Question. Dr. Hinshelwood first of all, after several weeks, how did you find the reply of the Conference happened in Rome on the 3^rd and 4^th of October, to the theme of your book “Research on the Couch”? And what do you think about the reading given by the Italian psychoanalysts who were present at the Conference?

R.D. Hinshelwood. This is a difficult question because it is so much more difficult to reflect on presentations at a conference – and especially when my work is the focus of interest.  I have various feelings of satisfaction and annoyance, all of which interfere with my ability to fully respond to what is said at the time (and until I see it on paper), and indeed I then remember it in a biased way.  So I think first of all, I cannot give a detailed response and analysis of what was said.  I have only general impressions, and they cannot be very reliable.
My general impressions were two:  First it was extremely kind of the conference organisers and the presenters to spend a day considering my work.  And, moreover, it is not just my work; it is important to me that other people in the psychoanalytic world are interested in the comparative study of psychoanalytic ideas, however painful it is to put our own ideas up for scrutiny in a rigorous and comparative way.  So I am grateful to the organisers and presenters, and indeed to Stefania Marinelli for her translation into Italian of Research on the Couch, and its publication.  I am encouraged that there are other people who do want to address the need for better clinical research, and this is hopeful for the future of psychoanalysis in general.  It would be nice if my book created interest in many other countries – not necessarily to agree with my argument, but to develop more concern about how to do research in the most rigorous way.
My other thought was that it is not so easy to begin to think about research in the clinical setting.  I don’t wish to sound critical, because I understand this difficulty – it took perhaps more than 10 years thinking about the problem that my books addresses before it could be written, revised, and published.  So, I do think it takes a long time to think these issues through.  Thinking generally still, psychoanalysts tend to find criticism of their views a complicated issue.  Of course we do not like our ideas to be scrutinised in a critical way.  But also we are accustomed to dealing with criticism in the clinical situation, where we tend to think of the other person’s motivation – the patient’s motivation in the transference.  Often this moves into our professional world, and we automatically begin to think about our critics (even if they are colleagues) in terms of their unconscious motivation to criticise.
Am I being unfair?  I think there is a lot of reaction amongst psychoanalytic colleagues of this kind – assessing their colleagues motives, rather than their arguments.  There is less discrimination between understanding what colleagues say, and what patients say – and we should be clearer about the discussions we have about research and professional matters, and the discussions we have about someone’s unconscious motives.  This, it seems to me gets in the way and obstructs good professional debate, and it takes a long time for us to be able to make that discrimination and to address the research issue in a way which is not contaminated by addressing issues of motivation.  So there are problems for presenters in the kind of setting that the conference was; in particular, there is the anxiety about their own ideas which may have to be scrutinised, compared, and researched, and an understandable reaction to feeling scrutinised as if it were the scrutiny of a patient.
Well, I don’t know if this is a useful answer to this question.  It is not, unfortunately a detailed reply to the other presenters.  But I hope my attempt to understand why that is a difficult debate for me and for the presenters too, perhaps, could be interesting.

Question. Dr. Hinshelwood, after the debate developed during the Conference, we could say that the scientific way to do research in psychoanalysis points to interpretation as the only tool of the analyst able to verify hypothesis: an interpretation is truly verified if only there was an answer from the unconscious of the patient.
I found that this was a cardinal point of your lecture and should be the benchmark of the daily clinical practice of each psychoanalyst.
So, I would like to ask you in what way regarding to this is it possible to read the importance of maintaining separated transference and countertransference in the work with patients as Freud pointed out in 1918, when he said that an analyst had to reject the risk to turn the patient in his own private property or in who mirrors his Ideals?

Robert D. Hinshelwood. Of course it is true that the analyst should resist making the patient just part of his own private world.  And yet at the same time that is what people do – they construct those they relate to in terms of categories and functions familiar to them in their own life histories.  How is the analyst any different from that?  How could he be different?  This is important.  And it is fundamental not only to my model of research in the psychoanalytic setting, but to psychology in general.
If each person exists in his own world how is it possible for two persons to relate to and engage with other?  In fact,  human beings do.  We are not completely solipsists – unless perhaps we are autistic or psychotic.  Some people are autistic, and we can study the difference  between them and the rest of us.  Something intervenes so that autistic people differ from those of us who do relate in ordinary ways.
The awareness of another mind means we can understand that they are not just viewing us in terms of their own standard categories but are aware of us as having our unique properties, and they recognise us as also aware of their uniqueness.  This reciprocation of other mindedness is sometimes now called ‘mentalisation’, but it is worth  unpacking.  As noted above, we do live in our own world of expectations, but also there is an awareness of the reality of others.  The reality principle also applies to recognising other minds.  Perhaps it especially applies – that is what is at the root of object-relations theory in psychoanalysis, and indeed it is the important gift that object-relations theory adds to the more traditional ego-psychology of Freud.  In recent years of course, the discovery of ‘mirror neurones’ implies that there is a physical scanning system of the brain, capturing other person’s brain activity, and relating to it.
Now, this can in my view be condensed into a fairly simple understanding.  If the patient’s role is to help the analyst understand the patient’s categories and functions for thinking about others; the analyst uses his categories and functions to understand the patients!  In other words, the analyst maybe using his conceptual equipment as background, but his job is to build up a picture of the patient’s conceptual equipment.  So the simple thing to understand from this is that the object of analysis is the patient’s theories rather than the analysts.  I would say that by keeping in mind whose theories are important – the patient’s or the analyst’s – we can give ourselves a good start in avoiding the risk of making the patient just a part of our personal world.  In other words we do not fit patients to out theories – rather the opposite.  When we allow the transference to develop we allow the patient to fit us to his theories.
I think this will resonant through my thoughts about the other questions as well, but I’ll make a couple of further points here.  The temptation, which Freud was concerned about, is that analysts will tend to simply use their categories to fit their patient’s into (rather than the other way around).  He thought of this as wild analysis.  Many analysts used Freud’s ideas in this way simply to categorise patients as if the theories of psychoanalysis were eternal and absolute truth.  Freud, I believe, felt anxious about this, and although he did often promote his ideas as ‘truth’ against the unreasonable opposition, it is clear that at other times he wanted psychoanalysis to be an open system that could allow developments, face questions and contradictions,  and grow in an organic way in relation to practice and  to other scientific results.
This openness requires the ability to set aside one’s theories – and most specifically to set them aside in favour of the patient’s.  The terse, though less than clear, statement that captures this, is ‘abandoning memory and desire’ – that is the analyst’s act of abandonment of his theories and categories.  This admonishment was Bion’s, in his famous 1967 paper, and was in support of what he called ‘reverie’.  Reverie is the intuitive gift of a mother (or other care-giver) to respond to and ‘know’ the baby’s experience, without language and the explicit forms of communication that humans use.  It is implicit, an intuitive being-in-touch with another human.  This intuitive capacity needs to be rescued by the analyst from his theories, and used for his own proper purposes.
In part my model depends on this command by Bion.  The capacity of the analyst for reverie.  This implicit and intuition-based communication is what sets him most closely in line with the patient’s way of constructing others (and of himself, the analyst, of course).  It is this process that give the analyst some chance to put a distance from his own theories and categories, and to reach for the patient’s.  Of course, who is to say if the analyst does successfully give the patient’s theories prioroty – rather than his own?  Well, there is one person, who can say if the analyst succeeds.  That person is of course the patient! – although perhaps not the patient’s conscious mind.  This is a major part of my book – the way the analyst may allow himself to ‘read’ the confirmation (or otherwise) that the patient’s unconscious gives.

Question. The debate developed around the issue of your book and your aim to propose a logic model, has invoked a primordial matter about what is the field of psychoanalysis. Freud failed his Project in 1895 and then there were many different thoughts about psychoanalysis and its connections with human sciences but what seems has been lost during this century is the awareness about the only condition that made psychoanalysis and its discovery possible: language and its rules.
Don’t you think that a return to the unconscious’ discovery and on how it happened could make clear the range in which the question- “Could psychoanalysis be considered a science?”-, has reason to exist for us?

Robert D. Hinshelwood. Yes, something does get lost of the true nature of psychoanalysis, I think.  And Freud very quickly realised that  his science in his 1895 Project was pseudo-science, and he made efforts to suppress it.  At the same time to the end of his life he claimed psychoanalysis to be a science ‘like any other’.   The problem is to ask, and answer, how like other sciences?  And in what respect is psychoanalysis like other sciences.  This, Freud did not adequately discuss, taking it for granted that everyone knew what science was.  However, in fact the nature of science was changing throughout the 20^thCentury, partly in response to relativity and quantum theory.  And actually, philosophers in Vienna were particularly active in revising what science is.  If psychoanalysis aims to be a science, then the aim is a moving target.  My work on psychoanalytic research tries to address this issue, coming to the conclusion it is better to characterise the nature of psychoanalytic research in its own terms.  And to forgot the attempt to chase after other sciences in imitation, or to pick up the choicest of the droppings of other sciences. It seemed to me that the core of psychoanalytic work, and therefore the research we wish to do is concerned with the way a person engages with another – as sketched in the answer to the previous question.  This kind of engagement between minds can only be researched by an act of engagement itself – the relating of the two persons of analyst and patient.  And the core of that engagement is the experiences that each have of the other as they are allowed to impinge on each other.  But alternatively, they may impinge by clashing over whose theories shall prevail, and reduce themselves to swapping theories.
About language…this is a complicated topic in my view. The nature of language does indeed need to be explored more by psychoanalysts. It is taken, after Freud’s discovery of the meaning of dreams, to be a simple system of meanings, but this does indeed seem simplified. The role of language is complex, and its connection with other communication systems obscure.
The manner by which one mind effects another has many modes and indeed functions.  As mentioned above there is a direct, non-verbal impingement of expectations and experiences of the other. But the verbal and linguistic mode is important. It is semiotic and requires a community of people to agree the rules of syntax, and vocabulary, between them. Thus a language is an entry into a social community, but it is a bargain; joining a language community implies accepting the explicit but also implicit assumptions, constructions, and prejudices of that community.
I guess, Sabrina, that this is the importance you are indicating – the imposition of the semiotic system on the emerging personality of the language learner.
The external world gets as it were into the person in an active way, and appears to be in contrast to perceptions which have a more passive existence.  However this is a contested position.  As described above, the non-verbal communicative aspects of relating to other minds has an active quality. The intuitive process engages and activates the other in some more direct sense; and each of the two minds – subject and object – allow this activating process to occur. Of course, there are social pressures and constraints that surround and inhabit these intuitive processes.  But the engagement is primarily with the other mind and its experiences, however much the social influences act to constraint, to form, to liberate or oppress.
I am now become rather abstract in my attempts to keep us in the more concrete world of direct influences as opposed to semiotically systematised ones.  But there are a couple more points to make about the ways in which other minds, individually through intuition, or collectively through semiotic systems engage. And this is especially important in trying accurately to place the role of language. If there is a social and interpersonal role for language as a means for communicating systematically with others, there is also an internal role for language.  In other words, language is implicated in the infant’s ability to make sense of his world, probably from around the beginning of the second year of life – at least that is when language as an external communication appears to begin.
Internal communication and the subject’s ability to make sense and to represent his world for himself, depends on language as well as external communication with others – Freud knew this from early on, when he wrote his treatise on aphasia (in 1891).
Language has multiple roles.  Not just a means of communication with other minds, but the internal capacity to represent meaningfully within oneself. And then in addition to that, the capacity to communicate to others the internal meanings that are represented.
This internal presence (or representation) of something not actually present is important, and was important to Freud. It comes from Freud’s philosophy teacher, Franz Brentano – the internal existence of a representation of something not actually present in the world, was called ‘inexistence’ by Brentano. It is the uniqueness of the human being to be able to communicate to other minds that which does not exist in reality (it ‘inexists’ in the mind). Language is the unique tool that can point to these inner representations, just as pointing with one’s finger, points to those things that exist externally.  In fact, human beings are the only animal that can point, and the activity of pointing with the finger emerges at exactly the same moment in development as the beginnings of language – around 12 months of age. The importance of language goes much further than Freud’s idea of an object-presentation being composed of a fusion of a thing-presentation with a word-presentation; and in my view goes beyond the understanding of how social meanings get ‘inside’ the mind.  It has a role in the capacity to make representations at all.
Well, I have been provoked a lot by your question about language, haven’t I?  It is something I have been thinking about recently; and I am trying to make my thoughts public and coherent for the first time.

Question. I would like to conclude the Second Part of our Interview, asking to you what is your opinion about the recent interest of psychoanalysis in the possibility to develop a research “out” the reality of the couch’s room?
I’m thinking to the most frequent use of Skype as an alternative way of being present but which places a question that we have to cope:
Where psychoanalysis is going to put the place and the space given to the bodies, to the importance of being present each one with his own body in a work on sufferance?

Robert D. Hinshelwood. The new electronic forms of communication – even in real time – present us with the possibility of the engagement of minds without the proximity of bodies.
For many analysts, their body is a clue to their feelings, and their unconscious feelings in particular.  It has been a puzzle throughout the history of psychoanalysis that the unconscious of two minds can make direct contact, or communication, between them.  At the time when Freud was formulating this – he said the analyst ‘must turn his own unconscious like a receptive organ towards the transmitting unconscious of the patient’ (Freud 1912 ‘Recommendations’, p. 115) – he took an interest, with Ferenczi’s encouragement, in spiritualist seances, and the notion of ‘thought transference’.  But he did not think this solved the problem for him.  Since then we have had a century of psychological research including the emergence of the idea of non-verbal communication.  And this sits quite well with the concept of projective identification in which one mind has a direct influence on another without words.  There is no doubt that we communicate with each other without words, and this must of course be the initial form of communication before infants learn language.  When a baby cries, the mother feels alarm, and she may even feel it in a visceral, bodily way, as a physical disturbance in the tummy for instance.  Emotions are often described in terms of bodily feelings – in English we talk of ‘butterflies in the stomach’, meaning feeling anxious, or a lump in the throat, when we want to cry.  In fact humans are the only animal that cries.  Emotional states and bodily states are closely connected.
So there must be a real question whether this route for communication still exists for one unconscious to be in contact with another when using electronic media.  In principle, there is no reason why empathic reactions, like feeling sad for one’s patient, or angry with him, should not carry over via skype. But in practice, does it still work?  I have to say that I have little experience in this electronic form of analysis or therapy, and cannot say how it works in practice. I can only raise a couple of theoretical questions.
First is the curious fact that the purpose of skype it to allow visual perceptions of each other, but the ordinary psychoanalytic setting avoids eye contact, and the patient does not see their analyst at all.  How should the skype setting be arranged so that it preserves the essential characteristics of the traditional setting? And that provokes the question: What are the essential ingredients of the analytic setting which need to be preserved?
I have not done research on what ingredients are required. However, we know that Freud himself requested patient’s to lie on the couch because he was uncomfortable with being looked at so relentlessly on a daily basis. He felt exposed. It suggests a particular concern about being looked at, and indeed looked into, as if there is a particular penetration that can potentially occur in the analytic setting. This is perhaps an important issue to recognise – the potential for an intrusive kind of intimacy.
Especially with Freud’s suspicion of the analyst’s feelings, countertransference, he wished to remain a ‘blank screen’, as if entirely neutral.  That suspicion and his wish to avoid an emotional exposure suggests he was in fact aware of the patient’s disturbing ability to arouse the analyst’s feelings at will.        For much of the history of psychoanalysis this suspicion has been of considerable concern, but we can wonder if there is the same risk if the two parties are not physically in each other’s presence.  The temptation for physical seduction, one by the other, is perhaps considerably reduced.  Moreover, there is today a sense that countertransference is not merely a threat, but can be carefully used to help understand the patient’s transference.  There may therefore be a case for the particular threat of exposure to be considerably reduced in a skyped session.  And therefore we may possibly relax the strict criterion against visual contact.
Arising from this is a further interesting point.  The essential purpose of the setting is to maximise the development of unconscious aspects of the patient’s personality.  We know too, from the prevalence of unconscious-to-unconscious communications, that this is a very sensitive interaction, and requires us, as analysts, to observe the effects on us unconsciously.  Freud’s suspicion of countertransference was an attempt to avoid the pitfalls and mistakes that come from countertransference – including unprofessional transgressions – but the benefits are now regarded as outweighing those pitfalls.  Proximity, and the opportunity to be affected by the slightest indications coming from the patient’s demeanour and movements, is a seriously important form of observation for the science of subjectivities.  We might need to know, therefore, how much that sensitivity of the analyst is numbed by the virtual distance of the skyping system.  This can only be discovered by formal research perhaps.  It might entail the assessment of the correctness of interpretations made on the basis of countertransference experiences, by comparing the tradition setting with the skype setting.
Finally, psychoanalysis works by making some interactive possibilities between the unconscious-to-unconscious level of communication and semiotic systems of communication imposed from outside the individual – the relation perhaps between the real and the symbolic. This is mediated most often by the use of bodily levels of phantasy – especially the phantasies of eating, shitting/peeing, and sex.  Then there is the question whether such phantasies are just as much present even with the virtual system of skype – or is it diminished?  It is probable that the primal narratives of body function are more available where bodies are closer.  If that were the case, then the virtual distancing would be an obstruction to the refinement and elaboration of unconscious-to-unconscious.  However, this again requires some research; the occurrences of body phantasies in dreams, or even perhaps in conscious phantasy, could be compared quantitatively between the traditional and the skype settings.
I guess that your questions led me into speculative thoughts about the psychoanalytic process.  Speculation is not necessarily bad provided it is tempered by more formal investigations to check the speculations in the reality of actual practice.  Once again thank you for the challenging questions which make me consider many things, and try to reach levels that point to new thoughts.  Many thanks.