IN THIS small book, expanded from two New Yorker articles, Janet Malcolm distills much reading by and about Sigmund Freud as background for a vivid portrait of Dr. "Aaron Green," 46, a devoutly orthodox psychoanalyst. Her treatment of the subject is original, rich, and will reward anyone interested in the science or business of changing minds. Freud's ideas--much more than the efforts of a few thousand analysts--have so influenced the 20th century that even people who have no interest in therapy must reckon with him.
Take Oedipus, for example. In 1900 the brilliant, ambitious Viennese neurologist used an ancient Greek myth about a brilliant, ambitious foundling to make a psychological template for modern man, not only for the Aaron Greens but for many writers, artists, philosophers and social scientists. Those who rejected the thesis that all boys want to murder Father and marry Mother worked hard, with limited success, to dismiss the hoary drama. We still do not know why the incest taboo is universal, and Freud's imaginative leap, though scientifically dubious, was a creative venture into that particular void.
Aaron Green has no doubt about the truth of the Oedipus complex, even insisting that we accept it as we do the findings of modern physics. Such confidence in hunches marks both genius and folly, visionaries and blind followers. For the most part Malcolm lets the reader decide how much to accept; she sits back observantly and has the analysts reveal themselves, sometimes murderous and inbred, for our edification.
Having uncovered the Oedipal motif in his own psyche, Freud used his gift of eloquence to capture the imagination of multitudes. A psychological sculptor, he took a great myth, molded it in his own image, fired it in the kiln of contemporary science, and brought forth a demigod. Unlike Eros, who succumbed to Psyche's beauty, Freud kept his distance, directing his wit and energy, like Oedipus, to solve a sphinxian riddle which stumped other men. Psychoanalysts then, as now, outdid themselves in fealty to the new model of the mind, exalting its parts as they were cast (and sometimes recast or renamed) by Freud: the unconscious, defenses, libido, infantile sexuality, ego, transference. . . . The model has explained enough to create a whole new psychology, though it is largely unproved or beyond proof.
The new psychodynamic psychology began as a treatment, and led to a panoply of therapeutic approaches over the next eight decades. To what extent do psychoanalysis and the other, more widely practiced, less intensive psychotherapies depend on insight versus relationship, knowledge versus feeling? The question remains fundamental, and Malcolm quotes Ferenczi, Leo Stone, Kohut, Alexander and Searles on the side of emotional encounter; Aaron Green heatedly opposes such relaxation of Freudian austerity and extols Charles Brenner as his model. Malcolm wonders whether such different theorists actually conduct themselves so differently with their patients. I believe they do.
A neglected facet of the subject brought out by Malcolm is how therapists use language in the "talking cure." She introduces Hartvig Dahl, whose painstaking research on tape recordings of analytic sessions shows how therapists lose clarity and emotional contact with a few clumsy sentences. Analysts say much less than other psychotherapists, so let them learn to say it well, as Freud must have done.
Freud's analytic stance combined the austere with the intricate. He used the simile of the surgeon, whose caring for the patient betrays no emotion, whose movements are spare and sure, guided by extensive knowledge and technical expertness. Opening a numb thorax, however, is not the same as sitting close to a depressed or anxious personality, or to someone blossoming in your presence with elation or love. It is one thing to cope with hemorrhage in a stranger, another to deal both humanely and expertly with an outpouring of emotion from someone who has become more intimate with you than with almost anyone else.
Over three centuries ago the English physician Thomas Sydenham said of patients with hysteria, "They love without measure those whom they will soon hate without reason." Freud's response to these strong tides of emotion was a new concept, transference: feeling derived from early relationships and displaced onto the neutral figure of the doctor. Malcolm exaggerates, I think, in calling this concept "Freud's most original and radical discovery." She then slides with Dr. Green into the slough of despond, saying that all relationships have a "profound impersonality" which means, "We cannot know each other." This view of transference reduces human encounter to a charade of lost or fantasized relationships. Love and hate are sham and shadow. Repetition rules our lives. In Oedipal terms, I suppose, a man can leave his mother and take a wife, but there is no one new under the son!
Despite his pessimism, rigidity, and aloofness, Dr. Green betrays some sympathetic human qualities. His wonderful encounter with Janet Malcolm, who emerges as a formidable analyst of psychoanalysis, cannot have left him unchanged. The profession itself must benefit, too, since its arch- defenders if left alone might strangle it to death. Malcolm's book is also a gold mine of consumer information for patients present and future who may be saved from useless or even harmful variants of a potent treatment.
The "impossible profession" requires of Dr. Green that he be intimate without involvement, control feeling with knowledge, even resist the temptation to be helpful. Intellect rides roughshod over experience, emotion, relationship. Perhaps there is another moral to be drawn here from the Oedipus tragedy. When the oracle predicted the double crime, the parents of Oedipus put him out to die. Patricide and incest then became emotionally feasible because child and parents were estranged. Excess knowledge applied to human relationships can be disastrous. Oedipus, a good and clever man, could solve the riddle of the Sphinx, but the loss of certain relationships was too much for his intellect to overcome.
Freud thought the self-blinding of Oedipus was symbolic castration. Why not consider it the straightforward emotional reaction to a surfeit of vision--too much foresight, insight and hindsight? Surely some of the resistance patients put up against self- knowledge is their healthy response to a warped world view in which intellect is power and love the remnant of a childish wish: hence the impossibility of "pure" psychoanalysis. Without love in his hands, the surgeon might as well wield a hammer as a delicate knife.