Psychoanalysis On and Off the Couch

Psychotherapeutic Aphorisms: Reflections from a Lifetime of Listening with David Joseph, MD (Washington DC)


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"Some time ago, I realized that there was such a thing for me as experiencing my patients as being friends, but they were psychoanalytic friends. It was a psychoanalytic friendship that was quite unique and unlike any other friendship. I think that's what people are talking about when they write about psychoanalytic love. It's not love like any other kind of relationship, because the psychoanalytic relationship is so unique. And I feel the same way about psychoanalytic parenting. It's like it's close to mentoring, but it's different because the structure of the relationship is different than from a mentor or an esteemed and loved teacher. It really is helping somebody with the whole process of development and helping them grow, mature, and become more comfortable with themselves and to know themselves better. That seems to me the essence of parenting, and I don't think we should feel defensive about thinking about it that way. That doesn't seem to me that it's my counter-transference in needing to be a good mother, a good father, a good parent to my patients."

Episode Description: We discuss the challenge of transmitting the experiential knowledge of the dynamic therapies to new generations. David's book on therapeutic aphorisms demonstrates a number of key elements of this unique relationship - symbolic meanings in symptoms, 'psychotherapeutic parenting', the simultaneous use of medications and working with the unlikable patient to name but a few of the topics he brings forward. He describes the challenges of the negative therapeutic reaction, how "transference reactions are the creative soul of the patient's story" and what it was like for him to admit to a patient that he lied to her. We close with his reflecting on the meaning to him of retiring from full time practice, noting "I haven't retired my psychoanalytic mind."

Our Guest: David Joseph, MD is a supervising and training analyst at the Washington Baltimore Center for Psychoanalysis where he served as chair of the board and director of the Institute Council (education committee). For many years he was the Director of Residency Training at St. Elizabeths Hospital in Washington, DC.

He has a long-standing interest in ethics and has written and spoken about a number of ethical issues in the practice of psychoanalysis. He closed his clinical practice several years ago, at the age of 82. In June 2025, his book: Listening for a Lifetime: The Artful Science of Psychotherapy, was published by Mission Point Press.

Recommended Readings:

Freud's technique papers.

Greenson, R. (1952) The Mother Tongue and the Mother. JAPA, 1

Zetzel. E. (1956) Anxiety and the Capacity to Bear It.

Schafer, R. (1976) A New Language for Psychoanalysis. Yale University Press. New Haven

Wachtel, P. L.(1977) Psychoanalysis and Behavior Therapy. Basic Books, NY.

Greenberg, J. and Mitchell, S. A. (1983) Object Relations in Psychoanalytic Theory. Harvard University Press.

Arlow, J. (1995) Stilted Listening: Psychoanalysis as Discourse. PQ, 215-233.

Schafer, R. (1999) Disappointment and Disappointedness. IJP, 80: 1093-1104.

Pine, F. (2011) Beyond Pluralism: Psychoanalysis and the Working of Mind. PQ: 80, 823-856.

Poland, W. (2018) Intimacy and Separateness in Psychoanalysis. Routledge, NY.

Holmes, D, (2022). Neutrality is not Neutral. JAPA, 70: 317-322

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Psychoanalysis On and Off the CouchBy Harvey Schwartz MD

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