Review of Drozek on Ethics and PsyA

Psychoanalysis as an Ethical Process, by Robert P. Drozek, Routledge, Abingdon and New York, 2019, 295 pp. (review hhcovitz)

Theodore Reik (1949) opined that all love begins in envy. The lover recognizes something in the beloved that is out of the lover’s reach and seeks to share vicariously in that which is envied through the loving attachment to that beloved other. He recognized that there is the ever-present danger that such beneficent envy can turn into hateful and toxic envy. A journal reviewer, one who reads someone else’s labor which has occupied that Other for months or years, is in a position where either type of envy may dominate. In rare circumstances, the book review editor has let a not-very-rich book into the cue which is worthy of only criticism; that is not a common occurrence. Most often, the reviewer meets the words of another worker in the same field who has thought deep-and-hard about their subject and has gone through the many crucibles and more sundry hurdles of the publishing process and come out the other end with something of great value. The reviewer, then, has the opportunity, so to speak, to get into a beautifully crafted boat, fashioned by the shipwright and the honor to row with that author, even if just a little bit.

Peter Fonagy writes (p. x) in his Forward to Robert Drozek’s work that he brought it with him on holiday anticipating a ‘‘light-hearted journey through the ethical complexities of psychoanalysis,’’ but warmly admits that he ‘‘was not anticipating one of the most rigorous and scholarly explorations of the process of therapeutic change in the insight-oriented therapeutic endeavors.’’ My experience was homol- ogous to Fonagy’s. Before finishing the first several chapters of Drozek’s gem, I found myself – after having written many dozens of reviews and for the very first time – wishing that I had authored this book. I remain happily in this state of beneficent envy for an author I’d never heard of prior to opening this paperback. What a lovely experience! In my own writings, I had struggled to align clinical technique and practice with psychoanalytic theory and notions of the Healthy Life but had never fully succeeded in bringing them together as does Robert Drozek.

Drozek describes his/our experiences working with patients. Towards the end of?Psychoanalysis as an Ethical Process?(p. 194), he opines:

Personally, these formulations play a powerful role in my experience of psychoanalytic work. At the start of every treatment, I feel a strange mixture of exhilaration and dread. I know that I’m going to violate this patient, and ultimately to fail her in a very real way. There is no way for me to anticipate what shape this will take, and I likely will be unaware of this for quite some time.

He goes on to say that,?if?(and I think he intends?only if, as well) he can eventually own and recognize this, both he and his patient will heal ‘‘in a way that is expressive of something that both of us need from each other’’ (p. 194). He does this, I want to add with great delight, without relying on such notions as?projecting into?or?projective identifications?which arguably situate the locus of responsibility for such untoward thoughts and feelings in the patient.

He warns us (p. 193) that an intellectual understanding of our inextricable embroilment in problematic relational patterns is not the same as ‘‘feeling ethically responsible for that pattern (and) ethically obligated to change ourselves in order to alter it,’’ which he sees as necessary for therapeutic success. I’d like to think that those of us who have taken on the responsibility of raising the young and who come to it with some understanding of the costs, difficulties and pitfalls of doing so find these insights familiar. Freud listed parenting as one of the impossible professions, alongside of psychoanalysis. Perhaps, it’s fair to say that, if we knew – holding that new wondrous baby – how very trying it will be to raise her to a good-enough life and how often we would fail to provide precisely everything that she will need to reach the Good Life, we would panic, right then, on day one. Life is messy and the knowledge that we will betimes fail those we love (and even those whose books we review) is no small part of that messiness.

Building briefly on Kant’s notion of the ethical stance; on Searles notion of the patient as therapist to the analyst; on Winnicott and Lachmann and Beebe’s work on the Mother-Infant dyad; heavily on Benjamin’s Moral Third and on the Relational Schools’ notions about the intersubjective therapeutic relationships, in general; and providing continuing clinical vignettes, throughout, Drozek weaves a compelling argument that when Psychoanalysis works, it does so by bringing both parties and the dyad closer to?the Ethical?or to what others call?the Good Life. Drozek relies heavily on his notion that in a relationship with ourselves or with an-Other we may feel unconditionally valued or conditionally valued; we may have either attitude towards the Other, as well. Drozek sees unconditional valuation as central to the ethical stance.

Having thus lauded Drozek and recommended the book to many, many colleagues and to all who are reading this review, let me?qua?reviewer offer what I promised: some rowing of my own in the direction in which Drozek has pointed me. Let me say, too, that everything I’m about to say is implicit in Drozek’s gem.

Beginning in the early 1980’s, I began to question whether Freud’s?sexualtheorie?was – he required this promise from Jung – an absolute and necessary bulwark against the forces that opposed Psychoanalysis. My thinking, at the time, had turned to the Oedipal situation (later fleshed out in Covitz,?1998) that had become a shibboleth for entering the front-door of psychoanalysis during its first century. It occurred to me (based on a reading of Joseph’s dreams in Genesis 37) that our instinctual lives begin in seeking unilaterally dyadic relationships with all others. All such others, to begin with, are either prey or predator?...?sources of supplies or deprivers of those resources. They were objects (and pointedly not subjects), prominently defined by their utilitarian function in our lives and required for our early development. Civilization and our heightened ability to imagine or to

mentalize the inner workings of others whom we recognized as similar to us, however, brought us to assign value to caring for others and, in time, moved us to assign value to interpersonal ethics. Still, ontologically, these had to develop.

Two correlated capacities needed to arise in the child during the early years. In the first place, the viewing of all others as fitting the part of provider of resources (prey) or dangers (predators) had to be followed by recognition of differences in these others; let me call that object-object differentiation. ‘‘Mom and Dad are different; so is little Sister.’’ Without this recognition, subjectivity and what Drozek calls value have neither momentum nor force. Perhaps, in the early stages of the oedipal years, that recognition goes no further than recognizing that Mom and Dad provide different resources but that would not be sufficient for the youngster to arrive at intersubjectivity or an ethical sense.

What is so very necessary, I argued, for attaining what we think of as an ethical stance towards others and what Freud thought of as the resolution of oedipal strivings is the subsequent recognition – perhaps, the biggest leap for mankind, bigger than a Moon-walk – that others have ideas, feelings, and relationships all of their own and that to a not insignificant extent exclude the child. The ability to be aware of this, to learn to cherish these relationships and to not recoil from that recognition (with defenses or with symptoms) became for me the essence of the resolution of the family romance. Most of the biblical Decalogue and the Ego Ideal follows: I shall not kill someone who is a Subject like me, nor will I steal their spouse or their ox or their ass. I shall speak truth of my neighbor as I wish them to speak truth of me and I shall honor my parents. I need a day to rest and so does my servant and the sheep whose wool clothes me.

Drozek adds something, else. Not only does an ethical stance embrace the aspirational unconditional value of others but the good-enough analyst that Drozek is describing is motivated to act due to his cherishing of the subjectivity of his patient and others, too. (There is a lengthy discussion of Drozek’s notion of relational motivation following Drozek,?2010.)

In closing, let me briefly address our history. Psychoanalysis began as a treatment carried out by a technically qualified and impassionate surgeon. In a public address in Philadelphia in 1977, Anna Freud noted that Psychoanalysis later became the first theory of normality and pathology in which the treating practitioners were recognized as suffering from the self-same psychological predilections as their patients – the difference was only a matter of degree. We have developed beyond that, too, in our thinking to deeply believe that our practice is a quintessentially relationally human one, as Drozek argues, between two equal but different beings who are striving to ethically embrace and value each other. I’ve read no book that says this better.

Howard H. Covitz, PhD, ABPP, NCPsyA Elkins Park, PA, USA e-mail: [email protected]

REFERENCES

Covitz, H. (1998).?Oedipal Paradigms in Collision: A centennial emendation of a piece of Freudian Canon (1897–1997). New York: Peter Lang. Republished by Object Relations Institute Press. New York 2016.

Drozek, R. P. (2010). Intersubjectivity theory and the dilemma of intersubjective motivation.?Psychoanalytic Dialogues, 20(5), 540–560.

Reik, T. (1949).?Of love and lust: On the psychoanalysis of romantic and sexual emotions. New York: Farrar, Strauss, and Co.

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https://doi.org/10.1057/s11231-021-09273-3