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âMy interest is to rather than continue with the psychoanalytic tilt which has tended to try to find the words - to find the areas of the analyst that has words to engage with these states and then help the patient transform these states into something thinkable and communicable. [In contrast] my interest has been to take the patient where they are; itâs kind of a radical way of saying âmeeting the patient where they areâ, and find our way and lend ourselves to engaging with them in their own idiom, using Bollasâs term, in their own way of being and to find ways to be with them that donât necessarily rely on talking about things and making things known.â
Episode Description: We begin by considering patient's non-represented mental states and their manifestation in somatic and motoric registers. Robert describes his understanding and approach to clinically engage those who "barely experience continuity of the self or subjectivity in themselves or others." He recommends 'companioning' with them. This entails not trying to "move the patient out of these regressed areas into greater relatedness ...but to welcome these other dimensions and their full expression within the analytic space." We consider the role of enactive engagements, the non-verbal vs the pre-verbal and 'radical neutrality'. He presents a case where the patient and analyst shared music, food and not discussed emotional intimacy between them that he felt was vital to enable the patient to emerge as a 'real person'. We close with speaking of Robert's professional history of working early on with psychotic individuals and finding that his approach enabled them, often to their surprise, to feel heard. He also describes his attunement to the experience of being an 'other' that emerged from his growing up as an 'other' - a Jew in London.
Our Guest:
Robert Grossmark, Ph.D., ABPP, is a psychoanalyst in New York City. He works with individuals, groups, and couples. He is on the teaching and supervising faculty at the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis, The National Institute for the Psychotherapies Program in Adult Psychoanalysis, The National Training Program in Psychoanalysis, National Faculty Member, the Florida Psychoanalytic Center and lectures at other psychoanalytic institutes and clinical psychology training programs nationally and internationally. He is an Associate Editor for Psychoanalytic Dialogues. He is the author of The Unobtrusive Relational Analyst: Explorations in Psychoanalytic Companioning and co-edited The One and the Many: Relational Approaches to Group Psychotherapy and Heterosexual Masculinities: Contemporary Perspectives from Psychoanalytic Gender Theory.
Recommended Readings:
Grossmark, R. (2024) The Untelling, Psychoanalytic Dialogues. In press.
Grossmark, R. (2019) The anguish of fatherhood, Psychoanalytic Perspectives, 16 (3), 316-325.
Grossmark, R. (2023) A child is being murdered: A contemporary psychoanalytic treatment of a compulsion to child pornography, Psychoanalytic Psychology, 40: 25-30
Bach, S. (2011) Chimeras: Immunity, interpenetration and t he true self. Psychoanalytic Review, 98(1): 39-56
Winnicott, D. W. (1974). Fear of breakdown. International Review of Psycho-Analysis, 1(1-2), 103â107.
Bollas, C. (2011) Character and interformality. In C. Bollas, The Christopher Bollas Reader (p. 238-248)
Ogden, T.O. (2017) Dreaming the analytic session: A clinical essay. Psychoanalytic Quarterly, 86: 1-20.
Stern, D.B. (2022) On coming into possession of oneself: Witnessing and the formulation of experience. Psychoanalytic Quarterly, 91: 639-667
Symington, N. (2012) The Essence of psychoanalysis as opposed to what is secondary. Psychoanalytic Dialogues. 22, 4, 395-409
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"The first line treatment for adolescents with anorexia now is family-based therapy typically, which involves helping the parents facilitate the refeeding of the adolescent. So, I was working with the patient in that way and found it to be helpful and useful, but was consistently struck by the neglect of the patientâs inner life, and found, at least based on my experience with many patients, that while you could get some symptomatic relief, if you didn't, in some way, address the deeper dynamics, the aspects of the patient's personality organization that drove the disorder, that were implicated at the disorder, there was a way that the patient would snap back to their old behaviors over time, that deeper change and a deeper understanding of what was going on was really necessary; and so that's been kind of evolution from my work over the past ten years from my first book, which was about anorexia in males, and tried to present a kind of Integrative understanding of that phenomena, increasingly over time I've become more and more interested in the deeper kind of analytic thinking that we can bring to bear on this kind of suffering.â
Episode Description:
We begin with a description of the common contertransferential pull to intervene behaviorally in the face of repetitive self-destructive eating disorder symptoms. This intention can inform but not compel the clinical decision as to the indicated treatment of choice for someone at any particular moment. Behavioral and pharmacologic treatments can be important in softening the pressure of eating disorder symptoms. They do not, however, give an individual access to their interoceptive life, from which these disturbing self-preoccupations emerge. We discuss the challenges of working with those who have limited capacities for mentalisation and as a result, live out their inner lives somatically and motorically. Immersive treatment leads the clinician to experience these proto-affects in one's own body and in one's own ruminations. Tom discusses alexithymia, typical family structures, and the presence of the 'abject' experience in the lives of these patients. He presents a disguised case of a patient who was able to work through both the early struggles and later neurotic aspects of these conflicts analytically. We close with his sharing with us his vision for the future which includes more integration between the dynamic and adynamic approaches to these challenging patients.
Our Guest: Tom Wooldridge, PsyD, is Chair in the Department of Psychology at Golden Gate University as well as a psychoanalyst and board-certified, licensed psychologist. His first book, Understanding Anorexia Nervosa in Males, was published in 2016. His second book, Psychoanalytic Treatment of Eating Disorders: When Words Fail and Bodies Speak, an edited volume in the Relational Perspectives Book Series, was published in 2018. His third book, Eating Disorders (New Introductions to Contemporary Psychoanalysis), was released in 2022. His fourth book, co-edited with Burke, Michaels, and Muhr, is entitled Advancing Psychotherapy for the Next Generation: Rehumanizing Mental Health Policy and Practice. He has also written a novel about the process of psychotherapy, Ghosts of the Unremembered Past, additionally released as an audiobook. He is a Personal and Supervising Analyst at the Psychoanalytic Institute for Northern California and a Training Analyst at the San Francisco Center for Psychoanalysis. He is on the Scientific Advisory Council of the National Eating Disorders Association, Faculty at the Psychoanalytic Institute of Northern California (PINC), the Northern California Society for Psychoanalytic Psychology (NCSPP), the William Alanson White Instituteâs Eating Disorders, Compulsions, and Addictions program, and the San Francisco Center for Psychoanalysis, and has a private practice in Berkeley, CA.
Recommended Readings:
Williams, G. (1997). Reflections On Some Dynamics Of Eating Disorders: âNo Entryâ Defences and Foreign Bodies. International Journal of Psycho-Analysis., 78, 927-941.
Brady, M.T. (2011). Invisibility and insubstantiality in an anorexic adolescent: phenomenology and dynamics. Journal of Child Psychotherapy, 37(1), 3 â 15.
Bromberg, P.M. (2001). Treating patients with symptoms â and symptoms with patients: Reflections on shame, dissociation, and eating disorders. Psychoanalytic Dialogues, 11(6), 891 â 912.
Petrucelli, J. (2015). âMy body is a cageâ: Interfacing interpersonal neurobiology, attachment, affect regulation, self-regulation, and the regulation of relatedness in treatment with patients with eating disorders. In J. Petrucelli (Ed.). Body-states: Interpersonal and relational perspectives on the treatment of eating disorders. (Psychoanalysis in a New Key). New York: Routledge.
Sands, S. (2003). The subjugation of the body in eating disorders: A Particularly female solution. Psychoanalytic Psychology, 20(1), 103 â 116.
Wooldridge, T. (2021). Anorexia nervosa and the paternal function. Journal of the American Psychoanalytic Association, 69(1), 7-32.Wooldridge, T. (2018). The entropic body: Primitive anxieties and secondary skin formation in anorexia nervosa. Psychoanalytic Dialogues, 28(2), 189 â 202.
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Fehlende Folgen?
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"The ability to play means we can indulge in a kind of illusion, not delusion, and make a distinction. It always amazes me that when the patient arrives, they like the routine of an analysis; nobody breaks that, it's an illusion; it is a piece of theater every time. We open the door to our patients and they lie on the couch, and yet there is something enormously gratifying as the patient works out their sense of reality from that illusory field. I think it is exactly what the mother is able to bring to the infant - this capacity to play and this capacity to continue to evolve beyond the analysis as an internalization of that experience of being listened to and being with someone. The details of that is related to an intrapsychic surviving and non- surviving object in the analyst who continues to think and feel and be with the patient in the consulting room.â
Episode Description: Joel begins his conversation with Jan around Winnicott's conceptualization of aggression in development and in the analytic encounter. She noted that he had a very sophisticated developmental theory of aggression which culminated with the role that the destruction of the object plays in constituting reality. Jan explains that she has elaborated Winnicottâs late theory of aggression with her notion of the âsurviving object'. She distinguishes the 'surviving object' from the 'good object', especially as it stands apart from a moralizing position. She considers its internalization as an essential condition for healthy development. They discussed the role that insight continued to play for Winnicott after he emphasized the importance of the patientâs experience in the analytic process. They also consider the âfear of womanâ as a root of misogyny. After discussing the uniqueness of the analytic setting to facilitate play, fantasy, and âmagic which is not psychosis,â Jan concludes by emphasizing the importance of in-person treatment in order to have an in vivo experience of the non-retaliatory analyst.
Linked Episode:
Episode 144: Why Winnicott? Joel Whitebook, PhD
Our Interviewer and Guest:
Joel Whitebook, PhD is a philosopher and psychoanalyst. He is on the Faculty of the Columbia University Center for Psychoanalytic Training and Research and was the founding Director of the Universityâs Psychoanalytic Studies Program. In addition to many articles on psychoanalysis, philosophy, and critical theory, Dr. Whitebook is also the author of Perversion and Utopia (MIT) and Freud: An Intellectual Biography (Cambridge).
Jan Abram, PhD is a training and supervising analyst of the British Psychoanalytical Society and in private practice in London. She is a Visiting Professor of the Psychoanalysis Unit at University College London and is currently Vice President of the European Psychoanalytic Federation for the Annual Conferences. She is President-Elect for the EPF to start her term in March 2024. She is a Visiting Lecturer and supervisor at the Tavistock Clinic in London. In 2016, she was a Visiting Professor at the University of Kyoto, Japan, where she resided for a writing sabbatical. Jan Abram has published several books and articles notably The Language of Winnicott, Donald Winnicott Today (2013), The Clinical Paradigms of Melanie Klein and Donald Winnicott: Comparisons and Dialogues (co-authored with R.D. Hinshelwood 2018); The Surviving Object: psychoanalytic clinical essays on psychic survival-of-the-object (2022) and her second book with R.D. Hinshelwood: The Clinical Paradigms of Donald Winnicott and Wilfred Bion: Comparisons and Dialogues (2023).
Recommended Readings:
ben
Abram, J. (2022) The Surviving Object: Psychoanalytic Clinical Essays on Psychic survival-of-the-object New Library of Psychoanalysis Routledge
Abram, J. (2023) Holding and Containing: on the specificity of Winnicott's object relations theory Holding und Containing: Zur spezifischen Natur der Objektbeziehungen bei Winnicott. Psyche - Z Psychoanal 77 (9), 768-796 DOI 10.21706/ps-77-9-768
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âI was speaking to the tendency of the popular media to perceive narratives of Indian women's sexuality via the lens of oppression. Now, of course, sexual violence against women is an important concern in India, as it is worldwide. But telling the story of violence against women misses the story of how women desire, which is what I wanted to highlight. What struck me from reading the responses from these psychoanalytic interviews that I did was just how much women adapted their Eros to their circumstances. Particularly the older women that were interviewed, those who were older than 35, didnât feel very oppressed, even as they narrated experiences and circumstances that sounded oppressive to me. Of course, if these were patients instead of the psychoanalytic interviewees that they were, one might wait for a kind of realization of oppression, but I wanted to see how psychoanalysis could be useful in mapping how Eros leaks within a framework where oppression is internalized, as it was for many of my interviewees. What I found very interesting was some of the imaginative ways that women found to satisfy their sexual desires while still maintaining community belonging. Viewed from the outside, this can look like oppressive forms of hypocrisy or enactments. But within the frame of these women's lives, it seems like they had found some creative ways of making Eros central and also of having Eros and breathing it at the same time in order to move forward."
Episode Description: Amrita focuses our attention on the presence of women's active sexual desire which often gets obscured by society's tendency to see women as simply victims of violence and oppression. In her book, Women's Sexuality and Modern India - In a Rapture of Distress, she shares with us the results of in-depth interviews as well as latent clinical data from educated and financially comfortable Indian women. We discuss the erotic aspects of modesty; the differences between Indian and International feminisms; the role of the protective parent to foster girlish excitement, i.e. to offer a helping hand to their daughter; and the importance of the involved father to enable an identification for comfortable aggression. We close with a description of an unusual culturally imbued sexual practice that invites Amrita's deep attunement to multiple levels of meaning.
Our Guest: Amrita Narayanan, PsyD, is a Clinical Psychologist and Psychoanalyst and the author of Women's Sexuality and Modern India: In a Rapture of Distress. She has a longstanding interest in how a civilization's culture shapes its sexuality and its psychoanalysis. She is an essayist in The Parrots of Desire: 3000 Years of Erotica in India and in Pha(bu)llus: a cultural history of the Phallus. She also writes a monthly column, Sexual Politics, for a newspaper, The Deccan Herald, Bengaluru. Aside from her clinical practice, Amrita is a Visiting Professor of English at Ashoka University, New Delhi, where she teaches psychoanalysis at the undergraduate and Masters level.
Recommended Readings:
Narayanan, A. (2023) Women's Sexuality and Modern India: In a Rapture of Distress (Oxford University Press, 2023)
Kakar, S. (1990) Intimate Relations: Exploring Indian Sexuality. Penguin Books: New Delhi.
Menon, M. (2019). Infinite Variety: A History of Desire in India. Speaking Tiger Books: New Delhi.
Narayanan, A and Kakar, S. (2023) The Capacious Freud In Busch, F and Delgado, N. The Ego and Id: 100 Years Later. Contemporary Freud, Turning Points and Critical Issues Series. Routledge: UK.
Narayanan, A. (2018). When the Enthralled Mother Dreams: a clinical and cultural composition. IN Kumar, M. Mishra, A., and Dhar, A. (Eds). Psychoanalysis in the Indian Terroir: Emerging Themes in Culture, Family and Childhood. Lexington Books: USA.
Narayanan. A. (2013). Ambivalent Subjects: Psychoanalysis, Womenâs Sexuality in India and the writings of Sudhir Kakar. Psychodynamic Practice. 20-3. 213-227
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"The genetic asymmetry [with sperm donorship] will create issues and complications - it puts a strain on the relationship, i.e. who is excluded; who has more rights to this product? In other words, if the sperm donor is from a stranger, the father feels âam I really adequately or sufficiently related that I could claim fatherhoodâ?â
Episode Description: We begin by acknowledging the erroneous assumption that unconscious conflicts over becoming a parent are etiologic for what had been called 'psychogenic infertility.' Correlation is not causality. We review the widespread use of assisted reproductive technologies, with up to 750,000 babies born per year through these methods. Mali presents a composite case of a 48-year-old woman who went through many arduous IVF cycles before appreciating the degree of omnipotence and denial that characterized her approach to this problem, as it had toward many other issues in her life. She shares with us the common experience of infertility representing a sense of defectiveness and guilt. We consider the many challenges of sperm and egg donorship, including who one chooses as a donor as well as when one should tell children of their biological origins. We close with Mali sharing with us her recommendations to rejuvenate the field of child analysis.
Our Guest:
Mali Mann, M.D, is a Training and Supervising psychoanalyst and Child Supervisor at the San Francisco Center for Psychoanalysis. She is a clinical professor Adjunct at Stanford University School of Medicine, Department of Psychiatry and Behavioral Science. Some of her published papers include, "Immigrant Parents and their Emigrant Adolescents: The Tension of Inner and Outer Worlds;" "Shame Veiled and Unveiled," "Aggression in Children: Origins, Manifestation, and Management through Play," Adolescent Psychoanalysis book chapter. "The Formation and Development of Ethnic Identity." Her edited book, Psychoanalytic Aspects of Assisted Reproductive Technology, won three awards: 1) Pinnacle Book Award, 2) International Book Awards in Family and "Parenting and Family" category in 2016, 3) Finalist for Book Vana Award in 2016. She has published two books of poetry: Whisper, Forget Me Not, and A Path with No Name. Her latest book, My Pony, Keran, is a semi-autobiographical children's book. She has been a member of Flying Doctors for nearly three decades (Los Medicos Voladores). She and her late husband, Dr. William James Stover, traveled to the Orphanages in South America and Mexico to offer medical help to children and their families. In her spare time, she paints abstract expressionism and figurative; her art has been exhibited in US galleries and won several awards.
Recommended Readings:
Allison. G. H. (1997). Motherhood, motherliness, and psychogenic infertility. Psychoanalytic Quarterly, 66: 1-17
Ludden, J. (2011) A. F. (1961). A new openness for donor kids about their biology. NPR:
Making Babies: 21st Century Families.(17 September).
Bibring, G. L.â Dwyer, T. F., Huntington, D.S., & Valenstein, A. F. (1961). A Study of Psychological Process in pregnancy and the earliest mother and child relationship. Psychoanalytic Study of the Child, 16: 9-72
Ehrensaft, D. (2008), When baby makes three or four or more, Psychanal. Study Child, 63:3-23.
Freud, S. (1914). Remembering, repeating, and working through. (Further recommendations on the technique of psycho-analysis II.) S.E., 12.
Inderbitzin, L. B & Levy, S. (1998). Repetition Compulsion revisited: Implication for Technique, Psychoanalytic Quarterly. 67:32-53
Lester, E. P. & Notman, M. (1986). Pregnancy, developmental crisis, and object relations: Psychoanalytic considerations. Int. J. Psychoanal., 62: 357-366
Notman, M. & Lester, E. P. (1988). Pregnancy: theoretical considerations. Psychoanl. Inq., 8: 139-160
Pines, D. (1982). Relevance of early development to pregnancy and abortion. Int. J. Psychoanal., 61: 311-318
Zallusky, S. (1999). Infertility in The Age of Technology, Journal of American Psychoanalytic Association, 48: 1541-1562
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"As I elaborate in the book, there was no physical contact or romantic engagement. The reason why I chose the âloverâ as the [psychoanalytic] analogy is, in the real world outside of psychoanalytic practice, where else do you have an interpersonal encounter that is so intensely engaging, attentive, respectful, and caring? That would be in the first six weeks or six months of a romantic relationship. If we eliminate the romantic/sexual part and just stay with âwow, this other party is paying such attention to meâ - reminds me of Lacan's idea that what we really seek in the other is their desire for us, which by the way, I don't completely agree with because I think it goes both ways - I would say that that is the analogy from the world of lovers that I would map onto psychoanalytic work at least on the part of the psychoanalyst - he or she ideally pays that kind of intense attention, care, respect and attunement, that you would find between lovers.â
Episode Description: We begin with discussing the various ways that we can shape our psychoanalytic frame to enable a deepening of the clinical encounter. This is in contrast to frames that have gone awry. In his book Lover - Exorcist - Critic Alan describes a composite patient where he became over-involved to the detriment of the work that was eventually repaired. We reference a problematic frame in his earlier training analysis that perhaps set the stage for this difficulty. He shares with us his concept that "by enlightening subjectivity, by raising consciousness, depth psychotherapy liberates." We discuss in some detail the forces in him, his patient, and their relationship that led him to greater enactments than were useful. He shares with us the challenges he faced in remedying his emotional imbalance with her and the intense rage it awakened in her, deriving from various periods in her life. We both emphasized the vital role of the consultant at such times. We close with Alan describing his co-founding and leadership in the Rose City Center - a low fee clinic providing dynamic psychotherapy to individuals who would never otherwise see the inside of an analyst's office.
Our Guest: Alan Michael Karbelnig, PhD is a psychoanalyst, writer, teacher, and forensic psychologist and practices in Pasadena, California. He is a supervising and training psychoanalyst at the New Center for Psychoanalysis in Los Angeles. He lectures nationally and internationally, including in China, India, Thailand, and Israel. He writes a weekly Substack newsletter titled Journeys to the Unconscious Mind. Alan has published 20 scholarly articles and five book chapters in addition to his book Lover, Exorcist, and Critic. He considers his 2004 founding of Rose City Centerâa nonprofit clinic providing psychoanalytic psychotherapy for economically disadvantaged persons throughout Californiaâhis proudest professional accomplishment.
Recommended Readings:
Bellow, H. (1962). Herzog. New York: Viking.
Bromberg, P. (1996). The multiplicity of self and the psychoanalytic relationship. Standing in the spaces: Essays on clinical process, trauma & dissociation. London: The Analytic Press.
Greenberg, J. and Mitchell, S. (1983) Object relations in psychoanalytic theory. Harvard University Press. Cambridge, MA.
Karbelnig, A. M. (2022). Chasing Infinity: Why clinical psychoanalysisâ future lies in pluralism. International Journal of Psychoanalysis, 103(1):5-25.
McEwan, I. (2019). Machines Like Me. New York: Anchor.
Strenger, C. (1989). The classic and romantic visions in psychoanalysis. International Journal of Psychoanalysis. 70:593-610
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"What's the spiritual room? For me, it does tend to be a connection to something greater than just me; it is a contemplative space; it is getting to the core of who I am, allowing in some ways for the best of me to come to the fore; to have space for grace. I am humbled by what people bring to tell me. I take what I'm doing in the office very seriously because it is really like sacred work in terms of people being able to work, love, and play. I mean that is for them to find their real callings rather than the false selves that they may experience; it's a similar call for finding one's true self, and that is really important work."
Episode Description: We begin by considering the presence of religion as part of the cultural heritage which patients bring to the clinical encounter. Ginta shares with us her upbringing in the Lithuanian Catholic church and its presence in her life, in her journey to medical school and to her psychiatric and analytic training. She speaks of the relationship between her sense of spirituality and God, the importance of Jesus' human/divine amalgam, and how prayer provides her access to her interiority. We consider the similarities and differences between speaking freely to God and speaking freely to one's analyst. We discuss the narthex, the church antechamber, and its association with the analytic waiting room and how the structure of the Mass has similarities with the structure of the analytic session. We also consider her reflections on abortion - including a quote from Freud on the topic. Ginta closes by sharing with us her sense of the sacredness of our work.
Our Guest: Ginta Remeikis, MD, is a psychiatrist and psychoanalyst practicing in Rockville, MD. Having graduated from Northwestern University Medical School, she completed her psychiatric residency at Georgetown and Chestnut Lodge Hospital, where she then served on the medical staff and psychoanalytic training at the Washington Psychoanalytic Institute. Most recently, she has presented at meetings of the APCS (Association for the Psychoanalysis of Culture and Society) and AABS (Association for the Advancement of Baltic Studies) on intergenerational transmission of trauma; diaspora experiences; the psychic role of language, especially bilingualism; the use of literature for processing trauma; and psychodynamics around disability. In 2003 she organized the New Directions weekend conference, âThe Future of Religion in the Psychoanalytic World: Revisiting the Mind/Soul Dilemmaâ and for several years presented on issues of psychiatry and religion to Georgetownâs psychiatry residents. Besides enjoying reading, she has published poetry in Lithuanian in several collections and journals.
Recommended Readings:
Corcoran, Paul, âSeamus Heaney lost his Catholic faith. But his poetry still sought transcendence.â in America; The Jesuit Review, Sept. 15, 2023.
Epstein, Mark, Thoughts Without a Thinker: Psychotherapy from a Buddhist Perspective, Basic Books, 1995.
Greeley, Andrew M., The Catholic Myth: The Behavior and Beliefs of American Catholics, Charles Scribnerâs Sons, NY, 1990.
Merton, Thomas, New Seeds of Contemplation, New Directions, NY, 1961.
Rizzuto, Ana-Maria, Why did Freud Reject God?: A Psychodynamic Interpretation, Yale University Press, New Haven, 1998.
Smith, Joseph H. and Susan A Handelman, editors, Psychoanalysis and Religion, Psychiatry and the Humanities, vol. 11, The Johns Hopkins University Press, Baltimore, 1990.
TrinkĆ«nas, Jonas, editor, Of Gods & Holidays; The Baltic Heritage, TvermÄ, 1999.
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"My analysis not only allowed me to grieve [my mother], with my analyst patiently pushing me in the direction of my feelings, but it radically transformed my life. I wouldn't have had kids if I hadn't had my analysis because I thought âI'm an ambitious person, I want a career, you can't do everythingâ. I didn't know any models of women who had a career and enjoyed motherhood. In my analysis I learned just through analyzing my own dreams and free associations, that this was all a rationalization. I was a very maternal person and I had the unconscious belief that if you become a mother you die. Once that was conscious, I talked to my husband who was excited about the idea about having kids. We had our two daughters, and so my life is in very concrete ways radically enriched by my psychoanalysis. So I went into the field with a deep conviction of how therapeutic this process is and it's been kind of a straight line from there."
Episode Description: We begin by describing the arc of learning that characterizes our psychoanalytic life journey. The oral tradition starts with our first supervisors and extends from there to study groups and to becoming a supervisor oneself. Nancy shares with us her professional trajectory from being an eager college student first encountering Freud to becoming a best-selling psychoanalytic author. She relates the transformative experience of her own analysis, the steps of maturation in her clinical work, and how she has faced the traumas of older age. We discuss the role that students have in relating to their more experienced colleagues and we close with her sharing her hope for our field's future.
Our Guest: Nancy McWilliams, PhD is Visiting Professor Emerita at Rutgers Graduate School of Applied & Professional Psychology and has a private practice in Lambertville, NJ. She is author of four textbooks (on psychoanalytic diagnosis, case formulation, therapy, and supervision) and is co-editor of both editions of the Psychodynamic Diagnostic Manual. A former president of the Society for Psychoanalysis and Psychoanalytic Psychotherapy of the American Psychological Association, she is a member of the Austen Riggs Center Board of Trustees. Her books are available in 20 languages and she has taught in 30 countries.
Recommended Readings:
McWilliams, N. (2022). Credo: Psychoanalysis as a wisdom tradition. In J. Salberg (Ed.), Psychoanalytic credos: Personal and professional journeys of psychoanalysts (pp. 70-77). New York: Routledge.
McWilliams, N. (2021). Psychoanalytic supervision. New York: Guilford Press.
Lingiardi, V., & McWilliams, N. (Eds.) (2019) Special Issue: The PDM-2 and clinical and research Issues in psychoanalytic diagnosis. Psychoanalytic Psychology, 35.
McWilliams, N. (2017). Psychoanalytic reflections on mortality: Aging, dying, generativity, and renewal. Psychoanalytic Psychology, 34, 50-57. Also in C. Masur (2018), Flirting with death: Psychoanalysts consider mortality (pp. 25-40). New York: Routledge.
McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality in the clinical process, rev. ed. New York: Guilford Press
McWilliams, N. (2004). Psychoanalytic psychotherapy: A practitionerâs guide. New York: Guilford Press.
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"The fact that music is so important for our constitution - that music is almost how we move in the world, that our own bodies are played through by musical forms, that the way we relate to our own way of being in the world is sort of mediated by music - this is powerful stuff. But it's not always very fitting to us. We hear a lot of music in our lives, we don't always choose what we hear. We donât choose our analystâs musicality, we donât first check what kind of musicality an analyst has. We are bombarded by music; music can be imposed upon us, it can make us feel within ourselves in a way that doesn't feel right to us. There is a lot of complexity here as we think about this matter of music being so central to us. But we can find the music that works for us, but we donât create the music. It belongs to the realm of collective cultural life. There is a lot of struggle in music, and in the analytic setting there is a lot of struggle - because for many patients a lot of the work rests on whether there can be any shared sensory experience or not.â
Episode Description: We begin with recognizing that the process of human musicalization begins in utero and forms the basis of much of psycho-somatic-social life. Peter, Michael and Adamâs written collaboration, Here I'm Alive - The Spirit of Music in Psychoanalysis is intended to be a musical book about psychoanalysis - a representation of how music binds us to the individual and cultural domains of life. We discuss rhythmizing consciousness, atavistic vs enhancing music, and the blues as a companion soundtrack for loss and tribulation. We take up the relationship between Freud's dream book and his joke book, how present analytic melodies contain aspects of the past, and how dissociation requires a remusicalization of the psychoanalytic situation. We close with Adam reading a paragraph which includes "The capacity of the sexual drive to propel the body back into musical movement and transmute the seizure of trauma into conducted energy to ground the current."
Our Guests:
Peter Goldberg, Ph.D., is a Personal and Supervising Analyst at the Psychoanalytic Institute of Northern California, Chair of Faculty at the San Francisco Center for Psychoanalysis, and on the faculty of the Wright Institute in Berkeley. He has presented widely and written on a range of clinical and theoretical topics, including the evolution of clinical theory in psychoanalysis, sensory experience in analysis, the concept of the analytic frame, the theory and treatment of dissociative states, non-representational states; and the impact of social trauma on individual psychology. He is in private practice in Albany, CA.
Michael Levin, Psy.D. is a Training Analyst and Faculty Member at the San Francisco Center for Psychoanalysis. He has taught and presented on topics including the work of Laplanche, phenomenology, and psychoanalysis, and the place of psychoanalysis in cultural and intellectual history. He is in private practice in San Francisco.
Adam Blum, Psy.D. is an Adjunct Faculty Member at the San Francisco Center for Psychoanalysis. He has written and presented on psychoanalysis and the music of Björk, Kendrick Lamar, Frank Ocean, Stephen Sondheim, Aretha Franklin, and Michael Jackson. He is in private practice in San Francisco.
Recommended Readings and Videos:
Nicholas Spice, âWinnicott and Musicâ (2001), in The Elusive Child, ed. Lesley Caldwell (London: Karnac, 2002).
Peter Sloterdijk, âWhere Are We When We Hear Music?â (2014), in The Aesthetic Imperative: Writings on Art (London: Polity, 2018).
Francis Grier, âMusicality in the Consulting Room,â International Journal of Psychoanalysis 100:827â51.
Sondheim Teaches "My Friends" from Sweeney Todd (video) .
Byung-Chul Han, The Scent of Time: A Philosophical Essay on the Art of Lingering (London: Wiley, 2017).
Maurice Merleau-Ponty, The Phenomenology of Perception (London: Routledge, 1962)
The Late Late Show with James Corden, âPaul McCartney Carpool Karaokeâ (video).
Harmut Rosa, Resonance (Cambridge: Polity, 2019).
Meshell Ndegeocello, The Omnichord Real Book (2023) (album), Blue Note Records.
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âDiscrimination is something that is needed for the child to create himself as a person. You need to be discriminated from the other, and the other is useful for you, as Freud said, as a model, as a rival, as an enemy. There are different kinds of relationships with the other - you need the other, and we are persons connected with the other. If you discriminate you from the other, this is benign. But if you are doing it from a power position, saying: âThese people are not like meâ - this is malignant othering. It is malignant because when you are marking these people as different, as the Nazis did with the Jewish people, then it is very easy for these people to become the target for any kind of attack when there will be social or economic problems. Malignant because you are doing it from a position of power and because these people that you are discriminating from you may become targets for possible attacks for different reasons in the community."
Episode Description: We begin with Abel reading a statement from the Prejudices, Discrimination and Racism Committee which is included below. He shares with us his personal and family story that led him to be interested in racism and to chair this committee. We discuss the differences between benign otherness and malignant othering. He emphasizes the presence of negation in all of us, tempting us to ignore the dangers from discrimination. He speaks of the future of psychoanalysis and how he feels it depends upon its application in settings off the couch. We consider the risks of dilution of the training experience and also the great benefit to the many who will receive treatment from analytically oriented care. He warns us of the dangers of making the perfect the enemy of the good.
Statement from the IPA Prejudices, Discrimination, Racism Committee:
The rise of antisemitism in the wake of the Hamas barbaric attack
We strongly condemn the murder, maiming, and abduction of hundreds of Israeli civilians and soldiers during an unprovoked attack by Hamas terrorists. The scale of this terrorist attack is unprecedented in recent history. It can only be viewed as a pogrom, and we express our deep solidarity with the victims. Hamas is a terrorist organization, and Palestinians are also their victims. We feel sorrow for all civilians who are killed or suffering in this war, including so many in Gaza.
In its founding document, the Hamas Charter, Hamas states that it is committed to waging Jihad, or holy war, in order âto raise the banner of Allah over every inch of Palestineâ. Its stated goal is to eliminate the Jewish state and kill Jews. It must be made clear that the terror against Israel is not motivated by economic, geographic, or political conflicts: all of Israel is considered a holy land that must not be defiled by the presence of "infidels", whether Christians or Jews. The statement of freeing Palestine from occupation, âFrom the River to the Seaâ, reveals a clear intent to eliminate the State of Israel. A fight against Hamas is a fight of light against darkness, of liberalism against the forces of oppression.
We, as psychoanalysts, can identify the dehumanization of the Jewish population that was displayed by the horrific massacre on the 7th of October. In addition to the suffering of IsraelÂŽs population, antisemitic manifestations and attacks have increased exponentially all over the world. As the Prejudices Discrimination and Racism Committee we are alert to antisemitism and the dangerous consequences of its negation. We hope that in due course, it will be possible to find strong leaders who will have the courage to meet and negotiate peace between Israelis and Palestinians.
Abel Fainstein (Chair) Argentine Psychoanalytical Association (APA)
Paula Kliger. Michigan Psychoanalytic Society (MPS)
Rosine Perelberg. British Psychoanalytical Society ( BPS)
Leonie Sullivan. Australian Psychoanalytical Society (AP
Raya Zonana. Brazilian Society of Psychoanalysis of Sao Paulo. (SBPSP)
Mira Erlich-Ginor (Ex officio) Israel Psychoanalytic Society (IPS)
Our Guest: Abel Fainstein, MD is a Psychiatrist, Master in Psychoanalysis,
Full Member and former President of the Argentine Psychoanalytical Association (APA) and the Psychoanalytic Federation of Latin America (FEPAL). He is a former member of the IPA Board and Ex Com ,Current Chair of the Prejudice, Discrimination, Racism Committee of the IPA, current advisor of the IRED Interregional Encyclopedic Dictionary in Psychoanalysis by the IPA, and of the Revista Uruguaya de PsicoanĂĄlisis by APU. He is a judge for the first IPA Tyresias Award on Sexual and Gender Diversity, 2021. He was awarded the KONEX Award in Psychoanalysis, 2016.
Recommended Readings:
Busch, F. ( 2023) Psychoanalysis at the Crossroad. An international perspective. Routledge. NY.
Cabral. A.C ; Fainstein A.M ( 2019 ) On training analysis .Debates. APAEditorial. Buenos Aires
Sandler,P. ; Pacheco Costa G. (2019 ) On Freud's "The Question of Lay Analysis.â Turning Points and Critical Issues (The International Psychoanalytical Association ... Turning Points and Critical Issues Series) Routledge. London.
Powell, J.A, Menendian, S. (2016) The Problem of Othering. Othering and Belonging. Expanding the Circle of Human Concern.
Othering & Belonging is published by the Haas Institute for a Fair and Inclusive Society at the University of California, Berkeley.
Winer,R; Malawista,K (2017 ) Who is behind the couch. Karnac. London
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âThe situation was that I went with my husband Danny, who is also a clinical psychologist, and we were on the team that came and told people when family members were identified and that they had been murdered. There was one time when we went to two kids, telling them that their parents were murdered. We were with them in the room with an aunt and another family member. All of a sudden, I said, âDannyâs father and my father were in the Holocaust, and they also lost their parents. And you know they became happy people and good fathers for us. And here we are with you now.â It was like my telling a lullaby - I knew that they hear us and they don't hear us, but I believed that the unconscious can hear me. That's how my personal transgenerational story helped me to help them to believe that a life can become after this disaster.â M.R.
âAnd the music in your saying whatever you said was part of what worked there, both the liveliness and something that has a real connection to experiences one can survive from. This is a very unusual kind of intervention for psychoanalysts, and also that it may not fit everyone. There is a match between how can one make use of oneself and go out of oneâs skin and oneâs routines, i.e. the way I always do whatever I do. Instead,to do something different that is echoing the needs of the person with whom you are in contact.â M.E-G.
Episode Description: We begin by tracing the recent history of those organizations that are dedicated to the premeditated butchery of civilians. Both Merav and Mira share with us their experiences when the sirens went off on Saturday morning October 7th. We follow them as they attend to those who physically survived the mutilation, murder and kidnapping of their family members. Merav, building from her personal family Holocaust history, created a series of guidelines with which to engage those who were overwhelmed. It became a sort of proactive psychoanalytic manual to give structure to and help regain the alpha function of those who are suffering while also recognizing the presence of past traumas in their lives. They share with us their personal experiences, the crucial importance of President Biden's speech and visit, and the vital assistance that all the Israeli psychoanalytic organizations are providing. Central to their personal and professional message is We have survived traumas in the past, and we will survive again this time.
Our Guests: Merav Roth, Ph.D. and Mira Erlich-Ginor, Ph.D., are both members of the Israeli Psychoanalytic Society.
Linked Episodes:
Episode 110: PCCA (Partners in Confronting Collective Atrocities) and Working with Ukrainian Current Atrocities with Mira Erlich-Ginor
Episode 96: Why Do We Read Books? Literature and Psychoanalysis with Merav Roth, Ph.D.
For Donations: First Line Med
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IPAOfftheCouch.org
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"The gift of the [traditional] healer that he shares with those of us who do psychoanalytic work is that we are given an idea of the human mind as being always in a process of mediating the real world and the drives of sex and aggression - which if not moderated can lead to terrible things. We're in there, and that's what our training helps us to do.â
Episode Description: We begin with Martha describing her social work background and how it informed her approach to working with overwhelmed children in New York. She recounts her efforts in El Salvador and her understanding that children who were violent were actually children who were over-exposed to violence. She also functioned as one who accompanied those clinicians who themselves were at risk of being overwhelmed by the violence in their work. We take up her engagement in Angola and their cultural model of the individual as "the self that exists for the purpose of social participation." We consider the case of a child soldier who was treated by traditional healers for multiple symptoms related to his involvement in atrocities. We note the similarity with Bion's Knowing and Love as it is lived between the individual, the healer and the community. We close with recognizing the importance of the 'moral third' and the centrality of reparation in both African and American cultures.
Our Guest: Martha Bragin, Ph.D., is jointly appointed Professor at the Silberman School of Social Work at Hunter College and the Ph.D. Program in Social Welfare at the Graduate Center of the City University of New York. She joined the faculty after 30 years of experience supporting United Nations agencies, governments, nongovernmental and peopleâs organizations to address the effects of violence and disaster on children, youth, families, and the communities in which we live. Dr Bragin is a Fellow of the Research Training Program of the IPA and the editorial board of the International Journal of Applied Psychoanalytic Studies. She serves as a member of Inter-Agency Standing Committee (UN-IFRC-NGO) Reference Group on Mental Health and Psychosocial Support in Emergency Settings, a globally representative body that sets and monitors standards for psychosocial interventions in emergencies. Dr Bragin is recipient of the International Psychoanalytic Associationâs Tyson Prize as well as the Hayman Prize for published work on traumatized children and adults in 2011 and 2021. She is the author of numerous peer-reviewed publications and is in private practice in New York City.
Recommended Readings:
Bragin, M. (2003). The effect of extreme violence on the capacity for symbol formation: Case studies from Afghanistan and New York. In J. Cancelmo, J. Hoffenberg, & H.
Myers (Eds.), Terror and the psychoanalytic space: International perspectives from Ground Zero (pp. 59â67). New York, NY: Pace University.
Bragin, M. (2004). The uses of aggression: Healing the wounds of war and violence in a
community context. In B. Sklarew, S. Twemlow, & S. Wilkinson (Eds.), Analysts in the trenches: Streets, schools and war zones (pp. 169â194). Hillsdale, NJ: Analytic Press.
Bragin, M. (2005). Pedrito: The blood of the ancestors. Journal of Infant Child and Adolescent Psychotherapy, 4(1), 1â20.
Bragin, M. (2007). Knowing terrible things: Engaging survivors of extreme violence in treatment. Clinical Social Work Journal, 35(4), 229 â 236.
Bragin, M. (2010). Can anyone here know who I am? Creating meaningful narratives among returning combat veterans, their families, and the communities in which we all live. Clinical Social Work Journal, 38(3), 316â326.
Bragin, M., & Bragin, G. (2010). Making meaning together: Helping survivors of violence and loss to learn at school. Journal of Infant Child & Adolescent Psychotherapy, 9(2), 47-67.
Bragin, M. (2012). So that our dreams will not escape us: Learning to think together in time of war. Psychoanalytic Inquiry: A Topical Journal for Mental Health Professionals, 32 (2), 115â135.
Bragin, M. (2019) Pour a libation for us: Restoring the sense of a moral universe to children affected by violence. Journal of Infant, Child, and Adolescent Psychotherapy 18 (3), 201- 2011.
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"Instead of the analyst being in a position where they know something about the patient, they are with the patient. As Winnicott says in his late work, if you are a philosopher in your armchair, you have to come out of your armchair and be on the floor with the child playing. I donât think that one should act that out with an adult patient- however it is that approach to actually being with the patient, listening to the patientâs words, listening to their state of mind without preconceived ideas. Thatâs almost impossible, but Winnicott says that psychoanalysis is an objective study, an objective way of looking at things without preconceived ideas, without preconceived notions. It links with what you said about ânormativeâ - if we go into the consulting room feeling that our patients need to be as we are or need to fit in some kind of norm, then I donât think this is psychoanalytic. I think it is against the whole aim of psychoanalysis.â
Episode Description: Jan begins her conversation with Joel by sharing her background in theater and the steps she took to train as an analyst. She describes what drew her to Winnicott and how she sees him as broadening, not replacing, Freudian thinking. She distinguishes her understanding of Winnicott from others who believe that, by speaking of the importance of the environment, he minimized constitutional factors and the unconscious. She interprets what he meant by the environment in terms of the âpsyche-bodyâ and the motherâs unconscious. Jan discusses a paradox in Winnicott in that he offers a positive theory of health while also being uniquely non-judgmental and non-pathologizing. She concludes with a controversial observation that a five times weekly in person training analysis is essential to achieve a deep regression that will familiarize analysts with the primitive parts of their personalities so they will be able to accept and deal with those parts of their patients' personalities.
Our Interviewer and Guest:
Joel Whitebook, PhD is a philosopher and psychoanalyst. He is on the Faculty of the Columbia University Center for Psychoanalytic Training and Research and was the founding Director of the University's Psychoanalytic Studies Program. In addition to many articles on psychoanalysis, philosophy, and critical theory, Dr. Whitebook is also the author of Perversion and Utopia (MIT) and Freud: An Intellectual Biography (Cambridge).
Jan Abram, PhD is a training and supervising analyst of the British Psychoanalytical Society and in private practice in London. She is Visiting Professor of the Psychoanalysis Unit, University College London, and is currently Vice President of the European Psychoanalytic Federation for the Annual Conferences. She is President-Elect for the EPF to start her term in March 2024. She is a Visiting Lecturer and supervisor at the Tavistock Clinic, in London. In 2016, she was a Visiting Professor for the University of Kyoto, Japan, where she resided for a writing sabbatical. Jan Abram has published several books and articles notably: The Language of Winnicott, Donald Winnicott Today (2013), The Clinical Paradigms of Melanie Klein and Donald Winnicott: comparisons and Dialogues (co-authored with R.D. Hinshelwood 2018); The Surviving Object: psychoanalytic clinical essays on psychic survival-of-the-object (2022) and her second book with R.D. Hinshelwood: The Clinical Paradigms of Donald Winnicott and Wilfred Bion: comparisons and dialogues (2023).
Learn more about Jan Abram
Recommended Readings:
Abram, J. (2007) The Language of Winnicott: A Dictionary of
Winnicottâs use of terms Routledge
Abram, J. (ed) (2016) André Green at the Squiggle Foundation Routledge
Abram, J. (2008) Donald Woods Winnicott (1896 â 1971): A brief introduction Education Section Int J of Psychoanal 99: 1189 - 1217
Abram, J. (2021) On Winnicottâs Concept of Trauma Int J of Psychoanal 102: 4 10
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"I made a film for PepWeb on the research of Beatrice Beebe. I made the video for her picture book, The Mother-Infant Interaction Picture Book, and various other short films. These are deep dives into mother-infant dyads that reveal something, i.e. rupture and repair, various kinds of dyadic interchanges. These are available for free on YouTube. That's another way that I use my analytic self and my documentary maker self together. I'm much happier with the YouTube films even though they're less produced because they reach a wide audience - they are for parents, not clinicians. I want to get the story of this way of thinking or various ways of working, or psychoanalysis itself out to the greater public because Iâm such an evangelizer for it. It changed my life in so many ways, and I think it's a very different animal than what the wider world (if they've heard of it at all) thinks that it is - itâs so alive these days, so integrative, and so worthy of letting people know.â
Episode Description: We began with Karen sharing with us her journey from documentary filmmaker to psychoanalyst. She discusses her immersion in the world of cinema verité - "a camera capturing life" - as the pathway that brought her to train in psychoanalysis. We consider the similarities and differences between these ways of thinking and how she feels that for her, they are additive in deepening her listening abilities. She describes her films of Beatrice Beebe's work, how she serves as a consultant to filmmakers, and how she often treats those in the field, especially in regard to their (over)involvement with trauma. We close with Karen's recommendations for using YouTube to let the wider community know about psychoanalysis.
Our Guest:
Karen Dougherty is a Psychoanalyst (FIPA) and documentary filmmaker. She has an MA in English Literature (McGill) and an MA in Psychoanalytic Studies (University of Sheffield). She is a clinical supervisor and course instructor at the FPP and the Advanced Training Program in Psychoanalytic Psychotherapy, with a particular focus on attachment, relationship issues, and trauma. In addition to her private practice in rural Amaranth, Ontario, Karen is the host of the podcast for the Canadian Psychoanalytic Society, Conversations in Psychoanalysis. Since 2022, she has been a member of the IPA Think Tank on the Resolution of Intractable Conflict, for which she produces a YouTube Channel. The recipient of a PEPweb video grant, she has made several films on the research of Dr. Beatrice Beebe for clinicians and parents. She continues to collaborate on documentary projects as a researcher and story consultant (recent films include Toxic Beauty; Category: Woman, both directed by Phyllis Ellis). Bridging these two careers, Karen is both a communications consultant for psychoanalytic organizations and a mental health consultant for film and television.
Linked Episode:
Episode 97: Off the Couch and into the Political Arena with John, Lord Alderdice FRCPsych â IPA Off the Couch
Recommended Links:
Karen Dougherty
The CPS podcast will be accessed through the CPS website.
The PEPweb citation for the documentary for clinicians:
Dougherty, K., Beebe, B., Margolis, A., Altstein, R., Berman, J. & Mathieson, G. (2016) Mother-Infant Communication: The Research of Dr. Beatrice Beebe. PEP Video Grants 1:11.
Beebe, Dr. Beatrice, prod., Dougherty, K., dir. âJoining Your Babyâs Distress Moments: A Story of One Mother and Infantâ:
âDecoding Mother-Infant Interaction: A Story of One Mother and Infant,â the first two of a series of short films for parents showcasing the research of Dr. Beatrice Beebe:
Allan King, The Criterion Collection
Allan King, Queens University Film and Media Collection
Allan Kingâs Warrendale, a âdirect cinemaâ documentary about a home for emotionally disturbed children in Toronto:
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"We know as analysts thereâs a long literature on mourning and its connection to creativity from the time of Freudâs work to George Pollock's work and others - but that's too intellectual; let me make it more personal, and then I'll talk about Freud and Maimonides. My father and my mother lost a combination of 10 siblings and a granddaughter murdered by the Nazis, plus their parents and aunts and uncles. I've heard stories about their siblings and I think: âLook what they would have done, what they would have created not just families but ideasâ, and I realized in my analysis that for years I have been trying to make up, by writing books, what would have been done by the aunts, uncles, and cousins that I never knew because they were murdered. So creativity can have a reparative, never enough perhaps, but a reparative quality.â
Episode Description: I introduce the topic of the not fully acknowledged role of religion in the lives of analysts and analysands, which will be explored in future conversations. Nathan begins by sharing his personal connection with his religion, which he feels does not involve a belief in a God. He describes how his relation to his Judaism, like his essence as an analyst, entails an attunement to an inner life, a commitment to proper behavior, and a search for hidden meanings. He describes his family of origin and their almost complete annihilation in the Holocaust. We discuss the similarities he feels exists between Maimonides and Freud, the importance of mourning in their creative processes, and the great attention to 'the word' that both worldviews exhibit. We also take up whether 'belief' is an appropriate term to characterize one's psychoanalytic clinical work. We close with his sharing clinical examples where religion played an important role in the treatment.
Linked Episode: https://harveyschwartzmd.com/2021/04/23/ep-6-how-to-raise-loving-and-creative-30-year-old/
Our Guest:
Nathan Szajnberg, MD, is Retired Freud Professor, the Hebrew University and former Wallerstein Research Fellow in Psychoanalysis. Born in Germany, he attended the University of Chicago College and Medical School. His most recent books are Psychic Mimesis from Bible and Homer to the Present (Lexington) and The Secret Symmetry of Maimonides and Freud (Routledge). His third novel is A Windmill, A Knight, A Jerusalem.
Recommended Readings:
1. Freud, Future of an Illusion (1928) Hogarth Press.
2. Meissner, W. W. (1985) Psychoanalysis: The Dilemma of Science and Humanism. Psychoanalytic Inquiry 5:471-498
3.Szajnberg, N. (2019) Jacob and Joseph, Judaismâs Architects and Birth of the Ego Ideal. Cambridge Scholars Publishing
4. Wallerstein, R. S. (1998) Erikson's Concept of Ego Identity Reconsidered. Journal of the American Psychoanalytic Association 46:229-247
5. Wallerstein, R. S. (2000) The Analysis of the Hysterical Patient: Limitations?. Forty-Two Lives in Treatment: A Study of Psychoanalysis and Psychotherapy 56:293-321
6. Wallerstein, R. S. (2014) Erik Erikson and His Problematic Identity. Journal of the American Psychoanalytic Association 62:657-675
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"Conscience represents ethics that are not socially constructed and not socially learned but built-in. In fact, the whole of psychoanalysis is grounded in such an ethic - we all as analysts value life over death, we value truth over lies, we value love over hate, kindness over cruelty. Like those little three-month-old infants that Bloom studied at Yale, these values are grounded in our biology. They are part of what Winnicott would call our true self and they are quite distinct from the very different moral notions that wind up in our superego. After all, our superego contains our racism, it contains our sexism, it contains our heterosexism and those values are very distinct from our core values: love over hate, life over death. We all know on a fundamental level whatâs right and whatâs wrong on that very basic level, and that is the voice of conscience; we donât need God for this; it is built in biologically.â
Episode Description: Don begins by describing the difference between the narcissistically based superego from the object-oriented conscience. He sees the former as culturally derived and the latter as biologically given. We discuss how in the clinical situation persecutory guilt, i.e., superego, may often be emphasized to defend against the vulnerabilities associated with loving and being loved. We consider the use and overuse of the concept of trauma in contrast to intrapsychic conflict, and he distinguishes between empathy and sympathy. He shares his view that the edges of our political parties are imbued with the self-certainty born from the paranoid position. Ultimately, he concludes, "Iâm not afraid that analysis will disappear - people who have problems with their soul will seek out soul doctors."
Our Guest: Don Carveth, Ph.D., is an emeritus professor of sociology and social and political thought at York University in Toronto. He is a training and supervising analyst in the Canadian Institute of Psychoanalysis, a past Director of the Toronto Institute, and past editor-in-chief of the Canadian Journal of Psychoanalysis. He is the author of The Still Small Voice: Psychoanalytic Reflections on Guilt and Conscience, Psychoanalytic Thinking: A Dialectical Critique of Contemporary Theory and Practice, and Guilt: A Contemporary Introduction. Many of his publications are available on his York website (yorku.ca/dcarveth) and his current website (doncarveth.com); his video lectures are available on his YouTube channel (YouTube.com/doncarveth). He is in private psychoanalytic practice in Toronto.
Recommended Readings:
Carveth, D. (2016). Why we should stop conflating the superego with the conscience. Psychoanalysis, Culture & Society(2017) 22, 15-32.
Carveth, D.(2023). Guilt: A Contemporary Introduction. New York: Routledge.
Carveth, D. (2006). Self-Punishment as Guilt Evasion: Theoretical Issues." Canadian Journal of Psychoanalysis/Revue Canadienne de Psychanalyse 14, 2 (Fall2006): 172-96.
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"One of the changes that analysis provided me with was an awareness about how similar we all are, of course with a few differences. For me, an analyst is before all a person who had the opportunity to realize how we all human beings are very similar. We can familiarize with ourselves and with others thanks to these similarities and continuities. I would say like all my colleagues I asked for analysis when I was a young doctor in order to be helped. This is what is common to all analysts - analysts are people who are more aware and more experienced to ask for help than other people because they had the opportunity to be helped by a good treatment and to have the opportunity to integrate better.â
Episode Description: Stefano begins by describing the characteristics of many analysts today who seek treatment through the lens of mistrust of dependency and mutuality. Instead, defensive styles lean towards pseudo-autonomy, entitlement, and suspiciousness. We discuss how dealing with initial resistances to the transference is both similar to and different from generations ago. We consider the theoretical advances in understanding earlier developmental struggles as well as our greater appreciation of the medium of countertransference. Stefano notes that today's longer training analyses are an important contribution to these more profound clinical skills. He discusses some of the environmental contributions to current narcissistic inclinations as well as the temptations to reduce the uniqueness of the analytic experience to the familiar and comfortable. He closes by sharing with us his personal story and the essential step for all of us to be able to "ask for help."
Our Guest: Stefano Bolognini, MD, is a psychiatrist and training and supervising analyst of the Italian Psychoanalytic Society (SPI), where he served as president (2009-2013). He also was an IPA Board member (2002-2012) and was IPA president from 2013-2017. He was a member of the European Editorial Board of the International Journal of Psychoanalysis and a founder of the IPA Inter-Regional Encyclopedic Dictionary of Psychoanalysis. He has published over 260 psychoanalytic papers, and his books on empathy and on the inter-psychic dimension have been translated into several languages.
Recommended Links and Readings:
Bolognini, Stefano:
Secret Passages. The Theory and Technique of the Interpsychic Relations. IPA New Library, Routledge, London, 2010
Vital Flows between Self and Not-Self, Routledge, London, 2022
The Analystâs awkward Gift: balancing Recognition of Sexuality with parental protectiveness. Psychoanal. Quart., vol. LXXX, 1, 33-54, 2012.
Enchantments and disenchantments in the formation and use of psychoanalytic theories about psychic reality. The Italian Psychoanalytic Annual, 13, 11-24, July 2019.
New forms of psychopathology in a changing world: a challenge for psychoanalysis in the twenty-first century. The Italian Psychoanalytic Annual, 2020.
Reflections on the institutional Family of the Analyst and proposing a âfourth Pillarâ for Education. Opportunities and problems of transferal dynamics in the training pathwayâ. In Living and Containing Psychoanalysis in Institutions. Psychoanalysts Working Together, edited by Gabriele Junkers, 89-104, Taylor & Francis, 2022.
From What to How: A Conversational with Stefano Bolognini on Emotional Attunement by Luca Nicoli & Stefano Bolognini. The Psychoanalytic Quarterly, 91 : 3, 443-477, 2022.
The Interpsychic, the Interpersonal, and the Intersubjective: Response to Steven H. Goldbergâs Discussionâ. The Psychoanalytic Quarterly, 91:3, 489-494, 2022.
Hidden unconscious, buried unconscious, implicit unconscious. The Italian Psychoanalytic Annual, 16, 87-102, 2022.
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"Technology is based on the premise that there can be an optimization of things through algorithmic understanding. âOnes and zerosâ data can be manipulated and thus produce an optimal outcome which is a lovely idea for certain kinds of things. It's not necessarily, in my opinion, the best idea for the psyche or for happiness or for developing a life that's meaningful. I think a psychological mindset is slightly different in that our colleagues are really concerned with being with the person, making meanings, suffering sometimes through difficult things, so there isn't just an automatic assumption as there is in the tech mindset that we're trying to optimize for whatever it is that's good. It becomes very philosophical in the end⊠What is optimized? What is good? Why should we do it? There are all these kinds of questions that one may ask the technology mindset person: Why would we want to hack our nutrition or our mental health in order to become stronger or better? It is a little problematic, I think, as an end goal."
Episode Description: Nicolle begins by describing her journey from being a math teacher in the inner city to then becoming a consultant in the early days of the tech revolution. She shares the ethical concerns that led her to shift her interest to the mental health field and her eventually becoming Dean of the School of Professional Psychology and Health at California Institute of Integral Studies. While there she observed that "analysts think differently." This led her to seek to train as an analyst while also utilizing her familiarity with the tech mindset to create bridges with those in each field. We discuss the differences in ways of thinking between technologically immersed individuals and those with a psychological orientation - keeping in mind that each has much to learn from the other. We consider the dangers in the developing technological world, which include matters of privacy, distractedness, and a capacity to sit with suffering. We close with Nicolle sharing her vision for the future, which includes analysts playing a part in developing ethical approaches to the upcoming new developments. Her podcast is titled Technology and the Mind.
Our Guest: Nicolle Zapien, Ph.D. is a licensed MFT with 20 years of clinical experience. She is a post-seminar candidate at the Psychoanalytic Institute of Northern California (PINC). She serves on the Ethics committee and the Visiting Scholar committee at PINC and also on APsAâs committee for public information. From 2015 to 2019, Dr. Zapien served as Professor and Dean of the School of Professional Psychology and Health at California Institute of Integral Studies, overseeing 6 clinical training degree programs and 5 training clinics. There, she served on the IRB and chaired the research committee. Prior to her clinical work, Dr. Zapien spent a decade as a consultant designing, conducting, and/or overseeing over 200 quantitative and/or qualitative studies for industry clients and non-profits. Some of these studies employed user experience and human factors design methods to optimize the user experiences of technology products and services delivered via smartphones, tablets, websites, or kiosks. She has authored 2 books and several academic articles on themes associated with human decision-making, ethics, and phenomenology.
Recommended Readings:
Bednar, K., & Spiekermann, S. (2022). Eliciting Values for Technology Design with Moral Philosophy: An Empirical Exploration of Effects and Shortcomings. Science, Technology, & Human Values.
Frankel, R. & Krebs, V. (2022). Human Virtuality and Digital Life: Philosophical and Psychoanalytic Investigations. Routledge: New York, NY.
Greenfield. A. (2021). Radical Technologies: The Design of Everyday Life. Verso: New York, NY.
Marshall, Brandeis Hill (2023). Data Conscience: Algorithmic S1ege on our Humanity.John Wiley & Sons: Hoboken, NJ.
Millar, I. (2021). The Psychoanalysis of Artificial Intelligence. Palgrave MacMillian: Cham, Switzerland.
Turkle, S. (2022) The Empathy Diaries. Penguin Press: New York, NY.
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"In divorce it's fundamental that even though the couple ends, there's not an end to the family. We still owe a debt to the other - that other who offered to love us, who we had the opportunity to love, our debt to the children of that union. We are irrevocably called to ethics and to the continuing sense of responsibility to that other. Even though the marriage doesn't survive, the family needs to. In the high - conflict scenario, not only does the marriage not survive, often the family doesnât as well. In that sense it is profoundly unethical. So when I attempt to work with people in that situation, I always do so from an ethical perspective - ethical in the sense of creating a third, so that you try and enter into that system, but it has to be a profoundly ethical presence which I also find is distinctly psychoanalytic. I think our method is saturated with ethics without even realizing it, we're always thinking in ethical terms, managing transference, powerful forces within analytic relationship - it's a profoundly ethical task that we do. In that sense we also serve as witnesses to what our patients have experienced. The witnessing is also a kind of engagement and we try to do that when we work with people in the high-conflict position."
Episode Description: We begin by distinguishing high-conflict divorce from less malignant versions. Arthur has found that high-conflict divorce is characterized by a particular timeless destructiveness that lacks regard for the sense of the family or the history of affection that had existed within and between the individuals.
He has noted an experience of overwhelming disillusionment in the histories of those who are unable to mourn and instead remain immersed in vendetta seeking. We discuss the role of ethics, witnessing, and the capacity for the 'third' in these couples. Arthur shares with us his clinical experience with same-sex couples as well as with the unfortunate scenarios of alienated children who attempt to bolster the fragile capacities of one parent by refusing any contact with the other. He concludes by describing that his attention to the inner realities of these individuals is what he uniquely brings as a psychoanalyst to these often behaviorally tumultuous human tragedies.
Our Guest: Arthur Leonoff, Ph.D., is a psychologist and Supervising & Training Analyst of the Canadian Psychoanalytic Society. He is a past president and recipient of his Societyâs Citation of Merit. He is also an Honorary member of the American Psychoanalytic Association. Dr. Leonoff was the first president of the North American Psychoanalytic Confederation. He currently is chair of the IPA Committee International New Groups.Dr. Leonoff has maintained a private psychoanalytic practice for more than four decades. He is an active clinician, teacher, supervisor, and presenter, as well as author. Recently he has contributed to two edited volumes, Dear Candidate and Psychoanalysis at the Crossroads. He has written on diverse subjects of clinical interest, including the kindling of metaphor in recovering from the impact of early complex psychic trauma.In addition to his psychoanalytic practice, Dr. Leonoff has worked extensively as a consultant and expert witness to the Canadian courts on the confluence of psychopathology and high-conflict divorce. He is the author of three books in this field, most recently The Good Divorce (2015) and When Divorces Fail, Disillusionment, Destructivity & High Conflict Divorce (2021), The Good Divorce has been revised and republished as The Ethical Divorce, which is available from Friesen Press.
Recommended Readings:
Leonoff, A (2021). When Divorces Fail: Disillusionment, Destructivity, and High Conflict Divorce. Rowman & Littlefield.
Leonoff, A. (2021) The Ethical Divorce: A Psychoanalystâs Guide to Separation, Divorce, and Childcare. Friesen Press.
Fidler, B. and Bala, N. (2020). Conclusions, concepts, controversies, and conundrums of âalienation:â Lessons learned in a decade and reflections on challenges ahead, Family Court Review, 58(2). 576-603.
Greenberg, L., Fidler, B. and Saini, M.A. (Eds). (2019). Evidence-Informed Interventions for Court-Involved Families: Promoting Healthy Coping and Development, Oxford University Press.
Levinas, E. (1985). Ethics and Infinity: Conversations with Philippe Nemo (R.A. Cohen, Trans.). Duquesne University Press.
Wallerstein, J. and Kelly, J. (1980). Surviving the Breakup: How children and Parents cope with Divorce. Basic Books.
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âThe basic principle in defense analysis is that one approaches what is going on right now - it's an experience-near technique. You don't make conjectures about what would be called experience-distant phenomenon until you have a lot of material, a lot of knowledge about the patient. As the treatment goes on you really stick with what the patient is doing right now.â
Episode Description: Leon shares with us what he sees as the fundamental method of analytic treatment, which "regardless of the manifest theoretical orientation of the therapist ... are effectively utilizing the technique of interpreting defenses against unwelcome affects." He emphasizes the importance of being interested in the patient's defenses and less so the warded-off content. We consider the term 'protection' in place of 'defense'; how these interventions are an amalgam of clarification and interpretation; and the source of the bad reputation that attaches to the concept of 'defense interpretationâ. He shares with us how this approach links with the neurosciences and the concept of implicit emotion regulation. We discuss the work of Berta Bornstein, who introduced the importance of defending against unpleasant affects. He discusses two cases of disruptive children and their use of aggression in an effort to avoid sadness and loneliness. We close with his sharing his view of our field and his conclusion that "analysis will survive - it's too powerful a tool."
Our Guest:
Leon Hoffman, MD, is a psychiatrist and child and adolescent psychiatrist. He is a Training and Supervising Analyst at the New York Psychoanalytic Society and Institute. He is the Co-Director of the Pacella Research Center of NYSI. Among many publications, he is co-author with Timothy Rice and Tracy Prout of Regulation Focused Psychotherapy for Children (RFP-C): A Psychodynamic Approach and with Timothy Rice Defense Mechanisms and Implicit Emotion Regulation: A Comparison of a Psychodynamic Construct with One from Contemporary Neuroscience. In 2022, he presented the Norbert and Charlotte Rieger Psychodynamic Psychotherapy lecture at the American Academy of Child and Adolescent Psychiatry on âHelping Parents Spare the Rod: Addressing Their Unbearable Emotionsâ based on a paper he authored with Tracy Prout. He presented the Paulina Kernberg Memorial Lecture at Weill Cornell Medicine Child & Adolescent Psychiatry Grand Rounds. On Regulation Focused Psychotherapy: An evidence-based psychodynamic treatment for children with disruptive behaviors. And The Bruce A. Gibbard Lectureship in Psychiatry, University of Vermont, Department of Psychiatry.
Linked Episode:
Episode 38: A Psychoanalyst Studies âWhy is it easier to get mad than it is to feel sad?â with Leon Hoffman
Recommended Readings:
1. Hoffman, L. (2007) Do Children Get Better When We Interpret Their Defenses Against Painful Feelings? Psychoanalytic Study of the Child 62:291-313.
2. Hoffman, L. (2014). Berta Bornsteinâs Frankie: The Contemporary Relevance of a Classic to the Treatment of Children with Disruptive Symptoms. The Psychoanalytic Study of the Child 68:152-176
3. Rice, T. R., & Hoffman, L. (2014). Defense mechanisms and implicit emotion regulation: a comparison of a psychodynamic construct with one from contemporary neuroscience. Journal of the American Psychoanalytic Association, 62(4), 693-708.
4. Prout, T. A., Rice, T., Chung, H., Gorokhovsky, Y., Murphy, S., & Hoffman, L. (2021) Randomized controlled trial of Regulation Focused Psychotherapy for Children: A manualized psychodynamic treatment for externalizing behaviors. Psychotherapy Research, 32(5), 555-570.
5. Hoffman, L. (2020). How can I help you? Dimensional versus categorical distinctions in the assessment for child analysis and child psychotherapy. Journal of Infant, Child, and Adolescent Psychotherapy, 19(1), 1-15.
6. Leon Hoffman, Tracy A. Prout, Timothy Rice & Margo Bernstein (2023): Addressing Emotion Regulation with Children: Play, Verbalization of Feelings, and Reappraisal, Journal of Infant, Child, and Adolescent Psychotherapy, DOI: 10.1080/15289168.2023.2165874
7. Prout, T. A., Malone, A., Rice, T., & Hoffman, L. (2019). Resilience, defenses, and implicit emotion regulation in psychodynamic child psychotherapy. Journal of Contemporary Psychotherapy, 49(4). 235-244.
8. Hoffman, L., & Prout, T. A. (2020). Helping parents spare the rod: Addressing their unbearable emotions. Psychoanalytic Study of the Child, 73(1), 46-61.
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