CHAPTER FIVE

An “ethical code” for authors?

Parthenope Bion Talamo

When I first started thinking about the possibility of producing a paper on writing in psychoanalysis, I had something very simple and practical in mind; not exactly along the lines of an American-style course on “creative writing”, but something of that sort. So I was aiming to speak about writing considered as interpersonal communication, which is the area that the people on the board of editors of the Rivista di Psicoanalisi usually find themselves dealing with, inasmuch as they function as editors rather than as analysts—and it is also the level on which they find that they have trouble. As I slowly mulled over the (few) ideas that I had on the subject, while being influenced by recent vicissitudes in the Italian Psychoanalytic Society, gradually some thoughts that were connected a little more clearly with the ideal, triangular relationship between the writer, psychoanalysis, and the reader, emerged. At this fatal point (in the sense that chance plays its part, too) Alberto Semi asked me, without the slightest warning, what the title of my paper was going to be … and the outcome is something of a hybrid, perhaps rather unpleasant title in fact, even though softened by Alberto's having wisely added a question mark to the original.

In any case, I will try both to keep to my original project and also to blend in with it some of the ideas that came into my mind later, after having tied myself down to a title. The later ideas arose partly in connection with the vicissitudes of the Italian Psychoanalytic Society (I.P.S.), which had undergone a split, and partly from the need to provide the Society with an ethical code to clarify the approach of analysts to the ethics of psychoanalysis. A further train of thought was set in motion through a series of connections that formed in my mind between a few papers, some specifically analytical and others more general, which seemed to me to be pertinent both to the ethical and to the practical side of the question. The first of these, from a chronological point of view, is Jaques' (1981) short paper “The Alms of Psychoanalytical Treatment”, which highlights the concept of the “unconscious will to live” (p. 423), describing the behaviour that is a consequence of this will, and how all this lies at the base of our psychoanalytic concept of “normality”. The unconscious will to live, as well as linking the single individual to his community through the survival of the species, also becomes an important criterion for the termination of an analysis. It seems to me that with this paper by Jaques at the back of my mind it is possible to perceive that the communication of scientific work between colleagues is vital for the survival of the psychoanalytic community; communication has valences that go beyond the individual's narcissism to become a group link and thus has an extremely important role to play within the group. Most of the papers by analysts that I have looked at tend to deal with the subject of writing mainly, if not exclusively, from the point of view of the writer's inner world; this is certainly an extremely important aspect, but I think that it lies outside the task that I have been set. I will not go into this aspect, then, since it seems to me to be more specifically psychoanalytical and not so necessarily pertinent to the editor's work (I am referring principally to the Nouvelle Revue de Psychanalyse, 16, 1977, and also to the Revista de Pslcoanalisis, 49 (1), 1993).

To go back to my starting point, that of the usefulness of some sort of guideline to good literary behaviour—not quite a book of etiquette, but getting on that way: I was very much struck by two papers in the first number of Medifax. The first of these is by Stephen Lock (1991), the director of the British Medical Journal, and the second by Giuseppe Ippolito (1991), who is coordinator of the Giornale Itatiano dell'AIDS. In this paper, Ippolito indicates standards of behaviour for the referees of scientific papers, showing the need to proceed step by step along a sort of critical path that can be formulated through a series of questions more or less as follows: is the paper original? Is it clearly set out? Does it take the relevant literature into account? Is it complete with bibliography and summary? Is the title appropriate?

These questions which the referee ought to ask himself about every paper that he vets stimulated me to think further about the writing of papers—understood as a moment in which the aim is to communicate something—from the point of view of a psychoanalyst, not restricting myself to simply following this advice as an editor of the Rivista. Another tessera in the mosaic of my thoughts, placed alongside Ippolito's paper, was the fact that at just about the same time I came across a contract for the publication of a book, in which the author practically has to swear that the text that he presents for publication contains no material that is defamatory or could be offensive, and that the contents are truthful to the best of his knowledge. This contract made me think that publishers and editors must, in fact, really find all sorts of things on their desks …

At this point of my meandering around the problem, a colleague very kindly lent me a recent monographic number of the Revista de Psicoanalisis, entitled “Escritura in Psicoanalisis”, in which one of the papers (Moscone, 1993) presents a whole list of questions—four entire pages of them—which, according to the author, any analyst who wants to embark on the writing of a paper should ask himself. Moscone maintains that the writing of psychoanalysis is essentially different from all other writing and requires a specific procedure; hence the questions, which can be thought of as outlining a sort of “pathway to self-knowledge” for the analyst, covering the ground of the nature of his work with the patients about whom he intends to write, and that of his own attitudes, which can be narcissistic, prejudiced either towards or against a given theory, and so on. It seems to me that Moscone's questions can be a useful complement to Ippolito's more technical ones, although, as we shall see, I do not agree at all with the idea that the writing of psychoanalysis differs substantially from any other scientific writing.

Some of the questions that Moscone poses show a preoccupation with the writer's intellectual honesty, and I think that this problem of honesty, and everything connected with it, is one of the elements that all scientific writing presents (and this is the basic reason why the term “ethical” ended up so uncomfortably in my title). I can agree with Moscone when he states that writing psychoanalysis has a nature of its own, but only insofar as it seems to me that, as we are analysts, we have heuristic tools at our disposal that allow us to enquire into our “doing” in a new and much more powerful way than was possible earlier (or is possible even now 1f we restrict ourselves to the use of exegesis and hermeneutics, which Moscone quotes as being inadequate). However, this does not prevent the useful exportation to other fields of the results of a psychoanalytically informed enquiry into writing. This persuasion of mine also implies the idea that, fundamentally, scientific method is one, and that it can be studied apart from the specific contents of the single sciences. I hold, furthermore, that the study of scientific method, which includes the communication of scientific activity both to colleagues and to society at large, cannot do without a psychoanalytical enquiry that clarifies the ways in which both scientific method and communication are structured. I intend to discuss this second aspect now, and it seems to me that it is possible to embark on a specifically psychoanalytically informed enquiry, with the aim of attaining something useful and practical, even though what I am going to say at this point may look like a long digression.

Which are the pertinent psychoanalytical theories? Although it may seem anti-historical, I am led by the nature of my argument to start with Bion and go on to Freud—a “minor” Freud, but most significant for the intuitions expressed.

In Learning from Experience, Bion (1962b) speaks of the way in which the individual's relationships with his inner and his external objects—with the whole world—are carried on under the aegis of particular mental states that emotionally colour both the links that are set up and the very setting up of the links themselves. Bion chooses three specific, more or less hegemonic, states—Love, Hate, and Knowledge, indicated by the letters L, H, and K. He also speaks of the three complementary states, -L, -H, and -K, in which the positive characteristic of moving towards an object, to enrich both it and the subject, becomes instead a “draining away” from the object, a “depriving” it of the quality in question. In our context, we could say that a scientific paper written under the aegis of K is one whose content has been adequately worked through in the author's mind, and that the latter can feel that he has a reasonably good command of the ideas he has expressed, which also comes from having sufficient experience and maturation, from a sufficiently long study of his particular subject. A paper, on the other hand, that has been written under the aegis of -K, since -K is not simply the opposite of K, not only does not have these characteristics but is written—is thought—in such a way as not to give any new information to the reader, and does not stimulate the latter to produce new thoughts for himself. Writing of this sort is in no way interactive with the reader, it does not allow a dialogue with him, it is almost as though it were dead. I expect that we can all call to mind an example of this sort of writing; for me, at the top of the series (or perhaps the nadir), is a history of the birth of the State of Israel, which is also a biography of Theodor Herzl (Elon, 1975). This is a book that, most unusually for me, I have never been able to finish, because it made me feel that it was never going to get off the ground. It seemed to me that it was a sort of hagiography that went on repeating ad nauseam that Herzl was a brilliant man who had had a brilliant idea, without ever going into the details of what he had thought or how his ideas had developed. (Obviously, this is not an analytical book but has pretensions in the direction of scientific historiography; I realize that my reaction to the text might merely be idiosyncratic, but even when I take it up again, years after the first attempt, it has the same frustrating effect on me. Among the books at the other end of the scale, one would certainly place Freud's works.)

It would also be possible to write a scientific paper under the aegis of L; in fact, I am sure that a good scientific paper, well written and which thrills the reader with enthusiasm, cannot be without feelings of love for psychoanalysis, for the creative act of writing, for the use of the tongue in which it is written and the appropriate language, and feelings of love too towards those people, as yet unknown, who will read the paper. (Naturally, the person who was best able to express this concept could not but be a poet, who consigns the beauty of his loved one to posterity in order to keep it alive, and in so doing implies gratitude towards those who will, by reading, further his project: “… So long as men can breathe and eyes can see, / So long lives this, and this gives life to thee.”) Again, a paper written under the aegis of -L, always supposing that it is possible to write in such a colourless mental state of indifference and emptiness, would be extremely difficult to tolerate. Perhaps the chapter of The Interpretation of Dreams (Freud, 1900a) that Freud found so difficult to write, the one in which he “had” to review the previous literature on the subject, might be considered an example of writing in which one catches just the faintest whiff of-L (Jones, 1953, I: p. 358).

We can draw up the hypothesis, then, that a good piece of scientific writing has the characteristics of L and K links. But does this hypothesis lead us anywhere? It takes us in two directions, I think: in the first place, a paper written exclusively as a form of knowledge, that is, under the aegis of K, might well remain a private fact, without the third pole—the reader, the public—being called into the question. When the L link comes into the picture, this third pole becomes more important, because love for psychoanalysis and for writing requires that there be someone to receive the communication, in the same way in which a musician is not complete if there is never anyone to listen to him.

Calling the reader into the question, however, sets off other psychological mechanisms, which, as far as I know, have not been much studied with reference to groups. I am referring in particular to projective identification (on the writer's part) and to the capacity for toleration, on the part of the group of readers (or listeners, if the paper is read at a conference) (Bion, 1962a), acting as a container for the projective identifications. (In the case of a conference, the interplay of projective identifications, in both directions, is much more evident and can lead to modification of the paper even while it is being read.) All of us may—and do—have conscious expectations about the way in which our mental products will be received, whether they be in the form of a conference, a seminar, or a publication for reading in private, which range from the Nobel Prize, or the “Booker”, the “Strega”, or the “Goncourt”, at one end of the scale, to bad eggs and tomatoes, or the exclusion from civil society for the rest of one's days, at the other. In some way or other we usually manage to deal with these fantasies so that they do not interfere too outrageously with our capacity for work.

I am less optimistic, however, as far as our capacity for dealing with projective identifications is concerned, particularly the less realistic ones (which can in some ways be likened to unconscious expectations). When I mentioned mental products a little way back, the idea of a very small baby also came into my mind, depositing its faeces in its mother's lap. How many of the papers that have been sent to the Rivista have been unconsciously accompanied by messages that would have been appropriate x years previously, when he, the author, was held in his mother's arms? How many papers seem to need maternal care to clean and tidy them up, and how many have been felt— correctly, I think—as hostile and arrogant attacks on the reader? In how many papers does one come across howlers that make one think that the author must have had strong feelings of envy, hatred, or who knows what—perhaps simply deathly boredom— towards the author or authors whom he is himself quoting? As an example of this sort of thing, I would like to quote a well-known and esteemed psychoanalyst who, in a paper that seems to have been produced for teaching purposes, states:

… the first group considers that the aim of interpretative work is to produce a deep understanding, which will allow the patient to carry out his wishes without anxiety or feelings of guilt; the others (for example Bion, 1976) say that analysis aims at reaching a state “free from remembering, desiring or understanding”.

(“The first group”, in this passage, consists of Anna Freud, Eissler, Fenichel, Greenson, Lampl-de Groot, Loewensteln, Neyraut, Sandier, Zetzel; while “the others”, apart from Bion includes Balint, Bouvet, Giovacchini, Kernberg, Khan, M. Klein, Little, Rosenfeld, Segal, Winnicott—two rather mixed bags, though united in the author's mind, it would seem, by a certain amount of spleen—Cremerius, 1985, p. 115.)

If it is to be supposed that some of these meta-messages that show through between the lines of scientific papers are in fact signs pointing to the presence of projective identifications, it is also true that the person who is reading has to come to terms with his own reactions as “container”; he has to decide, that is, whether the acidic comment or the excited enthusiasm that rises unexpectedly to consciousness are really in tune with the work they are reading, or whether there is not something excessive in these reactions, which might be a way of responding to a projective identification that is felt to be hampering the course of thought and yet needs to be taken in and seen to. I think that some of our difficulties as readers (and as writers) may lie on deep levels of the unconscious where there is in fact an interplay of projective identifications that imply an incorrect, since unrealistic, attribution of characteristics and functions.

One of the problems that we meet if we try not only to ferret out this sort of difficulty but also to act in order to resolve it to a certain extent is our (correct) sense of reserve over using psychoanalytical concepts, theories, and understandings outside the analytical context proper. But we go on being analysts, that is to say, people whose sensitivity towards certain types of behaviour should be sharpened by the work we do, and this sort of sensitivity cannot simply be turned off outside the consultationroom. This means that sometimes we find that we are faced with a scientific paper that disturbs us, maybe violently, and that furthermore we have to face up to these feelings and also interact in the outside world, in our dealings with the colleague who has written the paper. So far, the structure of the Rivista has involved “blind” reading, which can be a help, in the sense of allowing a freer expression of one's unease, but there comes a moment when one of us has to get into touch with the author and say something to him, preferably in a civil fashion, to give him support, if necessary, and at the same time do this without being intrusive.

At this point, we can turn to the other branch that stems off from the hypothesis of a paper written under the aegis of L and K (I am not taking into consideration works written under the aegis of H, though I think that they exist). The writing of a scientific paper entails not only the creation of links, internal ones in the first place, with the subject of the paper, but also—at a stage that is either earlier or contemporary with the creation of inner links—many passages from the paranoid-schizoid position to the depressive one and vice versa. It seems to me that usually this is anything but pleasant, being accompanied by feelings of anxiety and a general sense of malaise, of which the well-known block when confronted with the white page (or equivalent) is just one example. It is an unpleasant situation—principally, I think, because these processes are deeply unconscious during most of our waking life, and having to perceive them consciously, even if only very dimly, undoubtedly entails the arousal of anxiety and feelings of pain and loss. Freud was aware of this sort of problem, as we can see from his note on the prehistory of psychoanalytic technique, in which, à propos of free association, he talks about creative writing and mentions the article by Ludwig Börne, “The Art of Becoming an Original Writer in Three Days” (Freud, 1920b). Börne says that one must write notes for three days on everything that comes into one's head, as a method for becoming a writer; he then remarks that in reality the individual lacks moral courage, not ideas. Here it seems that Freud almost prepares the ground for the much later theory of the paranoidschizoid position (and the oscillations between this and the depressive position) as a constitutive element of creative thought, but the comment on the “moral qualities” of the writer is also pertinent to my idea, though it is still vague and not clearly formulated, that writing psychoanalysis also calls an ethical element into the field.

At this point, my original intention of writing an “ethical code” for the authors of psychoanalytical texts seems to have disappeared completely, and to be rather difficult to retrieve, after this long theoretical digression, mainly on a limited aspect of Bion's theory of thinking. But there is in fact a connection, and perhaps more than one, between two subjects that appear so far apart.

If we now take a look at a series of “defects” in writing (many of which can probably be found in this paper I am writing/ reading), perhaps we can form a few ideas about the way they come into being and hence suggest a system for limiting them— a system that will in fact be akin to an “ethical code”. This kinship exists, to my mind, because those aspects of a written text that simply appear under the guise of technical “defects”, so to say, are in reality the expression of subterranean states of psychological malaise of various sorts. An ethical code for the psychoanalyst/writer of scientific papers could then be useful to the author, as a sort of memorandum that would allow him to check—through the external signs that he comes across in the way the text is written—the state of health of his own creativity, of his relationship with his work, and of his relationships with his colleagues. This sort of code can be considered to be “ethical” insofar as our working tool, our mind, “must” be kept in good working order; it is part of the duties one takes on if one decides to become a psychoanalyst, duties that concern not only our relationships with our patients or our colleagues, but also those that we have towards ourselves. (In the same way in which someone who wants to be a musician or a neurosurgeon, for example, has to give up those sports that strain the hands excessively, we have to keep an eye on the efficiency of our mental functioning and protect it.)

The first “technical defects” that come to my mind are the following:

1. the use of a language that is too specific, verging on jargon for those In the know, in the context of psychoanalytical theorization, which cannot reasonably be held to be of common use and hence known to everyone (I am thinking of Wlnnlcotttalk, Blon-talk, and so on);

2. the use of terms in foreign languages without an explicatory note, where a term in the language used for the rest of the text could be adopted or, failing this, an adequate explanation of the foreign term;

3. the lack of a summary;

4. the lack of a bibliography;

5. the use of clinical vignettes that do not seem to be connected to the theoretical part or do not illustrate it adequately;

6. a confused and untidy presentation of the contents, which gives the impression of thoughts jumping here and there;

7. the quotation of a mass of bibliographical data that suffocate rather than illuminate the author's thesis;

8. the use of justifications for the correctness and validity of a theory made exclusively with reference to other theories instead of on the basis of clinical experience:

“Freud says …” is not enough to guarantee the truth of an author's statement about a theory of his own.

It seems to me that the first group of defects, from 1 to 4, has a ground in fantasies in which the readers are invested with various sorts of parental characteristics. The use of (1) jargon and of (2) untranslated terms in other languages has a great deal to do with fantasies of infantile omnipotence; while the lack of (3) summary and of (4) bibliography seems, rather, to be connected with fantasies that consider potential readers as “containers” that “must” busy themselves with cleaning up and with completing the things that the child has left undone.

The defects that I have gathered together under points (5) and (6)—inappropriate use of clinical illustrations and a confused and untidy presentation—would seem, rather, to stem from a sort of stickiness, as though the author had got rather mixed up in the paranoid-schizoid position and were not quite able to free himself from it to make that last passage to the depressive position, which would allow a better tidying up of the whole paper.

The last two defects—(7) too many bibliographical data and and (8) validation “between theories”—concern the fantasy relationships between the writer and the group that is his reference point in the real world. In our case, this is the I.P.S., certainly, but also “Psychoanalysis” and furthermore “La Rivista”, which is often felt to be a sort of bugbear among those who do not have much to do with it. (Even I, who ought to feel that I “belong” to the Rivista and who should have felt that I was playing on home ground during the day-long study-group, found that I had a good many qualms, in the first place while writing this paper, and in the second while presenting it.) The unconscious fantasies at the base of this sort of situation are rather paranoid, the interlocutor Rivista being felt to represent something imposing that requires a rigidly orthodox attitude on the part of the postulant, without which it will not be possible to placate it. The nature of this orthodoxy is not defined in the fantasy, and the minor sort of orthodoxy that is actually required of the authors, outlined in the “Notes for Authors”—for many years defined as “Standards”—is happily ignored most of the time, perhaps because it is of no use for quieting the unconscious fantasies?

This grouping of the most frequently met defects also corresponds to different areas of problems, which range from the relationship with oneself, to the one with our discipline, and with our colleagues, and all three of these areas can be suffused with feelings of love or knowledge to a greater or lesser degree. The ideal situation, a sort of “state of grace” for the writer of psychoanalysis, would correspond to one in which he feels that he has a tranquil mastery of the subject, he knows that he will not damage the patients of whom he wishes to speak, he wishes to present his ideas to colleagues towards whom he has friendly feelings, and from whom he expects to receive a respectful hearing that might give rise to reasoned criticism from which he thinks that he will be able to learn something. Briefly, he expects both to give and to receive through the act of communication that he is about to undertake. (It was pointed out to me during the debate that this does not correspond to an ideal state but rather to an idealized one. This is a valid criticism, and I am bringing it in here not only because of its intrinsic value, but also because it throws light on the way in which both my conscious and unconscious preoccupation with very uneasy feelings connected with the current splitting tendencies in the I.P.S. can colour the formulation of a theory, in an idealizing way in this case, letting fall by the wayside those aspects of healthy aggressiveness that are also part of the humus from which a new idea is born. This aggressiveness is recognized as such and at times arouses polemical reactions in the listeners or readers.)

We have now reached the fateful question: What sort of an ethical code, then, and how is it to be drawn up? Given the precedents of Ippolito and Moscone, it seems that it will necessarily have to be a questionnaire, an enquiry, not the Tables of the Law.

But if, as I think, this sort of ethical code ought basically to be part of one's own self-analysis, how can one draw up a set of questions that will be valid for everyone? Semi's famous question mark turns out to be an important integration of my title, not just something that softens its harshness. Writing psychoanalysis, communicating with our colleagues, is an integral part of the scientific side of our work, and the latter cannot be separated from a continual questioning of oneself on the meaning of what one is doing. Perhaps the most important part of the analyst's thinking in the here and now of the session comes about through his formulation of those specific questions that are valid in that moment in order to push his thoughts still further, though most of the time, of course, he keeps these questions to himself, does not express them out loud, and does not inflict them on the patient. Therefore each of us might amuse himself by drawing up his own personal ethical code, changing the questions in it from time to time, according to his evolution, trying to be as honestly aware as is possible of his own emotions and unconscious tendencies.

But it is by no means easy to carry out self-analysis—this is the reason why our patients allow us to work—and perhaps it would be a good idea to have a friend to whom one could entrust a reading of the manuscript in fieri¹—someone who, without going into details intended to reveal the writer's unconscious, could say to him: “Look, here you sound a bit fed up, here it's not so clear—and if you changed the order of those two paragraphs? …” This is not the role of the editors of a psychoanalytic journal, although sometimes I get the feeling that it is what the aspiring authors propose we should do. Perhaps one of the problems that we ought to face up to as members of an editorial board is precisely that of a sort of “bringing up” of our authors, with a greater awareness than we have had so far as to what is involved. We can gain this both from technical hints like those in Ippolito's paper and from our professional awareness of the unconscious aspects of writing and communicating.

NOTE

1. In fierl: in preparation.