Sex, Death and the Superego
Experiences in Psychoanalysis
by Ronald Britton
Published by Karnac Books
1855759489 Pbk £19.99 pp190
This book is a personal reappraisal of psychoanalytic theories in the light of clinical experience. There are three parts to the book. The first part is about sexuality and begins where psychoanalysis began, with hysteria. The second part is about the ego and the superego, the relationship of which dominated Freud's writing from his middle period onwards. The last part is on narcissism and the narcissistic disorders, a major preoccupation of psychoanalysis in the second half of the twentieth century.
'Ronald Britton s papers over the past fifteen years or so have been beacons of clarity and creativity. He has reformulated Kleinian thinking (as far as I am concerned) in the same paradigm shift way that Bion did forty years ago. I have learnt more from his writings than any other member of our Society writing today.'
Peter Fonagy, Professor of Psychoanalysis, UCL
Published July 2003
Sex, Death, and the Superego is the latest work by eminent psychoanalyst Ronald Britton. Featured below is the preface from this absorbing work, and we are grateful to Karnac Books for giving permission to reproduce it here.
"You cannot create experience, you must undergo it."
This book is a personal reappraisal of psychoanalytic theories in the light of clinical experience. There are three parts to the book, and what they have in common is that they all are attempts to articulate what I think now about some historically important analytic concepts. The first part is about sexuality and begins where psychoanalysis really began - with hysteria. The second part is about the ego and the superego, the relationship of which dominated Freud's writing from his middle period onwards. The last part is on narcissism and the narcissistic disorders, a major preoccupation of psychoanalysis in the second half of the twentieth century.
I would like to claim that what I write is "experienced based" to complement the fashionable phrase of the moment, 'evidence-based' The phrase "evidence based" has spread from medicine to psychiatry and now to psychotherapy. It has merit, but as a phrase it resonates with the lawyer in us perhaps more than the doctor or psychoanalyst. Its ambience seems more courtroom than consulting-room, and a frisson of fear in the clinical professions accompanies its use. The claim 'evidence-based' seems to brook no argument and dismisses all those activities, clinical opinions, and theories not easily demonstrated or for which there is not yet sufficient evidence.
Rather than finding them unproven, it makes them seem unreasonable. The usual muddle of clinical practice suddenly seems reprehensible. It is a phrase that supplies a sense of authority in situations where uncertainty is a daily companion, anxiety is high, and needs are pressing.
The other aid to personal assurance in such difficult situations is the authority of experience. In practice, until sufficient personal experience of the problem is garnered, or sufficient collective evidence is produced and formulated, it is the authority of teachers or teaching manuals that is relied on. The hope is that they based their authority on experience. With the best will in the world, however, they are likely to be contaminated by overvalued ideas. The recipients of medical training have the opportunity to amend their teacher's nostrums and modify received wisdom in the light of experience in a relatively short time, but at this point psychoanalysis has a problem. The acquisition of personal experience is very slow, and therefore the reliance on the authority of others is protracted. In the practice of analysis, it is not only the patient who has a prolonged period of dependency. When I first worked in a neurology hospital, my chief reassured me that the complexity of the clinical pictures and the laboriousness of anatomical diagnoses would, through familiarity, become easily recognized patterns. And so they were, after a few months of seeing a good number of new patients a week. It is the same in psychoanalysis, but the time scale is greatly different. The patterns in analysis that eventually become familiar are those of the transference-countertransference relationship. It takes many years, however, to see enough patients and hear about more for these patterns to become very familiar; in the meantime, the authority of the teacher/ manual is relied on.
This prolonged period of dependence on authority heightens the already existing tendency to follow the leader or to remain attached to a theoretical "set". As a consequence, the contamination of experience with overvalued ideas is a particular problem of psychoanalysis. When we look at our colleagues, we see that once such overvalued ideas have a foothold they are hard to shift; if we look at ourselves, we can see how hard it is to relinquish them.
The reader will find that I have made no attempt to be comprehensive and that I have not tried to evaluate the many and various contributions from other authors from a variety of psychoanalytic schools. This is not because I am unaware of them, nor because I doubt their value. As a member of the British Psychoanalytical Society I have been constantly exposed, and undoubtedly influenced, by at least two other schools of thought in addition to the one I espoused. I have not tried to correlate my comments with North American ego psychology, nor with Kohut and self-psychology, nor with Lacan s discourse. I can see relationships and overlaps, but if I try to address these I leave the path of my own thoughts and lose any clarity I might achieve. So I leave it to others to make these connections. I believe they will find them, because if theories are based on valid clinical experience, there is bound to be considerable overlap. I believe there is "common ground" in psychoanalysis, as Wallerstein (1992) suggested, and that ground is clinical experience.
"Nothing ever becomes real 'til it is experienced." John Keats