Abstract
‘It is doubtless no accident that Freud was halted, in his dream interpretation, by the recounting of dreams of death. They marked, in effect, an absolute limit to the biological principles of the satisfaction of desire; they showed, Freud sensed only too keenly, the need for a dialectic’. Miche l Fouc ault [1]
If he'd ever heard it, Alexis de Tocqueville would have understood the meaning and referent of the expression ‘God's own country’. The perceptive Frenchman visited the United States of America in 1830, and discerned in the young republic an optimistic social experiment – a nation founded on the rights of the individual which believed itself destined by God to promote Democracy and Capitalism [2]. De Tocqueville lacked the conceptual and methodological tools of social science to explain this phenomenon, for this was some decades before works such as Emile Durkheim's Elementary forms of religious life and Max Weber's The Protestant ethic and the spirit of capitalism appeared.
By late 19th century, the implicit values of the ‘American experiment’ flourished in the philosophical school of Pragmatism, exemplified by William James, with his principles of radical empiricism, pragmatic theory of truth and the ‘stream-of-consciousness’ model of the mind. Browning's paper draws on this tradition, but neglects another.
Unlike James, some of his European contemporaries (artists, poets and philosophers, including the anti-Kantian Romantics) expressed fears about the destructive consequences of Human Reason as manifested in industrialization and liberal capitalism. (People have similar concerns today about corporate or monopoly capitalism.) Thus Nietzsche, anticipating Freud, articulated strifetorn, historical narratives and grim parables of individual and collective conflict. For him, the apparent triumph of Human Reason also announced the death of God. Nietzsche warned that human beings, released from their ‘slave morality’, would now behave like gods [3].
While individualism survived in the USA, by midtwentieth century, according to the sociologist Philip Rieff, the bold experiment was exhausted. American individualism turned ‘inward’ creating the social type Rieff termed ‘psychological man’, who sought explanation and consolation for his place in the cosmos in the theories and therapeutics of Freud and his often-fractious associates [4].
Freud, on his visit to the USA in 1909, had famously confided to his travelling companion, Carl Jung, ‘they don't realize that we are bringing them the plague!’ But, perhaps traumatized by the Holocaust which had eradicated Jewish life in Christian Europe, and intimidated by the anticommunist, god-fearing McCarthyism that swept America in the 1950s, American psychoanalysis after World War II was socially conservative rather than bubonic. Most psychoanalysts concurred with Freud's scepticism about religion, and eschewed the socialist activism of their youth in pre-War Europe [5]. As Rieff's book memorably concludes:
‘… the therapy of all therapies is not to attach oneself exclusively to any particular therapy, so that no illusion may survive of some end beyond an intensely private sense of well-being to be generated in the living of life itself… (this) announces a fundamental change of focus in the entire cast of our culture – toward a human condition about which there will be nothing further to say in terms of the old style of despair and hope [4], p.261]’.
It is at this point that Browning, a theologian and social philosopher, seeks to re-engage with psychiatry via psychotherapy, and his paper resounds with the pragmatic, optimistic spirit of the American ‘project’. He would have struck a more cautious tone if he had complemented Rieff's thesis with critiques by two other psychoanalytically literate sociologists, Christopher Lasch and Michael Rustin, and the afore-mentioned post-Kantian European philosophers.
Lasch addresses the development of the modern family [6, 7]. He draws on the researches of the Frankfurt School of Critical Theory, which used the theories of Marx and Freud to explain the rise of European fascism and the bureaucratic rationality by which the subsequent genocide was so efficiently implemented.
Lasch argues that economic and social changes in modern American society have reduced the family's civic and political significance to that of a mere sanctuary or haven from the pressures of work and society, thereby undermining the process of identification with authority figures which mediates the resolution of a child's Oedipal complex. This, in turn, fosters the rise of the narcissistic character as the predominant personality type in a society whose citizens are increasingly disenfranchised from meaningful participation in political action. Psychotherapy and family therapy are blind to these ‘structural’ problems in the internal and external worlds of their patients.
Rustin's critique [8] is at the societal level. Using Melanie Klein's account of the development of the child's capacity for moral feelings and post-Kleinian ideas on the nature of creativity and the capacity to think the truth, Rustin warns against the envy and violence implicit in the demagogic populism of the New Right which seeks to gain control of the political process and social institutions, including schools, universities, hospitals and welfare services (and psychiatric practice, too!).
Browning uses many psychoanalytic concepts and metaphors. While concerned about biological reductionism in psychiatry, he ignores the hostility and scorn often displayed by the current leadership of psychiatry towards psychoanalytic thinking; and even when some psychoanalytic principles are taught, they are often based on oversimplifications and distortions which are uncritically accepted by students. One such example is Kohut's oft-quoted, but flawed distinction between Guilty Man (Kohut's view of Freud's model) and Tragic Man (Kohut's view of his own model), to which Browning only alludes.
Then there is Freud's controversial analogy between religion and neurosis: ‘… obsessional neurosis is an individual religiosity and religion is a universal obsessional neurosis [9].’ One thoughtful response is that of the philosopher Paul Ricoeur [10], whose magisterial study charts both a theory of drives (biology) and hermeneutics (meanings) in Freud. Accordingly, Ricoeur differentiates between the ritualistic or dogmatic aspects of religion, where Freud's formulations about the developmental legacy of human infantile dependence and identifications based on guilt-laden resolution of the Oedipal complex may have validity, and Faith.
Many psychoanalysts also consider Freud's views on religion to be incomplete. Some use Winnicott's idea of the transitional experience to bridge the subjectiveobjective divide in human reasoning, which may result in a creative transformation of the world, an experience which religion shares with art and science [11], and, I would add, with love.
Bion's clinical and wartime experiences led him to formulate profound insights about group behaviour, leadership and organizational conflict in the Church, Army and society [12]. Bion wrote:
‘The work group, under the religious vertex, must differentiate between man and god. Institutional religion must make man conscious of this gulf in himself and in the counterparts of himself in the group of which he is a member [13].’
Rezende [14] comm ents: ‘the mystic's problem is not that of wanting to be God but of how to remain at peace in the knowledge that he is not God. The true mystic is the opposite of Narcissus.’
Beyond the consulting room, these psychoanalytic formulations encourage dialogue between psychiatry and the Frankfurt School about rationality and communicative ethics in society [15], and with post-Holocaust moral philosophers such as Emmanuel Levinas [16].
Psychoanalysis and related therapies offer psychiatry a radically different, clinically relevant way of thinking about the ‘empirically obvious’ distinctions which shape our lives: female/male, mind/body, subjective/objective, child/adult, true/false, thought/feeling, reality/fantasy, self/other, individual/social, normal/pathological, and, as Foucault's quote at the beginning of this paper implies, asleep/awake and life/death.
Now, a century after Nietzsche, Browning invites psychiatry to reconsider the human/God distinction. Of course, Browning probably is a pragmatic, optimistic American, whereas Nietzsche, Freud and Foucault were fretful, iconoclastic Europeans. I'd like to see contemporary Australian psychiatry free itself from the stultifying grip of authoritarian scientism and accept Browning's invitation, in either its American or European interpretation (or both!).