Abstract
Psychoanalysis and the therapies which derive from it infer latent meanings and causes to clinical data. This book deals with the uncertainties in making those inferences. It focuses on the earliest phases of interpretation, the methods of seeking, construing, formulating and justifying latent meanings and determinants.
Chapter 1 looks at the source of the trouble, where Freud's positivist preferences for pure observation, objectivity and certainty contributed to his ambivalence towards interpretive methods. This first section discusses how he attempted to deal with the methodologic conflicts.
The next chapter continues the historical background in a detailed review of logical positivism and the post-positivist turn in both philosophy and the conduct of science. The post-positivist approach resulted in greater acceptance of interpretive methods. A balanced, middle ground between the extremes of absolute certainty of logical positivism and absolute relativism of ‘anything goes’ was required. Post-positivism recognised that science builds upon the best beliefs available, while leaving all aspects of those beliefs open to revision or rejection.
Next follow two chapters on the contemporary approaches. Chapter 3 looks at the ‘methodologic lag’ where some positivist features continue in contemporary models of interpretive inquiry. In particular these are:
Monistic and method-oriented approaches, such as Kohut's insistence that empathy is the only useful method of understanding latent mental contents; Doctrinal or theory-driven approaches, such as a Kleinian methodology of interpretive inquiry, which, by imposing preconceived meanings and determinants on productions, may take away spontaneity of interpretation as occur in data-driven approaches; Overconfident and dogmatic attitudes towards interpretations, rather than sceptical and error correcting approaches.
Chapter 4 extends the discussion by looking at language-based models of interpretive inquiry. Freud suggested a number of relationships between interpretive methodology and language. Lacan believed he discovered something law-like and universal, and claimed there was no mental structure except that of language. However, he failed to recognise the limitations of language as a model of mind and in reformulating Freud's theories severely limited them. Among other topics covered in this chapter are the narrative models, which are overly concerned with coherence at the expense of interpretive accuracy. While the chapter is a critique of language models, it also helps find what they contribute to a flexible model of interpretive methodology.
The next two chapters study interpretive procedures in non-clinical fields to learn more about the nature, problems and possibilities of improving the methodology of clinical interpretation. Disciplines reviewed include (i) relation- and pattern-oriented methodologies, including gestalt psychology, system theory and hermeneutics; (ii) language-related disciplines, including linguistics, semiotics, literary theory and criticism and archaeological decipherment; (iii) cognitive science, including cognitive psychology, information theory, computational model of the mind and artificial intelligence; and (iv) common-sense psychology which attempts to explain the particular, which is consonant with an idiographic method such as psychoanalysis. This last moves into a discussion of intentionality, the ‘object-directedness’ of the mental.
Justifying interpretations is covered in chapters 7 to 9 and this section begins with the philosopher of science Adolf Grunbaum's philosophical critique of psychoanalysis and its interpretive methodology. The author sets out Grunbaum's 10 major arguments and highlights where they are useful and where they are not applicable to psychoanalysis. Counter arguments are mounted.
Chapter 8 focuses on a number of challenging questions about whether interpretations must be justified; whether they can be justified and, if so, can they be justified intraclinically, and the problems with clinical evidence. Then follows a long list of methods of justifying interpretations and their relative probity.
In the next section Rubovits-Seitz gives an illustration of the ‘recurrent cycles’ (RC) methodology in which a case is studied post-treatment. A traditional case report is given and then the RC approach applied to the material. The final chapter looks at the problems and progress in the methodology of clinical interpretation.
This book is a scholarly tome with sources meticulously quoted. The author works as a synthesiser, bringing together a wide range of sources. He casts a challenging eye over what psychoanalysis seeks to do. He turns his analytic investigative skill onto how interpretations are developed. The subject of the book is the philosophical underpinnings.
Rubovits-Seitz takes on a question, a belief or approach and responds to it by surveying the leading thinkers of the century. It is a gathering together of many views. The references occupy 100 pages, and there is a detailed author and subject index.
The language is scientific and demands time, thought and effort of the reader. While it is written for a reader familiar with philosophy, it is not out of reach of those without such a grounding. The subsections are easy enough to follow and the clinician can enrich the reading, if clinical vignettes come to mind, to fully grasp how the theories fit with everyday experience. Learning in a relatively narrow field of medicine and psychiatry, we are often not aware of how much we borrow from other fields, much in the way orthopaedics borrows from carpentry, engineering and mechanics.
The book deals with the philosophic positions taken by various theories and methods, the generalities about human beings and ways of understanding them, rather than the unique one-on-one study in the consulting room. While psychoanalysis deals with the forces in the individual's unconscious, this book is on a different level. It is highly conscious, cerebral and logical in trying to determine the best way to measure those matters of the unconscious, namely mental productions and the interpretation of their meanings.
This book educates about philosophical questions relevant to psychoanalytic theories and clinical interpretations. For the clinician, knowledge of interpretive methodology can reduce errors by increasing understanding of, and confidence in, what he is doing, and learning the limitations and avoiding the pitfalls of interpretive work.