IV

Interpretation and Change

How might the perspective of change help to explore the idea of interpretation in psychoanalytic psychotherapy? Change is troubling for interpretation because, while positive change must be its avowed purpose, the fluidity the notion suggests places interpretation in question: if that which is being interpreted is subject to change how can we maintain firm notions of truth and accuracy. Furthermore, we might ask what sort of change does psychoanalysis have in mind when an interpretation is offered. If we keep fidelity to the strictures of theory is it change in a pre-ordained direction, a change perhaps tantamount to a form of suggestion, or can interpretation be used to bring some form of ‘newness’ into being?
 

To begin we need to be clear what we mean by psychoanalytic interpretation. In an essay characterised by marvellous clarity, entitled with a tactical simplicity, ‘What Analysts Say to their Patients’, Charles Rycroft briefly outlines the theory of psychoanalytic interpretation as it has come down to us from Freud. Rycroft begins by suggesting that interpretation involves analysts asserting ‘that what their patient has been telling them has wider implications than the patient has appreciated.’ (58) I will return to this very first definition later. The paradigm for such interventions is the interpretation of dreams, where the analyst suggests an explanation for the condensed and displaced nighttime images the patient presents, the accuracy of the interpretation being tested against the recollection by the patient of an event or a feeling which might accord with the explanation offered by the analyst. Psychoanalytic interpretation developed two further techniques: the interpretations of defences and of transference. Rycroft wittily ventriloquizes these latter two forms of interpretation thus: ‘you are using such-and-such a defence to prevent yourself remembering such-and-such a wish, feeling or memory’ (66) and ‘you are using such-and-such a defence to prevent yourself becoming aware of such-and-such a feeling towards myself, to whom you are reacting as if I were your mother or your father.’ (66) So these are the central forms of psychoanalytic interpretation: the interpretation of dreams, of defences and of transference. Rycroft’s essay turns when he makes what I consider two separate comments indicating the limits of the classical model of interpretation. First he notes:

… this view assumes that the analyst is an external, objective observer of the patient’s intrapsychic processes, that interpretations are interventions from outside the system […] 

He goes on to argue:

It is, however, possible to look at psychoanalysis [in a way] which assumes that there actually is a relationship between therapist and patient, that interpretations constitute a special class of communication between patient and therapist, and that they are one of the several kinds of things that therapists say to their patients while relating to them. 

I want to deal with the first element of Rycroft’s criticism of interpretation, turning to the second element as a form of conclusion. The first element hinges on psychoanalytic interpretation’s claim to a sort of quasi-scientific objectivity – its sense that it is an intervention mounted from an outside that explicates an inside. The view that this is not really what interpretation is or how it works has a long history and can be ascribed to a number of otherwise opposed psychoanalytic thinkers and schools: that is to say, an opposition to the notion of scientific objectivity in interpretation can be held for very different reasons. For instance it is a position held by figures such as Rycroft, who worked in the Winnicottian tradition who might view psychotherapy as a more down-to-earth activity than the name science implies. It can also be seen in the tradition of psychoanalysis inaugurated by Jacques Lacan, who felt that interpretation as such was a problematic category, as language does not so much communicate a content as compel misrecognition. I do not intend to get bogged down in retracing the various turf wars that have characterised psychoanalysis since it was inaugurated. I will just mention that Peter Lomas, who was a close associate of Rycroft, commented in a moment of uncharacteristic fury that Lacan ‘is not one of my favourite boys’.
 

So, the idea which is shared by many who have come after Freud is that there is a problem in the assertion within psychoanalysis that it offers a form of interpretation that claims objective truth. There are a great deal of complex works whose subject has been the problems or indeed impossibility of interpretation. Jacques Derrida’s Of Grammatology perhaps represents the high point (or low point depending on your point of view) of the post-war critique of interpretation and meaning. However, as I have already suggested, in our case we not need have recourse to complex theories such as deconstruction to establish the philosophical ‘problematic’; just a mention of our theme – change – and the technical difficulties for psychoanalytic interpretation become clear. In a unsually practical exploration of Lacan, Bruce Fink comments, ‘Truth has a funny kind of temporality in psychoanalysis.’ (76) Something said in one session by either therapist or patient that seems true and of enormous importance, can come to seem not quite so striking, perhaps a touch hollow, or even completely untrue in another.  Freud himself was aware of this phenomenon. In his essay ‘Constructions in Analysis’, he approaches the notion from the opposite point of view, that is, from interpretations which a patient feels are untrue, but the implication is the same. ‘A patient’s ‘No’, he comments,

is equally ambiguous, and even less usable than his ‘yes’’. […] Since every such construction is incomplete and cobtains only a small part of the forgotten events, we are at liberty to assume that the analysand is not actually denying what he has been told, but is basing his resistance on the part of the material that has not yet been revealed. 

In a rather off-hand manner Freud here asserts that an interpretation can never be complete, can only be provisional, that what is offered can never be the whole truth. Thus, though what is offered by the therapist might be accurate in a local way, because material is left unsaid, it is rejected. What we might infer from Freud’s comment is that the reason why something said might come to feel hollow is precisely because it has been articulated. The spoken is always in danger of ossifying into dead matter – the obvious, the uninteresting. What feels alive still, what feels like the truth, is always just out of reach, yet to be said.
 

Nevertheless, if change is the problem, perhaps it also offers us a solution. To return to Bruce Fink. He comments:

If there is some criterion of accuracy or truth beyond the analysand’s subjective sense […] what would it be if not the changes that actually occur for the analysand?

An interpretation in the classical style that offers to explain one intrapsychic phenomenon in a one-to-one correlation with a pre-existent tenet of theory is unlikely to foster change. Given the aim of transformation the purpose of interpretation is not to pin meaning down but to open it up. As Lacan commented ‘An interpretation whose effects one understands is not a psychoanalytic interpretation.’ (Quoted in Fink, 81) One way to explain what Lacan has in mind is to suggest that an  interpretation that comes from a position of prior knowledge and certainty runs the risk of imposing finality, order, monolithic deadness on material that is vibrant, polymorphic, and unending. Another approach might be to focus on the role of interpretation in bringing to light the unconscious itself. We might briefly consider Freud’s dictum for psychotherapy: ‘Where id was, there ego shall be.’ (1973, 112) In this understanding, the therapist’s role is to tame the irrational, to turn the challenge of the unconscious into something conventionally understood. Lacan’s approach seems to seek to allow the unconscious to remain unpredictable, to encourage its ability to destabilise and unsettle the ego.

I suggested in my opening comments, an interpretation that sought to replace the id with pre-existing theoretical knowledge would be tantamount to a form of suggestion – a demanding of assent from the patient. We are now ready to return to Rycroft’s first definition of interpretation: ‘that what their patient has been telling them has wider implications than the patient has appreciated.’ The word to focus on is wider; psychoanalytic interpretation only happens when the implications widen rather than narrowing.
 

Interpretation cannot simply be the assertion of a meaning by the therapist. It occurs in a mobile situation; in facilitating change it, so to speak, signs its own death warrant, but only to allow its own rebirth in a new and unpredictable form.  Stephen Frosh writes of interpretation in exactly this way:

the interpretation has effects that result in changes in the thing interpreted, making the original interpretation immediately out of date. Something is communicated between interpreter and interpreted, between analyst and patient, making it possible for the latter to share and engage in the interpretation that has just been offered. Something occurs, therefore, which is more than just revelatory; it is also constructive and transformative. The analyst gives an interpretation, the patient hears it and works on it, absorbing it and making it her or his own. In the process, the patient is changed and something new appears in the place of what was previously an absence, a failure to own or understand the voice which was speaking from within. In this newness, there is more material for interpretation because it is in the nature of human subjectivity that the unconscious is never exhausted and that fantasies keep pumping away, reimagined and continually active. (113)

Frosh begins with the idea we have already encountered of the immediate ‘out of date-ness’ of an interpretation. However, if the interpretation has allowed change, widened implications, something ‘constructive and transformative’ occurs. The ownership of the interpretation means that it is absorbed into a new and fundamentally different concept of self. But this does not finish the process, it begins it anew.
 

Frosh uses the language of communication and of sharing and this points us back to Rycroft’s second criticism of classical interpretation: Rycroft would have us see it as a form of communication within a relationship; that psychoanalysis is not a matter of an objectified patient being intellectually dissected, but rather a matter of more or less equal individuals entering into a close rapport in the hope that one can assist the other in alleviating mental distress. In Adam Philips book on Winnicott he comments that,

under the aegis, though not the leadership, of Winnicott, a Middle Group emerged … of whom Masud Kahn, Charles Rycroft, Marion Milner, John Klauber and Peter Lomas are the most distinguished […] For Winnicott and those who were influenced by his work, psychoanalytic treatment was not exclusively interpretive, but first and foremost the provision of a congenial milieu, a holding environment analogous to maternal care […] the patient does not undergo authoritative translation – but is enabled, as Winnicott wrote, ‘to reveal himself to himself’. 

So the Middle Group, influenced by Winnicott, valued relationship over interpretation and assisted self-revelation over authoritative explanation.

I want to finish by looking at an example of this approach to interpretation in the work of Peter Lomas. In The Limits of Interpretation he describes a rather shy young woman whom he has been seeing for a few weeks asking ‘May I use your loo’ shortly after arriving for a session. Lomas replied ‘Yes of course’ emphasising that she was welcome and need not be so hesitant. He then comments:

I could later have made what is commonly called an interpretation. … ‘I notice that during sessions you are at pains not to be a nuisance to me. You never show any aggression, you speak little and quietly, you try to be “good”. May it be that in going to the loo just before the session you try to get rid of the messy, dirty, unacceptable bits of yourself in case they emerge in some form during the session.’ […] However, I made no comment. 

His reason for not offering the interpretation is that it might have made her feel criticised, or suggested that he did not want her to use his loo, or that he did not like her body, or indeed her; furthermore, it might make her think the relationship was based entirely in his careful scrutiny of her. He presents his quite spontaneous interaction – his agreement to her visit to the loo – as, in a way, analogous to an interpretation.I am saying to [her] ‘I believe that your view of yourself, or our relationship and of the way people can best behave towards each other is mistaken […] I am surprised by your diffidence, for which, as I see it, there is no need.
 

He adds that she may have read other implications as well:

‘My body is more acceptable to him than I supposed. He doesn’t regard me as an intrusion into his life even when I don’t confine myself strictly to the agreement that I am allowed into his consulting room.’ That is to say, the comment would probably have symbolic as well as overt meanings … . (53-54)

The criterion for the interpretation is not whether it is true, but what the outcome is and that can only be judged in the relationship – are they ready to hear this? Can they work with it? Is it likely to close things down, or open things up? This can only be judged case by case. Something that seems clever may well backfire, a simple act of kindness may well enable insight.  It is certainly true – and indeed a truism within psychoanalysis – that a premature or mistimed interpretation is likely to receive a defensive response. With change and not accuracy as our guide, it is essential that a therapist think carefully about the relationship that is being developed. However, Lomas does not seem simply to be making that point. Instead he is making the broader point that a non-interpretive intervention – really just a way of relating that seems normal, spontaneous and intuitive – can be just as effective, if not more so, than interpretation as it is usually understood.

Just as a last thought, I want briefly to investigate this notion which is so key to the Middle school – as Philips puts it: emphasising the ‘holding environment’ over interpretation. I just wonder if it might be the case that without an interpretive intervention even on some distant horizon – when she might be ready to hear it and work with it – Lomas’s young woman might come to feel that there is an unwillingness on the therapist’s part to examine or confront the depths of experience; that the therapist might unwittingly communicate that he is as afraid of or repelled by the dirty, unacceptable parts of her that dwell in her unconscious as she is? Might this unwillingness potentially threaten the ‘holding environment’? Indeed, is there possibly a danger here of developing a safe, intimate stasis in the relationship that might not offer the possibility of change, even though some form of transformation was precisely the reason she entered therapy? I will finish with words from Ian Suttie’s Origins of Love and Hate, which seem to me to capture a mixture of ‘holding’ and interpreting. He asks what characterizes all analytic treatment:

Impeturbability and perfect tolerance on the part of the analyst, his inexhaustible patience and unfailing interest in the patient’s mental processes (highly reassuring to infantile anxiety), a ready memory and responsiveness of mind that makes the patient feel at one with the therapist and valued by him and an unerring insight that not only gives the former confidence in the latter, but convinces him ultimately that there can be nothing in his own mind wholly alien to the mind of the analyst, or alien to those other patients from whom the analyst has learned. 

 

 

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