Psychoanalysis On and Off the Couch

"First, when we started to work online, it was exhausting. Now, I cannot say it is exhausting at the same level but it is still exhausting. You feel very tired and you miss the in-person contact. It has been more than one and a half years...I think that we will be able to think about the consequences and the impact of working in this way, and in the upcoming years we will have a lot of material."

Episode Description: We begin with a review of our first two podcast conversations - the first being the inaugural episode and the second coming one year later at the beginning of the COVID lockdown. Now we are able to look back at what we hope is the worst of the pandemic and its impact on our lives and on analytic practice. The clinical implications for online and in-person contact will be studied for some time ahead. Virginia discusses her views on the politics of the IPA, the meaning of being the first woman president, and the importance of her being a child analyst. We close with an affirmation of her optimism for our field which is seen as more essential than ever.

Our Guest: Virginia Ungar M.D, is a Training Analyst at the Buenos Aires Psychoanalytic Association (APdeBA) where she lives and practices. She specializes in child and adolescent analysis, was the former Chair of the IPA's Child and Adolescent Psychoanalysis Committee (COCAP) and of the Committee for Integrated Training. Dr. Ungar was given the Platinum Konex Award for Psychoanalysis in 2016.

She has just completed her term as the President of the International Psychoanalytic Association, 2017-2021.

They forced me into this tiny little interrogation room off the big anteroom, a whole mob of policemen shouting and screaming. I thought I would perish there, that I was going to die there and then, which was exactly what they wanted me to think. Their intention was to overwhelm me with terror, and they did. But then Swanepoel's interrogation partner, a man named Harvey Richter, produced this brick and he held it up in front of me right across my eyes and I thought, looking at its granular surface, that it would abrade my face when he hit me with it. But he didn't, he put it down in front of me and said: Stand on it.

Episode Description: John begins our journey through his past by describing his family life before his arrest and torture at the age of 21 at the hands of the South African Security Police. We learn of his family's longstanding history of opposition to political injustice. He then recounts his methods of survival during his imprisonment which included forming a 'relationship' with the brick he was forced to stand on for days and nights. He also internally relied upon his loving parents, his girlfriend, his Jewish identity, and The Sounds of Silence. He was held in solitary confinement and brutalized until his release to travel to Israel.

After establishing his life in England, John eventually began training as a psychotherapist. He describes having life-changing personal treatments including two analyses and he has become a contributor to the field especially to the world of analytic group therapy. He shares with us vignettes of patients he has worked with and how he has turned 'swords into plowshares' in his efforts at transforming his own scars into the act of healing others.

Our Guest: John Schlapobersky, BA MSc is a psychoanalytic and couple psychotherapist and a group analyst accredited by the United Kingdom Council for Psychotherapy. After many years in private practice at the Group Analytic Practice, he established his own Bloomsbury Psychotherapy Practice in 2009. He is also a training analyst and faculty member at the Institute of Group Analysis and an honorary research fellow at the Birkbeck College University of London. He has served as faculty at the London Centre for Psychotherapy, Tavistock Centre for Couple Relationships (TCCR) and is a founding member of the British Society for Couple Psychotherapists and Counsellors. He teaches internationally on topics that include group studies, psychoanalytic and relational theory, and trauma. His commitments include programs in Australia, China, Denmark, Germany, Israel, Japan, Poland, Russia, South Africa, Sweden, Switzerland, the USA, and elsewhere. He was Program Chair for the Group Analytic Society Symposium in 2011: Cultures, Conflict, and Creativity. John was formerly a Consultant Psychotherapist for the Traumatic Stress Clinic, London, and The Medical Foundation for Victims of Torture which, as a founding trustee, he helped establish in 1985. It is now called Freedom From Torture, a leading human rights charity.

Recommended Readings:

Bernstein, H. (1994) The Rift: The Exile Experience of South Africans. London: Jonathan Cape. Reissued Persephone Books, Bath UK, 2020.

Pines, M. (1998) Circular Reflections: Selected Papers in Psychoanalysis and Group Analysis. Jessica Kingsley, London.

Rosenthal, N. (2014) The Gift of Adversity. New York: Jeremy P. Tarcher/Penguin.

Sachs, Albie. (1969) The Jail Diary of Albie Sachs. London: Sphere. Reissued Africa Book Centre, London, 1978.

Sachs, Albie (1990) The Soft Vengeance of a Freedom Fighter. Oakland: University of California Press. Reissued Souvenir Press, 2014.

Schlapobersky, J. (2016) From The Couch To The Circle: Group-Analytic Psychotherapy In Practice. Routledge, London.

Schlapobersky, John R.(2021) When They Came For Me: The Hidden Diary Of An Apartheid Prisoner. Berghan Books, Oxford and New York.

I observe what many of the French analysts and my supervisees say [about online treatment] - they are absolutely happy by how fantastic the patients talk, they talk much easier than before, they have dreams, and they relate their dreams and even sexual fantasies which they never did before. I understand them of course because they talk to them as easily as they would talk to a taxi driver that they will never see again.

Episode Description: We begin by recalling our first conversation in March 2020 (Episode #43) at the beginning of the lockdown in Paris and the switch from in-person to online analytic treatment. We discuss the impact of the missing bodies in the office and its implications for the freedom that some patients now feel to be more open. Marilia wondered about how analysands will feel when they return to in-person treatment after revealing more online than they would have otherwise tolerated. This forced experiment in technique will hopefully shed light on what is essential in our work in contrast to what are non-essential "rules."

We also discuss her 45 years of practicing analysis, her deepened comforts in aloneness, and her view on the future of our field.

Our Guest: Marilia Aisenstein is a Training and Supervising Analyst in the Hellenic Society and the Paris Society and past president of the Paris Society. She has served as the IPA's Board representative to the Executive Committee and the past president of the International New Groups Committee. She has been the Editor and co-founder of the French Review of Psychosomatics and President of the Paris Institute of Psychosomatics.

Her most recent book translated into English is Desire, Pain, and Thought.

Episode referred to

http://ipaoffthecouch.org/2020/03/31/episode-43-a-report-from-paris-with-marilia-aisenstein/

A decade ago I started to tell my colleagues that there is something big here in the therapeutic room and if we don’t talk about it in the room and in supervision there’s something we are missing here. We are not talking just about two people who can speak only on the humanistic level - just to be human one to the other or a good object one to the other. We have to talk about what is going on outside and how every one of us in this therapeutic dyad is coming from a threatening group to the other.  

 

Episode Description: We begin by appreciating how ethnic affiliations have a presence in the therapeutic encounter. Whether therapist/patient cultural allegiances are manifestly similar or different, when the therapeutic space allows for exploration internal meaning can be revealed. These possibilities become fraught when the external representations of these ethnicities are at actual war. Dr. Srour describes working through his countertransference struggles which he felt was essential in coming to empathize with the internal experiences of his Jewish patients. He characterizes this as 'political countertransference' and feels that the freedom to speak of outside realities in the treatment dyad is an essential aspect of a deepening psychotherapy. 

 

Our Guest: Dr. Roney Srour, a Palestinian-Israeli clinical and educational psychologist is married and the father of 2 sons who lives in Haifa and works as a clinical psychologist in the Israeli Ministry of Health and in private practice. Dr. Srour teaches and researches “psychodynamic psychotherapy with cultural and political competence” at the University of Haifa and is a lecturer and supervisor in two post-graduate programs of psychotherapy. He is an activist in the field of the Israeli-Palestinian conflict. 

 

Recommended Readings: 

Gorkin, M. (1986). Counter-Transference in Cross-Cultural Psychotherapy: The Example of Jewish Therapist and Arab Patient. Psychiatry, 49, 69-79. 

 

 

Srour, R. (2015) Transference and Countertransference Issues During Times of Violent Political Conflict: The Arab Therapist-Jewish Patient Dyad, Clinical Social Work Journal, 43(1). 

 

 

Baum, N. (2011). Issues in Psychotherapy with Clients Affiliated with the Opposing Side in a Violent Political Conflict. Clinical Social Work Journal, 39, 91-100. 

 

 

Altman, N. (2000). Black and White Thinking: A Psychoanalyst Reconsiders Race.  Psychoanalytic Dialogues, 10(4), 589-605. 

 

 

Ghassan Kanafani, Men in the Sun Lynne Rienner Publishers 1999  

"Thousands or millions of people who will never meet each other sharing certain sentiments - these sentiments have historical, cultural and linguistic backgrounds. When I started this, of course, conflicts between large groups have certain realistic aspects as you can imagine: political, personal and legal ones, but underneath those I figured out that everything is in the name of maintaining and protecting one's large group." 

 

Episode Description: Dr. Volkan begins by describing his experience of loss and conflicted mourning as a stimulus for his life-long study of large group phenomena and its application to international diplomacy. We review his concepts of 'chosen trauma' and 'chosen glory' as they function to emotionally collapse time for large groups seeking to intergenerationally transmit a sense of collective entitlement. Dr. Volkan gives examples of how his understanding of large group phenomena has informed and impacted diplomatic negotiations. We conclude with his sharing his view of both the progress that psychoanalysis has made over the past half century and some of his concerns for its future. 

 

Our Guest: Vamık Volkan, MD is an Emeritus Professor of Psychiatry at the University of Virginia, a former president of the International Society of Political Psychology, the Virginia Psychoanalytic Society, the American College of Psychoanalysts and the Emeritus President of the International Dialogue Initiative (IDI). He applied a growing theoretical and field-proven base of knowledge to issues such as ethnic tension, racism, transgenerational transmissions, leader-follower relationships, and other aspects of national and international conflict. He was a member of the International Negotiation Network (INN) under the directorship of former President Jimmy Carter (1989-2000). He was nominated for the Nobel Peace Prize five times with letters of support from 27 countries. Dr. Volkan is the author, co-author, or editor of sixty books. 

 

Recommended Readings: 

Volkan, V.D. (2006, 2019). Killing in the Name of Identity: A Study of Bloody Conflicts. Durham, NC.: Pitchstone. 

 

Volkan, V. D. (2013). Enemies on the Couch: A Psychopolitical Journey Through War and Peace. Durham, NC: Pitchstone Publishing. 

 

Volkan, V. D. (2015). A Nazi Legacy: A Study of Depositing, Transgenerational Transmission, Dissociation and Remembering Through Action. UK: Karnac. 

 

Volkan, V. D. (2017). Immigrants and Refugees: Trauma, Perennial Mourning, and Border Psychology. UK: Karnac. 

 

Volkan, V. D. (2020). Large-Group Psychology: Racism, Societal Divisions, Narcissistic Leaders and Who We Are Now. UK: Phoenix. 

 

Volkan, V. D. (2021). Sexual Addiction and Hunger for Maternal Care: Psychoanalytic Concepts and the Art of Supervision. UK: Phoenix. 

"I was somebody who all throughout my academic career was very affected by good teachers. In fact, my becoming a psychologist – I took my first psychology undergraduate course as a junior and it had such a profound effect upon me that I stayed in college an extra year to get all the requirements to go on to a Ph.D. program. There have been certain teachers that I’ve had that have really inspired me and changed my life."  

 

Episode Description: We begin by discussing the origins of the book Dear Candidate which consists of 42 letters written by senior analysts from around the world to candidates in training. Notable is the enthusiasm, wisdom, affection, and encouragement that the older generation conveys to the future generation of psychoanalysts. Fred and I each read to each other favorite paragraphs from selected letters that emphasize valuing international input into one's clinical thinking; tolerating uncertainty; recognizing one's place in the social/political arena; addressing the literal and fantasy-driven physicality of the work, and acknowledging all that it means to be an aging analyst. Fred shares with us his own journey of learning and the importance to him of having had teachers who made a difference in his life. 

 

Our Guest: Fred Busch, Ph.D. is a Training and Supervising Analyst at the Boston Psychoanalytic Society and Institute. Dr. Busch has published over 70 articles in the psychoanalytic literature, and five books, primarily on the method and theory of treatment. His work has been translated into ten languages, and he has been invited to present over 160 papers and clinical workshops nationally and internationally. His last three books were: Creating a Psychoanalytic Mind; The Analyst's Reveries: Explorations in Bion's Enigmatic Concept; and Dear Candidate: Analyst from Around the World Offer Personal Reflections on Psychoanalytic Training, Education, and the Profession. All published by Routledge.  

 

 

Recommended Readings: 

Busch, F. (2013). Creating a Psychoanalytic Mind: A psychoanalytic method and theory. Routledge: London 

 

Busch, F. (2019). The Analyst's Reveries: Explorations in Bion's Enigmatic Concept. Routledge: London. 

 

Green, A. (1974). Surface Analysis, Deep Analysis (The Role of the Preconscious in Psychoanalytical Technique). Int. Rev. Psycho-Anal., 1:415-423. 

 

Gray, P. (1982). "Developmental Lag" in the Evolution of Technique for Psychoanalysis of Neurotic Conflict. J. Amer. Psychoanal. Assn., 30:621-655. 

 

SEARL, M. N. 1936 Some Queries on Principles of Technique Int. J. Psychoanal. 17:471-493 

"She [his mother] felt that his kicking was deliberate evil and she responded with wishes for an abortion. She also stopped breastfeeding because she felt that the sucking was so strong and aggressive that it was destroying her. Without the father as a triangulating object he had no one to contain this - every child needs a container of his aggression."

 

Episode Description: July 22, 2021 marks the 10-year anniversary of the murder of 77 individuals and the injuring of hundreds more by Anders Behring Breivik - the largest mass murder in Norway since World War II. This was a freely admitted act done under the guise of an extreme right-wing ideology of 'saving Europe.' We discuss the role of psychoanalytic hypothesizing in such cases given that "In psychoanalysis, the validity of an interpretation lies in the dialogue with the patient..." We consider the relative importance of individual psychopathology vs cultural ideology with special attention to what leads such an individual to cross over from imagination to action. On the cultural side, it is noted that we face a challenge in recognizing both the value of opening one's culture to new influences and also honoring the mores and history of one's traditions.

 

Our Guest: Dr. Philos Siri Erika Gullestad is professor emeritus of clinical psychology, University of Oslo, and Training and Supervising Analyst, IPA. She is former Head of the Department of Psychology and former President of the Norwegian Psychoanalytic Association. Dr. Gullestad is the author of many articles and books in psychoanalysis. Her most recent book, with Bjørn Killingmo, is Theory and practice of psychoanalytic therapy. Listening for the subtext. Routledge, 2020. Dr. Gullestad was awarded the Sigourney Prize 2019.

"In such moments [of shared danger] you work with the present and not the representation. In analysis we work all the time with representation - the transference is a representation, the countertransference is a representation. They are related to our past when such things happened. At these moments it’s not important if the patient goes over their Oedipus or not, if he has a good momma or a bad momma. In this moment I can say to the patient: “Wow, we are going through something both together, try to talk, I will talk and you talk, and we will see what is coming up from that."  

 

Episode Description: The realities of the recent hostilities between Israel and Hamas challenge familiar conditions for analytic work. The threat of imminent physical danger to both parties in the dyad pervades the clinical setting at such times as it has intermittently for decades. Dr. Gampel describes years of experience integrating the facts of external forces into a treatment process that simultaneously honors internal reality as well. We discuss her work with her analytic colleagues in their study group on this topic called A Wall Falls Down as well as her 30 years of work in Gaza with her Palestinian colleagues. We close with her recounting her family's journey from Lithuania to Argentina and then to Israel. 

 

Our Guest: Yolanda Gampel, Ph.D., Training Analyst, and past president (1989–1991) of the Israel Psychoanalytic Society; Professor, Faculty of Social Sciences, Department of Psychology and Program of Advanced Psychotherapy, Sackler Medical School, Tel-Aviv University; Invited Associate Professor, l’Université de Paris Nanterre de 1985-1987 et à l’Université Lumière II en 2001 Lyon 

Dr. Gampel won the Hayman International Prize for Published Work Pertaining to Traumatized Children and Adults, 2001, and the Mary S. Sigourney Award, 2005. 

Dr. Gampel's work has focused on social violence and its impact on development and on the therapeutic process. She has worked with Shoah survivors and South American and Israeli victims of trauma. She has also established a training program in dynamic psychotherapy for Palestinian psychologists in Gaza and participated in the training program organized from the summer of 1993 until 2000 through the auspicious of Tel Aviv University. 

 

Recommended Readings: 

Yolanda Gampel, The Wounded Passion: The Inner Experience of an Israeli Psychoanalyst bPs 467-477 | Published online: 22 Oct 2020, in INQUIRY: Summary: A Moment of Theoretical Focus on Passion, Faith, and Truth. Silence and Bearing Witness, the Riddle of Survival. The Background of the Unheimlich. Events in Israel and Their Effects on Psychotherapeutic Working Trough. 

 

Yolanda Gampel, The Pain of the Social, Pages 1219-1235 | Published online: 23 Dec 2020 International Journal of Psychoanalysis 

 

Puget, J., and L. Wender. 1982. “Analista y paciente en mundos superpuestos.” [Analyst and Patient in Overlapping Worlds]. Psicoanálisis 4: 502–503. [Google Scholar] 

 

Puget, J., and L. Wender. 1987. “Aux Limites de l’analysabilite. Tyrannie Corporelle et Sociale.” [At the Limits of Analysability: Physical and Social Tyranny]. Revue Française de Psychanalyse 51 (3): 869–885 

 

Janine Puget. How Difficult It is to Think About Uncertainty and Perplexity Pages 1236-1247 | Published online: 23 Dec 2020. International Journal of Psychoanalysis 

"A big part of my graduate education at Harvard was critical thinking. The general idea that theories come and go, even the data come and go because it’s modified as new experimental paradigms develop. So the idea of fixity. that “now we now know and it’s set in stone”, was not at all in my thinking by the time I left Graduate School if it ever had been."

 

Episode Description: Guest host, Dr. Joel Whitebook, interviews another elder from our field, Dr. Fred Pine. A discussion of the history of Dr. Pine's long and rich career is not only fascinating in its own right, but it also raises an important question: what combination of character traits and personal experience allows one to become an independent thinker? Dr. Whitebook also invites Dr. Pine to explain his basic theoretical approach which is both clinical and developmental. When he observes a phenomenon in an adult patient, Dr. Pine asks “what can we hypothesize about the person's development so that it would have produced the phenomenon in question?” And when he observes a developmental phenomenon, he asks the opposite question “what sort of adaptive and pathological phenomena might we expect to result from it in the person's later life?” It was through this use of a clinical/developmental approach that Dr. Pine was able to introduce many important innovations in our field. 

 

Our Guest: Dr. Fred Pine is a Professor Emeritus in psychiatry at the Albert Einstein College of Medicine. In 1956, he received his Ph.D. from Harvard University's Social Relations Program, where he studied with such eminent scholars as Henry Murray, Gordon Allport, Clyde Kluckhorn, and Talcott Parsons. After working for six years at the NYU Research Center for Mental Health, Dr. Pine did his psychoanalytic training at The New York Psychoanalytic Institute. In addition to his own extensive contributions to the literature, Dr. Pine was also a co-author of a psychoanalytic classic, The Psychological Birth of the Infant. 

 

Recommended Readings: 

Pine, F. (1979). On the Pathology of the Separation-Individuation Process as Manifested in Later Clinical Work: An Attempt at Delineation. Int. J. Psychoanal.  60:  226-242. 

 

Pine, F. (1993). A Contribution to the Analysis of the Psychoanalytic Process. Psychoanal Quarterly. 62: 185-205, 1993. 

 

Pine, F. (2004). Mahler's Concepts of "Symbiosis" and "Separation-Individuation":  Revisited, Reevaluated, Refined.  Journal of the American Psychoanalytic Association. 52: 511-533. 

 

Pine, F. (2006). If I Knew Then What I Know Now:  Theme and Variations.  Psychoanalytic Psychology. 23:1-7. 

 

Pine, F. (2011). Beyond Pluralism:  Psychoanalysis and the Workings of Mind. Psychoanalytic Quarterly. 80: 823-856. 

 

Pine, F. (2005). Theories of Motivation in Psychoanalysis. In: A Textbook of  Psychoanalysis. Eds.  Person, E. S., Cooper, A., and Gabbard, G. Washington, D.C.:American Psychiatric Assoc. Press, pp. 3-19. 

 

Pine, F. (1998) Chapter 5. The ego in the session. In: Diversity and Direction in Psychoanalytic Technique. New Haven:  Yale Univ. Press 

 

"In the group that I co-chair on the Aging Analyst we’ve talked a lot about what difference it makes having practiced a long time. One of the ideas that emerged is not only that this varies from person to person, but that there is a lot more freedom to use some different approaches, less rigid, less specifically theory focused. The role of life experience certainly changes what you hear and how you hear it."

 

Episode Description: We discuss how practicing analysis for many decades impacts one's approach to the work. Dr. Notman has focused her career on women's psychology, especially as it relates to body image and reproduction. She has also worked at the interface between psychoanalysis and psychiatry. A leitmotif of her analytic thinking is the importance of listening to the patient's felt experience — not theory and not what you think they should be saying. We discuss the impact on one's work of living through history and cultural movements, from anti-Semitism to feminism to racism, and how this informs one's attunement to the experience of otherness that is both universal and particular. We close with some thoughts on the importance of organized psychoanalysis widening its tent while also maintaining what is unique to becoming a psychoanalyst.

 

Our Guest: Malkah Notman, MD is a Training and Supervising Analyst at the Boston Psychoanalytic Society and Institute (BPSI) and has been practicing for over 50 years. She is a Professor at Harvard Medical School and on the faculty of Cambridge Health Alliance. She is co-chair of the BPSI committee on the Aging Analyst where they have been exploring the impact of age on changes in one's work and also on working with older patients.

 

Recommended Readings:

Settlage, C. Transcending Old Age. IJP 1996, 77, part 3, pp 549-564

 

Notman, M. Reflections on Widowhood and its Effects on the Self, Psychodynamic Psychiatry. 2014, vol 42, pp 65-88

 

Orgel, S.A. Patient Returns. JAPA ,2013:61, pp935-946