"I have had quite some reactions to the article [on their psychoanalyses]. I was also telling Mauro and my colleagues that out of quite a number of articles I've published on maybe more pressing issues in the field of cancer research, for example, brain tumor research that I've spent quite some time with, I think it's actually the article [on psychoanalysis] that probably prompted the most reactions, at least in my personal surroundings, and the reactions have been overwhelmingly positive. So colleagues are very interested. They often ask questions about psychoanalysis, quite specifically, how it works, how it contributed, and also complemented the article in the sense that it was something that was quite outside of the box, so outside of the typical surgical publication.” - FV

"How can we reach surgeons? How can we make this interesting and attractive for them to even consider? I think most surgeons will be very performance-driven people, and I think that it goes hand in hand that that type of person will seek ways to improve themselves, but probably more in a technical way. Let's say they want to get faster in their operations. They want to get more skillful. They want to do more complicated surgeries. So there's a lot about self improvement in that you exercise until you master something. And I think that analogy with sports was our way of saying, hey, you know, this is actually pretty cool. You can compare yourself to  professional athletes, in terms of self improvement, and this is actually one way you can get there, how you can improve. At the same time, it was also important for us to acknowledge that it's not for everyone so we also mentioned alternatives, of course." - MV

Episode Description: Mauro and Flavio begin by describing the encouragement they received from their father to pursue personal analysis "to explore our unconscious minds for a lighter life and less emotional baggage." They share their psychoanalytic journeys and give examples of how their greater capacity to reflect instead of react has led to improved surgical patient outcomes. They also describe collegial tensions that were more clearly addressed through their ability to authentically know how they felt. They recommend that like elite athletes who have sports psychologists to address obstacles to their performances, so might surgeons appreciate the utility of psychoanalysis and other measures to improve their clinical attunement. Mauro concludes "Everyone has their baggage - don't be afraid to look at it and to understand what's going on. It's worth it."

Our Guests:

Flavio Vasella, MD PhD, is a junior attending neurosurgeon at the University Hospital Zurich, with a clinical and research focus on neurosurgical oncology. He earned his PhD in Molecular Life Sciences at the University of Zurich, where his research explored genome editing strategies in primary brain tumors. His primary academic interests include translational and clinical neuro-oncology as well as surgical education.

Mauro Vasella, MD, is a board-certified plastic surgeon with multiple years of clinical experience specializing in reconstructive surgery. He is affiliated with the University Hospital Zurich in Switzerland and the Royal Melbourne Hospital in Australia and has held positions as a fellow and attending surgeon. His practice and research field focuses on regenerative-reconstructive surgery and burn injuries.

Recommended Readings:

FV -

• Paul Kalanithi – When Breath Becomes Air

This memoir by a neurosurgeon-turned-patient is a poetic and piercing meditation on mortality, identity, and the transition from doctor to patient. It explores the tension between the analytical and emotional mind (somewhat paralleling the internal work of psychoanalysis) and offers profound insight into the humanity at the core of medical practice.

• Bill George – True North: Discover Your Authentic Leadership

This book presents a leadership philosophy rooted in self-inquiry, values, and life stories. True North emphasizes that effective leadership comes from understanding your life narrative and using that insight to lead with integrity and resilience. True North challenges leaders to cultivate authenticity by exploring their internal landscape. While the book focuses on leadership in a business context, it offers a compelling, practical perspective for medical professionals as well.

• Atul Gawande – Complications: A Surgeon’s Notes on an Imperfect Science

Gawande offers a candid look at the uncertainties, dilemmas, and emotional burdens of being a surgeon. His reflection on fallibility and decision-making underlines the importance of non-technical skills and the internal work required to become not just competent, but humanely attuned, in medicine.

• The impact of nontechnical skills on technical performance in surgery: a systematic review. Hull L, Arora S, Aggarwal R, Darzi A, Vincent C, Sevdalis N. J Am Coll Surg.2012 

This systematic review analyzed 28 studies linking surgeons’ non-technical skills—such as teamwork, situational awareness, and stress management to actual technical performance in the operating room. It found evidence that effective NTS positively affects outcomes, while fatigue and communication failures contribute to technical errors.

MV -

• The Art of Loving – Erich Fromm

Realizing the simple but somehow not always obvious fact that before being able to truly love someone, one must truly find themselves loveworthy. This implies and demands introspection, as well as forgiveness towards yourself and others.

• Outliers: The Story of Success – Malcolm Gladwell

To master something, one must invest a substantial amount of time and dedication – this is not only true for technical skills, but also non-technical skills. Personal growth is only possible if you invest time, such as undergoing a psychoanalysis or similar.

• The Checklist Manifesto – Atul Gawande

While the checklist itself is very technical, the way it was conceived and its effect was and still is rather non-technical. It is a question of putting your ego aside and truly focusing on areas which you can improve.

“I really think that the purpose is to make space for the unknown, uncertainty, and for our kind of humility in the face of the complexity of our belonging to the physical world. So it's our animality, our physicality, all of that is so complicated and difficult to grapple with. The unknown is uncontrollable and is a huge abyss, as we know, for everybody. I do think that I'm trying to pivot here a little bit towards meeting the patient's attempts to grapple with that unknown.”

Episode description:  We begin by examining the assumptions of causality that we humans commonly invoke when faced with physical ailments. Childhood imaginings come forward during such times, and, despite being distressing, they offer comfort in the face of frightening uncertainty. Similarly, analytic theorizing has occasionally suggested certainties in the face of the unknown. This may limit the analytic space, thereby making vulnerability, fears, and new awarenesses less accessible. Sharone presents clinical material from patients with testicular cancer and lymphoma, where their psychogenic theories of etiology interfered with their medical care. We consider the distinction between patients with somatic symptoms and psychosomatic patients. We question the ability of the analytic method to uncover the origins of medical illnesses while emphasizing the importance of recognizing the "particular possibilities of our method."

Our Guest: Sharone Bergner Ph.D. is a clinical psychologist and psychoanalyst in full time private practice of psychoanalysis, psychotherapy and clinical supervision in New York City. She is a member and former faculty at the Institute for Psychoanalytic Training and Research and is Adjunct Assistant Clinical Professor and a clinical supervisor at the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis, in the Contemporary Freudian track, where she teaches a course called The Body in Analytic Reverie. She is a member of the International Psychoanalytic Association and the editorial board of The Psychoanalytic Quarterly. She has a special interest in the body/mind in relation to maternal reverie in early development, vitality, embodiment, and medical issues, having worked early in her career in a cancer hospital, with the internal medicine, OBGYN, and dermatology clinics of a large urban teaching hospital, with political refugees and with parent-child pairs. 

Recommended Readings:

1. Bergner, S. (2011). Seductive Symbolism: Psychoanalysis in the Context of Oncology. Psychoanalytic Psychology 28:267-292.

2. Gottlieb, R. (2003). Psychosomatic medicine: the divergent legacies of Freud and Janet. Journal of the American Psychoanalytic Association, 51:857-881.

3. Winnicott, D.W. (1966). Psycho-Somatic illness in its positive and negative aspects. International Journal of Psychoanalysis, 47:510-516.

4. Lombardi, R. (2017). Body-Mind Dissociation in Psychoanalysis: Developments After Bion. Routledge.

5. Lemma, A. (2015). Minding the Body: The Body in Psychoanalysis and Beyond. Routledge.

6. Miller, P. (2014). Driving Soma: A Transformational Process in the Analytic Encounter. London: Karnac. Not to be missed: case vignette: Recalling a Challenging Analytic Case, pp. xxvi-xxxviii

“The subject of affairs, I think it's of interest to everybody. We have all had an Oedipal experience - we've all been babies who have at some point realized that we are not the only person. We're not perfectly fused with our mother, and she has other things to do, and there may be a father. We've all known what rejection feels like, and probably betrayal, and I think that affairs are in our unconscious. I think that's sort of evident in the way that most great novels, most great films, or at least many, have an affair at their heart. From Anna Karenina to Madame Bovary to Fatal Attraction, I think this is something that is just interesting. I wanted to write about affairs because I think they are a way of showing what psychoanalysis can do in a field in which everyone has an opinion on, and probably most people, in some way, have been indirectly or directly affected by. That was really the sort of the genesis for wanting to write about affairs.”

Episode Description: We consider the challenge of writing about dynamic treatments in a manner that is accessible to the non-clinical reader. Juliet's book about affairs opens up this widely recognized experience and adds intrapsychic insights without using emotionally - distancing jargon. She introduces us to individuals who have been involved in affairs, with carefully protected confidentiality, who generally reveal the power of past experiences to influence adult choices. Some end happily, and some end in agony. Juliet demonstrates the usefulness of bringing a dynamic listening to both accepting and deepening each individual's lifelong search for love.

Our Guest: Juliet Rosenfeld is a psychoanalyst and a member of the British Psychoanalytical Society, London. She studied at Oxford before a 15-year career in advertising and marketing, ending up in Government Communications. During this time, she began a Master's at the Tavistock and Portman Trust in Organizational Consultancy and started training as a psychotherapist a year later. She qualified as an integrative psychotherapist in 2012. Juliet was an elected trustee of the UK Council of Psychotherapy for four years, and is presently one of two clinician Trustees at the Freud Museum London, Sigmund Freud's final home. Juliet is the author of two books, The State of Disbelief ( 2020) and Affairs, True Stories of Love, Lies, Hope and Desire. Juliet's broader interest is in how psychoanalysis might be more accessible, and its ideas put into non-clinical language for audiences who may never be able to access psychotherapy themselves but are curious about what the unconscious means and what goes on in the consulting room.

Recommended Readings:

Creativity and Perversion by Janine Chasseguet-Smirgel (W. W. Norton & Co., Inc., 1984)

Dreams of Love and Fateful Encounters by Ethel S. Person (American Psychiatric Association Publishing, 2006)

Home Is Where We Start From by D. W. Winnicott (Penguin, 1990)

Love in the Time of the Internet by Martina Burdet (underbau, 2020)

Sex, Death and the Super Ego by Ronald Britton (Routledge, 2020)

Sexual Attraction in Therapy edited by Maria Luca (Wiley-Blackwell, 2014)

Sexuality and Attachment in Clinical Practice edited by Joseph Schwartz and Kate White (Routledge, 2019)

The Bonds of Love by Jessica Benjamin (Knopf Doubleday Publishing Group, 1988)

The New Sexual Landscape and Contemporary Psychoanalysis by Danielle Knafo and Rocco Lo Bosco (Confer Books, 2020)

Novels about Affairs

Anna Karenina by Leo Tolstoy (Penguin Classics, 2003)

A Very English Scandal by John Preston (Penguin, 2017)

Deception by Philip Roth (Vintage, 1991)

Getting Lost by Annie Ernaux (Fitzcarraldo Editions, 2022)

Madame Bovary by Gustave Flaubert (Wordsworth Editions, 1993)

Middlemarch by George Eliot (Wordsworth Editions, 1993)

The End of the Affair by Graeme Green (Vintage Classics, 2004) 

“Now's the time to tell that wonderful story of the little boy. He was about two or three years old, and he went in the icebox to get some milk, and he managed to get this big carton and spill it all over the floor. Now, needless to say, there'd be a lot of parents that would react very negatively and frustrated - this mother happened to be a scientist. So she came in, she saw the bottle of milk, and what had happened. She went and got some paper towels, put them on the milk, and said, ‘Look at this. Look how the milk starts creeping up these fibers of the towel. Isn't that cool?’ And then she said, ‘Look, if you have something heavy you need to get out of the refrigerator, feel free to call me. But how neat is this that  the milk is being absorbed by the towel?’ Well, she was a scientist, and he became a world-class scientist. She understood his interest and she didn’t bring a fear and shame-inducing reaction, and all the negative effects that could have resulted if she had handled it differently. Instead, she put a sense of joy and interest in being intrigued with his interests, and turned the whole thing around.”

Episode Description: Paul starts our conversation about affects by referencing Tomkins’ work, which identified 6 negative and 2 positive affects/feeling states, all of which are represented by different facial expressions in infancy. He reports on clinical work that is enhanced by locating the patient's affective surface, which enables meaningful contact within the dyad. We focus on the affect of interest and how essential it is in establishing a sense of self in the world. He also shares the many ways that this interest can be undermined by the child's environment. He describes research on the capacities of 18-month-olds and how they differ from 14-month-olds regarding the awareness of self and other. Paul also emphasizes how destructive corporal punishment is in the lives of children and in society at large. We end with the final sentence from his book, a quote from Abraham Lincoln, "We can succeed only by concert. It is not 'Can any of us imagine better?' but 'Can we all do better?' Object whatsoever is possible, still the question recurs, 'Can we do better?'

Our Guest: Paul Holinger, MD, MPH, is a psychiatrist and psychoanalyst, Faculty and Former Dean at the Chicago Psychoanalytic Institute, Training/Supervising and Child/Adolescent Supervising Analyst. He is Professor of Psychiatry (Retired) at Rush University Medical Center, Chicago. His most recent books include Affects, Cognition, and Language as Foundations of Human Development and What Babies Say Before They Can Talk: The Nine Signals Infants Use to Express Their Feelings.

Recommended Readings:

Holinger PC: Violent Deaths in the United States: An Epidemiologic Study of Suicide, Homicide, and Accidents. New York: The Guilford Press, 1987.

Holinger PC: Offer D; Barter JT: Bell CC: Suicide and Homicide Among Adolescents. The Guilford Press, 1994.

Holinger PC: What Babies Say Before They Can Talk: The Nine Signals Infants Use to Express Their Feelings. New York: Simon & Schuster, 2003. (Several Translations)

Holinger PC: Affects, Cognition, and Language as Foundations of Human Development. New York/London: Routledge, 2024.

Holinger PC: Violent deaths as a leading cause of mortality: An epidemiologic study of suicide, homicide, and accidents. Amer J Psychiatry 137: 472-476, 1980.

Holinger PC: A developmental perspective on psychotherapy and psychoanalysis. Amer J Psychiatry 146: 1404-1412, 1989.

Holinger PC: Noninterpretive interventions in psychoanalysis and psychotherapy: A developmental perspective. Psychoanalytic Psychology 16: 233-253, 1999.

Holinger PC: Further issues in the psychology of affect and motivation: A developmental perspective. Psychoanalytic Psychology 25: 425-442, 2008.

Holinger PC: Further considerations of theory, technique, and affect in child analysis: Two prelatency cases. International J Psychoanalysis 97: 1279-1297, 2016.

Holinger PC: The problem of physical punishment and its persistence: The potential roles of psychoanalysis. The Psychoanalytic Study of the Child 73:1-9, 2020.

“In the analysis, the place where you face the experience of otherness, of foreignness, of the unconscious that goes through you, it doesn't appear as knowledge. Of course, in an analysis, you get a lot of knowledge, but it's not an important aspect of an analysis. I think that in the analysis, and that's the idea of using that word ‘transmission’ instead of ‘teaching’, what you receive is something that the analyst doesn't have. When you receive some knowledge from a teacher, you receive the knowledge the teacher has. When you transmit something, or when you receive something that has been transmitted by the analyst or by the psychoanalytical setting, is something that the other doesn't have. It's a kind of void. It's a kind of fire. It's like the baton that every runner passes to others in a relay race. It is something more difficult to be grasped with words, is something elusive to words, but it does exist.”

Episode Description: We begin with describing the 'necessary foreignness' of psychoanalysis, "It is from both a foreign perspective and foreign listening that makes it possible to notice the concealed underpinnings, to discover the new, and to express the unexpressed." We consider the clinical asymmetry that allows for the patient's unbridled freedom to think and speak the unspeakable. Educationally, Mariano discusses the essential transmission of analytic experience as contrasted with the teaching of knowledge - a distinction between science and mystery. He shares his thoughts on eclectisism, hypothesis testing and risk. We close with recognizing that the "anachronistic method of psychoanalytic listening is the most authentic way of being contemporary."

Our Guest: Mariano Horenstein, PhD is a training and supervising analyst who belongs to the IPA, FEPAL (Latin American Psychoanalytical Federation), and the international research group "Geographies of Psychoanalysis". He is an IPA Board member and a former chief editor of Calibán, the official Journal of FEPAL. Former Training Director of APC (Argentina). His articles have been translated into Portuguese, English, Farsi, French, Russian, Italian, Portuguese and German. Author of four books :Psychoanalysis in Minor Language, The Compass and the Couch. Psychoanalysis and its Necessary Foreignness, Funambulistas. Travesía adolescente y riesgo and Artists, Writers and Philosophers on Psychoanalysis. From the Couch. He has received international awards as M. Bergwerk (about the clinic forms of Evil), Lucien Freud (about Psychoanalysis and Culture); Elise Hayman Award for the study of Holocaust and Genocide (given by the IPA); A. Garma (given by the Spanish Association of Neuropsychiatry); the FEPAL Award and Carolina Zamora Award (given by Madrid Psychoanalytical Association).

http://www.marianohorenstein.com/

Recommended Readings:

Horenstein, Mariano, The compass and the couch. Psychoanalysis and its necessary foreignness, Mimesis, Milan, 2018.

Horenstein, Mariano, Artists, writers and philosophers on Psychoanalysis. From the couch, Routledge, London, 2024.

Horenstein, Mariano, Psicoanálisis en lengua menor, Viento de Fondo, Córdoba, 2015.

Preta, Lorena (ed), Dislocated subject, Mimesis, Milan, 2018.

Preta, Lorena (ed), Geographies of Psychoanalysis, Mimesis, Milan, 2015.

Preta, Lorena, The brutality of things. Psychic transformations of reality, Mimesis, Milan, 2019.

Wohlfarth, I., Hombres del extranjero. Walter Benjamin y el Parnaso judeoalemán, Taurus, CDMX, 2014.

“I think that my analytic awareness of denial and projection and the concreteness of psychic reality when executive function wanes, that I could help the other caretakers to understand some of what was going on - to give them a way to understand that relieves their sense of frustration and uncertainty. I think that the analytic awareness of denial, of projection, that these things are not generally recognized by many caretakers, but it does reorient and make the caretaking function much more tolerable. It expands the understanding of what goes on in the waning personality. I also think that analytic work fosters the capacity to tolerate ambiguity, uncertainty, pain and frustration and in that way may allow us, the analytic mind, to tolerate some of the intense affect - as sort of the phrase I love from an Italian analyst, as “writings waiting to be completed” - by the analytic mind. We can hold and metabolize the difficulty and offer that kind of function rather than unpleasantness just to be rid of. These are some of the things that I felt are useful as a psychoanalyst.”

Episode Description: We begin with describing how dementia is a cloud over our field both for individuals and for institutes. Maxine then introduces us to 'Sally' who was her analysand 40 years prior to recontacting her to care for her cognitive decline. Maxine mentions that just hearing her former patient's voice instantly brought alive her past experiences with her. We discuss how she approached the issue of caring for her and her neurological condition. We consider the at times overlap between psychogenic and organic symptoms and she shares with us her countertransference experiences of herself losing her memory. Maxine also shares her approach to answering Sally’s questions about the possibility of recovering. We close with her describing how she feels that being an analyst aided her care of Sally and what she learned from that experience that she brought to her other patients -"to face the pain of difficult truths."

Our Guest: Maxine Anderson, MD, is a training and supervising analyst at the Northwestern Psychoanalytic Society and Institute, the Seattle Psychoanalytic Institute and Society and the Canadian Psychoanalytic Society. Originally trained in psychiatry, she pursued psychoanalytic training in Seattle in the early 1970s and then pursued post-graduate work at the British Psychoanalytical Society for 8 years, returning to Seattle in 1992.  Thereafter, she became a Founding Member of the Northwestern Psychoanalytic Society and Institute. Maxine has published several articles, and chapters and 3 books, the most recent being The Hardest Passage: a psychoanalyst accompanies her patient’s journey into dementia (Karnac, 2025). Feeling herself now to be an Elder in life and in her field, Maxine hopes to continue to think and write about this phase of personal and professional life.

Recommended Readings:

Balfour, A. (2007). Facts, phenomenology, and psychoanalytic contributions to dementia care.

 In: R. Davenhill (Ed.) Looking into Later Life: a psychoanalytic approach to depression and dementia in Old Age. (pp. 222–247). London: Routledge, 2007.

Davenhill, R. (Ed.) (2007) Looking into Later Life. A Psychoanalytic approach to Depression and Dementia in Old Age. London: Karnac.

Davenhill, R. (2007). No truce with the furies: issues of containment in the provision of care for people with dementia and those who care for them.

In: R. Davenhill ( Ed.), Looking into later life: a psychoanalytic approach to dementia and depression in old age. (pp. 201-221). London: Routledge.

Evans, S. (2008). “Beyond forgetfulness”: How psychoanalytic ideas can help us to understand the experience of patients with dementia”. Psychoanalytic Psychotherapy, 22(3):155–176.

Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Milton Keynes: Open University Press.

Malloy, L (2009). Thinking about dementia – a psychodynamic understanding of links between early infantile experience and dementia. Psychoanalytic Psychotherapy, 23(2): 109–120.

Plotkin, D. (2014). Older adults and psychoanalytic treatment: It’s about time. Psychodynamic Psychiatry, 42(1): 23–60.

Sherwood, J. (2019). Dementia: childhood and loss. In White, K. Cotter, A. & Leventhal, H. (Eds.), Dementia: An Attachment Approach. London: Routledge.

“All of this together shaped how I began to think about mind, not as something to be mastered, but as a landscape of the unspoken whether it was ghosts or griefs or desires that were hard to relinquish. I saw that the ghost was not always an ‘other’. It was often intimate, tied to lost ones, sometimes to unmet desires, to unbearable longings, but in some ways possession was an attempt to keep close what was slipping away. The ghost doesn't just haunt, it feels as if it wants something, and we just have to learn to develop ears to listen to what it wants.” 

Episode Description: We acknowledge Loewald's concept of 'ghosts becoming ancestors' and consider the similarities and differences with those who hold 'ghosts' to be literal. Shalini shares with us her journey to open herself to the uncertainty and ambiguity of these externalized entities while appreciating both their cultural and intrapsychic sources. We learn of her family's involvement with exorcisms, especially her grandmother's "fearless warmth" and "empathy that saw beyond the terror of the ghosts." She considers the many facets of mind that are represented by 'ghosts' and the essential value of approaching them as guides to the "landscape of the unspoken." Shalini describes a long term engagement that she had with an individual who "taught me to receive the inchoate and horrific...to contain the brokenness and not interpret it away.. and to appreciate the glimpses of beauty in the most grotesque parts of self."

Our Guest: Shalini Masih, a psychoanalytic psychotherapist and writer, grew up in India amidst priests and healers, witnessing spirit possession and exorcism. Now based in Worcestershire, UK, she holds a Master’s degree in Psychoanalytic Studies from Tavistock & Portman, London, and a PhD from the University of Delhi. Mentored by psychoanalysts Michael Eigen and Sudhir Kakar, she’s an award-winning scholar of the American Psychological Association. She has taught and supervised psychoanalytic psychotherapists in Ambedkar University, Delhi and in Birkbeck, University of London. Her acclaimed paper, 'Devil! Sing me the Blues', was nominated for Gradiva Awards in 2020. Her debut book is Psychoanalytic Conversations with States of Spirit Possession: Beauty in Brokenness. 

Recommended Readings:

Kakar, Sudhir. Shamans, mystics, and doctors: A psychological inquiry into India and its healing traditions. Chicago, IL: University of Chicago Press, 1991.

Kakar, Sudhir. Mad and Divine. India: Penguin Books India, 2008.

Eigen, Michael. “On Demonized Aspects of the Self” In The Electrified Tightrope. Routledge. 2018.

Kumar, Mansi, Dhar Anup & Mishra, Anurag. Psychoanalysis from the Indian Terroir: Emerging Themes in Culture, Family, and Childhood. New York:Lexington Books, 2018.

Meltzer, Donald, and Williams, Meg H. The apprehension of beauty: The role of aesthetic conflict in development, art and violence. Karnac, London: The Harris Meltzer Trust, 2008.

Obeyesekere, Gananath. Medusa’s Hair: An Essay on Personal Symbols and Religious Experience. Chicago, IL: University of Chicago Press, 1981.

Ogden, Thomas. This Art of Psychoanalysis—Dreaming Undreamt Dreams and Interrupted Cries. East Sussex: Routledge, 2005

Botella, Cesar, and Botella, Sara. The Work of Psychic Figurability: Mental States without Representation. Brunner-Routledge. Taylor and Francis Group: Hove and New York. 2005.

Winnicott. Donald W. “Transitional objects and transitional phenomena.”  International Journal of Psycho-Analysis, 34, (1953): 89–97

“The theme that I found with IPSO [International Psychoanalytical Studies Organization] was that there was a common theme [in psychoanalytic training].  There was an initial phase full of terror and excitement, and then a middle phase of maybe some lethargy or apathy or disillusionment. In that middle phase, many candidates found IPSO, or IPSO found them, where they found refuge. They found solace. They found community, not just at their local institutes, but at this kind of world market. Many of the candidates talk about what a timely and wonderful experience it was to be seen, to be validated by fellow candidates in a way that only fellow candidates can do. At least a couple of the authors have written about how they were delighted to see that more than anything else we are similar as human beings, no matter where we're from.” 

Episode Description:  We begin with recognizing the deep attachment that many analytic candidates have about their training experiences, which includes affections and resentments. Himanshu outlines the process of reaching out to candidates globally, inviting them to share their reflections on their journeys. We read from a sampling of their essays that eloquently describe their idealizations and de-idealizations, their delights and their burdens, their profound regard for the mysteries of the mind and the appreciation of the power of psychoanalysis to engage with it. We discuss the importance of IPSO, the difficulties associated with Covid and the relevance of our field's traumatic origins. Himanshu closes with sharing his story of encountering an insightful analytic supervisor during his residency and declaring "I want to be like him."

Linked Episode:Episode 89: Wisdom and Enthusiasm for Today’s Candidates with Fred Busch, PhD

Our Guest: Himanshu Agrawal, MD is an adult and child psychiatrist and recently completed psychoanalytic training through the Minnesota Psychoanalytic Institute. He is an associate professor of psychiatry and behavioral medicine at the Medical College of Wisconsin in Milwaukee where he sees patients, conducts research, and teaches. He recently completed his term as the president of the candidates’ council of the American Psychoanalytic Association

Recommended Readings:

Busch F (Ed), Dear candidate. Routledge, 2020

Agrawal H,  Trials and Tribulations of being a candidate. The American Psychoanalyst, winter 2022

Kernberg O, Thirty methods to destroy the creativity of psychoanalytic candidates. International Journal of psychoanalysis, 77, 1031- 1040

“When we reconstruct [in a patient] a possible lacking object or role or function, we  see that if the analyst himself has been able and the patient allowing him to be able to enter to a deep level the objective reality of the internal world of the patient, it can happen that some new function or position can be achieved. This is something that could be rare but it happens. This is one more reason for not blaming the length of some analytic treatments, because time is needed  for entering that internal deep area where the analytic relation can create something new. Transformation is also one of the words that in our analytic world became more and more common and utilized because we have achieved the certainty that there can be a transformation. Not only an understanding or a clarification, but also a transformation of the quality of the objective world and of the relation with it.” 

Episode Description: We begin by describing the differences in psychoanalytic approaches today as compared to past generations. This shift has occurred alongside changes in patients' concerns; currently, individuals are disproportionately preoccupied with how they perceive themselves through others' eyes, rather than grappling with internal conflicts related to guilt. Stefano posits that this increased narcissistic investment stems from alterations in family structures and premature disruptions in "the physiological fusionality" with the early maternal caretaker. We discuss how this sense of distrust in the availability and reliability of caretakers affects the manner in which one introduces a patient into analysis, as well as the broader cultural emphasis on superficial bodily care - what he terms the aperitif experience. We consider the fundamental importance of the depth of object relations in understanding sexual diversities. Stefano concludes by reading the final paragraph from his book, which acknowledges the invaluable lessons learned from his analyst. We reflect on the enduring presence within him of this profoundly personal connection.

Linked Episodes: Episode 140: Are Patients Different Today? with Stefano Bolognini, MD (Bologna)

https://youtu.be/rjzpA8QZrWk?si=Srf_Tuxt0zTpsKNK

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 280 psychoanalytic papers, and his books on empathy and on the inter-psychic dimension have been translated into several languages. 

Recommended Readings:

Bolognini, Stefano -

Secret Passages. The Theory and Technique of the Interpsychic Relations. IPA New Library, Routledge, London, 2010

https://www.amazon.com/Vital-Between-Non-Self-Library-Psychoanalysis/dp/1032132973, Routledge, London, 2022

https://pubmed.ncbi.nlm.nih.gov/21387998/ 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 “fourth Pillar” for Education. Opportunities and problems of transferal dynamics in the training pathway“. 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. Goldberg’s Discussion. The Psychoanalytic Quarterly, 91:3, 489-494, 2022.

Hidden unconscious, buried unconscious, implicit unconscious. The Italian Psychoanalytic Annual, 16, 87-102, 2022.

“The original papers that were written about the analyst’s unconscious being attuned to the patient's unconscious  by Hyman and Racker, in both cases they talk about this phenomenon. But both of them utter a caution, which is that one always has to take into account one's own ‘mishegas’.  Essentially, what they're saying is, the unconscious is pretty individualistic and we have our own things, and we have to consider that possibly it's our own difficulties, our own unconscious, that is playing a bigger role in our countertransference reaction to the patient's unconscious.”

Episode Description: We begin by discussing the meaning of the many italics throughout the book and my sense of their being an expression of Fred's wish to be carefully understood. This is part of our conversation where we examine how internal reactions are used to comprehend another person's mind. There are a number of themes to this work, and to Fred's contributions over the years, which focus on helping individuals understand the way their mind works, as distinct from the particular contents of their mind. One of the gifts of psychoanalysis is to facilitate patient's discovery of the freedom to think which allows for a post-termination capacity for self-analysis. We discuss how self-criticism can serve as an unconscious lifeline, the importance of attending to the need for silence as distinct from what is not being said and the seductiveness of gossip, to name but a few of the topics in the book that we cover. Fred closes by describing "The wonderful thing about being a psychoanalyst is there are always things to learn and ways to grow."

Our Guest: Fred Busch, Ph.D. is a Training and Supervising Analyst at the Boston Psychoanalytic Society and Institute. He has published eight books, and over 80 articles on psychoanalytic technique, along with many book reviews and chapters in books.  His work has been translated into many languages, and he has been invited to present over 180 papers and clinical workshops nationally and internationally. His last six books are: Creating a Psychoanalytic Mind (2014); The Analyst’s Reveries: Explorations in Bion’s Enigmatic Concept (2019); Dear Candidate: Analyst From Around the World Offer Personal Reflections on Psychoanalytic Training, Education, and the Profession (2020); A Fresh Look at Psychoanalytic Technique (2021), Psychoanalysis at the Crossroads: An International Perspective (2023).The Ego and Id: 100 years later (2023), How Does Analysis Cure? (2024).

Recommended Readings:

Busch, F. (2014). Creating a Psychoanalytic Mind: A Psychoanalytic

Method and Theory. London: Routledge.

Busch, F. (2019). The Analyst’s Reveries: Explorations in Bion’s

Enigmatic Concept. London: Routledge.

Busch, F. (2021). A Fresh Look at Psychoanalytic Technique: Selected

papers on Psychoanalysis. Routledge: London.

Busch, F. (2023) The Significance of the Ego in “The Ego

and the Id” and its Unfulfilled Promise. International Journal of

Psychoanalysis 104:1077-1090.

Busch, F. (2000). What is a deep interpretation? J. Amer. Psychoanal.Assn., 48:238-254.

Busch, F. (2005). Conflict Theory/Trauma Theory. Psychoanal.Q., 74: 27-46.

Busch, F. (2006). A shadow concept. Int.J.Psychoanal.,87: 1471-1485. Also appearing as Un oncerto ombra, Psycoanalisi, 11:5-26.

Busch, F. (2015). Our Vital Profession*. Int. J. Psycho-Anal.,

96(3):553-568. Reprinted in Busch, F. (2015). La nostra

professione vitale. Rivista Psicoanal., 61(2):435-456; Busch, F. (2015). Nuestra profesión vital*. Int. J. Psycho-Anal. Es., 1(3):605-627; Busch, F. (2015). Nuestra profesión vital1. Rev. Psicoanál. Asoc. Psico. Madrid, 75:131-153.