Open Door Review

negative instances – when A was not followed by B – which may lead him to question the premise that A is always followed by B. Psychoanalysts are not alone with this problem. All human reasoning is substantially flawed in this regard (Johnson-Laird & Byrne, 1993; Wason & Johnson-Laird, 1972). Even when specifically asked to do so, we are reluctant to recognise the relevance of not observing B following A when evaluating the premise A always follows B. This is referred to as the failure to negate the consequent . We neither observe, nor use in psychoanalytic theory building, the many instances where the patient’s reaction is not as we should anticipate it to be on the basis of a specific premise. To take a deliberately simplistic example, signs of unconscious anger with an ambivalently cathected object are readily identified in cases of depression (Freud, 1915). But what of cases where the inward direction of anger does not appear to lead to depression? If such cases were treated with equal attention as cases where the premise clearly holds, the development of the theory of depression might, just might, have been more orderly. To ask clinicians to pay attention to such negative instances, however, seems to me to be asking them to do something profoundly counter-therapeutic and to be specifying a clinical situation where the therapeutic and research aims can no longer be simultaneously pursued in equal measure. The limitation of human reasoning identified by Wason, Johnson-Laird and their colleagues may be a core limitation on clinical research methodology. "#0!&0<$30%2(0!1)<49)%1#4!):!1647#)2*2<4($7!7)*701(6! As clinical material is used in a limited way by theoreticians who are themselves clinicians, new theories tend to be developed and readily obtain confirmation. Unfortunately this process tends to occur without systematic reference to the old as ‘supplemental’ to the original theory. Thus new ideas have been observed to overlap, rather than replace, the original formulation (Sandler, 1983). This very quickly gives rise to partially incompatible formulations which, nevertheless, need to be employed concurrently. To give just one example, Freud’s move from the topographical to the structural model completely reconfigured the nature and role of an object. As psychoanalysts still needed to talk to their patients about issues conveniently taken up in the context of the topographical model (e.g. dreams, drive fixations) at the same time as wanting to address issues of adaptation and relationships (using ideas derived from structural theory), they were forced to extend the definition of the notion of the object. This strategy was extensively used to deal with the many instances where several partially incompatible or partially applicable frames of reference needed to be used side-by-side (Sandler, 1983). Again, this is neither unusual nor reprehensible. It is the way that human language and, in fact all human conceptual systems, deal with the complexity of the phenomena we require them to signify. Rosch (1978), building on the work of Wittgenstein (1969), termed such fuzzy-edged concepts polymorphous concepts. They cannot be defined by distinctive features (a set of necessary and sufficient features). Rather, examplars of a category are identified in terms of a required level of similarity with a prototype. Thus “chairs” represent such a heterogeneous category that they cannot be defined in terms of either their function, their structure, their constituent properties, their shape etc. For example what do a barstool and an aircraft seat have in common which differs from a seat at a bus stop? Yet most people would identify the first two as chairs, but rarely the third. The problem of psychoanalytic language is in essence no worse than the problem of every day language. What is disappointing is that psychoanalysts have tended to accept the argument that complexity precludes unequivocal definition as an adequate reason for rarely attempting operationalisation and frequently embracing ambiguity. Here I would disagree with Roger Perron who also denies the possibility of unequivocal definitions for our concepts. Yet there can be little doubt that while the same term may be used with very distinct scientific meanings, the tendency for fragmentation will be reinforced since the use of the same term in quite different contexts undermines the possibility of

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