There’s a complex and convoluted metapsychology underlying psychoanalytic praxis, a theory about what it’s like to be human and how change happens. But the practice of analysis is minimalist in the extreme. As Sinthome describes it in the commentary to one of his recent posts, the third in a series on Lacanian sexuation:
The analyst barely says anything at all, often simply repeating certain phrases or remarks that the analysand makes, occasionally modifying them slightly. It is the analysand that does all the work.
Recently an online friend told me about SAA — Sex Addicts Anonymous, a 12-step program modeled on AA. Here are the first three steps:
- We admitted we were powerless over addictive sexual behavior – that our lives had become unmanageable.
- Came to believe that a Power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood God.
The SAA meetings consist largely of public confessions and testimonials; outside the meetings members talk with their “sponsors” — those who have been “sober” for awhile, who are farther along the 12-step path to recovery.
These radically different psychologies share at least one thing in common: a tenuous connection between theory, practice, and results. If a Lacanian analysand actually achieves change, can it really be attributed either to the analyst’s interventions or to the structural alterations proposed in Lacanian theory? If the sex addict kicks the habit, can it really be attributed to meetings and the sponsorships or to the higher Power who works through these means?
Hence the shallow pragmatic skepticism of the empirical approach. We can speculate all we like about why things happen, but at least we can document what happens. If you think the outcomes being measured inadequately reflect the real changes being effected, then tell us what you think those changes really are and we’ll figure out ways to measure them instead. If you can’t distinguish your services based on outcome then price and customer preference become the deciding factors. Some people like to take a bath; others prefer to pay $80 for a massage. Some jog around the neighborhood; others join an athletic club.