Excerpts from Must Read Books & Articles on Mental Health Topics
Articles- Part XXIV

Robert S. Wallerstein (2002)

The roots of ego psychology trace back to Sigmund Freud's The Ego and the Id (1923) and "Inhibitions, Symptoms and Anxiety" (1926), works followed by two additional fundaments, Anna Freud's The Ego and the Mechanisms of Defense (1936) and Heinz Hartmann's Ego Psychology and the Problem of Adaptation (1939). It was brought to full flowering In post-World War II America by Hartmann and his many collaborators, and for over two decades it maintained a monolithic hegemony over American psychoanalysis. Within this framework the conceptions of the psychoanalytic psychotherapies evolved as specific modifications of psycho-analytic technique directed to the clinical needs of the spectrum of patients not amenable to psychoanalysis proper. This American consensus on the ego psychology paradigm and its array of technical implementations fragmented several decades ago, with the rise in America of Kohut's self psychology, geared to the narcissistic disorders, and with the importation from Britain of neo-Kleinian and object-relational perspectives, all coinciding with the rapid growth of the varieties of relational psychoanalysis, with its shift in focus to the two-person, interactive, and co-constructed transference-countertransference matrix. Implications of this intermingled theoretical pluralism (as contrasted with the unity of the once dominant ego psychology paradigm) for the evolution of the American ego psychology are spelled out.

My intent here is to present an overview of ego psychology, the metapsychological paradigm developed in the immediate post-World War II period, primarily in America, by a brilliant cluster of European refugee analysts in their adaptation to the scientific and intellectual climate of the New World. Actually, of course, the roots of ego psychology trace back in a direct line to two fundamental works by Freud: (I) The Ego and the Id (1923), which established the tripartite structural model--id, ego, superego--as the components of the psychic apparatus, through the interactions of which human behavior was to be understood and explained; and (2) "Inhibitions, Symptoms and Anxiety" (1926), which positioned anxiety, or the threatened eruption of signal anxiety, as the impetus to the ego's synthesizing and executive functions of mediating the pressures of the three major forces impinging on it--the peremptory instinctual drives of the id, the constraining and channeling moral and value judgments of the superego, and the adaptational requirements of external reality--and fashioning then the best behavioral compromise of these disparate, and often conflictual, pressures.
     Over the remaining years of Freud's lifetime, two additional fundaments were included in this edifice, both dealing with the functions of the ego, by then a central focus of psycho-analytic inquiry. This marked the transition of psychoanalysis from being primarily an id or drive psychology, focused on the vicissitudes of the instinctual drives (centrally the libidinal and the aggressive) as the prime movers of behavior, normal and neurotic, to a period in which the ego was accorded equal importance and was regarded as the prime shaper and modulator of behavior, again both normal and neurotic. In America this came to be called the era of ego psychology.


The first of these fundaments was Anna Freud's The Ego and the Mechanisms of Defense, published in German in 1936 as a tribute to her father on his eightieth birthday and translated into English in America in 1946. (It was also a response to what Viennese analysts considered the extremes to which Wilhelm Reich had carried his theoretical and technical views on character armor in his 1933 Character Analysis.) In her monograph, Anna Freud attempted to systematize the array of defense mechanisms her father had described in various papers, as well as adding some others to the enumeration. She tried, as best she could, to link the appearance of particular defense mechanisms to the stages of psychosexual development in which they presumably originated, and to the various psychopathological formations in which they were prominent. The emphasis throughout was on the defensive functions of the ego.
     The second fundament to be added was Heinz Hartmann's Ego Psychology and the Problem of Adaptation, published in German in 1939. Although it did not appear in its entirety in English (again in America) until 1958, major sections of it had been published in 1951 as a chapter in David Rapaport's Organization and Pathology of Thought. In contrast to Anna Freud's focus on the defenses of the ego (primarily against the pressures of id and superego), Hartmann's focus was on the adaptive functions of the ego, as it fitted the individual's behavior to the requirements of external reality, what Hartmann called the "average expectable environment." Hartmann's central conception was of a conflict-free sphere of the ego, a sphere in which functions of primary autonomy (e.g., perception, motility, language, thinking) grew not out of conflict between the id and the outer world, but rather apart from conflict, on an innate maturational timetable. These conflict-free functions could of course be invaded secondarily by conflict, as witness hysterical paralyses, speech disorders, and the like.
     In a tribute to Hartmann on his seventieth birthday, Anna Freud (1966) noted that "in the field of ego psychology ... we appeared almost at the same time, in the 1930s. I came into it more conventionally, from the side of the ego's defensive activities against the drives; Hartmann, in a more revolutionary manner, from the new angle of ego autonomy, which until then had lain outside analytic study" (p. 18). This was indeed Hartmann's central conception, critical to the full evolution of the ego psychology paradigm, and key to its alienation from other theoretical perspectives, including Kleinian analysis, which was developing in England during the same period, and Lacanian analysis, which would arise in France somewhat later.
     It was this set of constructs--the tripartite structural model; the ego, pushed by threatened anxiety, as the mediator of the conflicting pressures of id, superego, and external reality; the defensive functions of the ego; and, last, the autonomous functions in an evolutionarily determined adaptation to reality--that the tide of Hitler refugees (most from Vienna) carried to the receptive soil of America, above all to New York. With few exceptions, the group associated with the full flowering of ego psychology--Hartmann, Kris, Loewenstein, Jacobson, the Eisslers, Annie Reich, Mahler, Spitz, Waelder, Fenichel---came to work and teach at the New York Psychoanalytic Institute, then and now the single largest affiliate of the American Psychoanalytic Association.
     It was there, with Hartmann as principal architect, working with his closest collaborators, Ernst Kris and Rudolf Loewenstein, that the complex structure of the ego psychology paradigm was elaborated out of the concepts of autonomy and adaptation. That structure included, to name only the most salient conceptions, the undifferentiated phase of development; the growth of the conflict-free sphere of the ego; primary and secondary ego autonomy (with attendant change of function); inborn ego apparatuses and autonomous ego development; the synthesizing and integrating functions of the ego; ego interests and intrasystemic (as distinct from intersystemic) conflict; the separation of the ego concept from the self concept; the opposition of self- and object representations; the equal status of the aggressive drives alongside the libidinal; the transformation of the concept of sublimation into deinstinctualization and neutralization; the principle of multiple appeal; and the concepts of social compliance (analogous to Freud's somatic compliance) and the average expectable environment. Rapaport (first at The Menninger Foundation in Topeka and later at the Austen Riggs Center in Stockbridge, Massachusetts) became the paradigm's declared systematizer.
     For a summary review and explication of all these terms and concepts, nothing perhaps serves so well as Rangell's paper of tribute (1965) to Hartmann on his seventieth birthday. Rangell viewed Hartmann's labors as a Herculean effort to systematize the "fragments" of ego psychology into a composite whole, pointing always toward organization, equilibrium, and harmony. He saw this as Hartmann's effort to make psychoanalysis the fulfillment of Freud's dream: psychoanalysis, born of the study and treatment of neurotic illness, of psychopathology, would become a truly general psychology, fully explanatory of both normal and abnormal mental functioning. Indeed, Freud had begun this task with his studies of dreams, jokes, and parapraxes, and of other psychopathologies of everyday life. Rangell also pointed to the links Hartmann was forging with the child observation and longitudinal developmental studies of Rene Spitz, Margaret Mahler, Ernst and Marianne Kris, and John Benjamin.
     Roy Schafer's overview (1970) of Hartmann's contributions to psychoanalysis--written within five years of Rangell's tribute--placed the emphasis rather on Hartmann's strenuous efforts to fit psychoanalysis into the framework of natural science. To Schafer this seemed the fulfillment of yet another aspect of Freud's original vision: psychoanalysis as the explanation and representation, through the ego's functions and apparatuses, of humankind's evolutionary biological adaptation as a successful social animal in a difficult and indifferent outer world. Schafer emphasized that Hartmann's choice of adaptation theory as his scientific option was but one of several frameworks that could have been chosen--a linguistic or hermeneutic one could as easily have been adopted. Once made, however, Hartmann's choice was carried to its uttermost possibilities as a theoretical explanatory system. As Schafer declared, "Hartmann's contributions put an end to the period when psychoanalytic theorizing was a law unto itself. He brought psychoanalysis into the world of modern natural science" (p. 430). But Schafer could also be critical of Hartmann's thinking, in light of the explanatory paths foreclosed in this theoretical edifice, built as it was on concepts of structures and functions, forces and energies. Hartmann's conceptions clearly bypassed the ubiquitous problems of purpose, intention, and meaning that are the very essence of clinical psychoanalysis. "The biological language of function," Schafer noted, "cannot be concerned with meaning" (p. 440).
     For those who wish to explore Hartmann's theorizing more extensively, and in its original form, reference can be made to two volumes published in 1964. One, Essays on Ego Psychology, is a collection of twenty theoretical papers written over two decades (1939-1959); the other, Papers on Psychoanalytic Psychology, is a monograph comprising six articles written with Kris and Loewenstein. The effort to create a systematic and hierarchical organization of the concepts and tenets of ego psychology was undertaken in Rapaport's 1960 monograph, The Structure of Psychoanalytic Theory. Rapaport considered the task eminently achievable, the creation of an evolutionarily derived, biologically anchored general psychology, explanatory of the entire range of human behavior, from the indubitably normal to the flagrantly aberrant, save for one gap in comprehensiveness: "If we must single out an outstanding limitation of this theory's claim to comprehensiveness, then we should choose its lack of a specific learning theory" (p. 34). Rapaport dedicated the last years of his life to trying to fill this hiatus through a series of psychoanalytically conceived experiments in human learning.
     A few years after Rapaport's monograph, his close friend and co-worker Merton Gill (1963) attempted to elaborate the hierarchical organization of the psychic apparatus by systematically exploring the continuing need for the topographical point of view, once considered an essential component of Freud's metapsychology. Gill's conclusion was that no such need exists. His book was in fact a quite extended version of a short article he and Rapaport had published in 1959, detailing five fundamental assumptions and metapsychological points of view that together were deemed essential to the full psychoanalytic understanding of any and all behavior. These were the genetic, the economic, the dynamic, the structural, and the adaptive. Notably, the topographical had been dropped, all its explanatory capacity said to be subsumed by the other five perspectives.


To this point I have focused on the issues of ego psychology as a theory, one that aspired to make psychoanalysis both into a general psychology--though with Rapaport's caveat regarding learning theory--and into a general science linked to the universe of the biological sciences. Indeed, it was Hartmann's penchant, and that of many of his colleagues, to focus on theory--abstract, austere, and, to the extent possible, elegant and aesthetic.
     It fell to Kurt Eissler (1953) to articulate the implications for clinical work of the ego psychology framework. His famous paper on "parameters" served for at least two decades as the benchmark against which the analytic technique of those trained in American ego psychology would be measured. It too, presented an austere model. The analytic patient on the couch displayed, via free association, and in ever more regressive fashion, the full panoply of his or her transferences, the engrafting of the most salient object relations (or self-object interactions) from the infantile past upon the neutral, objective analyst. The latter, from a position outside the transference display could, through appropriate interpretations, bring to light and to mutual discussion, the transference-drenched and therefore distorted representations of the analyst.
     This was to be done by a process of veridical interpretation alone, with of course many variations of the interpretive process over time, leading finally, by "working through" the varying but similar interpretations around each transference theme, to meaningful insight and consequent change, and ultimately to resolution or "cure." Through a split in the cooperating patient's ego, first described by Richard Sterba (1934), whereby the experiencing part of the ego (which reenacted the old interpersonal dramas) and the observing part (in league with the analyst and the analytic function), the analyst (whose ego was similarly split, but with the observing part dominant) was able in time, from the position of outside observer, to unravel the patient's projected transference distortions and undo the neurotic character formations. Countertransference, when it reared its complicating head, was to be properly mastered and controlled, lest it distort the analytic understanding (A. Reich 1951). Any departure from properly timed and dosed interpretation, regarded as the only true road to insight and eventual change, was labeled a "parameter," a deviation from technique, necessary perhaps in relation to the clinical exigencies of patients with less than "normal" egos, but to be interpretively resolved (i.e., totally undone) within the analytic situation in the interest of analytic thoroughness.
     The hallmarks of this analytic posture were the objectivity, neutrality, abstinence, and relative anonymity of the analyst; an unremitting focus on the intrapsychic conflicts in the mind of the patient; extrusion of the personality and potentially interfering countertransferences of the analyst; and a conception of the analyst's veridical interpretations, properly reinforced through the process of working through. Together these were regarded as the necessary and sufficient road to insight, change, and cure. In recent years this view of analysis has been called a "one-person psychology"--that of the patient.
     Against this understanding of what constitutes a proper psychoanalytic process there developed--first on these shores--various conceptions of psychoanalytically informed psychotherapy. These ranged along a spectrum from the closest in technique to psychoanalysis, expressive psychoanalytic psychotherapy, to the farthest, the form called supportive psychoanalytic psychotherapy, which, though psychoanalytically conceptualized, introduced the greatest technical departures from the strictly psychoanalytic method. The line of demarcation (often blurred) between the two variants was between expressive psychotherapy, which aimed at the uncovering and resolution of intrapsychic conflict (though within a range more focused and restricted than the open-ended exploration of the entire life experience that characterizes psychoanalysis), and supportive psychotherapy, which aimed through various techniques to strengthen the embattled ego's capacity to cope with, and often to cover over, inner conflict.
     These psychoanalytic psychotherapies arose first in the United States--though they subsequently spread, first to Britain and then to Germany, Holland, and Scandinavia--as an adaptation of European-grown psychoanalysis appropriate to American conditions. A hostile social and professional milieu in Europe had from the start imposed an isolation on Freud and his early followers, which effectively barred them from access to medical schools and teaching hospitals, thereby consigning psychoanalysis as a therapy to a private practice setting, and as a healing discipline to free-standing night schools, the early psychoanalytic training Institutes of Central Europe. By contrast, American analysts, strengthened enormously by the influx of refugee analysts in the 1930s and 1940s, were determined to capture psychiatric departments in medical schools and teaching hospitals. Their goal was nothing less than to establish psychoanalytic conceptions as the predominant psychology and major therapeutic in treating the gamut of mental illnesses and disorders.
     This effort to be fully accepted within the medical establishment played a significant role in the fierce opposition of American analysis to the training of nonmedical analysts, an opposition not fully overcome until the settlement of a major lawsuit half a century later (see Wallerstein 1998a). That is another story; the point here is that from the 1940s through the 1960s, as major chairs in psychiatry, until then in the hands of the Adolf Meyer-trained psychobiological generation, became vacant, American medical schools avidly sought psychoanalysts to chair departments of psychiatry. They sought to introduce psychoanalytic concepts into the understanding of mental health and illness, and to adopt whatever modification of classical psychoanalytic techniques might be required to deal with the psychological disturbances of the far sicker patients encountered on the inpatient wards and in the outpatient clinics of these medical school-linked psychiatric treatment centers. This was a population very different from the private practice neurotic outpatients from whose treatments the traditional conceptions of psychoanalytic technique had evolved.
     Thus was born the panoply of psychoanalytic psychotherapies, across the spectrum, from expressive to supportive, that has characterized American practice for half a century, though with major shifts in the relationship between these psychotherapies and their psychoanalytic parentage. The conception of expressive versus supportive psychoanalytic psychotherapies was delineated most clearly by Knight (1949, 1952) and Gill (1951, 1954). Most succinctly, expressive therapies are geared to the expression of intrapsychic conflict, leading to working through and resolution with insight; supportive therapies are geared to supporting the ego in its struggle to contain, or repress intrapsychic conflicts and to suppress their symptomatic expression. A given therapy, of course, can also be an admixture of both expressive and supportive techniques. In the 1950s, the similarities and the differences, as worked out by a host of contributors--Gill, Rangell, Edward Bibring, Leo Stone, and Anna Freud being the most significant--were clearly delineated and consensually agreed on, with sharp distinctions in the aims of the varying therapies, from the most supportive to the most expressive-analytic, and equally clear distinctions in methods and technical approaches. The minority who demurred from this consensus, who sought to blur rather than sharpen the distinction between psychoanalysis proper and the range of psychoanalytic psychotherapies--Franz Alexander and his followers, Frieda Fromm-Reichmann and hers--were in the main ruled out as unanalytic. The debates that raged at the time around this issue found expression in three panel discussions in an issue of JAPA (Panels 1954; for a more extended presentation of this period and these issues, see Wallerstein 1995).
     The consensus achieved in the 1950s on the differences and similarities between psychoanalysis and the psychoanalytic psychotherapies--the technical implementation of the precepts of the dominant ego psychology paradigm---has long since fragmented. But that is getting ahead of my story. What remains to be stated is that the ambitious Psychotherapy Research Project of' the Menninger Foundation, launched in 1954 by me and a group of coworkers (Wallerstein et al. 1956), a wide-ranging, in-depth study of' psychoanalysis and the psychoanalytic psychotherapies that came to final publication in my book Forty-two Lives in Treatment (Wallerstein 1986), was conceptualized entirely within the ego psychological framework then regnant in America, and in which my research colleagues and I were all trained.
     It is difficult to appreciate now, a full third of a century after the heyday of ego psychology in America--and in the midst of our current pluralism--just how monolithic was its hegemony through the 1950s and 1960s, and even into the 1970s. The ego psychology paradigm was presented in those years as the direct descendant of, and heir to, the psychoanalysis of Freud, originally a drive psychology but now immeasurably enhanced as an ego psychology through the work of Anna Freud and Hartmann, and now prevailing in America as the legitimate expression of the Freudian heritage. (In Britain this tendency found expression in the Anna Freud group within the British Society, and prevailed at the Hampstead Clinic under the leadership of Anna Freud and Dorothy Burlingham.)
     For those trained in American psychoanalytic institutes in the 1950s, as I was, ego psychology was the total representation of the proper psychoanalytic world. Institute syllabuses were constructed around Freud's writings, of course, with some side ventures to Abraham and Jones (but not Ferenczi, who was to be ignored), and continued through the line of ego psychological authors I have mentioned. "Safe" journals numbered but a handful: Psychoanalytic Quarterly; Psychoanalytic Study of the Child (an Anglo-American but totally "Freudian" enterprise), and the newly created Journal of the American Psychoanalytic Association.
     While there were important articles to be read in the International Journal, to be sure--notably those of Sterba and Strachey in 1934--it was also a minefield strewn with Kleinian articles to be meticulously avoided, interspersed as well with object-relational articles from the Middle Group, or now Independent Group, which were to be equally avoided, with but a few exceptions. I remember two such exceptions, both by Winnicott, his "Hate in the Countertransference" (1949) and "Transitional Objects and Transitional Phenomena" (1953). In fact, everything other than ego psychology was covered in the four-year curriculum in but one course, of perhaps eight to ten sessions, that would include Jung, Adler, Rank, the Kleinians, American interpersonalists and culturalists like Sullivan and Horney, and whoever else the instructor might wish to pack in. As for Kleinian views, then rapidly developing in England and spreading to Latin America, they were peremptorily dismissed, as in Rapaport's well-known footnote to his historical survey of ego psychology (1959): "The `theory' of object relations evolved by Melanie Klein and her followers is not an ego psychology but an id mythology" (p. 11).
     But, of course, the psychoanalytic world has not stood still since the heyday of ego psychology. The paradigm had been created by emigre analysts from Europe, primarily the Viennese, with close personal ties to Freud and his immediate circle. It had been treated as a precious gift, handed down to be preserved and protected from dilution by nonanalytic pragmatic approaches like the behavioral therapies emerging within academic psychology; from the Kleinians, whose ideas about infantile mental states were regarded as totally speculative and incapable of verification (and therefore unscientific); and from the British object-relational school, whose approach was declared superficial and charged with sacrificing a depth-psychological understanding of the drives and with underplaying the centrality of infantile sexuality and the oedipus complex as nodal points of neurotic psychopathology. I separate out, as distinct theoretical tendencies, the Kleinians (adherents and further developers of the views innovated by Melanie Klein) and adherents of the British object-relational approach, the latter a quite diverse group including Fairbaim, Winnicott, Balint, Bowlby, and Guntrip, who came together in a declared "middle group," neither (Anna) Freudian nor Kleinian. The Kleinian metapsychology, though heavily emphasizing internalized object relations, was anchored in the vicissitudes of the endogenous drives, with a particular focus on the aggressive drive, regarded as the expression of the death instinct. By contrast, the object-relational middle group's metapsychology was built around the centrality of object relations--the ego as object-seeking, not gratification-seeking--with psychopathological outcomes arising from traumatic and/or deficient developmental experiences, especially within the earliest caretaker/infant interactional matrix.
     Early papers by Paula Heimann (1950) and Margaret Little (1951) on the ubiquity of the analyst's countertransference involvements and their potential use in better understanding transference-countertransference manifestations, thereby placing the analyst within (not outside) the analytic situation, were responded to with alarm. Annie Reich's 1951 article--which assigned countertransference the status of a frequent but unwelcome intrusion into the analytic process, to be mastered and kept from interfering--had the effect of delaying for twenty years any serious discourse in American psychoanalysis on the topic of countertransference, except insofar as it was regarded as an ever present potential interference.


Nonetheless, by the early 1970s cracks had begun to appear in the ego psychology monolith. Curiously, a major impetus of this development came from some of Rapaport's closest collaborators. Merton Gill, George Klein, and Roy Schafer began by collectively attacking the energic hypotheses of the economic point of view, but the critique rapidly spread to much of the structure outlined by Rapaport and Gill (1959) in their paper on the points of view and assumptions of metapsychology (see Klein 1976; Schafer 1976). This assault was carried to its extreme in Psychology versus Metapsychology (Gill and Holzman, 1976), a collection of articles written by former students of Rapaport and dedicated to the memory of their colleague George Klein. The most notable contribution was Gill's "Metapsychology Is Not Psychology" (1976), in which he turned his back on a quarter-century of writing. In a personal communication he told me that he wished he had written none of his earlier work and that he disavowed every word of it.
     At the same time, the interpersonal psychiatry of Harry Stack Sullivan (quite akin to British object-relational views) had never died out completely, but had been kept alive in the Washington area at Chestnut Lodge Sanatorium and the Sheppard and Enoch Pratt Hospital (see Searles 1979). At the William Alanson White Institute in New York it began to flower, with Edgar Levenson (1972, 1983) and his many colleagues making significant contributions. Prominent among these was the groundbreaking Object Relations in Psychoanalytic Theory, by Jay Greenberg and Stephen Mitchell (1983), which ushered in an explosive outpouring of contributions, marking the sea change into what I have called the "new American psychoanalysis" (Wallerstein 1998b). This is an object-relational, interpersonal, and social-constructivist theoretical perspective, a "two-person psychology" (analyst and patient as co-participants in an interactional relationship, to which they each bring their psychologies and pathologies as co-creators of the therapeutic situation), that today vies for pride of place with the continuation, much transformed, of the original ego psychology, the contemporary expression of a still basically one-person psychology.
     But the hegemony of the ego psychology paradigm in America was not really endangered until Heinz Kohut's self psychology (see Kohut, 1971, 1977, 1984) began to take shape, a psychoanalytic paradigm built not on conflict and its resolution, but on deficit and its repair--not on Guilty Man, epitome of the oedipal drama, but on Tragic Man, carrier of an unintegrated self, subject under stress to disorganizing and fragmenting pressures. It was Kohut and his rapid winning of adherents, not only in his own Chicago institute but in psychoanalytic settings across the country (Cincinnati, St. Louis, Los Angeles, Washington, Boston), that propelled to the fore an alternative psychoanalytic paradigm, thereby destroying what to that point had been an unquestioned, almost total adherence in this country to American ego psychology, until then accepted as the uncontested and legitimate Freudian legacy, warranting naturally the epithets "traditional" or "classical." Kohut himself, in a personal aside to me at one of the early annual self psychology conferences--he as the charismatic leader of the gathering, and I as one of the few invited "friendly critics"--confided, "I'm not sure how enduring my own psychoanalytic contributions will, in the end, turn out to be, but you'll have to admit that I've sure shaken up the ego psychology establishment." He was, of course, correct, and it has never been quite the same since.
     Developments in American psychoanalysis since then--the late 1970s--can be traced along three parallel and related lines: (I) a growing acknowledgment and acceptance of an increasing pluralism, with Kohut's self psychology as the first metapsychological alternative to ego psychology; (2) the burgeoning of an object-relational or interpersonal paradigm, with a variety of roots (some domestic and some imported), given its impetus by the 1983 Greenberg and Mitchell book and effecting (with major recruits from the ego psychology camp) the sea change that has occurred in American psychoanalysis; and (3) internal evolutionary changes within ego psychology, which likely remains the majority position in America, though with far-reaching alterations, centered chiefly around the work of Charles Brenner, that are truly major modifications, both of the theories advanced by Hartmann, Rapaport, and their coworkers, and of the austere technical prescriptions of Eissler and his adherents. I will discuss the historical changes in American analysis in the last two decades along each of these three lines.
     One can question the bundling together of the British object-relational perspective, with its roots in Winnicott, Balint. Fairbairn, and even Bowlby, and the interpersonal perspective (indigenously American) grounded in Sullivan and his allies (Fromm-Reichmann, Fromm, Horney, Thompson and others). The distinction would be in the British object-relational effort to maintain its derivation from, and linkages to, the Freudian corpus, and the American interpersonal and culturalist effort to reconstruct psychoanalysis on a different, non-Freudian theoretical and epistemological foundation. This would suggest a bifurcation between the object-relational and the interpersonal approaches traceable in their theoretical conceptualizations, though with much commonality and various hybrid forms--all represented on the American scene today. This point bas been emphasized to me by Peter Goldberg.


The first of these, our ever increasing pluralism, was the subject of my two presidential addresses to the International Psychoanalytical Association--"One Psychoanalysis or Many?" (Wallerstein 1988), delivered in Montreal in 1987, and "Psychoanalysis: The Common Ground" (Wallerstein 1990), given in Rome in 1989. Briefly, my thesis was that Freud failed in his ambition to maintain as a movement, unitary in its structure and unified in its performance, the science and therapy he had almost single-handedly brought into existence. Although Freud was able to extrude early dissidents (Stekel, Adler, Jung, and, somewhat later, Rank) as proponents of theories deviating from psychoanalysis as he and his followers defined it, the Freudian striving for theoretical and clinical unity broke down, even in Freud's lifetime. In England the Kleinian movement arose in opposition to the precepts of the Viennese surrounding Freud-- thus pitting a so-called London School against a so-called Vienna School--with the former refusing to be cast as outsiders. They in fact declared themselves more loyally Freudian by virtue of their embracing Freud's hotly contested theory of a death instinct, whereas most of the Viennese, closer to Freud personally, took sharp exception to the concept, which they regarded as biologically dubious and clinically unnecessary.
     Eventually the Kleinians became the largest group within the British Society, and soon their doctrines spread to continental Europe. During the rapid post-World War II proliferation of psychoanalysis in Latin America, Kleinian ideas swept that continent. There then developed--also in Britain--an object-relational theoretical tendency (called first the Middle Group, situated between the Kleinian and the Freudian, and today called the Independent Group) that coalesced around the early contributions of Suttie, Fairbairn, and Guntrip, and then Balint, Winnicott, and Bowlby. Their rallying cry was Fairbairn's declaring the ego not a drive-gratification seeking organ, but an object-seeking and object-relating one. Soon thereafter came Wilfred Bion's extensions of Kleinian thought in Britain, the rise of the linguistically based Lacanian perspective in France (which soon spread over much of Romance-language Europe), and the philosophical and hermeneutic perspectives on psychoanalysis exemplified by Ricoeur and Merleau-Ponty in France and by Habermas and Gadamer in Germany.
     From Freud's death up to the decade of the 1970s, America alone had been resistant to this spreading diversity, remaining true over several decades to the founder's vision of a unitary psychoanalysis. In America the ego psychology descended from Freud through his daughter and Hartmann had become hegemonic and was called simply Freudian, traditional, or classical psychoanalysis. (In Britain, it was called Freudian, or Anna Freudian, in distinction from the Independent and Kleinian schools.) In the U.S., the exceptions to this hegemony were a small Kleinian enclave in Los Angeles, established in the late 1960s and early 1970s, and encouraged by Bion's visit of several years during that period; a small handful of psychoanalytic scholars espousing Lacan's views (supported by significant theoretical interest in those views among academics in university departments of French, English, and philosophy); and a growing interest in the object-relational perspective stemming from the work of Sullivan, Horney, and Fromm, and by their ideological descendants in the William Alanson White Institute and other independent groups in New York. Aside from these scattered and at the time not numerous groupings, up until the advent of Kohut's self psychology, which came into full flower only in the 1970s, American psychoanalysis, politically organized within the American Psychoanalytic Association, could see itself still as the unified and unitary analytic "mainstream."
     Since that time, many influences have conduced to the growing awareness and acknowledgment of our theoretical diversity, and of the growing allegiance of psychoanalytic workers to alternative psychoanalytic perspectives once considered deviant. Indeed, so far has this progressed that Leo Rangell, a powerful advocate of the evolving ego psychology tradition, has lamented publicly, on more than one occasion, that the mainstream seems no longer "main." Foremost among these influences has been the increasingly palpable presence of the International Psychoanalytical Association in American consciousness. Growing numbers of U.S. analysts have been attending the biennial IPA Congresses, where they meet and hear presentations by colleagues of theoretical persuasions other than the ego psychological. Increasingly, U.S. analysts serve on IPA committees, often making site visits to troubled or developing component groups around the world.
     Curricula in American institutes have been broadened to offer courses on Kleinian and object-relational perspectives (though Lacanian views are more rarely taught). Visits by leading Kleinians and object-relational thinkers, mostly from Britain, and to some extent by representatives from France and its analytic tradition, both to meetings of the American and to many of its affiliated institutes, have become almost de rigueur. Kleinian and object-relational authors have become more widely read in the United States, through distribution of their books and through the pages of the International Journal. English translations, particularly of French authors (notably Green, Chasseguet-Smirgel, McDougall, and Anzieu), as well as of Germans and Latin Americans (of the latter, Heinrich Racker stands out as one of the very first), have become widely available, and there is a growing clamor for more. It was within this increasing internationalization of American psychoanalytic discourse, and based on my almost twenty years of involvement in the scientific and administrative affairs of the IPA, that I felt it appropriate to choose, as the theme for my 1987 and 1989 presidential addresses, the scientific and political issue of our growing psychoanalytic diversity and its implications for what holds us together as adherents of a shared psychoanalytic identity--i.e., our psychoanalytic common ground.


I turn now to the second line of development in American psychoanalysis over the past two decades, that of an interpersonal or object-relational paradigm. Its seeds are to be found in the indigenous "interpersonal psychiatry" of Sullivan and the culturalist emphases brought to America by Horney and Fromm, ideas originally decried as superficial social psychology. Adherents to these views either were extruded from organized American psychoanalysis (as were Horney and Fromm and their followers) or remained, in part at least, quietly within it (as did the Sullivanians entrenched in the Washington Psychoanalytic Institute). Their influence remained small but steady, mostly in the New York and Washington areas, and mostly in independent institutes and training centers outside the American Psychoanalytic Association. That influence grew wider with the publication of Levenson's first books (1972, 1983), a growth culminating in the major impact on American psychoanalytic thinking by Greenberg and Mitchell's Object Relations in Psychoanalytic Theory (1983). This success was followed by the 1991 launching, under Mitchell's editorship, of Psychoanalytic Dialogues, a journal of "relational perspectives" that quickly assumed a major position among American psychoanalytic journals. Mention should be made here also of Psychoanalytic Inquiry, inaugurated a decade earlier, in 1981, under the editorship of Joseph Lichtenberg. Taking a developmental and self psychological perspective, the journal is broadly sympathetic to the object-relational movement and interrelates with it in a variety of ways, as does self psychology itself. A 1990 volume by Howard Bacal and Kenneth Newman traces quite convincingly the precursors of Kohut's self psychology in the contributions of Balint, Fairbairn, Guntrip, Winnicott, and Bowlby, and even earlier in those of Ian Suttie. Kohut, who liked to regard his work as a totally new direction in psychoanalysis, never acknowledged these forebears. Of current theorists, Robert Stolorow and his collaborators most explicitly express the links between self psychology and the relational turn in recent American psychoanalysis (Atwood and Stolorow 1994; Stolorow, Brandchaft, and Atwood 1987; Stolorow and Atwood 1992).
     Since then, of course, these various object-relational trends, most claiming postmodernist auspices, and each with distinctive particularities, have swelled into a wide stream under many rubrics: the interpersonal, the interactional, the intersubjective, and the perspectivist (or, later, social-constructivist, and now dialectical-constructivist). Under these designations, major authors have emerged, of whom I will name a few, at the risk of omitting others, equally worthy of note: Neil Altman, Lewis Aron, Adrienne Harris, Irwin Hoffman, Donna Orange, Stuart Pizer, Charles Spezzano, Donnell Stern, and Robert Stolorow; from a more feminist perspective, Jessica Benjamin and Muriel Dimen; and from a more Kleinian (or perhaps Bionian and Winnicottian) perspective, Thomas Ogden. This current is what I have called the New American Psychoanalysis (Wallerstein 1998b), which vies now with the ego psychology tradition for recognition as the mainstream.
     These various object-relational perspectives all share what has come to be called a "two-person psychology," in contrast to the traditional "one-person" or ego psychology focused on the intrapsychic conflicts within the patient as understood and interpreted by an objective analyst through the transference projections of the patient within the psychoanalytic situation. By contrast, the two-person psychology is focused on the interpsychic, or interpersonal, experience within the transference-countertransference matrix, of two interacting personalities or subjectivities--of patient and analyst--together constructing the meaning of their shared experience of the interactive process, and relating their characteristic ways of experiencing that interaction to the personality structure and life experience of both participants, primarily of course with the intention of unraveling the genesis and development of the patient's presenting psychopathology. Unlike the effort to avoid or to master countertransference involvements as threatening impediments to the analytic work, which is the usual stance within ego psychology, within the two-person framework countertransference is understood as inevitable and ubiquitous, and as an essential ingredient of the psychoanalytic process, vital to the analyst's understanding of his or her own participation in co-constructing the meanings of the psychoanalytic dialogue, and vital also to understanding the patient's inner psychology through the impact made on the analyst's mental equilibrium.


The third line of development in American psychoanalysis over the last few decades, the continuing evolution of the ego psychology paradigm, is the one most central to my concerns. Changes here have been both conceptual and technical. Elizabeth Zetzel (1956) and Ralph Greenson (1965) together pioneered the "alliance" concept in American analysis--actually an elaboration of Freud's remark (1912) that the "unobjectionable" positive transference, as an aid to the analytic work, does not require analysis (p. 105). Greenson used the phrase "working alliance" to focus on the patient's highest-level secondary process functioning, as it cooperates actively with the analyzing work of the analyst and stands apart from the fluctuating vicissitudes of transference manifestations. The alliance thus provides a framework within which transference oscillations can be safely contained. Zetzel introduced earlier the phrase "therapeutic alliance," to emphasize the role of the alliance in supporting the therapeutic process. Unlike Greenson, she stressed the archaic and infantile origins of the alliance in the earliest period of mother-infant interactions, the period in which, optimally, the child's "basic trust" is established (Erikson 1950, p. 75).
     Whatever its origins (more primitive or later), and however constituted, the alliance for both Zetzel and Greenson is essential to the proper conduct of analytic therapy. In "normal neurotic" patients it can usually be taken for granted, but in sicker patients whose developmental history has failed in the proper nurture of this capacity, it often requires special attention and direct cultivation. The alliance conception has never seemed useful to adherents of paradigms other than ego psychology, and it has been sharply attacked even in friendly quarters (see Brenner 1979; Stein 1981) as shielding from analytic scrutiny transference manifestations that often are highly conflicted and therefore "objectionable." This is probably because two-person approaches have no need of an alliance concept, which had emerged within ego psychology specifically to take account of the "real" interaction with the second person, the analyst. But whether disputed or embraced, the alliance conception was a breach in Eissler's austere technical doctrine that the only proper psychoanalytic activity is unremitting interpretive attention to the transference manifestations of the patient's intrapsychic conflicts.
     An even larger breach in the rigorous Eissler model, embedded as it was in the abstract theorizing of Hartmann's natural science vision of psychoanalysis, occurred during that same time period with the technical softenings proposed by Leo Stone (1961) and the conceptual recastings of Hans Loewald (1960). Stone's plea was for a humanization of the analytic process, a modification of Eissler's austere ideal, the insertion of a frank and avowedly therapeutic commitment, what he called the "physicianly" attitude of explicit concern and care for the feelings and the psychic well-being of the patient. This attitude could include the simple gratifications expected in ordinary social and/or professional discourse, as well as the offering of important information or judicious advice when clinically indicated, all unnecessary and misguided "parameters" in Eissler's sense, and all recognitions of the interactional two-person nature of the analytic situation.
     Loewald's precepts were conceptually more far-reaching and revisionary. Stone's emphasis was on the necessary "humanness" of the analyst-analysand relationship; Loewald's was on the analyst's role as a "new object" in the patient's life, with whom therapeutically productive "integrative experiences" were to be achieved. Desired resumption of the patient's ego development consequent to the progressive analytic process was contingent, Loewald believed, not only on proper analysis of the transference relationship with reawakened old objects, but equally on the forging of a new relationship with a new object, the analyst as coactor on the analytic stage, on which the childhood events that culminated in the patient's infantile neurosis are reactivated and restaged via crystallization and resolution of the contemporary transference neurosis.
     In this reconceptualization, which drew explicit analogies to early mother-child interactions optimally reexperienced in the therapeutic present with less pathogenic and more adaptive resolutions, Loewald, though retaining the language of classical ego psychology, significantly moved it in the direction of a two-person psychology. It may not be too much to state that it is this stance by Loewald, developed with increasing specification in a sequence of papers spanning three decades (Loewald 1980), that was the major impetus for the gradual movement of many gifted analysts, trained within the ego psychology tradition (even when it was most demanding in its technical strictures and unyielding in its theoretical formulations), toward intellectual fellowship with the object-relational descendants of Sullivan and Horney. Among those gifted analysts I include such figures as James McLaughlin, Dale Boesky, Warren Poland, and Judith Chused, and, perhaps even more fully, Theodore Jacobs, Owen Renik, and Merton Gill (in the case of Gill, in an extraordinarily fertile intellectual partnership with Irwin Hoffman). Here again the question arises whether Loewald's work forges a bridge from classical ego psychology to the interpersonalist inheritors of Sullivan and Horney (Mitchell, Aron, and their colleagues), or to a more "Freudian" form of two-person psychology as elaborated by most of the authors I have just listed. If such a distinction has significance, I would incline to the latter view, of a bridge, through Loewald, to those trained within the ego psychology framework.
      Yet another influence may be cited in the opening up of the American ego psychology paradigm. John Gedo, first in a book with Arnold Goldberg (1973), and then in several books of his own--notably, Beyond Interpretation (1979)--developed a hierarchical and developmental model of the psychic apparatus, and of technical implementations appropriate to each of the five stages in this schema. These stages, three drawn explicitly from Freud and two based on the emerging formulations of Kohut, were (1) the stage of the reflex arc model of primary narcissism; (2) the stage of the self-object model, after differentiation of self from object; (3) the second self-object stage, with its danger of castration and its central "phallic narcissism"; (4) the stage of the tripartite structural model, following superego formation; and (5) the mature stage of the evolved adult psychic apparatus.
      The point most relevant here is that in Gedo's schema interpretation, in the classical Eisslerian sense, is the appropriate therapeutic intervention only with individuals functioning at the fourth level, that of the traditional neurotic disorders. At the other levels, which correspond, in ascending order, to states of traumatic disorganization, psychoses, narcissistic personality disorders, and (skipping to the fifth) the highest achievable nonneurotic adult functioning, other intervention strategies are recommended. These, again in ascending order, are designated as pacification, unification, optimal disillusionment, and, at the highest level, thoughtful introspection. What in Gedo's view is accomplished here is a breaking of the bounds of the classical ego psychology framework, with a far wider array of theoretical conceptualizations and technical derivations made available to the clinician.
     These various developments (or, rather, transformations) in ego psychology have together, I believe, encouraged a growing acceptance of object-relational thought within American psychoanalysis, where increasingly it exerts a further influence on traditional ego psychology. My point is that the contributions of Kohut, Loewald, and Gedo, as I have outlined them, all bring, with increasing explicitness, a developmental perspective to ego psychology, which now directs greater attention to the role of adequate development in adaptive personality functioning, and of developmental failures in the formation and evolution of psychopathology (for a similar perspective from the side of child analysis, see Seligman 1997). Once this ground was broken, the way was paved for the growing receptivity of traditional ego psychologists to object-relational, even Kleinian, theoretical perspectives. To these influences may be added theoretical developments within child analysis per se, or even the "baby watching" developmental research of Robert Emde, Louis Sander, Daniel Stern, and others, all conceptualized within the ego psychological tradition. These changes--e.g., the elaboration, within the Freudian group in London, of Anna Freud's conception of developmental lines (1965, pp. 62-91), or Stern's conceptions of the attunement of mother and infant to each other from the very start of extrauterine life (1985, pp. 207-214)--have each contributed to the internal evolution of ego psychology.
     Germane in this context, too, has been the profound alteration, over recent decades, of the relationship between psychoanalysis and American academic psychiatry (see Wallerstein 1980, 1983). Briefly, the growth of neuroscience and the rise of biological psychiatry have displaced psychoanalysis from its earlier, virtually hegemonic position within academic psychiatry; the result has been labeled the "remedicalization" of psychiatry. The void caused by this loss of cultural and political dominance within American psychiatry has in a real sense been filled by psychologist psychoanalysts, who are indeed the chief authors of relational analysis, which by and large emerged politically and has been nurtured within Division 39 of the American Psychological Association. The concomitant increasing feminization of all the psychotherapeutic disciplines (Philipson 1993), as well as the breakdown of the exclusionary policies of the American Psychoanalytic Association against the clinical training of nonmedical analysts (Wallerstein I998a), have likewise played their part in the shift in psychoanalysis from a clear hierarchy of theory and technique within a natural science perspective in which facts are understood as knowable and fixed (the original ego psychology one-person paradigm), toward the conception that knowledge is conditional, contextual, and co-constructed (central tenets of the relational two-person paradigm). I have not attempted to cover here the impact, on the world of ego psychology, of relevant critiques brought by disciplines separate from psychoanalysis: the feminist attack on adaptation theory as actually a psychology of gender oppression; the neuroscience critique of Freudian drive theory; and the press by nonanalytic child development research toward an interactional, two-person psychology. All of these have also played a role in altering psychoanalytic conceptualizing in ways that could well be the substance of another paper. (For fuller development of these views, see Seligman 1996.)
     Given, then, the panoply of these internally developed and externally enhanced enlargements of classical ego psychology--the alliance conceptions of Zetzel and Greenson, the focus on the quality and nature of the psychoanalytic relationship by Stone and Loewald, and the hierarchical schema of Gedo (all of whom, incidentally, always saw themselves as operating within the ego psychological paradigm, even while "pushing the envelope")--what corresponding changes have occurred in the recent transformation of ego psychology by those who have always been regarded as its staunchest guardians, linked closest in lineage to the original group around Hartmann? Among these, Jacob Arlow and Charles Brenner, central figures in the same New York Psychoanalytic Institute where ego psychology experienced its original flowering, and frequent collaborators (see, e.g., Arlow and Brenner 1964), have been the most influential voices.
      Arlow's special contribution has been in filling the lacuna left by the demise of one of Freud's (and Hartmann's and Rapaport's) central metapsychological viewpoints, that of the economic or energic constructs. Though energic concepts had their continuing defenders (e.g., Lustman 1969), they had been increasingly attacked as mischievous and misleading metaphors, with no conceivable relation to any of the customary scientific meanings of the concept of physical energy, and also as totally unnecessary to psychoanalytic explanation. They were attacked first by the original defectors from Rapaport's systematization of metapsychology--George Klein, Gill, and Schafer--and then by a host of others. In 1975, I chaired one of the last panel discussions of this issue in the American Psychoanalytic Association (Wallerstein 1977), and today Freud's energic constructs, for all their central importance to his theorizing, no longer have serious defenders.
     Instead, as portrayed by Arlow in a series of articles (for two of the most significant, see Arlow 1969, 1985), the function of the energic constructs in motivating behavior is replaced by the role of unconscious fantasy in the constitution of psychic reality and in the motivation of normal and abnormal behavior. The memories that constitute our life history are created, in Arlow's conception, through the mingling of external perceptions with unconscious fantasies, as experienced against the background of the individual's past development, itself a mingling of earlier perceptions and unconscious fantasies into encoded memories.
     Brenner, accepting Arlow's reformulation of energic constructs into the unconscious fantasies that motivate behavior, proceeded to a more total revision of the tripartite structure of the psychic apparatus. He became a principal spokesman for the general retreat from Hartmann's (and Rapaport's) vision of psychoanalysis as a general psychology, explanatory of the entire range of human mental functioning within a biologically anchored natural science framework; this entailed the dropping of any central concern with a structure of autonomous ego apparatuses developing in a conflict-free sphere. The result was a reversion to Freud's conception of psychoanalysis as explanatory only of that aspect of mental life born of psychic conflict. This was stated aphoristically in the 1940s by Ernst Kris, otherwise Hartmann's closest collaborator, as the conception of psychoanalysis as nothing but human behavior considered from the point of view of conflict. And this is the conception that Brenner has systematically developed to its fullest.
     Brenner's The Mind in Conflict (1982), in which he presented a new, revisionary framework for what would become contemporary ego psychology, is thus aptly titled. Since the ego in its manifold functions was so central to the formulations of ego psychology, Brenner begins with the ego, but with the ego specifically in its functions in relation to conflict--the classically established defense mechanisms. His thesis is both sweeping and simple, that there are no special defense mechanisms, that any aspect of ego functioning can serve a defensive purpose but can at other times, or at the same time, serve also as a vehicle for drive gratification, as the expression of superego pressures, or as an adaptation to the requirements of external reality. In Brenner's words (1982), "no aspect of ego functioning, no ego function is a `defense mechanism.' All aspects of ego function are all-purpose" (p. 80). They can equally well serve drive gratification, expression or modulation of anxiety or depressive affect, defensive needs, or superego strictures--simultaneously, or alternately, or successively, often of course weighted more in one direction than in another.
     How then, does Brenner conceptualize the play of forces in psychic conflict? It is via compromise formations as the omnipresent accommodations to mental conflict--and compromise is declared to be ubiquitous in all neurotically impaired behaviors, as well as in all (or perhaps almost all) so-called normal behaviors. And what is it that enters into these compromises? Four elements are involved: the push of drive expression; the pressures (opposing or not) of the superego; the ego's defensive need to modulate these expressions in the interest of adaptation to external requirements; and the ego's intent to ward off or minimize dysphoric affects. These last are of two kinds, in Brenner's conception of equal status: anxiety (central to Freud's thinking), which is the fear of pending risk or danger, and depressive affect (which Freud denied equal status), which is the fear or the consequence of a dangerous situation that has already befallen the victim.
     Compromise formation in response to psychic turmoil becomes then, in Brenner's view, the all-purpose explanatory principle that marks (and unifies) the structure of this contemporary ego psychology. Brenner tries to show, through illustrative vignettes (which incidentally never characterized Hartmann's presentations), that any thought, speech, wish, plan, fantasy, dream, behavior, neurotic symptom, joke, or parapraxis can be usefully dissected, to show in it the four elements noted above, and the compromise formation that at once represents it and modulates their conflict. Brenner then extends this way of conceptualizing even more broadly, encompassing what Kris (1936) called "regression in the service of the ego," at work in all intellectual and artistic creativity, as well as in public entertainment, religious thought and activity, support of art, music, sports and games, and the like. In the final section of his book, Brenner considers, from the point of view of the compromise formations formed out of human conflict, such diverse human expressions as normal character traits, choice of vocation and avocation (hobbies and interests), choice of sexual/marital partner, folk tales, myths, legends, superstitions, organized religion, sociopolitical and governmental forms, and the writing of fiction. And, of course, all object relationships, including those at play in the transference-countertransference matrix, are themselves but compromise formations.
     It is clear by now that, in Brenner's words, "conflict and compromise formation are not the hallmarks of pathological mental functioning. They are equally important in normal functioning" (p. 115). As for the purpose of it all, "In their role as executants of the drives and, later, of the superego, ego functions will grant to both the fullest expression compatible with a tolerable degree of unpleasure" (p. 116), meaning tolerable anxiety and depressive affect. Actually, in the fullest extension of this thinking, Brenner seems to come close again to Hartmann's vision of psychoanalysis as a general psychology explanatory of all individual and social behavior--not through reestablishing Hartmann's biological anchorage, but by extending the reach of his own conceptions of conflict, with a concomitant deemphasis or neglect of Hartmann's array of conflict-free ego functions and apparatuses.
     Brenner does leave a little room for these central Hartmannian ideas in his statement of "the proposition that a dynamic interaction among the components of psychic conflict underlies much or all of the subjectively conscious and objectively observable phenomena of adult psychic life and behavior" (p. 214). It is in the phrase I have italicized, "much or all," that space is provided for the existence (and relevance) of conflict-free functions of the ego. To fill out Brenner's new conceptions, it remains only to delineate his views of superego origins and functions. Put simply, his view is that the superego is "definable as one of the consequences of psychic conflict [i.e., a compromise formation itself] as well as a component of all later conflicts [i.e., after its formation, one of the conflicted components in all subsequent compromise formations]" (p. 121). "The compromise formations that make up the superego form the basis of the moral aspects of psychic functioning" (p. 123). Thus, superegos can occupy a range from normal to pathological in their psychic impact; Brenner has no use for the idea that the superego has defects, or lacunae--rather, it is more or less normal and adaptive in its functioning, or not.
     So much for Brenner's transformation of ego psychology into what is now a rather widely accepted revision of that framework. The familiar psychic instances of Hartmann are all still there--drives, ego, superego, outer reality--but very significantly altered in function and structure, with a dropping away not only of the focus on the conflict-free in ego functioning, but also of the preoccupation with the explanatory interplay of the five metapsychological points of view accorded such importance in the 1959 Rapaport and Gill paper. Though all this is at considerable remove from Hartmann's model, Schafer in a 1995 paper, "In the Wake of Heinz Hartmann," has tried to establish, in what I think is a considerably strained manner, a continuity in the theory of therapeutic action from Hartmann's era to today's ego psychology. Contra the many efforts at debunking Hartmann and consigning him to history, his adaptational theory in general, and his ego psychology in particular, are presented almost as precursors of the shift to an interactive view of the two-person analytic situation.
     Schafer's main thesis in this regard is that "by theorizing the mature, the rational, the stable, and the modulated, the ego psychologists have established that primitive and damaged must be defined by the otherness of the nonprimitive and the so-called `normal"' (1995, p. 244; emphasis added). And that otherness relates to "two-ness," whether of the interaction with the other person, or with a larger, nonpersonal entity (the outer reality to which the individual adapts). It is this concept of adaptation, so central to Hartmann's thinking, that Schafer sees as leading inevitably to modern conceptions of dialogue (and even intersubjectivity), though Schafer acknowledges that Hartmann never took that step. And even the conception of identity is declared to depend on difference from the other. If one says "I am this," it means "I am not that," though again Schafer acknowledges that the psychoanalysis of Freud--and of Hartmann, as his interpreter and extender--is not primarily field-theoretical, as a truly two-person psychology would have to be.
     But then Schafer makes an effort to link the two main directions into which the once unitary structure of American ego psychology has now split: on the one hand, its revision by Arlow, Brenner, and their adherents, and on the other the object-relational perspectives that have coalesced into what is today an alternative mainstream. Schafer's point is that epistemologically the two cannot be disentangled: "For that attempt at complete systematization [of the dialogic and intersubjective stance] must take for granted that the speaker or writer on its behalf is an objective observer who may be relied upon to give a once-and-for-all definitive account of the patient, the analyst, and the analytic process. In other words, the systematization necessarily presupposes a privileged protagonist who is qualified to argue the superiority of the dialogic and intersubjectivist position. Thus, there is a hidden return to, and dependence on, the rejected positivism and, by the same token, a new vulnerability to a critique developed from the standpoint of perspectivism and so on ad infinitum" (1995, p. 228). Similarly, from a pragmatic clinical, rather than philosophical, standpoint, Gill, who had long seen himself as a full-fledged convert to the two-person interactional perspective, reverted in his final book, Psychoanalysis in Transition (1994), to a stance in which he upheld the necessity of both the one- and the two-person psychology. He considered both to be vital, employed often in successive or interacting ways, to the fullest pursuit of the clinical requirements of the evolving analytic situation. This is fully consonant with my belief that though both perspectives (one-person and two-person) exist within clinical psychoanalysis, and some use one, some the other, and some both, at this point of uneasy equilibrium no one can properly claim the epistemological high ground.


Where does all this leave my overview of the current status of American ego psychology at the turn of the century, as compared with its beginnings more than half a century earlier? There are those who agree with Greenberg and Mitchell's categorical statement in 1983 that an irreconcilable chasm has opened between ego psychology, however evolved since Hartmann's day, as still clearly a drive/structural perspective embedded in a one-person psychology and their own object-relational perspective embedded in a two-person psychology. To them there exist today in the U.S. two distinct conceptions, fundamentally antithetical, of the nature and practice of psychoanalytic therapy.
     Those on the other side of this divide, however, regard ego psychology, as currently reformulated, as a sufficient explanatory framework, and therefore eschew object-relational approaches as both incompatible with their own and unneeded for clinical work. As I have indicated, of course, a significant number of prominent analysts trained in the ego psychological tradition have come to adopt object-relational perspectives, and so have recast the transference-countertransference matrix into two-person interactional terms. In varying degrees they maintain as well the usefulness of ego psychological precepts and the one-person view.
     Perhaps the staunchest advocate of the continuing explanatory sufficiency of the natural science ego psychology initiated by Freud and transmitted through the chain of Anna Freud and Hartmann (with Fenichel included as a major influence) down to Arlow and Brenner, is Leo Rangell (1988). "My theoretical overview," he has written, "is the presence and desirability of what I call `total composite psychoanalytic theory,' including all the metapsychological points of view, culminating in the structural. I have pointed out repeatedly that self, object, interpersonal, preoedipal, all elements which have served as nodal points of alternative theories, are included in the total unitary theory, whereas the converse is not true: that other theories of self, or object, or the Kleinian view, eliminate variable essentials of the developed, cumulative psychoanalytic theory" (pp. 316-3 17). Clearly this view of the ego psychology paradigm, as an overarching composite subsuming all other psychoanalytic perspectives as but partial expressions or offshoots of the whole, would hardly be accepted by adherents of other theoretical positions. Indeed, in this era of theoretical pluralism, of increasing acceptance of a diversity of competing explanatory frameworks, it might meet with little agreement even among those Rangell would count in his camp.
     Another approach to this breach in what once was the unquestioned hegemony of the ego psychology paradigm is exemplified by Otto Kernberg and Joseph Sandler. Contra the views of Greenberg and Mitchell, they have devoted major efforts to reconciling--even creatively amalgamating--the seemingly disparate metapsychologies of ego psychology and object relations theory. Kernberg and Sandler have of course not been alone in this enterprise. As already noted, so prominent an early ego psychology stalwart, later turned wholeheartedly relationist, as Merton Gill in his final book (1994) returned to a plea for a complementary, if not yet integrated, view of both one- and two-person conceptualizations (theoretical and technical) of the psychoanalytic process. More recently, Nancy Chodorow (1999) bas developed an amalgamating path toward a "both-and" synthesis of ego psychological (one-person) and object-relational (two-person) psychoanalytic perspectives, with Loewald her declared theoretical forebear. Kernberg's effort, spelled out in a sequence of books (1975, 1976, 1980), has been to conceptualize internalized object relations--i.e., sequences of self- and object representations and the affective valences linking them, established in the infant's earliest interactions with the ambient (primarily maternal) world--as primordial motivators of behavior and building blocks of subsequently crystallizing psychic structures that culminate, in full personality development, in Freud's tripartite structuralization of id, ego, and superego.
     Sandler's path (1987) originated in his studies of the logical structure of classical psychoanalytic concepts, which he examined for their explanatory fit with the data of the psychoanalytic treatments conducted at the Anna Freud Centre, as discerned through the descriptions in the Hampstead Child Therapy Clinic index categories. This led, through an incremental transformation of the traditional Freudian drive/structural paradigm, based on an economics and dynamics of drives and energies, to a more object-relational model, an economics and dynamics of fluctuating feeling states embedded in internalized object relations, and reflecting the full human feeling range, from anxiety, depression, and pain to well-being and safety. This was accomplished, however, without his losing sight of the vital links to issues of instinctual gratification and frustration, so centrally important as the ego balances danger and safety, and adaptively regulates its shifting feeling states.
     In this sense, Kernberg and Sandler have been converging in carefully crafted efforts at the theoretical amalgamation or integration of paradigms Greenberg and Mitchell had declared totally distinct and irreconcilable. Perhaps in pursuit of this agenda, Kernberg in 1993 published an article, titled "Convergences and Divergences in Contemporary Psychoanalytic Technique," in which he sought to demonstrate converging trends in clinical technique across what traditionally had been regarded as totally distinct theoretical perspectives, from each of which, presumably, a set of clearly differing technical precepts derives. And though he tried, in an attempt at evenhandedness, to delineate areas of seeming divergence, these seemed both less consequential and more alterable than the convergences. Did he mean this as a forecast (or at least a portent) of a growing coalescence, the restoration, out of the present congeries of distinct and competitive theoretical paradigms, of a unified science and praxis of psychoanalysis?
     Given this array of differing voices, we each of us, especially if trained within that earlier unified vision, have our choices to make at the start of this second century of psychoanalysis. Should we hold the ego psychology paradigm distinct (or even supreme) in its modern transformed version? Or should we see it existing alongside, and in healthy intellectual competition with, all the other psychoanalytic metapsychologies that have been developed, going back to the Kleinians in the 1930s? Or should we, as Fred Pine (1990, 1998) suggests, adopt a pragmatic willingness to employ these systems in shifting explanatory endeavors in relation to the fluctuating vicissitudes of our patients' mental processes? Or should we rather embrace the convergences held out by Kernberg and Sandler? All we can be certain of is that this is all part of the healthy, creative flux in our psychoanalytic discipline today, not just concerning ego psychology in its evolution to date, but challenging all our psychoanalytic thinking at this moment in time, however stable or uncertain our theoretical allegiances.


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