Book Review
Psychotherapy
Oedipus and Beyond: A Clinical Theory. Jay Greenberg. Cambridge (MA): Harvard University Press; 1991. US$20.50. 274 p.
Reviewer
rating*: Excellent
Review by: Paul Ian Steinberg, MD, FRCPC
Edmonton, Alberta
Greenberg’s problem with classic theory of motivation is that 4 basic motivational principles are condensed into a single principle related to “the operation of biologically rooted, phylogenetically determined sexual and destructive needs” (p 3). That is, rarely do references to conflict not imply that sexual or destructive impulses are parties to conflict. Conversely, Greenberg suggests that motivational aspects of perception, memory, and objective self-description cannot be explained simply as transformations of sexual or destructive impulses. This constitutes an argument for dropping the libido–aggression theory while retaining the principles of psychic determinism, unconscious motivation, and ubiquitous conflict. Greenberg describes development from the ages of 3 to 6 years in refreshingly jargon-free English, acknowledging Freud’s achievements and their limitations. He proposes a “new Oedipus Complex [that] would recognize the range and complexity of motives, emotions, and impressions that contribute” to it.
This book is divided into 3 sections. The first, “Drive Concepts,” begins with a chapter titled “The Interpretative System of Psychoanalysis.” This chapter describes steps in the development of drive theory from symptoms to the unconscious, from the dynamic unconscious to instinct or drive, and from the life of the instincts to sexuality. Greenberg suggests that “the drive model (but not the libido/aggression theory) is the core of an interpretative system that powerfully supports” central psychoanalytic assumptions (p 38). In the chapter “Drive Without Meaning,” he describes 5 strategies by which Freudians attempted to retain the term “drive” while altering its implications. This cogent summary of Freud’s heirs’ revision of drive theory is well argued and comprehensive, but perhaps more than many psychiatrists wish to read. Greenberg emphasizes that “drive is a motivational system that emerges from the earliest social experiences” (p 61). The chapter “Drive and the Relational Model” describes the implications of object relations theory and self psychology. In the chapter titled “The Somatic Strategy,” Greenberg states that “Freud built psychoanalysis on the assumption that the body moves the mind” (p 100), that organic stimuli drive the mind and therefore initiate and colour all psychological experience. For Greenberg, this is only strategy—“a theoretical option, not an a priori necessity in building psychoanalytic theory” (p 101). Greenberg concludes
that the somatic origin of the drives is held necessary to account for needs that are preemptory but that there are some needs that are too preemptory “. . .” to be accorded a fundamental role in the structure of psychoanalytic theory (p 104).
Here, he adds that a range of human motives exercise a more preemptory influence on human growth and development than do sexual and aggressive discharge. Abandoning the somatic strategy, Greenberg does not think of a drive as something that accumulates and requires discharge but, rather, as a directedness that governs human behaviour, a tendency that underlies motives and through which stimuli require meaning. In the chapter “Dualism Redux,” Greenberg replaces the libido– aggression theory with another 2-drive system: safety and effectance (that is, a sense of agency). He describes this as follows: “the feeling state that is the aim of effectance is characterized by a sense of self-sufficiency, autonomy, and individuation” (p 137). The effectance drive explains the existence of antagonism that is neither a reaction to the object’s failure nor the derivative of a primary endo- genous destructiveness. Greenberg describes intrapsychic and interpersonal conflict apropos this new dualism, concluding that every motive and every function is potentially a source of conflict.
Section 2, “Structural Concepts,” begins with the chapter “Clinical Structure and Psychic Structure.” This chapter describes repression and the sense of self, psychic conflict and structural models, and repression and the drive model. The section concludes with “Structural Models, Procrustean Beds,” wherein Greenberg reflects on the concept of meaning analysis (1). In the chapter “Wish, Affect, Representation,” Greenberg offers a model of mental contents and the dynamic relationships among them that come into play in the course of treatment. He describes the construction of mental representations, concluding that “the outcome of any event as it is experienced by the subject alters the shape of both the self and the object representation” (p 174). Here, he is consistent with Horowitz’s work on schemata (2). Greenberg interprets triangular events thus:
“The psychological significance of triangular relationships lies in the representation of a social network; the triad embodies not just a third person but all those not immediately present (p180).
That is, in triangulation, the subject has some experience of the effects of his wishes on distant events, which greatly increases the impact of fantasy. In “Repression,” Greenberg shows that “people keep certain mental contents out of conscience because these contents evoke intolerably painful self- representations” (p 188). He emphasizes that re-represented experience is inevitably triangular.
Part 3, “Technical Implications,” begins with a chapter titled “Theoretical Models and the Analyst’s Neutrality.” Analysis promotes therapeutic change in the observing self, and Greenberg’s representational model has implications for the analyst’s stance. His approach to neutrality includes both the inevitability of the analyst’s participation in the clinical process and the therapeutic value of the analyst’s impartiality.
In “Freud’s Playground Reconsidered,” Greenberg distinguishes between transference of impulse, in which the analyst comes alive for the patient mainly as an object of desire, and transference of conviction, which revolves around the patient’s ideas of the analyst. Greenberg sees transference more as the patient’s creation than as a distortion. He describes phases in the resolution of the transference and deals with counter- transference, including the analyst’s vulnerability to his patient’s convictions.
This well written and engaging text provides an excellent constructive critique of classic psychoanalysis. Despite his involvement with object relations theory (3), Greenberg does not hesitate to expose the limitations of the relational approach. I found little to criticize in this book, apart from the annoying absence of a couple of references from the reference list. All mental health professionals interested in psychoanalytic psychotherapy will find this text to be a clear and useful review and revision of motivational theory. I warmly recommend it to a wide readership.
References
1. Dorpat TL, Miller ML. Clinical interaction and the analysis of meaning. Hillsdale (NJ): Analytic Press; 1992.
2. Horowitz MJ. Cognitive psychodynamics: from conflict to character. New York: John Wiley and Sons; 1998.
3. Greenberg JR, Mitchell SA. Object relations and psychoanalytic theory. Cambridge (MA): Harvard University Press; 1983.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
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