Contemporary Psychoanalytic Culture(s) in Anthropological Perspective by Robert Paul with Introduction on by Nathan Szajnberg

What’s Culture Got to do with Id? Introduction to Bobby Paul on Culture and Psychoanalysis.
 
N. Szajnberg, MD

An overture to a remarkable guest article by Bobby Paul on culture(s) and psychoanalysis; his work will re-frame how we think about variations in psychoanalysis.  Like an overture, I will present some themes; then, listen to Bobby Paul develop them.

This is the first of several guest pieces on culture and psychoanalysis. IP.net is international; its audience diverse.  These guest pieces will address the nature of psychoanalysis across cultures and our ability to understand each other.

Bobby Paul is a cultural anthropologist, a psychoanalyst and retired Dean of Emory University.  He presented this paper at the 2009 IPA  congress, which centered on variations in psychoanalytic practice. 

A fine thinker and teacher, he engages us with questions.  There are variations in psychoanalysis.  We know this. Why, he asks, is there such anxiety, concern, soul-searching?

What’s the “right” psychoanalysis, or the prevailing one, or the mainstream version?  And what forces in the professional community shifts us to believe that there is a reigning form of knowledge?  How do communities determine practice validity?

If psychoanalysis is a science, it would have all the valued attributes of Western science since the Renaissance:  credibility, validation, prestige, even money.

If psychoanalysis is not a science, then it could be 1. a (devalued) pseudo-science or religion;  2. a form of craft, discipline, skill; or 3. an “art.”

Paul, sidesteps this divisive question for the moment and suggests we think of psychoanalysis as a “system of knowledge.”

“All knowing takes place in context” (which hints at Sandler’s implicit theories), and contexts are culturally constructed.  Consider psychoanalysis a knowledge system about inner space.

Paul borrows from Emerson’s parable of seven men —  farmer, soldier, physician, astronomer, geologist, realtor, poet — surveying the same field.  All see the same field, but look with different lenses.

Read how Paul develops this concept as he observes how cultural differences between Asian and non-Asian analyses. The differences are related to reverence for authority. Listen to how differently both beginning and developing the transferences proceed.  Paul develops in far more detail Erik Erikson’s ideas of the essential tension between our basic existential commonalities (trust/mistrust; autonomy/shame, doubt; initiative/guilt; industry/inferiority; initimacy/isolation; generativity/stagnation; integrity/despair) and how these commonalities develop themes and variations across cultures.

Enough overture, let’s turn to the main piece. It is a catalyst to understand analysis across cultures; to understanding both what binds us as human and humanly differentiates us. 
Contemporary Psychoanalytic Culture(s) in Anthropological Perspective
Robert A. Paul, Ph.D.***
 That there is variation in the way psychoanalysis is practiced around the world is an empirical fact.  My question is why is this a cause for concern, anxiety, or soul-searching?  Why does the International Psycho-Analytic Association feel moved to make an examination of this state of affairs the theme of its biennial congress? In my experience, most fields of study appear much more unified to an outside observer than they do from within.  In my own academic field of anthropology, this is certainly the case, with the great divide being between biological anthropologists, who generally espouse evolutionary theory, opposed to cultural anthropologists who see themselves as pursuing a critical cultural and historical agenda, for whom the theory of evolution is just one more cultural system.  The split in academic philosophy in the US between analytic and continental schools of thought is no less virulent.  And even in what is often taken as the prototype of a really coherent science, physics, the theoretical physicists and the experimentalists have almost nothing to say to each other; and the disagreement over the validity and status of, for example, string theory is as divisive as any internal squabble among psychoanalysts.  To an outside observer, then, the division of the psychoanalytic world into varying schools of thought, and different traditions of theory and practice, seems to be about par for the course.
 Of course, the matter looks different from within any of these fields, including psychoanalysis, since the existence of varying and even incompatible approaches to theory and/or practice seems implicitly to pose what seems to be a crucially important question: which one of them is right?  Which one ought to prevail as established knowledge, and which others should lie outside the mainstream of permissible thought?  These questions may, on the one hand, be conceptualized as scientific questions, to be decided by some universally accepted procedure of testing, demonstration, or falsification yet to be undertaken.  Or, on the other,  they may be thought of as social, historical, and cultural issues, according to which the question to be asked is: how does it come about that at a certain historical moment, and in a certain geographical social space, certain ideas seem hegemonic, in the sense of self-evident and mainstream, and others appear to be marginal or heterodox, and how do the forces determining which knowledge regime is regnant shift over time and space? 
As soon as one opts for trying to answer one or the other of these questions, one has already made a critical decision about what sort of intellectual enterprise one thinks one is undertaking – are we answering a scientific or a cultural historical question?  Does one think an idea is hegemonic because it is right, and the aim is to find out what is right? Or is it that the idea’s apparent rightness is itself an artefact of its being hegemonic, and the aim is to discover how that came to be so?
There are manifestly many thinkers in the psychoanalytic world who believe that, since psychoanalysis is a science, or at least that it ought to aspire to be a science, the task should be to agree upon a discovery or testing procedure that would convince everyone which of several rival theories is a correct description of how things actually are in the world, or which among rival techniques actually is demonstrably superior to others in its effectiveness  – or both, if they in fact correspond.  It is implied in this position either that psychoanalysis is essentially a method for the treatment of certain disorders, therefore a clinical practice, and hence subject to the canons used in general to determine the value of any clinical or medical practice; or that it is a theory of human mental functioning and of the disorders to which it is subject, therefore a branch of academic psychology, and thus subject to the canons in general use to determine the validity of hypotheses in that field.  In either case, the methodology for validation involves the use of statistical correlations in large data sets, with control subjects or placebos, and with various measures taken to exclude any bias from the subjective position of the one doing the inquiring.
From the cultural historical point of view, such procedures are by no means misguided or pointless in themselves.  The problem is rather that they do not address the question that is being asked.  The question of the rightness or wrongness of a theory or practice is not at issue; what is to be determined is how and why a certain community of professionals has convinced itself that this is the way to determine the validity of a practice, and has decided to accept certain results as proven.  In the scientific discourse, that question never arises, since it is itself the grounding presupposition upon which the entire enterprise rests that the validation procedures are themselves  valid.
From the perspective of the scientific discourse, it is therefore a scandal for there to be competing and incompatible psychoanalytic cultures, because it is in implicit assumption of this perspective that the world in itself is one way and not another.  It cannot exist as more than one state of affairs at a time.  Either it is round or it is flat, either it goes around the sun or the sun goes around it: it is inadmissable that both propositions could be the case.  A valid science, therefore, ought to aspire to describe and account for the way the world is at is actually is, and since what it is must be singular (though of course highly complex) for any given point in time, so the theory would have to be singular also.  Since, however, psychoanalytic is no longer (if it ever was) singular and unified, then it would seem to follow, according to this line of thought, either that psychoanalysis is not a science, or it has not yet become one – or, to add another possibility, that it is therefore an incorrect theory that ought to be consigned to the dustbin of history (a view presumably not held by most of those assembled here, but certainly not an uncommon one in the world beyond these walls).
There are good reasons to want to be a science.  The scientific method has produced wonderful additions to our store of knowledge, and to our ability to solve problems and treat illness.  And in the realm of psychoanalysis, scientific research in fact has produced many very noteworthy results.  But it is not primarily because we were convinced by any of these,  I would wager, that most of us in this hall chose to invest the enormous amounts of time, effort, inconvenience, and expense required to become psychoanalysts.  Indeed, had we been guided by such factors, we should more likely have become cognitive behavioral therapists, or gone into biopharmacology. I would propose it as an empirical fact that a person’s conviction about the truth of psychoanalytic propositions by and large rarely if ever does actually derive from its validation by scientific procedures. Why then are we so anxious that psychoanalysis should be a science?
I will leave aside as an obvious answer the positive value of science and turn to other compelling but not quite so high-minded reasons.  Most of these have to do with the fact that, to continue with the language I have been using, science is, in the world we live in, hegemonic, in the sense that it enjoys high prestige and is taken to be the repository of truth in the contemporary Western secular cultural milieu.  I can count on your own experience with contemporary culture to confirm this observation, but it can also be supported by very simple objective criteria, such as, for example, a comparison of the annual budget in the US of the National Science Foundation, or the National Institutes of Health, with the annual funds allotted to the National Endowment for the Humanities or the National Endowment for the Arts (I grant that the situation is somewhat more favorable to the latter pursuits in other countries).
To be a science, or to follow scientific method, means to get NIH grants,  to be eligible for insurance coverage, and all sorts of related real world considerations which currently work against the financial viability and the prestige of the practice of psychoanalysis.  Psychoanalysts do not publish in Science or Nature, they don’t win Nobel prizes, they don’t receive funding from pharmaceutical companies, and in general they play second fiddle to many other medical and academic specialties, which is certainly a frustration and perhaps a source of both pride and  envy.
But I think the main unspoken anxiety surrounding the status of psychoanalysis in relation to science is this question: If psychoanalysis is not a science, then what is it?  And here’s the rub: Science as opposed to what?  There is, I would argue, in contemporary society, no rubric equivalent to science to which any non-science might belong with equal prestige and value, and there are many candidates for “not-science” that are positively damning, as our detractors rarely let us forget.  In the latter category are, for example, “pseudo-science”, or “religion” used in the pejorative sense meaning “a dogma accepted only because of the charisma of the founder and resting on faith rather than reason”.  More positively, something that is not a science might be a craft, or a profession, or a discipline, or a skill, but none of these designations implies a legitimate claim to be grounded in objective certainty as science does.  Perhaps the most flattering alternative to science is “art”, and few who practice it would doubt that there is an art to psychoanalysis.  But art suggests the free play of the imagination which, charming and excellent as it may be, is the very opposite of the grounded objective certainty that science promises to deliver.
The worst alternative of all, however, seems to be that if something is not a science, then it is nothing.  If there is not certainty, and no method for determining what is objectively true, then, it is said, we have a chaotic situation to which a number of evocative phrases maybe attached: “Babel”; “Everything Goes”; “Rashomon”.  The fear of those within the science discourse is that if there is no right answer, then there are no criteria at all for preferring one interpretation over any other.   “Hermeneutics” is understood to mean, not a theory of sound interpretation, but rather license to say or do anything one wants. If we are only weaving narratives, then who is to say where truth lies?  Hegemonic power goes to the best or most persuasive story-teller of the moment or, worse yet but more likely, to whoever holds dominant positions of power and can thus enforce acceptance of a certain line of interpretation.
The word “Rashomon” – the title of a movie by Akira Kurosawa, (“Rashomon” being the name of the temple where the narrative of the film takes place) – has come in modern discourse to signify a certain philosophical stance that has much in common with such western ideas as nihilism, existentialism, and now post-modernism.  In the movie, four different narrators tell radically different stories about an incident in the forest that left one of the participants dead (he tells his story through a medium).  These are not merely differing perspectives but quite incompatible stories and, according to the way in which the word “Rashomon” is typically used, there is no way for us to judge among them: there is, in a word, no truth of what really happened, but just a social arena or  marketplace or court in which differing narratives abound and to some extent compete, with no higher court to which we can appeal for a final authoritative decision about the truth.
(I will make a quick diversion to point out that I too assumed that this was what the movie was about, until I decided to actually watch it again recently.  In my view, there can be little doubt that the point of the film is that the three active participants in the story – the husband, the wife, and the bandit — all told falsified stories to make themselves look good; while the woodcutter who happened upon the scene and watched it unfold as an objective observer told the story as it actually happened.  Kurosawa’s point is not that we can’t posit any underlying truth behind our narratives, but rather that people are self-serving liars and we can’t know the truth not because there is none but because no one can be counted on to tell it. I think this is a lot closer to the ideal psychoanalytic perspective than the nihilistic reading would be. But that is neither here nor there; “Rashomon” rightly or wrongly, continues in common parlance to signify a situation in which a diversity of stories indicates a denial of the existence or possibility of any underlying actual true story).
Let me suggest two other ways in which a diversity of views of the same phenomenon may be understood, besides “Rashomon”.   The first is that described in the well-known parable of the six blind men and the elephant.  One, touching the tusk, declared that elephant to be like a spear; a second, touching the trunk, said it was like a snake; a third, touching the ear, asserted it was like a fan, and so on.  The story implies that there is a real elephant, and  we who are not blind know what it is really like; but those without sight seize a partial corner of the whole, and take it to be the complete elephant.  By analogy, we who are not omniscient perceive the world based on our inevitably limited experience of it, and so succeed only in elevating a part to the status of the whole.   And, minus the somewhat condescending tone of the parable, this is a commonly held view of the multiplicity of the sciences and other disciplines: each perceives a part of the whole, and if it were possible to get them all to collate their expertise in their own particular slice of reality into one larger overview, we could arrive at the true picture of reality as it is.

Certainly one can apply this to psychoanalysis, which seeks, among other things to explore and describe the ideas, memories, emotions, and fantasies in the unconscious mind.  Since we now believe (and,  thanks to cognitive science, we can even claim to know) that the realm of what is conscious pales in comparison with what is not, referring to “the unconscious” is a bit like saying “not Chicago”: one who sets out to explore that realm and  heads west will describe vast prairies, one who heads north will paint a scene of lakes and forests, one who heads east will tell of great rusting industrial cities, and so on – and they will all be right.  So too, Freud looked at hysterics and obsessionals and saw conflicts about sex and aggression ; Klein looked at disturbed young children and saw splitting, introjection and projection, Winnicott looked at mother-infant dyads and saw transitional space; Kohut looked at narcissists and saw self-objects, Lacan looked at adult paranoiacs and saw the mirror effect and the desire of the other; and maybe they are all right, each just a partial view of the totality that we should be able to mold into one grand theory with many subparts.  I am not sure this is an incorrect view, though only the eventual actual emergence of such a viable grand theory would constitute confirmation.
But let me also propose another model for the appreciation of diversity, which I take from the Journals of Ralph Waldo Emerson.  Under the heading “Bias”, he wrote as follows:
            Seven men went through a field, one after another. One was a farmer, he saw only the grass; the next was an astronomer, he saw the horizon and the stars; the physician saw the standing water and suspected miasma; he was followed by a soldier, who glanced over the ground, found it easy to hold, and saw in a moment how the troops could be disposed; then came the geologist, who noticed the boulders and the sandy loam; after him came the real-estate broker, who bethought him how the line of house-lots should run, where would be the drive-way, and the stables.  The poet admired the shadow cast by some trees, and still more the music of some thrushes and a meadow lark.  (1914, v. 10, pp. 146-47)
The burden of this brief meditation is different from the case of the blind men, each one of whom only perceives a part of the whole elephant.  In Emerson’s case, each man sees the whole field – nothing is hidden from view.  But each sees it in a context determined by the particular project on which he is launched, and shaped by his expertise and the questions he asks of it.  What each sees differs widely, but it would be wrong to say that their views are incompatible, for that would imply they were each attempting to do the same thing. In fact they are doing different things and so their views are neither compatible nor incompatible, but only different.  The question of the best spot to deploy the troops is simply not one that comes up in the gaze of real-estate developer or the farmer.  The fact that these perspectives are entirely context-bound, however, and radically different, does not by any means imply that they are not subject to validation, or that they are chaotic or random.  There really is a best place to deploy the troops; there really are boulders and loam, there really is a best agricultural crop for this place, etc. and one can say really true things about these matters.  They just don’t show up when an astronomer is walking across the field, and so the astronomer does not see them, not because he is blind, or his viewpoint is lacking something, but because for him they are not part of the picture, not what he is trying to find out.
I find in this example a very clear refutation of the idea that the opposite of science is chaos.  All knowing takes place in a context, and the geologist has real knowledge just as do the farmer, the soldier, and the physician.  They are all looking at the same thing and asking different questions about it that can be answered in ways that are entirely subject to the form of validation appropriate to that particular perspective – even the poet’s lyric will be judged by his readers by current canons of literary taste.  For example, today’s physician walking the same ground would judge his predecessor in Emerson’s time to be wrong about miasma, just as the soldier of Emerson’s day would be mowed down in today’s warfare.  There is, then, I want to argue, no necessary contradiction between the fact that knowledge is always culturally constructed, never a pure reflection of what is out there; and at the same time it is a reflection of what is out there that can be understood more or less well with knowledge that is subject to testing, validation, and genuine grounded evaluation within a certain viewpoint.  By this logic, then, the Freudian who sees sexual conflict and the Kohutian who sees a defective self may in fact be surveying the same real-world phenomenon, but observing something that emerges from seeing it from the perspective of a particular world system that asks only certain question and therefore only gets certain answers.  In the same way, the question “who is right, the scientist or the cultural critic?” makes as much sense as asking whether the soldier or the housing developer gives the more correct description of Emerson’s field.  And lest we feel that this is slim consolation consigning psychoanalysis to an inferior position in the status hierarchy of knowledge systems, let us remind ourselves that even in that supposed ultimate paragon of “science”, physics, there currently co-exist quantum theory, Newtonian mechanics, String Theory, and Einsteinian relativity, each of which gives excellent descriptions of the world seen from a certain  perspective, but which remain irreconcilable with each other.
Unlike the scientist acting within a certain paradigm, the cultural anthropologist, more in line with the Emersonian perspective, is in the business of understanding systems of thought comparatively as perspectives and points of view, not in judging them to be right or wrong.  The course of cultural theory has been marked by various efforts to provide methods for analyzing cultural systems, looking for regularities, networks of meaning, and symbolic constructions that  both reflect and inform a particular socially grounded form of life.  In the remainder of this paper I want to use one of these, a relatively simple one since I have only a very short amount of time and space at my disposal, to think about some key differences in a few broadly defined psychoanalytic cultures.  The system I will employ comes from the book Structures of Social Life (1991), by the psychological anthropologist Alan Fiske, now at the University of California at Los Angeles.
Fiske’s contribution consists in having taken a great number of previous social theories and synthesized them, producing a system that claims to account for the myriad social and cultural arrangements in the world through the combination of just four elementary structures of social life out of which all more complex social organizations are constructed.  These four structures of social relation include the following: Communal Sharing; Authority Ranking; Equality Matching; and Market Pricing.  Communal Sharing is “a relationship of equivalence in which people are merged…so that the boundaries of individual selves are indistinct”.  Authority Ranking “is a transitive asymmetrical relationship. It is a relationship of inequality”.  Equality Matching is “an egalitarian relationship among peers who are distinct but coequal individuals.” And Market Pricing is “a relationship mediated by values determined by a market system. Individuals interact with others when they decide that it is rational to do so in terms of these values”.  (Passim, pp. 13-15)
Although all societies use all four of these types of interaction in some situations, the domains in which they are typically applied, and the values, positive or negative, that are placed on them, are what create the obvious differences in social and cultural systems found in the ethnographic record.  For example, speaking in very broad terms, in US society, Market Pricing is seen as pervasive and given a high positive value, and indeed in some influential social theorizing, such as the Rational Actor theory of economics or its close related neighbor the Reproductive Success Maximization theory of genetic strategy in evolutionary thought, it is taken to be the only recognized form of action and the only operative motivation in normal behavior.  Equality Matching, insofar as it posits social actors as separate, self-contained peers of equal rank, is an ideal of US culture, while Communal Sharing is generally  marginalized, somewhat devalued and, in the extreme case, demonized as “socialism” or “communism”.   Likewise, although in reality hierarchies are pervasive in US society, Authority Ranking as a value is seen as either a necessary or an unnecessary evil that should be eliminated where possible.  While this may be a caricature, I think it is a very recognizable one with some use. 
In many Asian societies, the positive value placed on legitimate authority has no counterpart in western thought, but it predisposes the student or analysand to revere the teacher or analyst in a way that may preclude the kind of conflictual transference confrontations that are to be expected in the typical US analysis.  A well known variation on this theme is to be found in the case of psychoanalysis in Japan.  Many western analysts are by now familiar with the concept of amae, introduced by the recently deceased analyst Takeo Doi in his book The Anatomy of Dependence (1973).  Whereas dependency longings, which imply a positive acceptance of authority ranking and of one’s inferior position in it, are not explicitly endorsed or approved of in US culture, there is in Japanese culture a much more explicit concept according to which a person tries to get another to indulge him and act as a doting caretaker to him.  This motive, captured in the verb amaeru, is conscious and acceptable in Japanese culture, so that what the US analysand must uncover in his unconscious through emerging anxieties and ambivalences about dependency on the analyst, the Japanese analysand brings straightforwardly to the expected analytic contract. 
This same dynamic appears in accounts of psychoanalysis in India, which, though it is certainly culturally very different in many ways from Japanese culture, shares with it the assumption of the legitimacy of deferential respect – Authority Ranking – in the relationship with a  teacher or spiritual superior.  There is no idea that this should be analyzed away, as is implicit in the US case, where in the ideal case the analysis ends with a de-idealization and corresponding de-mystification of the tranferentially induced hierarchical fantasies about the analyst.  On the contrary, there is value placed on what in the US would be dismissed as a mere “transference cure”, instead of the “liberation” of the individual from bondage to external authority.
In addition, it is often remarked in connection with analysis in the India context that the US assumption that analysis is a relationship between two separate but equal individuals does not translate easily.  Indian people are much more comfortably merged, in a cultural-syntonic way, with their family and with others in close social groups than are US individuals.  To quote the American analyst Alan Roland, who worked extensively exploring psychoanalytic therapy in India and Japan:
What my subjects [in India] emphasized over and over again are the strong emotional connectedness between Indians, usually experienced on a non-verbal level; a more symbiotic mode of thinking of and being constantly sensitive to the other, with internalized expectations of full reciprocity; a tremendous (from an American’s view) giving and taking or constant indulgence of warmth and concern; and a sense of we-ness and partial merger.  This is in contrast to the relative lack of closeness, sensitivity, warmth, consideration, intimacy, and emotional exchange they experienced in most American relationships. (1988, 196-97).
 The idea that as a result of analysis an Indian patient would be freed of “symbiotic
enmeshment” – or alternatively phrased, “deep attachment” –  in a family group would be received not with anticipation but with anxiety, given the expectations and norms of Indian society. 
These characteristics are precisely those associated with the value of social relationships marked by Communal Sharing.  In US culture, Communal Sharing, which assumes the partial merger of individuals with others in the same group, and shared participation in a superordinate social whole, violates the prevalent norm valorizing the ideal of the individual self as an autonomous entity separate from but equal to others, as in the structure of Equality Matching.  Though this dimension of Indian social life has sometimes led to its being judged in disparaging or pathologizing terms by psychoanalytic and other US observers, in a cultural analysis it merely reveals a different arrangement of the elementary building blocks of social and cultural life, which strike the participant as normal and the observer from another system as strange or even bad in some way: the Indians Roland cites find Americans cold and rejecting just as the Americans find the Indians overly enmeshed.
I recently had an opportunity to have a very graphic view of the reality of these cultural differences in a paper  delivered by a student of Fiske’s, Seinenu Thein (2009) at a conference on Psychological Anthropology.  Thein, who is Burmese herself, was able to do field work in Burma, where she pursued a fascinating comparative study that produced contrasting video footage of Burmese and US children in ordinary situations to show how non-verbal bodily practice inculcated and illustrated different cultural norms.  For example, one scene depicted a situation in a US household in which a mother with small children is visited by a female friend also with young children.  The four children are being fed, and they all sit around a rectangular table, each with an identical plate of food and a glass of milk, looking at each other across the table and talking while the mothers serve them and chat with each other.  In an exactly analogous case in a Burmese household, there is no table; the mothers sit on chairs near each other, while the children are distributed on their laps and on the floor at their feet.  The mothers and children put food from a communal plate in each other’s mouths and the children offer each other drinks from shared cups, but they are not arranged so as to be looking at each other, giving the impression more of a single entangled mass of humanity looking out at the world from a unified place, rather than of separate individuals experiencing “fairness” among them and “communication” between them across an empty space  The images are striking illustrations of the very real ways in which different values are inculcated: the US children are being trained to be equal separate individuals, the Burmese children to experience themselves as deeply connected to a larger whole of which they are simply one part.   Or in other words, the Asian person is taught to expect Communal Sharing in a situation that in the US is construed as an occasion for learning the dominant value of Equality Matching.
An equally striking video sequence, illustrating the contrast between US expectations of, and socialization into, Equality Matching with Burmese expectations of Authority Ranking, shows scenes in an early grade of elementary school in each culture.  In the Burmese case, the children all automatically bow when they pass by Thein herself holding the video camera, since she is seen as a grown-up and a teacher, and deference is shown by lowering oneself before the authority figure.  In the US case, the footage shows various instances in which in order to talk to the child on its own level, the teacher herself squats or sits near her so that her head is at eye level with the child’s.  In the latter case, Equality Matching is being enacted and demonstrated by the socializer, whereas in the Burmese school, the student would never place him or herself above or equal to the teacher.  
When we turn back from the helpful corrective of looking at other cultures to look at ourselves (and I write of course as someone from the US), we may say that, in contrast with many Asian societies, one of the main story lines of the cultural history in the West has been a relentless attack on, and resultant weakening of, the legitimacy of most forms of authority, whether religious, royal, familial, or otherwise.  The Renaissance and Reformation, the Enlightenment, the process of industrialization, urbanization and the rise of the modern era and subsequently of the post-modern, have all contributed to this trend.  This assault on Authority Ranking as the prototypical norm for the organization of states, communities, organizations, or families has, however, led in two different directions.  One of these, which we may characterize as “liberal”,  has held up as the post-hierarchical ideal an image of society as a product of the collective actions of free, autonomous individuals, each equal to the others in rights and status, who choose to contract together when it is to their benefit according to rational and enlightened self interest.  This, then, is a picture of the historical replacement in many spheres of Authority Ranking by the twin ideals of Equality Matching and Market Pricing. 
The other trend has been the replacement of Authority Ranking with an ideal of Communal Sharing, which, elevated to a political principle, also enjoins equality among people, but now by virtue of their participation in an overarching social unit to which they are loyal through their identity with it.   As a political ideology this trend can lead to such diverse outcomes as nationalism, socialism, and more recently, identity politics, with the latter’s close alliance with post-modern, as opposed to modern, ideas and political views.
In this historical context, psychoanalysis can certainly be seen as part of the critical, even radical, attack on traditional modes of thought and action, in its unmasking of various illusions and hypocrisies of the old regime.  It also played, and plays, an emancipatory role in the lives of individuals, liberating people from the inhibiting effects of excessive repression and superego prohibitions.   Freud’s focus on the centrality of the story of Oedipus, the mythic regicide and patricide, seems to epitomize the anti-authoritarian spirit of the age. Looking from today’s perspective, of course, one can see that  classical Freudian analytic practice nonetheless retained a certain degree of the authoritarianism of the European milieu in which it had been born.
Classical Freudian analytic technique is clearly based on the idea of the separate autonomous individual actor, enough of whose rational, reality-oriented mind must be intact so that he can form an alliance with the analyst against the conflict-ridden neurotic part.  The ideal concept of a cure rests on the assumption that the analysand will be restored as a fully autonomous person capable of managing his impulses and his anxieties and thus functioning in the social world and the marketplace.  The technique consists of taking what starts as a contractual, rational agreement between a prospective analysand and an analyst and allowing it to develop into a relationship in which what are taken to be repressed, infantile, regressive wishes and fears take over, so that what once was a contractual agreement about the fee or the schedule turns in to a psychodrama with the analyst about love, rejection, authority, defiance, and so on. 
One of Freud’s simplest but most powerful techniques for this achieving effect was the use of the couch.  When the prospective analysand first comes in to consult, he is sitting face to face with the analyst, as in any client-to-professional situation in an Equality Matching, Market Pricing system. But when he lies on the couch, he assumes a position more consistent with Communal Sharing and Authority Ranking  than with Equality Matching – like a child on his mother’s lap looking outward at the world, or an infant in a stroller, with the mother experienced as a more or less reliable and empathic self-object backing him up.  The aim of inducing this relationship is, however, not to allow it to prevail, but rather to expose it to critique through interpretation, and thus strengthen the hand of the forces of rationality, that is, of Equality Matching and Market Pricing.
Most of the trends within psychoanalysis that have sought to revise Freudian theory and technique may, by contrast, be seen to be assuming as a default position of human being not the autonomous individuals of Equality Matching but the deeply connected and to some degree merged selves of Communal Sharing.  From this point of view, the Freudian position is criticized as a “one-person” psychology in which the analyst, himself unengaged with the patient except at a professional level, tries through interpretation to bring about changes in the internal regulation of the drives, affects, and fears of the patient.  From the more relational points of view, the person is never an autonomous being, but is always already defined by participation in multiple relations, so that a view inside his mind reveals not the dynamic play of internal forces, but the representations, projections and introjections that are his end of the many connections he always has to others.  The “two-person” psychology means that the analyst, too, has multiple connections with which he reacts to the analysand, who is not an “autonomous ego” who “has” a “disorder” but a being globally seeking connection, and eliciting it in those he interacts with, including the analyst.  The goal of the analysis is not to rid him of his wishes for attachment, merger, and dependency, but rather to make up for deficiencies in his relational history that have prevented him from developing optimal adult relational abilities.
What I have tried sketch here, then, if all too briefly, is a conceptual grid of how different ways of thinking about psychoanalysis as a technical method vary according to whether one is found in a cultural milieu in which the dominant value is Authority Ranking, or Equality Matching and Market Pricing, or Communal Sharing.  Opposite valuations of Authority Ranking differentiate various Asian situations from most of those in the West, while within the West, with its anti-authoritarian stance, the split is between those for whom the prototype of personhood posits the autonomous individual of Equality Matching and those who value the connected, deeply socially embedded person of Communal Sharing.  Each one can find fault easily enough with the other, and from its own perspective each appears to the others to be missing the most important or valuable points.  But I propose that  the more helpful perspective is the one that surveys them all and recognizes them each in their integrity and their coherence in their own terms, and learns to move among them with a certain degree of ease.
References
Doi, Takeo.  1973.  The Anatomy of Dependence. Tokyo: Kodansha
Emerson, Ralph Waldo.  1914.  Journals, Boston & New York: Houghton, Mifflin.  Vol. 10
Fiske, Alan.  1991.  Structures of Social Life.   New York: The Free Press
Roland, Alan.  1988. In Search of Self in India and Japan.   Princeton: Princeton University             Press.
Thein, Seinenu, & Alan Fiske.  2009.  “Our Bodies, Our Minds: The Bodily Experiences of
 Children and How They Come to Know the Sacred, the Powerful, and the Communal,
 an Ethnographic Comparison of Burma and the United States.”  Paper presented at the
 biennial meetings of the Society for Psychological Anthropology, Asilomar, CA. March              27, 2009._______________________
 ***    Emory University, Atlanta, Georgia:   Presented at IPA Chicago Meeting 2009.