Identity or Regression in
American Psychoanalysis?
ROY R.
Introduction
I N MAY 1964, Dr. Maxwell Gitelson ad¬
dressed The American Psychoanalytic Associa¬
tion on the subject of "The Identity Crisis in
Psychoanalysis" and very soon thereafter his
paper was published in the Journal of the
American Psychoanalytic Association.1 It is
concerned with the formal relations between
psychoanalysis on the one hand and psychiatry,
psychodynamics, and psychodynamic therapy on
the other. As Rado et al2 have stated before,
what happens in the psychoanalytic field and in
its official societies and, as well, the pronounce¬
ments of its spokesmen are still of some sig¬
nificance to American psychiatry. Much of what
Gitelson writes has been said before, by him¬
self 4 as well. Nevertheless his current recom¬
mendations are so at variance with the goals and
standards of psychiatry and psychoanalysis that
these recommendations, if nothing else, require
answering.
In the body of the paper the word "debate"
is used several times, but it is not explicit whom
Gitelson is debating or challenging to debate.
This in spite of his previous statement: "It
would seem that the wisest procedure would be
to avoid outright debate or other open encoun¬
ter with the organized proponents of so-called
liberalism." It may be assumed, since he criti¬
cally quotes and misrepresents the meanings of
my writings, that he is debating with me3 al¬
though he avoids using my name except in the
bibliography. It is, therefore, incumbent upon
me to answer on behalf of psychiatry the
statements made by an individual who as¬
sumes spokesmanship for International Psycho¬
analysis.
Submitted for publication Nov 11, 1964.
Renrint requests to 29th St and Ellis Ave,
111 60616.
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GRINKER, SR, MD, CHICAGO
In this "debate" I shall orient my discussion
as closely as possible, but not exactly, to Gitel-
son's format and, therefore, divide it in accord¬
ance with the numerical system he uses. I must
apologize for the frequent use of quotations
from my own writings in order to correct Gitel-
son's distortions.
In this section Gitelson quotes Schilling 5 to
the effect that science has the qualities of a so¬
cial enterprise in that it involves interaction,
cooperation, and sharing—". its own creeds
. .
and beliefs, orthodoxies and heresies. . ." Al¬
.
though Schilling wrote about physics, Gitelson
states he could be talking about the psychoana¬
lytic "movement."
Despite the recognized interdigitation be¬
tween science and culture, Gitelson wrote else¬
where °: "Adaptation to a culture has no place
in psychoanalysis which needs to be free of the
gravitational pull of a specific culture." He also
lamented that teaching and education in psycho¬
analysis have not been "authoritarian" enough
and implicitly advised intensification of the pol¬
icy of dogma and self-serving regimentation.2·6
There seems to be no doubt according to the
historians of science 10 that the nature of the
contemporary culture and society, the social dis¬
tresses, conflicts, and ways of viewing the
world—the Zeitgeist—contribute to the appear¬
ance of men of greatness and their closely-knit
interacting colleagues. Science is closely related
with' its cultural environment because it is a
study of interbehaviors (Kantor u).
According to Mead 12 : "The most distinctive
characteristic of an evolutionary cluster is the
presence in it of at least one irreplaceable indi¬
vidual, someone with such special gifts and
imagination and thought that without him the
Chicago, cluster would assume an entirely different char¬
acter." This kind of person is called a genius.
 But "the effectiveness of a genius appears to be
highly dependent only
not the state of the
on
culture and the period in which such an indi¬
vidual is born but also on the exact position in
the social structure which he occupies and the
exact composition of the cooperative face-to-
face group within which he acts."
One can hardly imagine a psychoanalysis,
which furnishes the raw data of psychoanalytic
science, without the analyst living as an ade¬
quate and integral part of his contemporary
society, culture, and reality in order to under¬
stand the patient and to help him unlearn his
neurotic and unrealistic patterns of living. Cer¬
tainly the process of analysis cannot be con¬
ducted in gravitationally free outer space, nor
can intrapsychic processes be understood apart
from behavior in life.
Early in its development a science organizes
for action against inertia and resistance within
the cultural environment. Faith in the "great
man" is the impetus for the beginning of a
"movement." It is also responsible for exclu¬
sion of nonbelievers, as Freud's Vienna group
forced him to do to some members of the Swiss
psychoanalytic society, over Bleuler's protests,
and which caused that great psychiatrist to
withdraw his support of the psychoanalytic
movement.13 It is responsible for Freud's writ¬
ing to Ferenczi not to be troubled with other
theories for, "We possess the truth." 14 It is
questionable whether any other young science
even as an early movement was as cultist, as
self-contained, and as mystically oriented.
Granted that the psychoanalytic "movement"
was a of development, it would be ex¬
phase
pected by now that these characteristics would
have been outgrown especially in view of the
wide acceptance of psychoanalysis in the United
States. But even today some societies do what
Bleuler objected to—at times exclude nonmem-
bers from its scientific meetings. Or, as Mead 12
states :
. the methods of Freudian analysis have been
preserved
.
and transmitted in an apprenticeship situ¬
.
ation, but expensively, by the establishment of a cult
atmosphere and with a very low level of communica¬
tion between the psychoanalytic theoretician and the
rest of the human sciences.
Those like Gitelson who advise continued iso¬
lation and more withdrawal are said to fear
emotional opposition from their nonanalytic
professional environments. To the contrary,
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my observations indicate that there is less re¬
sistance from nonanalysts but more valid scien¬
tific criticism from within by some progressive
analysts and pressure for more communication
and cooperative research with representatives
of other sciences. The qualities of a social en¬
terprise need to be revived and intensified rather
than suppressed.
Unfortunately the opposing withdrawal and
"movement" qualities are most evidenced in the
training institutes where they do most harm.
Questioning, doubting, and critical discussion
by students with curiosity are often silenced
with explicit and implicit threats that this repre¬
sents nonconformity, "return of the repressed,"
and indicates a need for "more analysis."
II
In my paper which Gitelson criticized
3
by
means of distortions I wrote:
Our current view of the world of man and his
problems is under the influence of the revolution be¬
gun by Freud. His paradigms have been applied to
psychosomatic, psychiatric, social, cultural, and educa¬
tional approaches. Many hitches, however, have been
observed in the last decade, and increasing evidences
of rigidity are at hand. Stereotypes are rampant, theory
is reiterated, and proof is attributed to repetition of
hypotheses.
But a revolution or what we call a "breakthrough"
has not yet appeared. Where and how will this occur?
As members of a contemporary scientific culture
bound to our paradigms, we cannot predict when and
how a view of man's problems in humanness will
appear. Perhaps it has already begun and is not recog¬
nized. All we can say is that some of us know that
it is overdue.
If, however,
.
we continue to believe unlike
. .
Kuhn 1ß that progress is slow and moves by ac¬
cumulation of verified knowledge, we then
should be convinced that thorough grounding
in contemporary science is necessary for prog¬
ress. Then we should modify our
concepts of
teaching in every field related to human behav¬
ior. Broad education must take the place of
narrow technical training.
If we consider the final physical evolution of man as
a resultant of countless mutations and slow natural
selection, appropriate analogies may be made between
genetic mutations and scientific revolutions or genera¬
tive ideas (Langer17) and between natural selection and
the rigorous scientific testing of hypotheses.
Other than a scientific revolution, which is unpre¬
dictable, our only current alternative, if we do not
choose to fall back on philosophy or the supernatural,
 is to educate disciplined investigators who are com¬
mitted to rigorous testing and searching.
Kuhn believes that a science which has passed
through its preliminary phases of observation
and description and becomes systematically or¬
dered develops a paradigm which defines the
problems and methods used to solve them. Then
follows a period of "normal science" which per¬
sists until something goes wrong and novelty
emerges again to create a new paradigm by
revolution. According to Kuhn normal science
often suppresses fundamental novelties because
they are necessarily subversive of its basic com¬
mitment. Some scientists do not aim to develop
new theories and are often intolerant of those
invented by others. The paradigm must account
for everything. Through an esoteric vocabulary
and ultrarefinement of concepts there is less
resemblance to common sense. The scientists'
vision is restricted, and resistance to change in
the paradigm increases. Then something hap¬
pens and novelty emerges again and the resist¬
ance increases; hence anomalies stand out more
strikingly and prepare the way for change.
Paradoxical new findings result in support¬
ing splintered movements, but I do not believe
that these are necessarily antagonistic to each
other. Putting aside the Jungian and Adlerian
psychology, the schisms in modern psychoana¬
lytic societies have been precipitated over dis¬
agreements about methods and contents of
training. In my opinion the splintering within
the American Psychoanalytic Association has
centered around liberality and conservatism
(orthodoxy) in the training program. The neo-
freudians emphasized social factors in the
causal matrix of neuroses and the Academy of
Psychoanalysis is not a new movement but an
attempt to furnish a more liberal * forum for
any psychoanalytic or related research. These
then are not based on paradoxical new findings
but are evidences that the freuclian paradigm
is not viewed by every analyst as entirely
crystallized.
Unfortunately one cannot speak of explicit
psychoanalytic theory unless it is dated, since
* Gitelson views liberalism destructive and like a
as
true reactionary casts aspersious on "liberalization"
whereas Webster's dictionary defines "liberal" as free,
not literal or restricted, not narrow or bigoted, and
favoring reform or progress and greater freedom of
thought or action.
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theory and modifications are interspersed with
reaffirmations of old concepts, confused by
metaphors and circular reasoning, and embodied
in poetic literary style; out of this conglomera¬
tion, it is difficult to develop precise declarative
sentences suitable for the development of test¬
able hypothesis.18 In fact, it is difficult to for¬
mulate the "essence" of psychoanalytic theory,
even if one uses Freud's four contingencies of :
unconscious mental processes, resistance and
repression, sexuality, and the Oedipus conflict.
Gitelson states:
Though currently there has appeared an inclina¬
tion to invalidate even these (basic science of psycho-
dynamics and its offspring, dynamic psychiatry and
psychotherapy) ; nevertheless they require our atten¬
tion since they are the basis for the view—though not
stated in these terms—that a scientific revolution is in
process in psychoanalysis.
Actually I wrote :
Unfortunately contemporary psychiatry has almost
completely adopted the psychoanalytic or psychody-
namic model. Psychodynamics is purported to be
the basic science of psychiatry. It is frequently stated
and written that the core process in psychiatry is a
dyadic "depth" relationship in which diagnosis, prog¬
nosis, therapy, and research are processed. There is no
need to differentiate whether so-called "depth" is
achieved with reference
to psychoanalytic, transac¬
tional, or information theory; the basic technique is
utilized by a participant-observer of uncertain relia¬
bility.
Gitelson states:
There is an inclination to declare the existing psy¬
choanalytic paradigm defunct or rapidly expiring.
I actually wrote:
The professional view held by psychiatrists is today
mixed and confused. Psychoanalysis, for which many
have sacrificed so much, has not become the thera¬
peutic answer ; it seems to be mired in a theoretical
rut vigilantly guarded by the orthodox and,
except
for relatively few examples, prevented from commin¬
gling with science. The great breakthrough promised by
the modern psychosomatic approach, with its con¬
cepts of specificity of psychological etiology of de¬
generative diseases, has succumbed to the hard facts
of multiple causation and critical phases of develop¬
ment. Small wonder that with these disappointments a
fertile soil has been created for new therapies—
pharmacological, psychological and social—each one
rapidly exploited as a panacea.
Gitelson states:
psychoanalysis, though actually operating as
.
"normal science," has been declared bankrupt ;
. .
a new
synthesis which will clarify everything is thought to
be already here or visible on the horizon.
I wrote :
In my opinion we should approach living human
beings as if they existed in a total field of multiple
 transactions without connotations of significance,
hierarchical importance, or conceptual devices called
levels. Thereby we avoid the dichotomies of nature vs
nurture, organic vs functional, lower vs higher, or
reduction vs extension. Furthermore, we can opera¬
tionally behave in dealing with multivariable problems
as if we really believed in multicausality of both
healthy and disordered function. This is transactiona-
lism in a total field whose constituents range from
physicochemical to symbolic foci.
Ill
Gitelson contends that psychoanalysis was no
longer a movement but had reached the stage of
"normal science" by the time the European po¬
litical chaos forced many analysts to migrate to
the United States. Here they met another
"movement" which latched on to psycho¬
analysis:
For it the wishful humanism of the Mental
was
Hygiene Movement and the need for a scientific
foundation by a psychiatry whose barrenness dimin¬
ished its professional stature which, together pro¬
jected on psychoanalysis their own extravagant social
hopes and ambitions, and fell in love with the image.
This statement, poetic though it may sound,
unfortunately is not
historically correct. The
early migrating analysts in the 1930's were not
readily accepted by American psychiatry; they
came with no cohesive paradigm but struggled
bitterly against each other and the early Ameri¬
can students who had returned from abroad,
and as Europeans attempted and succeeded for
a time to concentrate organizational power in
their own hands. Clinical practice was difficult
to obtain, fees were low, and students scarce.
Actually American psychiatry became imbued
with interest and gradual acceptance of psycho¬
analysis, except for the early efforts in New
York and Boston, during and after World War
II. Profound social, economic, and emotional
upheaval led the public to search for the security
it could not find in disorganized family life, in
religion, or government. The new psychology
seemed a hope as long as the rampant free anx¬
ieties were attributed to past experiences (ge¬
netic factors) yielding current internal conflicts
(dynamic). On the other hand the neofreudians
ascribed more external or social causes to the
anxieties, and finally the existentialists entered
with an old philosophical concept of anxiety to
which they applied therapeutic techniques
which are difficult to understand.
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In the meantime during the war many Ameri¬
can psychoanalysts treated war neuroses and
taught countless general medical officers using
psychoanalytic theoretical constructs. The re¬
sult was a rapidly increasing interest in psycho¬
analytic training. Psychosomatic approaches
based on psychoanalytic theory and psycho¬
analytic treatment became household words.
The intelligent public clamored for treatment,
and young psychiatrists pounded on the doors
of training institutes to become "first-class
citizens."
Although our experiences which were so salu¬
tary during the war did not include actual psy¬
choanalytic techniques, our post-war work and
our teaching as typified by that at Michael
Reese Hospital and other new major psychiat¬
ric training centers were largely based on psy¬
choanalytic theory which has acquired the
euphemism "psychodynamic theory." Because
of this and other related factors, students en¬
tered into the specialty of psychiatry with the
goal of becoming analysts. These two fields
were so interlocked in our own minds that we
originally chose our psychiatric residents simul¬
taneously with our local analytic institute, and
a resident entering
training was, therefore, a
preliminary candidate for psychoanalytic train¬
ing. In those days, then, we graduated people
who we hoped were general psychiatrists but
who became analysts and restricted their pri¬
vate activities, as many graduate analysts do, to
the office practice of psychoanalysis. However,
many of them also remained on our staff as
teachers in the role of supervisors of residents'
psychotherapy in a one-to-one relationship. As
a result, the pedagogical
point of view not only
maintained its psychodynamic purity but in¬
creased in intensity to the relative exclusion of
consideration of other forms of treatment.
Many analysts who ascribe to the separateness
of psychoanalysis from psychotherapy are the
same people who teach and supervise psycho¬
therapy as if it were a modified form of psycho¬
analysis. We, like so many other institutions,
became recognized as proponents of psycho¬
analytic psychiatry.
We have realized for some time that limita¬
tion of the psychoanalytic point of view and
that the rigidity and the circumscribed nature
of a training program based exclusively on in¬
ternal dynamics, conflicted with out attempt to
 develop teachers and investigators and seri¬ Indeed psychiatry is not barren, but it lacks
ously impeded our attempts to add the teaching a unified theory although some have been sug¬
of milieu therapy, group therapy, family dy¬ gested.20 But where is such a unified theory to
namics, family therapy, basic principles of bi¬ be found ? Psychoanalysis is in no better shape,
ology including genetics, and social psychiatry although some contend it has a unified theory
to the training program. It was not that we capable of explaining all of psychological life
wished to dismiss psychodynamic principles nor and all of behavior. Its theories are precisely
reject psychotherapy based on these principles. focused on intrapsychic processes—they cannot
We did, however, desire to add to the sum total be applied in toto to constitution, biogenetics,
of knowledge, basic principles of an extended learning, society, culture, or reality at large, all
and expanded psychiatric field without sacrific¬ components of an extended field of which intra¬
ing the dynamic point of view. Indeed this psychic processes are but a part.
created resistances of an almost insurmountable
nature and brought us into a struggle for what IV
I should call, for want of a better name, Gitelson criticized the wide variety of names
eclecticism.19 related to, but not standing for, psychoanalysis
It is not the group of analysts who were edu¬ including "interpersonal" and "transactional,"
cated since the war who are disappointed in the meaning of which he obviously does not
the therapeutic efficacy of psychoanalysis—it is understand. He contends that their only sub¬
the older group which is disillusioned, as was stance "is to be found in the survival in them
Freud himself, and they are not the ones who of the pale shadow of existing psychoanalytic
openly question psychoanalytic theory. Criticism concepts." Animal experimentation, says Gitel¬
arises from the more scientific sophisticated son, is the degradation of the problem of the
group within the psychoanalytic organization human mind, and derivative psychotherapies
(cf later). Yet here Gitelson makes his first represent insufficient sensitiveness to the mean¬
gratuitous psychoanalytic interpretation which ing of unconscious processes. Then Lustman 21
has no place in a rational debate. "None of us is quoted to the effect that critics represent anti-
can say that we are not disillusioned. Unfor¬ theoretical 19th century criteria of science.
tunately many have also been bitterly disap¬ This is leading some research analysts to abandon
pointed. The difference is between insight and the analytic method for the comparative methodological
transference reaction." Those who criticize safety of laboratory research. Experimental sophis¬
.

have transference reactions, and in the next tication and scientific sophistication are not synon¬
. .

ymous. It prevents or should prevent analysts from

section he says: "Paradoxically, but not in¬
comprehensible to psychoanalysts, the child has
turned against the father while accepting its
birthright."
There can be question that psychoanalysis
no
has its own paradigm which is but a part of total
psychiatry. Psychoanalysis, as long as it in¬
volves a special method applicable to people mo¬
tivated for relief of suffering, whether the
analyst has research interests in addition to his
commitment as a therapist or not, is a part of
psychiatry. It cannot withdraw without ad¬
mitting failure as a therapeutic technique.
Psychiatry as a science is a composite field
in which several disciplines using various meth¬
ods from appropriate frames of reference are
concerned with transactions (reciprocal modi¬ Kubie, Knapp, Stein, Mirsky, Colby, Marmor,
fying interrelationships). Each frame of ref¬ Masserman, Kaufman, Kris, Margolin, Pum-
erence and method is based on theoretical
constructs somewhat different from all others.
distorting and diluting their area of study through the
use of available experimental techniques developed by
neighborhood disciplines.
Contrary to Lustman's idea that the labora¬
tory of research is safe, any research worthy of
the name is hard and frustrating in contrast with
the pale cast of abstract theorizing for which
there is no negation. We need not search di¬
rectly for unified theory but for as much theory
as we can, step by step, as we accumulate solid
data and broaden our concepts.
Analysts who have strayed across the fixed
boundaries of the psychoanalytic method are in¬
deed numerous and comprise some of the most
gifted people in the field. Just to name a few
they include : Alexander, Benedek, French,
pian-Mindlin, Anthony, Engel, Fisher, Kepecs,
Lidz, Rado, Seitz, Sklansky, P. Solomon,

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Stanton, Tidd, Wallerstein—and these are
all. This is an impressive group to accuse of
being antitheoretical and refugees into labora¬
tory safety. Researches on sleep and dreams,
new results from electrical stimulation of the
human cerebral cortex evoking memories,
handling of infantile animals leading to altera¬
tions in subsequent learning, psychophysio¬
logical studies on the menstrual cycle,
experimental neuroses, and the ego psychology
of academic psychologists all are contributing to
modification of psychoanalytic theory.
Let us now turn to what others have written
about "dilution." Kubie, who is highly critical,
states that "other sciences will clarify what is
confused and muddy in psychoanalytic theory,
concepts and terminology and will furnish mate¬
rial for critical self-examination." Sandford f
believes that "other methods besides the psycho¬
analytic one are useful for testing psycho¬
analytic hypotheses and that these hypotheses
are no less psychoanalytic for being tested out¬
side the consulting room." Stanton $ advocates
using methods not characteristically psycho¬
analytic. Pumpian-Mindlin J stated that psy¬
choanalysis as a model is a closed system which
blocks certain observations. Hartman § admits
that distortions of self-observation as well as of
observations of others may occur. Bellak J like¬
wise critically states that psychoanalysts are ap¬
plied scientists, professionals, or therapists and
as such are sometimes ambivalent in their at¬
titude toward theory, poorly trained in scientific
methods, concept formation, or other rigors of
thought taught to graduate students of science.
As Bellak states, clinicians generally and psy¬
choanalysts particularly are wary of the aca¬
demic approach.
Colby24 states that psychoanalysis is a
branch of science still trying to "develop
scientific methods appropriate to its data and
problems." It proposes a system of theory and
observations about human behavior. The train¬
ing of psychoanalysts has been limited for the
most part to the transmission of this system
without encouragement of original work. Low-
level observational statements refer to what per¬
sons actually say or do in the psychoanalytic
situation. Observations should be systematic,
t See Hook.22
Í See Whitelock.23
§ See Hook.22
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not recorded, and controlled. They may include the
use tape-recorders and multiple observers.
of
However, experimental observation remains an
undeveloped aspect of psychoanalysis. Colby
further states that theoretical biases have main¬
tained the f reudian dual instinct theory as well
as unrecorded observations, lack of quantifica¬
tion, lack of experimentation, lack of controls,
lack of follow-up, lack of cooperative research,
lack of predictive statements, lack of interpretive
ruses and obscurantist language.
Rapaport 2B states, despite the fact that Freud
said that psychoanalytic theory can be validated
only by the psychoanalytic method (and he says
it has), that independent confirmation is needed
by direct observation on infants and children.
Psychoanalysis has no learning theory of its
own. The field is beginning to extract valid
contributions from theories of the neofreudian
schools. These are statements from a leading
psychoanalytic theoretician.
Finally :
The Editors (of Psychological Issues, cf, especially
vol 4, No. 1, 'The Influence of Freud on Ameri¬
can Psychology' by David Shakow and David Rapa¬
port) believe that relevant contributions can come
from experimental studies as well as from clinical
ones, from controlled developmental studies as well
as from genetic explorations of psychoanalytic
therapy, and that investigations carried out without
any concern for psychoanalysis may nevertheless con¬
tribute to the theory.
.
While psychoanalytic psychiatry which fo¬
. .
cuses on internal dynamics attempts to recover
the libidinal experiences and the vicissitudes of
the instincts in reconstructions of childhood ex¬
periences within the therapeutic transference,
Piaget2ß has attempted to observe, describe, and
classify actual childhood behavior in the process
of development. Psychoanalysis because it has
not developed a learning theory, instead, leans
heavily on vaguely expressed concepts of con¬
ditioning.27 Piaget has stimulated the develop¬
ment of research in child development to the
point where it is becoming an independent
discipline. Mother-child transactions in infancy
in natural homes, foundling homes, and hos¬
pitals have been studied by several investigators.
Engel and Reichsman,28 especially, have been
able to observe in a child with a gastrostomy
opening, changes in behavior and gastric acidity
on approach and departure of friendly or
strange adults. The field of child development
will become basic to our understanding of nor¬
mal and pathological personality development
and extend beyond the "reconstructive"
anthropomorphizing about infantile fantasies.
Finally studies of "health" and "normality" are
beginning ^to refute the psychoanalytic concepts
of Eissler and Gitelson || that "normality" can
be characterized simply as a defense.
Critics of psychoanalysis receive from Gitel¬
son analytic interpretations among which are
included : the return of the repressed, anti-in¬
tellectual trends, atavistic, antitheoretical, etc.
Helen Tartakoff 30 asks whether the Academy
of Psychoanalysis is "concerned with psycho¬
analytic education or with relating psycho¬
analysis to other disciplines by which eventually
it is to be replaced"? Gitelson believes that co¬
operation with other sciences is an intellectual
flight from the unconscious; that psychoanalysts
moving out into research using other than psy¬
choanalytic methods are concerned with prestige
and with secondary gain of government financial
support; that social anxiety leads them to action
to counteract this feeling; and that objectifying
techniques (such as observations and recording
of sessions) introduce new variables—as if
living in the world did not.
In a 1963 paper about psychoanalysis in 1911-
1912 I pointed out that little progress has been
made in even beginning to investigate: "The
same questions arise over and over again and
cannot be answered by affirmation, but only by
persistent solid research too long absent in the
psychoanalytic discipline." Rather than being
an evidence of some horrendous neurotic trends,
criticisms are not destructive. To the contrary,
they are constructive, ie, future oriented. I
stated :
The critics today are not overwhelmed by tradition,
worship or adulation of the originators of the method.
They hope to move forward, leaving behind what is
disproved or unconfirmed, and to make a "science of
psychoanalysis" more than an easily mouthed phrase.51
In this section the search of psychiatry for a
scientific foundation is emphasized. Here again
Gitelson extracts selected partial sentences from
my paper; excerpts that, he says, repudiate psy¬
choanalysis in the name of "big science" and
See Mead.12
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represent "a return of the repressed in the form
of the wish to reverse history by expunging the
effects that psychoanalysis has had and still
exerts on psychiatry. .". .
Actually I stated:
These "dynamic" approaches within a dyad have
superseded and even resulted in a depreciation of the
basic psychiatric techniques through which so much
progress was made in the nineteenth century. These
are the methods of careful unbiased and controlled
observations and accurate descriptions of behavior over
time including verbalizations but not limited to them.
Observation of behavior rather than inferences about
feelings is the keystone of psychiatric research. Be¬
havior represents in actuality functions allocated to an
hypothetical ego which filters perceptions on the one
hand and actions on the other, which expresses re-
portable motivations, affects, defenses, and com¬
promises, which employs symptoms and sublima¬
tions and demonstrates integrative capacities and
disintegrative trends. About any of these there need
be few inferences or interpretations. As observa¬
tional material they can be coded and rated, re¬
peated and replicated, and tracked through time. These
basic living data can then be interpreted according to
fruitful theory and placed in juxtaposition to any
hypothesis. Information gained from "depth" inter¬
views in addition may account more adequately for
déviances and inter-individual variability, but the be¬
haviors of the participant-observer and of the subject
whose "internal behaviors" are being observed as in
psychoanalytic sessions require adequate systems of
recording of data and their subsequent analysis. I
contend that the acquisition and validity-testing of
behavioral data are the core operations of psychiatry
as a science.
In short, behavior in interrelations is the sub¬
ject matter of all psychologies—human behavior
ultimately.
For the last 100 years psychiatry has been
considered as a specialty of medicine defined as
the medical practice or applied science of treat¬
ing and preventing mental diseases or disorders
of the mind. However, today Masserman's 32
definition is more appropriate : "Psychiatry can
be broadly defined as a science which deals with
the determining factors of human behavior, its
variations and viscissitudes, the methods of its
analysis, and the means that may be employed
to align behavior with optimal personal and so¬
cial goals." The disparity between these two
definitions indicates the profound changes that
have taken place in psychiatry during the last
century.
Then Gitelson indicates that as rebels with¬
out a cause, critics like myself advocate a return
to scientific atavism—a "naturalistic state of
 science in which human phenomenology is de¬
hydrated. ." In contrast, I stated:
.
Behavior as the central theoretical focus of psychi¬
.
atric research is not a simple-minded fractionation of
man as a totality isolated from his environment of
things, people, and symbols. It does not ignore his
nervous, circulatory, and endocrine systems, his vis¬
ceral and somatic organs, and their constituent cells
and fluids. We often find ourselves involved in con¬
troversy with the reductionists who hope to explain
man's behavior on a physicochemical or cellular basis,
or the extentionists or humanists who focus on society
and culture. These are futile arguments based on the
seemingly interminable resurrection of the either/ ciple that psychological processes should be
or and single cause concepts. The neurological or social
sciences cannot explain behavior, nor can the psychi¬
atric behaviorist do without them. How should we
consider the operational relationship of these other
approaches of bordering fields to our own? Do these
many techniques study hierarchical series of levels animal
each with its own system or variables? Do we "bor¬
row" information from other sciences or extrapolate then what? Do not the methods and results re¬
from them by analogy? Or is there a more fruitful
way of viewing relationships?
It is indeed unfortunate that this formulation
of field theory and transactionalism should be
termed atavistic by orthodox analysts, for it
represents an expression of modern sophistica¬
tion such as is embodied in general systems
theory. It certainly is an antidote to the other
aristotalian linearity of cause and effect, frag¬
mentation of frames of reference and either
reductionism or extensionism.
Again, I wrote:
All this should be known and understood by students
of psychoanalysis, yet they and those in other discip¬
lines should not be tempted to throw out what is
valuable in this psychology. Until we resolve the mind-
body problem with the help of a unified theory, we ods alien to them and so are
shall have to deal with correlative relationships be¬
tween structure and function with causes and effects
taking either direction. We may use analogies for some put psychoanalytic research in a double-bind.
time yet; fruitful if we do not fall into the trap of
thinking they represent advances in knowledge. We methods of
will have to maintain hypothetical constructs for the
invisible and give them names just as do the physicists
and geneticists, as long as we do not reify them. We
shall have to continue to infer and make interpretations
of verbal, motor, visceral and total behavior, but only does not occur in isolation but
as hypotheses to be tested.#
VI
In his sixth section Gitelson states that free
association in the analytic situation "is ex¬
quisitely suited for confronting nature"— This
is held to be a fact with no doubts expressed re-
# See Bailey.3
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garding the freeness of free or the contingencies
on which it depends. It is the only way, but
surely, if it is the keystone of psychoanalysis,
much research should have been expended on its
dimensions. "But no such studies of the human
personality will have their necessary scientific
sophistication, no matter how refined their 'de¬
sign' unless they are governed by the psycho¬
analytic experience," says Gitelson.
These are broad statements for which there is
a core of validity. Freud established the prin¬
studied by psychological methods. Even though
the data may be difficult to verify and historical
anecdotes may lead to invalid inferences, Freud
did develop a paradigm suitable to man as an
capable of symbolic transformation
which in essence was a scientific revolution. But
quire research and modifications ? No scientist
can consider that they represent the final
"truths." No science can live by reaffirmations
alone.
Gitelson states, quoting from Hartman, that,
when nonanalytic methods are used to examine
psychoanalytic generalizations, none has been
than confirmatory. Rapaport25 has written
on this point. He states that an investigator is
usually the captive of his method. Theory can
predict only those phenomena elicited by the
method ; what is not amenable to study ceases to
influence theory. In turn, all theories whose
methods do not apply to the phenomena are
considered wrong. If tested at all it is by meth¬
obviously wrong.
This verbal maneuvering certainly attempts to
Psychoanalysis, I believe, can utilize scientific
operating without sacrificing its con¬
ceptual domain. There is a great need for it to
become an open system with freer exchange
through its boundaries. Progressive evolution
only through
partial isolation and by transaction with other
groups.33
VII
Throughout his paper Gitelson insists that a
paradigm cannot be relinquished until another
available paradigm is compared and found bet¬
ter. Where is the alternative paradigm for ex¬
plicit comparison ? 22 he repeatedly asks. Earlier
in this paper I have corrected the assumption In the ensuing 35 years there have been many
erroneously made by Gitelson that I propose discussions involving the definition of science,
abandoning the paradigm but this does not mean its methods and its students, involving psycho¬
that it should be maintained in its entirety as an analysis as well. Philosophers of science in in¬
ultimate truth or stand alone. creasing numbers in modern times have
In the second place the word paradigm which attempted formulations of science and the sci¬
Gitelson uses so vaguely, represents a conglom¬ entific method allocating to each a wide and
eration or cluster of theories, hypotheses, and "permissible" range, and some like Kuhn have
methodologies having in common some special outlined the stages of evolution of particular
way of viewing the world. Science may progress sciences.
by modifying any part of the paradigm, without Feigl,35 for example, states that scientists
seek descriptions, explanation, and predictions
destroying the whole, as the result of certain
anomalies or "hitches." Unfortunately this has which are as adequate and accurate as possible.
been disappointingly slow in psychoanalysis be¬ The most important regulative ideas are inter-
cause many orthodox analysts like Gitelson subjective testability, reliability, or a sufficient
maintain the "all or none" concept. degree of confirmation, definiteness and preci¬
sion, coherence or systematic structure, compre¬
Finally it seems to me that Kuhn's specula¬ hensiveness or scope of knowledge. Finally:
tions are based on the history of the physical
"Instead of presenting a finished account of the
sciences in which revolutions are easily possible
by the shift of a single basic assumption, ie, world, the genuine scientist keeps his unifying
hypotheses open to revision and is always ready
relativity. It does not seem likely that such a
thoroughgoing overhauling of psychoanalytic to modify or abandon them if evidence should
render them doubtful." Feigl's basic assumption
theory as indicated by the term revolution could is that
occur. Rather one would hope that slowly evo¬ empirical science is an unending quest
for knowledge and that its claims to truth are
lutionary processes derived from rigorous re¬ never but always held open to correc¬
search could alter what is needed to change. Not absolute,
to countenance change without a revolution, to tion, verification, or disproof, and, therefore,

insist on the established, to advocate withdrawal scientific truths differ only in degree from
from the world of psychiatry (and science) knowledge accumulated throughout the ages by
sound common sense. The quest for scientific
this is a backward movement.
—

truth which gives it a unique character is regu¬

VIII lated by certain standards or criteria which are
best formulated as ideals to be approximated
Psychiatry is not a science—psychoanalysis is rather than as goals ever fully attained. Accord¬
a basic science of individual psychology. These
ing to Feigl it is a sign of maturity to be able to
are strong phrases used by Gitelson, denying live with an unfinished world view.
the scientific basis of psychiatry and allocating
Kaplan 3e states that the behavioral sciences
to psychoanalysis the position of being basic. are overloaded by theories and their prolifera¬
There is a turn-about nature to this declaration, tion. A
good theory is one worth being acted on
since for decades the criticism has been leveled in contexts of
inquiry or of other action. Theory
that psychoanalysis is not a science. For ex¬ is true if it fits the facts—if
predictions made on
ample, in the 1930 edition of the Encyclopedia the basis of theory are in fact fulfilled but not if
of the Social Sciences Horace Kalian * wrote the facts are wholly constituted by the theory
that psychoanalysis has no quantities, meaning
they are adduced to support—if they lack an
systems of measurement, and could never be a operational core. The value of a theory is not
science. He stated that inferences were em¬
only in the answers it gives but in new questions
ployed as agents in their own verification and it raises.
that psychoanalysis is a faith and a dogma ;
Nagel % wrote that it must be possible to de¬
psychoanalysts are judges of their own truth duce determinate consequences from the as¬
and of criteria of their own validity.
sumptions of theory, if the theory is to be
*
See Seligman and Johnson/ i See Hook.2:

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 capable of empirical validation. Some theory
must be tied down to fairly definite specified
observable materials by way of rules of proce¬
dure. Finally a credible theory must be capable
of being negated by evidence.
Sidney Hook22 also says with specific
reference to Psychoanalysis :
A subject is usually regarded as unscientific if in
principle no observable state of affairs could falsify its
claims, so that by ad hoc modifications its assertions
can be made compatible with any state of affairs what¬
soever.
It is obvious from these brief excerpts that
the philosophers of science are not agreed on a
definition of science. Each seems to demand
varying degrees of rigor in accepting evidence.
The question of prediction vs explanation is
not resolved, and the historical method so im¬
portant to psychoanalysis is not universally ac¬
cepted as a scientific method. It needs better
validation.
IX
Gitelson insists that the basic theories and
methods of psychoanalysis have not and need not
be questioned. He puts it as follows: "How¬
ever, this debate is not concerned with the
scientific substance of psychoanalysis but with
the social and psychological issues surrounding
that substance." In other words, the problems
that the field of psychoanalysis is experiencing
today are projected by Gitelson onto its environ¬
ment. This is an easy escape hatch. To the
contrary, I believe that, if there be a crisis, it is
in the utilization of theory and methods by
psychoanalysts.
We would all agree that there has been no
breakthrough of radically new insights in the
recent American engineering sense, but has
there been enough "spadework of normal sci¬
ence" and "quiet ferment" of progress? Here
is where disagreement is acute. The issue is
joined in Gitelson's statement : "Therapeutic
versatility and scientific rigor are incompatible."
Yet it has been frequently stated that psycho¬
analytic theories and hypotheses can only be
confirmed or disproved by the use of the psycho¬
analytic method. Although I have already dis¬
agreed with this statement, let us suppose that it
is correct. What this means is that psycho¬
analytic theory needs empirical data derived
from the use of the psychoanalytic method which
can be utilized in actual practice only on un-
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happy neurotic patients who are motivated to
undergo therapy. Therefore, therapeutic versa¬
tility (I would say experimentation) is the basic
source of empirical data and not only compatible
but necessary for scientific rigor. This means
experimentation, not rigid adherence to the
classical technique and the exclusion of "param¬
eters" in Eissler's sense. Scientific data can only
be derived from a variety of controlled condi¬
tions, interferences, relationships, etc.
Rapaport25 stated that the subject matter of
psychoanalysis is behavior (including the latent
forms) and that these data are subjected to three
levels of analysis: biological, intrapsychic, and
real. For all of these we need more empirical
data. Waelder,34 in a carefully conceived answer
to critics of psychoanalysis, demonstrated levels
of science as exemplified in this field. These are:
level of observation, level of clinical interpreta¬
tion, level of clinical generalization, level of
clinical theory (repression, defenses, return of
the repressed, regression, etc), level of meta-
psychology (cathexis, psychic energy, instincts,
etc), and finally the level of philosophy ( faith in
reason) which is most known by the intelligent
public.
The basic foundation is at the level of ob¬
servation in which humans are viewed from a
special frame of reference based on analytic
theory. As in all sciences there must be a
transactional relationship between data and
theory each by feedback reciprocally modifying
each other.
As Mirsky § said to Ostow, "I'd like to see the
data," but there is a paucity of data in psycho¬
analytic writings. Freud's writings after the
1920's contained little of his empirical observa¬
tions. Careful perusal of the literature reveals
to the
a too frequent jump metapsychological
level, and many times I have heard the criticism
that the observations do "not fit into our meta-
psychology." Conclusions of one author are re¬
stated as facts, and verbal innovations are
quickly adopted without proof. As Mendelson 38
stated in a thorough review of the psycho¬
analytic literature on depression—it is a great
debate, not a great investigation.
The need for improvement was recognized by
no less an analyst than Ernest Jones, who in his
Presidential Statement in May, 1936, said:
§ See Whitelock*
 In the field of Theory, on the other hand (in
contradistinction to technique), I am inclined to antici¬
pate very considerable changes in the course of the
next twenty years or so. The scaffolding, as he
modestly called it, that Freud has erected, has stood
much rough weather extraordinarily well, though he
has had to repair and strengthen it from time to time.
But it would be counter to all our knowledge of the
history and essential nature of science to suppose that
it will not be extensively modified with the passage of
time. The preconceptions from the world of con¬
temporary scientific thought . with which Freud
approached his studies had a visible influence on his
. .
theoretical structure, and they necessarily bear the
mark of a given period. We must expect that other
workers, schooled by different disciplines than his,
will be able to effect fresh orientations, to formulate
fresh correlations. In spite of our natural piety we
must brace ourselves to welcome some changes, forti¬
fying ourselves with the reflection that to face new
truth and to hold truth above all other consideration
had been Freud's greatest lesson to us and his most
precious legacy to psychological science.
Also, Glover called attention to the lack of
scientific controls and to what we have indicated
as "the increasing tendency not to apply to the
data of observation or to the methods of in¬
terpretation such scientific controls as are avail¬
able. The consequence is that a great deal of
what passes as attented theory is little more than
speculation, varying widely in plausibility." 2
The sum and substance of my attitude toward
the contents of this section is that the serious
critic does not suffer from "existential anxiety"
(at least not in this context) nor from "return
of the repressed," but he is painfully aware that
the capacities of psychoanalytic theory and
method are being prostituted in the name of
"differentiation and functional adjustment" in
the back street of scientific life.
X understand psychoanalytic theory well.
Gitelson in this section suggests abrogating
what the American Psychoanalytic Association
has stood for in upholding its medical standards.
Gitelson states that psychiatry is mental healing
and not a science but that psychoanalysis is a
separate scientific discipline, "whose practition¬
ers can be various kinds of intellectually quali¬
fied persons who are humanly qualified for the
human experiment which is the psychoanalytic
situation." "Perhaps it is necessary to cast a
wider net for students of psychoanalysis."
In Gitelson's view the application of psycho¬
analytic theory in any other manner except in the
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psychoanalytic situation is not psychoanalytic
research. Data derived from laboratory experi¬
ments on animals and humans, and from the
social and psychological sciences are not sig¬
nificant. Therefore, any psychoanalytic research
demands work in human patients who suffer
from illness—the healthy cannot be motivated
for treatment. So we now have the suggestion
that nonmedicai persons "humanly qualified"
shall work with patients.
Gitelson's suggestion to train nonmedicai per¬
sons as investigators in psychoanalysis only re¬
peats Freud's 39 statements on lay analysis, the
suggestions in which were repudiated by
American psychoanalysts. The Council of the
Association for Psychoanalytic Medicine re¬
affirms this stand in the following statement :
It is one matter to offer training in psychoanalysis to
promising qualified research specialists from other
disciplines to deepen their research in their own fields
as well as to qualify them for a research career in
psychoanalysis itself. This should not be equated with
embarking on programs leading to the unrestricted
training of non-medical psychoanalysts for practice.
The former may indeed develop the intrinsic scien¬
tific possibilities of psychoanalysis. The latter serves to
revise the operational relationship existing between
medicine and psychiatry and psychoanalysis.
We certainly permit and welcome psychiatric
social workers and psychologists to work with
patients under some supervision. But that super¬
vision immediately complicates the research
aspects of the field by adding another and sig¬
nificant bias. Although PhD graduates of the
social sciences, psychology, and the humanities
may be well trained in scientific rigor, if psycho¬
analytic concepts are to be used in research con¬
ducted within their own fields, they should
Gitelson terms his withdrawal and backward
look, not as a policy of isolation but as "differ¬
entiation and functional adjustment." These
words indicate a return to the "movement" phase
of Freud's days of "splendid isolation." Today
analysts are psychiatrists and part of the field,
and they are in it to stay. As Booker T. Wash¬
ington said about the American Negro, "You
can build a wall to keep the Negroes away from
the whites, but seven walls ten feet high can't
keep the whites away from the Negro." And so
it is with psychoanalysts who cannot and should
not be kept away from psychiatry.
 XI
In his final section Gitelson denies that there
is acrisis in psychoanalysis but by the very na¬
ture of man the return of the repressed with
subsequent "efforts at re-repression are taking
the form of dilution or denial of what we know."
No possibility is entertained that the crisis repre¬
sents legitimate and rational doubts. Again
Gitelson states that psychoanalysis is caught in
an identity conflict between psychiatry which is
a therapeutic specialty of medicine (no smidgon
of science admitted here) and psychoanalysis
which is a basic science.
I reaffirm what Percival Bailey has critically
stated about me—I, and many others, have faith
that out of psychoanalytic theory could come
fruitful and testable hypotheses instead of the
worn-out hackneyed reiterations and reformula¬
tions and the stultifying stereotypes stated as
positive facts, based only on inferences. Either
psychoanalysis will move into a scientific posi¬
tion using scientific methods and not rest on the
boastful statements of "our science," or it will
give way to a new paradigm. There are forces
moving in each direction. The most potent push
for the extinction of what is good comes from
the "faithful" who maintain organizational
boundaries as barriers against the free flow of
people and ideas. The most significant progres¬
sive trend, I believe, is expressed by those who
recommend bringing psychoanalytic institutes
into the universities.
For me, trained and experienced in jacksonian
neurology and in psychoanalysis, and seeing
much in psychoanalysis which can be under¬
stood in terms of physiological processes, I hope
that what is fruitful can be extracted by serious
scientists who can doubt as well as speculate,
who can critically observe and experiment as
well as infer.14
Eventually this will happen for as Boring 10
recently wrote:
At any rate, though scientific progress may be
hindered by dissonance, it is not necessarily blocked,
for there is always waiting off in the future that most
objective of critics, posterity, as well as posterity's
posterity.
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