The Letter, Issue 38, Autumn 2006, Pages i - v
Editorial
Barry O'Donnell
In a footnote to the opening page of his three volume biography Ernest Jones tells us of the error in the registration of the date of Sigmund Freud's birth - March where May should be. The biographer lets us share his enjoyment of this auspicious start to the marking of Freud's life given the attention his subject would pay to the slips and other transient and all too easily dismissed formations of our mental lives - our dreams, jokes and forgettings. This attention, of course, yielded to Freud the insight into our thought processes (the greater part of which he thereby discovered to be unconscious) which radically and effectively re-orientated clinical work in the field of the mental.
Freud 150 was a day of papers and discussion held on 12th May 2006 in the Education and Research Centre, St. Vincent's University Hospital, Elm Park, to mark the one hundred and fiftieth anniversary of the birth of Sigmund Freud. It was an occasion to attend to Freud. The high level of interest shown as well as the considerable turn out on the day from non- analytic quarters strongly suggests that there are those in the field of mental health work, and elsewhere, who are, in fact, very open to hearing something from psychoanalysis in order for it to inform their work and its interrogation.[1]
On the day Professor Kevin Malone of the Department of Psychiatry and Mental Health Research in St. Vincent's provided opening remarks in which he re-iterated his support for psychoanalytic work and the training informed by it as well as indicating its crucial contribution to mental health work in Ireland.
Cormac Gallagher spoke first. This was most appropriate since it was Cormac who introduced Lacanian psychoanalysis to Ireland in the 1970's and psychoanalytic training to St. Vincent's in the 1980's (along with Professor Noel Walsh and Dr. Mary Darby). A key message in Cormac's paper is the way the Freudian discovery has been elaborated and kept alive through the work of Jacques Lacan. He referred specifically to the re-articulation of the Freudian myths of Oedipus and of the Primal Horde in Lacan's formulae for sexuation as indicated in his title. Reminding us that we should not be afraid to have confidence in the worth of the insights of great minds, Cormac proposes a response to Freud's work, through Lacan's lens, which allows it to contribute productively to the clinical investigation of the speaking human being and to the treatment of its inevitable subjective suffering through attention to the unconscious and language.
Through a sensitive consideration of Freud's short paper The Moses of Michelangelo and Lacan's formulation of logical time Helen Sheehan directs our attention to a moment in the history of psychoanalysis when Freud took up a position which marked psychoanalytic work off from other modes of psychological work, such as were being developed by Carl Jung and Alfred Adler. This again is an important paper for psychoanalytic practitioners in their articulation of their relation to psychoanalysis but also for those new to the field. Helen articulates how psychoanalysis requires a position distinct from other forms of psychological work, a position achieved through one's own analysis so that it has a chance of not being directed by frustration or the fashionable whim of the crowd.
Drawing on his training in Chinese medicine Gerry Sullivan presents Freud's work as providing a new approach to articulating and responding to our human being. Chinese thought can also be the basis for identifying and clarifying our presuppositions about our being in the world and Gerry proposes investigation of what should be a productive dynamic between these two traditions.
On the day of Freud 150 Mary Darby introduced six speakers who gave brief presentations outlining how psychoanalysis informs their work in a variety of settings. Angela Noonan and Emer Rutledge spoke of how psychoanalysis relates to their work as Senior Registrar psychiatrists in the mental health services. Angela questions the speed with which we medicalise difficulties and Emer proposes a psychoanalytic response to Borderline Personality Disorder. Claire Hawkes, who works as a psychotherapist in Schizophrenia Ireland, proposes combining medication with psychoanalytic work in the treatment of psychosis. From his work with young people Malachi McCoy suggests that the actions of the self-harmer and the car thief be considered the expression of the same fundamental difficulty in different languages. He quotes the French child psychoanalyst Catherine Mathelin who has said that the child's world is one of horror, hatred and death for which a "sugary response" is not appropriate. Bernard Kennedy presents work in progress from his Ph.D. research on the sense of the symptom in psychoanalysis as a response to the question of subjective suffering. Mary Cullen writes of her work in the
Mount-town Community Youth Project in South Dublin highlighting the place and the function of the father in society and in each individual's structure.
Patricia McCarthy takes us through two recent documents which require response from psychoanalytic workers: A Vision for Change produced by the Government's Expert Group in Mental Health Policy and a mission statement form UCD regarding research. While challenging to a discourse which responds to human subjectivity Patricia advocates that psychoanalysis should engage with these discourses of state and university in order for it to inform developments in these areas in accordance with psychoanalytic principles.
In a paper that should be required reading for all training psychiatrists Aisling Campbell presents thought-provoking questions concerning the differences between psychiatric and psychoanalytic work. As a consultant psychiatrist and practising psychoanalyst she asks to what extent current psychiatric practice in Ireland will allow itself to be informed by Freud's work. It is psychoanalysis, after all, which provides insight into the inevitable transference which determines the course of treatment in the state health services. For its part Aisling asks how psychoanalysis, founded on the concept of the unconscious, can situate itself effectively in relation to the mental health services without being undermined by the demands for outcome in terms of clear therapeutic effect.
My paper argues that Freud's discovery of transference emerged alongside his redefinition of hysteria. This redefinition uncovered a specific aspect of human being which psychoanalytic work takes as its material and which is not reached by medical or psychological interventions despite presenting itself for these. The paper suggests that hysteria, as articulated in the work of Freud, is not a medical problem as such but that it is a problem for the medics and other health care professionals to whom it is addressed every day of the week and whom it successfully provokes and frustrates.
The discussion which followed on the day testified to the very real questions mental health practitioners have concerning their work. One response raised the concern psychiatry can have regarding psychotherapy with patients with a psychotic structure. Both Cormac Gallagher and Professor Noel Walsh replied that when this was let happen with appropriate experience and supervision a patient could benefit greatly from the opportunity to speak about their life and articulate their condition. A consultant liaison psychiatrist commented that, unlike with the major mental illnesses where it had a treatment response, psychiatry could do with guidance when it came to the other forms of psychopathology.
It is now the task of psychoanalytic practitioners in Ireland to respond to the questions, respecting their provenance, so that the insights of Freud and Lacan can effectively inform the work of mental health practitioners in Ireland today. It is hoped that publishing these proceedings in this issue of The Letter will contribute in its way to furthering an openness to psychoanalysis in settings as diverse as addiction clinics, prisons, GP surgeries and community programmes.[2]
Barry O'Donnell
References
[1] It subsequently came to my attention that contemporaneously in the May 2006 issue of the American Journal o f Psychiatry an editorial appeared calling for a return to the clinical formulations of what is referred to as the psychodynamic tradition. Written by three psychiatrists on foot of their preparing a revised edition of their 1971 book The Psychiatric Interview in Clinical Practice, the message to psychiatry is that the diagnostic terms abandoned by DSM III (such as hysterical personality, narcissism and masochism), along with their theoretical elaboration, are now recognised as crucial to everyday clinical practice. In other words the psychoanalytic tradition is acknowledged as a rich and essential resource for clinicians. See P.J. Buckley, R. Michels, & R.A. MacKinnon, ‘Changes in the Psychiatric Landscape', in, American Journal of Psychiatry, 163, 5, May 2006, pp. 757- 760.
[2] All but one of the papers presented on the day are included in this issue of the journal.