Adult Psychoanalytic Training (APT)
2021-22, 2nd Trimester — Fridays, 3:30-5:00pm
Melissa Stoker, MS
Table of Contents
Introduction
The First Two Classes
I have structured this brief look at aggression around two authors, Stephen Mitchell and Otto Kernberg, each of whom presents a broad look at the topic of aggression in their respective articles. They are interesting to read together because they openly disagree with one another, and would even appear to be saying that the other is mistaken in their understanding of aggression. They can both, I believe, be seen as psychoanalytic-theoretical chefs, cooking up their own unique recipe, while drawing from other chefs before them. For the most part, both are careful to give credit to who and where they’ve found their ingredients, so in studying their works we can be exposed to still more theoreticians than simply the two of them.
My initial goal for our meetings is that we start by carefully looking at each article, digging deep in an attempt to first understand what Mitchell, and then Kernberg, are saying-- regardless of whether we agree or disagree, trying as much as possible to suspend that question. (Beginning with what feels right to us can sometimes inadvertently lead to theoretical blindspots.)
As you read make notes of any points that you want to clarify further. We will try to address these as a group. Once we agree upon a general understanding of the author’s basic thesis, we will critique it—looking for areas or points that seem questionable or unclear. Mitchell and Kernberg are or were gifted thinkers and it’s easy to be in awe of their ideas and command of the subject. However, it’s in our questioning and critiquing that we can clarify and sharpen our own thoughts.
After this first step, when we can to some degree ‘think like Mitchell’ and ‘think like Kernberg’, the next step is to try on both perspectives with clinical material—whether that is process material, discussing an interaction or dynamic with a particular patient, a conceptualization of a patient, or whatever you all choose to bring to the classes. I will also bring some clinical vignettes. Theory is only interesting if we can attach it to actual interactions with people.
In addition to knowing what Mitchell says, and what Kernberg says, each paper is, I believe, a lot more interesting when considered in light of the other paper – as a dialog between two extremely thoughtful people. When reading each writer more closely, I think it is worth questioning whether they are sometimes not as much disagreeing as talking past one another, using language in a similar but not precisely the same way – enough so that it can obscure meaning. Different theories, or different personalities? Do theories guide us, or provide a rationale for what we do? Mitchell wrote in 1993, when he was in his 40s, ten years after he published his groundbreaking book with Greenberg. It was pre-9/11 and pre-Trump. Kernberg wrote his article in 2009 when he was 81 – post 9/11 (pre-Trump, obviously). Kernberg fled Vienna and the Nazis at the age of 10 with his family, emigrated to Chile, and then immigrated to the US at the age of 30. How much might a person’s biography influence their theoretical proclivities?
The Third Class
I have left our last meeting unscheduled with the hope that we can plan it together after we’ve met and begun our exploration of the topic of aggression. These first two classes are the start of a framework for exploring aggression, but I haven’t met with you all as a group since your first year in training. You’ve obviously had many years of didactics and experiences since then. I’ve relied on what I think will be interesting and useful to you, and on what I personally have found compelling in my reading to prepare for these classes. I want to leave some room for the final class so that we can be responsive to what thoughts and questions arise in the first two meetings.
A few ideas: we could discuss a patient in more detail (or a few patients, dividing the time) using the ideas and framework we’ve gained from Mitchell and Kernberg. Another option – while Mitchell and Kernberg cover a lot of territory, one approach that may be significantly different enough to not be well represented here is self psychology. I saw that your class read “Heinz Kohut’s Theory of Aggression and Rage” by Strozier et.al. in February of this year as part of your course in self psychology. If the group is interested we could expand on that with another reading. Or we can consider a reading from some other theoretical orientation that a majority of the group might want to explore in more depth. Other options are possible and welcome; I look forward to discussing and deciding as a group.
About the Authors
Stephen Mitchell offers in his paper a psychoanalytic history of how aggression has been conceived, which has led to certain technical approaches. Mitchell warns of an artificial bifurcation that he believes occurs in psychoanalysis around the topic of aggression. (Whether the bifurcation exists, or Mitchell creates it in order to contrast what he sees as the uniqueness of his approach, is one of the questions we might consider about his article.) In any case, Mitchell offers an overview of Freudian drive theory, Kleinian theory, and ego psychology on the one hand (which he groups together in their approach to aggression as a fundamental human drive or instinct) and relational, self psychology, American object relations, and an intersubjective approach on the other hand (which he groups together in their perception of aggression as a response to injury or trauma). You can see here how the question of whether aggression is an innate drive within each of us or a response to trauma or frustration from outside of us could also be reshaped into whether we see aggression starting inside ourself or outside ourself.
Otto Kernberg is a synthesizer and pulls together a bit of Kleinian or British/European object relations theory, a bit of neuropsychoanalysis, and a sprinkling of affect theory to create his understanding of aggression. In the article I’ve chosen Kernberg is focusing on the death drive, which is not synonymous with an aggressive drive, but obviously deals with aggression. I chose the article because it is one of the shorter and more accessible of Kernberg’s writing. His writing does not draw the reader in, as Mitchell does. It may even be a bit of a slog. However, he provides a useful counter to Mitchell’s clean, simple style and story.
Kernberg actually does not see drives as primary, but rather he puts affect in the primary spot as motivators for people; the affects are then grouped into the two drives, all of which is connected to “affectively valenced representations” (i.e., unconscious fantasy). Mitchell did not directly address unconscious fantasy (at least not in those terms), yet the concept may be important for drawing distinctions between the various approaches. Kernberg concludes that a death drive is not an inborn drive, but that it is an important phenomenon that occurs in some people. You will see in the article that he describes work with severely destructive people, and it could be tempting to see that population as out of the scope of our practices, and hence we don’t have to think about it too much. However, going back to the chefs and the recipes metaphor, sometimes a minor ingredient, even just the seasoning, can have a major impact on the outcome of the dish. Ideas about serious disturbances in people can be helpful even in working with people who appear to function better.
I look forward to meeting with you all on the 3rd.
Learning Objectives
At the end of these three classes, associates will:
- broaden their understanding of how different psychoanalytic theories view the place and function of aggression in people, and
- increase their flexibility in trying out new (perhaps formerly uncomfortable) ways of conceptualizing their patients’ aggression
- increase their empathy for their patients, and increase their confidence in addressing aggression in their work with patients
December 3, 2021
[32 pages]Mitchell, S. (1993). Aggression and the Endangered Self. The Psychoanalytic Quarterly (62):351-382.
December 10, 2021
[15 pages]Kernberg, O. (2009) The Concept of the Death Drive: A Clinical Perspective. International Journal of Psychoanalysis 90:1009-1023
January 7, 2022
Reading for this session to be agreed upon by the group after meeting together.