Discussion of Eisold's “Profession of Psychoanalysis”
Jon Meyer, M.D.
I DO NOT REMEMBER psychoanalysis in its 1950s heyday. But I grew up professionally in the 1960s and 1970s, when psychoanalysis had the credibility, privileged status, and self-regulation that marked, in Eisold's terms, a successful professionalization “project.” Psychoanalysis was in the public eye and in demand, with waiting lists of patients and candidates. It was a prestigious calling, although even then somewhat outside the intellectual and collegial frame of what might reasonably be considered allies. We have fallen from that state of grace, as it were, and Eisold asks “why”? He also asks how we might return, not to the same place, but to a better one.
There is no doubt that psychoanalysis has its problems. Some are in the broad cultural context of healthcare industrialization. That context includes managed care deprofessionalization of mental health; so-called providers; lowest common denominator, manualized methods; neglecting mind for brain; and mechanistic, descriptive formulations of sentient, dynamic human beings. Dr. Eisold does not examine the effects of this cultural shift, but that is not his focus. While we are not responsible for the profit-cost-driven challenges of “industrialization,” we are responsible for ineffective responses. The failure to mount timely and effective responses is consistent with Eisold's thesis.
He suggests that we look in the mirror for the cause of many, if not most, of our difficulties. He reflects the well-known comment of Pogo, my favorite comic strip sage, who said, “We have met the enemy and he is us.” As Eisold notes, psychoanalytic proactivity and responsivity have been troubled from the beginning by conflicts, theoretical splits, and personal rancor. He suggests that psychoanalysts managed to appear cohesive and obtain a culturally privileged position only through appeal to the authority of Freud, theoretical purity in emulation of Freud, and an emphasis on Freud's pure gold of psychoanalysis. That strategy, however, could only be effective for so long, and its time has run out.
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