The application of postmodern thought to the clinical practice of psychoanalytic psychotherapy

The purpose of this article has been to acquaint psychoanalysts and psychoanalytically oriented psychotherapists with some of the most current ideas in philosophy and psychology, which have crucial implications for our professional organizations and our clinical work. The basic stance of this postmodern thinking constitutes a challenge to what is called foundationalism, which dominated scientific and philosophical thought until recently. In place of foundationalism, even in the production of scientific or philosophical works, we could hope for an ongoing dialogue between a king or queen who states the basic theoretical orientation, the loyal opposition that looks for inconsistencies and kinks in it, the jester who deconstructs the whole thing and introduces parenthetical digressions, and finally, a secret society of organization that functions to hold the adherents of the theory together and provide them with a unifying ego ideal. Postmodern thought is described and there is some discussion of its "four horsemen," Derrida, Rorty, Foucault, and Lyotard, who in general question the possibility of whether any form of interpretation can be thought of as related to reality or the truth. My own point of view is that an intermediate position is necessary rather than a binary opposition between nihilism and foundationalism or more specifically, postmodernism and traditional psychoanalysis. That is to say, within certain horizons and with an understanding of the cultural and historical referents that always affect and delimit both the patient and the therapist, it is still possible to reach conceptions about what is going on both in the psychoanalytic process and the psyche of the patient that have at least a tentative "truth." Careful attention to the patient's material following an interpretation can provide clues about the validity of our conception at the time. But the horizons and historicity that delimit all "truth" reduce the authority and the stature of the analyst, make the analyst less of an arbiter of what is "reality," and focus greater attention on the therapist-patient dyad, which is consistent with the modern trend in psychoanalytic treatment anyway. The notion of social constructions as constituting the psychoanalytic process was discussed and it was suggested that this notion suffers from the lack of sufficient attention to the historical determinants of how a given individual reacts in a given situation. A patient will react differently to different therapists, depending on the transference or projective identifications that the patient brings to the treatment, regardless of the interpersonal interaction. This is in opposition to the idea that transference is primarily an effect of the therapist-patient dyad, and preserves a major aspect of traditional Freudian theory. The dangers of postmodern thought disintegrating into nihilism are described, and the limitations of so-called postmodern thought are discussed, including the intrinsic paradoxical nature of any postmodern proposition. At the same time, postmodern thought is useful in calling attention to the "space of the Other" in human affairs, to the tendency to form binary oppositions in which the second element in each binary pair is part of the Other and is depreciated, and to remind us that there are always further interpretations of the narrative that emerges from the psychoanalytic situation. The feminization of psychotherapy and its relationship to feminism are important current issues. Postmodern thought is valuable in responding to the common complaint of feminists about Nietzsche's attitude toward women; postmodernist approaches emphasize the ambiguous and the allegorical aspects of Nietzsche's thought, to the extreme orf Derrida's contention that Nietzsche is not really interpretable at all. At the same time feminists legitimately object to postmodernist erosion of the grounds for political action. (ABSTRACT TRUNCATED)