The surgical metaphor

I cannot advise my colleagues too urgently to model themselves during psychoanalytic treatment on the surgeon, who puts aside all feelings ... (Freud, 1912, p. 115)

Consistent with his topographical model and archaeological stance, Freud believed in the essential exteriority of the analyst (of which, sitting behind the couch might be seen as an expression), who carries out treatment "in abstinence" (this idea being based on the instinct model). His recommendation in 1912 was that the analyst "Should be opaque to his patients and, like a mirror, show them nothing but what is shown to them" (1912, p. 118). The classical theme of surgical detachment was consistent with Freud's identification with the scientist who bases his approach on objective treatment.

In this model, with its vertical perspective, the authority of the analyst is enshrined. Although we have little direct sense of how Freud worked in practice (and he certainly did not advocate coldness), the tone of writing and interpreting in his case studies often appears as one of "explanation", "pointing out", "demonstrating to". Foulkes (1975a) comments on the term Deutung and suggests that the interpreter in the

Freudian conception has "a specific knowledge . by no means open to everyone, but only to the select few who have been initiated on the strength of a quite peculiar ability" (p. 114). Foulkes' (1964) reference (see quotation at start of chapter) to the importance of incompletion and values of non-closure, typifies a stance (in theory) of hermeneutic openness. The contrast to this is characterised by Arlow (1995) as the tradition of "stilted listening" in psychoanalysis, with implications of infallibility, or at least of an incremental notion of the truth, with the good analyst in an increasing relationship of truth to his patient. From the early phase onwards, dissenters begged to differ, and analysts, such as Ferenczi, found themselves in increasing trouble with "loyal" analysts.

The surgical metaphor, then, is tied up with the power of the physician (the early generation of analysts were all physicians, and Freud uses the terms interchangeably). The historical context in which this occurs is important, a culture which enshrined a strict hierarchy and elevated the authority of the physician over the patient. In the early phase of psychoanalysis, and often since, there was simply no acknowledgement of the socially constituted nature and location of analytic authority and the analytic dyad.

On history and the psychoanalytic movement

This is not psychoanalysis ... (Freud, quoted in Eisold, 1997, p. 97)

The history of the psychoanalytic movement is of considerable interest to the student of intersubjectivity and group analysis. I have suggested some parallel between some of the theoretical concepts and metaphors of psychoanalysis, such as archaeology and surgery, and Freud's stance as the leader of the movement he founded. As with all movements, we see the creation of "foundation" myths, legendary aspects through which the ideas and individuals involved are seen. Perhaps in Freud's own preferred myth of isolation and resistance around his discoveries, he comes close to identifying with his boyhood idol, Hannibal, who challenged an empire and conquered Rome. Sterba (1982), in his fascinating recollections of the early Viennese days, talks about the analysts, like himself, as a group of exceptional, "gebildete" people, individuals who are well-educated, able to speak languages, and are familiar with high culture, literature, and art—and, of course, in this regard, "Sigmund Freud was above us all" (p. 87).

In the early years, with the creation in Freud's flat of the "Wednesday Evening Society", the early psychoanalytic ethos was reflected in some aspects of the proceedings. Kanzer (1983) observes, for example, that, "Freud always presided, so that a distance was established between himself and his followers" and that following presentations he "alone had the privilege of intervening at will" (p. 8).

The relationship of Freud to the psychoanalytic movement that unfolded, and to the organisational structures devised, is a complicated one and we know that in many ways Freud was a reluctant leader. With the creation, in 1910, of the International Psychoanalytic Association, a complex co-relationship existed between Freud and those to whom he turned to safeguard and to continue the enterprise of psychoanalysis. Eisold's (1997) fascinating research suggests that Freud gravitated towards becoming, in Bions terms, a "fight leader", with himself and his Viennese followers needing a culture of allegiance (the members being still dependent on Freud) as well as needing to promote the professional aspirations of the membership. An "unconscious pact" resulted, argues Eisold, "in which they sought and rooted out "enemies" within the movement ... who questioned his basic concept of childhood sexuality and would lend support to the external enemies of psychoanalysis" (p. 87). This can be linked to the notion of resistance to psychoanalysis from outside and from within.

The notion of "orthodoxy" is an important one in understanding the behaviour of groups. Who has the power to sanction orthodoxy, and what is the shibboleth distinguishing the adherents of a movement from its opponents? (Roustang, 1980). Using an intersubjectivist viewpoint, how might we understand the selfobject needs of the members of a movement or emergent orthodoxy? In many ways, the fledgling or fragile movement reflects the fragile self; for example, Freud's own anxieties about what he had discovered, the dependence of his colleagues on his support, his dependence on friendly allies, and a host of other narcissistic needs: for recognition and admiration and for the consolidation in this first generation of analysts of a new "analytic identity" (Bergmann, 1997).

 
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