Psychoanalysis On and Off the Couch

“Attachment theory is a psychoanalytic theory that extended its field to the neurosciences, to clinical trials, and to behavioral observations such as going to the schools and seeing teachers and children together. We can observe children's' behavior and use psychoanalytic theory to understand them allowing us to detect problems even in infancy.”

Description: Dr. Harvey Schwartz welcomes Dr. Humberto Persano. Dr. Persano is a psychiatrist and an adult and child psychoanalyst at the Argentine Psychoanalytic Association where he is a training and supervising analyst. In addition, Dr. Persano has been appointed the Director of Mental Health Services for the City of Buenos Aires. Dr. Persano is a full professor in Psychology and Nutrition in the School of Medicine at the University of Buenos Aires. He is as well the author of The Importance of Psychodynamic Diagnoses in Patients with Severe Mental Illness, and he was also a collaborator on the Psychodynamic Diagnostic Manual, second edition. Drs. Persano and Schwartz have worked together on the IPA in Health Committee. Dr. Persano shares in today’s interview how his roles as both a psychoanalyst and as a mental health administrator interact with each other and how he applies his psychoanalytic thoughts and knowledge on a large scale

Key takeaways:

[4:44]What does being the Mental Health Director of the city of Buenos Aires entail?

[9:04] Dr. Persano talks about his mentors.

[9:54] Dr. Persano describes Buenos Aires’ main features (population, geography, hospitals)

[11:07] Buenos Aires counts with four public psychiatric hospitals and seven psychiatric units in general hospitals.

[12:13] There is a need in Buenos Aires to create more mental health units in general hospitals in order not to stigmatize people suffering from mental disorders.

[15:10] Dr. Persano talks about his professional background.

[17:14] The relationship between psychoanalysis and psychiatry.

[20:55] Dr. Persano talks about the attachment behavior in the transference process.

[25:35] Dr. Persano shares an example on attachment of his work in the early 90's.

[30:40] Dr. Persano talks about a research that was conducted in Sweden about the role of a psychotherapist in the long term psychic organization of the patient.

Mentioned in this episode:

IPA Off the Couch www.ipaoffthecouch.org

Recommended Readings:

Beutel, M. E., Rasting, M., Stuhr, U., Rüger, B., & Leuzinger-Bohleber, M. (2004). Assessing the impact of psychoanalysis and long-term psychoanalytic therapies on health care utilization and costs. Psychotherapy Research, 14(2), 146-160.

Fonagy, P. (2018). Attachment theory and psychoanalysis. Routledge.

Lingiardi, V., & McWilliams, N. (Eds.). (2017). Psychodynamic diagnostic manual: PDM-2. Guilford Publications.

Persano, H. L. El mundo de la Salud Mental en la Práctica Clínica. Editorial Akadia, Buenos Aires, 2018.

Sandell, R., Blomberg, J., Lazar, A., Carlsson, J., Broberg, J., & Schubert, J. (2000).Varieties of Long-Term Outcome Among Patients in Psychoanalysis and Long-Term Psychotherapy: A Review of Findings in the Stockholm Outcome of Psychoanalysis and Psychotherapy Project International Journal of Psycho-Analysis, 81(5), 921-942.

“My intent behind that was to startle people into thinking about how normal so many of the underpinning psychological elements of fraud and the relationship between deceiver and deceived is, and to uncover people’s misunderstanding of people who commit fraud  as necessarily some radical other.”

Description: Steven S. Rolfe welcomes Alexander Stein, PhD who is a psychoanalyst and Principal in the Boswell Group, serving as a confidential advisor to CEOs and senior management teams. He is the founder of Dolus Advisors, a consultancy specializing in detecting, mitigating and resolving challenging human factor disturbances, including fraud, corruption, executive misconduct and the human element in cybersecurity. Dr. Stein is widely published and cited in the business press and varied industry publications including Financier Worldwide, the Journal of International Banking Law and Regulation, Asset Recovery Watch, FraudNet Report, and the Wall Street Journal, and he is currently a regular contributor to Forbes writing on the psychology of leadership and misbehavior in business. He is a frequent speaker and panelist at conferences focused on fraud, corporate ethics and compliance, and cybersecurity and technology. He has also published many essays and book reviews in psychoanalytic journals including the International Journal of Psychoanalysis and the Journal of the American Psychoanalytic Association.

Key takeaways:

[3:45] Dr. Alexander Stein talks about some of his significant career transitions.

[9:31] How can a psychoanalyst leave the office to have an impact on institutions, their leaders, the decisions they make and the effect they have?

[10:58] Dr. Stein educated himself about how institutions function and malfunction.

[13:02] Dr. Stein talks about how he wrote his first article about the psychology of leadership.

[15:30] Overcoming the simplification of complex issues by addressing the root causes.

[17:40] Dr. Stein addresses the conflicts leaders were facing in his earliest interventions with small business owners.

[20:56] The resistance encountered when identifying as an analyst and going into the business world.

[22:14] Confronting the misunderstandings regarding who a psychoanalyst is and what a psychoanalyst can do.

[23:25] Dr. Stein talks about the beginning of his work in fraud and asset recovery.

[27:34] Why is everyone a fraudster?

[29:06] Dr. Stein shares a case example of his work with fraud in large enterprises.

[33:40] Understanding of the fraudster and the victim.

[34:48] The particularities of economic crime.

[36:35] Having empathy for the victim.

[40:27] Dr. Stein shares his work as a psychoanalyst in  the area of cybersecurity.

Mentioned in this episode:

IPA Off the Couch www.ipaoffthecouch.org

Recommended Readings:

A Few minutes with Alexander Stein [interview]

Elon Musk's Fateful Tweet: A Lesson About Impulses and Paying Attention

How, then, do we stop the fraudsters among us? by Martin Kenney

What Corporate Boards Really Need to Consider When Looking for a Replacement CEO

Reparation and Redress: Ethical Solutions to Graceless Governance

Often, The Best Compliance Presentations Are After The Compliance Presentation

“What makes the human being need to be in relationships and how can one affect these relationships to allow growth? I am encompassing something which is moving from the sciences to relationships.”

Description: Harvey Schwartz welcomes Dr. Yehudah Fraenkel, who is a psychiatrist, a psychoanalyst and a member of the Israeli Psychoanalytic Society. Dr. Fraenkel has spent most of his professional career working at the intersection of medical care, psychiatry, and psychoanalysis. He has devoted his career to teaching medical students and residents, and also working for many years with family physicians. He has run a Balint Group for family physicians since 1995, as well as run courses in psychotherapy and consulting for a large group of family physicians since 1993. Enjoy today’s interview with Dr. Yehudah Fraenkel.

Key takeaways:

[3:20] The mind-body interface and somatization.

[6:09] Dr. Yehudah Fraenkel talks about how he understands the concept of the mind-body interface.

[7:45] Somatization. When the body manifests feelings or unconscious conflicts that cannot be felt or spoken.

[8:40] Psychosomatics deal with panic.

[10:45] The support system for people that are being discharged from the hospital is a great predictor of how their health is going to progress.

[11:40] How depression is related to death from cardiac disease.

[12:13] Dr.Schwartz talks about broken heart syndrome.

[15:36] Dr. Fraenkel shares his experience working with family physicians.

[18:38] Dr. Fraenkel presents a case of pelvic pain syndrome.

[20:17] The value of teaching splitting to physicians

[21:43] Teaching doctors to deal with passive-aggressive patients.

[22:15] Balint groups as a useful tool for doctors to share and reflect their feelings.

[26:27] Transference is much stronger when the doctor puts his hands on you.

[27:44] Dr. Fraenkel talks about his personal and professional background.

[30:20] How the general medical community receives Dr. Fraenkel’s work.

Mentioned in this episode:

IPA Off the Couch www.ipaoffthecouch.org

Recommended Readings:

Depression Following Myocardial Infarction Impact on 6-Month Survival, Nancy Frasure-Smith, PhD; François Lespérance, MD; Mario Talajic, MD JAMA. 1993;270(15):1819-1825.

The Doctor, His Patient and the Illness, Michael Balint Elsevier - Health Sciences Division 2000

Mind and Its Relation to the Psychosoma. In: through Pediatrics to Psychoanalysis. Winnicott  D.W. Karnac, London1987

“There is nothing faith-based in the least about the Buddhist approach to spirituality. It is also direct and personal, there is no intermediary needed to access, to experience and to investigate the spiritual path in Buddhism”

Description: Harvey Schwartz welcomes Dr. Kathleen A. Lyon, who is a Training and Supervising Psychoanalyst at the Psychoanalytic Association of New York. Dr. Lyon has been practicing privately in New York City for almost 30 years. She has taught many courses in the psychoanalytic program at PANY and is currently teaching an advanced theory course on transference. She is also the former chair of the Education Committee and the Admissions Committee. Dr. Lyon has been a practitioner of Tibetan Buddhism for over 20 years and has developed a course called Resilience Through Compassion Training which provides a structure for compassion-based practices. 

As you will hear, Dr. Lyon starts from a Buddhist foundation for inner-thinking which allows her to engage patients who otherwise might be disinclined to seek treatment from a psychoanalyst. She also introduces the idea of Spiritual Bypassing, which is an appreciation of how spirituality can be used for defensive purposes. She demonstrates the skill with which she addresses those defenses for the benefit of the patient.

Key takeaways:

[4:09] Dr. Lyon talks about the differentiation between Buddhism, meditation and mindfulness.

[9:54] The Buddhist practice is the practice of meditation.

[10:40] Meditation is divided into two main categories: the concentrative and mindfulness practices.

[13:22] Where does the sense of self reside?

[16:05] The more experience a person has in meditative practice, the greater increase in one’s confidence in their ability to tolerate states that had been perceived as intolerable.

[17:47] The sense of self includes the sense of others and relationships.

[18:50] Dr. Lyon shares the concept of spiritual bypassing.

[22:45] Dr. Lyon presents examples of spiritual bypassing.

[33:04] Dr. Lyon shares how she became interested in spirituality and Buddhist practices.

[35:56] Dr. Lyon runs programs based on compassion based practices and meditation.

Mentioned in this episode:

IPA Off the Couch www.ipaoffthecouch.org

Recommended Readings:

Spiritual Bypassing in the Contemporary Mindfulness Movement. Carla Sherrell and Judith Simmer-Brown, Naropa University. Initiative for Contemplative Inquiry and Action, Vol. 1, No. 1, July 2017, a special project of Journal of Contemplative Inquiry, Association for Contemplative Mind in Higher Education.

Psychotherapy Without the Self: A Buddhist Perspective, Mark Epstein, Chapters 1-3.  Yale University Press, 2008

What Makes You Not a Buddhist, Dzongsar Jamyang Khyentse. Shambhala Publications  2007

“We sat down in a meeting and I talked about adolescent sexual development and what I found was a tremendous resistance even in the community to hear about the issues of sexuality.”

Description: Harvey Schwartz welcomes Dr. Monisha Nayar-Akhtar, PhD, who did her adult and child psychoanalytic training at Michigan Psychoanalytic Institute. She is a training and supervising analyst at the Psychoanalytic Center of Philadelphia as well as at the Psychoanalytic Association of New York. She is the Editor-in-Chief and Founder of the journal Institutional Children: Explorations and Beyond, she is also on the editorial board of Psychoanalytic Inquiry and the Psychoanalytic Study of the Child. Dr. Nayar-Akhtar is the author of two books: Play and Playfulness: Developmental, Cultural, and Clinical Aspects and Identities in Transition: The Growth and Development of a Multicultural Therapist. She is also the director of the Indian American Psychoanalytic Alliance. Today, we will learn about her work offering psychoanalytic consultations to an orphanage in India and the profound impact her work has had there.

Key takeaways:

[4:15] Dr.Nayar-Akhtar shares her sense of what psychoanalytic thinking can contribute to an orphanage.

[6:33] Most of the children in the orphanage in India had severe cases of trauma.

[7:38] Dr.Nayar-Akhtar talks about the series of workshops that were developed at the orphanage in Delhi directed to the social workers.

[9:54] The outcome of the first year of working at the orphanage: the development of a journal.

[12:30] The aim was to create a journal that addresses the needs of the population, has International recognition and brings forth analytic ideas.

[13:01] Dr. Nayar-Akhtar shares the clinical example of adolescents that leave the program when they turn 18 years old and the psychological implications in these young adults.

[17:22] Assisting the caregivers for them to feel heard.

[19:57] An example of the work with  young girls who were becoming sexually active.

[25:04] What lead Dr. Nayar-Akhtar to this work.

[28:55] Dr. Nayar-Akhtar talks about her goal of communicating about the impact of institutionalization.

Mentioned in this episode:

IPA Off the Couch www.ipaoffthecouch.org

Journal Institutionalized Children: Explorations and Beyond

Recommended Readings:

Nayar-Akhtar, M.C.: On the seashore of sunshine homes: psychoanalytic perspective on working with institutionalized children in India: Children in Need: Analysts in Alternative Settings. Psychoanalytic Inquiry, (in press).

Akhtar, M and Ariely, Sumedha. G.: Attachment and Context:Evolving Perspective in a Clinical Realm. In Essays from Cradle to Couch, In Honor of the Psychoanalytic Developmental psychology of Sylvia Brody, 2017, pp. 137-171, IPBooks, Astoria, NY 11102

Heidi Keller: Journal of Cross-Cultural Psychology originally published online 27 December 2012

“In Jacques Cousteau’s book there’s this turning point moment when he looked into the water and it was a completely different world and then he looked back up and he saw people going around, with no idea what was under the surface...There are people who can dive into topics that are kind of unbearable, I mean beyond comprehension, and have the ability to put them into words we can understand.”

Description: Harvey Schwartz welcomes Dr. A. Chris Heath, who is a psychiatrist and psychoanalyst in private practice in Dallas, Texas. Dr. Heath has dedicated himself to helping people understand their unconscious mind and he’s done this through his remarkable YouTube channel called HeathMD where he features entertaining videos about how the mind works and it has more than 45,000 views. Dr. Heath is a member of the social media and board of the International Psychoanalytical Association as well as a member of the Committee for Public Information of the American Psychoanalytic Association. As you will hear in the interview, there is an aliveness and vibrancy to Dr. Heath - he shows all of us his love of the work, his enjoyment in explaining it and the gift he has of taking nuanced concepts and presenting them in a very user-friendly fashion.

Key takeaways:

[3:17] Video from Dr. Heath called “How does psychotherapy work?”

[5:06] Dr. Heath talks about how he started his YouTube Channel and what is the feedback he receives from the audience.

[7:15] The contrast between the privacy of the psychoanalytic process and how psychoanalysis outreaches to the community as a tool to achieve profound life changes.

[7:44] Psychoanalysis in times of “quick fix” approaches.

[8:40] People tend to be afraid of psychoanalysis, perceiving it as a “swallowing hole”.

[10:20] Dr. Heath talks about the style he uses in his videos.

[13:07] Dr. Heath ́s YouTube Channel audience is people in the range from 25 to 35 years old.

[16:25] The ability to put into accessible words abstract concepts for everyone to comprehend.

[18:15] The biggest source of anxiety is irrational.

[20:54] The audience who actually view Dr. Heath’s YouTube channel was not the one he was aiming for.

[22:05] Dr. Heath talks about the feedback from the viewers while interacting with the comments section on his YouTube Channel.

[25:10] Dr. Heath shares how his work on YouTube relates to his own personal life and professional career.

Mentioned in this episode:

IPA Off the Couch www.ipaoffthecouch.org

Dr. Heath YouTube Channel: HeathMD

Recommended Readings:

Bill Nye (2015). Unstoppable: Harnessing Science to Change the World. St Martin's Press

Jaques-Yves Cousteau (2004). The Silent World. The National Geographic Society

Heath, AC (2018). Will a Video-Based  Psychoanalytic Outreach Effort Engage a Young Audience? The Freudalicious Mind Project. Journal of the American Psychoanalytic Association 66(4): NP1- NP6

Obaid FP (2014). The Incidence of Freudian Self-Analysis in the Construction of the Psychoanalytic Theory of Anxiety. International Journal of Psychoanalysis 95(1): 15-41

“We live inside architectural structures, for instance, our own, but at the same time they live inside our minds, in dreams, for example, we can build architectural structures, modify them or destroy them.”

Description: Harvey Schwartz welcomes Dr. Cosimo Schinaia. Dr. Schinaia is a training and supervising psychoanalyst at the Italian Psychoanalytic Society and a full member of the International Psychoanalytic Association. He has been a psychiatrist who has worked as a director of the Mental Health Department of central Genoa for many years where he now works in private practice. Dr. Schinaia is widely published - a number of his papers in English are: On Preservation and Destruction in the Unconscious: Freud and Bion which was published in the European Journal of Psychoanalysis in 2018; Respect for the Environment Psychoanalytic: Consideration on the Ecological Crisis, which was published in the International Journal of Psychoanalysis in 2019; and The Feelings of Those Who Have Been Expelled: Notes of a Psychoanalyst Forced to Leave Genoa because of Racial Laws in 1938, published in Trauma and Memory also in 2019.

He has written two books that have been widely translated, the first in On Pedophilia originally published in Italian and translated into Spanish, Portuguese, Polish, French and German, and his most recent work which is the subject of today’s conversation, Psychoanalysis and Architecture, the Inside and the Outside, published by Karnac originally in Italian and translated into English and Spanish.

As you will hear in today’s interview Cosimo shares his Italian point of view on the role of the environment in reflecting our intrapsychic life and also influencing our intrapsychic life.

Key takeaways:

[4:32] Dr. Schinaia shares why he has a special interest in the relationship between psychoanalysis and architecture.

[6:20] The symbolism of a house in dreams.

[9:35] The difference between the European consulting rooms in comparison to the Americans and their implications in the psychoanalytic process.

[12:00] The case of a patient whispering sexual material and forcing the analyst to get closer to her.

[15:20] Different generations of psychoanalysts and the settings of the consulting offices.

[16:40] Dr. Schinaia talks about the excess of intersubjectivity in self-disclosure.

[18:05] The particularities of Kleinian offices.

[21:49] Clinical example where attention to the architectural space has played a part in deepening the work with the patient: the influence of the light in a consulting room.

[27:11] Dr. Schinaia shares his motivation to study the relationship between architecture and psychoanalysis.

Mentioned in this episode:

IPA Off the Couch www.ipaoffthecouch.org

Recommended Readings:

On Preservation and Destruction in  the Unconscious: Freud and Bion, Dr. Cosimo Schinaia

Respect for the Environment Psychoanalytic: Consideration on the Ecological Crisis, Dr. Cosimo Schinaia

The Feelings of Those Who Have Been Expelled: Notes of a Psychoanalyst Forced to Leave Genova because of Racial Laws in 1938. Dr Cosimo Schinaia

On Paedophilia, Dr Cosimo Schinaia

Psychoanalysis and Architecture, the Inside and the Outside, Dr Cosimo Schinaia

“The idea was that what we called  ‘phantastic objects’ get created sometimes in the mind of investors, which promise much more than just money; it is of course money, but they are ‘phantastic objects’ in the sense that Melanie Klein or someone like that might mean them, things that if you possess are like magic…”

Description: Dr. Steven Rolfe welcomes David Tuckett from London. David is a fellow of the Institute of Psychoanalysis as well as a Professor and Director of the Centre for the Study of Decision-Making Uncertainty at UCL in the Faculty of Brain Sciences. As an undergraduate, he studied economics, politics, and sociology at the University of Cambridge. During this time he became very interested in psychoanalysis and went on to train as an analyst a few years after graduating. He qualified with the British Psychoanalytic Society in 1977. Throughout his career Professor, Tuckett has worked part-time in private clinical practice while also conducting research in the fields of psychology, medicine, the social sciences, and more recently economics. . He is a former President of the European Psychoanalytic Federation, Editor in Chief of the International Journal of Psychoanalysis and Principal of the Health Education Studies Unit at the University of Cambridge. In 2007, Professor Tuckett won the Sigourney Award for distinguished contributions to the field of psychoanalysis. In 2011, he published his book Minding the Markets: An Emotional Finance View of Financial Instability and his current book ( in press) is The Role of Conviction and Narrative in Decision-Making Under Radical Uncertainty.

In this conversation, David Tuckett engages in a conversation about his work; his pluralistic approach to analysis, his commitment to identifying the core ideas of psychoanalysis, and his application of a psychoanalytic perspective to behavioral finance and decision making.   

Key takeaways:

[4:51] David Tuckett talks about his work focused on pluralism.

[11:02] David Tuckett’s work in providing a method to really see what different analysts do.

[13:48] When the focus is on the analyst rather than the patient.

[14:28] What are the core ideas about what an analyst is?

[16:09] The effort for formalizing pluralism.

[17:15] The importance of holding a scientific debate to make judgments in the psychoanalytic field.

[19:58] David Tuckett shares his thoughts about the core ideas of psychoanalysis.

[25:15] The use of psychoanalytic core ideas in economics.

[31:54] David Tuckett presents the concept of emotional finances.

[34:45] Examples of consulting with organizations and institutions.

[39:45] How developing a conviction narrative is applied to the investing field.

Mentioned in this episode:

IPA Off the Couch www.ipaoffthecouch.org

Recommended Readings:

Rickard Nyman, Sujit Kapadia, David Tuckett, David Gregory, Paul Ormerod and Robert Smith (2018) News and narratives in financial systems: Exploiting big data for systemic risk assessment. Bank of England Staff Working Paper No. 704

David Tuckett & Milena Nikolic, M (2017) The Role of Conviction and Narrative in Decision Making under Radical Uncertainty. Theory and Psychology. 27 issue: 4, page(s): 501-523

Kimberly Chong & David Tuckett (2015). Constructing conviction through action and narrative: how money managers manage uncertainty and the consequence for financial market functioning. Socio-Economic Review, 13 (2), 309-330. doi:10.1093/ser/mwu020

David Tuckett (2011) Inside and Outside the Window: Some fundamental elements in the theory of psychoanalytic technique. Int. J. Psychoanal. Dec; 92(6):1367-90

David Tuckett (2011) Minding the Markets: An Emotional Finance View of Financial Instability. London and New York: Palgrave Macmillan

David Tuckett and Richard J Taffler (2008) Phantastic Objects and the financial market’s sense of reality: A psychoanalytic contribution to the understanding of stock market instability. International Journal of Psychoanalysis, 89 (2), 389-412

David Tuckett, Roberto Basile, Dana Birksted Breen, Tomas Bohm, Paul Denis, Antonino Ferro, Helmut Hinz, Arne Jemstedt, Paola Mariotti, and Johan Schubert (2008) Psychoanalysis Comparable and Incomparable The evolution of a method to describe and compare psychoanalytic approaches.  New Library of Psychoanalysis, London: Routledge.

David Tuckett (2005) Does Anything Go? Towards a framework for the more transparent assessment of psychoanalytic competence. Joint winner IPA Training Today Award, 2003. International Journal of Psycho-Analysis: 86: 31-49.

“The experience and feeling that another person who is close to you is really curious about you and who really wonders who this person is - someone who is interested in asking the question: ‘Who are you?’ I think it is through that type of curiosity and the relationship which stems from that, that we develop a lot of our sense of self and who we are.”

Description: Harvey Schwartz welcomes Dr. David Clinton from Stockholm, Sweden. He is originally from Scotland but is now based in Sweden where he has been working in the eating disorders field for over 30 years. He is a member of the Swedish Psychoanalytical Association and an associate member of medical psychology at the Karolinska Institute in Stockholm and the Director of Research at the Institute for Eating Disorders in Oslo. David is involved with research and training in eating disorders professionals at the Karolinska Institute and has a private practice in psychoanalysis, psychodynamic psychotherapy, and clinical supervision, working in both English and Swedish. For 10 years, Dr. Clinton has worked closely with the eating disorders advocacy group called Healthy and Free which is part of the National Association against Eating Disorders. Together with this group, he has been actively exploring new ways of stimulating closer collaboration between clinicians, researchers, patients, and families. Outside of the eating disorder field, Dr. Clinton has been engaged in psychotherapeutic work at the Swedish Association for Sexuality Education which runs a public-funded clinic for psychosexual health. He has worked with eating disorder patients who struggled with pervasive problems linked to sexual self-destructiveness and trauma.

As you will hear in my conversation with David, he has taken up the challenge that a patient posed him many years ago, when he was working just with symptom alleviation - the patient said: “You helped me to survive, but now you have to help me learn to live.”

Key takeaways:

[4:44] The interference of eating disorders with intimacy.

[5:39] The morbidity of eating disorders.

[7:09] Going beyond the symptoms.

[7:37] The role of trauma in patients with eating disorders.

[9:34] The trauma caused by not being seen.

[10:56] The feeling of lack of presence in the other person’s mind.

[12:09] The curiosity of the patient regarding the therapist.

[15:30] From the concrete to the metaphorical.

[15:47] Dr. Clinton shares a case example.

[20:36] Patients working to be seen and loved for who they are.

[22:25] When the patient becomes aware that the therapist does not think about them as an object but as a subject.

[23:35] Discovering a new inner self.

[24:15] Dr. Clinton talks about his work with the patient advocacy group.

Mentioned in this episode:

IPA Off the Couch www.ipaoffthecouch.org

Recommended Readings:

Bruch, H. (1973). Eating disorders: Obesity, anorexia nervosa and the person within. New York: Basic Books.

Clinton, D. (2006). Affect regulation, object relations and the central symptoms of eating disorders. European Eating Disorders Review, 14: 203-211.

Forsén Mantilla, E., Clinton, D. & Birgegård, A. (2018). The unsafe haven: Eating disorders as attachment relationships. Psychology and Psychotherapy: Theory, Research and Practice, 92: 379-393.

Robinson, P., Skårderud, F., Sommerfeldt, B. (2019). Hunger: Mentalization-based treatments for eating disorders. Cham, Switzerland: Springer.

“Interpreting experience in role, is in relation to the mission of the organization, is an extraordinarily useful way of beginning to develop a shared understanding of  organizational dynamics.”

Description: Steven Rolfe welcomes Dr. Edward Shapiro, who is a training and supervising analyst at the Berkshire Psychoanalytic Institute. He is a former Medical Director and CEO of the Austen Riggs Center in Stockbridge, Massachusetts. He is a Professor of Clinical Psychiatry at Yale University School of Medicine and has been an organizational consultant for over 35 years. Dr. Shapiro has consulted with hospitals, mental health clinics, law firms and family businesses focusing on organizational transition, mergers, organizational structure and dilemmas of authority, management and delegation. He has coached executives in health care, law , education and business. He is the author of Finding a Place to Stand: Developing Self Reflecting Institutions, Leaders and Citizens, and co-author of Lost in Familiar Places: Creating New Connections Between the Individual and Society. Dr. Shapiro received the Felix and Helene Deutsch Scientific Award from the Boston Psychoanalytic Society, the Research Prize from the Society for Family Therapy and Research, and the Philip Isenberg Teaching Award from McLean Hospital.

Key takeaways:

[4:05] What stimulated Dr. Shapiro to write a book on citizenship?

[5:06] Interpreting society as an enormous challenge.

[6:14] Unconscious forces drive groups and organizations.

[8:38] Dr. Shapiro talks about his training as an analyst and consultant.

[12:03] Projective identification as crucial in the understanding of families and groups.

[14:05] Running the program at McLean Hospital.

[15:44] Austen Riggs.

[20:33] Transition from McLean to Austen Riggs.

[21:25] Organizations and society are interdependent.

[23:15] Working with limited resources .

[24:25] Patients as citizens of the Riggs community.

[25:48] The political aspect.

[27:10] Telling stories to make ideas accessible to people.

[32:50] Transference and the role of the analyst.

[34:07] Dr. Shapiro talks about his most recent book.

Mentioned in this episode:

IPA Off the Couch www.ipaoffthecouch.org

Recommended Readings:

Shapiro, ER. (2020) Finding a Place to Stand: Developing Self-Reflective Institutions, Leaders and Citizens. London: Phoenix.

Shapiro ER. (2012) Management versus interpretation: teaching residents to listen. Journal of Nervous and Mental Disease, 2012, 200 (3): 204-207.

Shapiro ER. (2011) Psychoanalytic institutions and treatment resistance: Commentary on Kafka: Journal of the American Psychoanalytic Association, 2011, 51: 71-79.

Shapiro E.R. editor (1997). The Inner World in the Outer World: Psychoanalytic Perspectives. New Haven: Yale University Press.

Shapiro, E.R. and Carr, A.W. (1991) Lost in Familiar Places: Creating New connections between the Individual and Society. New Haven:Yale University Press.