The Analyst's Preconscious

Abstract

The rich and complex experiences that Victoria Hamilton brings to her work become apparent in this book. Her education in philosophy and art prior to obtaining analytic training gives a refreshing perspective to her original study. Her exposure to the British analytic milieu, with three competing and well-differentiated groups informed by different paradigms, places her in an optimal position to compare different analytic cultures. Her move later to Los Angeles, where she now practices and teaches child and adult analysis, adds still another important dimension to her becoming a critic of the analytic panorama. It is not surprising that she can maintain a broad and pluralistic view that helps give an organizing perspective to her investigation. Her method of inquiry is relatively simple. She chose 65 psychoanalysts from the three different currents dominant in Great Britain: Freudians, Kleinians, and the Middle Group. They were from New York, San Francisco, and Los Angeles (including self psychologists and interpersonalists). The design of her study consisted of two parts. First she devised a relatively simple 20-item questionnaire (Psychoanalysts' Orientation Questionnaire; POQ) that she sent to the participating analysts to survey their opinions of how different frameworks have influenced their techniques. Second, she conducted semistructured interviews with each of the participants, lasting between 45 minutes and 2 hours, following a protocol of 27 different dimensions. Using the central concepts of transference and its interpretation, Dr. Hamilton mapped out clusters of beliefs that did not appear to be dependent on the consciously perceived and declared acknowledgment of theoretical influence. From a prior pilot study she arrived at a grouping of analysts in five major categories: 1) developmental Freudian, 2) classical Freudian, 3) self-psychological, 4) Kleinian, and 5) independent. The author believes that the analyst's preconscious provides an intermediate area of the analyst's mind where the link occurs between privately held and publicly expressed beliefs, greatly affecting how analysts “really” handle the transference. As the author indicates, it is easier to make clear and consistent judgments when we are in the safe arena of academic discussion than when we are under the constant pressure of the patient's demands in the consulting room. As the book, in a very original and carefully designed way, attempts to elucidate, the analyst's preconscious is fully at work. In our current analytic world, where there is no one theoretical position that has a corner on the market, Dr. Hamilton's attention to the pluralistic position is most welcome. As the analyst constantly navigates in a sea of uncertainty, absolute views can be very comforting and not without a very strong attraction, particularly for the beginner. While the pluralist draws from a variety of analytic models and tries to integrate them, the monist adheres to one overexplanatory model, hoping that it provides all of the necessary answers. The author uses the term analytic culture to refer to a complex network that exerts considerably more influence than the purely defined intellectual or public analytic positions. The attachments that we form to our teachers, leaders, colleagues, and own analysts shape our function as analysts in ways of which we are not completely aware. One most remarkable aspect of the book is the transcript of the interview segments, which the author typed herself for maximum immersion in the material. Here the reader has opportunity to access the raw data and reach his or her own conclusions. On the other hand, the fact that the author chose what to present as a portrayal of an opinion, out of the context in which the interview occurred, raises another set of questions. This becomes a very attractive feature of the book that at the same time leaves the reader with some unanswered questions. The organization of the book becomes very demanding at times. To follow the different characters, with the affiliation and the geographical location assigned to them, in the broader context of the other interviewed analysts becomes like a fascinating walk through a labyrinth. The reader who is sufficiently familiar with the psychoanalytic literature and its evolution will be treated to a most intriguing review of the major issues in psychoanalysis, through the eyes of 65 analysts from two continents and five cities, and with very divergent points of view. The book offers a great deal of fascinating information for the clinician who wants to learn more about the current positions that are held by psychoanalytic practitioners.