that it may be false, for example, in the light of new evidence.

ReferencesFreud, S. (1933) On the question of a worldview. New Introductory Lectures. SE 22, pp.

158–82.Gillies, D. (ed.) (1992) Revolutions in Mathematics. Oxford: Oxford University Press.Osborn, R. (1937) Freud and Marx. Left Book Club. London: Gollancz.

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When Theories Touch: A Historical and Theoretical Integration ofPsychoanalytic Thought by Steven J. Ellman. Published by Karnac,London, 2010; 736 pp; £39.95.

The title of this book might well capture the imagination of all those morethan a little interested in the development of theory building whatever theareas of study. How does one theory emerge from another? Who fashioned itand how and with whom? Who influenced it and why and when? And is anytheory at any given time really any different from what has come before? Somany curiosities arise about the touchings that go on between theories. And

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none more so perhaps than in the wide open field of psychoanalysis – anarena replete with the complexities of human nature and relationships inwhich there is so little that is tangible and so much that is possible. The busi-ness of a theory is to make sense of complexities, to construct a speculative‘system of ideas or statements explaining something’ based on ‘a hypothesisthat has been confirmed or established by observation or experiment and isaccepted as accounting for known facts’ (New Shorter Oxford English Diction-ary). In psychoanalysis, this theoretical endeavour has led to a veritable efflo-rescence of ideas, clustered and reconfigured in all kinds of ways, as more andmore practitioners – turned theorists – tumble into the fray adding this convic-tion and that almost at random as they seek to understand the mysteries thatconfront them.

Theory building in psychoanalysis seems to have no bounds. Psychoanalytictheorists, faced as they are with their observations of people whether or not intreatment, weave various patterns of ideas that are often as much to do withtheir own personal experiences, assumptions and values.

As psychoanalysts have taken on a wider variety of patients, so their theorieshave multiplied to take account of fresh observations. This may well be a causefor celebration but for some it is worrying. For them, there are simply too manytheories, separate, idiosyncratic, in rivalry and competition. Fonagy and Target(2003) have argued, for example, that the way in which most psychoanalytictheories are built only serves to bolster their main predilections. That is to saythat, through ‘enumerative inductivism’, theorists look for ‘positive instances’ intheir observations to support their theories rather than ‘negative instances’ thatmight challenge them. As a result, ‘new theories are felt to supplement ratherthan replace older ones’ (p. 289), leading to a kind of unbridled proliferation oftheories that, against the interests of psychoanalysis as a whole, destroy anysemblance of coherence.

It is into this quite bewildering world that Steven J. Ellman enters withcommendable fortitude. He inevitably encounters many different preoccupa-tions and languages, many ideas emerging and changing, and many theories inthe throes of revisions and alterations. Nevertheless, as a New York psychoana-lyst who has read and written widely in the field, he is more than well qualifiedto take on the challenge. This book must take its full place alongside otheroutstanding works that have addressed the wide span and richness of psycho-analytic thought such as Greenberg and Mitchell’s (1983) Object Relations inPsychoanalytic Theory and Fonagy and Target’s (2003) Psychoanalytic Theories:Perspectives from Developmental Psychopathology.

Ellman has for the most part written this book by himself but, to guardagainst what he calls his own ‘political tendencies’, he has recruited others tocollaborate with him in some of the chapters. The main inspiration for thebook, however, is clearly his and in the preface he spells out clearly what hasdriven him into this work. At the heart of it all is his growing impatiencewith the prejudices and snobberies that pervade the psychoanalytic world. Ashe sees it, all too often, jibes and taunts are made about who is and who isnot the ‘true’ analyst, who is and who is not capable of conducting the ‘real’


analysis. Narrow petty-mindedness in the political world of psychoanalysishas, in his view, clouded its progress. He is also none too pleased with the waymost theorists tend to bifurcate the field, for example, emphasizing a basicincompatibility between a drive/structural model and a relational/structuralmodel. The essential purpose of this book is to counter these tendencies andto own up to the fact that most clinicians implicitly construct a theory of theirown, drawing as they think fit from other theorists, to make sense of theirobservations and practice.

The book is divided into three parts. The first is devoted to Freud. Thisconstitutes a full quarter of the entire text. In the Preface, Ellman explains why:

Given today’s movement away from Freud, why did I include four chapters onFreud in the present volume? It seems to me that it is still impossible to understandthe controversies and oscillating positions in psychoanalysis without understandingFreud. Most of the issues that are being debated started with, and are stronglyinfluenced by Freud. (p. xxi)

The second part of the book moves on to discuss the major theorists followingFreud during the 20th century. The final part of the book is a concentration oncontemporary issues in psychoanalysis.

Ellman identifies four main eras in the development of Freud’s theories, eachcaptured in different chapters. ‘Freud’s Heroic Era: The First Ten Years’; ‘ThePsychoanalytic Era Begins: Dream Theory – Psychosexuality’; ‘Freud’s ObjectRelations Era: The Metapsychological Papers’; and, finally, ‘The StructuralModel’. This division is very useful since it highlights the way Freud’s theoriesevolved as he dealt with differing clinical problems and resistances. Ellmancaptures the strength of Freud’s genius as Freud forged his ideas and struggled tomodify some of them that he had hitherto cherished. The more he exploredhuman sexuality the more he had to accept that there is more to pleasure thansimply the reduction of instinctual tension.Similarly, the more he was confrontedwith negative therapeutic reactions, the more he had to accept that there wereunconscious parts of the ego and that there might be forces at work beyond thepleasure principle. Freud’s theories touched each other in so many ways that it isdifficult to grasp their full evolution and meaning at any given time.

There can be no doubt that, whatever Freud had on his mind, others were notslow to proclaim what was on theirs. From early on, Adler, Jung, Rank andothers took issue with his ideas and went their own ways. And in his later years,he witnessed extraordinary goings-on as his much favoured daughter, Anna,entered into battle with others, not least Melanie Klein. Anna rode the closestto Freud’s ideas and emphatically developed an ego psychology that proved tobe much followed in America where many of her Viennese friends had settledin flight from Hitler. Her seminal work was Ego and the Mechanisms of Defencein which she delineated with great clarity the different ways the ego deals withanxiety. She was above all concerned with the integrity of the ego. Hartmannjoined with her in focusing on the adaptive strengths of an autonomous ego thathad the ability to desexualize instinctual forces in the service of general cre-ativity. All might have proceeded in this quite ordered and coherent vein for

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some while had it not been for the arrival of Klein who set about ruthlessly todismiss the ego psychologists as being too rational and insufficiently in touchwith the repressed unconscious instinctual life. Ellman entitles his first chapteron Klein as ‘The Kleinian Revolution’.

That Ellman should go on to spend so much time in this book on Klein, muchmore so in fact than on Anna Freud, is something of a mystery. He is clearlytaken with the ‘vibrancy’ of Klein’s ideas and her extraordinary influence onsubsequent theorists, however much the post-war American psychoanalysts didnot take to her. And yet he remains unconvinced of some of Klein’s fundamen-tal postulates, for example, of conflating triangulation with the oedipal situation:‘In my view, there are various triangulations that are present pre-oedipally thatdo not involve oedipal dynamics’ (p. 615). No doubt, Ellman is impressed by theextent to which Klein took psychoanalytic thinking deeper into the minds ofinfants. The theoretical constructions she made on the basis of her observationsof infantile life, though at times highly convoluted, opened the door for manyothers to explore the beginnings of human mental life. Fairbairn was the first tofollow alongside. It is however perhaps remarkable how relatively little atten-tion has been paid in psychoanalytic theory to later stages of development, as ifall that mattered in human growth was to be settled very early on. It is curious,for example, that Ellman pays such scant attention to Anna Freud’s interest innormality and pathology in childhood, to her singular contribution to a psycho-analytic understanding of adolescence or to her applications of psychoanalyticknowledge in the fields of education and the law – or indeed to Erikson’s eightages of man.

Beyond Klein and Anna Freud and the now infamous Controversial Discus-sions which raged as the bombs fell on London in the World War II, Ellmanstrides on with lively interest along the pathways set by Winnicott, Sullivan,Mahler, Kohut, Kernberg, Bion, Mitchell and many others. Throughout, hewrites with great respect for those he is reviewing, and is respectful of othertheories. He has set about his work endeavouring as far as possible ‘to getinside’ each theory and to find out what it has been that has impelled theauthors to construct theory in the way that they have. He has tried to cutthrough the obscurity of some of their languages in order to help him trace theconvergences and divergences that exist between them.

This is an unusual book. It is both a textbook, formal, scholarly and wellbalanced and also a personal exploration, less formal, more conversational intone: ‘One could win a bet with most psychoanalysts by asking them what wereFreud’s psychosexual stages in 1911’ (p. 121). It is this combination that makesit so informative and entertaining. His fascination is in the many oscillationsthat have occurred as the body of psychoanalytic theory has swerved around thetensions between the subjectivists and objectivists, the classicists and the revi-sionists, the drive and relational theorists, the transference purists and theothers.

In the later chapters of the book, he makes much more of a declaration ofwhere he stands. In terms of therapeutic practice and psychopathology, forexample, he makes it clear that:


I do not think that an analyst can be neutral, a blank screen, anonymous orobjective . . . I do not think that all psychopathology (or even most, in my experi-ence) resides in oedipal conflicts, and to think of conflict mostly in terms of driveand defence is in my view a mistake. (p. 584)

In many ways, he is much influenced in this thinking by the contemporaryrelational theorists such as Mitchell and Gill. However, he bucks at the tendencyamongst them and indeed theorists of all kinds towards dichotomous state-ments: ‘If one is told there is an unbridgeable gulf [between classical andrelational points of view] one has to choose sides’ (p. 622).

He clearly refuses to do so and instead offers a ‘tentative developmentalmodel’ that can embrace both positions and others besides.What he has in mindis a ‘truly dynamic theory’ with ‘moving parts’ which takes into account themany differences in the make up of people – ‘people where innate factorspredominate and others where experiential factors predominate’ (p. 622). Hisfundamental questions are: ‘Can a theory be even more flexible than so faroutlined and state things in contingency terms that imply or state probabilities?’or ‘Can it move so that it can accommodate factors that it normally does notaccentuate?’ Thus, as he puts it: ‘A certain type of infant might be difficult tosoothe under many conditions, but can a theory state some conditions underwhich this difficulty is minimized?’ (p. 623). He is emphatic that any viablepsychoanalytic model should be multi-factorial.

The subtitle of this book is A Historical and Theoretical Integration of Psy-choanalytic Thought. This is an ambitious project with Ellman in pursuit of anintegration that many might say is impossible. He himself condemns those manytheorists who appear to have no appetite for integration, as consumed as theyare with the rightness of their singular visions. As he has so skilfully shown,there are indeed many such visions, the nuances of which are difficult to capture.So too are the innumerable emotional alliances and betrayals that have beenbuffeted about during the history of psychoanalysis. The touchings of onetheory to another have been gloriously varied – some caressing and supportive,others in collision and opposition. However, notwithstanding all of this, Ellmanholds on stoutly to his faith in creative interaction. His parting sentences at theend of his 656-page text expresses well his mission:

It has also seemed important to me to try to show how various theories havedeveloped. It is useful to see what a theorist is opposing as well as what they areembracing. It is my hope that this book will encourage more theoretical touchingand the constructing of wider and deeper psychoanalytic theories. (p. 656)

Peter WilsonConsultant Child and Adolescent Psychotherapist, London

[[email protected]]

ReferencesFonagy, P. & Target, M. (2003) Psychoanalytic Theories: Perspectives from Developmen-

tal Psychopathology. London: Whurr.Greenberg, J.R. & Mitchell, S.A. (1983) Object Relations in Psychoanalytic Theory.

Cambridge, MA: Harvard University Press.

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Life Within Hidden Worlds: Psychotherapy in Prisons edited by JessicaWilliams Saunders. Forensic Psychotherapy Monograph Series. Pub-lished by Karnac, London, 2001; 118 pp; £23.99.

This short book, ten years old but of considerable relevance today, was writtenby forensic psychotherapists whose concern it is to develop a psychodynamicunderstanding of the offender patient and, in this context, to understand how thecrime becomes the means of a behavioural enactment by the individual, whichuniquely demonstrates something of their internal object relations. The treat-ment was carried out in remand/local prisons, Category A, B, C and D prisons,open prisons and young offender institutions, with a comprehensive descriptionof each individual setting together with a flavour of life within these walls.

On reviewing this book, I was reminded of the four years I had spent prac-tising psychotherapy in a regional secure unit with offenders who had all killeda loved one (Polledri, 1997). What I did not have to guide me was a book suchas this one whose contributors have all worked in high security hospitals andprison settings and who all have a background history of considerable experi-ence working for the forensic mental health services. For example, issues such asthe ability to be able to step back and reflect upon the process of treatment withthe prisoners in order to safeguard the capacity to think and feel within a systemthat tries not to. Another important dynamic which the contributors touch onbut do not elaborate on is the ‘index offence’, that is, the criminal act itself – andjust how brave one has to be to keep that in mind when practising psycho-therapy with murderers – in such a split-off environment, whilst psychicallydigesting the horror of the crime committed by the person sitting opposite youin the treatment room. Never mind the institutional dynamics running parallelto such a process.

My overall impression is that this book spells out, in great detail, the problemthat every prison system in the world faces; that is, the care and treatment ofthose who have committed the most outrageous crimes on their fellow men.Their care is beyond the capabilities of prison staffs and they need differenttreatment, which is where psychotherapists come in, not working apart but inpartnership with prison officers. It is well known within the discipline of forensicpsychotherapy that prisons are not ideal environments in which to practisepsychotherapy but they are places in which it is needed urgently by providingspecial treatment to prevent the individual re-offending. As the Foreworddescribes, too many people fail to understand the need or what therapy canoffer, and ignorance is a powerful enemy of practice. On the issue of safety,there is mention made of two important questions that must be asked: firstly, isprison a safe place in which to explore the inner world of prisoners who havecommitted fairly horrific crimes; secondly, have boundaries been set up aroundthe process to ensure that there is a chance of psychotherapy actually takingplace? This recognition is important because control and therapy are notnatural bedfellows in prison.


The culture in prisons is described not only of prisoners but of prison officers.Both cultures are essentially masculine, typified by a ‘macho bravado’ that isitself something of a defence mechanism against others and against the pris-oner, as many prison officers adopt an attitude of having to outsmart prisonersby beating them at their own game of toughness.

Jessica Williams Saunders writes a very comprehensive Introduction in whichshe discusses with great clarity the issues, themes and dynamics of psycho-therapy in prisons. Although the subject areas she has chosen are vast andcomplex, nevertheless she presents relevant issues for consideration – startingwith ‘Scene Setting’: a discussion based on imprisonment and humanitarianconcerns, exploring the dichotomy of treatment versus punishment, and sheputs forward some key points about the practicalities that need to be consideredwhen engaging in the practice of psychotherapy in prisons. Williams Saundersdraws on her own clinical experience to illustrate her points as her chapter isprimarily concerned with introducing the reader to prison life and examiningthe impact and implications that life holds for the process of psychotherapy, theprisoner in prison and in treatment, and the practitioner carrying this out.

In her section on ‘Background’ she discusses overcrowding in prisons. Tenyears ago, the total number of offenders (including young offenders) housed inprisons within the United Kingdom amounted to 69,952, with women account-ing for 3,170 of these figures. She goes on to describe ‘Prison Types: SentencingStage and Implications for Psychotherapy’, in which she discusses how there area number of different types of prisons in the United Kingdom, and how eachposes different constraints and issues for the practice of psychotherapy. Shepoints out that there is currently only one prison, HMP Grendon, that is runentirely on therapeutic community lines within the security of the prison walls.

Various headings of interest in the rest of Williams Saunders’ Introductioncover ‘In the Beginning: On Remand’ which deals with a largely transitorypopulation – and indeed one might question whether it is ethical or viable toengage a prisoner in this type of self-exploration, given the brevity of theirprospective stay. During this stage, prisoners may also be in a state of shock andtrauma when the full realization of what they have done begins to sink in andthere may be a very real need for psychic holding in a remand setting. The nextsection, ‘In the Middle: Serving a Sentence’ describes how navigating the courseof treatment during the remand and sentencing stages is always vulnerable tounexpected changes beyond the therapist’s and sometimes the prisoner’scontrol, because the prisoner may be ‘shipped out’ to another prison. WilliamsSaunders takes the reader through headings which relate to ‘The Ending: Pre-release’, ‘The Treatment Room’, ‘Keys’, ‘The Individual and the Group’, ‘Pris-oners’, ‘Prison Officers’, ‘The Psychotherapist’, and, in ‘The Conclusion’, shereflects on how her contribution is concerned with providing the reader with aflavour of life within prison walls, with particular reference to some of thefeatures that the psychotherapist will need to keep in mind when practising thisHerculean task. However, she also questions whether the environment andculture of a prison are a ‘safe’ place in which to venture into the prisoner’s innerworld and whether it is actually possible to hold the paradox that therapy and

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incarceration present. She believes that the concrete holding of the prisonprovides the feeling of safety the prisoner needs to find a relief from thepsychological and emotional incarceration they experience.

In her chapter entitled ‘Psychotherapy in Prison: The Ultimate Container’Lyn Greenwood takes up many of the above issues spelled out by WilliamsSaunders. She writes about her experience as a psychotherapist in WormwoodScrubs. She gives a very vivid account of the patient–therapist relationship andthe psychodynamics she encountered in the treatment of a man who had mur-dered. Transference, countertransference and projective identification play amajor part in her response to the power and horror of the material which has tobe processed so it is crucial to be able to draw on the support of colleagues and,of course, a first-rate supervisor.

Ronald Doctor’s chapter entitled ‘Psychotherapy and the Prisoner: Impasseor Progress?’ provides the reader with a discussion of the psychodynamicprocesses involved in treating offenders with addictive behaviour in criminality;in sexual and drug abuse within a psychotherapeutic community and withgroups in particular. Doctor argues that, although the prison culture is anobstacle to the effectiveness of psychotherapy, with the use of the therapist’scountertransference a humane understanding of the conflicts can be achieved.In his section on ‘The Prison Setting’ he discusses how, for him, the mainobstacle to working as a psychotherapist in the prison lies in the prison cultureitself, a culture that is formed and made up of entrenched attitudes adoptedby the prisoner, within the prison setting, which dictates his relationship toothers. This self-same culture, of macho-bravado, keeps prisoners emotionallyensnared and renders them unable and unwilling to express themselves. Thoseon the receiving end, the prison officers, are also engaged in a relentless struggleto preserve and defend their self-esteem and masculinity against the deceptionof the prisoners. By contrast, Doctor says, the psychotherapists, psychologistsand probation officers who act as receptacles for all the disowned feelings offrailty and tenderness are consequently regarded as a ‘soft touch’. He describeshow one has to bear the antagonism from the prisoners, medical officers andprison staff towards the psychotherapeutic community as a whole for being ‘awaste of time’, a ‘soft option’ or a ‘dumping ground’ for sex offenders, the weakand the cowardly. He concludes that, although it has been suggested that theprison culture is an obstacle to the effectiveness of psychotherapy, its concreteholding may also be an advantage for certain individuals and may also offer aunique opportunity and setting for the treatment of disturbed individuals.

Paola Franciosi’s chapter describes the struggle to work with locked-up painin her experience of carrying out treatment in a prison that houses femaleoffenders, two-thirds of whom are awaiting trial. She discusses how the femaleprison population in England and Wales is approximately one-twentieth of themale prison population.There were, she says, 3,200 women and over 62,000 menin custody in November 1998. Franciosi describes her work with women whohad harmed their children and goes into great detail about the disturbing effectthat has on the therapist and how she was unable to see more than one patientwho harmed her child at any one time in order to provide containment in her


own mind of very disturbed and disturbing feelings and thoughts that belongedto the patient. She discusses how psychotherapists might be anxious aboutoffering to treat ex-prisoners in the NHS without forensic training because theyfeel unsure about handling patients who have acted out their destructive mur-derous wishes. This is a real concern as the therapist has to hold onto verydisturbing feelings whilst the patient becomes more able to think and to movefrom persecutory anxieties to more depressive ones.

Mark Morris writes about his work at Grendon – a psychotherapeutic prison.He discusses how the concept of prison psychotherapy is a contradiction interms. Psychotherapy, he says, is a voluntary process, a self-exploration that isusually painful and difficult, carried out in a setting where the client is free tocome and go. Prison is prison. Grendon is a prison whose primary aim ispsychodynamic psychotherapy and has been in operation for over 30 years. Heexplores in his chapter the contradiction that is Grendon by looking, firstly, atthe theory and practice of the therapy and, secondly, at the context in which thetherapy takes place He looks at the nature of the prison environment in termsof concretization, the client group, anxieties about caring and the trauma on thestaff.

Although this book does not provide the reader with any conceptual basis forunderstanding the aetiology of violence and murder from a psychodynamic orpsychiatric perspective, I would strongly recommend it to those interested inpractising psychotherapy in prisons; especially as psychotherapy should not beseen as antithetical to the ethos of a prison. For anyone interested in venturinginto the field of forensic psychotherapy, this book explains simply yet graphic-ally the challenges that face psychotherapists entering this hidden world and,with great compassion and wisdom, provides a framework in which they will beable to find the freedom to think.

Patricia PolledriLondon Centre for Psychotherapy, London

[[email protected]]

ReferencePolledri, P. (1997) Forensic psychotherapy with a potential serial killer. British Journal of

Psychotherapy 13(4): 473–88.

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Documents

Lacanian Psychoanalysis: Revolutions in Subjectivity – By Ian Parker