Article: ‘Ontological Psychoanalysis or “What do you want to be when you grow up?”‘ by Thomas Ogden (2019)

In his 2019 paper, ‘Ontological Psychoanalysis or “What do you want to be when you grow up?”‘, Thomas Ogden describes two dimensions of psychoanalysis: epistemological psychoanalysis and ontological analysis. He is careful to point out that these dimensions frequently overlap, and neither ever exists in pure form, but that they do nevertheless involve quite different modes of therapeutic action. Epistemological psychoanalysis, as practiced by Freud and Klein, has to do with knowing and understanding; while ontological psychoanalysis, in Winnicott’s or Bion’s hands, is more concerned with being and becoming. The titular question, ‘What do you want to be when you grow up?’ is the key (but probably often implicit) question posed by the ontological analyst, and Ogden implies that the analysis is only approaching its goal once the patient is able to answer the question truthfully and wholeheartedly: ‘Myself’.

Though he never states it explicitly Ogden leans very heavily towards the ontological analysis side, which we infer from his wonderful descriptions of the ‘playing’ that both analyst and patient engage in. This conception of ‘playing’ Ogden gets from Winnicott, who describes it as a transitional experience, somewhere between fantasy and reality, whereby the child/patient and mother/analyst engage in an interaction in which it would make no sense for the mother/analyst to ask of the child/patient: ‘Did you conceive of this object or was it presented to you?’. Ogden suggests that therapeutic healing happens when the patient and analyst are able to play together from within the patient’s transference-countertransference enactments.

This is a very appealing idea, and Ogden describes some beautifully sensitive clinical cases to elucidate what he means by this joint form of playing within the analytic sessions.

I also loved Ogden’s description of the end goal of psychoanalytic therapy, what sounds to me like ideal psychological health:

“…for Winnicott and Bion, the most fundamental human need is that of being and becoming more fully oneself, which to my mind, involves becoming more fully present and alive to one’s thoughts, feelings and bodily states; becoming better able to sense one’s own unique creative potentials and finding forms in which to develop them; feeling that one is speaking one’s own ideas with a voice of one’s own; becoming a larger person (perhaps more generous, more compassionate, more loving, more open) in one’s relationships with others; developing more fully a humane and just value system and set of ethical standards; and so on.”

But I couldn’t help having the nagging thought that such a strong emphasis on ‘being and becoming more fully oneself’ might resonate more with Western audiences with their freedom- and self-actualisation-oriented moral compasses than other groups, and that it might be missing something as a result.

Book Review: ‘The Adolescent Psyche’ by Richard Frankel

This book is filled with wisdom, and I think it would be helpful for any mental health professional working with adolescents (regardless of their preferred brand of therapeutic approach) so I’ll attempt to summarise its main points:

The Freudian psychoanalysts were wrong to treat adolescence as primarily a return to infantile id drives/impulses (only with different conflicts against a more strongly developed superego), and instead it should be seen on its own terms, as a distinct developmental period. We should take the transformations of puberty and the tumultuousness of the experience as meaningful in itself, and with its own progressive functions (telos), rather than as some kind of a backward step. And to do this we should use a phenomenological approach, staying close to the actual experiences of adolescents, rather than theoretically hypothesising what we think is happening…

The best starting point for understanding adolescence is seeing it as time of paradox and conflict – the adolescent is pulled in both ways at once: back towards its childhood, but also towards adulthood and the wider social world (beyond the family unit). This paradoxical position, or point of tension, defines what it is like to be an adolescent. Adolescents are both a child and an adult at once, and they are constantly negotiating between the archetypes representing these: the puer (youth) and the senex (older adult). What I think Frankel takes from Donald Winnicott is also the idea that the boldness and bravery of adolescence is something society needs as a creative and refreshing force; we should appreciate their ‘fierce and stubborn morality’ and their way of refusing ‘false solutions’. Winnicott wrote somewhere that ‘Infinite potential is youth’s precious and fleeting possession’. What typically society tends to dislike about adolescence is something that we should rather appreciate and value in itself – ‘Could we imagine that the instinctual turmoil of adolescence creates a special sensitivity and receptivity to the world and that this can manifest in the pleasure with which ideas are entertained, engaged and undertaken?’ (98)

Adolescents in our era have a particularly difficult time also because there are no, or few, community-organised initiatory rites designed to mark the transition period. Primitive societies usually did have some kind of ritual/initiation designed to mark the young person’s entry into the adult world, which meant that it could be a fairly quick and organised process. Frankel quotes Michael Ventura here: ‘Tribal adults didn’t run from this moment in their children as we do; they celebrated it. They would assault their adolescents with, quite literally, holy terror: rituals that had been kept secret from the young till that moment – rituals that focused upon the young all the light and darkness of their tribe’s collective psyche, all its sense of mystery, all its questions, and all the stories told both to contain and answer those questions’ (69). Because these initiatory rites are an ‘archetypal human need’, our adolescents can’t just skip them, but rather must invent a kind of replacement for these community-organised ones on their own, and evidence of their attempts can be seen in youth gang culture, self-mutilation, substance-abuse, and impulsive/risky sexual behaviour.

Frankel offers Jung’s insights as more helpful and relevant to working with adolescents than Freud’s, primarily because Jung sees the self as a ‘self-regulating system’ (5), in contrast to Freud’s Id which is always in need of externally-imposed prohibitory forces. If parents and clinicians of adolescents remember that the best way to stop someone – particularly an adolescent – doing something unhelpful is to speak to with their own ‘inhibitory’ sense, and get them to arrive at the desire not to do it themselves (rather than simply acting as that external prohibitory force), then they’ll be better able to help them.

Final point that I want to share is Frankel’s suggestion that art and cultural artefacts should have a much larger role to play in clinical work with adolescents. In connection to the idea that inhibitory forces must be engaged with adolescents having a particularly difficult time, Frankel writes that: ‘The inhibition of action produces imagination. Experiencing an inhibition is feeling into the imaginative pattern that contains the impulse towards action. Engaging an instinctual impulse imaginally, feeling where it is rooted in the body, may reduce the need literally to take action. Thus imagination is one of the most effective tools we have in working with adolescents who are prone to impulsive behaviour.’ (169) In order to connect meaningfully with adolescents, we must be prepared to meet them on their own level, which might not necessarily be the ‘literal’ adult world. We must instead stay empathetically attuned to the deeper meanings in their narratives – and art might provide that fruitful meeting-ground.