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Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBecoming MyselfBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the 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Second EditionWhen the Body SpeaksWhispers from the EastWise TherapyWittgenstein and PsychotherapyWorking MindsWoulda, Coulda, ShouldaWriting About PatientsYoga Skills for Therapists:Yoga Therapy
This is the tenth volume in Masling
and Bornsteins effort to wed psychoanalytic theory with empirical research.
For those familiar with the history of psychoanalytic theory, such an
enterprise can be seen as either a welcome matrimony or an ill suited shotgun
wedding. Previous volumes have tackled various constructs dear to
psychoanalytic clinicians. This volume wades into some controversial waters.
Ever since Gloria Steinem and her feminist ilk began using Freud as a punching
bag for his patriarchal" view of women, combining gender and
psychoanalysis in a sentence, never mind a full book, has not been for the
faint of heart.
The first chapter begins as it does
for many of the previous volumes, as a declaration of intent. It is made clear
by the editors that this series is an attempt to combine the strengths of
empirical validation with the strengths of clinical observation so championed
by psychoanalytic theory. The tone of the opening chapter at least implicitly
leans in favor of empiricism, hinting that psychoanalytic thought needs a
rigorous grounding to avoid going the way of the dinosaur. This point is driven
home by a meta-analysis of past attempts at scientific exploration of
psychoanalytic gender research, showing an embarrassing absence of exploration
with subjects other than men, by researchers that are almost exclusively men.
In the past, it seems, ideas on gender in psychoanalytic theory were based on
assumption, distortion and speculation.
The second chapter, by Cain,
reviews social-cognitive theory research in respect to childrens individual
(including gender) experiences of helplessness in response to task achievement
motivation. Cain gives an extensive review of empirical studies related to the
topic, exclusively from social cognitive model. Cain then presents a
developmental model of child helplessness built mostly from social-cognitive
research and theory.
The truly remarkable third chapter
tackles the core psychoanalytic construct of primary process thinking, its role
in creativity and its relation to gender. The author Russ presents research
(using the Rorschach and a coding system for childrens play) linking ideas of
both psychoanalytic and cognitive theory. Both schools of thought view the use
of primary process thinking (here defined as affect laden cognitions) as necessary
for creativity and play. However, Russ demonstrates that incidences of affect-laden
cognition are more common for boys during creative play than for girls, with
this difference explained as boys having a higher aggressive content in their
play. Russ hypothesizes that western socialization, along with the possibility of
physiological differences and evolutionary trends, has effectively stifled the
feminine expression of primary process, particularly through limiting
aggressiveness. This has lead to the lack of adaptive use of primary process in
creativity for women.
The fourth chapter, authored by
Cramer, explores defense mechanisms, particularly the defenses of denial,
projection and identification. The author utilizes the Thematic Apperception
Test and the Defensive Mechanism Manual to support the theory that these
defenses are developmentally linked (denial is more common for children,
projection for early adolescence and identification for late adolescence), that
awareness of a defense decreases its usage, and that defenses are used
unconsciously. Furthermore, support is lent for the theory that defenses are
used when a threat is perceived, that defenses mediate negative arousal and
that the use of developmentally early defenses by adults is associated with
psychopathology. Cramer also shows empirical support for gender differences and
defensive style, with women more likely to use denial (internalizing conflict)
and men using projection (externalizing conflict). Further data suggests that reliance
on denial as a defense for both genders leads to psychopathology, while women
who utilize more masculine externalizing defenses appear healthier.
Fowler, Brunnschweiler, and Brock
contribute a chapter devoted to the exploration of bulimia in women. Using
demographics, the Rorschach and behavioral observation, the authors study women
diagnosed with the eating disorder and compare them to women without the
diagnosis in an effort to test their hypothesis that a key factor in the
disorder is a development conflict between dependency and autonomy. Their
results lend support for this hypothesis.
Brody, Muderrisoglu, and Nakash-Eisikovitz, again uses the
psychodynamic notion of ego defenses as a point of empirical exploration. The
authors propose, with supportive data, that womens sense of self is preserved
through communion (relationships with others) and that mens sense of self is
maintained through autonomy (achievement and a sense of agency). Using a bevy
of self report measures, the authors conclude that women use internalizing
defenses to preserve relationships (thereby defending the self) and men a
variety of externalizing defenses to maintain a sense of autonomy (also
defending a sense of self). These findings are converted to clinical caveats,
chief being the need for clinicians to stray from assuming a defense is
healthy or pathological without first considering the role of gender.
Sohlberg and Jansson present a
complex study of internal objects by using the tachistoscopic Subliminal Psychoanalytic
Activation procedure. Here the phrase Mommy and I are one is presented
subliminally, hypothetically inducing unconscious defense against symbiosis.
Though little in the way of direct statistical significance is uncovered, the
authors contend that the even smaller results for women suggest the complexity
of female personality development.
Tangney and Dearing finally broach
a Freudian construct still raising much ire, namely Freuds notion that women
have undeveloped superegos or immature moral development. Using data from
their research and a review of relevant literature, the authors show that
findings are actually the opposite of Freuds predications. Women show higher
propensities for shame and guilt (hypothesized as more mature moral emotions).
However, the difference is slight (men arent immune from shame and guilt
either), shame proneness reflects greater degrees of maladjustment for both
genders, and guilt proneness reflects better adjustment for both genders. Since
women as a gender have a propensity for both shame and guilt, they receive the
best and worst of both worlds.
There are a plethora of strengths
in this volume. In fact, any undertaking that attempts a synthesis of
psychoanalytic theory with constructs outside its insular halls is to be
commended. Dusting off theoretical constructs that have often been thought too
fanciful for real science and showing their utility in understanding the
human condition is commendable. In fact, one could argue that, as the social
sciences become more sophisticated in their ability to operationalize and test
ideas, the often neglected hidden treasures of psychoanalytic theory could be a
wellspring for advancing our understanding of humanity.
However, the volume does have its
weaknesses. Though most of these studies do little violence to the original
psychoanalytic ideas in their operationalizing and testing, one could argue
that others so distort the basic constructs that they cease to be
psychoanalytic. In addition, some
chapters, like that of Cains, dont seem to be really psychoanalytic at all.
Furthermore, one could argue as to how empirical" some of these chapters
actually are. Projective tests like the Rorschach and TAT, often criticized for
their subjectivities, are the standard of measure in a few of the studies
presented. Also, there was little direct connection between the studies here
and clinical treatment. Psychoanalytic theory was born in the consulting room,
and its ultimate utility lies there.
Quibbles aside, this volume and the
entire series is quite simply wonderful. To those who teach psychoanalytic
theory, wish to advance research or are simply intrigued by the vagaries of the
inner world, endeavors such as this are the rare treat. Often, psychological
research seems removed from the conflict of existence, appearing too often as
bland, laboratory white versions of individual experience. Say what you will
about psychoanalytic theory. Even at its extremes, it can provide a necessary
tonic to the often dreadfully unfanciful crawl of cognitive and clinical
researches. Heres to more books such as this.
© 2002 Dan L. Rose
Dan L. Rose, Psy.D. is a Clinical
Psychologist involved in direct clinical work and training at Columbus State University
and in private practice. His interests include psychoanalysis, neuroscience,
religion and literature.