Psychoanalytic Theory, Research, and Clinical Practice

Downloaded by [New York University] at 04:57 12 August 2016 PSYCHOANALYTIC THEORY, RESEARCH, AND CLINICAL PRACTICE

“This is a wonderful book. Not only is it a richly deserved tribute to Joe Lichtenberg, who has made such seminal contributions to psychoanalysis, but it is a volume that contains some of the most original and penetrating essays on motivational systems, infant development and theories of therapy that have appeared for some time. This is a book that will enrich therapists everywhere.” —Theodore Jacobs , M.D.

Psychoanalytic Theory, Research, and Clinical Practice: Reading Joseph D. Lichtenberg explores both Lichtenberg’s psychoanalytic theoretical contributions and innovations in clinical technique, and how these have infl uenced the work of other psychoanalysts and researchers. Lichtenberg’s approach integrates a developmental perspective on the life cycle, self psychology, attachment theory, and his theory of motivational systems. The commentaries in this volume are divided into several sections. Part I is devoted to informal interviews with Lichtenberg that portray an account

Downloaded by [New York University] at 04:57 12 August 2016 of the evolution of psychoanalysis through Lichtenberg’s eyes, interwoven with the development of his own psychoanalytic identity. Part II celebrates the role of friendship within his psychoanalytic circle, and Part III highlights his leadership role in the development of creative structures: the journal Psychoanalytic Inquiry; The Institute of Contemporary Psychotherapy and Psychoanalysis (ICP&P) and its training programs; and the ongoing Creativity Seminar. Additional sections provide commentary by psychoanalysts and researchers which demonstrate Lichtenberg’s theoretical and clinical impact on his colleagues. Psychoanalytic Theory, Research, and Clinical Practice provides an in-depth encounter with a major contributor to the psychoanalytic fi eld. Engagement with the openness, fl exibility, and inquiring spirit of Joseph D. Lichtenberg offers respect for and hope in the psychoanalytic process. This book is essential reading for psychoanalysts, mental health professionals, and graduate students interested in how theory, research, and technique are creatively integrated by a renowned psychoanalytic clinician and teacher.

Linda Gunsberg, Ph.D. is a psychoanalyst and forensic expert. She chairs the Family Law and Family Forensics Training Program at Washington Square Institute (NYC) and co-chairs the Psychoanalysis and Law Discussion Group of the American Psychoanalytic Association. Gunsberg is a Consulting Editor for Psychoanalytic Inquiry and has co-edited Fathers and Their Families and A Handbook of Divorce and Custody.

Sandra G. Hershberg, M.D. is a psychoanalyst and adult and child psychiatrist. She is the Director of Psychoanalytic Training, Founding Member and Training and Supervising Analyst at the Institute of Contemporary Psychotherapy and Psychoanalysis in Washington, D.C. She is a Training and Supervising Analyst at the Washington Center for Psychoanalysis. Hershberg also serves as Associate Editor of the International Journal of Psychoanalytic Self Psychology and is a Consulting Editor for Psychoanalytic Inquiry . Downloaded by [New York University] at 04:57 12 August 2016 PSYCHOANALYTIC INQUIRY BOOK SERIES JOSEPH D. LICHTENBERG Series Editor

Like its counterpart, Psychoanalytic Inquiry: A Topical Journal for Mental Health Professionals, the Psychoanalytic Inquiry Book Series presents a diversity of subjects within a diversity of approaches to those subjects. Under the editorship of Joseph Lichtenberg, in collaboration with Melvin Bornstein and the editorial board of Psychoanalytic Inquiry, the volumes in this series strike a balance between research, theory, and clinical application. We are honored to have published the works of various innovators in psychoanalysis, such as Frank Lachmann, James Fosshage, Robert Stolorow, Donna Orange, Louis Sander, Léon Wurmser, James Grotstein, Joseph Jones, Doris Brothers, Fredric Busch, and Joseph Lichtenberg, among others. The series includes books and monographs on mainline psychoanalytic topics, such as sexuality, narcissism, trauma, homosexuality, jealousy, envy, and varied aspects of analytic process and technique. In our efforts to broaden the fi eld of analytic interest, the series has incorporated and embraced innovative discoveries in infant research, self psychology, intersubjectivity, motivational systems, affects as process, responses to cancer, borderline states, contextualism, postmodernism, attachment research and theory, medication, and mentalization. As further investigations in psychoanalysis come to fruition, we seek to present them in readable, easily comprehensible writing. After 25 years, the core vision of this series remains the investigation, analysis, and discussion of developments on the cutting edge of the psychoanalytic fi eld, inspired by a boundless spirit of inquiry.

Vol. 2 Vol. 13 Psychoanalysis and Infant Research Self and Motivational Systems: Toward Joseph D. Lichtenberg a Theory of Psychoanalytic Technique

Downloaded by [New York University] at 04:57 12 August 2016 Joseph D. Lichtenberg , Frank M. Vol. 8 Lachmann , & James L. Fosshage Psychoanalytic Treatment: An Intersubjective Approach Vol. 14 Robert D. Stolorow, Bernard Affects as Process: An Inquiry into the Brandchaft , & George E. Atwood Centrality of Affect in Psychological Life Vol. 10 Joseph M. Jones Psychoanalysis and Motivation Joseph D. Lichtenberg Vol. 16 The Clinical Exchange: Techniques Vol. 12 Derived from Self and Motivational Contexts of Being: The Intersubjective Systems Foundations of Psychological Life Joseph D. Lichtenberg , Frank M. Robert D. Stolorow & George Lachmann , & James L. Fosshage E. Atwood Vol. 17 Gherardo Amadei & Ilaria Working Intersubjectively: Bianchi (eds.) Contextualism in Psychoanalytic Vol. 27 Practice Toward a Psychology of Uncertainty: Donna M. Orange , George E. Trauma-Centered Psycho analysis Atwood , & Robert D. Stolorow Doris Brothers Vol. 18 Vol. 28 Kohut, Loewald, and the Transforming Narcissism: Refl ections Postmoderns: A Comparative Study of on Empathy, Humor, and Expectations Self and Relationship Frank M. Lachmann Judith Guss Teicholz Vol. 29 Vol. 19 Mentalization: Theoretical A Spirit of Inquiry: Communication in Considerations, Research Findings, and Psychoanalysis Clinical Implications Joseph D. Lichtenberg , Frank M. Fredric N. Busch (ed.) Lachmann , & James L. Fosshage Vol. 30 Vol. 20 From Psychoanalytic Narrative to Craft and Spirit: A Guide to Empirical Single Case Research: Exploratory Psychotherapies Implications for Psychoanalytic Practice Joseph D. Lichtenberg Horst Kächele , Joseph Schachter , Vol. 21 Helmut Thomä & the Ulm Attachment and Sexuality Psychoanalytic Process Research Diana Diamond, Sidney J. Blatt, & Study Group Joseph D. Lichtenberg (eds.) Vol. 31 Vol. 22 Toward an Emancipatory Psychotherapy and Medication: The Psychoanalysis: Brandchaft’s Challenge of Integration Inter subjective Vision Fredric N. Busch & Larry S. Sandberg Bernard Brandchaft , Shelley Doctors , & Dorienne Sorter Vol. 23 T rauma and Human Existence: Vol. 32 Autobiographical, Psychoanalytic, and Persons in Context: The Challenge of Philosophical Refl ections Individuality in Theory and Practice Robert D. Stolorow Roger Frie & William J. Coburn (eds.) Vol. 24 Vol. 33 Jealousy and Envy: New Views about Psychoanalysis and Motivational Two Powerful Feelings Systems: A New Look Downloaded by [New York University] at 04:57 12 August 2016 Léon Wurmser & Heidrun Joseph D. Lichtenberg , Frank M. Jarass (eds.) Lachmann , & James L. Fosshage Vol. 25 Vol. 34 Sensuality and Sexuality across the Change in Psychoanalysis: An Analyst’s Divide of Shame Refl ections on the Therapeutic Joseph D. Lichtenberg Relationship Chris Jaenicke Vol. 26 Living Systems, Evolving Vol. 35 Consciousness, and the Emerging World, Affectivity, Trauma: Heidegger Person: A Selection of Papers from the and Post-Cartesian Psycho analysis Life Work of Louis Sander Robert D. Stolorow Vol. 36 Vol. 45 Manual of Panic Focused Creative Analysis: Art, Creativity and Psychodynamic Psychotherapy – Clinical Process eXtended Range George Hagman Fredric N. Busch, Barbara L. Milrod, Vol. 46 Meriamne B. Singer , & Andrew C. A Rumor of Empathy: Resistance, nar- Aronson rative and recovery in psychoanalysis Vol. 37 and psychotherapy The Abyss of Madness Lou Agosta George E. Atwood Vol. 47 Vol. 38 Enlivening the Self: The First Year, Self Experiences in Group, Revisited: Clinical Enrichment, and The Affective Attachments, Intersubjective Wandering Mind Regulations, and Human Understanding Joseph D. Lichtenberg, James L. Irene Harwood , Walter Stone , & Fosshage , & Frank M. Lachmann Malcolm Pines (eds.) Vol. 48 Vol. 39 Kohut’s Twinship Across Cultures: The Nothing Good Is Allowed to Stand: An psychology of being human Integrative View of the Negative Koichi Togashi & Amanda Kottler Therapeutic Reaction Vol. 49 Léon Wurmser & Heidrun Jarass (eds.) Psyc hoanalytic Theory, Research, Vol. 40 and Clinical Practice: Reading Joseph Growth and Turbulence in the D. Lichtenberg Container/Contained: Bion’s Linda Gunsberg & Sandra G. Continuing Legacy Hershberg Howard B. Levine & Lawrence J. Out of Print titles in the PI Series Brown (eds.) Vol. 1 Refl ections on Self Psychology Vol. 41 Joseph D. Lichtenberg & Samuel Metaphor and Fields: Common Ground, Kaplan (eds.) Common Language and the Future of Psychoanalysis Vol. 3 Empathy, Volumes I & II S. Montana Katz (ed.) Joseph D. Lichtenberg , Melvin Bornstein , & Donald Silver (eds.) Vol. 42 Psyc hoanalytic Complexity: Clinical Vol. 4 Structures of Attitudes for Therapeutic Change Subjectivity: Explorations in William J. Coburn Psychoanalytic Phenomenology

Downloaded by [New York University] at 04:57 12 August 2016 George E. Atwood & Robert D. Vol. 43 Stolorow Structures of Subjectivity: Explorations in Psychoanalytic Phenomenology and Vol. 5 Toward a Comprehensive Contextualism , 2nd Edition Model for Schizophrenic George E. Atwood & Robert D. Disorders: Psychoanalytic Essays in Stolorow Memory of Ping-Nie Pao David B. Feinsilver Vol. 44 The Search for a Relational Home: An Vol. 6 The Borderline intersubjective view of therapeutic Patient: Emerging Concepts in action Diagnosis, Psychodynamics, and Chris Jaenicke Treatment, Vol. 1 James S. Grotstein , Marion F. Vol. 9 Female Homosexuality: Choice Solomon , & Joan A. Lang (eds.) without Volition Elaine V. Siegel Vol. 7 The Borderline Vol. 11 Cancer Stories: Creativity and Patient: Emerging Concepts in Self-Repair Esther Dreifuss-Kattan Diagnosis, Psychodynamics, and Vol. 15 Understanding Therapeutic Treatment, Vol. 2 Action: Psychodynamic Concepts of James S. Grotstein , Marion F. Cure Lawrence E. Lifson (ed.) Solomon , & Joan A. Lang (eds.) Downloaded by [New York University] at 04:57 12 August 2016 PSYCHOANALYTIC THEORY, RESEARCH, AND CLINICAL PRACTICE

Reading Joseph D. Lichtenberg

Edited by Linda Gunsberg, Ph.D. and Sandra G. Hershberg, M.D.

Downloaded by [New York University] at 04:57 12 August 2016 First published 2016 by Routledge 711 Third Avenue, New York, NY 10017 and by Routledge 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN Routledge is an imprint of the Taylor & Francis Group, an informa business © 2016 Taylor & Francis The right of the editors to be identifi ed as the authors of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice : Product or corporate names may be trademarks or registered trademarks, and are used only for identifi cation and explanation without intent to infringe. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloguing in Publication Data Lichtenberg, Joseph D. Psychoanalytic theory, research and clinical practice : reading Joseph D. Lichtenberg / edited by Linda Gunsberg & Sandra G. Hershberg. pages cm 1. Psychoanalysis. 2. Psychotherapy. 3. Lichtenberg, Joseph D. I. Gunsberg, Linda. II. Hershberg, Sandra G. III. Title. RC506.L5227 2016 616.89′17–dc23 2015013027 ISBN: 978-0-415-87495-3 (hbk) ISBN: 978-1-138-90655-6 (pbk) ISBN: 978-0-203-86173-8 (ebk) Typeset in Sabon by Out of House Publishing Downloaded by [New York University] at 04:57 12 August 2016

Charlotte Anne Silberstein Lichtenberg September 27, 1927–January 2, 2013 Charlotte was the lifelong partner and wife for 63 years of Joseph Lichtenberg. She was loved and respected by all of us at Psychoanalytic Inquiry and will be deeply missed by the psychoanalytic community. Downloaded by [New York University] at 04:57 12 August 2016

Joe at the helm (at age nineteen) Downloaded by [New York University] at 04:57 12 August 2016 CONTENTS

Acknowledgments xv Prologue xvii Sandra G. Hershberg, M.D.

PART I Up Close and Personal: The Evolution of a Creative Psychoanalyst 1

Introduction to Interviews with Joe 3 Linda Gunsberg, Ph.D.

1 Interview I 4

2 Interview II 41

Downloaded by [New York University] at 04:57 12 August 2016 3 Interview III 61

4 Interview IV 77

5 Interview V 91

PART II Friendship 115

6 Sixty Plus Years of Friendship and Still Going Strong 117 Ernest Wolf, M.D. xii Contents

7 Joseph Lichtenberg: A Personal Memoir 119 Jay L. Bisgyer, M.D.

8 Joe and Charlotte 124 Linda Gunsberg, Ph.D.

PART III The Development of Creative Structures 127

9 Creativity Seminar: The “Flame” in Dialogue and Dialectics 129 Leon Wurmser, M.D.

10 Development of Psychoanalytic Inquiry : My Most Unforgettable Character 132 Melvin Bornstein, M.D.

11 Development of the Institute of Contemporary Psychotherapy and Psychoanalysis: The Birth of the Institute of Contemporary Psychotherapy and Psychoanalysis 138 Rosemary Segalla, Ph.D.

12 The Development of a Psychoanalytic Training Program : The Road to Becoming a Training Analyst and Beyond: Traversing the Terrain between Accommodation and Creativity 144 Sandra G. Hershberg, M.D.

13 Supervision : Learning Motivational Systems Theory from the Inside – My Supervision with Joe Lichtenberg 152 Elizabeth M. Carr, APRN, MSN, BC Downloaded by [New York University] at 04:57 12 August 2016

PART IV Professional, Artistic, and Familial Partnerships 161

14 Running with Joe 163 Frank Lachmann, Ph.D.

15 The Lichtenbergs as Art Collectors: Interview with George Hemphill 165 Sandra G. Hershberg, M.D. Contents xiii

PART V Motivational Systems Theory 173

16 From Lichtenberg: Three Contributions to the Theory of Therapy 175 Lawrence Friedman, M.D.

17 The Centrality of Motivational Theory in Psychoanalysis: Motive/Intention as the Basic Unit for Understanding Psychological Life 187 James L. Fosshage, Ph.D.

18 Joseph Lichtenberg’s Infl uence 201 Alan Kindler, MBBS, FRCP(C)

PART VI Developmental Theory 209

19 Reconsiderations on Infant Development Theory 211 James S. Grotstein, M.D.

20 Play, Semblance, and Self 223 Russell Meares, M.D.

PART VII Attachment Research and Implications for Treatment 235

21 The Attachment Patterns of Therapists: Impact on Treatment Alliance, Therapeutic Process and Outcome 237 Diana Diamond, Ph.D. and Sidney J. Blatt, Ph.D. Downloaded by [New York University] at 04:57 12 August 2016 22 Attachment, Dyadic Interaction, and Aggression 250 Frank Lachmann, Ph.D. and Beatrice Beebe, Ph.D.

PART VIII Clinical Papers 263

23 Filling the Envelope: What Joe Lichtenberg Has Done for My Psychoanalytic Theory and Practice 265 Judith Guss Teicholz, Ed.D. xiv Contents

24 What I Learned from Joe 277 Estelle Shane, Ph.D.

25 The Dying Third: The Impact of the Loss of the Remaining Parent and Subsequent Adoption 285 Linda Gunsberg, Ph.D.

PART IX Selected Contribution of Joseph D. Lichtenberg 295

26 Freud and Kohut: What Lasts, What Fades 297 Joseph D. Lichtenberg

Epilogue 307 Linda Gunsberg, Ph.D.

Notes on Contributors 310 Name Index 314 Subject Index 319 Downloaded by [New York University] at 04:57 12 August 2016 ACKNOWLEDGMENTS

It is not easy being the living subject of a tribute to one’s life, work, and inquiring spirit. We want to thank Charlotte and Joe for graciously welcoming us into their homes in Annapolis and Bethesda, and in allowing us to zoom in on their lives in a way that we hope was comfortable for them. We wish to thank our contributors for the serious and creative ways in which they gave themselves to this project, as well as their responsiveness to our editorial suggestions. We thank George Hemphill for enlightening us on Joe and Charlotte’s appreciation of art and as collectors. Sadly, we note the loss of three esteemed contributors prior to the publication of this volume, Sidney Blatt, James Grotstein and Alan Kindler. A special thanks to Kris Spring and Kate Hawes, Publisher, of Routledge, Taylor & Francis. We originally conceptualized this project as a monograph for Psychoanalytic Inquiry . After hearing the scope of what we wanted to achieve regarding the celebration of Joe Lichtenberg, Kris Spring felt the topic and our vision were deserving of a book. Kate Hawes was available and supportive as we transitioned from Kris to her as our editor and facili-

Downloaded by [New York University] at 04:57 12 August 2016 tator of the completion of this project. Anice Jeffries was involved in this project from the beginning to the end in various capacities, including transcription of the audio-taped interviews with Joe, and George Hemphill, as well as Joe’s 2005 talk, What Lasts, What Fades. We also appreciate her insightful questions and comments along the way which helped create a more refi ned result. Thanks to Asaph Rom, Ph.D., who very carefully read and raised thoughtful questions about Joe’s work. This project became a multiple family affair: Joe and Charlotte’s, Sandy’s, and Linda’s. A special thanks to Jamie Zwiebel, Sandy’s husband, who photographed the art in Joe and Charlotte’s home in Bethesda. Additionally, xvi Acknowledgments

Jamie was extremely generous of his time and technical expertise, which was invaluable in the transatlantic journey between us and Routledge in England. We also thank Dina and Mollie Zwiebel, Sandy’s daughters, for their editing of several papers for this book. We greatly appreciate Linda’s daughter, Dana Ernst, who taught us the oral history approach which we used during our interviews with Joe. And thanks to Philip Ernst, Linda’s son, who has encouraged her throughout this project. We especially thank our husbands Michael Cheatham and Jamie Zwiebel for their forbearance while we worked on this book over the past few years. Finally, a thank you to Ann Sopher, Joe and Charlotte’s daughter, who helped gather some of the photos included in this book. In the process of this collaboration, a time in our lives when there were many changes, Sandy and I became more intimately familiar with each other and each other’s families. As a result, our knowing, respect, and affection for each other have deepened, which has in turn enhanced our friendship and our partnership in this project. And as two psychoanalysts coming from different perspectives, we learned a lot from each other. Linda Gunsberg, Ph.D. and Sandra G. Hershberg, M.D. Downloaded by [New York University] at 04:57 12 August 2016 PROLOGUE

Sandra G. Hershberg , M.D.

I trust my mind. So far it has not let me down. (p. 11) When there is something I don’t understand, I can’t let it go. It stays in my mind. It is like a splinter. It is there and until I can sense it and make sense of it, I don’t let it go. And I think some of my best understandings and most innovative ideas have come from some issue that has puzzled me and bugged me. (p. 56) [Interviews with Joe Lichtenberg, weekend of April 16–18, 2010 ]

We celebrate Joe and his ever-inquiring, adventurous spirit – his many contributions over the past 50 years to the fi eld of psychoanalysis as analyst, teacher, supervisor, theorist, editor-in-chief, and writer. Joe continually and with extraordinary focus, grapples with ideas, theories, and clinical conun- dra with his disciplined, creative, synthetic, respectful, and ethical “minds.” He brings these capacities to whatever he does – as art appreciator and col- Downloaded by [New York University] at 04:57 12 August 2016 lector, friend, collaborator, and in his partnership with his late wife Charlotte and the ways in which they constructed their life together. Howard Gardner (2008 ), in his Five Minds for the Future , discusses the kind of minds (emphasizing the actions, thoughts, feelings, and behaviors) a person needs to cultivate in order to thrive and lead, qualities which Gardner feels are especially important in integrating the complexity of the modern world. He designates these as the disciplined mind which focuses on the consistency, dedication, and continued learning necessary for mastery of a subject; the synthesizing mind which absorbs information from various sources and assembles it in a way that is coherent to the synthesizer and xviii S.G. Hershberg

others; the creating mind which dreams up novel ideas and ways of thinking and comes up with unanticipated answers; the respectful mind which har- nesses one’s sensibility in experiencing similarities with an other and also appreciating differences; and the ethical mind which thinks beyond one’s self-interest and, in accordance with a set of values, and mindful of context, fashions a code of conduct. Our intention in honoring Joseph Lichtenberg is to illuminate how one analyst has pursued, in his way, the cultivation of these various “minds” in his work and in his life. The idea for this project emerged during Joe’s 85th year (at the 2010 Psychoanalytic Inquiry Board meeting), when Linda Gunsberg and I spontaneously expressed to each other what an important role Joe has played in the development of our psychoanalytic careers. Our desire was to honor Joe at this point in his life when he is vitally alive and very much valued. Linda and I conducted interviews with Joe and had discussions with Charlotte at their homes in Bethesda and Annapolis over a long weekend, April 16–18, 2010, and conducted an interview with George Hemphill, an esteemed Washington gallery owner and Joe and Charlotte’s photography advisor. Prior to the April 16–18, 2010 weekend, we worked for several months outlining the scope and questions for the interviews and carefully considered approaches to interviewing. We have organized this volume to refl ect themes that evolved as we thought about Joe’s life and work, pathways where his desire to learn were piqued, and where serendipitous opportunities led him. We focus on the motifs of friendships (Bisgyer, Gunsberg, Lachmann, and Wolf), the development of creative structures, as in the co-creation of the Institute of Contemporary Psychotherapy and Psychoanalysis (Hershberg, Segalla); the birth of Psychoanalytic Inquiry (Bornstein); the ongoing creativity study group in existence for over 30 years (Wurmser); and teaching and mentor- ship (Carr). Within the personal domain, we highlight Joe’s 63-year partnership with Charlotte including their relationship as loving parents and grandparents (interviews with Joe and discussions with Charlotte); the signifi cance of adoption upon the death(s) of biological parent(s) (Gunsberg); and Joe’s Downloaded by [New York University] at 04:57 12 August 2016 relationship with the visual, a shared passion with Charlotte, which, over time, grew into a museum quality photography collection (Hemphill). Joe’s research and clinical interests have taken him in many directions. In particular we concentrate on the areas of attachment theory (Diamond and Blatt, Lachmann and Beebe); infant development theory (Grotstein); play (Meares); and motivational systems theory and technique (Fosshage, Friedman, Kindler, Shane, and Teicholz). In addition, we include a previously unpublished paper, Freud and Kohut: What Lasts, What Fades, the Kohut Memorial Lecture, delivered at the Psychology of the Self Conference in Baltimore, Maryland in 2005. This Prologue xix

paper illustrates Joe’s historical connection and in-depth understanding of major psychoanalytic theories and his rendering of complex theoretical con- structions into accessible well-written English, a conviction that Joe exem- plifi es in this work and which contributes to his skill as a master teacher. In this presentation, Joe moves theoretically from Freud’s structures to Kohut’s self-structures to introducing his motivational systems theory focusing on the importance of intentions. The reader would, no doubt, be interested in a short description of Joe’s writing process. Joe’s handwritten index cards are jam-packed with information and are amazingly readable despite the miniscule size of his print. He writes all of his papers and books in long-hand fi rst, having already thought through, before he takes pen in hand, most of what he wants to formulate with minimal revision. At the yearly Psychoanalytic Inquiry Board meetings, we experience Joe’s desire and invitation to bring colleagues together to discuss and challenge divergent views and help each other think through ideas for journal issues in a mutually vitalizing, high energy, accepting intellectual environment. One of the fortuitous outcomes of being on the Editorial Board of Psychoanalytic Inquiry and an additional reason for which we are indebted to Joe is the wonderful friendship that has developed and fl ourished between Linda and myself in the course of our collaboration on this project.

Reference

Gardner , H. (2008 ). Five Minds for the Future. Boston, MA: Harvard Business School Publishing . Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 PART I Up Close and Personal: The Evolution of a Creative Psychoanalyst Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 INTRODUCTION TO INTERVIEWS WITH JOE

Linda Gunsberg , Ph.D.

The interviews with Joe and discussions with Charlotte took place over a long weekend, April 16–18, 2010, in Bethesda and Annapolis. Sandy and I worked for several months outlining the scope and questions for the interviews, and carefully considered approaches to interviewing. Everyone, including Joe, was nervous about what the interview material would reveal. We were surprised at various junctures to discover that certain experiences did not have the impact on Joe that we had imagined. What emerged was a recognition on all our parts that this project was a serious one. Joe at times expressed his concern regarding why anyone would want to read all of this about him. Also, there was concern about if we got so “up close and personal,” what fl aws and imperfections would be discovered. All-in-all, it was a gratifying experience for each of us. For Sandy and myself, it was an unusual opportunity to get to know how the multifaceted dimensions of Joe fi t together and to appreciate his humanity and humor even more. It was also an opportunity to envision a historical psychoana-

Downloaded by [New York University] at 04:57 12 August 2016 lytic journey through his eyes and experiences, embedded within his broader sweep of world history and a rich cultural context (Anice Jeffries, personal communication, Feb. 17, 2014). 1

INTERVIEW I Friday Afternoon, April 16, 2010

Home Office, Bethesda, Maryland

LG: Joe, Sandy and I have been looking forward to this. We have done a considerable amount of preparation. It has been a wonderful collaboration for us and we are hoping you like what we have done thus far. We’ve got some very favorable responses to the outline for the book and how we are going to put it together. Our book editor is very excited too. From his point of view, it is a very creative compilation of your work by including a lot about you – autobiographical material. So what we did was we came up with a number of questions. We do not feel any need to rush through it. Whatever amount of time you want to give to each question is fi ne. If we don’t fi nish up this weekend for some reason, we can make other dates to do this. SH: You will see as we go through we have divided up the questions in various sections to be able to have a multiplicity of ways of looking at you both in terms of your personal life and as an accomplished analyst, teacher, supervisor, writer, and editor. Downloaded by [New York University] at 04:57 12 August 2016 JL: Good. Sounds good to me. SH: Just to orient, we are going to ask some more general questions and then we are going to move into your own analytic experiences and the infl uences they have had on you (your three analyses) and then the self-analysis, from a more Kohutian perspective. We also would like to ask about your training analysis; your views on the process of psychoanalysis; your thinking regarding supervision; your perspectives on teaching; thoughts about your Interview I 5

collaborations and how you work in collaboration; your role as an editor, and then moving more into your personal life. How would you describe your psychoanalytic theoretical evolution? JL: I think I would have to start with saying when I was 15 years old and between high school and starting Johns Hopkins as an undergraduate, that summer I read most all of Freud’s introductory lectures which I think I found in the family library. I always had access to the Enoch Pratt library but I sort of think they were part of the family library. I also read through a lot of O’Neill’s plays and somehow or other the two together seemed to make a lot of sense since obviously O’Neill was using psychoanalytic concepts whether he always acknowledged it or not. He also had some personal treatment. It was sort of known that I was going to go to medical school because that was what in my family lore was my destiny. It also had to do with the idea that I was fulfi lling my grandmother’s unrealized dream because she had wanted to go to medical school and she had actually audited some lectures at Hopkins medical school. In any case, as a 15-year-old I was not thinking that I was going to become a psychoanalyst. I was just thinking that I was going to go to college and probably go to medical school. That was about it. As things worked out, after two plus calendar years of college, World War II was on and I joined the Navy and I was eventually, after numerous ups and downs in the Navy, a regular offi cer and was fl oating around in the Pacifi c with Gray’s Anatomy and somewhere along the line I was thinking – do I really want to go to medical school, or am I just accommodating a family dream? Is this my idea or what? So I reviewed other possibilities. I could be a businessman like my grandfather and make money, but I thought that would be pretty boring, or I could be a lawyer like my father. But having helped him with some briefs I didn’t like the looks of that. So it suddenly dawned on me, as often things do, where I just get an idea that comes in my head and it crystallizes and makes sense and there it is. So I had the idea – I know how I can be a doctor and not have to be a doctor. I can be a psychoanalyst. Which was like saying, I can put my personal desire and stamp

Downloaded by [New York University] at 04:57 12 August 2016 on it. So knowing very little as to what that meant, but just having a kind of sense about it, a feel for it, I decided okay. When the war was over and I went to medical school, I went to medical school with the clear and defi ned intention of becoming a psychoanalyst, still not knowing what it meant. Then we had courses in psychiatry. They didn’t interest me that much because they didn’t resonate with what I was interested in. In my second year of medical school, between the second and third year, I decided … you know it is all well and good to have this great fantasy of going into psychoanalysis and psychiatry … but I don’t know what I am talking about. I decided I had better fi nd out. I mentioned this to my father and he said that he had a dear old friend from childhood 6 Interview I

named Isadore Tuerk who was then either the assistant superintendent or the superintendent of a state hospital. The state hospital had recently been written up as Maryland’s shame. But I went out with my father and met this gentleman, and Dr. Tuerk said, “Would you like to make rounds with me?” I said “okay” and we went to this building. When you walked into it, the stench hit you like a brick. This building had been built before the Civil War and was used during the Civil War as a general hospital for Yankee soldiers. Then it had been turned into a warehouse for chronic patients who were suspending themselves in every kind of catatonic pose anybody had ever seen or heard of in the worst of asylums. Patients were running up to Tuerk and screaming. It was a complete hell hole. Now I had been a naval offi cer and I assumed I am being hazed. This is a test. So I am not playing the game. He said, “You still want to do this?” I said, “sure.” So he hired me but said, “You are not going to work there. You are going to work in the hospital part of the hospital.” That summer and off and on for the next period of time, I worked there and got a feel for what it was. I met these old line psychiatrists who worked there. In the meantime, in medical school my two best friends were Ernie Wolf and Jay Bisgyer, each of whom were going to go into internal medicine. I assume I had some mild infl uence on them. They would never agree to that. They would say Finesinger who was then an analyst who had come to teach infl uenced them and I think that’s perfectly true too. The three of us in the fi rst year had followed my crazy inclination which was that I couldn’t stand the way things were taught. I thought things were taught very poorly. So I organized the three of us as faculty. We had eight members of the class who came and we had our own little medical school in my townhouse where I grew up in Baltimore. We became very close, Ernie, Jay, and I, by virtue of this sort of alliance from the very beginning in medical school. All the way through medical school I kept the goal to be a psychoanalyst. At the same time as I started working at Spring Grove, I decided I will go into analysis. How I got to a young woman named Helen Arthur I do not remember how the referral was made. She had an offi ce in a very nice building in downtown Baltimore. I would drive in every day and I started Downloaded by [New York University] at 04:57 12 August 2016 my analysis with her. I found her intelligent, warm, appropriate. She was neither seductive nor offputting. She was just to me a sensible person who knew something to do with people and I got on the couch and I started to free associate. At least what I thought was. A couple of things I remember … to make the broader point … my work with her certainly confi rmed for me that this was something I wanted to do. Then I had to wait until I fi nished my internship and I think a couple of years of residency before I could apply. And then I applied to the Baltimore Psychoanalytic Institute. LG: Did you leave college at mid-point in order to go into the Navy? Interview I 7

JL: I had fi nished three and a half years of credits in two plus years. I went briefl y to Swarthmore in the Navy V12 program, and Hopkins awarded me my degree. I had more than enough credits. I was one class away from being a history major. I was one class away from being an English major. Of course I had all the science I needed. But my areas of interest would take me into literature and history. At 17½ I knew a hell of a lot about history. I knew a fair amount about literature. I knew nothing yet really about music and art. All of that came later. But at 17½, it was enough. SH: … For now we are looking at the trajectory … how you view the theoretical evolution of your thinking. JL: My training in the Baltimore Institute was a clearly defi ned ego psychology approach with a reasonably solid historical sense of Freud’s early writing leading right up to ego psychology. The gods were Hartmann, Kris, and Loewenstein, and they had four disciples: Beres, Arlow, Brenner, and Wangh. These people came to the various institutes and said, not enough aggression in your curriculum. All the things I knew working with psychotic patients were infl uenced by Sullivan, Bowen, Searles, and Otto Will. They were all contemporaries. And they are all going one place. I could not put together the interpersonal and ego psychology approaches. I decided essentially to let it be but knew that something didn’t fi t. I couldn’t always let it be. I had one classic exchange with Charlie Brenner. He came and I was a candidate and he gave a seminar for the candidates in which he was talking about schizophrenia. His theory with Arlow was that schizophrenia was oedipal confl icts, just worse. I said, “I would like to ask, given these experiences (this and this and this), how do you fi t that into what you are saying?” He looked at me very hard and said, “Next question?” Well, I knew I was going to get a very bad report to the seniors in the institute. Before long I got known as a troublemaker, even though I tried so hard to be a good boy. I have always had this dilemma. I think in some hypothet-

Downloaded by [New York University] at 04:57 12 August 2016 ical way I would have preferred to be a good boy, but I have never had any success being it. LG: What’s a good boy, and what is a troublemaker? JL: A troublemaker is someone who asks questions as I did. Who proposes answers that other people don’t particularly want to hear. So I have been what I would call a consumer of information from whatever … the Sullivanians, the early Freudians, middle Freudians, late Freudians, ego psychologists … and then the biggest body of later information, from infant studies. Having 8 Interview I

said that, I have been attempting all along the line to reconcile these differences, these things that don’t fi t, to fi nd some kind of way of making some sense. Testing it out against further information – neuroscience, anything and anywhere – to then try and see what kind of sense I can make without trying to throw the baby out with the bathwater. When I learn something, I can learn it and I can teach it. So I became a very well-recognized teacher of ego psychology. And I wrote a series of papers that are based on ego psychology, but that moved it some. My papers on defense mechanisms used infant studies to talk about defenses. A lot of my early papers were used in teaching in institutes that were looking for people who knew about infant psychology. When Kernberg used to come here and talk “Kernbergian-Kleinian” I was the one who was put there to argue with him. When Grunberg came to argue against the idea that we didn’t have any proof, I also was put there to argue with him. I can take a stand within a particular argument because I think I can understand the argument. I don’t stand on my own ideas. I am perfectly willing to move from whatever idea I have if someone can show me a better one, or if I can fi gure out a better one. LG: But I think the important thing is you have intimately mastered the other arguments, and you therefore can see both views, integrate both views, and you don’t let go of the original view. It always stays with you. SH: Yes. It’s not so much that you are in opposition to it. It is that you are picking and choosing and thinking how is it clinically relevant. JL: Yes … I have a fi rm belief that anyone who came up with any of these ideas is as smart as I am. It is just that there are different ways to play with ideas. I am a great believer in the idea of playing with ideas and keeping them literally in play rather than concretizing. I am very against concretizing. When we get to Paul Ornstein – you know the metaphor he gave? This is a great metaphor he gave at a meeting. He said, you know these houses are big and Downloaded by [New York University] at 04:57 12 August 2016 you can have different occupants. I live in the center room of a house of self psychology, and there is one out there Lichtenberg – motivational systems, and there is Bob Stolorow out there with inter-subjectivity, and these guys in these other rooms make a lot of noise and it gives me a headache. I thought it was a lovely metaphor! He was dead right. Except that what he did not say was that there was a very comfortable conduit between Bob Stolorow and me so that the two outer rooms had a very nice intimate connection and were not in any kind of opposition [laughing]. So that gives you an idea. And even when I got to self psychology I said, my god this has got so much right to it. I also said, in order to place emphasis where it does, it leaves out Interview I 9

a lot. What I want to do is stay with its main precept and then put in the concepts it is leaving out so it does not look like it is too narrowly focused to coordinate with a lot of other information. LG: Would it be fair to say when you play with ideas you do not really commit yourself to one way of looking at it? It always remains fl uid. JL: Yes. Because I do not know when the next perspective is going to come into my head. The only thing I can tell you is that in all these years, a perspective keeps coming into my head. I don’t know when the next one … in concep- tualizing a reason for writing the new book, about four different ideas came into my head, some of them borrowed – in which I said this study, this theory is right and I’ve got to deal with it – and then maybe another perspective that is original will come to me. So I don’t know when … all I know is that it happens, I don’t go looking for it. New thinking will come to me. LG: Does the new book have a name yet? JL: Yes. Psychoanalysis and Motivational Systems: A New Look. LG: When do you hope to have that out? JL: It will be published in early September [2010]. SH: It is interesting the way you present it. There is not any particular loyalty to a school or an idea. It is really a constantly evolving idea. JL: There are people who say I don’t want to be labeled as anything. I have no such problem. If you want to call me a Freudian, I’m a Freudian. I’m

Downloaded by [New York University] at 04:57 12 August 2016 perfectly happy with that label. If you want to label me a self psychologist, I am happy with that. I am not so happy to be labeled a relationalist because I don’t know what it means. It is so amorphous as a term. If you say well, there is a relational perspective, would you say you are that? I would say yes, as well as all self psychologists that I subscribe to have a relational perspective. But then who doesn’t? Therefore, the broadest label I would be under is self psychology. I remember years ago giving a talk in Florida, before self psychology, and the colleague who introduced me said that I was coming from the Baltimore Institute and therefore it would be assumed that I was a classical analyst and interested in ego psychology. But by his notion, I am something called a Lichtenbergian [laughing] meaning 10 Interview I

I go my own way. At the moment I am happier being called a self psychologist because I feel that probably the most infl uential way of framing my approach has to include the empathic mode of perception. Sensing into another person’s perspective, that way of looking at things, is the central focus when doing analytic work, to say nothing of marriage and a few other things, raising children. SH: One thing related to this … what psychoanalytic interest have you not explored, and what are you now thinking about exploring, especially now that you are done with this book? JL: I have given Bion a lick and a promise (I fi nd the language offputting), and I have given Lacan a lick and a promise (I fi nd it idiosyncratic). I have looked more thoroughly into the Kleinian perspective and see important similarities in the way that they listen and work very close to the immediacy of the material, but not the theory they are applying to it. As new things come along … I look at Ferro. Some of those things he says make sense. I have quoted him. If I have to choose from the vast literature arriving every day, I tend to look at the research. LG: How does it happen, Joe, when you are starting to look at something new, that you then go and delve into the research. How does that happen? Where does it fi t into the process for you? JL: I am probably one of the most unsystematic persons in terms of doing background research. I operate hugely on serendipity. I just sort of follow my nose and sometimes that is very costly because I know I want to make a reference but I can’t remember where it was because I am not systematic. One of my colleagues years ago said, you don’t keep any records of the papers you’ve written! I said, unfortunately I don’t. I am so busy thinking about

Downloaded by [New York University] at 04:57 12 August 2016 the next one that I am not at all interested in what the hell I did [laughing]. I am very unsystematic in my way of going about things and all I can say is it works. And that I have an uncanny way of reaching up on the shelf and pulling down a book. Sometimes I do it systematically because I have to. When I wrote the 56-page summation of three thick issues for Psychoanalytic Inquiry on attachment issues, I was systematic. I took each one and then organized it in groupings as I went with it. I do the same thing when I am summarizing whole meetings. I do not know if you know this about me, but I have often been asked at the end of 4- or 5-day meetings to pull the whole thing together. I don’t do it in any systematic way. I just let the stuff fl oat around Interview I 11

in my head and then somehow or other start to talk and the stuff fl ows out. I trust my mind. So far it hasn’t let me down. LG: What is the process of your working? JL: Let me tell you that I am systematic in one respect. I have evolved the following system. I get up around 5:30 in the morning and I then exercise for somewhere between 45 and 50 minutes. Either swim or walk. This morning I walked a touch under two miles. While I do that, I systematically review all my patients and supervisions from the day before. All ten hours of my work. Essentially I supervise myself by going carefully over the sessions, including the supervision. Then when I am fi nished with that, which is two laps per session if I am swimming, I then review the coming day, and put the people into place. And then I write, if I have anything in my head to write. If I don’t have anything in my head to write, I just let my associations go wherever they want to go. LG: Just give me a sense of what time of the day – and perhaps it is different each day – at what point you are writing. Are you saying after … JL: If I am in the middle of writing and the patient is fi ve minutes late, I have a pad there, and I just start writing. SH: So you can use that short amount of time. JL: Yes. Because it is already in my head. If it is not already in my head I can’t write. SH: You are transcribing.

Downloaded by [New York University] at 04:57 12 August 2016 JL: Yes, I am transcribing. The whole idea of motivational systems came to me in a swimming pool one day in a fl ash. Another example was the Kohut Memorial Lecture. Charlotte said to me the day before, “What are you going to talk about?” I said, “I don’t know.” That morning I got up with a full clear outline in my head. LG: So you had been working on that for a long time, up here. JL: Yeah. It was sitting back there percolating from the time I titled it “What Lasts, What Fades.” But I trust it. 12 Interview I

SH: You are saying the process is that it percolates but it increasingly gets organized in a form that by the time you write … JL: I sent you that little paper on Creativity Enters the Analysis. I was saying to myself, I’ll talk about the creative moment during treatment. Could be boring. Hasn’t it been already done? I don’t want to. So I kept putting it off because I didn’t think I had anything to say. Then suddenly I had a thought. Isn’t the model of an analyst’s creativity similar to the mode creative artists follow? What does a painter do? He has a dialogue and a medium. He has to have a medium to have the dialogue. So how does he do it? He works within whatever idea he starts with, then he tries to realize it, then he dialogues with what he has done, and then he plays around with it. And I just said, hah! And that was my fi rst sentence. The paper went from there. LG: Let me ask you this. Playing. This comes up quite a lot. Playing with ideas … playing around with them. Do you like to play around with this alone? I am thinking about children. Children who like to play alone. JL: I was an only child. I didn’t have a lot of choice. LG: I was going to get to that. And there are also children who have siblings who don’t like to play with their siblings. Sometimes that can happen. But do you think being an only child has had an impact on your playing with these ideas? JL: I think clearly so. I lived in a house of all grown-ups and I spent an awful lot of time alone. But fortunately I was reading very early, I think when I was four. By the time I got to the fi rst grade, I was reading at the fourth grade level. That is why I didn’t stay in the fi rst grade for more than two weeks. So I lived in a world of creating my own world, my own amusement, my own Downloaded by [New York University] at 04:57 12 August 2016 mind, my own things, and feeling my way into organizing things. And I had much more complex things to organize than I think kids ordinarily have. LG: What do you mean? JL: Well my mother and father were divorced when I was nine months old. I had to organize what I was hearing from this lot with what I was hearing from that lot. And what I am getting from the people I really trust who were the black ladies, my baby nurse and the next one, and so on. And Interview I 13

FIGURE 1.1 Joe as a baby, 1–2 months old

my grandparents who were the power people … my aunt. I have to say all of these people adored me so I was very, very fortunate. But still, how do you make sense of this mess? Well I was very busy trying to make sense, order, something out of it and fi nd my way along. The other thing that I will say I think is a characteristic of mine is I have always been able to fi nd people who fi t a need. So that when I was about nine and a chubby citifi ed un-athletic kid, probably destined for not very good relations with other kids, to say nothing of my body, I found Uncle George who “adopted” me and took me to live with him in the summers. He turned me into a swimmer and a runner and an athlete and a boy. A boy-boy. Downloaded by [New York University] at 04:57 12 August 2016 SH: Was that a need you were aware of having? JL: It’s hard to say what level of awareness I had. When Uncle George said, “You know all the kids who live down here on the shore go barefoot. If you don’t want to, okay.” So off go the shoes and socks onto the gravel road with the stones and it killed. It really killed. I wasn’t going to not do it. “All the kids down here know how to box. Do you know how to box?” “No.” “Well, I’ll teach you. And then you go into the ring and you fi ght.” And of course when you go into the ring and you don’t know what you are doing, you get 14 Interview I

FIGURE 1.2 Joe as a toddler with his mother, Hortense Davis, on a park bench

your head knocked off. Well, I come out of it, tears streaming down my face and he says, “Okay, do you want to do it again?” I say, “But I want to learn to do it better!” So I did. I became a very good boxer. So he fi t my needs and I went with it. I took advantage of it. I totally believe in serendipity. I believe all the critical things in my life have been taking some advantage of a serendipitous opportunity and going with it. SH: Who was Uncle George? Was he a family … Downloaded by [New York University] at 04:57 12 August 2016 JL: … This was during the depression. We had this big townhouse and my grandmother had cancer and we were spending a fortune. We were well-to- do people but the money … I mean our properties were all devalued. So we decided to rent out the third fl oor to this man who lost his fi rst wife in an accident and he had remarried. He and his new wife needed a place to stay and so they rented our third fl oor. I took one look at him, and fortunately he and his wife took one look at me and welcomed me, and I started spending a lot of time on the third fl oor. Now my family knew him. Not only did my mother’s family know him because he was living upstairs, but my father Interview I 15

FIGURE 1.3 Joe, age 6, with his mother (Hortense Davis) and grandfather (Max Davis) in Atlantic City

knew him because my father’s building in downtown Baltimore was near him and they knew one another. Therefore Uncle George said to my mother, “How about his spending the summer with me?” “But, I don’t know if his father will allow that.” And he said the same thing to my father and we got the go-ahead. So I then spent every summer for a long time. It was like I had another home and I had another family. So that also prepared me since the shore is a redneck world, that also prepared me to live in a redneck world and get along with people in that world. In the Navy … it was very important as a naval offi cer to be able to know what and how to get along. Downloaded by [New York University] at 04:57 12 August 2016 SH: So you were like Oliver Sacks, An Anthropologist on Mars, an anthropologist in a different world. JL: I was an only child observing everything. Observing the reform congrega- tion of my mother’s family. My father’s choice of synagogue. And my father’s father’s orthodox shul that he founded. I would sit there very alert trying to fi gure out everything. What is everybody doing? What does it mean? What are those things? Why in this place do you sit here while women don’t? … All of that. Endless questions and an endless fascination to know. 16 Interview I

FIGURE 1.4 Joe, age 9 or 10, with maternal grandfather Max and Uncle George, at Uncle George’s house on the Chesapeake Bay

I’ll give you one more story. I was on the train with my father to go to Norfolk to visit a Lichtenberg cousin who was a ship chandler there and on the way down, I am being me. I am maybe nine years old. I am asking endless questions. And then my father (like any human being) would say, enough, enough [laughing]. And the person sitting in the seat behind says, you shouldn’t tell him to be quiet. I am so interested in all the things he is coming up with. So that was me. I never stopped. LG: Speaking of never stopping. How do you decide at the end of the day to

Downloaded by [New York University] at 04:57 12 August 2016 stop? Is it when the thoughts are no longer there? JL: No, it is more clock oriented. LG: What do you do, look at the clock and decide it’s late? JL: Yeah. Or I’m hungry. LG: So it’s more needs oriented. Interview I 17

JL: I have no problem stopping. The ideas will be there tomorrow. I can leave in mid-sentence. It doesn’t bother me. I don’t regard my writing as a permanent contribution to the world of literature. I am not writing Shakespeare. Every sentence I have ever written could be said better. I am not going to try and spend my life saying it better. If the idea is communicated so that someone gets the idea, that is good enough for me. So I am not trying to be a crafts- man. Once in a while, if I write a well-crafted sentence, I am very pleased. But that is not my goal. That is the happenstance. LG: Your goal is to get your ideas across. JL: Right. Exactly. I try also to follow some of the good rules of writing which I know. As an editor, I know some of the good rules. But I don’t fuss with it. LG: Well that would be very cumbersome. That would take away from the play. JL: Yeah, exactly. It’s inhibiting. I have had to learn to be less Germanic … not write in long sentences … complicated sentences. SH: So in terms of style. JL: Simplify. Simplify. SH: So that is something you work at. JL: Yeah. Well, it’s like a progressive thing I have been trying over the years. LG: Is there any particular psychoanalytic writer that you have great respect for? Downloaded by [New York University] at 04:57 12 August 2016 Not in terms of the ideas, but in terms of this quest to get your ideas across and communicate those ideas well? JL: Freud. I think most of the ego psychologists write very poorly because they invented a complex language, a closed system of language, in which each concept is defi ned by some other defi nition within the system and that is what brought it to its demise. SH: Is there any other writer outside of psychoanalysis that you feel … 18 Interview I

JL: … Oh G-d, I don’t know. Because I am reading everything. If I am reading Jane Austen, then it is Jane Austen. If I am reading Henry James, then it is Henry James. It is whatever I am into. In our creativity seminars we have covered much of the great literature of the world. LG: I don’t know about this. Let’s hear about this. JL: Something like 30 years ago, I decided to have people come and discuss a great writer, or a great creator. Sometimes we have done a musician … Beethoven. I came up with an idea of how to do this. We meet four times a year. The idea is that we would select for each meeting a particular book, novel, play – of that author. The requirement was that the author be someone we all want to read and that there be at least one good biography so that we could really know about the author’s life. And that for each session all of us would read or have read the biography as well as read the particular reading assignment. One person would be a presenter and that person would present in whatever form he/she chose for 35 minutes. Usually there are excellent papers that are written by presenters and when the paper is fi nished, I raise a discussion. I don’t have the paper ahead of time, I just listen to the paper and I raise questions from the paper for discussion. Then we have a coffee break and we have a discussion that lasts an hour, an hour and a quarter. And it’s a free-for-all. Somewhere between 18 and 25 people attend these things and they come from Chicago, New York, Connecticut … whatever … locally. And it is a changing cast because it has been over 30 years. I noticed that Bill Adams who is one of the original people just died. Leon Wurmser has been with us for a long time. Lucy Zabarenco has been with us for a long time. Curtis Bristol has been with us for a long time. At any rate, we have been doing this with new people always joining. It has been a fascinating experience because we all profi t. Pearl Katz is an anthropologist who has been with us for a long time. I could give you the list of some of the people whom we have studied. But it is hard to think of an

Downloaded by [New York University] at 04:57 12 August 2016 important writer that we haven’t. LG: The people who are in this creativity group, are they all analysts? JL: No. Some people are outside. Most are analysts. Frank Lachmann, David Wyner, Barbara Feld, Ruth Gruenthal, Mauricio Cortina, Dori Sorter. Rosemary Segalla is a therapist. SH: Do the spouses come too? FIGURE 1.5 Joe in home offi ce, Bethesda, Eggleston’s tricycle photo above Joe Downloaded by [New York University] at 04:57 12 August 2016

FIGURE 1.6 Joe’s home offi ce, Bethesda 20 Interview I

JL: Yes. If they wish to. And most of us go to a dinner on Friday night. I usually let everybody know what is going on in the art world so on Saturday morning they can go. Sometimes I go with them. Sometimes I do the tour. We reconvene on Saturday afternoon from 2 to 5. [Interview Break] [Looking at photographs in Joe’s offi ce as interview resumes] JL: The photograph over my head where I sit is Eggleston’s tricycle. It was used by the Corcoran for their ad poster when they had an Eggleston show. These photos I look at over the patient’s chair are all Brett Westons. LG: And who is Brett Weston? JL: If you are going to talk about the greatest photographers in the last little while you would start with Weston, Strand, Steiglitz, Ansel Adams. Edward Weston’s son is Brett Weston. That is Holland Canal, the next is the New York Arboretum, the one to the right is the Dunes in California which he did when he was 17 years old, and then the next one is Garrapata Beach, also in California where he and his brother had a shack. SH: Which is your favorite, Joe? JL: The third. As someone who has a lot of photographs, that is a photograph that to me is perfection. Every aspect of it works, the texture, the sky, that line that comes right across in the center, the grey line that makes the black not just monotonous, and then the alternative, the gray pyramid to the left and then that sky. That’s a sky that any painter would be utterly delighted to have painted. And there are a lot of these little objects that patients have given me. LG: Downloaded by [New York University] at 04:57 12 August 2016 Do you take photographs on your own? JL: Once I started seeing what masters did, I stopped taking them. I am proud of the wonderful animal videos that I have taken on safari in Africa. LG: Where on safari did you go? JL: We went on three. One to Kruger, one to Kenya and Tanzania, and one to Botswana. Interview I 21

LG: So now we are going to move into the area of your analyses. Basically, we are going to ask you some questions about each analysis. But I am wondering if you would start it off by just telling us naturally whatever you choose to tell us and then we have some questions that if you don’t cover we will get to. JL: As I said before, I don’t know how I got referred to Helen Arthur. Helen Arthur was an attractive young woman probably, maybe 30. I was at the time, let’s see 1949, I would have been 24. Probably in retrospect, she was a candidate. I didn’t know … I didn’t even know what a candidate was. She had an established offi ce and she was a child analyst. I was in medical school working in the summers at Spring Grove State Hospital and I found her to be just what I would have hoped to have; someone who could listen, someone who made intelligent comments. I developed an absolutely intense oedipal transference to her, struggling not to say all of my mean thoughts about her husband in my oedipal rivalry and found a wonderful way to get at some stuff of my own using dreams but also using the Brothers Karamazov so that I could talk about the ways I was similar and dissimilar to Alyosha as a sensitive person but not a very active into-the- world person, or a somewhat arrogant dismissive person like Dmitri with intense feelings and such, and I am trying to remember the name of the other brother, the very obsessional and controlled, Ivan. I used those as vehicles to get at who am I, seeing myself as like each of them. I refused to see myself as Smerdyakov, the bastard child who was really a villain. That was not me. I could pretty well say I am a person who is more inclined to be helpful to people than I am to be destructive. I can be angry, but I am not destructive. That was clear to me. What I don’t like, I try to build better. I don’t take vengeance to destroy, which is what Smerdyakov would represent. And then one day I stopped dreaming and I stopped associating and I went through this dry period. I didn’t know what was going wrong but

Downloaded by [New York University] at 04:57 12 August 2016 I was getting nowhere and this was not happy. She struggled with it, she was patient, she couldn’t say anything. Then I did have a dream and I told her the dream and she said something about – I don’t remember the beginning phrase just the word came out – menstruation. And I screamed no, no, no, no menstruation! She said you are right, I am not menstruating, I am pregnant. Apparently she had missed two periods. So my sensitivity was to what was going on in her body. Now there is obviously history to that. At some point or other my divorced mother was in bed with something that people were sort of shushed about. I don’t know whether she had a pregnancy, an abortion or what. That is sort of a reconstruction. But that was my capacity to be sensitive enough to what 22 Interview I

was going on in her body. So we worked with that and we are doing fi ne and now we are getting on to a question about was I going to have to leave her if I wanted to enter the Institute and this is all fl oating around and I get a telephone call from her husband – she is ill, she won’t be coming in that week. And the telephone call the next week – she is dead. Apparently she died of some rare complication at the end of pregnancy in which the lungs thrombosed. I don’t know what. I never heard of it before or since. Anyway, dead she was and so I had a total traumatic end to that very, as far as I am concerned, very successful therapeutic experience. Meantime, I got married. SH: This was subsequent to … JL: No, this was during. I got married. A lot of very very good things. Sitting in the waiting room from time to time, as I would come out with the tears streaming down my face, was this Chinese gentleman. He would nod, cool as a cucumber, and I was looking at him with a glint in my eye. I am in such disarray and he is so cool. One day, by whatever accident, she was on time and so we ended on time and so sauntering up the hill was this Chinese gentleman and he looks at me and he says, “me late?” and I said, “you late!” All my sadism! And he wasn’t! I was getting back at him for all his cool. Well, as it turns out he is the biological father of what are now my children. That was Ping Pao. That was how we met. An odd beginning to a friendship that lasted 30 years until his death. We wrote together and I edited his work. Then I got into the Institute and started analysis with Loewald. We’ll just call this my second analysis. We are talking about a world famous analyst. SH: So how did you come to choose Loewald? JL: Within the group there were Sarah Tower, Francis McLaughlin, Sam Novey, and Hans Loewald, all of whom shared an offi ce. They were all training analysts and senior people along with Jim Bing. I may have read some of his

Downloaded by [New York University] at 04:57 12 August 2016 writings. His writings are incredibly impressive. He was a brilliant contributor by everybody’s standards. Nonetheless I had a terrible, dreadful, horrible time. I can give you many instances of what led to this being a horrible time. Probably the single-most signifi cant one on a list would be in response to my mourning. My grandfather had died somewhere around this time, my mother’s father. I adored my grandfather. He was my buddy and he was a wonderful man. He made the fortune we all lived on and he was just a dear person. So I am mourning him and Helen Arthur which totally made sense and Hans couldn’t take it. One day he said, “You know, that was not an analysis you had with her, all she did was hold your hand.” Interview I 23

And my thought which I suppressed because I didn’t have the courage to say it – I wish I had – was, “You idiot, if you just would hold my hand we might get on with this.” Another upsetting exchange was when he rattled his coffee cup and I complained he said, “You want my undivided attention?” I didn’t have the courage to say, “And you want my undivided $25 bucks!” Another empathic failure was as I was dealing with what I experienced as his rigidities, which I equated with my grandmother, he said, “You’re not seeing me as if I am like your grandmother, you are seeing me as if I were your grandmother.” If I had only had the ability I would have said, “Well, if you would stop behaving like her, I would not have that reaction.” Now in retrospect I understand aspects of the enactment. I am jumping ahead to my fourth analysis – my self-analysis – to make this point. Once I got into self psychology, I came to believe that he required an idealizing transference. If you had an idealizing transference, he was a wonderful, sensitive, related analyst, as evidenced by a lot of people who had good results. Not all people had. There are stories that have come up subsequently indicating other people had experiences somewhat like mine. No human being has to be perfect for everybody. But driving up to Washington for our classes, I would be in a car with three other candidates who were in analysis with Loewald and they were all extolling, oh so wonderful, oh he said this, oh so helpful, and I am slinking down lower and lower in my shame and humiliation. They were doing fi ne. I wasn’t. Only later did I understand what it was about. I can fi nish the story by saying that when I talked about this in the plenary that I gave at the American, one of the people who wrote a commentary said that I needed to go back into analysis if I was thinking about him that way. Two other pieces with Loewald then we will fi nish with Loewald. How did it end? It ended in this way. I started to have a fantasy which I couldn’t get out of my head of metamorphosing à la Kafka, not into a cockroach, but into a crab that was lying on its back. When crabs are lying on their backs, they use everything they have to get off their backs and I suddenly realized, I have to get off that couch. That is what this fantasy is telling me. I said, “I am quitting” and he said, “Well then, you might as well drop out of the Downloaded by [New York University] at 04:57 12 August 2016 Institute, you’re through.” I said “Okay, I’m through – out of here.” Then Sarah Tower called me on behalf of the Institute and said, “We don’t want you to just drop out. You can be on a leave of absence.” I decided that if they wanted to put me on a leave of absence they could but I was through! SH: So how long were you in analysis with Loewald? JL: About three years. The last piece of the story with Loewald is that years later I am now an analyst, a well-published analyst. I am on a panel for 24 Interview I

an anniversary of the Washington Institute with Loewald and a couple of others. And Loewald gave a very good talk. His writing is wonderful! He gave a very good talk but he was very old and his voice did not carry and so it did not get to the audience. When we fi nished our formal presentations we each had fi ve minutes where we could go back, and I am thinking – what he is saying is what I believe in. So I used my fi ve minutes to tell the audience what he said. Whatever animosity I had to my grandmother and to Loewald, I feel is largely resolved. That sort of fi nished it. On the plus side I learned a huge amount from that experience with him. LG: What did you learn? JL: What not to do. I learned that narcissistic injury is not what we are there to infl ict. I learned that if you fi nd you have done something that has infl icted a narcissistic injury you take responsibility and you deal with it, in some form. I am supervising an experienced training analyst and he just did that with a candidate patient. The patient is in a very distressed state. The analyst explains the patient is caught up in sadomasochism. I said, “Look, don’t have that patient come in and lie on the couch and you interpret his presumed sadomasochism. Put the candidate in a chair, talk to him.” My supervisee asked, “What do I say?” I said, “Go back over exactly what happened and your part in it and say that ‘ we created a serious problem and we are going to try and sort it out.’ Take responsibility for your piece in it, present it not using the fancy word co-creation, but think that way and talk to the patient as a person.” He said, “I never would have thought of that.” LG: So fascinating. JL: This was just two days ago. So I learned a ton of what not to do and subsequently I had to learn what to do rather than that. Returning to when I left Loewald and was on leave of absence from analytic training, now I am at

Downloaded by [New York University] at 04:57 12 August 2016 Sheppard Pratt Hospital and I am one of the most valued residents. Lewis Hill is my mentor. Lewis Hill is a brilliant, exquisitely sensitive, and intuitive. He said to me, “You have to go back and fi nish the training.” I said, “I don’t want to.” He said, “Look, you are a natural born analyst. Go get your piece of paper, you have your whole career ahead of you.” I said, “Okay but who do I go to (thinking I am in trouble with all of the training analysts)?” He said, “Go to Russell Anderson.” “Russell Anderson?, you said this and this and this about him!” And Lewis, who is very Prussian with this clipped haircut, looked at me and said, “You listened to me then, but you won’t listen to me now?” “Yes Lewis, okay!” Interview I 25

So off to Russell Anderson I go. At this point I am a much older, much more experienced, much more sensible person. LG: How old were you at this point? JL: Okay. 32. LG: So how many years after the end of Loewald? JL: Two or three. LG: It’s good you had an early start, Joe. JL: Well look, I still graduated as an analyst in 1960 when I would have been 35 or 36 – that was early in those days. LG: And how many years between Helen Arthur and Loewald? JL: Maybe a year, a year and a half, something like that. So I went to Anderson and was in classes and started control cases and fi nished three years later. LG: And what was it like with Anderson? JL: Anderson was a kind, sensible man with whom I got along well by deciding that for once in my life I would take what I could get, use it, and not fi ght the system. Just go with the fl ow of the system. By that I mean I was trying to keep my mouth shut in classes. I wasn’t having a hard time – I wasn’t feel-

Downloaded by [New York University] at 04:57 12 August 2016 ing oppositional to the teachers. I had my own ideas about the theories but that was okay. This is what I concluded. I concluded that I was a much more intellectual person than Anderson. I also concluded that Anderson would not agree with that. That he considered himself much more of a thinker than I thought he was. By this time I knew not to fi ght it. The things that I thought were problems with him, I essentially said there is more good than bad. I am going to get the good. Perfection ain’t in this world – with him, with me, with anybody. I am not asking for perfection. I am asking that he is a helpful man and he is listening to me in a caretaking way. That is good enough for me. That he says useful things from time to time, that’s good. 26 Interview I

LG: And he wasn’t cruel. JL: Not in the least. Not vindictive, not cruel. At the end of three years he said, “Enough of you. Graduate, go.” So I got off of the couch thinking there is an awful lot more here that needs to be done. But I’m out of here. I’ve gotten what I feel he has to give. So I graduated. That would have been 1960. SH: Did you have to fi nish your analysis in order to graduate? Was that a requirement? JL: Sort of. But you didn’t have to complete a case. You could graduate if your case was far enough along that it would likely go to a successful completion, and you had demonstrated that you could conduct an analysis. Sarah Tower authenticated my case. Now this is 1960. I graduate. I am practicing analysis using what I know of ego psychology and the approach and defense analysis. I am not completely in agreement with Paul Gray but I am learning from him and I am a teacher instantly. All these people that came; Curtis [Bristol], Larry Inderbitzen, and Floyd Galler were in some of my classes. I quickly became one of the popu- lar teachers because I could explain the concepts we read. I take theories and render them into ordinary language which I think makes for a good teacher. Now we have to jump ahead from 1960 to 1970 or 71 when The Bulletin of the Philadelphia Association of Psychoanalysis asks me to review a book, The Analysis of the Self, by an analyst I had never heard of. I read this book and I had rarely ever been moved so much by a book. Not the theory, the clinical cases. I saw through the clinical cases what hadn’t been done for me that needed to be done. I saw the whole issue of narcissism – horrible word – as sensitivity to issues of pride and shame and how no one worked with me with any knowledge of that and how the whole issue of defense analysis has as a component, shaming. You are doing this bad thing and interfering with the good work I could be doing with you. If you were not doing this bad Downloaded by [New York University] at 04:57 12 August 2016 thing [using denial, reaction formation, projecting], we would be successful. Essentially, stop the bad stuff and we can do the good stuff. That is the sub-text. Obviously that is not what was meant, and obviously the positive qualities of the treatment did come through and defense analysis did work. Nonetheless, there was a powerful component of shaming in the traditional technique which an empathic approach gets around. So I discovered that and then I discovered what I needed to deal with regarding some of my own unresolved issues. Some of my arrogance didn’t have to be. I didn’t need that for pride. I ended up resolving a fair amount of stuff with myself. I could accept that I am a bright person. I am a bright and creative person. Interview I 27

I could accept that without either having to deny it so people wouldn’t envy me or I wouldn’t get into all kinds of trouble with people, but I also could accept it without having to be arrogant with respect to other people. Now it is that kind of understanding that I had worked out with myself using Kohut’s ideas. It is then that I also understood the idealizing transference which I believe was a problem with my analysis with Loewald. And so a lot of things came together for me and in the process of this, I wrote the review. LG: What I would like to know … you understood this and you are calling this your self-analysis. JL: Yes LG: Now, if you did not know about Kohut, would you have after Anderson thought about doing a self-analysis, or was the self-analysis compelling because … JL: I was always doing self-analysis, but I didn’t have the tools to do it differently. I mean I was always struggling with these issues to try and sort them out. As I review every hour every day, I am doing bits of self-analysis. SH: So is that like thinking about the patient? JL: Yes, and as I was also learning so much more about attachment research, I was then able to use that material for myself. SH: Oh, I understand. So it was different theoretical positions, different developmental insights that you then applied to yourself that weren’t available to you before and therefore you were not thinking of yourself in those ways.

Downloaded by [New York University] at 04:57 12 August 2016 JL: Right … I already could look at my toilet training and understand pieces and parts of things that come from that, the Oedipal and so on. I had done that. But what I wasn’t able to do was to look at this other dimension. What Kohut gave me the opportunity to do was to look at a whole other dimension. Classical analysis as practiced in Baltimore was vicious on the subject of narcissism; it was to be stamped out. He is grandiose! Make him give it up. Stop it. I must tell you the other story because I think this is so relevant. When I graduated, I wrote a paper on my fi rst control case, who was a social worker. This patient had some weird symptoms which I was able to analyze 28 Interview I

using infant studies to do it. I wrote a paper using Spitz’s book, No and Yes. I used this concept. The Baltimore Institute had decided to form a triumvir- ate with the Philadelphia Association (not the Philadelphia Society, they are not classical enough) and Cleveland with the Katans. The three institutes held a symposium together and a call for papers. Two papers were to be accepted from whatever number came in from the three institutes. One paper was accepted for the morning by Eli Markowitz, who was then a very senior analyst who had written a lot on sadism and aggression. The other paper was mine. Now, the seniors in an institute can react to that in different ways. I would hope that at ICP&P, our institute, we would be overjoyed, we would be proud. My institute regarded it as hubris that I had even submitted a paper. The Katans in Cleveland made everyone send it through them if they ever wanted to send it in for a meeting. But I just in my own hubris way sent the paper, and it was accepted. So in the afternoon when I gave my paper, many of the seniors decided that they would sun themselves by the pool. SH: So your family left, so to speak. LG: But at least they didn’t destroy you. They let you present your paper. SH: That was their protest. JL: That was their view of me. To fi nish the story with a positive. I felt that I didn’t get much of a discussion. It wasn’t bad. And I knew I couldn’t publish it because of confi - dentiality issues. So I wanted a discussion. I sent it to Geneva to René Spitz and I got back an immediate note saying thank you, I will be happy to look at it but I have many things. When it rises to the top of the pile, I will get back to you. I thought I will never hear from him again. Three months later, a seven-page discussion arrived. One of the comments I remember was, on

Downloaded by [New York University] at 04:57 12 August 2016 page 3 when you say so and so, the people in the front of the room might understand it but the ones in the back need a little more help, you can make that a little clearer. His comments were just delightful. That taught me something. All of the papers and requests that come to me, I always respond to. I have always tried to be helpful. If Spitz would do that to someone he had never heard of, that was a model for me. SH: There is something else you said about people responding to you. That is, even though you did not get the response from the desired people, you nevertheless found someone else from whom you could. Interview I 29

JL: Yes … It was a good paper. I would stand by it as a good clinical description of that experience. One part was the reconstruction of her symptom of a fear that she would not be able to close her mouth; that she would be stuck in that kind of position. She referred to it as, “I can’t swallow.” We did what we could with associations to swallowing. And then as she was talking about letting her older child feed her baby, she was describing a bad moment when the nipple … and suddenly I got the symptom. I am sitting in the chair behind the couch and I felt that symptom. I felt that nipple going down too far, and I said it in whatever form I said it. And [then] she got the symptom and then we looked at it. We found out that as the more diffi cult twin (the mother was happy to feed the other, her bigger sister) and assigned her to the older daughter. So she had been fed by a child feeder who didn’t know how to hold the nipple and caused the choking. My understanding of infant studies, and the tiny detail of feeding made it possible for me to understand that. I do not think that every analyst was going to have that experience or even have the bodily openness to the body response. So that was a piece of it and it makes for an interesting story that was part of the paper. The bulk of the paper deals with the problem that she had with agency, of being able to deal with “no” enough to be able to accept “yes.” The group of senior analysts could take no pride nor share my pride. It was just a display of my narcissism and it should have been squashed. While I am not easily squashed, they did prevent me from becoming a training analyst. SH: Yes. That was one impact. Can you say something about that experience? JL: Well you know, it was divided. There were people who had been positive sponsors and people who were negative. The people who were very negative were very powerful. Finally that and some other things led me to decide that I have had enough of Baltimore. Paul Gray was inviting me to come to Washington again. Some were warning me and others were telling me we don’t want you, not directly but indirectly. And Ping Pao was here so

Downloaded by [New York University] at 04:57 12 August 2016 that was encouraging. I was promised a job in the State Department which I thought was interesting, so I moved us here. I spent one year fi nishing up the Baltimore patients and starting up the Washington patients. That was the only year I didn’t write anything. I was just so exhausted from the going back and forth, the driving back and forth, and the trying to make this change, and juggle all the issues at home of we have to move and lose our friends. It just absorbed me, there was nothing left of the creative side of me. It was just a year to survive. SH: Now when you mention Ping, can you mention the thread of it? 30 Interview I

JL: Well we went to Sheppard together. SH: And that was? JL: 1953. We were together at Sheppard from 1953 to 1956. That was after. He started at Seton Institute and I started at Spring Grove. We spent a couple of years there. I wrote a paper there, that was the fi rst paper I wrote. Then we both went to Sheppard at the same time. And we were at Sheppard for either two or three years together and became very close friends. We really respected one another and wrote a couple of papers together. One really interesting study that we did – here was the question. What is it that when you look at some married women with psychoses, and you just evaluate them, some whom you think have a very poor prognosis do very well and some who look like they have a good prognosis don’t do too well. And they are in the same hospital, with the same senior staff and roughly equivalent residents. So we concluded that it had to do with family. We then started studying the relationships with the husbands. We then did a study that indicated that those husbands that came regularly, who would come into couples meetings and who were in it with their wives, they were the ones who did well. So we wrote a paper on that study. SH: That’s wonderful. So was he your fi rst collaborator? JL: Yes. I would think so. Then a funny thing happened on the way to the forum. I left Sheppard to go into private practice but I didn’t have enough patients so I worked half-time at the Courts as consultant for the Supreme Bench of Maryland under a brilliant man named Manfred Guttmacher who is a pioneer in forensic psychiatry. You have heard of him. He was responsible for the Patuxent Institute, a place for the treatment of criminals. Working with me there was

Downloaded by [New York University] at 04:57 12 August 2016 a psychologist named Len Ainsworth who happened to be married to a psychologist named Mary Ainsworth whom I then got to know and that got me into attachment in 1957. LG: A “strange situation.” JL: A strange situation indeed. That research was done in Baltimore. So again – serendipity. Total serendipity. As that year was coming to an end, I get a call from Sheppard. Will you come back and be the Clinical Director? I said, “Alright, but I don’t want to give up my practice.” We made a very sensible Interview I 31

arrangement. I would come back. I would work half-time, I would be paid half-time, I would not be called director, I would be called coordinator. As it worked out, and I might have expected I did everything you would do full-time, half-time, and then went and did my practice. Another interesting little sideline. I said to Lewis [Hill], I assume you wanted me to come back or I wouldn’t have come back. When I had talked to the medical director he had said well, we had a hard decision to make whether we were going to have a Jew on the senior staff. I said to Lewis, “Did you really want me to come back?” And he said, “Of course, very much. Why did you ask me, what a strange question?” I said, “I know you referred a lot of patients to a resident who left when I did in the course of the year and you never referred a single one to me,” and he said, “He needed them.” SH: What did you think before he said that? JL: I couldn’t understand it. I had no question that he thought very highly of me. I had every reason to believe it. SH: But he didn’t think you needed to be taken care of. JL: That’s right. You can take care of yourself. He needed it. SH: There was one point about Ping. JL: Let me just fi nish. When I did that, Ping had gone to the Lodge and the Lodge had a rebellion in which Harold Searles, Otto Will, and Marvin Adland walked out because they were not given an opportunity to buy into owner- ship. That left a big vacuum and so Ping became the Clinical Director there. And so the two of us were running these two major hospitals, Chestnut Lodge and Sheppard, at the same time. It was just kind of an interesting

Downloaded by [New York University] at 04:57 12 August 2016 phenomenon. SH: I wonder also about the Helen Arthur connection. JL: Who knows. The two of us who grew up under such totally different cli- mates, environments. It was very funny because Charlotte would say, “How is it that the two of you go spend an hour talking about a paper or an idea or the book that Ping is writing and you come out and instead of Ping speaking proper English, you are speaking pidgin English?” I said, “We save a lot of time that way!” I edited everything he wrote, we shared ideas, his wonderful 32 Interview I

book on schizophrenia is a gem, I helped with it. We had a fi ne friendship and collaboration. LG: How did he help you, Joe? JL: Wonderful ideas, sharing of ideas with a friend with a very bright creative mind. I have had the good fortune of having a long series of collaborations. The next series of papers largely on defense mechanisms and a proposed defensive organization was written with Joe Slap, a Philadelphia analyst, and it ended in exactly this way. I proposed a paper on the development of the sense of self using Kohut, Mahler, and traditional thinking. He said, “There is no self.” I said, “Hmm?” He said, “It is a construct; it has no meaning.” We could not work together after that. That ended that collaboration. I wrote that paper and it became the lead paper in JAPA. At that point, I had already published in JAPA , I had published in the International , I had published in the Quarterly . I think it was that paper as the lead paper that was an entrée more into the upper echelon of analytic contributors because I was invited more to be on big panels after that. The next big step occurs in the 1970s. This is a panel on the development of the object. I gave a paper, one that I am not particularly proud of. It was constructed stuff. And in the end of it a man came up and said, “I would like you to write a paper on how the new fi ndings in infant research apply to analytic theory.” I said, “Thank you, I need projects like that like a hole in the head, but what do you have in mind?” He said, “Look, there are very few people who have the kind of mind that can put all of this together. You do.” I said, “What people are you talking about?” And he reels off a list of names, Trevarthan, Sander, Brody, a whole list of people who are doing infant research at the time. I said, “I don’t know any of their work.” He said, “Okay, but you should, and if you are working on the topics you are writing about, you should.” So I said, “thanks” and came home. We had a friend who was a librarian for the Michigan Society and I gave

Downloaded by [New York University] at 04:57 12 August 2016 her some of these names and she sent me a long readout of names. I saw that a goodly number of them were contained into about fi ve books. I got the books, was fascinated, and started to write about infant studies. I wrote a paper, and then another paper, and then I wrote another paper. And by the third paper I realized, I’m writing a book. I didn’t know I was writing a book. I hadn’t planned to write a book, but I had just written the fi rst three chapters. So out of that came Psychoanalysis and Infant Research. That book was like a little bit of a bombshell because it raised a critical eye onto the whole theory of development based on research that had been based on reconstruction from adult analyses. Interview I 33

I am on a panel with Jim McLaughlin and Charlie Brenner, I think in New York, and Charlie makes the famous comment that he is for research, he has done research, he has only good things to say about research, but if you’re treating adult patients you can learn just as much from doing research on pigeons as looking at babies. So Jim and I say, WHAT? But because the book had become known, I was invited to Montreal to give a paper on infant studies. I get to Montreal and I give my paper and the fi rst question from the audience is, what do you know about pigeons? The word had spread across the border! So much for Charlie, this was another round for Charlie and me. By this time I am on par with him. I am not the candidate in the room any more. One more piece of that story is that Dan Stern’s fi rst two books came out right about the same time so that two of us coming at it, one from the adult practice side and the other from the baby watch side, were saying very similar, very compatible things raising serious questions about analytic theory. We were both pioneers, he in a much more knowledgeable way from direct research and me from absorbing everybody’s work. LG: You know I just want to say, Joe, that there is a theme here of how you have had to come to terms with some of these big analytic fi gures and I wondered, other than the example that you gave of them walking out, how do you understand what they needed to do in order to deal with you? How did they come to terms with you basically? You had, with a lot of these large fi gures, some incidents, some dealings, some unpleasantries. So I understand how you learned how to deal with them but how did they learn to deal with you? JL: I can give you a partial answer to that. I had left the Baltimore Institute & Society where I had been President of the Society for a year or two. I came to Washington and I am in the Washington Institute where I am the Program Committee Chairman. From the time I entered high school at the age of 13, I ran a program from my homeroom class for three years. How I got selected, I do not know. Why anybody picked this 13-year-old fi ve foot tall

Downloaded by [New York University] at 04:57 12 August 2016 kid and gave me the assignment, I do not know, but I have been running programs since I was 13. So I was the Program Chairman for the Washington Society and I was taking Richard Sterba to lunch at the Jockey Club. The two of us are sitting at the Jockey Club having lunch and now I’m with one of Freud’s inner circle, a major, major fi gure. Richard says to me that he and Edith are very fortunate because there is a Korean couple that they have found that live with them and look after them and make it possible to carry out their careers. I make a comment that when you look across the world spectrum and you see that every culture that developed a high culture in arts and literature is 34 Interview I

a culture in which some people had the leisure time to manage these things and always there was a group of people who looked after them, sometimes unfortunately suppressed people in one form or another, or captured people, nevertheless, this is a phenomenon. So he and I started playing history and we started reviewing ancient Greece, ancient Persia, and going over the world. A woman sitting next to us said, “You two are terrible men! Don’t you know …” and we are getting a lecture on suppressed people from this lady. We deal with this and Richard says to me at the end of this, “Where are you from?” I said, “Baltimore” and he says, “No, where are you really from?” And I said, “I don’t know what you mean.” He says, “Where in Europe are you from?” and I say, “If you go back far enough I am from Berlin, three generations back.” He said, “You can’t be.” What he meant was that he, Richard, was accepting me as a confrère, because I know the things Europeans know. I have found it easy to share experiences with the European analysts I have met. Jenny Waelder-Hall had a big affair given in honor of her. I was the one who helped with the arrangements for the Europeans and wrote up the proceedings. Maybe under whatever false illusions it took, I have gotten a lot of acceptance. I was accepted at the national and international psychoanalytic meetings. On the big stages, I have been very easily accepted. SH: It’s more at the local level so to speak … LG: It sounds like the whole thing has mellowed. JL: I’m director emeritus at ICP&P, so I am not fi ghting with anyone about anything there. In self psychology, I was the fi rst elected president and I served my term, and I fought the battles and won in that the people who were really, really fi ghting me quit. I prevailed there. At the moment, I am not in battle with anything or anybody. I have had wonderful collegial relationships with Frank Lachmann and Jim Fosshage. Downloaded by [New York University] at 04:57 12 August 2016 LG: Tell us about that. JL: We are three independent minds who come from three different places: Jim from the Midwest and bits of a Jungian background, with a major interest in dreams; Frank comes from Europe and was very early friends with Bob Stolorow and a lot of the non-M.D., non-New York Psychoanalytic group, and very interested in intellectual things; and I come from where I come from. We just liked each other’s minds. When I have an idea and I tell it to Interview I 35

them, they feed back ideas and we just go with it. When I said to Frank, “I think the idea of fractals is an important idea that can be used to understand things,” he said, “What’s a fractal?” So I told him and he said, “You are going to have to educate me.” So I did and he did research on his own and then he wrote up a statement on fractals which included things that I would not have gotten to and so then we said here is how we are going to apply it to a case and he wrote up the case, and I read the case and said the case is too much a case. What we have to do is restructure it. Use the same content but structure it so we can use it for the theory. We did that and it just goes back and forth like that. It was agreed he would write the case and I would write the theory, but we would use both of our ideas and put them together. I had this idea, from what do we get the inferences we make? What is the process of listening to a patient? What in our head do we do with it? And I started to think about the way we form inferences and I was helped by Blink , the book. Because that is what he [Gladwell] is talking about. He had come up with a lot of good research that saved me a lot of time. I said to Jim, “Do you want to play with this?” So Jim and I played with the making of inferences, collecting some data to show how it works and tracked out a whole idea. I had what I think was a very interesting idea which was, if you want to know where theory plugs in to the clinical moment, it is right there. It is as you make an inference. That is the moment where theory plugs in. That would be an idea that I developed after the fact. It was agreed that Jim would write the chapter and when he wrote the chapter, I had some critiques to make and the chapter was re-written based on what we agreed upon. I wrote the prologue and sent it to them and they just accepted it. There wasn’t any need to do anything. That is just how we work together. LG: Back and forth. JL: Back and forth, yeah. SH: Downloaded by [New York University] at 04:57 12 August 2016 So among the three of you … JL: Yes. It just circulates around and – I was going to say, if we disagree – we rarely disagree. I mean rarely an “I don’t agree.” LG: What form would it take? See it sounds like what happens is you enter into this as we want to learn about X. So then you take a piece and they respond. Or they take a piece and you respond. So what is there to disagree with if it is presented in a context like that? Where is the disagreement? 36 Interview I

JL: We don’t. SH: How did you come to know Jim and Frank? JL: It is a weird thing. I don’t remember. I’ll give you a little piece of story. Analysis of the Self came. I wrote the book review. I got a telephone call from Ernie Wolf saying Heinz Kohut will be in Washington. He is staying at the Inn of the Three Georges. He would like to see your review. I said, “What, Ernie! Authors don’t look at reviews until they are published.” There is a dead silence on the phone and Ernie says, “Joe, it is very important to us to see what people are saying, what people like you are saying.” I took the review down and left it at Kohut’s hotel. I didn’t see him. I didn’t even know what he looked like. If I had seen him it would not have meant anything to me. I just left it there. Next thing I know a few weeks later Russ Anderson, my former analyst, calls me up and says, “We are having a meeting to discuss a new book by a man named Kohut and there are going to be about ten people, will you come?” “Sure.” So I go. I don’t know if he has read the review or whether it was Russ’s idea or his. There are about ten people, Anderson and Kohut. Kohut starts out in Kohut’s classic way, soft voice, “I am going to say a few words, just a few words to begin with and then we will discuss the new book and the ideas. If at any time you want to interrupt, just do so and we will consider it.” He didn’t mean a word. He was not going to talk a few minutes. He was going to talk the whole time. And you were not to interrupt the opus. In this very quiet and controlling way, he starts to talk and he is looking at the group and is going back and forth like that and he gets to a certain point and he says, “Some people don’t understand some of the things” – and then eyeballs me – and then spells out exactly what he said and exactly what I said and gives his explanation about four or fi ve times. I mean okay, at least the man read it. He read it carefully. He had gotten it. He had taken it dead seriously. That to me was the end of that except the next thing I know there is going to be

Downloaded by [New York University] at 04:57 12 August 2016 a big meeting in Chicago and I am invited to run a workshop on transmuting internalizations which was one of the concepts I had thought poorly of. So okay. I go and we stay at the Ritz Carlton in very fancy digs. This is a big enterprise. Everything is beautiful, everything is really done exquisitely. I am chairing the workshop and in the workshop are two people whom I had never laid eyes on before, Alan Kindler and Bob Stolorow. Later, Bob and I were giving a lecture together at one of the New York groups. I had laryngitis and Bob had Deedee Socarides [to be Stolorow] read my paper for me. We then had a Cape Cod meeting and it could be at the Cape Cod meeting that there were Frank and Jim. It was somewhere in there that we started Interview I 37

talking. I proposed the motivational systems idea to them. I said, “I think another book needs to be written about it to make it more accessible, to talk about in a more clinical and easily explanatory way.” We agreed then to write Self and Motivational Systems . SH: Would you say that usually the initial idea comes from you? JL: Yes, I have proposed each of the books. But from there on in there is total equality. And I generally propose the organization like saying, “How about you writing this and you writing this,” the divvying up. But there is never an issue about it. It just goes. LG: Well, I think the premise is the total equality premise. I wonder how much without being consciously aware you are picking these people with whom you can have a totally equal relationship, as opposed to some of these other fellows. JL: I have written little where I have not been the lead author. But I have. Russell Meares and I wrote two papers, one in which he was the lead and one in which I was, but it was basically his ideas. He is the one who wrote the book, The Metaphor of Play. We wrote a couple of papers based on that – his lead on one, my lead on the other. Frank and I wrote a paper on model scenes and he took the lead on that because, although the idea of model scenes was originally mine, the application to the clinical material was Frank’s. I am perfectly agreeable to do it either way. It is just that usually I am the one who proposes the idea. But the clinical material we each provide. And Frank is a fantastic resource for clinical material. So is Jim. And we like each other’s clinical material. LG: Do you work clinically similarly?

Downloaded by [New York University] at 04:57 12 August 2016 JL: Probably but who knows. I can’t imagine that we work too dissimilarly. But I would also say that what is really interesting is that we might say a similar thing in a similar moment, or we might not. But I think we create an ambiance that is similar enough, and yet we create three different presences. I am – it is very hard to say what one’s self is. I think my presence tends to be more formidable. At least some people react to me that way. Frank can be formidable for sure … but he has a kind of jolly, humorous quality. And Jim is … going to more easily get a more romantic quality ambiance, a certain good-looking quality. I think we emanate different vibes. But then all analysts emanate different vibes. I don’t know 38 Interview I

how to describe it, but in sharing ideas it just works. Nobody is shy and nobody is overbearing. I am the one who is more likely to be overbearing but I don’t think I am. And I don’t think I get anything from them that says I am. LG: I will tell you the way you are describing this, and we are going to go into it later, this is not very different from how Psychoanalytic Inquiry is conducted. JL: Well you are there. You know. LG: Very similar. I can tell you this, when you don’t like an idea, it doesn’t go. I have seen it disappear in the air. We will talk about that more later. JL: No. I wait till the right variance. You can’t be a leader and not lead some. I mean a leader has to lead or else nothing gets done. But the fi rst leadership battle to begin Psych Inquiry was a real battle. LG: You want to go there? JL: Okay. Serendipity. I am invited to Detroit, Michigan to give a paper and the Program Chairman is Mel Bornstein. So I give my paper and I leave and that is the end of that. And I think I had some battles with their classical people. I get a telephone call from Mel. I can still literally picture sitting at the desk in the kitchen and Mel says, “We have gotten a contract to have a journal and we don’t know how to do it and we are having a lot of trouble, and we need an Editor-in-Chief. Will you be the Editor-in-Chief?” He said, “There are fi ve of us.” I said, “contract with whom?” “International Universities Press.” Okay. 4–5 people he tells me, never heard of them, or maybe I did hear of one or so. I said, “I have never been the Editor-in-Chief of any jour-

Downloaded by [New York University] at 04:57 12 August 2016 nal!” He said, “I know you can do it. Just think about it.” I said, “Okay, I will think about it but I have a lot of misgivings.” Charlotte was watching TV in the den and I decided I wouldn’t disturb her. So I came down to my offi ce, sat down behind that desk over there, took a piece of paper and wrote down 12 things that would make a journal. They were in the back of my head (I had no idea). I had never thought about it. But I wrote down a whole series of things about how I would go about it if I was the Editor-in-Chief of a journal. What would be my goal and what would be the whole way to organize it. I called him back and said, “Here are my ideas. If the group will do that I will do it. If the group doesn’t want to do that, no problem with me. I have nothing invested in Interview I 39

this game.” He said, “Come out to Michigan and tell us.” I fl ew out and we had a meeting in the airport and I presented my ideas. One by one they argued. “Oh, we have to have book reviews.” “No, we are not going to have book reviews; they take up a lot of time, a lot of space. Since we are going to discuss topics in each issue, that is the equivalent of a book review, that’s what you get out of a book review. This is going to be that kind of journal. We don’t need book reviews.” “Okay. I want a broad perspective board.” “Well, we have so and so and so and so and so and so.” “I don’t want them, they are all one group. I want to have a variety of perspectives. We will cover every issue from every standpoint. As editors we don’t agree or disagree, we cover the topic from every standpoint. And in order to have the readers understand something, you have to take them by the hand and lead them right through. So we have a prologue.” And I went through the whole thing. Everything you see in Psych Inquiry today was in my concept list. And they bought it, I guess out of desperation or whatever. The man who wanted the book review said I don’t want to play, so he disappeared. And so on. It ended up with Mel and me. And then we went to work. And then IUP took the money for subscriptions and only published two of the four promised issues. We were rescued by Lawrence Erlbaum who essentially lent us $33,000. That is how we got started. It was total serendipity. Out of the absolute blue. So I ended up being Editor-in-Chief of a journal which normally you are for two years, fi ve years, ten years … this is what … thirty years? Since 1980. SH: Well, it is interesting hearing the list that you came up with because it was so different from the way most journals were organized. JL: And the fi ghts, the fi ghts, the ghts.fi Not with the group. The fi ght was with people who said, “You know you are doing a terrible thing. You know that there are not that many good papers, you will be taking good papers away. You could be publishing papers that will be harmful to psychoanalysis.

Downloaded by [New York University] at 04:57 12 August 2016 They are not going to be scrutinized by an established organization like the American and the International. Many people are very unhappy about this.” The usual – you’re gonna get into trouble. You’re gonna get into trouble! I’ve been hearing that forever. SH: Did that affect your … JL: Within a very short time everybody wanted to write for us. So, so much for that. Did it affect my position or power? Who knows. There was nothing I wanted that anyone could take away from me. I mean I was already on 40 Interview I

the program committee. I was already well respected on the program committee. My ideas were always listened to. I don’t think the threats amounted to anything. And certainly if I wanted to submit a paper to one of the other journals nobody was going to not accept my paper if it was worthy of publication. Downloaded by [New York University] at 04:57 12 August 2016 2

INTERVIEW II Saturday Morning, April 17, 2010

Home Office, Bethesda, Maryland

LG: Do you leave a few minutes in between your patients? JL: Absolutely. LG: How much time do you leave? JL: I start at 7:45 am and end at 8:30 am. Start again at 8:45 am. Fifteen minutes after the fi rst one. I want to give myself bathroom time, recovery time after the fi rst one. Then that takes me up to 9:30. Then a ten-minute break. Then the 9:40 one. Then 9:40 to 10:25 – then I only take a fi ve-minute break because I’d rather have the extra time at lunch. Then the next one is a fi ve-minute break. Finish at 12:05 pm. Then I start again at 1:40 pm. I have given myself essentially an hour and thirty-fi ve minutes. I can clear the computer, the emails out, the phone calls I need to make, take a nap if I need Downloaded by [New York University] at 04:57 12 August 2016 to. I am very fortunate. I can sleep for two minutes. I can just lie down for a fi ve-minute interval and sleep, feel restored, and I am fi ne. Then I do ve fi more hours in the afternoon and fi nish at 6:05. LG: How do you feel about working from home as opposed to your offi ce in Washington? JL: I love working from home. But in terms of having to turn people away who would have been happy to come to Du Pont Circle on the metro … so it certainly makes a difference in getting patients. But it [working from home] 42 Interview II

is like giving me two hours every work day. A certain number of patients said they wouldn’t come. And then a certain number who said they wouldn’t come, did. It also is true that my practice is a bit skewed in that I supervise people all over the country. I am doing a lot of supervision over the phone, so it doesn’t matter where I am as far as that goes. LG: Do you do Skype sessions? JL: No. I have the thing but nobody has pressed on it and I’d just as soon not. I don’t need it.1 LG: But when you have a phone session with a patient … I will tell you the difference between a phone session and a Skype session is amazing! JL: What is it? LG: I have this patient. It was phone for a while and then it became Skype. He does not even get dressed for the sessions. He is in a tropical zone and he doesn’t even have a shirt on. I would never know that on a phone. Or I would never see the condition of the house that he lives in. I wouldn’t know that. Or I wouldn’t see how often he lights up a cigarette. I wouldn’t hear it. I wouldn’t know it. But I can see what is going on., the non-verbal stuff, very, very clearly. I can see when he gets irritated and disturbed with an interpretation, or is just in an irritated mood even before the session begins. You can see so many things. JL: How about the distortion? LG: It is not that bad. Now sometimes it can freeze up – especially if it is international – so one computer freezes. Then one person can only see the other Downloaded by [New York University] at 04:57 12 August 2016 person. JL: But the sound is working? LG: The sound is fi ne! The sound is good. You know what’s really good. Privacy is better with Skype because there is no record of this phone call, whereas in a phone call it can be tapped. SH: I used to speak to somebody in China. He was concerned … he would talk … but that was a concern because everything is tapped. Interview II 43

JL: Well if somebody asks to do it, I would be perfectly willing to try it. So far nobody has been pressed to do it. I love this place [home offi ce] as far as the setup. I am very comfortable and I am not dealing with crazy people down in the lower level of the offi ce building and all of the craziness. If I have snow to deal with, I’ll deal with it. I don’t have to wait on other people. It gives me more control over the environment. LG: You [to SH] of course work from your home. I have shifted a bit where I do more of my writing and my Skype sessions from home. I must tell you I love being home and I love being home when no one is home. When do you get your home to yourself? Sometimes it is a wonderful feeling. Also just walking around in whatever clothes you want to walk around in as opposed to how you feel you have to put yourself together in a certain way for your patients. SH: That is also interesting when people do phone sessions. Where they speak … for example, if they are upstate. Things shift a little at times when I have talked to people in a less formal, a different location. It shifts and what a difference it makes. I grew up talking on the phone and I tend to be sensitive to the different shifts in the way … JL: I know that my patient – in the book she is called Veronica – spent a year in Germany in about the third year of her treatment. She never missed a call. She called me every hour on schedule and now she is again having to move around, and she manages to get a call in when needed. So we work on the phone or she comes. An interesting variable in treatment outcomes is when I look back, I can see that I have had a signifi cant number of women who have come as single women and who have ended up marrying and having children. And I have also had what I consider a small number of patients that got divorced. I have Downloaded by [New York University] at 04:57 12 August 2016 felt that for the ones who did, it was sensible. It has been rare. One was an heiress who was married to someone who clearly was exploiting her, and it made sense for her to get out of that. I think that there is an infl uence that analysts have based on our cultural values that we are conveying without knowing we are. I think we think we are more neutral in value transmission than we are. Now when it comes to gross things like don’t pound your kid, we know where we stand. But in the more subtle values, I think we are very often conveying directives that we may not mean to be explicitly transmitting. SH: I think that is true that there is an infl uence of values that gets transmitted by us. That you can’t just completely empty yourself. 44 Interview II

JL: John Gedo and I wrote a paper together – I don’t know if we wrote the paper together or just talked about it – on the transmission of value judgments. Way back. We were essentially saying that analysts have value judgments and that they are there and that making believe they are not there is make-believe. This was when he wrote his fi rst book, Beyond Interpretation . I became very good friends with John for a long time. LG: Joe, we want to go back to some questions about your specifi c experiences with your three different analysts. We had a whole bunch of questions about Helen Arthur. I think the reason why we have these questions is we have the feeling that she was so very important to you. JL: Uh-huh. LG: Let me start again by saying if there is anything you feel you do not want to discuss … JL: I can’t think of anything I do not want to discuss. LG: First, going back to your relationship with Ping. We understand that Ping died after his wife died, but we want to know a little about the fi nal phase of your relationship with Ping and how that led to the decision you and Charlotte made to adopt his children. JL: Well, we did not agree entirely. Charlotte sensibly pictured all the problems and I just pictured that you do it. And also since I don’t dump all the work on Charlotte, whatever work was going to be required, I was up to contributing. So I didn’t even think about whatever work. Charlotte also thought that our children were leaving and she was looking forward to not having

Downloaded by [New York University] at 04:57 12 August 2016 children to care for. So she was hesitant until one day Ann said, “Mother, you can’t not do this,” and Charlotte said, “No, I can’t.” Especially after William walked in … So that was that. And once she said yes, that was the end of it. It was all aboard. And when William came, she set some perfectly sensible and good limits. Not that there was any problem setting limits with William – a wonderful person. They are about as productive, competent, wonderful human beings as you will fi nd anywhere. They are very superior human beings, as parents, as professionals. I mean you don’t get much better than Harvard cum laude, Yale M.D., Ph.D. for William and Maryland who has an M.D. from Hopkins and is Director of inpatient psychiatry research at NIH. Interview II 45

LG: Now I think we have the answer to this question, but you said before that you knew Helen Arthur’s husband. Did you tell us before that he called you and said that she was sick? And did he also call you and tell you that she had died? JL: That’s right. He made the call. The “who” called me was so unimportant to me at the moment … I knew him from Spring Grove. He was a psychiatrist there. So it would be natural for him to call me. LG: You certainly indicated when you went into treatment with Loewald that he could not offer you the space in the treatment process to really mourn the loss of your fi rst analyst, but what reactions and grief did you experience regarding the death of Helen Arthur? JL: Well, I was very shook. I was astounded at fi rst. Two weeks before, I am there and she looks fi ne and she seemed to be thriving through the pregnancy. We were going to have to stop. She was going to have her baby. I was going to have to leave her and go to a training analyst. We were planning to end. Let me just give you one tiny example of Helen. I am in the waiting room and she comes into the waiting room and says, “Do you have any money? I have a child in there and he is without any money and no one is coming to pick him up so I have to send him home in a cab and I don’t have any small money. Do you have any money I can use for the cab?” “Sure.” I handed her the money and she said, “thank you.” Now that was so atypical and so human and so straightforward. No baloney about it. No now we are going to have to analyze the meaning about it. Just entirely sensible, appropriate, human. To me that was an example of a human being who happens to be a psychoanalyst who happens to be dealing with a human being who happens to be an adult patient.

Downloaded by [New York University] at 04:57 12 August 2016 LG: Absolutely. JL: When you sat in Loewald’s waiting room, along with all the chairs for the fi ve people or so in the offi ce, the secretary was like a spy. If you did anything, you got reported. I was standing by her thing … she called me over … and I looked down (I am a compulsive reader. If there is written material I will read it. Wherever it is … if it is on a can, I will read it) and there was a paper by Sam Novey there and I said: “Gee that is interesting. I wonder if Dr. Novey might have a copy. I would love to read it.” It got reported that I was nosy, intrusive, and sneaky or some such damn thing. 46 Interview II

LG: How horrible. JL: It was crazy! If I was Sam Novey I would think that is a compliment that someone found something interesting and wants to read it … I might say no you can’t read it, I don’t let things out until I publish them or something. Then I had to analyze. Crazy-making. LG: It is. It really is. JL: My initial interview for analytic training was another strange experience. I am in the same waiting room. I am applying to be a candidate. A senior analyst comes into the waiting room and gestures me into his offi ce. So I get up and I go in and he stands there and I stand there looking at chairs. No indication where to sit, what to do. So I pick a chair and I sit down. He sits in the other chair and he stares at me. My fi rst thought is does he think I am a patient who is coming to start analysis or what? So I don’t know. I fi gure maybe he wants to know something about me. I better tell him something. So I start to talk. I tell him I am here as a candidate to apply to the Institute … And I stop. Nothing. So I rev up again and tell him more. If he wants to say I am anxious he would be correct. I think any other human being would be. Finally I stop and he sits there. I say, “Is there more?” “Nothing.” So I said, “okay” and left. That was my interview. Okay [laughing]. So this is some of the background. Helen Arthur was none of that … the contrast was just striking. I don’t know that she was super warm. She was just sensible. It seemed to me appropriate. It was business-like but it was appropriate. Not this other madness. Loewald was also in the “liberal” wing of the Baltimore Institute. That was part of the reason I chose him. He writes like a total liberal. The writing is quoted now by all the relationalists … [who] revere him. And I don’t quibble about the writing. Downloaded by [New York University] at 04:57 12 August 2016 SH: And you read some of the … that is what drew you to him? JL: Oh yes. And he knew that. LG: You mentioned before that that was a very diffi cult time in your life because not only did she die, but your grandfather died. How did you deal with those losses given that you had an analyst who was diminishing the Interview II 47

importance, certainly of Helen Arthur? Did he deal with your grandfather in a similar way? JL: I don’t remember that specifi cally. My way of responding was … if I can’t get it, forget it. Don’t keep sucking a dry straw. I did not need him to mourn. I did not need him to know that my grandfather meant a lot to me. So if I didn’t get any help there, forget it. SH: Was your grandfather ill for a while, Joe? JL: My grandfather was only ill shortly before his death. When my grandfather was taken to the hospital I went in and I could see that they were wrecking his veins. So I drew the bloods and looked after him in his fi nal time. It was fi ne. It was a hospital death. SH: What did he die of? JL: He was 85. General cardiac failure. My grandmother had died of cancer, and that was a family trauma. Not so much a trauma to me. LG: How so? JL: Well, she was the boss. My mother was very dependent on her so it was really upsetting to my mother. She died in the same hospital I was in when I was 13. I had appendicitis when she died in the hospital. Therefore I was not actively involved with her death. I was recovering from my appendix operation. SH: She was ailing for a time? Downloaded by [New York University] at 04:57 12 August 2016 JL: Yes. She had the recurrence of cancer, getting thinner and thinner. I had a lot of respect for her. She was a bright woman and she did good things. She helped my grandfather become rich. She worked with him and then made the decision that they would sell the business and move back to Baltimore. He opened a dry goods store in Gettysburg, Pennsylvania. And my grandfather was an inspirational man in the sense that he was a very early-on entrepreneur. I am putting together stories now. This is my integration. My grandfather came from a well-to-do family outside of Riga. His father was the Czar’s import/export grain merchant. So they were well-to-do. They were 48 Interview II

a Jewish family, but from a totally German culture. They spoke German, not Russian, or Latvian. But still they were subject to the Czar’s army. My grandfather was a child of his father’s second marriage. So older brothers were already planted in the United States. He came and nobody gave him much help. He had to carry a pack on his back to sell. He did that one time and said, “I don’t want to live like this.” He said, “I want to live like those who have stores.” So he somehow got the Baltimore Bargain House – Jacob Epstein – to give him goods on credit. He opened a store in Gettysburg. Then he decided – this is what I think makes my grandfather unique – if all things are equal, why would anyone come to him? Why would they come to a Jew in Gettysburg, Pennsylvania? They know all the other storekeepers. They are the locals. He has got to do something else. Or why get a store in Pennsylvania when there are all these little towns. Pennsylvania has tourists, they have a battlefi eld. So okay, that is an extra. Well, people are coming in with their wagons and so forth from all over the country. He will put up a billboard – Come to the Davis Emporium! He was early into advertising. He hired men with billboards to wander through town: “Sale at Davis Emporium.” What is happening? Electrifi cation. He invests in that. Railroads. Anything that seems like progress. The future. He and my grandmother sort of worked this thing out. Then at some point my grandmother, around 1900 or so, said “Enough. We are rich enough. I don’t want to do this anymore. We are going back to Baltimore and I am going to Hopkins.” She attended lecture classes by the great medical professors as an auditor. She did that for a year or two. She knew she could not become a doctor so then she developed another interest, the ecumenical movement. This was when I was fi ve. So my house was the only house that I knew with priests and ministers and rabbis. She would hold meetings to promote ecumenical philosophy. She was an interesting, enterprising woman. I admired her, but I did not like her dictatorial ways. The other thing. We would go into a fancy restaurant. The place would be fi lled and people would look at the Jews coming in. The maître’d would come over to my grandfather and say, “Well, there is a table …” and my grandmother would say, “I don’t want that table. I see a table right here. Downloaded by [New York University] at 04:57 12 August 2016 Max, would you help this man out to get this?” My grandfather reaches into his pocket and out comes some money. And he says, “Madam, that table.” And my grandmother commanded. We got that table. SH: What a great story. JL: I can also tell you grandfather stories. We summered in Atlantic City. At the Ritz Carlton or the one that was next to it. We would take a suite and my mother and my aunt and I would go there and my grandfather would come Interview II 49

down on the weekend and I would so look forward to his coming down on the weekend. There he was with his straw hat and nicely dressed. He was a short man because he had had something wrong with his legs when he was a child. He had a big chest. There he was with his straw hat and his cane and we would walk down the boardwalk. Let’s say I’m maybe 5–6 years old. He would say, “Joe, where do you want to go today?” Now this was a ritual. I knew the game. I would say, “I don’t know Pop-Pop, where do you want to go today?” He would say, “No, no, no. This is your day. You choose.” I would say, “I want to go to the Steel Pier and see the horse jump off.” Steel Pier was an amusement pier with fabulous stuff. The big attraction was a horse would come out on about the third fl oor level. He would walk out on a platform blindfolded and jump off into a pool. And they would do that every day. And that is where I would want to go. And we would look at the sign board that showed all the shows and decide which one to go to. And people like Bob Hope were there. All the great vaudeville stars were there. So that was one day and it was wonderful. Next day. “Where do you want to go? It’s your day Pop-Pop.” “Well, I don’t know. Let’s walk down and see.” Well, I knew what that meant. So we walked down to the burlesque house to see who was performing. Who was doing the strip tease did not matter one bit to me, but who was doing the vaudeville routine did. So we would go there and we would sit in a box and we would be watching and I would mimic all the burlesque routines because by then I knew them. We had this wonderful sort of pal sharing in which we knew all the little nuances. I would at one point be sassing my grandmother or my mother and getting upset and my grandfather would look at me and say, “eeehhhhh,” meaning it’s not worth it … peace, peace. LG: He fi gured out ways to do what he needed to do. JL: Oh, he was not curtailed. When he was 80 years old, my mother and my stepfather said, “You cannot run your business anymore. You cannot keep

Downloaded by [New York University] at 04:57 12 August 2016 records. Tax people are on our back. We are going to get into trouble. You cannot run the business anymore.” So he got an allowance and he took his allowance and got on the trolley and went to South Baltimore where he would get in with the group called “the forty thieves” who bought and sold properties. He would buy his share in or out and then sell it and then take profi ts. Sometimes he would be stuck and he would have to come home and tell my mother which he did not like to do and then get the money to bail himself out. What he was doing he was doing. Charlotte was then a social worker and giving people money for rent which we were collecting because we owned 75 properties. My grandfather unbeknownst 50 Interview II

to any of us opened three accounts. One for my aunt, one for my mother, and one for me. He told us when he was just about 85, he separately told us, “You know, I have a savings account book, it’s hidden in this particular place and it’s in your name and my name.” He told my aunt, my mother, and me that. And then he died not too long after. We each went and found our books and we conferred with each other that we had these books. In one book was $5,050, in another $5,080, in the other $5,100. He had gotten to the $5,000 in each of the books and decided that was enough. So each of us had a little something for our own personal needs when he died, besides what he left. So that was my grandfather, a very dear man. LG: When you think of your analytic experience with Helen Arthur, was there anything about that analytic experience that has impacted on your sense of yourself as an analyst? JL: That someone who can be quiet, and listen, and gives space, and then par- ticipates – in that order – can do analytic work. LG: That’s really very nice. Do you think that you do these things in your work? JL: I try. I counsel others to do it. LG: Now this question is one that – speaking of inference and levels of inference – when Sandy and I were thinking about what we knew about you (which of course you have fi lled in considerably), we wondered if there is any connection between her pregnancy, the loss of her baby in pregnancy and her death, and your interest in infant observation later on? JL: I don’t think so. I don’t think I ever cathected her lost baby. SH: Downloaded by [New York University] at 04:57 12 August 2016 How far along was she in the pregnancy? JL: I think entering the last trimester … I would think my being an only child could be a remote factor. SH: As an only child, did you have an imaginary companion? JL: Not that I specifi cally remember. More imaginings from books. I read Bible stories and I had this wonderful book of illustrated Bible stories and so Interview II 51

I knew them all. The models of friendship were taken out of Bible stories and so book characters would have been my companions. I did not have to make up my own imaginary companions; book stories provided me with a great deal of imaginary companions. I think it is more that. SH: Did you have a favorite one, or one that particularly appealed to you of the stories? JL: Well, it was easy for me to identify with Joseph and his story. Certainly David which is my middle name – David and Goliath’s story. Was it Jonathan and David, there was a pair of best friends … all the stories were very alive for me. They were very easy for me to sink into and to play out in my mind and David playing the lyre and comforted Solomon … these things were all very much a place that I lived. I don’t remember any of the kind of child books that people have now, because I don’t think I had them. You know, Good Night Moon which we raised our kids with or Dr. Seuss books. They didn’t exist that I recall. It was really more the illustrated Bible stories that were … I did remember something that I thought of telling you about, because I had not thought about it in years. When I was fi ve, I was sent to Park School Kindergarten. That was where the German Jewish kids went. It was out in the country … and we were bused out there. While we were relatively well-to-do, some of these were really rich kids but all came from established families. All I remember about it was that I didn’t much like the bus ride with the older kids because they weren’t always very friendly (some were). But I did love the school. What I loved was they had wonderful construction toys and I remember looking at those construction toys and thinking, “Oh I know what can be made with this,” and so having an idea of what to do with this, I started saying to the other kids, “Let’s do this and let’s do that.” So I was construction contractor! [laughs]. Thinking up ideas and things to do. It just happened. And these kids were willing to go along with the ideas so I was doing that.

Downloaded by [New York University] at 04:57 12 August 2016 Larry Friedman said once, “You are somebody who sees the world as it is and decides on how you want to make it.” I have done that with the journal. Now other journals mimic Psych Inquiry . I don’t like the institutes the way they are constituted. I think up another institute and we have it. That was when that started I think, when I was fi ve years old. And I can get other people to do it. I could get Ernie and Jay Bisgyer to come along with me in our little private medical school venture. LG: How long did that last, that medical school venture? 52 Interview II

JL: Certainly for the fi rst two years. After that we went into the clinical years. So it didn’t make sense. SH: Who did you play with in those fi rst fi ve years? Who were the adults and children who were your playmates? JL: I remember occasionally being taken to play with the children of family friends who lived in a beautiful house in the country and I would be with Malcolm and his sister. There were two older boys who lived a couple of doors up the street whose father was a pediatrician. They didn’t want to go with their father so he would ask me if I would like to go on rounds with him. I would get in the car and I would go on rounds with him. But I didn’t really have any standard kid friends until later when I played football and baseball in the neighborhood. Then I had lots of kids to play with in organized games. But as a little kid … the fi rst three years I had my own baby nurse. Then she left. I don’t remember her name, I just remember that she was there and she was fi ne. From three to seven I had Sarah, an older woman who was very dear and very devoted. From seven until after I was married we had Etta who was both maid and looked after me. This is a telling story. Etta came when I was seven. By this time the depression had hit and so we were no longer that rich. We were down to one servant. Before that we had a house man and a cook and servants. So now we had one servant, and Etta came, and Etta was there. Etta was my buddy. Etta would stand there and make me cinnamon toast – like ten pieces if I wanted! So Charlotte and I are getting married and we are going to live in this fourth fl oor walkup apartment and my mother comes to me one day and says, “What did you tell Etta?” “What do you mean? I didn’t tell Etta anything!” Well my mother was very good on mythic stories, making up whatever seemed convenient for the moment. My mother says, “Etta tells me she’s leaving.” So I go to Etta and I say, “Etta, what did you tell my mother?” “Well, Mister Joseph, I told your mother I was leaving. I raised

Downloaded by [New York University] at 04:57 12 August 2016 you, I’s goin’ with you.” “What?” She said, “That’s right. I told her I’s goin with you.” So there I am in a fourth fl oor walkup apartment with a wife and Etta, who comes in every day. So Charlotte says, “This is ridiculous.” So she got Etta to work for her mother who lives a few blocks away. Etta would come back in the afternoon when Charlotte came back from work as a social worker and Etta would put a tray out for Charlotte. She would say to me, “Mr. Joseph, I don’t like that. Your wife should not be working.” This was a social embarrassment for her. This was Baltimore, the South. This was devotion. I had no shortage of people kind, caring, and devoted. Interview II 53

LG: Joe, you mentioned a stepfather. Did your mother remarry? JL: When my grandmother died, I was 13 and my mother remarried and my father remarried. It was as if the superego had suddenly been lifted off both of them [laughs]. LG: Were these marriages that remained? JL: Oh yes. LG: So you had a new stepmother. JL: I never counted her as a stepmother. She never got into that category for me. LG: What category? JL: My father’s wife. And I never also called my mother’s husband my stepfather either. He was a very decent man and we generally got along well. LG: With Hans Loewald, that is when you were in training, did he get selected for you, or did you select him? JL: I selected him. We were not forced to … LG: And Sandy had asked you if you had read some of his works beforehand. JL: I am not sure I knew where he stood on a number of theoretical matters. Downloaded by [New York University] at 04:57 12 August 2016 LG: How long did this analysis last? JL: Three years. LG: Now you pretty much said that you learned a lot from him about what not to do. Was there anything positive about him as an analyst? 54 Interview II

JL: I am sure that interpretations he gave me about associations, dreams, or reconstructions were probably accurate and helpful. I am sure that some of the things that he offered came across as sensible and useful. It would be hard to believe that I would stay there for that length of time if it were not so. LG: Now let’s turn to some more general questions about psychoanalysis. What do you think the analysand needs to achieve for the psychoanalysis to be completed? JL: Some very personal goals that are very particular to that person and that make general sense as goals. I do not consider understanding in the abstract to be the goal of analysis. I believe understanding is one of the vehicles for more personally meaningful goals. LG: So the way you look at it, you would have to take this question and answer it individually for each person. JL: For each person. Yes. Abstract comments like resolving the transference, hold no particular useful meaning to me. And I don’t think people have to “complete analysis.” I think people have to get out of the treatment what they hope to have gotten out of it and if that includes that they want to maintain some degree of contact with me, and that that would be useful to do, that’s fi ne. LG: Again, on a very individual basis. JL: On a very individual basis. LG: What about a patient who goes from analyst to analyst (not because of some of the circumstances you described yourself) but somehow does not feel Downloaded by [New York University] at 04:57 12 August 2016 that he or she can complete the goals of an analysis with one analyst. What thoughts have you about that? JL: Again, I would have to say it is highly individual. Almost all of us have had patients who come to us from other people, and almost all of us have had patients who leave us and go to someone else. Now I think every instance is a separate instance and it may be that the person has gotten all they could get out of the one, or it may be that things didn’t go well with the one, or it may be that the person is shopping and is looking for some sort of perfection that they are never going to fi nd. I hold it as a very individual thing. Interview II 55

But I also think that there can be very specifi c reasons. Jenny Waelder-Hall treated a man, a judge, for a long time and worked with him in a very helpful and very meaningful way. She helped this man to achieve a certain area of his goals very well. Then she concluded that he needed a man to work with since he needed to work out issues with his father and needed a man to do that. He came to me and he was a very good patient. He was well trained [laugh]. We worked along and what I discovered is that he needed to work out his issues with his grandmother as well as his father! And we did that very well. So there are going to be sectors that one analyst can deal with very well, other sectors that they can miss … I think again, there is no generic answer to that question. Take it individually, one at a time, and see what the issues are for this person. SH: What are your views regarding the importance of the analyst’s gender? JL: First of all, I think that a polarized male/female concept of gender is inaccurate. As Adrienne Harris says, gender is a soft assembly. I am very comfortable as a masculine person with what a lot of other people might call feminine traits. As far as holding babies, playing with babies, I like it, I have no problem with it. Doing household chores isn’t an issue with me. I think that there may be analysts that might fi nd it very hard to be empathic with some gender issues. I wrote in the Sensuality and Sexuality book about some of my “eeww” factors around certain sexual things that had come up in the course of years and years of treatment where I had an initial “I don’t want to go there, or I don’t like that behavior,” and where I had to deal with it nevertheless. One example is a gay man who did extremely well. He had an early dream in which there were certain associations that clearly pointed to me and the person in the dream was identifi ed as a fi st-fucker. I could not easily put myself in that position of someone who would want to ram his fi st up somebody’s anus, whether calling that loving, or affectionate, or sexual, or anything of the sort. Well, it was toward the end of the treatment where he was open to bringing up his doubts about me and my feelings about a

Downloaded by [New York University] at 04:57 12 August 2016 gay man. That opened up an area of our relationship that had not come up before. I could then get to my biases, and that’s what he was referring to in the dream. Everybody is going to have some biases. Take the idea that you don’t sleep with your children. Well, a lot of people in this world sleep with their children. The question is what about this child sleeping with this parent who fi nds it totally compatible and comfortable? What about this child who sleeps with a parent in this culture that says it’s horrible? Who determines if it is overstimulating as the theory has been interpreted to say? Is it the culture that determines the value? I ask what are the factors, what are the infl uences, what is the evidence? That is the way I feel about a lot of issues including this gender question. 56 Interview II

LG: Have an open mind to it. JL: Yes, but knowing that, I bring biases. I am open-minded enough to question my non-open mindedness. When I can recognize it. When a patient pushes it so I have to recognize it. Otherwise it will go right on by. If this patient didn’t have that dream and if I didn’t keep it in the back of my mind as an unsolved puzzle … When there is something I don’t understand, I can’t let it go. It stays in my mind. It is like a splinter. It is there and until I can sense it and make sense of it, I don’t let it go. And I think some of my best understandings and most innovative ideas have come from some issue that has puzzled me and bugged me. I asked myself how can it be that one group of analysts who are into psychosomatic medicine, eating disorders, and body regulation argue that’s the core of analysis? And other analysts say “sexuality,” that’s the core. And others, mastery, or aggression, or fi ght or ight.fl Many point to attachment as the core. I know that all of these theorists are seeing something important. But how to put it all together? That’s the puzzle that motivational systems theory was based on. How to resolve questions to which I don’t like any of the other resolutions. So if a patient has a dream and something is in it and I don’t understand it, I want to understand it. If I feel like there is some enactment going on and I don’t understand it, I am going to keep it in my head until it makes sense to me. Until I can fi gure out what sense it makes. LG: Now obviously you are a role model for the patient in that. Because the patient is going to pick up that you are persistent, that you must understand something. Now how do you think that impacts the patient? JL: Well, I don’t push it. I invite. Because I don’t want to be pushed. And I am much more responsive to an invitation. And I figure that if I convey to someone – there is something about this issue with your brother Downloaded by [New York University] at 04:57 12 August 2016 that has played out in some form that leads to your wanting nothing to do with him. Yet at the same time you are having a homosexual love affair with your roommate in college. There is something here that has to do with some aspect of this relationship. I don’t know what it is. Nothing you have told me makes it clear to me. At some point it would be helpful if we really could see what this might mean. And then let him alone. I have created the structure, explained my thinking, and offered him that. To which his initial reaction was I don’t want to think about my brother. I have put him out of my mind, and I am married now and I don’t want to think about my homosexual relationship in college. Okay. Let that be. And keep an open mind. Interview II 57

LG: How about this, Joe? How much explicit attention in analysis should there be to the skills that a patient needs to continue the analytic work by him or herself? You pride yourself on doing a self-analysis. Do you expect your patients to continue the treatment by doing a self-analysis? If you do think that is an important goal to work on, how do you help them achieve that prior to termination? JL: Okay. The fi rst part of that makes the second part easier. I don’t put expecting patients to do self-analysis up very high. I think there are people whose turn of mind will keep them asking questions away from sessions. I think there are people whose turn of mind will say if it isn’t of practical necessity, I’m not going there. It’s not instrumental to my way of being except when something comes up and I need to think about it, I will think about it. But in general I am not interested in keeping on some introspection that I don’t need, but if I need it, I can go there. And I believe that puzzling over issues will go on implicitly because they can’t stop it. And I believe if it is going to go on implicitly and they can’t stop it, I don’t feel like I have to do anything more. And that’s my answer. Maybe other people would disagree with me strongly. That’s my take. LG: So you don’t feel that there is any additional work that needs to be done in terms of skills. So what you are doing during the course of analysis is suffi cient. JL: Yes. My whole orientation toward a spirit of inquiry is the answer to that. That is the skill. It is not a skill, it is an orientation. It is a way of being. LG: Is there anything from any of your analytic experiences that had such a profound impact on you that you have kept it going for yourself, not only in your work with your patients, but in training analysis and in supervision? JL: Downloaded by [New York University] at 04:57 12 August 2016 Nothing that immediately comes to my mind. LG: Do you feel that there is something that you would want to say about how any of your analytic experiences have impacted on your writing? JL: Only in this sense – I see a reverberation between what I can say to a patient, what I want to say to a patient, what I feel is useful, and the conceptual ways of expressing ideas that I want to write about. So that I want to write in forms that would allow me and the reader to be able to use what I write clinically without having to translate it into ordinary language. 58 Interview II

SH: So you don’t have to shift to theoretical language. JL: I would never say superego to a patient. So that is why I can talk to a patient about physiological regulation, or spell out to a patient the physiological regulation of your eating, something like that, using a word like that. Or attachment. Attachment is a perfectly reasonable word. Or exploration … is a perfectly reasonable word. Or preferences, is a perfectly reasonable word. Or aversiveness, or antagonism, or withdrawal, or sensuality, or sexuality. Or caregiving, or affi liation. These are all ordinary words that I can say to a patient. I can also say to somebody I am teaching, that there is a system that is organized to deal with affi liation, and that it starts very early within the family. And that the experience of a group is different than the experience of a dyad. To try and use words like that that are just ordinary language. That has been my consistent effort in my writing. LG: All of the analysts that you had are no longer alive. If they were alive and they could look at you now – your achievements, your personal life … do you hear any conversations in your head about what they might say about you? Any one in particular? JL: Never thought about it at all. If I thought about it right now, I would assume Helen Arthur would be quite pleased with having had as a very young man an analysand who made contributions to the fi eld. She would be very pleased. I don’t know what Loewald would think. I will tell another story that is maybe in answer to this. About a year or two after the end of the analysis – or the interruption of the analysis, which is what he called it – I was in Philadelphia at a meeting and I was in a room at an art gallery, maybe half again the size of this room. There were paintings all around. There were no other human beings in the room. I was standing in the middle of the room looking at a painting. You know when you can feel someone entering a room? Someone else entered the room and I looked over and it Downloaded by [New York University] at 04:57 12 August 2016 was Hans Loewald. I looked over to him and he was not looking at me at all. And I thought, oh someone standing in the room you don’t necessarily look at them. You look at the paintings. First thought was – I bet he doesn’t know who I am. Let me fi nd out. Maybe he is very short-sighted. So what I decided to do with malice aforethought was to stand in the middle of the room. He would have to go right by me. And he did [laughs]. He went right by me. Looked at the painting. Went out of the room. No recognition at all. Now I don’t think he would care to know what has befallen me, plus or minus. I don’t think he would want bad things to befall me. I don’t think he would be vengeful about my quitting him. When I did tell the audience what Interview II 59

he had said at the meeting in Washington, I did get a note from either his wife or him thanking me for telling the audience what he had said. So I don’t know what he would say. I think Russ Anderson would be very pleased and would feel that he had been helpful and that I had gotten somewhere with him, benefi tting from his helpfulness. That would be my take on their views. LG: Well Joe, is that enough for today? JL: That is enough for today. I think the thing ought to be the other way – have you had enough of me! LG: We said before to ourselves when you went upstairs, we are really enjoying this. You know, you are giving us, from your own point of view of course, a wonderful history of psychoanalysis. It is a wonderful experience for us. JL: Well, I have had a long stretch of knowing what has been going on and I also have known some of the major fi gures. I had the opportunity to do that. I guess part of the reason is, I am not intimidated. I’m neither intimidated by power nor am I intimidated by position. I play with ideas and I am not intimidated by other people when it comes to ideas. SH: I think it is a rare experience for us to be able to talk to someone in a way that is both so personal and touches on all the interfaces and the development of psychoanalytic thought. JL: I never knew Freud but I did meet Anna Freud. I knew Robert Waelder as a friend to talk to. I knew Jenny Waelder. I met Ännie Manchen. I knew the Katans. I knew the Bibrings a little bit. I never knew Franz Alexander. I knew Lucia Tower [one of the leading Chicago analysts], and Hanna Segal. I had a warm friendship with Joe Sandler and served on the Program Committee

Downloaded by [New York University] at 04:57 12 August 2016 of the American Psychoanalytic Association under Arnold Cooper, Paul DeWald, Sid Pulver, Glen Gabbard, and Harry Smith. So I knew all of these people in one fashion or another so there is that kind of history. I heard Jeanne Lampl-de Groot tell me about some of her experiences with Freud. It has been a career that stretches way back and that kind of feeling about history is the same as when I would talk to my grandfather about people who he had known during the Civil War. That was like connecting all the way back to the 1860s. I was telling him about Thomas Wolfe’s You Can’t Go Home Again and some of the characters and he said, “Oh I knew who that was!” So there is that feeling of stretching time which I think is interesting. 60 Interview II

SH: It is important for someone to take on the responsibility for the intergenera- tional transmission of knowledge and history, as you and your grandfather both have. JL: A last quick story. I was in Philadelphia – maybe at the same meeting as Loewald – Anna Freud was up on the podium with other signifi cant people. The meeting hadn’t started yet and I had to give a message to Joe Slap. So I had to go up to the front of the room, across, to get to him, and as I am crossing over right in front of the podium (they are all sitting on the podium and waiting for the meeting to start), Maurice Katan jumps up and says, “Joe, I want to talk to you about the paper you wrote about Freud. I do not agree with what you said and I think …” And I am thinking as he waves his fi nger in my face, shall I bite? What am I going to do? So I said, “Maurice. Stop. What you are telling me is so brilliant, so wonderful, I don’t want to lose a word of it and I can’t get it all now. Would you please write it to me so I will have all of it?” Whoosh. And he did. He wrote it. I wish I had kept it. You were to write about Freud what they wanted you to write about Freud. I wrote a couple of papers about Freud. One was about Freud’s papers on technique. And one was about Freud’s Leonardo, which is a lovely paper, the title of which is Freud’s Study of Leonardo: Biography and Autobiography of a Genius, in which I say Freud made errors about Leonardo, but he did know how a genius worked. And that is the Leonardo he made up to write the paper.

Note

1 Since this interview on April 17, 2010, Joe has begun to do sessions on Skype. Downloaded by [New York University] at 04:57 12 August 2016 3

INTERVIEW III Saturday Afternoon, April 17, 2010

Home Office, Bethesda, Maryland

JL: I was just thinking about one of the things I loved having the opportunity to do. I was invited to give a course at Hopkins. I taught not at the medical school, but at the university. I was asked to design any course I thought would be interesting for undergraduates, to be offered as an elective. So I designed a course on biographies written by psychoanalysts. The idea was that you could look at it from the standpoint of a particular writing genre called psychobiography, you could look at it from the standpoint of how creative products are used by analysts to either create theory or confi rm theory, or you could look at it simply as a way to regard writing biographies about creative people. That was the design for the course and I used Freud’s Leonardo, one of Bonaparte’s biographies. I used a whole series consisting of Buddy Myer’s study of Conrad, I think Weissman’s study of O’Neill and my own work on O’Neill. About eight undergraduate students, two graduate students, and three senior faculty signed up. Charlotte came. We had a class of wonderful people. They were there because they really wanted to be. They were brilliant. They Downloaded by [New York University] at 04:57 12 August 2016 were challenging. They wrote some wonderful papers at the end. That was just a delight, such a fun thing to have an opportunity to do. I have taught endless classes in institutes but this was something that I would love to do again. SH: What are your thoughts about being the subject of this biographical endeavor in contrast to being the teacher of such endeavors? What does that evoke in you? JL: I fi nd it awkward and embarrassing [laughing]. While I am perfectly convinced I have made a continuing contribution to the fi eld, whether that 62 Interview III

contribution is worthy of being selected as the focus of this is something I have to leave to other people to decide. With a question mark on my part. SH: In terms of moving towards the biographical, today we were going to focus on personal life. Baltimore. Personal development and life experiences. We want to focus fi rst on your marriage with Charlotte. Tell us how long you have been married, and about your experience being married. JL: When I came out of the Navy in 1946, I then went to medical school and I was essentially dating three different girls. One I had been dating for a long time and then Charlotte, and a third. I had known Charlotte from high school fraternity dances but she was “too young for me.” Actually Charlotte is two calendar years [younger], but when I was in college she was starting high school and it looked skewed. By the time I came out of the Navy she was at Goucher, and I had used up a few years bouncing around in the Pacifi c. I met her at one of the swim clubs and she needed a ride home. I drove her home and we started to date. A little group of my friends decided that we would go to Tanglewood for the music festival. So Charlotte and another young woman (who was dating and eventually married one of my best friends), and my best friend and another friend without a date went in his big car to Tanglewood. The fi ve of us went to Tanglewood and heard the Boston Symphony and some young person who was leading the student orchestra. While conducting, he moved in a dancelike rhythm capturing the music. He created an ambiance with the orchestra that was so dynamic, so crazy, so wild, that we were absolutely enthralled. That was Leonard Bernstein just starting out. So that was a very special occasion. In the meantime Charlotte had been quasi-engaged. Somewhere around that time we decided we loved each other, and were going to get married, and did. We got married in 1949 at Charlotte’s family home on a day that was 96 degrees. This was pre-air conditioning. We went on our honeymoon stopping in Philadelphia on the way to Cape Cod. I planned this wonderful stopover

Downloaded by [New York University] at 04:57 12 August 2016 in Philadelphia because I had been to Swarthmore. So I knew Philadelphia and I think it was the Bellevue Stratford that had a junior bridal suite, but no air conditioning. We were to go to Bookbinder’s for a lovely dinner. We canceled going out to dinner and ordered room service. Between making love and showers we managed our way through the night and the next day and took off for Provincetown. We spent a couple of glorious weeks in Provincetown and then went to Tanglewood. So we split the month between Provincetown and Tanglewood. We went a day early to Provincetown so our place was not ready on the night we arrived. They said they could accommo- date us in Moonbeam. Moonbeam was a tiny cabin on an old fi shing pier. The fi shing equipment was gone and one of these little shack-like places was Interview III 63

FIGURE 3.1 Joe and Charlotte on their honeymoon on Cape Cod, Moonbeam Cottage (June 1949)

Moonbeam. We are handed the bed linens and Charlotte is not happy. This was not her idea of a honeymoon [laughs] … I make the twin beds, squished the two beds together and we were off. The next day we had sunshine. We had driven there and arrived in a wild rainstorm. We had a terrible time fi nding the place. We loved Provincetown so much, we went back year after year for 40 years staying within a city block of the same place we began. When our kids had grown up, we bought a place in Annapolis and decided it was not worthwhile to go all the way to Cape Cod to do what we could comfortably do in Annapolis. But we did love Provincetown, the art scene,

Downloaded by [New York University] at 04:57 12 August 2016 the music scene, the sailing, the friends, the Cape Cod Symposia. SH: How long was it from the time you and Charlotte were married to the time you started your family? JL: That is another complicated story. Charlotte kept losing pregnancies. Today’s fertility treatments were non-existent then. I don’t know what we would have done if it was today. But what we decided to do was to adopt. So it was ten years later when we adopted Ann and we got Ann when she was fi ve days old. Three years later, we got Amy. We got Amy at three days old. FIGURE 3.2 Joe and Charlotte as young marrieds, 1949 Downloaded by [New York University] at 04:57 12 August 2016

FIGURE 3.3 Joe and Charlotte in 1958 Interview III 65

So we then adopted these two little girls and lived in a little community of Hopkins’ people, lawyers, professional people, where both girls went to public school. It was a very good public education. And again, each was very different as to how they took to school and how they took to learning. Ann turned out to have a learning disability which we just dealt with. It was very clear that Ann is beautiful. She was startlingly good-looking and people would just respond to her. They would respond to her in different ways. Some teachers responded to her, since she was not a quick learner, “a pretty little blonde, she won’t go anywhere.” Actually one high school teacher said that and Charlotte went over and dealt with it and got the head of the department to take Ann in and Ann went from failing to “A.” Ann was exquisitely sensitive to how people regarded her. Amy was just quick at everything, but not as persevering. You have all these different qualities. I am not studying my kids, but I am observing. I observe everything, so why am I not observing my own children? Then when we got the other two children, William at 13 and Maryland at 18, we added two more people with totally different personalities. I think the beautiful thing is that they are all one family. They are always in touch with one another. If any of them ever needed anything, the others would do it. And we have been able, as far as I know, and I think I do know, to make a satisfactory arrangement about all the sharing even down to the nature of the will, with these very understanding, very sensitive four people. SH: How did that evolve? That is pretty remarkable. I mean, were they friends beforehand? Did you have some guiding principles that helped you in creating this? JL: I don’t think so. I think they are really all good-natured people. They all like to laugh, they like to play. They are generally happy people. And they are dedicated people and they all are helping people. William is doing cancer research. His father died of cancer. Maryland is doing psychiatry. Her mother and father were psychiatrists. And Ann worked with learning disa-

Downloaded by [New York University] at 04:57 12 August 2016 bled kids, with her learning disability. Amy has worked for me and ICP&P. So they are all involved in one variation or the other of the family business. We have eight quite wonderful grandchildren who are all quite accomplished. Two are probably genius or close to it. And one grand dog. SH: What would you say about the co-parenting of you and Charlotte, how you worked out those elements? JL: With what I would say were the ordinary quantity of disagreements [laughing]. I mean, Ann was easy. Amy was more diffi cult. We didn’t have Maryland 66 Interview III

as a youngster so we don’t know. And William came at 13. I have absolute total admiration for Charlotte. Once she decided we would do it, she totally fl ipped around. She took William in hand. He said, “Where is the Coke?” She said, “We don’t have Coke.” He needed to lose weight. She structured life for him, and he molded right into it. He had not done much with athlet- ics so I started playing tennis and sailing with him. In his senior year, he was voted the most valuable player of the tennis team at Sidwell. Sailing. Loving it. We did all kinds of things and he went along with me. And I was very delighted to have a son. I could have lived my life if I hadn’t. I was delighted with my two daughters. But it was wonderful to have another daughter and a son. William clearly appreciated it. One of the most telling moments … one day we got up on Saturday morning and went and played tennis for an hour or so and then we got cleaned up and got in the car, in my convertible with the top down, and drove to Annapolis and got into our sailboat and sailed for half a day and then got back into the car to drive back home. As we are driving along in the car I looked at him and said, “You look very pensive. What are you thinking?” He said, “I am thinking that if my father had lived I would never have had this day.” I said, “You are absolutely right, William. If your father had lived, you wouldn’t have gone sailing with him, you wouldn’t have played tennis with him because he didn’t do either of those things. You would have had a wonderful father. But you wouldn’t have had this father. And you wouldn’t have had this day.” And the tears are streaming down both of our faces. He is capable of putting it all together … At any rate, the co-parenting was no more and no less than the usual amount of disagreements and sorting outs and so on. One thing that I think does help is that despite being very busy, I always came home for dinner. I always tended to the children. I was always there at bedtime. I mean unless I was away somewhere. But as a daily routine, I was always very involved in baby and child care. I liked doing baby and child care. It wasn’t like I was stuck with it. I was just as interested in looking after the children. We shared many tasks. I didn’t cook the meals. Charlotte cooked the meals. But as far as who puts to bed, or who reads the nighttime story, or who gets up with a crying baby or whatever, it was shared. I had no sense of this traditional men Downloaded by [New York University] at 04:57 12 August 2016 don’t do. It never made any sense to me. A person does what a person needs to do. And it’s not a gender thing. I mean some things have to be divided up. If I am working full time, Charlotte’s got to do something to keep the home and so on. But as far as with the children, it was mostly shared. SH: Were you involved with other kinds of household tasks? JL: I am just as inclined to pick up and do something as not. I am not the sort of person who just plops in the chair and expects the world to serve me even though in a sense I was raised that way. It is funny, I never thought that it Interview III 67

was owed to me that I had servants looking after me. I didn’t look down on them, that they were to serve me. They were just, I thought, wonderful people and we were all doing our thing in life. And the thing they were doing I could do too. It didn’t have a quality to me that it would lose my dignity if I did the things that they did. It didn’t seem to me … maybe a good dose of Uncle George and that was useful for that. But my grandfather did things in the kitchen.

SH: What did he do? JL: Well, because he had leg problems, he had been sent to Germany to be operated on. As a child with problems he was in the kitchen with his mother. And so he learned to cook. He could stuff a turkey better than anyone I know. He made the breadcrumbs and the chestnuts and he could make kreplach. The things he learned from his mother. He was perfectly happy to be in the kitchen. The nicest thing. One more story … When I was dating, I would come in at whatever hour, twelve, one. My house was the entertainment center: for my grandparents’ friends, for my mother’s friends, for my friends. A big townhouse where everyone could con- gregate, could always raid the icebox. It was always open. Warm and generous in that sense. And so there would be a party at my house and I would take my date home and get back at whatever hour and I would hear my grandfather paddling down the steps and he would say, “Joe?” “Yes.” “Be quiet so you don’t wake your mother.” And he would say, “Can I help you clean this up?” Meaning don’t leave a mess because we will both catch it. We men will catch it. So I said, “Sure, Pop.” So we would gather up the glasses and dishes and go in the kitchen at two in the morning. The two of us are cleaning the dishes and talking and he wanted to know who was here and who are you with. He liked to catch up on what I was doing as the two of us cleaned up the kitchen. I don’t think very many boys of my ilk had that opportunity. So that meant there wasn’t anything about washing dishes. You washed dishes. In all that sense, I was prepared to be a helping husband. I was not trained in Downloaded by [New York University] at 04:57 12 August 2016 a traditional sense. My grandfather was certainly not a tradition-bound man. SH: That’s a great story. I am going to move on to some other questions about your family. JL: The one person I have not told you about is my Aunt Minnie, my mother’s older sister. LG: How much older was she? 68 Interview III

JL: Between fi ve and eight years. SH: What is your mother’s name again? JL: My mother’s name was Hortense. My aunt’s name was Mindelle. My grandmother was a bit poetic. My Aunt Minnie was a very cultured woman. She played the piano beautifully. Oh, I have to say this. Music was a component of my life in that my cousin Meyer Davis was the orchestra leader of the band that played at all the presidential balls and debutante parties. Meyer Davis Orchestra was “the” orchestra. If you were rich, that was who you got. Meyer’s brother was a composer and their sister could also play. So every other week, the two Davis families met in Baltimore or in Washington, my grandfather and the wife of his now deceased brother, her daughter, and her children. Meyer was not often there. But his brother Uriel, the composer and New York talent agent, was frequently there, and Bessie, the mother, and her three girls, twins more or less my age who were my best friends and my playmates, and their older sister. They were like sibs in a sense. I loved them. They were really my favorite people. Not the big sister who was a pain. But the twins. And we played together all the time. We also did the dishes together. That was our way of getting away from the grownups. The grownups would let us alone to go and do the dishes and then we could go play. They lived in Cathedral Mansions. Do you know where Cathedral Mansions is? Across from the zoo, that big building. Do you know where Uptown Theater is? Well, Meyer owned the Uptown Theater and there was a bowling alley there that he also owned. And we could go there to the movies and the bowling alley. We would run down the corridors and all over the place and the two grandmothers would plan for everybody’s life. And someone would sit at the piano and play. And they were all good! That was the background. I didn’t appreciate the music then, it was just there. And Minnie was a very sophisticated person who knew the art world

Downloaded by [New York University] at 04:57 12 August 2016 and the culture world of New York. When I was maybe eight or so, she started a fi ne dress shop, called The Joseph Shop. I would hang out and deliver things. Then she opened a second fi ne dress shop. She would go to New York on buying trips and she would take me. There was a hotel there that I think was called the Governor Clinton and she had a place that she would just call up and she’d get her place and we would go there. So I was taken regularly to Atlantic City in the summer, and New York City in the winter. I would go with her to the designer shops. I saw these ladies prancing down the way with all the clothes and like anything else, I would observe. I was observing. I had my own tastes. She would ask me, she would discuss with me the clothes so I learned a lot about fashion that way. Interview III 69

The other thing she [Minnie] would do is park me in Rockefeller Center. I would go in and watch the Rockettes and she would give the usherettes a couple of dollars and say, “anything he wants.” I would sit there watching the show, ask for whatever I wanted. Then she would pick me up. Her boyfriends would vie for good favors from her by being nice with me. So both my mother and my aunt’s boyfriends were generally dedicated to having me be reasonably happy. When I was ten years old, Minnie decided there was something I needed for my education and so she took me to Miller Brothers, the best seafood restaurant in Baltimore, and had the waiter come over and said, “I want him to learn how to eat a lobster.” So she ordered a lobster and had him come and show me how you take it out, how you eat it. And so at ten years old I learned how to eat lobster. She was very concerned that I had a proper cultural education. SH: Tell us more about Minnie. JL: Minnie was a fi rebrand in her own way and she was always ghtingfi with my grandmother who wanted more to quiet her down and domesticate her. Minnie adored me so we got along very well. And she loved the girls. When Ann and Amy came along, she was very devoted. As my mother was too. We got along fi ne. LG: Was it okay with your mom that Minnie took over these … JL: … Every once in a while, she would erupt and say, “He’s my son.” But that was an occasional eruption. LG: Minnie had no children? JL: No. Minnie married Alvin Erlich whose family lived across the street. Eutaw

Downloaded by [New York University] at 04:57 12 August 2016 Place in Baltimore was where all these townhouses were and where the doctors and all the professional people lived. Alvin was a handsome man, who made a lot of money until the crash and then really was helpless. He just couldn’t hack it. For example, before the crash, he bought me the most wonderful set of Lionel trains. They divorced and she never remarried. She had lots and lots of boyfriends. Men of some substance, over a period of time. But then she got the dress business. SH: Did she stay living in the family house? JL: Yes. 70 Interview III

LG: When she was married to Alvin, where did they live when they fi rst got married? JL: I don’t know. I was too young. LG: And then it was after the marriage that she came back and lived at your grandmother’s? JL: Yes. LG: And when your mom and dad … JL: … You see this house just held people! When I was 12 or so, I got assigned the whole back of the second fl oor so I had my own suite back there. Rooms big enough to have a ping pong table. So I had my own friends and we just retired back there, which was very nice. LG: When your mom and dad were married did they live in your grandparents’ house? JL: Yes. SH: At the time they separated, you were around nine months. What was your understanding about what went wrong, what were you told? JL: I have no idea. They were ill-matched from the beginning. I think my mother was extremely immature. I say I have no siblings, but in a way Minnie and my mother were like siblings. I was just like one more person in the family, Downloaded by [New York University] at 04:57 12 August 2016 just younger. But while I can truthfully say I was never unduly mean to my mother, I was also not very respectful. Her authority did not hold much weight. She had the assumption that because she was obedient to her mother that I would be the same to her, and that assumption carried through some 90 odd years in which it never happened. I am going to jump ahead because it is a telling story. The day my mother died. I had been in Europe and had just come back. Ann said, “Nana is in bad shape. She is really gone. I took the baby there and she didn’t even respond. She didn’t even know who I was. She always responded to the baby but not this time.” So I went to the hospital and went into the room. A nurse was standing on the other side of my mother’s bed. The nurse said, Interview III 71

“Who are you?” I said, “I am Dr. Lichtenberg. I am Mrs. Baker’s son.” My mother was lying in an embryo position, pale, really ghastly looking. And one eye opens, her head turns, and she says, “Oh, so you’re back.” One last guilt thrust [laughing]! I was thinking, “Yeah Hortie, I’m back.” So she says, “I want to do what my sister did.” Now that was a theme that was throughout her whole life, I want to do what my big sister did. Only I knew what she meant. My aunt when starting to develop gangrene and it was a question of … and I said, “Minnie, you are going to the hospital tomorrow and you are going to have to have this dealt with and there is no more staying at home. It has got to be dealt with.” And she said, “I would rather die.” I said, “If you can make that choice, it is your choice.” And she did. She died that night. LG: How did she do that? JL: I don’t know. She didn’t commit suicide. She was ill enough to die. So that is what my mother meant. I want to do what she did. I want to die. I have had enough. And I said, “That’s okay with me, but it’s not up to me, ask Him.” So after we talked and I left, I got a call about three in the morning that she had died. That tone, “Oh, so you are back.” It hadn’t worked all those years and it still didn’t work [laughing]. LG: But it didn’t stop her [laughing]. JL: So my mother and my aunt vied for authority or infl uence. My aunt didn’t try ever to be an authority. We just did things together. Uriel, my cousin, lived in New York and when I was in the Navy and going to Columbia, I stayed on weekends in his place on West End and 72nd. He had a very nice apartment. I would spend my weekends there and sometimes we would go to the beach. He is the composer, who was then a theatrical agent. So I met all kinds

Downloaded by [New York University] at 04:57 12 August 2016 of people through him. Also Meyer’s daughter Jinnie was Nanette Fabray’s understudy. His son Gary was Danny Kaye’s understudy. So I was backstage with the casts. LG: New York was wonderful for you. JL: When I was four or fi ve, my grandmother maybe had had a fi ght with my grandfather, I don’t know. We took a suite at the Barbizon Plaza. I thought that the nice green area across the street was my playground because I was taken over to play in the park. The memories I have are of the hotel, the 72 Interview III

playground, and Rumplemeyer’s pastry shop across the street. That is my earliest New York memory. SH: Meyer and Uriel were the sons of your grandfather’s older brother? JL: Yes. LG: So do you think we need a little family tree here? SH: That would help us. JL: I don’t have one. LG: That’s okay. Your mom. JL: My mother’s maiden name was Davis. LG: And your father? JL: Samuel Lichtenberg. My mother had one sister, Mindelle. My father had two brothers and one sister. The two brothers are signifi - cant in that one was a doctor, Moe [Moses]. And one was named Joe, Joseph Lichtenberg. And that is signifi cant and I will tell you that story although I don’t know why it would end up in a book. But the whole Lichtenberg family story circles on that. My grandfather’s (whose name I think was Isidore) wife died either in the fl u epidemic or in childbirth connected with my uncle Joe. I don’t know which story is correct. Joe would have been a very small baby at the time Downloaded by [New York University] at 04:57 12 August 2016 of the fl u epidemic, or childbirth. So these four kids were left motherless [the four Lichtenberg kids]. My grandfather, who owned the Lichtenberg building across from the University of Maryland Medical School, invited his widowed sister and her four kids [the Sussman kids] to live with him in that building. From all I knew, she was a tough lady. Eight kids, one set named Sussman and one set named Lichtenberg, wound up in this household. My uncle Moe became a doctor and a very privileged one in that one of the non-Jewish doctors made him a protegé. He did extremely well. He married into a wealthy Baltimore family which was somewhat upgrading in that my grandfather, while he had a very successful made-to-order tailor shop, was Interview III 73

not as wealthy or as established as the family my uncle married into. Moe’s wife died in childbirth. LG: There are two wives that died in childbirth. JL: My grandfather’s wife and my uncle’s wife. And so then he (my Uncle Moe) married the divorced wife of Al Jolson’s brother. So again show business in another form. Al Jolson’s brother was a pharmacist and my aunt Rhona was gorgeous. But she was a bundle. She is reported to have had affairs with people like Tony Martin. My uncle in his second marriage to Rhona became a sports doctor and a theater doctor. He was the doctor for the Hippodrome Theater in Baltimore and all the sports teams. He knew all the celebrities because he was the doctor for all the show people that came and they would come to his house and my aunt Rhona was beautiful, and she was fun. It was an interesting, colorful family. A lot of color, a lot of things, but my uncle Joe was a critical factor in this. He was a psychopath. He ended up in jail. He kited checks. SH: What is that? JL: Where you take good checks and add zeros. It was sad in that my grandfather used all his money to keep bailing him out. My grandfather just didn’t know how to do it. And my father was bitter, bitter, bitter. My father had to give up his law practice when he was starting in order to go back and rescue my grandfather by taking over the store in order to just keep things afl oat. He gave up a promising law career. My father’s situation was very sad. He did go back to practicing law, but in a desultory way. Let me just add one thing about my father. My father was brilliant. There were three subjects that he could deal with. So I learned how to interview, very early. If my father got on the subject of my mother and my mother’s family, I heard his paranoid offerings. I didn’t want that subject. But if my

Downloaded by [New York University] at 04:57 12 August 2016 father got on the subject of sports, he was encyclopedic. So we could talk about sports. If my father got on the subject of politics, world politics, and world events, he was brilliant. And so I could get a complete history course of whatever by just plugging in something. So I learned what to plug in and what not to plug in. SH: What was his style? JL: Oh, we would just talk. One of the things I do remember my father saying was, “You know there is a lot of steel being shipped to Japan. Someday all 74 Interview III

that stuff may come fl ying back at us.” I mean that was incredible way back before the Japanese attacked. Who is going to be the mayor? Well, I would get a complete account so and so is running, and so and so is doing this, and so and so will win. Or the president. Or whatever. He was a bright, knowledgeable man. I am sure he probably knew the law, but he wasn’t functional enough to make much of a living. He wasn’t functioning anywhere near his ability. LG: You probably picked up snippets along the way of what led to your parents’ divorce. JL: My assumption is my mother said, “I don’t want to be married to him anymore” and my grandmother and grandfather said, “out.” The details of the divorce might have been incredibly complicated as well as the fussing over how many days I would spend each week with him and how much he was to pay [child support]. SH: But he did pay? He did contribute? JL: Never enough. And I didn’t want to hear their mutual complaints. And I didn’t know what was enough and what was not enough and it didn’t matter to me. He had his rights and he came so that I was in contact with my father every day. He would come down and walk with me and my baby nurse in my carriage. And then when I went to junior high, maybe 20–25 blocks away, he would walk with me to school. He never lived more than fi ve blocks away … on the fi rst day of every Jewish holiday I spent with my mother’s family at the reform temple, the second day I spent at the conservative shul. One is eight blocks one way, one is three blocks the other way. I would sit there with my father at the shul and I would say, “What is that man doing … he is going back and forth across the aisle?” “Well, that’s the Chazen and what he is doing is that there are two rich men, one

Downloaded by [New York University] at 04:57 12 August 2016 is sitting on one side and one on the other, and he is going back and he is auctioning Aliyahs.” “What’s an Aliyah?” “That’s when somebody goes up on the pulpit to give a prayer.” “What do you mean auctioning?” “Well, they are both rich and he is going to see how much money he can get …” This is my education sitting in a synagogue. Everything is happening and I’m asking and my father is giving me an answer as to why this man is standing there and davening while everyone else sits down. Why he is a pawn broker and has more sins [laughing]. This is some of my father’s wisdom that I am picking up. I am learning the world. I am learning how the world functions. Interview III 75

On some occasions I went with my father’s father into the world of the Orthodox. My father’s father, Isidore, was the greeter for the Austro-Hungarian Empire. When somebody from the Austro-Hungarian Empire, somebody from Hungary, from Bulgaria, from Romania, came to the United States, if they came to Baltimore they came with a letter to Mr. Lichtenberg. He would meet them at the boat. He would take them to a fellow countryman, somebody who spoke their language, Romanian if they spoke Romanian, whatever. He met Charlotte’s grandfather who is Hungarian. This is Baltimore. He placed him with the Hungarians. Then come Sabbath, he would fetch them. When the shul got fi lled up, these little tiny Orthodox shuls, they fi ll up, he’d start another one. He started about four or fi ve shuls. Everyone knew Mr. Lichtenberg. Then when it came time for them to become citizens, he would take them. And then they would meet Mr. Kelly. Mr. Kelly was the ward boss, the Irish boss in the area Democratic Party. Mr. Kelly would say to them that there would be times when they would go to vote and if they weren’t sure, they could ask Mr. Lichtenberg and he would be sure to tell them how to vote and also if any trouble came, they should tell Mr. Lichtenberg, he would tell Mr. Kelly, and Mr. Kelly would see to it that the trouble was taken care of. That was how the world of that period worked and he was a critical factor in it for the immigrant Jewish community. My grandfather Lichtenberg would occasionally commandeer me on Sunday, ostensibly to take me to the zoo. We would start to walk out under the arch of the park. As you go into the park there is a street with no cars and benches on both sides. You walk, maybe a mile, till you get to the zoo. We would walk in the park and there are people sitting on the benches. Father, mother, children, Jewish families. We would get to the fi rst bench. “Ah, Mr. Lichtenberg!” It is as though this is Vienna. We are back in Europe. The father would say, “Let me introduce you to my family” and my grandfather would say, “This is my grandson.” Next bench … We never got to the zoo. But I learned old world manners. I learned to observe a whole other world that had been transplanted to the United States. It was fascinating because my mother’s family world was completely different. It was the German Jewish Downloaded by [New York University] at 04:57 12 August 2016 world of people who were completely acculturated into the American culture of relative wealth and privilege. And this other world of my grandfather in which everyone had to feel connected. They had to indicate and introduce their families. I hated going to the zoo with my grandfather because I never got to the zoo [laughing]! Again, it was interesting. Looking back on it, it was all a kind of an education to a broader perspective on the world. LG: How did you fi t together the religious aspect in your father’s family and the religious aspect, in your mother’s family? 76 Interview III

JL: Oh sure. They were Reform Jews. I think my great-great-grandfather Rosenblatt was one of the founders of the Reform movement. So we were very embedded in the Reform Jewish movement. We went regularly to temple on the holidays and I went to Sunday School and got a complete Reform Jewish education. My Bar Mitzvah was in the Reform temple. My identity is as a Reform Jew. The other were excursions. SH: The Jewish part for you was … JL: … Oh I tried very hard to believe. It didn’t come easily [laughing]. But I tried hard. I was asking unwelcome questions. But I wasn’t fussed about it because nobody was on my back. Nobody was asking more of me, until my grandmother died and I decided I didn’t want to bother being confi rmed. I am 16 and I am in my second year of college. It didn’t make sense to me but my mother said, “You have to be.” I said, “Why do I have to be?” “Well, your grandmother would have wanted it.” So I said, “Hortie, here’s the deal. You get one ‘your grandmother would have wanted.’ Pick any one you want. But you get one. If you get this one you have used it up.” My mother could never believe that. She would believe that I was always going to be obedient. Facts did not much penetrate. Reminds me of some of what we hear from the Republican Party debates. So she said, “Yes, your grandmother wanted.” So I was confi rmed. By that time it didn’t matter much to me. I was not religious in any deep sense, but I was ethnically affi liated. Spirituality is not my strong point. SH: And your own family, when you had children, were they raised that way? JL: Of course, Ann and Amy were raised Jewish and both were Bat Mitzvahed. When William called me and said that he had found a girl and that they really cared about each other a lot and they were going to get married …

Downloaded by [New York University] at 04:57 12 August 2016 “Okay William, out with it.” “Do you mind if I marry somebody who is Chinese?” I said, “No, I don’t mind if you marry somebody who is Chinese as long as she is Jewish” [laughing]. 4

INTERVIEW IV Saturday Late Afternoon, April 17, 2010

Home Office, Bethesda, Maryland

SH: In line with your description of all the different cultural and other infl uences of the world to which you were exposed in your childhood, how did this background impact on your decision to adopt two Chinese children? JL: First of all, it went so smoothly that it did not even seem to require any adjustment but it is also true that I already knew a great deal about Chinese culture. SH: How is that? JL: I had studied Chinese history. And having known Ping and Pearl all that time, I learned a great deal about the differences between Mandarin and Cantonese. Northern and southern China are like northern and southern Italy, or like Eastern European Jews and German-English Jews. And the chil- Downloaded by [New York University] at 04:57 12 August 2016 dren are Mandarin. They are from an upscale culture. As Ping would say, “my family not coolie.” The Cantonese restaurant people, and the people who run the laundry are not my Chinese children. I don’t know what it would be if it were them, but it’s not them. They are from a totally different culture. The great-grandfather was the mayor of Shanghai. They come from totally educated people. Ping’s cousin in China is a pharmacist who sur- vived the Cultural Revolution because they needed his skills. But the family home was taken and all they were left with was a little apartment. Anyway, I understand the culture and the culture was totally compatible so it was no issue. 78 Interview IV

LG: Was this cultural dimension an issue for Ann and Amy, or for Charlotte? JL: Not that I know of. These are people we have known forever. We were close friends. LG: Were the children also close friends? JL: Not really. LG: So that was a new piece. JL: They always knew one another, even though they were not close friends. Maryland went all the way through Sidwell and our kids were going to Whitman so they were not close in that way. Anyway, the culture I don’t think entered into it at all except that I understand their culture. Three things fed into it: my friendship with Ping; my understanding of Chinese history; and my work on contemporary China that I did with the CIA. I studied the Chinese leadership. I am probably more knowledgeable about China than most people are likely to be. SH: On another note, we wondered what thoughts you have about the infl uence of being a psychoanalyst on the fathering of your children? JL: There has been very little to do with that. There has been very little, as far as I can see, hypersensitivity or issues. I have a standard joke which is, “I don’t work unless I get paid”; that is, I’m not going around analyzing my kids, my friends, my anything. It is not that I can turn off the idea of paying attention to something. But I don’t use it. I don’t think my kids have any feeling that I am invading their heads. That is a terrible thing. And I am certainly Downloaded by [New York University] at 04:57 12 August 2016 not at all interested in invading their heads or giving them interpretations of their behavior. I will tell them when I think their behavior is something I don’t like and I praise them when it is something I do like. But I am not into analyzing it. SH: Can you say a little more about what it is like being a grandparent? JL: I love it. I don’t get enough of it. They are all so busy. They are at soccer, they are at their music lessons, at this, at that. It is hard to corral them. To the Interview IV 79

extent that I can get a hold of them, I love it. It is not the adults who are too busy, it is the kids that are too busy. I especially love teaching them sailing. SH: What thoughts do you have about being an octogenarian? JL: I have trouble sometimes coordinating the fact of age with my picture of that age. One of my quips is when I was a kid anyone my current age was dead. Therefore there were not a lot of ways picturing when I was six what someone this age would be doing. And they certainly wouldn’t be playing tennis and swimming distances. One tiny story on the age subject is when I was in Santorini, you can take a boat over to the Caldera, which is the live volcano. When you get there, there is a place to stay on the landing where Charlotte stayed, and from there they take you on the path up. You go up on the path about a third of the way and they say you have gone up about a third, and you know how diffi cult it is. It really is pretty tough. This is the place where people stop and can go back. And for those who really want to climb all the way up you can continue. I was going to go up. This was what I came for. So I go up and I slipped a little bit because it is lava rock, which is oily. I was slipping on some gravel and a younger person grabbed me and Downloaded by [New York University] at 04:57 12 August 2016

FIGURE 4.1 Joe and Charlotte’s grandchildren (2007). Back row, left to right: Andrew Shofer, Katie Shofer, Madeline Holland, and Jenny Holland. Front row: Lexy Shofer, Allison Pao, Lizzy Holland, and Lucas Pao. 80 Interview IV

held me and I climbed on up. At this time I was 75 and I had a thought, “Oh to be 70 again” [laughing]. I fi nd it diffi cult to connect the way I feel and the way I can function with the concept of 84. It makes this degree of sense. When I got to be 80, I said I do not want to work fi ve days anymore. I eliminated Friday, so I only work four days, ten hours a day. That is my work week. That means we go to Annapolis Thursday night. It is like I have two lives. It is a nice balance. That was one age determination. I also said that I was on a fi ve-year plan and when I got to 85, I would just reevaluate and see what if any changes I want to make. Some changes will be made for me whether I like it or not; my health will be a factor I can’t control. The other factor is to what degree people will continue to refer patients to me at my current age or older, and people come for supervision. I think it is more likely people will come for supervision because that does not stretch out in time, but who knows about patients. It may get determined for me. As to my present situation, the only bad thing I have to complain about is that the rotator cuff procedure on my right shoulder did not work as well as I had hoped. So I have some limitation with this and it limits the tennis and I don’t swim exactly the same as I did. I am still swimming three-quarters of a mile and I still can hit a tennis ball. I am put together with a lot of stuff, but it is put together. I can walk two miles without any problem. I don’t run anymore. I can sail boats very ably. I have, as most people do, some name recall issues … but it eventually comes. Conceptually I don’t see any limitation. New ideas still fl ow. Just as we were planning to do this, I had in the back of my mind, is there a paper I can write that can go in the book as a new paper? And I thought of a whole idea for one. I am still thinking things like that. I think this book, Psychoanalysis and Motivational Systems: A New Look , we [with Frank Lachmann and Jim Fosshage] just put together is fi rst rate. I am planning the program for a self-psychology institute … and so on. My head is still operating. I am running a panel at the American Psychoanalytic. It was my idea for the panel, and I am chairing it this June. And another in January. I don’t see what age has to do with any of that. But I know there is an inevitable end and when it comes, it comes. I would much prefer it come without a long Downloaded by [New York University] at 04:57 12 August 2016 debilitating yuck, but that is not something you can arrange. So that is my answer on the subject of age. Anyone is a fool to not recognize that the odds change all the time. The odds of continuing to be totally effective get worse and worse. Although my mother did live to 97 and her head was still intact, her eyes were not very good and her hearing wasn’t very good. But her head was still functional. And that is hopeful. LG: And also what is hopeful is your very long marriage. We were wondering what are your thoughts about how you and Charlotte have been able to sustain this marriage over 60 plus years, with the present divorce rate over 50 percent? How do you understand your success? Interview IV 81

JL: I don’t think I much like divorce. One experience was enough [laughing]. It seems to me that it is better to sort something out if you can, than it is to carry on a long grudge. Leaving aside Charlotte, in a general sense, I can be pissed off at certain things but they are more likely to be institutions. Where there are personal things, if the other person is agreeable to try and sort the thing out, then I would rather sort it out than carry a grudge or the disability of losing the benefi t there was of having the connection in the rstfi place. Now things cool. And that is inevitable. There are people you were once close with that cool, like Joe Slap. It just cooled. Now I feel nothing negative about him and I presume he feels nothing negative about me. It just ended. But then I don’t have to deal with him. With a wife I have to deal with every day, cool is not pleasant. Warm is much more pleasant. When warm goes, it is better to restore it. There is an underlying implication that intrinsic affection either carries on or something bad happens to it. I would say we have been able to carry that through times when the overt situation was one of disagreement. Our characters are different, but it is workable. I am a “let’s do,” and Charlotte is a “but here is the reason why not.” I have to then deal with the reason why not and if I can see the point to the reason why not, I can either change it or do something to deal with the reason why not. For example, we have together this quite remarkable collection of art. I say, “Let’s do this.” “No. We don’t want to spend the money for this” and Charlotte gives all the reasons why not. So eventually it became clear what the way to go about it was, since I ended up regretting not buying a couple of things because of this. I said, “We are not going to do it this way at all. Here is the way we are going to do it.” We walk into this room now and say, if we were to get one of these photographs, which one would you think? Almost invariably we come to the same one. Sometimes we come to a different one, but then I will look at the one she has chosen and I will think it is just as good or even better, or maybe they are equal. Then I will say, “Okay. I am just asking you.” She will know that our tastes coincide. I will make an executive decision about the economics. I will make a decision about whether I think we can afford it and where the money will come from Downloaded by [New York University] at 04:57 12 August 2016 and whether to buy it or not. And then I will tell her. She will say, “Are you going to get that?” We worked out a way to do it so she does not have to violate her conservative approach, and I don’t have to get into a fi ght with her about doing it. For the most part I don’t buy things that she has not seen. Occasionally I have because she was not there to see it or because I thought that she was going to like it enough, or because I know she is not going to like it, but I think it is important enough for our collection to get. Our concept changed from picking up this or that to having a collection. It is a different concept. When you have a collection, you fi t things into the collection. You add things that make the collection overall more cohesive and more valuable. And of course it is Charlotte who said, “I want some 82 Interview IV

sense of permanence.” She is the one who pushed us to make a big gift to the Phillips Collection. It is important for her, for us, to be the benefactors of a gift to an institution like the Phillips where we also loan many works and it is written up as the Lichtenberg Collection at the Phillips. In the beginning, the plan was more meaningful to her than to me. So when she said that, I then took her desire and fi gured out the feasibility. What can I do to make a signifi cant gift and have some advantages for us, tax wise. LG: When did talking about your collection being given to a gallery begin? JL: I don’t know. I am terrible about time. Ten years. Seems to me about ten years. Now we also cleared it with the children. Because actually we are giving away some of their inheritance. Ann’s husband who owns a big furniture store in Baltimore says he wishes we were all wealthy enough that we could hold the collection together after we die. But we are not. What happens after we die, I do not know. But the biggest chunk of our estate will be this collection and the children will have to deal with it, whatever way they choose to deal with it. SH: I guess it opens up the issue of how your interest in art began. JL: Well, Provincetown. We bought the very fi rst thing on our honeymoon in Provincetown. It is up in our upstairs bathroom. And then we bought works from a local painter named Herman Maril. His paintings are good. He was a painter in Provincetown along with Hans Hoffman, Milton Avery, and Robert Motherwell. He was an equal but never quite made it to their heights. But that is what we could afford. Then one day I had a revelation. I respond to three dimensionality. Then I knew what to do. We got educated how to collect sculpture. That is when we started to buy sculpture and started the collection. Then we got to a point that we couldn’t afford sculpture at the level we had it. Although we continued over the years to buy some sculpture, we were not building a big sculpture collection. Many things that were

Downloaded by [New York University] at 04:57 12 August 2016 available I did not get or could not get at the time. But I realized that in some photographs we could fi nd the same aesthetic, that is, the aesthetic about form. How is form dealt with? How is light and shadow and sometimes color used to exemplify form? Because that is what sculpture is, a way to exemplify form. When I realized that there are photographs that do it, that have this particular way of operating with perspective that somehow inform the form and bring it to you, then my eye started to develop a skill at seeing it in photographs and knowing just what photographs exemplify form. So all the photographs in the collection are based around that aesthetic. It is not about history, it is not about who, it is about that aesthetic. We agreed entirely on that, so that is when we started to do it. Interview IV 83

LG: How did it become a portrait collection? JL: Oh, the portraits just are there. We just grouped photographs in which the “form” is a portrait. We would buy heads because they are form. We would buy scenes like Holland Canal because that is form. Then it was a question of grouping them. I just decided one day, why don’t we make a group called Portrait Gallery? It had nothing to do with portraits. If you go through the rest of the house, you will see many other portraits that are grouped with other photographs and sculpture for other reasons. SH: How did you go about educating yourself or developing your tastes? The process of … JL: Charlotte had taken art courses and she took a course about sculpture at Hopkins for her masters degree. Charlotte asked the professor if I could audit it. The professor allowed me to audit but the other people in the class looked at me as if, who are you? But some obscure question came up that I had the answer to so that got me to be a part of the group. That is it. That is my total formal education. My informal education came from talking to an incredible dealer who had built major collections and who lived with ten million dollars of art in his apartment. We spent 1½ hours with him getting a complete education on how you buy. The market and how you deal in it. And otherwise I read, I read, I read, I study, I look, I read, and when I want to know … and by now, I know all the people I need to know to get answers. I have a whole group of people I can call up at any time and ask about something I don’t know or want to know. The top dealers in New York, here, they know me, I can ask, and we are on very friendly terms. LG: The art now, with you and Charlotte with the Phillips. Are you both involved in the communication with the Phillips? Downloaded by [New York University] at 04:57 12 August 2016 JL: Yes. Yes. They are exceedingly nice to Charlotte. They look after her. They see to it that her walking diffi culty is taken care of. They are as sweet to her as they can be, and well they should be. But hey, we are kind of important but in comparison to some people, we are small potatoes. I mean we are not wealthy. We are well-off people, but there are really wealthy people there. We are treated as well as anyone is treated. SH: In regards to your mother, what would you and she do together? How did you spend time together? What would be the way you and she … 84 Interview IV

JL: It seems to me we were always embedded in the family. I don’t think of something she and I did, just she and I. I can think of being on the beach in Atlantic City, but I don’t know if Hortie is on the beach with me. It could be any of the family. If I am going in the water to bounce around in the waves, I don’t know who is with me, but someone is there. And it doesn’t matter. It is sort of like that. There was no question that she was my mother … I am sure some of the time she put me to bed and read to me and I am sure some of the time someone else did. I think of her as leading a kind of young adult’s life. When I was three she would have been 23 and unmarried, and doing things a 23-year-old would do. It seems to me more just embedded in the family, but she was my mother. SH: When you look back on it what infl uence do you feel she has had on you? JL: I guess at the essential level, I know she cared a great deal about me and my accomplishments were very important to her. But I have the sense that my mother never really knew who I was, and not knowing really who I was, she had very little ability to help me to understand. Of the people who helped me understand the world, I don’t put her very high up on the list. I have standing jokes about my mother’s explanations to my questions. How come I was in the fi rst grade for two weeks then I was moved into the next grade? Well, they didn’t have enough chairs in one room so they had to move some children. Well, that is not an answer. That is not why I was moved. I was moved because I was reading at the fourth grade level and there was no point in keeping me in that class. Why in the third grade am I sent to Hopkins in the summer to spend six weeks doing another half school year in six weeks? Oh, they had teachers who needed to learn how to teach and so they needed some kids to practice on. Well, that was half true. It was teachers who needed to learn how to teach exceptional children. My mother was a source of essential connectedness and basic goodwill and affection. But I easily dismissed her and she was too much a source of

Downloaded by [New York University] at 04:57 12 August 2016 confl ict for me about my disregard for her. It wasn’t good for me to be as contemptuous of her as I was and it also meant that a girl I took out later, who would have made an excellent wife, I couldn’t marry because I felt the same contempt. Now Charlotte is Phi Beta Kappa. Charlotte is probably as smart as I am. She is not as dedicated to being productive as I am. Because she is as smart as I am, I don’t have contempt and disdain towards Charlotte. I was, thank G-d, free of that. That would have been one characteristic that would make the marriage not work. If I had felt that way, it would not have been good for me or for the victim of it. So my experience of my mother was a mix, but I had to learn about the signifi cance. I also felt that in my analytic experience far too little was ever done to analyze and Interview IV 85

help me with contempt and disdain. That is something I have really had to struggle with all the time because it comes too easily. That is but one aspect. On the other side, my mother was one of a group of people that valued me and was very affectionate. And I was a very affectionate little boy. That was easy and that was reciprocal. So I think I brought all of that into a marriage and a parenting relationship. SH: When you fi rst married, did you live in the family house? JL: No. I would not do that. SH: When your father remarried did he have more children? JL: No. SH: One thing you said was the importance of the nannies and maids and how essential they were and your appreciation of them. Could you talk a little bit more about them? JL: That is the other side of the contempt. I valued them very highly and it bothered me as a little boy that they could not read and I could. I thought that I would grow up and be a teacher and teach them to read. It seemed wrong that these wonderful people were limited in that way. The other was that when I would hear wonderful loving people called shiksa or nigger (which my family did not do), it bothered me. SH: Did your family refer to the nannies and maids as shvartzes? JL: Yes they did … I hated it. It would just stun me because that was again

Downloaded by [New York University] at 04:57 12 August 2016 this contemptuous, belittling way and somewhere I formed this fantasy that I would grow up and be a surgeon and be able to turn black skin white. It was a reaction to people that I loved so much and were so dear to me being treated that way. I am not talking about the big world, I am talking about my little world of family. It wasn’t that I loved every black kid. I knew from experience that a black kid could steal my bike. It was the people that were immediately there. My house man Nathan, who was also the family chauf- feur. On his Sundays off, he would take me in my little express wagon and pull me about eight blocks down to a train trestle where he would hold me up to watch the trains go by because that is what I wanted to do. He would use part of his Sundays off to do that. Then he would take me home and 86 Interview IV

he would go off for the rest of his Sunday. That was so loving and nice for a little boy. That is the way it was. I found them very dear. And they were so much closer, I don’t know … it is sort of awful to say … in the sense of appreciating child likeness. They were much closer. They were much more able to appreciate the world from a child’s perspective than were the [white] grownups, who were all busy doing their grownup thing. Totally appropri- ately. But they would play with me. Of course, when you have a baby nurse for three years she is going to play with you. That is what her job was. SH: Yes. But still, she did it lovingly. JL: Marie that came with us when we moved from Baltimore to Washington. She had been with us, after poor Etta developed a berry ruptured aneurysm. I took care of her and it was awful. She recovered. But then she couldn’t work anymore. When we moved here Marie said, “Oh, I’m not moving over there!” So we said “okay.” She said, “But I’ll come over and help you, I got to get you and the children settled.” Then, “I’ll come back next week.” So it worked out that she came for four days and then went back to Baltimore. She stayed to raise the children. I think we do something to encourage that devotion. It did not just come with the territory. You don’t buy it. There is a way of accepting, of fi nding the right balance between you serve us and we pay you, and you are a terribly important person and we care about you. Growing up in the Baltimore culture taught us how to set that balance for people who were in the Baltimore culture. At fi rst Marie did not like William. Everybody else loves William. She said, “What is that boy doin’ here?” See, her view was Chinese is lower than black. But very quickly all that negative reaction and prejudice disappeared. LG: She didn’t have the same reaction to Maryland? JL: Maryland was already off in college. Downloaded by [New York University] at 04:57 12 August 2016 LG: You talked about how your education was accelerated at many points. What kind of position did that put you in, being in classes with kids that were so many years older than you? From a social point of view, how did you negotiate that? JL: From a social point of view, it hardly ever mattered. From an athletic point of view, it made it hard to compete. It bothered me that way. But when I was in college, I joined a fraternity where I was just one of the members. I dated girls my age or older. I never felt socially out of it. Interview IV 87

As I said, I started at Hopkins in September 1941 when I had just turned 16 and left when I was 17½ in 1943. During that time when I was 16, my mother gave me a very small allowance. Most of the kids at college had a bigger allowance. There was a disparity there that I needed to repair. I was a very effi cient gambler. I could gamble on cards. I played hearts, poker, or bridge. I always had a ready source of income by gambling at ping-pong which I was masterful at. I could play right-handed, left-handed, sitting, kneeling, whatever. I always wanted to make certain that my opponent got 18 points because that kept him in the game and I made 21. Therefore, I made a small living and equalized the disparity by gambling. Well, age had nothing to do with that. I cannot say that my being younger ever mattered much. In Midshipmen’s School, it never mattered because I could do what I needed to do as far as learning and commanding men. SH: Can you say more about your Navy experience, and how that infl uenced you? JL: My Navy experience was bizarre. I went into the Navy at 17½. I went in on July 1, 1943. That is a date I do remember. I came out July 1, 1946. Three years and one day. The Navy sent me to Swarthmore to fi nish college. I assumed I was going to go to medical school. I applied to medical school and I was accepted at Jefferson and Hahnemann, both Philadelphia schools. I was just going to college in a naval uniform and having a very interesting time in this Quaker world, meeting another group of people and fi nding it fascinating. The teachers were very kind. I was taking a course in American Lit and the professor gave weekly tests on the readings, like who did what in the book. I fl unked them all because I don’t read that way. I don’t read a segment. I read a book. Then we also had essays. Somewhere in the middle of the course I got worried because I kept fl unking these quizzes and I went to him and I said, “You know, I am really concerned. You know, I am in the Navy and if I fl unk a class I am in big trouble.” He said, “What are you concerned about?” I said, “getting a bad grade.” He said, “What size A do you want?” I said, “huh?” He said, “Your essays are excellent, your participation

Downloaded by [New York University] at 04:57 12 August 2016 in class … you understand literature. A lot of Navy students – engineers – don’t understand as well so I have to give them tests that they can pass. That is what the tests are for. They are not for you. By the way, would you like to come to tea so we can discuss literature?” So I went to tea and at one point he asked if he could quote something I had written on Moby Dick . That was Swarthmore. Then one day I get orders to go to Kansas City Western Dental College. Dental College! Well it turned out the Navy had booked 16 places in this obscure dental school that nobody had signed up for. They were too embarrassed to just let it be and so they just picked pre-meds because we qualifi ed and sent us there. I did not do well. I never failed anything but 88 Interview IV

I made it unfortunately or fortunately clear, patently clear, that I did not want to be there. That I did not want to be a dentist. That this was not my idea or ambition or anything else. After a period of time, fortunately I was removed. Then I went to the head of the V-12 program for the whole area, who was at Lawrence, Kansas, Kansas University. He called me in and said, “You have disgraced yourself, you have disgraced the Navy. It is a shock that you would get yourself thrown out of a professional school this way. What have you got to say for yourself?” I said, “I understand your point, but I have a background in which I was pre-med and have very good grades and a very good background and acceptance in several medical schools and was waiting for the opening in medical school when with nothing that I have done or said I am suddenly in a professional school in an area I don’t want to be.” He said, “I do not believe a word you are saying. I think you must be a liar and I am going to check on you and you are under house arrest until …” Meanwhile, my mother was going out of her mind. I had been perfectly safe in the middle of the country. He said, “You are confi ned to the campus until further orders.” I am not a happy camper at this point. But so be it, I made my bed and I am lying in it. I am hanging around, playing ping-pong and whatever. Then one day he calls me back in. I am standing at attention. He says, “at ease” in a nice voice. He says, “I have every record of you from elementary school on. You told the truth. I cannot believe the Navy would do that,” he said. “It has taken so long because I tried to get you into medical school. I tried to arrange it. But there is a fi xed rule that you can only go to one professional school unless you do another tour. So I can’t do it. Here is your choice. I can either make you a third class corpsman and send you out into the fl eet, and then you can come back and through the Navy apply to medical school. Or, I can send you to Midshipmen’s School.” So I thought about it. Third class corpsman, fl eet marines, Iwo-Jima. No [laughing]. Naval offi - cer, Midshipmen’s School, doesn’t sound too bad. “Okay.” He said, “Okay, but you don’t have any engineering so here is the deal. You are going to Princeton for a course in engineering which will get you enough background Downloaded by [New York University] at 04:57 12 August 2016 and then you are going to Columbia Midshipmen’s School.” So, I come back to the East. Princeton I go to, engineering I learn. I can learn anything, but don’t give me an engine. I went to Princeton in April, and went to a Seder with Albert Einstein. Then to Columbia to Midshipmen’s School. Columbia was pretty interesting because everybody roomed with everybody by alphabet. I roomed with Walt Leitch. They placed the one Black with Goldberg from New York. Putting the New York Jew with the Black was the Navy then. I am a Southerner. That trumps. I learned very well how to get along in Midshipmen’s School. I worked on the yearbook and things. Being accepted is always a question. Was I a good guy or a bad guy? Interview IV 89

Walt Leitch, my roommate, was not a great student. I could get late night study permission because I was doing extra-curricular tasks. I didn’t need late nights. All I wanted to do was go to sleep. But he wanted to stay up late to study. I am on my top bunk and he is on the bottom and he’s saying, “On page so and so it says such and such, what is that?” I am answering him and all I want to do is go to sleep. He tells the guys I am a good guy. “Don’t get on the Jew kick.” That was useful because the Navy was really, really biased. Then I got my commission and wound up on a destroyer in the Pacifi c where all the other offi cers were selected to do something except me. And one day I was told the skipper was making me the aide to the executive offi cer. I am to run all the paperwork on the ship. I am to do all the things aides do: get cars, barter stuff, arrange for offi cer’s club, and so on. I am 19. One day I said, “Why me?” They said that the skipper, who was the great Hopkins professor Sir William Osler’s great-nephew, and the executive offi cer were always in trouble with the admiral because they were keeping the records of the fl otilla and they were endlessly in a mess. They thought if they could fi nd a smart Jewish kid from the East they could turn it over to him and he could run it. That was me. So I did. So I became an aide and that was a fascinating experience. I learned all the other things you had to do, gunnery, and being a deck offi cer, radar, sonar, and navigation. The gun crew on our sister ship blew itself up, killing all the people on the gun crew. After the Japanese surren- der, my gun crew is assigned a new chief gunner’s mate. We are having an anti-aircraft fi ring drill. The gunner’s mate stands down in the gun and I stand up in the turret with an enlisted sailor. We track the target and I set range. When I think the range is accurate, I tap the enlisted man on the shoulder and he starts fi ring. But I had been trained that before I tap, I look down and see that everything is right. I look down and the gun is open and this idiot’s head is looking in it. If I had gone ahead (I touched the cloth but not enough to put pressure that he would pull the trigger) one teeny bit farther, the shell would have gone in, the gun would have exploded, the gunner mate’s head would have been atomized and all the other shells would have gone off. There would have been a gaping hole in the whole area and Downloaded by [New York University] at 04:57 12 August 2016 we would have all been blown away. That close. I realized after that that I am dependable, and lucky. And that I know how to do things right and I can manage. It was a reassuring experience for a 19-year-old. It seemed to me after that that what I had to deal with in medical school or surgery, I can manage. I can do. I can take care of it. So the Navy experience was an important experience in my growing up to have confi dence in myself as a person who deals with people, and deals with complicated tasks. I could manage, I could lead. So all in all, that was a good experience. After I got out of the Navy, I learned to sail. Because we had a close, close friend of Charlotte’s, Gordon Cader, who was an internist and he had 90 Interview IV

a sailboat and said, “Do you want to sail?” I said, “great” and went to sail. He taught me and I’ve been sailing ever since. LG: How do you feel about sailing alone versus sailing with people? JL: I much prefer sailing with people, I prefer company. I do sail alone. If it is a choice of not going out on a gorgeous day, I will go out alone. My big boat is rigged so I can take it out alone. A sunfi sh you can take out alone. But I don’t go out for very long, maybe 45 minutes. I much prefer having company. LG: Does Charlotte go with you? JL: She used to for many years but not anymore. Downloaded by [New York University] at 04:57 12 August 2016 5

INTERVIEW V Sunday Morning, April 18, 2010

Annapolis, Maryland, Before Sailing

SH: There is one question which we haven’t covered so far which is, what are your thoughts about issues which remain unresolved in a psychoanalysis? How much can one cover in a treatment with the idea that there may be issues that remain unresolved, or less resolved? JL: I think that you inevitably have lots of things that are unresolved. It depends what you mean by unresolved. Since I believe that what we are dealing with is not something that you would call a discrete problem, and then you resolve that discrete problem … Take for example, if the patient says my problem is that I have dated a lot of people and I have never had much success in forming a lasting relationship and then you work with the issues about that, and then the person forms a lasting relationship, you could say that the problem has been resolved. No it hasn’t. What has happened is that the person has been able to accomplish something that he or she wanted to accomplish. But now life goes on and how will that pairing work out? Well, Downloaded by [New York University] at 04:57 12 August 2016 that pairing will work out however that pairing will work out. They start and all the things that will happen in the person, in the pair … in the dyad, and external events and so on. So life is much more complicated than what one is going to “do” in an analysis. Goals are going to be reached but that doesn’t mean something is done. It means that something has been accomplished but not, so to speak, resolved. Secondly, I think if you look at people who have had trauma, either pretty severe stress trauma or acute trauma, this leaves them with a vulnerability. The trauma is not a thing. It is dispositional. It tilts a person toward some expectations, towards some inferences, that are very problematic. You can 92 Interview V

reduce the degree to which that vulnerability plays out. You can alert the person to the issues. A person can be better prepared to deal with it. But vulnerabilities do not go away. Dispositional things play out, more or less. So you just help a person have it play out less. But that isn’t resolved. They don’t disappear. SH: How do you think about treatment goals? JL: Well, I think treatment goals are essentially co-created. I think it works poorly if one person has one goal and the other one isn’t there, isn’t anywhere near there. Then I think you end up with somebody being dissatisfi ed no matter how well the experience works. But in the course of treatment, the goals have to be modifi ed. A patient may say, “I am where I want to be” and the analyst says, “Well, what about this and this?” If the patient says, “I heard you but I am still where I want to be,” then the analyst either has to modify, or leave something of a bad taste in somebody’s mouth. Alternatively, if the patient says, “You know, I hear you. That is true. I still am having an issue with my anger or with whatever, and you are right. While I am satisfi ed in a general way and while I am really not all that eager to keep coming in and paying, you are right. I can see the point.” And then you can propose how and what and where. And again, that is co-creating. And then you arrive at something that is mutual. And that is actually a goal I would say for an analysis. To be able to arrive at that point where you can have something that has a sense of mutuality to it. SH: In addition, do you have any other thoughts about the process of psychoanalysis? JL: Well, all I can say is that the entire book that I have just fi nished with Frank [Lachmann] and Jim [Fosshage] is about the process. It is about looking at similarities – speaking in a very broad sense – giving similarities as great

Downloaded by [New York University] at 04:57 12 August 2016 a place as dissimilarities, in a whole spectrum of things to do with whatever motivational system you are talking about. And then we have looked at the way the two people are operating so that at any given moment, one or the other or both are making an inference about what is going on. The inference will be what are the activated intentions and goals. What is my intention and goal? What is the other’s intention and goal? What intentions and goals have we formed together or oppositionally? And then as each has an inference, it will guide what comes next since inferences are usually very rapid, blink-like. You don’t even know you have it but you are operating based on some inference you have. The patient walks in and you make an inference. She is depressed today. You haven’t formulated that at a level of Interview V 93

consciousness, it’s just a feel. Well, that inference that you feel is going to have an effect on the words that come out of your mouth or don’t come out of your mouth … the look on your face. And then you listen and try and confi rm or disconfi rm the inference that you have made. At that point you may bring it up into consciousness and say, this is what I think. We believe that Dan Stern and the Boston group are right about the “now moment.” We say the “now moment” is where an inference is formed, but that segments of time, roughly three to fi ve minutes, are segments of time in which inferences play out, through out-of-awareness into awareness, as a more symbolically recognizable stage. And that is where an interpretation may be made. Or a patient coming to some awareness. We are trying to suggest that if you look at the fl ow of material, you will see that it fl ows in segments, and we are looking at three to fi ve minute segments rather than just moment segments. So this is a difference about process. LG: How, in this more updated model that you have, do transference and countertransference play into that inference level? JL: For one thing, long ago I translated the concept of transference into a concept of expectations. Now I am not unique in doing that. I arrived at it on my own and discovered that other people also had arrived at it. What we are really talking about is not Freud’s image that is being projected onto a blank screen. That concept does not apply very well. What is happening is if a certain group of people has always been antagonistic to me, I am going to have an expectation if I meet somebody that I identify as similar to that group of people that things are not going to go well. The expectation affects me in such a way that I have a particular inclination at that point to deal with that person in some way that is likely to operate as an enactment of the very thing I am most leery of. Then there is a different me if I have a very different expectation. And that is what is going on on both sides. So each communication from one to the other will play out within that series of broader or tiny expectations. So I don’t need the concept of transference except to

Downloaded by [New York University] at 04:57 12 August 2016 know that when people immerse themselves in an intense dyad with high levels of communication and exploration, they open themselves hopefully to 1) feeling safe in revealing and 2) coming close to some of the core aspects of the expectation. And being closer to the core aspects of the expectation, they will bring forward what we refer to as transference. SH: Do you think those things need to happen with the analyst? JL: They can’t not. They need to in the sense that they are inevitable, and that is what we learn to be sensitive to and we respond to them in certain ways. 94 Interview V

The patient is saying here is how I see myself and my life experience. Here is how I see you responding to me as I tell you about my life experience. My way of seeing you. My way of seeing you may be accurate or inaccurate. And the other is doing the same. But there is a further one that does not get as much … I mean it was a part of infant studies years ago. It was one of the good ones from Mahler. The idea that, do I sense that you see me a certain way, and is that only immediate context limited, or do I sense that you carry me in your mind, and that I have an existence beyond the immediate context of the moment? And if I have an existence beyond the immediate context of the moment, then there is something there that either carries me, if it is a positive thing, or means you and I are not doing well. But if you don’t carry me at all, then nothing good is going to come. This idea of carrying the other in the mind is I think an important sense that one person has about another person. SH: Do you fi nd that the images and memories from your own experiences in psychoanalysis when you were a patient enter into your work as an analyst? JL: Well, there has to be! I mean, we cannot sense into the mind of another person without having some comparable experience. Again, this is an important piece about where similarity comes in or, and this is understated in the literature too, imagination. Imagining oneself into an experience that you haven’t had. And the openness to be able … It is similar to what Joe Sandler was trying to talk about when he talked about role responsiveness. Are you open to take on a role, which means imagine yourself in a situation that you are either actively imagining yourself into, or did imagine yourself into and then you have to bring into consciousness what you have done, simply slithered into? SH: So it is an aspect of play? JL:

Downloaded by [New York University] at 04:57 12 August 2016 I use theater as a modality for my thinking. Staging and the analyst as stage director, looking at the scene with the patient and the people in the patient’s world. I ask myself where am I? Am I on the stage? Am I not on the stage? If I never go on the stage, how can I work? If I am always on the stage, I am crowding out the world of the patient. The patient exists in a world other than the two of us. Theater is a metaphor that I and others fi nd useful. LG: Is there a particular example that you can give us where something of your own experience in psychoanalysis has come into your mind and entered very specifi cally into the work of an analysis with a patient? Interview V 95

JL: Here is a specifi c. I had a male patient who had been in the Vietnam war and was okay. He never had war trauma, but he had problems relating and he went through a lot of girlfriends. He would bring in dreams and for the fi rst 15 or 20 minutes of the hour, I would be engaged with whatever he was talking about. After the fi rst 20 minutes, I found my attention wandering. I found it very diffi cult to attend. It was like all the air went out of the bal- loon. I noted it but I couldn’t get anywhere with it other than just recognizing it and puzzling how come, since he brings in associations that sound as interesting as anyone else’s. At some point he was talking about a date and how it had started out fi ne and then went dull. What he was saying about the date experience was mirroring what we were experiencing. Some way in which he described it reminded me of my sitting with my kids watching a television show they wanted to watch. I would be interested in it for a while, but it being at a kid level, after a while my interest would fade. I would just be sitting there keeping them company, but I would have no real interest in what was tran- spiring. I offered that interpretation in some form, and he said he then had a memory. The memory was of himself sitting in a chair watching whatever was on television in the afternoon. His mother was sitting over in the corner, knit- ting, not involved at all. He had a rope that he would swing around like a lariat. He lived in this dull lonely environment with his father gone. He would sit and kill his afternoons in that way. With that we understood what we were doing with each other, and the ambiance we had co-created. With this recognition, we could bring the enactment into full awareness of his painful aloneness. It was my association to my comparable experience that allowed me to offer the particular interpretation.

SH: So would you be likely to bring in the experience or would you use the experience?

JL: Downloaded by [New York University] at 04:57 12 August 2016 I don’t remember what communicative vehicle I used. I will use any communicative vehicle I can think of to get it across. I do not believe that one has to be so utterly clean and parsimonious lest you contaminate the fi eld. Or that the patient is so open to total power infl uence that if I use a particular expression or metaphor, or tell a story, that that is going to mess up anything. I don’t believe that that is the way people are. That really is insult- ing to a person’s own ability to be his own self and do things sensibly. So I am not worried about that. I will tell stories. I will give analogies. It does not worry me. I could have said what I remembered, or I could have said it another way. 96 Interview V

LG: Did you ever have an experience with a patient where you actually recollected some exchange or some experience in one of your own three treatments? JL: I think it probably was likely, but I don’t think any main approach I follow was infl uenced by recoveries of pieces of my own analyses. For instance, I don’t think my concept of model scenes, which is one of my more original ideas, had anything to do with anything that anybody said to me, or anything I worked out as such. So the answer is I can’t come out with anything that seems to be powerful in that direction. Maybe Helen Arthur’s relative directness. SH: How have your views about being an analyst changed over time? JL: Well, I think my views regarding the centrality of neutrality, abstinence, and anonymity have changed. I don’t think very many analysts any longer are constrained by an ideal of technical purity. So I’m not any different. I can only tell you that I questioned it from the beginning. But that was what was demanded. I tried to do it. Secondly, I always believed that the intrapsychic total focus made no sense to me. I knew how to talk the theory. But it always seemed ridiculous to me that at a case conference someone would ask what is the father like? Or what is the mother like? If it is all intrapsychic, what the hell difference did it make what the father was like or what the mother was like? I mean, if you are just working your drives out against your own ego or superego, what difference does it make, since you are distorting everything and all you are living with are your own distortions. Then why ask the question? Well, we asked the question. Nobody questioned why we asked the question. But when we went back to theorizing, we went back to intrapsychic. And it was always, “If somebody reacted badly to you, what did you do to set it off?” It is all your intrapsychic doing. It was your drive that was activated. No, it did not make any sense to me. I learned how to speak in that language. If not, I would get Downloaded by [New York University] at 04:57 12 August 2016 into trouble. I learned how to try and operate from within that language, to a degree with success. I mean you can try and analyze a dream in that language. But I always had my doubts. It always struck me that there was an inherent contradiction. And that the approach that was being taken was at its core paradoxical. So in a sense all I have come to is tilted to the side of my original doubts from back then. Plus when you are working with psychotic patients, intrapsychic doesn’t work. It just doesn’t work. Since that is where I spent most of my fi rst ten years, I came into this with that background of doubt. But then the fi eld, it seems to me, has gone in a relational or intersubjective direction, so I don’t feel myself to be unique now in that. Interview V 97

SH: What would you say you have learned from your patients? JL: Well, I think every patient affects me, teaches me something. It is hard to specify. I fi nd myself working with one patient very effectively with early childhood reconstruction to make sense of things. With another patient, I won’t fi nd myself there much to speak of at all. I will fi nd myself with much later life issues. So what each person teaches me is that I must fi nd my way with each particular person. And then there is a testing and seeing and fi nding my way through my own reactions also. Do I feel a lot of something? Warmth. Negative feeling? Or do I feel very little? And what does that mean? Do I fi nd this person hard? Does this patient seem to always come up with an easy two-liner but nothing more? And somebody else, I am always ponder- ing and puzzling over something with each patient. All of that, I would say, speaks to the individual dyadic experience. LG: Did you ever feel that a patient said something to you, about you as an analyst, that stuck with you and that you worked on personally? JL: Oh yes. Many times. LG: Can you give an example? JL: I don’t have one handy. Let me think. LG: Either positive or constructively negative. JL: Well, there is a patient who likes to share ideas about books and concerts and then says how disappointed she is that her husband does not want to talk about those things. He does not want to hear about the book she Downloaded by [New York University] at 04:57 12 August 2016 is reading or how she is reacting. To me, that is true and understandable. And then the question is, am I commenting and sharing to be seductive? Am I trying to create a negative comparison? In other words, it is a fact we share, but where does that fact play out in terms of what we are trying to do? My goal is not to make her feel bad about her marriage, in any sense at all. And I also believe that if she wants literary discussion, there are plenty of places to get it outside of her marriage. That would be an example of somebody saying positive. But positive needs to be looked at in terms of possible other meanings. A patient, the wife of an analytic candidate, in the fi rst year of her analysis surprised me by presenting me with a Christmas present. Being constrained 98 Interview V

as I was then, I didn’t open it but gave it back to her at the end of the hour. She was hurt and furious. We analyzed an analogy to the deep hurt that nothing she gave to or did for her mother was ever accepted as good. Despite the rupture, the analysis proceeded favorably but the injury never faded and I clearly felt I had behaved foolishly. Although I knew I had hurt her, I did not believe I had been sadistic in intent. But foolish is bad enough as her recurrent dismay each Christmas indicated. We parted on excellent terms and some fi ve years later met at a party. After greetings and catching up on events, she reminded me of the one incident that still bothered her. I learned that analyzing a precursor to an analytic rupture and injury makes the vulnerability to the injury clear and sometimes resolvable, thank heavens, but sometimes not. I have dealt with patients’ gifts differently ever since. I have been accused of being unfair or unjust when I have charged for missed hours or refused to keep specifi c hours open after a long break. Well, am I capable of being unjust? Yes, I am capable of being unjust. Do I want to be? No. But I don’t want to sacrifi ce all self-interest either. Fair and just involves balancing two self-interests. And that is often not easy for one or both members of the dyad to achieve. SH: We were wondering how the experience of being a psychoanalyst has infl u- enced other aspects of your life. JL: You know, I fi nd it hard to answer that. I don’t know how much … if you are a person who is sensitive to other people’s feelings and attitudes and aware of the dynamics always playing out, you don’t turn that off. But I don’t turn that on in my ordinary life the way I would in the offi ce. So I am not somebody who is thinking psychoanalytically about the people I sail sailboats with or the people I play tennis with or basically in my marriage. I think my motivational systems have their switch points and I think I generally switch out of the psychoanalytic modality when I am not working as a psychoanalyst. I know there are people who don’t switch out and they are all over the place analyzing everybody. That is not me. Downloaded by [New York University] at 04:57 12 August 2016 LG: I think for myself, being a psychoanalyst has made me a better listener to my family members, that I allow them to explain themselves and to think before I say anything. I am just a better listener. So that would be one way for me that I … JL: I wish I could claim the same [laughing]. SH: We had some questions about you as a supervisor and your thinking about supervision. Interview V 99

JL: Okay. I do a lot of supervision. I supervise members-in-training at ICP&P and also senior analysts in three institutes at the moment, training and supervising analysts. I like supervising and teaching members-in-training. And I love supervising very experienced people because they can present so well. They organize what they are telling me so well. I think it is very rare that I fail to see some little thing that then helps to expand their awareness. I am not teaching them to do analysis. I am trying to help them expand awareness around something or other. Another way of looking at it. Not that is wrong, this is right. Another way of seeing it. Another way of approaching it. An alternative. Then sometimes I could suggest procedures to deal with administrative tangles within an institute. I enjoy doing it. I fi nd it very rewarding to do and obviously the people are satisfi ed because they have been working with me for a long while and they bring other people in. LG: Do you do it via telephone as well? JL: Yeah. It is all by telephone. You are talking about California, Midwest, South. So it is all by telephone. LG: Any international? JL: No. We have talked about it with a couple of internationals but it never got set up because of time barriers. I would, especially now with Skype. But I haven’t.1 SH: And what thoughts do you have about the process of supervision? Do you think much about your own style, or the supervisee’s? What you want them to learn? Downloaded by [New York University] at 04:57 12 August 2016 JL: I contrast it with an analyst who was on a committee to evaluate me to be a training analyst. He did not want to hear anything from me about my process notes, just wanted to talk to me about how I felt about the patient. In supervising I don’t primarily want the supervisee to tell me what he or she feels about the patient. I want to know how they interact, what they talk to each other about. What theme or themes the analyst recognizes. How to open fully the narrative envelope. Alan Kindler, whom I admire a great deal and who has given a lot of thought to supervision, is much more likely to ask, how did that strike you, 100 Interview V

or what did you mean by that? I do that secondarily. That is, if I feel I need to do that then I do that because I don’t primarily supervise for countertransference. I supervise for thematic awareness and shifting capacity for empathic entry, for the interaction. So I like to hear about how the hour unfolded and then I can comment about what I recognize is unfolding. Senior people know how to select. So they can give me the core process of a session within a time containment like 30 minutes so we have another 15 minutes to talk about it. But if they are not giving me process notes, or they have done something that I think was not the greatest idea, I will stop and pick up on that. And sometimes I will ask the Kindler question at that point. Or I will just say, you could have just said or asked this. And if I hear a certain questioning “hmm” then I will say tell me what you’re struggling with … then I will go into it. I am emphasizing that I make believe that I am just sitting in the room like a fl y on the wall and this is all going on, and here is my view as a fl y on the wall. But I am very aware of alternative ways of doing it and I will bring those in if I feel I need to, but that is not my main thrust. LG: Have you ever thought of writing about your process of supervision? JL: No. I could, but I just haven’t. LG: Do you feel you want to? JL: I don’t know to what end … I could write something descriptive: this is what I have evolved. But I am not sure if I have crystallized some particular reason for doing so. SH: Do you have any thoughts about ending supervision? JL:

Downloaded by [New York University] at 04:57 12 August 2016 I don’t think there is anything formal about it. I think people just feel they have gotten enough, or the patient they have been presenting to me fi nished, and they don’t want to present somebody else. I don’t think there is any for- mulary approach to that. SH: Is your approach to your work different when treating a patient in psychotherapy or psychoanalysis? JL: Oh sure. Interview V 101

LG: Can you tell us about that? JL: I regard the issue … the distinction between psychotherapy and psychoanalysis for me, as both a practitioner and a teacher, assuming now that we are talking about analytically oriented psychotherapy, analytically informed psychotherapy. The difference to me is simply opportunity. If I see someone three or four times a week I can do something … the opportunity for getting a fl ow, keeping something in the air is so much greater. If I am talking with someone in once a week psychotherapy, I will try to do the same thing but I cannot do it because the opportunity is not there. All I can say is mainly as I do analytic work, I want to help the person see the relationship between what has come up in this hour and what feeling may have carried over and appeared in a dream. Whereas when I am talking to someone in once a week psychotherapy, I will help them see what the dynamics are in that hour. But I can’t do the other. I mean some people can carry over from one week to the next and that will be included, but that sort of getting into the more sensitive fl ow can’t be done. Because you don’t have the opportunity. Not because of some technical issue. LG: Let’s say you have somebody come in for supervision of psychotherapy. Do you handle that supervision differently from how you would handle a supervision of a psychoanalysis? JL: I don’t see a difference. Tell me what went on and I will tell you how it strikes me, or what I can help you with in doing it. Or things change. Somebody is seeing a person once or twice a week and I say, “You know, this is moving in the direction that I think you can propose that you see the patient more than once or twice a week.” Or the supervisee comes in and says, “The patient is complaining that they can’t possibly afford the three times.” “So okay, let’s try once a week. And we will maintain what we can maintain for now.” It is just being fl exible with living in the real world. To try and superim- Downloaded by [New York University] at 04:57 12 August 2016 pose some ideal regarding what I would like to do or would like my supervisee to do would be beating my head against the wall. And it is so much more vital if it comes up organically. But to miss it when it comes up organically, that is not good. LG: So that is where you would put your emphasis, in helping them hear when it is there. JL: Yes. 102 Interview V

SH: Can you say something about the supervisions that have been unsuccessful? JL: I may be all too quick to say, “Whoa, what are you doing? She is trying to tell you this.” To be right is not necessarily to be right. But it may be possible to do it in a better way than I did it. So that would be one of the failures. A couple of people who have gone elsewhere have taken with them what they got then profi ted from the person that they went to. Now the opposite has occurred too. I have gotten people who have switched from other supervisors. I think it is just there are going to be good matches and not such good matches, and the same pair may be a good match at a different time. The person seeking supervision is now ready for one approach, when he or she was not ready for it before. This would I think go back to my sense of my grandfather. My grandfather’s mode of life … this is the way it is, what can I do to do the best I can with it? If it is his wife’s illness. If it is his daughter’s divorce. If it is property that went bad. It is what can I do to make the best of the situation, to do the least harm … and an adapting that is constructive. I think that is what I have tried to do. To accept things as they come. Adapt to them. And try to be constructive in the adaptation. LG: So your grandfather is your psychoanalytic role model. JL: Yeah [laughing]. He didn’t say all that. He just did it. Just being a sensible man. To have good sense is not a bad thing. SH: When I was at Mount Sinai, I had a supervisor who said sometimes he would think, what would Mrs. Goldberg say? You know, average, decent Jewish woman. What would she think about this or that? How would you compare and contrast supervising a candidate from ICP&P, with supervising someone from outside ICP&P? Downloaded by [New York University] at 04:57 12 August 2016 JL: I see more differences between people than I do in any other way. If we talk about candidate A, he comes with such a different experience than candidate B. I mean they are different in age, different in experience. Candidate B has been fully indoctrinated in a particular approach from the Washington School and so I have had to deal with that. I just think of it more as difference in people, and of course, the experience they bring. I will tell you one teaching experience that required ingenuity. I was teaching a continuous case seminar in the Washington Institute. The members of the class were at war with each other and you could cut the tension Interview V 103

with a knife. I already knew this about them. So I said that the way we were going to do this class was going to be different than what they were used to. The way we are going to do it is this. There is a game called “get the presenter.” I am sure you know the rules and the ways of doing it. And since you all know how to do it, and since you are all very well practiced at it, it seems useless for us to continue. There will be no further education on that. So here is what we are going to do. The presenter is going to present for an hour. No one is going to interrupt. We go right through the session. Then I am going to go around the room and ask each person what was the theme of the hour. So I went around the room and the presenter does not have to say anything. Well, that put them all on an equal par. And then I asked the presenter what did she think? Then I said, now we are going to go around again and based on what you thought was the theme of the hour, how would you go about doing it? How would each of you do it? What would be your approach? And so I made them all talk about their approach, including my co-teacher who would not always say what I would. I would comment and then we gave the presenter a shot at it. What that did is it made everyone have to think and expose their thinking. And it put everyone on an even par with the others and it totally detoxi- fi ed the experience. Subsequently, I was supervising an analyst who was running an institute who I advised how to set up a different class. And it worked beautifully. So that is meeting the situation and fi nding a way to work with it. Finding something constructive to do. If it didn’t work we would discard it. But since it did work we went with it. LG: This is similar to the question we had before. How have experiences from your own psychoanalyses entered into your work as an analyst? JL: Well, I’ll tell you what came into my mind. I think Russ Anderson was once asked about being on an elevator with a patient. And Russ said being on an elevator with a patient is like being with any guest who had come into your

Downloaded by [New York University] at 04:57 12 August 2016 house. You treat them like any guest who had come into your house. Now that was, I think, a very useful concept. He was a very friendly kind of man, in a straightforward way. At the same time, he had no lock on the bathroom door, which drove me nuts. But I also learned when I raised that with him, I got the kind of answer that said, don’t go there. You are not going to get anywhere. So I let it be. He had a manner that was like Helen Arthur. But I never felt that Hans [Loewald] did. But then it was so many things. Who knows. But Russ had a very nice manner. A pleasantness, a social gracious- ness that other analysts in my training period lacked. And I think social gra- ciousness is fi ne. I say, “Hi, good morning, come on in.” I say, “Goodbye … I’ll see you Tuesday.” All of those things are just human. 104 Interview V

I’ll give you another example. A patient is a senior analyst. I am away, and she comes to the door when I am not there and bangs on the door and gets pretty hysterical. The receptionist in the building said he’s away, he will be back on such and such a day. She describes this later, when she comes in and I am back. Very upset. She is in a rage. How can I do that? She had never been so upset. I reminded her that I gave her a slip of paper with the times I would be away. When we parted I said to her, “I’ll see you – and the date.” She kept on getting utterly hysterical and at the end of the hour she got up, so fragmented, and so completely chaotic over this. I said, “Wait a minute.” This is face to face. “What you are saying to me is that I totally failed to prepare you for my being away. That whatever I did did not get through to you. I completely failed in having you know when I would be away and when I would be back. So that you had no functional knowledge of that and I fully accept and appreciate that I failed in getting that information to you in a way that you could use it.” And she said, “okay” and left. And that resolved it. That is what I mean by trying to process a problem at a human level and not getting caught up in this as a distortion. Well, obviously she had a dis- sociative experience. Then we had to fi nd out what it meant. But from her standpoint, what came out was that she wasn’t prepared, and it was my job to prepare her. Which certainly I accept. It is easy to get defensive. Another example is a scientist who got into a distress state with me because he didn’t remember a dream and he didn’t know why I did not know it. Well, you could say this is delusional and crazy but what did it mean? He wanted me to be so sensitive, so close, so twinned with him that if he had an experience that was meaningful I would know it. I would feel it. I am always trying to fi nd the connection to the person who is that person. SH: Yes, right and what I hear you saying is you also have to deal with yourself fi rst. Regulate yourself until you can get there. JL: Obviously. Because your fi rst reaction is what the hell [laughing]! Downloaded by [New York University] at 04:57 12 August 2016 SH: And to get beyond that back to the empathic position. JL: A very good way to put it. Sure. Deal with the self regulation and … SH: … It’s like the airplane. Put the oxygen mask on you fi rst. JL: Like with a patient who demanded hour changes in a provocative manner. While I remained annoyed, I self-regulated enough to the degree that I could Interview V 105

say to him, “I don’t like that you are being so demanding. Your provocative- ness gets to me and it makes it more diffi cult for us to fi nd a way to cooper- ate.” He said, “You aren’t the fi rst person to tell me that.” SH: I think that is why too it brings up the issue of self-supervising versus going to a supervisor to be able to have that awareness of what one is doing and how one is doing it versus being able to talk with someone about it. It is really different. JL: I agree with you but I also have a thought. I believe writing is a very useful way of self-training. My being willing to tell the world about some of my thinking. One of the fi rst compositions I wrote in college was “Me,” the title. I wrote a biographical essay about myself at that point. That may have been the assignment. At Spring Grove, I got assigned one of the acute wards and I walk into this madhouse. Screaming, yelling, crazy people. I mean, that’s why they are there. And attendants who whack them. And who handle them roughly. What am I supposed to do [laughing]? Treat them? Have psychotherapy? It made no sense to me. So what I did was I decided I don’t know how to deal with these disturbed people. Maybe I can deal with the attendants. They all come from West Virginia. And they are all white tough ladies. And so I started regularly meeting with them. I started doing nursing tasks with them and we formed a team. And so I helped them to change their whole manner. I mean it changed! So the whole place changed and then I could get patients in and sit them down and talk with them! And so I wrote this up as an approach to working in a hospital on a ward like this, to form a treatment team using the existing people and meeting with them and working with them at their own level and it worked. But I wanted to explain it. That is why I wrote that paper. So the idea of wanting to explain to others allows you to explain to yourself. I think it is extremely good training for getting some clarity about what you really think. Because if you write and tell other people what you think, it forces you to get clear. So being a writer, I think, is an important form of

Downloaded by [New York University] at 04:57 12 August 2016 self-supervising. SH: How has your role in Psychoanalytic Inquiry enhanced your growth and development in other aspects of professional work and relationships? JL: Well, having the opportunity to be able to cover the fi eld at the broadest level is a wonderful opportunity. I have always liked to know something about a lot of areas. In childhood, I had this wonderful set of encyclopedias and I would open them to any place and read. I had the ambition to know everything that was in the encyclopedia. So having a broad spread of interests and 106 Interview V

being able to get issue editors to share in this at Psychoanalytic Inquiry meets the same need. Whatever we cover in Psychoanalytic Inquiry leaves open another interesting area so, I have never run out of ideas for issues. I am also delighted with all the people that come to me with ideas. And I can appraise the ideas and see how to make them happen and help. I love it. It’s great fun. I could not think of a better opportunity to play in all kinds of different play- grounds and help other people and encourage and mutually learn. I feel as interested and as fresh with it as I did 30 years ago when we started. LG: Let me ask you something. Let’s say you have a particular editor that is having a diffi cult time getting the issue out. What do you do? JL: Well, if I know about it, I start to fi nd out what the problem is and help. I will say I have not in the past been as assiduous with that as I could have been so sometimes things have gone a little bit past where they should have gone. But I got unhappy enough with that to reorganize the way we track so if you look at a new issue in the back are titles of the forthcoming issues and names of the issue editors. Having that there is going to give me more of an opportunity to keep track. Just having it there is pressure alone. So anyhow, that bothered me and that was my solution. LG: Any ups and downs that you want to mention in this endeavor? JL: All of the ups and downs were in the beginning with the original publisher. But nothing compares with the happiness of having people like Larry Friedman want to play with us over all these years and all the people that have been on the Board over time. On. Off. It has been wonderful. And the beauty of Psychoanalytic Inquiry is that we can cover every analytic perspective on each topic. One of the problems we started with was it was falsely perceived as a self-psychology journal. I fought that as hard as I could fi ght it. Downloaded by [New York University] at 04:57 12 August 2016 SH: Was that how it started? JL: Well, I am a self psychologist so the bias was it is a self-psychology journal. Don’t look to fi nd out. Just assume. What I loved was that the people who sit in the room for our annual editorial board meeting year after year are from every orientation, every everything. The more varied, that’s the point. That also is something that I think is unique to us and certainly coincides with my personal orientation. Ideas are ideas. Put them in the marketplace and let’s see what happens to them. Mine included. Interview V 107

SH: Do you think that the image of Psychoanalytic Inquiry as a self-psychology journal has been transcended? JL: Yes. Unless someone just wants to insist and what are you going to do about that? LG: And how do you and Mel Bornstein work? What is his role? What is your role? How do you come together? JL: Totally pleasantly. We have a complete understanding, I think. I don’t think we have ever had a harsh word or disagreement. Mel is a sweet man, he is a lovely man. And he is an easier, nicer person than I am. So if we had trouble it would probably be on my side. But we have had no trouble. LG: How do you defi ne your work roles? JL: Very simply. Mel values highly my creative entrepreneurial ability so he can leave that to me. I think he is more organized than I am. He is more willing to deal with detail so I do my thing and he does his thing. He is also creative and entrepreneurial and is stepping forward increasingly. And I also delve into the details and see that details are taken care of and so we have fl uid roles. He is happy to pick up on ideas I originate and edit issues on them. LG: We wonder about your work relationship with Lewis Hill. JL: Lewis was at one time President of the American Psychoanalytic Association. Lewis had been the man who was the analytic opposition to Sullivan. So he was an important fi gure in psychoanalysis. None of that was what drew me

Downloaded by [New York University] at 04:57 12 August 2016 to him. What drew me to him was he was one of the most exquisitely sensitive persons working with psychotic patients. I was always hearing stories about Semrad in Boston. Well, Lewis was Semrad. The wit. One of Lewis’ stories was about this persistently depressed person who aggressively argued her depressive contempt for any help she was offered, as if to say this is the damn miserable lousy world and Lewis said, “You work really hard being very careful not to let anything, anything whatsoever make you happy. You really work at it.” He delivered many such wake-up calls. He was somebody I greatly admired. I saw a movie when I was, I guess, 15. I think it was an Edna Ferber story. And it was a story of a Jewish man who went to medical school and 108 Interview V

then he went to train under Akim Tamiroff. Akim Tamiroff was the villain and he was the nasty, mean guy. And somebody asked this doctor, “Why do you put up with it?” And he said, “If there is something to learn from the devil, I will deal with the devil. I want to learn.” My feeling was I want to learn. I have dealt with whomever I had to deal with in the Baltimore Institute, if it was someone I could learn from. So I feel that some of the people whom I don’t like, don’t respect at all, taught me something. Some of the Institute leaders saw my curiosity, interest, and ambition as my being driven, being a troublemaker. Lewis was too. In a sense, they were right. And I still am. LG: What is your take at this point on the training institute? The different aspects of a training institute. Being a candidate at a training institute. Being in a training analysis. Being a training analyst. How all of that comes together and its impact on learning psychoanalysis and being supervised in psychoanalysis. JL: The hierarchal arrangements in the traditional institute were, I think, destructive. Simply put, destructive. And that is why when we started ICP&P, I said we are having none of the above. We will have people who will call themselves training analysts because the title has practical use. I can’t make the world not have meanings about titles. But how did they get the title? Who awards the title? A star chamber group of power operating people who make believe they are doing it on the basis of some ability when it often is awarding devoted followers and building power groups. No. The candidates create training analysts. They choose them. Who makes supervising analysts? Candidates by going to somebody for analysis or for supervision. So when somebody chooses you for supervision, you are a supervising analyst if you want to call yourself that. That is fi ne. But we have no one who is making you or unmaking you. Because I wanted to get away from the hierarchy. Because the hierarchy was abused for power purposes, not for

Downloaded by [New York University] at 04:57 12 August 2016 encouragement. I once asked a training analyst whether there was any plan to make some new training analysts for the Baltimore Institute. He said, “We have not appointed one in 15 years. And the last one was a mistake.” Now that is not encouraging. That is not saying to people come on, join us. Learn. Train, grow, and join us. So I think the whole system was power operated in the same way that all bureaucracies have a power component. And how that is used. Freud’s circle. You are either in the circle or you are out. If you are in it you have the power, if you are out then … that European centralization of power was brought to the United States and superimposed on all of our institutes and I think it was destructive. Interview V 109

It was all done under a banner of standards. Maintaining a standard. That person will not maintain the standard. So there were all these buzz words. It was destructive. Then you also got into another thing which was if you have a clique here and a clique here, then I won’t appoint one of yours if you won’t appoint one of mine. So you have all of these group process operations among people who denied there was any such thing as group process. It was full of holes. Now, am I complaining because I personally did not profi t? Yes. Was I made miserable? Yes. I spent a year being depressed at being turned down by the very people that I wanted most to appreciate me and the very people who I looked to for my training and so on. And when they nixed me, did that hurt? Yes. Did it take a long time to get to where I could extract myself from the narcissistic injury and take a broader view? Yes. Did I learn from it? Yes. I learned what narcissistic injury is and it feels terrible. And that feels helpful when I am dealing with patients to know what it is like because I can then deal with it with much more sensitivity. SH: What reasons were you given as to why they didn’t accept you as a training analyst? JL: Oh. He doesn’t work with the transference. Then they made me spend a year talking to a leading training analyst who did not like me, and who would fall asleep or seem to fall asleep regularly. Each of the leaders had their pet critique. “You don’t work with the depressive affect enough.” Or one of them was beating fantasies. “You are not bringing up the beating fantasies.” Each had his own angle. LG: But then you formed your own Institute. What would you say about the leap between that experience and forming your own Institute? JL: Well, I don’t think I was thinking about forming my own Institute anywhere

Downloaded by [New York University] at 04:57 12 August 2016 along these lines. I didn’t even think it was conceivable, that it was possible. But let me say this. The success of Psych Inquiry said you don’t need an institution. You don’t need the American Psychoanalytic or the International Psychoanalytic. Ideas will sell themselves if you have got good ideas and a way to put them out. So I had that experience behind me. And I do not know on what basis I came up with the idea … what day or what happened. But I was now suffi ciently unhappy with the Washington Institute and I decided that none of this was going to work for me. And I didn’t think it was working for a lot of other people. And I thought that there were a lot of excellent people around who wanted to belong to something that they were not being allowed to belong to. Social workers, 110 Interview V

psychologists, M.D.s, and nurses, so that was what got me to propose it to a few of my people and somewhere along the line I connected up with Rosemary Segalla, a psychologist and expert on groups. She loved the idea and then we sort of had two families, the family of analysts that I brought in and the family of therapists and group people that she brought in. And then the question was put to me, what do I need to do this, because I am the one that will pay the price. Price being, what is he doing? He is through in the local analytic world. And I said, I need 15 people to put up a thousand dollars each. Within two months, we had 33 people who put up a thousand dollars that paid for an offi ce and a secretary and so on. And we just did it and it kept growing and growing and we have about 285 members now. LG: And when did you start this with Rosemary? What year was that? SH: 92? The early 90s? JL: Yes. Something like that. I am terrible on dates. It just happened. It was an idea that was ripe for the time. Then we had a crisis in choosing a name. One of the founding analysts was going up for training analyst. She said, “Look, I am going to get into real trouble. How about calling this, not calling it psychoanalysis. How about calling it The Institute for Contemporary Psychotherapy?” That was our original title. And since I defi ne psychotherapy as a big umbrella including psychoanalysis, I did not have any problem with it. If that is going to help people not to suffer for joining, good for that. We started with a class teaching people how to do psychotherapy. Some of our best people are part of that original group. And that class went through in three years. At the end, a couple of the graduates came to me and said, “We want to be psychoanalysts. Can you train us?” I said, “okay.” And the word spread. I just thought okay, we will set up a program. Well, a convulsion followed. We do not want psychoanalysis. It will ruin the whole Institute. The ambiance for which we joined will go. This is terrible and if Downloaded by [New York University] at 04:57 12 August 2016 this is going to be, we will quit. I was astounded at fi rst but I soon realized what all this venom was about. These were all of the people who had been narcissistically injured by the arrogance of psychoanalysts. I was suddenly no longer the welcoming person who had invited them into my playground. Now I was this arrogant, miserable psychoanalyst who was now going to jam all of the nasty assumed superiority of psychoanalysis and psychoanalysts down their throats. It was really a scene and a half and it went on. So Rosemary and I decided (I was the Director, she was Co-Director) that we would hold the analytic training in abeyance. Let it cool. And she worked, because it was a lot of her people Interview V 111

who were really upset, and she worked with them and worked with them. And she really did a superb job of mollifying and getting people to calm down. And then it went through. But it almost blew our new Institute apart. Almost destroyed the whole thing. SH: Her feeling about it was critical in helping people come along. JL: Absolutely. Absolutely. SH: There were still some rumblings, but at a much lower level. JL: But if it had been left to me, I don’t think I could have succeeded. It clearly took her to do it. LG: But it really showed you how absolutely important it was to keep the old ways out. JL: Yes. But I never wanted them in [laughing]. There was no sacrifi ce to me to keep the arrogance out. LG: Did people believe that? JL: Certainly in time they did. But also the more senior people, like Fred Hilkert, like Sandy [Hershberg], like Jay Bisgyer, are not arrogant people. SH: I think we got caught in the same things we all got caught in not liking. LG: Yes. You were perceived in a certain way. Downloaded by [New York University] at 04:57 12 August 2016 SH: Right. And I had very good relationships with many people and taught with them but once this came up … JL: I mean the same people were looking at me like … my leprosy was showing. SH: We had lots of group meetings. We had a lot going on but ultimately, I think Rosemary’s openness to it and … 112 Interview V

JL: And then Rosemary said let’s change the name. I would never have … and then we made it ICP&P. It really was a group process issue of major, major, major importance. LG: Joe, you said you were thinking of writing something new for this book in your honor. Anything particular in mind? JL: Yes. I am thinking about what I have referred to as “the space between.” In the diagrams [in the book with Jim Fosshage and Frank Lachmann, Psychoanalysis and Motivational Systems: A New Look , 2011] you will see we have a shaded area where you have the dyads. There is a shaded area between the two. And what I am thinking about is the problem of things that are ineffable which means that you can’t write about them. But that doesn’t mean they don’t exist. So I am going to write about trying to talk about that. So what we co-create is another variant of the third in the sense that all of this is going on in me, all of this is going on in my analysand, and there is another infl uence and that is what we co-created. Now if what we co-created is an atmosphere of irritability, on a given day I may be feeling just fi ne, but as soon as the two of us get together the question emerges: Can we keep this out or is it going to dominate? I don’t think that much has been written about this, so that was something I thought of. LG: That sounds great. JL: And if you play with that idea enough you can even move into the even more ineffable things like spirituality as other factors, forces, the openness to … so anyhow, that was what I was thinking about.

Downloaded by [New York University] at 04:57 12 August 2016 Postscript When reading the transcript of our interviews with Joe, he added the following: I would like to conclude with three attributes that kind people have used to describe me: generative, generous, and as a clinician, trusting rather than suspicious. As I indicated earlier, I grew up in a family that was generative in a number of ways – music, fashion, medicine, law, business, but I always felt I was supported in going in the direction or directions my personal generative capacities took me. This sense of an essential mirroring of my ambitions and the directions I chose has stood me in good stead when obstacles have arisen that would thwart me for a time. Interview V 113

I stated that the big townhouse I grew up in was always open. What I mean by open was welcoming. Each of us could bring our friends. The ice box (later refrigerator) was full and available. Parties and entertaining were frequent. I assisted the houseman tending bar when I was age ten. My birth- days were wonderful occasions with children and grownup family friends. I also think having my fi rst four to fi ve years living in the glow (however false it turned out to be) of pre-depression optimism left a residual sense of well-being – hope – confi dence and with the other factors – generosity to share. It was Larry Friedman who in appraising my approach to clinical work remarked that I did not begin with an attitude of suspicion. I tried to describe the practice of non-suspicious clinical orientation in Craft and Spirit and especially in the working principle of “the message contains the message.” I believe we are more open to sensing into all relevant meanings if we are not focusing on deception. Trusting the existence of a shared purpose helps to bring about a sharing of purpose. Inspiring a spirit of inquiry – of trust and safety – promotes the emergence of the necessary mutual listening, understanding, and interpreting. Joseph Lichtenberg March 5, 2012

Note 1 Since this interview on April 18, 2010, Joe notes that he currently does international supervision by Skype. Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 PART II Friendship Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 6 SIXTY PLUS YEARS OF FRIENDSHIP AND STILL GOING STRONG

Ernest Wolf , M.D.

It was a bright Baltimore morning, back in 1946, when about 90 eager young men and women were assembled on the green lawn in front of the University of Maryland Medical School administration building. They were from all over the country, and having applied for admission to the Medical School and, most important, having been accepted for the Freshman class of 1946, had been told to gather here at the School. I was one of them and I remember that I didn’t know one soul in the group. We did not know what they, the School, wanted from us but somehow it felt pretty good to be asked to be here for whatever the School wanted from us. Then came the directive: divide into groups of four. This is not easy to do when you don’t know anybody. But somehow, I really don’t know how, I found myself with three other guys who didn’t know any better what the hell was going on and we were a group of four: Larry Demarest, Jay Bisgyer, Joe Lichtenberg, and me. Then we were told to go into the Anatomy Laboratory where each group was assigned a cadaver. Our cadaver had been an old Black man and we named him something but I forgot what. Thus I fi rst met Joe, Jay, and

Downloaded by [New York University] at 04:57 12 August 2016 Larry. We became cadaver mates and also friends. Larry married a classmate of ours who became a psychoanalyst. We lost touch with each other which I regret. Joe, Jay, and I became good friends, indeed, now 64 years later, we are still very good friends and frequently in touch with each other by visit or by phone. Sixty-four years! We are celebrating Joe’s development and ascent to becoming – what I have experienced as being – the most effective and successful leader in American psychiatry and psychoanalysis, indeed not just American but global leadership. As a close friend and colleague I have asked myself what makes Joe so effective. It is not just intelligence, we all are bright and serious professionals. No, there is something special about 118 E. Wolf

Joseph Lichtenberg that is hard to defi ne precisely but easy to describe in terms of interhuman experience. On a person-to-person basis Joe is a most responsive and understanding other whose empathic participation lifts the dialogue to a level of mutuality of experience. During this dialogue one’s acceptance of one’s self increases in strength and self-esteem but, equally important, one senses that the same is also raising Joe’s awareness of himself. Two people communicating with each other as positive aspects of their unconscious become more conscious. Naturally such working together produces creativity and innovation. These qualities of responsive collaboration are, of course, widely recognized. This is not the place to make a list of the many individuals and organizations that have benefi ted. Let me close this by saying that I feel most fortunate to be a friend of Joseph Lichtenberg. Downloaded by [New York University] at 04:57 12 August 2016 7 JOSEPH LICHTENBERG

A Personal Memoir

Jay L. Bisgyer , M.D.

Davidge Hall is an historic building at the University of Maryland School of Medicine. It contains two amphitheaters, an anatomical hall, and a chem- ical hall. Two hundred years ago, an underground passageway was constructed to smuggle bodies into the medical school at night for dissection. On a bright September day in 1946, at this building’s entrance, I met Joe Lichtenberg on our fi rst day of medical school, where we also met Ernest Wolf. We were joined at the dissection table by Larry Demarest. Perhaps it was due to long exposure to formaldehyde rather than simple coincidence that three of us became psychiatrists and psychoanalysts, while Larry married a psychiatrist! Joe, Ernie, and I have remained close friends for 65 years. My own interest in medicine began during childhood, observing how the quiet and competent manner of our family physician calmed the anxiety associated with illness. A favorite uncle of mine was a psychiatrist and psychoanalyst, and I visited him when I was about 11 years old while he was working at a psychiatric hospital. Perhaps most infl uential was my fourth grade teacher’s comment: “With your terrible handwriting, the only thing

Downloaded by [New York University] at 04:57 12 August 2016 you can do is to become a doctor!” While Joe’s remarkable intelligence and superb memory made him an excellent student, he also gave notice that he was not willing to totally conform to limits that he felt were arbitrary. I remember one afternoon when we were in the fi rst week of anatomy and we had fi nished a dissection, he convinced me to join him in leaving class early in order to see the fi lm Spectre of the Rose. He did conform well enough to complete midshipman’s school and serve on a destroyer in the Pacifi c. Joe recalled being ordered to report to San Francisco to board the ship to which he had been assigned. Upon his arrival he discovered that the ship had already sailed, and he was forced to endure many weeks in that city, quartered in a posh hotel, waiting 120 J. Bisgyer

for his ship to return to port. Since Larry also served aboard a destroyer, we heard many “Tales of the South Pacifi c” while at the dissecting table. The War was over and our class was composed primarily of returning G.I.s, some in their 30s. I was still 18, having gone through accelerated programs in both high school and college. My roommate and classmate that fi rst year had a Doctor of Science degree in Bacteriology. He had worked at Los Alamos on the effects of radiation during the development of the atomic bomb. He devoted four hours of study to our fi rst anatomy assignment, and having observed his diligence and seriousness of purpose impressed upon me that I needed to do the same. Joe’s home was a short distance from where I was living, and I was invited to dinner there on a number of occasions. The food was delicious and the conversation always lively. Joe went beyond hospitality when I had a brief illness, arriving at my room with dinner when he realized that I would be unable to leave my bed. As we attended various academic lectures it was apparent that Joe did not assume that a professor’s position of academic authority automatically warranted uncritical acceptance of the material being presented. Joe suggested that we augment the lectures by forming a study group composed of Joe, Ernie, myself, and several others. Many years later, two members of this group claimed that, without it, they might not have graduated. This proved to be the fi rst of Joe’s successful efforts to develop educational programs. Early in my fi rst year of medical school, I was fortunate enough to have attended a special lecture given by Hans Selye on the General Adaptation Syndrome, illustrating his lecture with slides of pathological fi ndings and objective laboratory conclusions. He demonstrated how stress resulted in physiological and ultimately pathological changes in people. Returning professors who had served overseas as physicians during World War II reported their experiences treating young men exposed to severe and chronic stress who then developed peptic ulcers, cardiac pathology, and other physical illnesses in addition to purely psychological symptoms. Such fi ndings gave credence to the concept of Psychosomatic Medicine. Alexander and French wrote a book with that title, and followed it with research which attempted Downloaded by [New York University] at 04:57 12 August 2016 to correlate certain diseases with specifi c focal confl icts. This later evolved into a more inclusive view of all aspects of health and disease. These concepts stimulated my own interest as a medical student, intern, psychiatric resident, and as an Air Force psychiatrist during the Korean War. I treated many patients diagnosed with combat-related illnesses, including those who would be diagnosed today with Post-traumatic Stress Disorder. I became a candidate at the Institute for Psychoanalysis in Chicago. I liked the fact that we were presented with excellent proponents of various theoretical perspectives who might disagree, but remained within the same institute. Among my teachers was Heinz Kohut, whose major course was Ego Psychology. He taught Freud’s “Problem of Anxiety,” and the work of Joseph Lichtenberg: A Personal Memoir 121

Hartmann, Kris, and Loewenstein. There was no hint of Kohut’s later focus on Narcissism and what would later evolve into Self Psychology. As medical students, Joe and I were delighted by the arrival from Harvard of a new chairman of the psychiatry department, Jacob Finesinger. With the assistance of a prominent professor of internal medicine and other colleagues who had been infl uenced by their experiences in World War II, Finesinger revolutionized the department and gained the respect of faculty and students. (Our class invited him to give the graduation address.) He secured my admiration during my fi nal year of medical school. I had been assigned to liaison psychiatry, where I interviewed a 16-year-old girl who had been admitted to neurosurgery for a prefrontal lobotomy to be performed by the head of that department. She was to undergo this procedure because she was considered to be “out of control” and “incorrigible.” By today’s standards, she would be considered to be only a moderately troubled adolescent. I was able to arrange an urgent psychiatric consultation and subsequent presentation to Dr. Finesinger, who had the courage to cancel the operation and face the wrath of the powerful and long-established chairman of neurosurgery. While I was in residency training in Chicago at the Institute for Psychosomatic and Psychiatric Research and Training, headed by Roy Grinker Sr., David Hamburg, and Melvin Sabshin, Joe completed his residency in Baltimore at Spring Grove State Hospital and Sheppard Pratt, headed by Lewis Hill, whom he greatly admired. Joe later became the Clinical Director of Sheppard Pratt. Upon the completion of his psychoanalytic training at the Baltimore/Washington, D.C. Psychoanalytic Institute, he joined the Washington Psychoanalytic Society and Institute. He also became a Clinical Professor of Psychiatry at Georgetown University School of Medicine. Joe’s educational interests culminated in the establishment of the Institute of Contemporary Psychotherapy along with a small group of founding members. It evolved into the Institute of Contemporary Psychotherapy and Psychoanalysis which provides active training programs in both psychotherapy and psychoanalysis. The Institute offers special lectures, classes, seminars, and workshops for professionals in a number of related disciplines with an emphasis on learning together. Downloaded by [New York University] at 04:57 12 August 2016 Joe Lichtenberg’s creativity continues to fl ourish with his many papers, books, lectures, and workshops that take place throughout America and around the world. Joe also became the fi rst elected president of the International Association for Psychoanalytic Self Psychology, and he has worked diligently to make it a truly international organization. While I was at the Chicago Institute, I became the director of a large community mental health clinic. My old friend and classmate, Ernie Wolf, had come to Chicago and we enjoyed sailing together on Lake Michigan with our two young sons. Ernie began his long and productive collaboration with Heinz Kohut. I returned to Washington, D.C. in 1963, where I practiced psychoanalysis and psychotherapy, primarily with young adults and adolescents. For the 122 J. Bisgyer

next 40 years I taught at the Washington Psychoanalytic Institute, where I was chairman of the Psychoanalytic Technique track and was a member of the Candidates’ Progress Committee. As program chairman, I brought some of my most esteemed teachers from Chicago and arranged a workshop on Heinz Kohut’s recently published book on narcissism. I was also a clinical associate professor at Georgetown University School of Medicine, where I taught psychotherapy for 40 years. I became one of the founding members of the Institute of Contemporary Psychotherapy where I was also on the faculty and Chairman of the Candidates Progress Committee. A few years after I returned to Washington, Joe Lichtenberg moved to the area from Baltimore. I discovered that he lived nearby when my son told me that he had hitched a ride to school from someone in a nearby community. It turned out to be my old friend Joe! We have remained close friends as well as sailing shipmates. Sailing together on the Chesapeake Bay provided countless opportunities for discussion, which often turned to Joe’s theoretical ideas as they were evolving. Sometimes our conversations were interrupted by the rapid approach of cargo ships, and Joe’s naval experience served him well, as he would tack just in time (I would have preferred to come-about much sooner, but he has always been right – so far!). Over the years, Joe and his wife, Charlotte, and my wife Lynne and I spent many evenings and weekends together. When Joe was writing a book (when wasn’t he?), we would frequently be presented with a chapter that he had just completed. Charlotte’s background in literature and Lynne’s experiences as a teacher and educational innovator often offered valuable perspectives. Joe was always interested in our reactions and open to considering our opinions, and we enjoyed seeing his creative process in action. From the vantage point of 65 years of friendship and professional association, Joe’s remarkable attributes are evident. It is obvious that he possesses a keen and highly developed intellect. For as long as I have known him, Joe has never accepted the idea that what is being presented as authoritative is the fi nal word. At the same time, he is no bomb-throwing rebel. He considers what is presented, may master the subject or even Downloaded by [New York University] at 04:57 12 August 2016 teach it. (He taught ego-psychology, as did Kohut, many years ago, before their own interest and perspectives diverged.) Joe has respect for the value of his own ideas, and he does not abandon them if they do not meet with immediate acceptance or acclaim. I remember attending a workshop at a meeting of the American Psychoanalytic Association where Joe presented his outline of Motivational Systems Theory. Someone in the audience rose and exclaimed, “Joe, why are you doing this to us?” Joe remained unfl ap- pable; he anticipates that new ideas will inevitably meet with resistance, just as a patient’s rejection of an interpretation does not mean that the interpretation was wrong, but that the patient might not be ready to have long-held beliefs challenged. Joseph Lichtenberg: A Personal Memoir 123

Confi dence in one’s own ideas when they diverge from the accepted wisdom of the time is characteristic of all who advance knowledge in every academic fi eld. In addition, Joe has a truly remarkable ability to integrate concepts from varied disciplines. He discovers those currents which are moving in a similar direction, and while giving credit to their originators, joins them in moving the stream forward, ever closer to achieving the most useful and accurate understanding of the complexities of the human mind. It is important to note that Joe subjects his own ideas to critical re-evaluation and modifi cation. They often derive from his clinical experience, and he tests and revises them in the crucible of the clinical exchange. Downloaded by [New York University] at 04:57 12 August 2016 8

JOE AND CHARLOTTE

Linda Gunsberg , Ph.D.

It was the Infant Psychiatry Congress in Nice, France, April, 1983, and Passover. The Congress had arranged for a Passover Seder at the hotel. I was alone and, within seconds, was motioned over to an empty big round table by Joe and Charlotte Lichtenberg. And this was the beginning of my relationship with both Charlotte and Joe. A few months later, Joe called me and invited me to sit on the Editorial Board of the newly formed journal, Psychoanalytic Inquiry . I was shocked since we hardly knew each other. But after someone at the Infant Psychiatry Congress told me he knew me through my publications on fatherhood and had imagined me to be much older than I was when he met me, I was prepared for any mistaken identity and even transferences. Lo and behold, when I asked Joe on what basis he was inviting me to be on the Editorial Board, he answered, “You remind me of my grandmother and she was a very smart woman.” Twenty-seven years later, during the interviews with Joe for this book, I began to understand who this grandmother was. Although pregnant with twins, I could not resist Joe’s offer. It was an

Downloaded by [New York University] at 04:57 12 August 2016 extraordinary professional opportunity and I accepted, not knowing for sure if I was Joe’s grandmother reincarnated or myself, but delighted either way. My fi rst issue forPsychoanalytic Inquiry was Application of Infant Research to Adult Psychoanalytic Treatment. Joe attentively listened to my fi rst drafts of the prologue and epilogue, and made a few suggestions. This is how he mentored, and this is how I learned. Before long, he was calling me and asking me to listen to drafts of his work. Again, I had to remind myself that I was Joe’s grandmother. His confi dence in me and his confi dence in himself in guiding me worked well for both of us. I always felt I wanted to do my best and would often fi nd myself taking big leaps, not necessarily Joe and Charlotte 125

feeling I was prepared or ready for them. But I knew, there was Joe, my safety net, who was available to catch me if needed. I rose to the occasion as an issue editor of Psychoanalytic Inquiry, in terms of creating and developing ideas and implementing them. My integrative abilities matured and my editing and organizational skills launched me on my own writing career beyond Psychoanalytic Inquiry. Joe also generously offered to include a co-edited volume, Fathers and Their Families (Cath, Gurwitt, & Gunsberg, 1989), into the Psychoanalytic Inquiry Book Series. Perhaps because I met Joe with Charlotte initially, I still always think of them as a couple. Charlotte attended the Psychoanalytic Inquiry Editorial Board breakfast meetings at the Waldorf Astoria, and I so much looked forward to seeing her – like in France – at meals, in elegant hotels, and seated at big circular tables. Charlotte made me feel special and always asked how I was doing and how were my children. She knew I was co-editing a Psychoanalytic Inquiry issue, The Adoption Journey , and told me she looked forward to reading it. After it came out in 2010, Charlotte spontaneously told me, “You know Linda, I read your adoption issue cover to cover and you didn’t miss anything.” This is the way Charlotte talked. She was direct, to the point, and laudatory when this was deserved. I found Charlotte to be a quiet person, comfortable in her own skin, and not needing to talk a lot. I appreciated our conversations, and hung onto every word. I found her to be strong and she shared her strength with those around her. In some unspoken ways, Charlotte and Joe were a strong team towards whom people gravitated because they would always make room for you. They never felt crowded around a table when they invited you to join them. I never felt there was not enough room at their table for me. For the past two years and some, Joe has had to carry the Charlotte and Joe torch on his own, but I can tell you, she is always right by his side. Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 PART III The Development of Creative Structures Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 9 CREATIVITY SEMINAR

The “Flame” in Dialogue and Dialectics

Leon Wurmser , M.D.

It is in a spirit of very deep gratitude and friendship that I would like to make a contribution to this volume in celebration of Joe Lichtenberg. I met Joe almost 50 years ago when I came with my family directly from Europe to the Sheppard-Enoch Pratt Hospital in Towson, MD. Joe was at that time, I believe, acting Director of Training. In 1964, on the fi rst Scientifi c Day there, he was discussant of a paper I had written with a colleague. This paper addressed chronic severe depersonalization and the close relationship between this clinically important state and shame. I do not remember Joe’s remarks except that he rightly used the metaphor of the three blind men describing the elephant, each from his particular perspective. In my youthful brashness, I was not amused by being viewed as giving just one idiosyncratic perspective, but I am sure now that Joe was right. A few years later, after having started my psychoanalytic training at the Baltimore Psychoanalytic Institute, Joe was assigned to me as an individual tutor in ego psychology, because my training analyst gave the introductory

Downloaded by [New York University] at 04:57 12 August 2016 course. This was a special privilege that gave me a lasting foundation in a fi eld I had already been much interested in long before coming to America. I felt Joe was not only very thorough and erudite, but full of respect for my own thinking and background and open to a free and critical discourse, rather different from what I was exposed to elsewhere in my training. This still took place in Baltimore. Not long after that, he moved to Bethesda and changed society and institute. It was, I believe, about 1973, that I was invited to join Joe’s seminar on creativity and psychoanalysis when it was studying Eugene O’Neill, among 130 L. Wurmser

other authors. I gave an early, not-very-well-thought-through presentation about Ibsen, and I soon realized that the demands of the presentation were to be more exigent, the level much higher, than I had been used to. Certainly at the latest in 1975, I became a regular member of the group when we started a three-year study of Henry James’ major works and biography by Leon Edel. Being a member of this seminar on creativity and psychoanalysis proved to be one of the most important, most formative experiences of my entire professional life and career. It opened a nearly uninterrupted dialogue about the great works of world literature where we were not anymore just three blind men groping for different aspects of leading creative oeuvres and their authors, but a developing, slowly expanding group of women and men trying both seriously and yet also with much fun to plumb the depths of creativity. I do not want to enumerate all the creators and books that we covered and continue to study (and also some non-verbal forms of creativity). I think it became an invaluable and tremendous source of enrichment for all the participants who typically came from far away to join together on four Saturday afternoons a year. This work had two poles: on one side there were the creative works, the creative minds of the authors, the interweaving of life and work, and the psychoanalytic study of the interaction between childhood, development, society, and culture. The other pole, however, was the integrative mind of Joe who in an admirable way after each presentation succeeded in pulling the main threads together, posing incisive questions, typically opening up new dimensions of the topic, and thus starting a wide-ranging and very free discussion where Plato’s metaphor, “after much needed discourse … and a life lived together, suddenly a light … is kindled in one soul by a fl ame that leaps to it from another, and thereafter sustains itself” (Seventh Letter, p. 341). That fl ame was, for Plato and Joe, a spirit of free inquiry, and spirit much nourished by the minds moving dialectically between opposites. One guiding principle for Joe, echoed in his recent study of Cervantes’ Don Quixote , is to focus on the aesthetic transformation of the creative act rather than its relationship to any specifi c psychoanalytic theory or Downloaded by [New York University] at 04:57 12 August 2016 pathological formation (Lichtenberg, 2010 ). This meant a strong guidance by the phenomena, a liberation from all clichés that would confi ne understanding, a consistent reopening of questions and avoidance of premature closure, and a profound shaking of dogma. This spirit of free inquiry proved, of course, heuristically of immense value in Joe’s synthesis of the insights from early development with fresh clinical experience and traditional theory. For me, this “fl ame” in dialogue and dialectics is fueled by respected differences in psychoanalytic understanding. I was and am much more focused The “Flame” in Dialogue and Dialectics 131

on the many layers of inner and outer confl ict and Joe, who was always utterly generous and gracious in accepting what I had to say, was focused more on the experiential context.

Reference Lichtenberg , J. ( 2010 ). Cervantes and Don Quixote . Psychoanalytic Inquiry , 30 : 267 – 275. Downloaded by [New York University] at 04:57 12 August 2016 10 DEVELOPMENT OF PSYCHOANALYTIC INQUIRY

My Most Unforgettable Character

Melvin Bornstein , M.D.

Joe is my most unforgettable character. As I was growing up, I would occasionally read the “Unforgettable Character” section of Readers Digest. Readers submitted stories about people who had made an enormous impression on them. The stories were about people the writers serendipitously discovered, who had special personality traits including courage, capacity for love, commitment, intimacy, and responsiveness to their culture. I met Joe in 1978. The changes in American culture were taking hold: civil rights, women’s rights, and the effect of the Vietnam War. It was a period in the history of the United States when the old order was beginning to change. Psychoanalysis was not immune to the alterations of the times. The leaders in psychoanalysis were third generation analysts, trained by students of Freud who immigrated to the United States before and after World War II. The idealization of Freud, most likely infl uenced by an incomplete mourning of his death, pervaded classical psychoanalysis and contributed to the rigid- ity and narrow-mindedness of many in that generation of psychoanalysts. Two examples of the corroding idealization of the old order (against cre-

Downloaded by [New York University] at 04:57 12 August 2016 ativity and freedom) come to mind. The fi rst example involves the concept of reporting Institutes. Several psychoanalytic Institutes in the American Psychoanalytic Association were reporting Institutes. A reporting Institute expected training analysts to report to education committees on the progress of the candidates they had in analysis. Looking at this grim period in the history of psychoanalysis, a group of training analysts claiming to know the truth about the complexity of an analytic process in which they were participating, in order to justify disclos- ing the candidate’s state of mind to a group of colleagues immersed in the group dynamics of an Education Committee, for the purpose of advancing truth in analysis, was utter arrogance. My Most Unforgettable Character 133

A second example involves the following: for almost a half a century after Freud introduced his libido theory, classical analysts were devoted to penis envy to explain female development and psychopathology. Today, we understand that penis envy is a response to a fantasy that does have a place in analytic understanding, but certainly is not central to female development and psychopathology. Unfortunately, many analysts rigidly adhered to this limited explanation, while female patients frequently felt cowed and overpowered at the persistent interpretations from their analysts. These analysts conveyed they understood more about their female patients’ experience than they actually did, and were not able to consider that their patients’ frustration could be caused by anything else, including the lack of understanding of their analysts. In 1978 when changes in the insularity of classical psychoanalysis had just started, I fi rst read one of Joe’s early papers, “The Testing of Reality from the Standpoint of the Body Self.” In this paper, Joe focused on several ideas that were new for those days. He wrote about the patient’s experience, which was before the onset of interest in subjectivity. He wrote about the importance of the Self, when Kohut was just beginning to publish his ideas on Self Psychology, and he wrote about the application of infant development in understanding clinical material which was beginning to take hold in the minds of psychoanalysts. Listening to Joe was like breathing fresh air because of his capacity to integrate a variety of ideas into the matrix of psychoanalysis. I immediately invited him to present a paper for the Michigan Psychoanalytic Society to show my colleagues who I had discovered. Six months later he presented “The Development of the Sense of the Object” to my colleagues in Michigan. In the paper he focused on ideas that were evolving, from the budding interest within classical psychoanalysis, on Object Relations Theory and the Self, while considering how they could be integrated with the fundamentals of instinct theory and ego psychology. During my fi rst few experiences with him, I felt like energy and freedom were being released from the depth of my mind as we discussed the rele- vancy of discoveries of infant researchers like Daniel Stern (1977), Louis Downloaded by [New York University] at 04:57 12 August 2016 Sander ( 1975 ), and Robert Emde (1981 ) and their missions to illuminate clinical psychoanalysis. Several weeks after he delivered his paper in Michigan, Donald Silver and I discussed the need in psychoanalysis for a journal that could be more integrating of a variety of analytic ideas with ego psychology. I then said, “If we had any guts we would do it.” Don replied, “So, let’s do it!” The nexus of Psychoanalytic Inquiry was born. Keep in mind that neither of us had any experience with publishing a journal. Yet, I knew that there was fundamental truth and value in psychoanalysis that enabled the transformation of suffering into joy and creativity even though I had grown to believe that ego psychologists had made a wrong 134 M. Bornstein

turn. A journal that could explore how ideas could be integrated into the body of psychoanalytic theory and technique to enable psychoanalysis to advance could be valuable and successful. We needed an editor-in-chief, someone whose talents would fi t with the mission of the journal; to open a diversity of ideas with the intent to add to the operating body of knowledge within psychoanalysis. In this way, any idea would be fair game, if it could be made to work with what was already useful. Of course, I knew the person who could fi t this bill. Actually, unconsciously the idea of a journal with Joe as the editor developed in my initial conversations with him, but I did not know that at the time. Late one evening, after a psychoanalytic meeting, I called him and told him of our plans for a new journal. I asked him to be the editor-in-chief. For the only time ever, he answered me with a, “Well I don’t know, there are expenses, fi nding writers, journals are not doing that well and there will be diffi culties in fi nding a publisher who would work with us.” My reply was none of these are problems that cannot be solved; we have a gold mine in psychoanalysis. The general value of psychoanalysis has not been recognized, because of the insularity that has pervaded the entire fi eld. This will be a journal directed to change that everyone will eventually, I emphasized eventually, be enriched because of it. He said, “I will think about it.” The next morning he called me and said he was thinking and after speaking to me, he would do it. I said that we have several people in Michigan who would like to create a journal, with you as editor-in-chief. We met, and after a lengthy discussion, we decided that the journal would be topical. There were no psychoanalytic journals devoted to one topic for each issue. We would invite contributors to write on a topic with different viewpoints. The journal would begin with a prologue, end with an epilogue, and serve the purpose of discovering creative approaches to integrating a diversity of points of view. The synergistic effect on its writers and readers was its principal value. We needed to develop an editorial board that would help us select topics, locate writers, and edit and organize journal issues. Within days, we had our editorial board, since Downloaded by [New York University] at 04:57 12 August 2016 virtually everyone we asked was enthusiastic about our project. At the time, many good writers could not get their papers published in analytic journals because their approach did not refl ect the current application of ego psychology. Without any experience, we entered into a contractual arrangement with our fi rst publisher which was entirely to the publisher’s advantage. We were naive, but entirely delighted that the publisher was interested in publishing our new journal. We were thrilled with the arrangement that we probably would have settled for any terms within reason. We launched Psychoanalytic Inquiry, and the fi rst issue began with our credo. We stated: My Most Unforgettable Character 135

We believe this to be a promising era of diversity and creative ferment in psychoanalysis. The legacy of Freud and of those who along with him pioneered the psychoanalytic exploration of the mind provides a solid base for the evaluation and integration of current divergent views. A common acceptance of psychic determinism, unconscious motivation, intrapsychic confl ict, genetic and experiential infl uences on maturation and development, and the signifi cance of the child-parent interaction in shaping individuality unites an extensive group of mental health professionals. These mental health professionals follow Freud in one or more of the three interrelated fi elds that he established: the clinical practice of psychoanalysis and psychoanalytically based psychotherapy, a far-reaching method of research into all areas of human development and productivity, and the formulation of a theory of mental functioning and of human individuality and interrelatedness. This journal, by taking up in each issue a topic chosen from the broad areas of practice, research, and theory, can offer the reader an appreciation of the diversity of views and the problems and potentials for synthesis. We believe that the mode of observation central to psychoanalysis is that which occurs in the formal clinical setting of analyst and analys- and. It is based on the unique experience of the shared perception of transferences being formed, analyzed, and resolved. From this source, especially with its expanding scope, comes a continuous fl ow of data – much confi rmatory of Freud’s basic proposals, much new and challenging. In addition, the expanding scope of research into neonate and child development, neurophysiology, and cognitive development, and studies of creativity applied to science and the arts have produced a healthy abundance of augmenting information. Through the presentation of original contributions on a topic in each issue, we plan to contribute to the transmission and comprehen- sion of the exciting profession of clinical and extra-clinical knowledge. We hope in this way to contribute to and participate in the open-ended discourse that we believe constitutes the essence of a broad, encompassing, psychoanalytic inquiry. Downloaded by [New York University] at 04:57 12 August 2016 And there you have it, a journal that promoted integration and pluralism leading to further development and sophistication, beginning with Freud’s basic theoretical and clinical ideas. Joe and I shared a conviction that when we got down to basics psychoanalysis was about the human capacity to bring coherence and meaning out of fragmentation, confusion, and chaos promoted by relatedness and intimacy. Joe and I were energized and immersed in an array of psychoanalytic ideas. In our work together it seemed that we were always on the same page. I felt that no one had the capacity to bring coherence from diversity like Joe. I think my reaction to what he said just resonated with my emotions. I felt 136 M. Bornstein

motivated to use his ideas to move my thinking along. This was not necessarily the direction of his thinking, but it felt like we had a semblance of a healthy twinship relationship, i.e., separate, but very similar. Disagreements were handled by a willingness to fi nd a creative way of integrating both our viewpoints which was an application of the strengths of psychoanalysis. We needed an engaging topic and writers for our fi rst issue. At that time it was rare, except at national meetings, to have an all-day symposium on a psychoanalytic topic. Locally, many of the clinical analytic meetings were closed to the public. Marvin Margolis, another psychoanalyst, and I fl ew to Philadelphia to attend the Margaret Mahler Symposium which was the only large clinical psychoanalytic symposium open to the public that we knew about. I recall being so impressed that there was a lunch served, and the presentations with enthusiastic participation from the audience ended in a dinner. We thought that this format was just what psychoanalysis in Michigan needed for our outreach activities. Regression in psychoanalysis was selected as the fi rst topic for our second annual symposium and became the basis of the fi rst issue of Psychoanalytic Inquiry , by elaborating on the symposium, with invitations extended to several additional analytic writers with a variety of perspectives: Nathaniel London, Paul Ornstein, Howard Bacall, Joe Lichtenberg, and Floyd Galler. I wrote the prologue and epilogue. A common theme in all the papers was that the pejorative meaning of regression commonly used in psychoanalysis does not suffi ciently address its value in human development and psychoanalytic therapy. As a complement to Psychoanalytic Inquiry, we arranged for the establishment of a Psychoanalytic Inquiry Book Series that fostered our credo. Joe and I fought many battles in promoting the credo for Psychoanalytic Inquiry . There is rarely a conversation that I have had with him during the last 30 years without his telling me of some new integrative and creative idea that he has for Psychoanalytic Inquiry, which I then devote the next week integrating with my thoughts and coming back with a creative, implementing plan. Joe’s boundless energy has resulted in a continual fl ow of publications Downloaded by [New York University] at 04:57 12 August 2016 which he has traveled the world to present, and has been Psychoanalytic Inquiry ’s wonderful development and advertising ambassador. He is my most unforgettable character because he is the credo of psychoanalytic inquiry.

Bibliography

Emde , R.N. ( 1981 ). Changing Models of Infancy and the Nature of Development. J. Amer. Psychoanal. Assn. , 29 : 179 – 219 . My Most Unforgettable Character 137

Lichtenberg , J. (1978 ). The Testing of Reality From the Standpoint of the Body Self . Journal of the American Psychoanalytic Association, 26 : 357 – 385 . Lichtenberg , J. (1979 ). The Development of the Sense of the Object. Paper Presented to the Michigan Psychoanalytic Society, January 13, 1979, Southfi eld, MI. Sander , L. ( 1975 ). Infant and Correcting Environment. In Exploration in Child Psychiatry , ed. J. Anthony . New York : Plenum . Stern , D. (1977 ). The First Relationship: Infant and Mother . Cambridge, MA: Harvard University Press . Downloaded by [New York University] at 04:57 12 August 2016 11 DEVELOPMENT OF THE INSTITUTE OF CONTEMPORARY PSYCHOTHERAPY AND PSYCHOANALYSIS The Birth of the Institute of Contemporary Psychotherapy and Psychoanalysis

Rosemary Segalla , Ph.D.

During the 1970s, the psychoanalytic world was in considerable foment. It was during this era that Freud’s theories were being challenged and revised to more adequately address the most pressing clinical and therefore theoretical issues of the day. The culture was in transition, with greater emphasis on the narcissistic needs of the individual as well as a gradually emerging willingness to re-examine the very essence of what was a healthy person. At this time, I was a member of a peer supervision group that met weekly to read and discuss new theoretical ideas as well as discuss pressing clinical cases. We pursued most of our study on our own but occasionally, when we felt that the theoretical material needed further elaboration, we would consult with someone in the fi eld we considered to be an expert. Joe Lichtenberg was an established and well-known psychoanalyst and we decided to meet with him for further clarifi cation of Kleinian theory. What was noteworthy for me about this fi rst meeting was not only the breadth of Joe’s knowledge but also his capacity to hold theory lightly, leaving the opportunity for the therapists and the group to present their ideas as well. Our group pursued

Downloaded by [New York University] at 04:57 12 August 2016 an earlier consultation with another well-known analyst in Washington because of questions we had about Kohut’s fi rst monograph, The Analysis of the Self (1971 ). Little did I know that my future engagement with Joe would be the result of our mutual involvement with Self Psychology. Joe was known to Heinz Kohut because of a review he had written about Kohut’s monograph, demonstrating not only his appreciation of Kohut’s ideas but also his keen observation that this man was offering something new and very different to the psychoanalytic world. Kohut was deeply appreciative of Joe’s capacity to understand his theoretical contribution. As part of my role in the Washington Society for the Study of Psychoanalysis, a local chapter of Division 39 of the American Psychological Association, that Birth of an Institute: the ICP&P 139

I had co-founded with Rochelle Kainer and others, I was pursuing my own exploration of Kohut’s work in preparation for teaching a two-semester course. At that time, Joe and I were vaguely aware of each other’s interests. Early in the 1980s, I received a call from Joe. He was interested in starting a Self Psychology study group and wondered if I might be interested. I was, and so we compiled a list of other professionals whom we knew to be interested in exploring Kohut’s ideas. The group met for a few years with members who embraced or ultimately rejected Kohut’s contributions. Early in the group’s development, we each discussed what we hoped to accomplish in this study group. In a quite spontaneous way, I spoke of my interest in applying self-psychological theory to my work as a group psychother- apist. Group psychotherapy seemed to be an ideal clinical application of these ideas. I presented my interest to the self-psychology study group and was especially attuned to Joe’s response to this idea. He responded warmly, and his encouraging response set the stage for the beginning of a lifelong pursuit of writing about group treatment. My fi rst paper was presented to a creativity group that was part of the Washington School of Psychiatry. It was well received and reinforced my desire to continue to explore clinical applications of self theory beyond the dyad. During this time, Joe and I kept in touch. He was aware of my teaching as well as my writing about group therapy. By now, it was the late 1980s, and the self-psychology organization was to hold its annual conference in Washington, D.C. Joe was chosen to direct this conference, formulate its content, and ask people to present particular workshops. He called me and asked me to present on the application of Kohut’s theory to group treatment along with my co-therapists, Bruce Wine and Damon Silvers, with whom I had been co-leading therapy groups for about eight years. The three of us subsequently presented our theoretical work for the next 15 years. As I write this, I become more and more aware of the subtle and not so subtle infl uence of Joe on my development as a psychologist. He has the capacity to encourage others in a generous and open manner, without competing with or wishing to diminish their work. Of course, this also captures his confi dence in the development of his own ideas, which continue to fl ow at a Downloaded by [New York University] at 04:57 12 August 2016 remarkable pace even today, 25 years later! By the mid 1990s, Joe had published several ground-breaking books, the latest at the time being Self and Motivational Systems ( 1992 ), co-written with Frank Lachmann and Jim Fosshage. His involvement with Self Psychology continued as did mine. We did not meet frequently but our contacts, either social or professional, were always warm. When we did meet, there was always some new idea to explore or story to share. Joe has always been a great storyteller and I have always loved to listen to stories. The biggest story for me was the one we co-created. In late December, 1993, during the quiet time between Christmas and New Year, Joe and I met to dialogue about the possibility of starting a free-standing Psychoanalytic 140 R. Segalla

Institute with Self Psychology as its primary theoretical commitment. I was skeptical, since I had previously been part of an earlier effort to create such a learning and training organization, the Washington Psychoanalytic Society. I received my own training in this local Institute where for four years I studied with many fi ne professionals. That free-standing Institute, spearheaded by Rochelle Kainer, Ph.D. and Susan Gourevitch, Ph.D. was an early effort to bypass local psychoanalytic institutes where psychologists and social workers were restricted to applying psychoanalytic training to research. In the late 1980s, this rule was challenged and overturned. I came to my meeting with Joe expecting to hear that he had some clearly formulated ideas but I did not expect to fi nd that his ideas and my own were so closely aligned. He suggested that we create something quite uniquely different from the traditional Institute model. We chose the name ICP, Institute of Contemporary Psychotherapy, because the local community was still quite devoted to traditional Institute models. Our decision was to wait before we considered a psychoanalytic training track. As Joe formulated it, ICP would be a member organization that would offer training, study groups, as well as several conferences per year, open to members and other mental health professionals. Our focus was on creating a non-hierarchical organization of mental health professionals from all disciplines that would offer a community to members who wished to be part of a group that encouraged open-minded exploration of cutting-edge developments in the fi eld. The difference between us, however, was in both the clarity of his plan as well as in the idea of making ICP a member organization. Members would pay dues and take advantage of the many study group offerings and conferences without taking part in a training program since many of them had already completed their training elsewhere. At this point I was stopped dead in my tracks. How would just the two of us make such a plan come true? Again, I was struck by the creativity of Joe’s thought process. To bring this Institute into being would require both money and people. Joe suggested that we each invite ten mental health professionals to dialogue about this venture. He was active in the psychoanalytic community and I in the psychology and social work communities. Downloaded by [New York University] at 04:57 12 August 2016 Drawing on these distinct communities would provide a strong and varied group of professionals. We suggested that each interested mental health professional invest $1000 in this project in order to launch it. Our fi rst meeting was scheduled for February 1994. This meeting was momentous and well attended, making it clear that the time was ripe for this venture. Ultimately, we had 31 founding members, affording us a good group comprised of social workers, psychiatrists, and psychologists as well as members from nursing and other related fi elds. Very quickly the group sprang into action and we were able to hold our fi rst conference, called the Annual Conference, in April 1994. Study groups were formed and people began meeting on a regular basis. Birth of an Institute: the ICP&P 141

Because Joe was so much a part of the Self Psychology community, we were able to invite those people to speak who were part of Kohut’s inner circle. It was a pleasure to welcome Ernie Wolf, Marian Tolpin, Anna and Paul Ornstein, Art and Naomi Malin, Estelle and Morton Shane. Of course, because of Joe’s writing collaboration with Jim Fosshage and Frank Lachmann, we were pleased to have them present their work. Beatrice Beebe was a favorite because of her unique work with infants. Many of the ideas for the topics of these early conferences came from Joe. At the same time that the Institute was offering these stimulating conferences, the study groups were also moving along very well. We were all in study groups that provided both intellectual stimulation and the opportunity to meet other professionals who shared similar interests. I always look with great interest on the new study groups being formed and fi nd that indeed these groups are studying ideas that are at the cutting edge of contemporary theory. This discourse would not be complete without an exploration of the training arm of the Institute. We now have three training programs (psychotherapy, psychoanalytic, and couples). Joe, in his effort to avoid a hierarchical organization, suggested that we do not use the term “student” for those in our program, in an effort to bypass the idea of those in training and not being full Institute members. He suggested, and I agreed, that students be called “members-in-training,” indicating their full membership in the organization. They also had a representative on the board to ensure their sense of full participation in the organization. We continue to use this term and hope to convey to all that the Institute welcomes input from these members. Efforts are continuously made to improve our offerings and upgrade the courses based on the input from those in training. By now, after 16 years, many of our faculty are graduates of our training programs. No Institute story would be complete without mention of some of the bumps encountered along the road. We were faced with requests from some ICP members to create a psychoanalytic training program. Both Joe and I agreed that this was an issue worth exploring. There were, however, members who raised strong reservations since their primary concern was the distribution of faculty. That is, they felt, that if we instituted such a psy- Downloaded by [New York University] at 04:57 12 August 2016 choanalytic training program, we would lose the psychoanalysts who were teaching in the psychotherapy program, thereby compromising the quality of the training. After considerable debate, we decided to hold a town hall meeting during which members could express their concerns as well as their negative feelings toward psychoanalysis based, I believe, largely on the fact that many members had indeed been stung by their own experiences of exclusion from the psychoanalytic community because of their training background. There was considerable concern that this disruption would cause a major break in the organization. Although I shared some of this concern, I believed we could fi nd a meeting of the minds that would be somewhat satisfactory for all involved. It was here that my training as a 142 R. Segalla

group therapist was helpful in moving the organization toward some kind of resolution. The outcome of the meeting was that we would establish a psychoanalytic training program in addition to the psychotherapy training program. Today, both programs exist side by side. The disruption as a result of the change in the Institute is probably mostly healed, but I believe some hard feelings remain. We did lose some members over this decision and indeed, members’ assessment that some of the psychoanalytic faculty would no longer teach in the psychotherapy program was correct. It took some years to adequately replenish faculty of the psychotherapy program. The losses are there, but so are the gains. With the addition of the psychoanalytic training program, we were able to offer our members psychoanalytic training and now many of these graduates are faculty members of the psychotherapy training program. This disruption was diffi cult for Joe who had lobbied so hard for an organization with a shared and equitable vision. I was less disturbed because I had an understanding of the negative feelings of those members who had felt slighted by the psychoanalytic community. Because of his embeddedness in the psychoanalytic world, Joe did not quite appreciate the depth of the non-psychiatric members’ experiences of exclusion from this hierarchical world. What I believe we did learn was that the organization could continue to thrive despite some disruption because of the basic design of the organization, attempting to afford equal voices for all in the community. I remain hopeful that any disruption we face as an organization will be met with an open-mindedness that is part of the culture of this Institute. As the Institute grew, a third training program – couples therapy – was added. This was the vision of one member, Barbara Shapard. This program has been thriving and fi lls very specifi c needs within the organization. The faculty of the couples therapy program is dedicated to providing a unique training devoted to applying self-psychological principles to couples treatment. With the addition of a psychoanalytic training program, we faced the need to change the name of the organization. We came up with a great variety of awkward choices and after much discussion decided on ICP&P, Downloaded by [New York University] at 04:57 12 August 2016 though some people still refer to it as ICP. The Institute of Contemporary Psychotherapy and Psychoanalysis captures both our original focus on psychotherapy and also acknowledges the presence of psychoanalysis as part of the organization. There have been many highlights too numerous to mention during all of these years. We offer short courses which refl ect the particular interests of a member or are topics requested by the members such as psychopharmacology and mind-body issues. Joe is part of that effort and is teaching from his latest book, Psychoanalysis and Motivational Systems: A New Look (2011 ), written with Jim Fosshage and Frank Lachmann. Birth of an Institute: the ICP&P 143

Joe does all of this while presenting around the world and playing a very active role in the International Association of Psychoanalytic Self Psychology. A group of us recently honored him with a celebration of his 85th birthday. He serves as a role model for all of us, offering the opportunity to confront and expand our abilities as therapists and psychoanalysts and to continue to grow in our understanding of human behavior. Joe has been an inspiration to many people who have been rewarded by his deep knowledge and understanding. His capacity for great pleasure is basic to who he is; this includes the gratifi cation he receives from photography, art, music, and literature. His interests are like the fountain of youth, keeping him vibrant and youthful, spilling endlessly from within him. I am sure the fountain has many more years to fl ow, and I look forward to being part of this.

References

Kohut , H. ( 1971 ). The Analysis of the Self . New York: International Universities Press . Lichtenberg , J. , Lachmann , F. , and Fosshage , J. (1992 ). Self and Motivational Systems . Hillsdale, NJ: The Analytic Press . Lichtenberg , J. , Lachmann , F. , and Fosshage , J. (2011 ). Psychoanalysis and Motivational Systems: A New Look . New York : Routledge . Downloaded by [New York University] at 04:57 12 August 2016 12 THE DEVELOPMENT OF A PSYCHOANALYTIC TRAINING PROGRAM The Road to Becoming a Training Analyst and Beyond: Traversing the Terrain between 1 Accommodation and Creativity

Sandra G. Hershberg , M.D.

Why is it, I have often wondered, that the trajectory of the psychoanalytic process itself, where the analyst promotes openness, self discovery, and affi rmation for the analysand along the way, can be and (if the open line of the American is any indication), has been for many such a different road from the process of becoming a training analyst? The latter route, unfortunately, is one more likely to call for caution about how much to reveal, to promote chronic wonder if what you know is good enough, and to feel all too isolated along the way. Having grown up in this system and viewing a training analyst as an accomplished highly esteemed professional, immersed in the intellectual and affective complexities and particularly the compassion necessary for the psychoanalytic endeavor, I have found these contra- dictions very troubling. While we would all agree that the process of psychoanalytic education requires evaluations to assess the progress of each candidate, institutes

Downloaded by [New York University] at 04:57 12 August 2016 under the aegis of the American Psychoanalytic Association, hierarchic- ally organized, require an extensive process of postgraduation examination, all with the aim of gauging an analyst’s clinical competence for becoming a training analyst, the sole criterion used in all cases. Other aspects of the analyst’s personal and professional capacities as part of a broader focus could easily include skills in research, scholarship, knowledge of literature, and other interdisciplinary understandings refl ecting a fuller image of an analyst. Such consideration has recently been included at the Berkshire Psychoanalytic Institute (personal communication, G. Moraitis, 2014 ). Becoming a Training Analyst and Beyond 145

The implementation of these evaluations as currently organized can engender a feeling that one has never arrived. The major steps in this system which contribute to the present state of affairs include: 1) an evaluative process, certifi cation, is a requirement for appointment which is based, in the end, on far less information about the analyst as compared to the analyst’s training evaluations and supervisory reports used to determine graduation; 2) an extensive evaluation process (CNSTA) following graduation and including certifi cation, in which there are additional assessments for becoming a training analyst, that can implicitly and subtly undermine the analyst’s sense of competence; and 3) in the context of a pluralism of models in contemporary psychoanalysis, diffi culties can emerge when the examiner evaluates using one model (most often the ego psychological model) and the examinee espouses another model to be more salient. I will examine these three critiques of the evaluation process in greater detail and then propose an alternative.

Certiﬁ cation and Assessment by CNSTA Committee Ironically, while supervisors spend hours reviewing a candidate’s weekly case material and process notes, somehow three such experiences of supervision of control cases are adequate for graduation but are not suffi cient for certifi cation. If one is fortunate or perseverant enough to mount these two hurdles (graduation and then certifi cation), there is yet a fi nal rite of passage, the assessment of the Committee for Nominating Supervising and Training Analysts (CNSTA) which the desirous training analyst-to-be must convince of his/her worth as a training analyst. In its role the CNSTA can recommend additional supervision or courses of supervision and additional case presentations before making a fi nal decision, a process which can take years. Shane and Shane (1995 ) speak to the importance of privileging the educational process with an emphasis on “fl exibility and contextual understanding in the application of standards” (p. 238) as an analyst goes through the evaluation process. They provide numerous examples in which a candidate

Downloaded by [New York University] at 04:57 12 August 2016 or by extension a training analyst-to-be is instructed, more or less openly, by well-meaning supervisors, themselves caught in a bind, to distort, edit or leave out data because they know from their experience that the candidate will be penalized for his/her candor. This systemic problem can all too easily lead to suppression and compliance, certainly qualities that we would all agree is not what we want to foster. Continual testing of the analyst maintains the hierarchical structure among analysts that can subtly undermine the analyst’s achievements and confi dence. In an informal inquiry of fi ve recently appointed Training Analysts from different institutes who were asked about their experiences going through the 146 S.G. Hershberg

fi nal phase of the process, which involved making presentations of cases to the CNSTA Committee, each became visibly uncomfortable and did not want to discuss it. My speculation is that the silence was related to shameful or humili- ating aspects of these experiences, which understandably but regrettably intensifi es the desire to avoid further discussion. On the positive side, those who have experienced these steps as problematic may feel greater empathy for those going through it and speaking about it could provide a level of understanding and responsivity that would serve as an antidote. Of greater concern is the potential for re-enactment, consciously or not, depending on the experiences of the particular analyst, and infl uences within the group, that is the history and culture of the particular institute and the patriarchal legacy of the American Psychoanalytic Association (Mosher and Richards, 2005 ).

Pluralism of Models Currently, a pluralism of models in contemporary psychoanalysis and an explosion of research in related areas have made the evaluative process far more complex and diffi cult. For the most part, institutes under the umbrella of the American Psychoanalytic have continued emphasizing Freudian and ego psychological models in training. The evaluators may not really understand, no less believe, in an alternative model and they may feel with emotional conviction that their model is correct. The result for the analyst who endorses a different model could easily be to feel pressured to comply or to suppress his or her independent creative direction and differing theoretical framework. The consequences of this situation leave the prospective training-analyst-to-be struggling with a confounding, potentially irrecon- cilable dilemma: If an analyst accepts that the accomplishment of the developmental task in one’s training analysis is as Edith Weigert ( 1954 ) wrote, “daring to relinquish a dependent identifi cation for a mutually respectful differentiation” (p. 637), then the analyst may be in trouble if he or she embraces the practical application of Weigert’s clearly stated goal. For example, when one adopts a different theoretical position that entails a different technical stance or view of therapeutic action, an analyst likely risks Downloaded by [New York University] at 04:57 12 August 2016 being judged, usually from the more traditional position, as unacceptable. It is the rare analyst who moves through each step without having to repeat some part of the process, leading inevitably to feelings of incompe- tence, defl ation, or humiliation about having been considered inadequate in some part of the process. This struggle can induce compliance with a sense of shame or rebellion with a sense of alienation (Buechler, 2008).

Autonomous Psychoanalytic Institutes While dissatisfactions with the current system have grown, or, perhaps, been more openly expressed, more substantive systemic changes are necessary to Becoming a Training Analyst and Beyond 147

promote an institute environment that rewards independent creative thinking. In my view, we would benefi t from looking at the experience of autonomous psychoanalytic institutes (for example, the Institute for the Study of Subjectivity in New York, the Institute of Contemporary Psychoanalysis in Los Angeles, and the Massachusetts Institute for Psychoanalysis in Boston), in which a greater degree of independent thinking and writing is encouraged and has fl ourished, while standards remain high and candidates are not infantilized. In a number of these institutes, after graduation, which involves case write-ups and often presentations to other analysts, analysts are requested to continue to present and discuss their clinical material in groups and may or may not continue to receive other forms of supervision. A customary practice among these institutes is to accept each graduate analyst, after fi ve years of postgraduate experience of carrying and discussing analytic cases, as a Training Analyst. In such an ambience the developmental arc of the analyst following graduation and into maturity can be respectfully and proudly encouraged rather than potentially constrained by repeated evaluations that can all too easily create a protracted period of adolescence.

Searching for a Psychoanalytic Home Which Appreciates and Fosters the Developmental Progression of the Psychoanalyst (and Training Analyst) In a sense many of us are psychoanalytic immigrants arriving from other psychoanalytic homes, traditions, and personal experiences. Laub’s (2013 ) description of the emotional terrain of the psychoanalytic immigrant who searches for a sense of home captures an aspect of the feeling that we are each, in our own way, seeking:

For an analyst to do the work, he must reside in his emotional home … a space where an inner truth can be safeguarded and protected, as well as shared with others who are receptive to it. Only in such a privileged space can processes of association, symbolization, and creative insight

Downloaded by [New York University] at 04:57 12 August 2016 fl ourish … Forced assimilation is inimical to the preservation of such internal protected space, to the safeguarding of personal truth. (pp. 475–476)

I did not realize that I was really seeking and would fi nd a clinical and theoretical home that would become a mainstay of my personal and professional growth over the ensuing years. In 1992, a study group consisting of graduate and senior analysts from local institutes (Joe Lichtenberg, Curtis Bristol, Floyd Galler, Fonya Helm, Liz Hersh, Fred Hilkert, Susan Lazar, David Levi, Charlie Olsen, Betty Ann Ottinger, Stefan Pasternack, Joe Silvio, and myself) met in Joe Lichtenberg’s home. We were surrounded by iconic images of famous fi gures of the twentieth century taken by master 148 S.G. Hershberg

photographers, dramatic photographs of African scenes, and, in addition, a breath-taking Burtynsky image of mined resources in China. These images provided an aesthetic sensibility, which, for me, elevated our endeavor as we communed with them and whose familiarity provided a visual backdrop that lent to the excitement and pleasure of our project. We read various papers from the burgeoning self-psychology literature. We grappled with this new theory trying to understand concepts of empathy, self-object, and intersubjectivity, and attempted to make these ideas our own, as well as to challenge them when they did not fi t our clinical experience. After a few years of participation in the study group, Joe raised an expansive and innovative idea. He wanted us to consider joining forces with Rosemary Segalla, an esteemed psychologist with particular expertise in group psychotherapy, to form an Institute with a self-psychological/relational orientation. Our analytic study group (and Joe’s other supervisees) would combine with a large group of therapists taught and supervised by Rosemary and her colleagues, Damon Silvers and Bruce Wine (leaders of the Group Psychotherapy Training Program at the Washington School of Psychiatry). As a result, the Institute of Contemporary Psychotherapy (ICP) was born.

Building a New Psychoanalytic Home The motivation of the group of founding analysts in ICP was rooted in our collective desire to build a psychoanalytic training program that was different from the kinds of experiences we had each encountered as candidates and afterwards in the more traditional institutes. We wanted to fashion the following: 1) an environment that privileges creativity and inquiry rather than imposed accommodation and compliance; 2) encourage independent thinking and scholarship while standards remain high and candidates are not infantilized; and 3) be a generative group, assist- ing candidates with needed teaching and supervision and simultaneously Downloaded by [New York University] at 04:57 12 August 2016 encouraging scholarship in exploration of one’s own creative theoretical and clinical ideas. The impetus for creating a psychoanalytic training program came from a few members within ICP who had completed advanced psychotherapy training programs at other institutes and wanted to participate in a psychoanalytic training program with a self-psychological theoretical and clinical focus. The Board ultimately approved the launching of a psychoanalytic training program within ICP. 2 At this point ICP was re-named the Institute of Contemporary Psychotherapy and Psychoanalysis (ICP&P). I became the Director of Psychoanalytic Training. Becoming a Training Analyst and Beyond 149

My Role as Director of Psychoanalytic Training The experience of creating a psychoanalytic training program from scratch is an exciting and daunting undertaking. All of us discussed the initial scaf- folding for structuring this program that refl ected the sensibilities of the core group of founding analysts. Looking back, I imagine Joe had thought about this project based on the evolution of his values and long experience in traditional institutes, and also, informed by his relatively newer knowledge of the differences in training and requirements in autonomous psychoanalytic institutes. These factors, I believe, led to a number of proposals during initial discussions, of establishing an innovative structure for psychoanalytic training. These included re-naming Candidates to be Members-in-Training to acknowledge a more egalitarian, democratic, and respectful status. The training period would not be open-ended but would be a fi nite period, generally from fi ve to seven years. To that end, Members-in-Training would be informed specifi cally as to where they stood in regard to their progression so that there would be few surprises along the way, unlike more traditional institutes where trainees could continue for decades. In the last year of formal curriculum, the Members-in-Training would participate in designing the curriculum along with the Director of Training to include areas about which he/she would like to learn. Finally, the designation of Training and Supervising Analyst would apply more broadly to include analysts who were fulfi lling those roles. How graduates would advance to a more senior status was touched upon only in a most general way. Those in the fi rst few classes moved fairly quickly into positions of responsibility for teaching and supervision at a time of rapid expansion of the Institute. Later on we thought more about the consolidation of an analytic identity postgraduation where the graduate would be encouraged to develop in a looser, but supportive structure to promote greater individual development, clinical expertise, and expansion of one’s own ideas and interests. More specifi cally in the three years post-graduation, graduates were encouraged to continue analytic work, participate in peer group presentation of cases, and partici-

Downloaded by [New York University] at 04:57 12 August 2016 pate in courses such as one on supervision. Many taught in the psychotherapy program. Our aim in changing the structure involved a continuing effort to be aware of and address subtle and not-so-subtle idealizing and devaluing patterns of interactions to provide an open and democratic structure and to recognize and support opportunities for candidates during and after their training. We all hoped that this alternative model for psychoanalytic training would be devoid of a hierarchical bent. While the faculty worked very hard to diminish this feeling, perhaps, and not surprisingly, there was a residue of themes that are inherent in any family system, themes organized around dominance and submission, competition, envy, idealization, and sibling rivalry. 150 S.G. Hershberg

In reflecting on the 14 years that I have been the Director of Psychoanalytic Training I am aware how the sense of community and the commitment of the faculty facilitate each candidate’s (and faculty member’s) individual developmental trajectory. For example, when a candidate I supervised indicated an abiding interest in intersubjectivity theory and formulating a treatment manual for the military, I strongly encouraged him to seek out Bob Stolorow as a supervisor, which helped forge an important personal and professional relationship. When another candidate who began her training with a weaker theoretical and clinical background was offered additional tutorials to supplement her learning, she became better equipped to work clinically. For me, taking on this position of leadership and responsibility presented a wonderful opportunity for personal and professional maturation. I became more actively engaged and dedicated to developing myself as a contributor to the psychoanalytic literature, a teacher, an accomplished analyst, and a leader.

Concluding Remarks How does one move into that professional sense of self, as a psychoanalyst with the feeling that “one has arrived”? I would suggest that the developmental arc is different for each analyst, and optimally includes a personal feeling of safety and excitement provided by the psychoanalytic home (institute) that the analyst chooses. Here, the analyst’s creative sense of self is protected, shared, and valued by receptive others. All analysts in this home have in common intellectual curiosity, spirit of inquiry, need for dialogue, community, support of initiative (Lichtenberg, Lachmann, and Fosshage, 2015 ) and like-mindedness helping to create a collaborative climate, that can embrace challenges and appreciate difference. In the larger psychoanalytic community the respect for a range of theoretical models and integration of research in neuroscience, infant studies, and changing ideas about therapeutic action encourages revitalization of the fi eld of psychoanalysis Downloaded by [New York University] at 04:57 12 August 2016 as a whole.

Notes 1 I wish to thank Linda Gunsberg, Ph.D. for her careful reading of the text and valuable suggestions for improving the manuscript. 2 Previously a training program in psychoanalytic psychotherapy existed. Subsequently a couples training program was instituted. Becoming a Training Analyst and Beyond 151

References

Buechler , S. (2008 ). Shaming psychoanalytic candidates. Psychoanal. Inq., 28 : 361 – 372. Laub , D. ( 2013 ). On leaving home and fl ight from trauma. Psychoanal. Dialogues , 23 : 568 – 580. Lichtenberg , J. , Lachmann , F. & Fosshage , J. (2015 ). Enlivening the Self . New York : Routledge, Taylor & Francis. Moraitis , G. ( 2014 ). Personal communication, March 25. Mosher, P. and Richards , A. (2005 ). The history of membership and certifi cation in the APsaA: Old demons, new debates. Psa. Rev. 92 : 865 – 894 . Shane , M. and Shane , E. ( 1995 ). Un-American activities and other dilemmas experienced in the supervision of candidates. Psychoanal. Inq. , 15 : 226 – 239 . Weigert , E. (1954 ). Special problems in connection with termination. J. Amer. Psychoanal. Assn. , 3 : 630 – 640 . Downloaded by [New York University] at 04:57 12 August 2016 13 SUPERVISION Learning Motivational Systems Theory from the Inside – My Supervision with Joe Lichtenberg

Elizabeth M. Carr , APRN, MSN, BC

I began to see Joseph Lichtenberg for supervision in 1986, before pursuing psychoanalytic training. Actually, my supervision with Joe played a pivotal role in inspiring me to seek psychoanalytic training and I entered the inaugural class at the Institute for Contemporary Psychotherapy and Psychoanalysis (ICP&P) in Washington, D.C. in 1998 with great anticipa- tion. I had already seen positive results from my supervision with Joe in terms of my ability to more deeply engage with my patients and believed that analytic training would be even more rewarding. At the beginning, however, I was a trainee in a psychotherapy program affi liated with a traditional psychoanalytic institute and Joe served as one of my supervisors. My prior supervisor, coming from an ego psychological perspective, proposed a clinical approach that focused on a patient’s intrapsychic confl icts and, as I experienced it, proposed a clinical approach that moved away from a patient’s subjective experience in order to interpret the presumed unconscious confl icts simmering below the surface. In this endeavor, little attention was given to the relational encounter playing out

Downloaded by [New York University] at 04:57 12 August 2016 between my patient and me. What a breath of fresh air it was to begin to work with Joe! From the fi rst meeting, Joe began to teach me a method of therapeutic listening and communicating that began with sensing into what my patient was telling me in the present moment. The goal was to try to understand as fully as possible my patient’s particular experience, including affects and motivations, and then to communicate that back. Finally, I was to closely track my patient’s responses to see what happens. From my earliest work with Joe, I felt an affi nity with this approach which remains strong today. Motivational Systems Theory from the Inside 153

I resonate with Joe’s (Lichtenberg, 1983 , 1989 , 2005 ; Lichtenberg, Lachmann, & Fosshage, 1992 , 1996 , 2002 , 2011 ) interests in attachment research, infant studies, neuroscience, and, most particularly, with his signature contribution to the fi eld, Motivation Systems Theory. In this ground-breaking theory, Joe integrates fi ndings from developmental psychology with his rich experience as a psychoanalyst to reshape psychoanalytic theory regarding motivation and human development. I fi nd that Joe’s expansion of motivation to seven systems (the regulation of physiologic processes, attachment, affi liation, caregiving, exploration and assertion, sensuality and sexuality, and the aversive system) helps me in my ongoing efforts to try to deeply understand a patient’s particular experience in moment-to- moment encounters. The theory also lays out contemporary clinical strategies that promote the full emotional engagement of the analyst in the dyadic treatment process. Further, the theory beautifully describes the implicit and explicit therapeutic processes that promote healing and growth. I fi nd the depth and breadth of Joe’s theory extremely helpful in my everyday work as an analyst.

Supervision during Psychoanalytic Training My fi rst control case, a man I will call Aaron, provided me with a wonderful training experience. Prior to working with me, Aaron had been in a psychoanalytic treatment that he found unsatisfactory and sought a consultation with Joe. Although Joe offered guidance to the treating analyst, Aaron remained dissatisfi ed and left that treatment. Upon Joe’s recommendation, Aaron came to work with me in late 1994 for psychotherapy and Joe served as my supervisor. By the time my psychoanalytic training began in 1998, Aaron was engaged in four-sessions-per-week treatment and I continued my supervision with Joe for this case. Aaron had a very traumatic childhood, as he suffered at the hands of his volatile, physically abusive father and his neglectful, manipulative mother. Of particular note, Aaron experienced his mother as promising to be there

Downloaded by [New York University] at 04:57 12 August 2016 for him but repeatedly failing him and then blaming him for her failure (Carr, 1997 , 1999 , 2006a , 2006b , 2008 ). In my supervision, I read through notes of sessions with Aaron focusing on the clinical interaction including my affective responses. This allowed us to track closely what happened in the sessions. Joe did not take notes during my presentation but at the end of a session, in a clear and concise manner, conveyed his thoughts about Aaron and our work together. He spoke in everyday language and rarely used theoretical jargon to express his ideas. At the time, it was remarkable to me the way Joe could track the clinical process within a session as well as over a series of sessions without taking a single note and he demonstrated an ability to recall exact 154 E.M. Carr

sequences of clinical interactions as well as to identify themes and pull many diverse aspects of the analytic conversation into a coherent whole. In my own development as an analyst, supervisor, and teacher, I, too, have become able to track sequences, identify themes, and create a coherent narrative regarding my own and others’ clinical interactions. I relate these developments to learning processes at both the explicit/declarative level and the implicit/procedural level in which, I believe, my supervision with Joe played a central role.

The Interpretive Sequence Joe taught me to listen carefully to how Aaron responded to my interventions and he stressed the importance of closely tracking a patient’s reaction to whatever I do or say. He said that I must try to determine whether the patient feels understood and if my interpretations seem to open up the exploratory process or shut it down. For example, in a session in the fourth year of analysis, Aaron refl ected on a sense of profound loneliness he felt upon being alone at home earlier in the day and became in touch with a memory around age 4.

A. Something was not right when I was home alone with my mother. I remember feeling a loneliness that was debilitating. What I remember is her ironing and it was like she was at the end of a deep hall. I see her at a long distance. She ignored me. E. Sounds like she was very shut down. (Thinking of his mother’s depression.) A. It was like she was a zombie and I was all alone … I can remember going to the bathroom and telling her. She told me that I don’t need to tell her. For me, I felt without telling her I would be lost and she would never know. E. You were telling her that you wanted to be connected to her and she was telling you that she did not want to be connected to you. That

Downloaded by [New York University] at 04:57 12 August 2016 must have been very confusing and hurtful. (Empathically fi lling out my understanding of his experience.) A. Yes, I felt all alone with no one to connect to. I think the anxiety I felt earlier today is connected to these experiences with my mother. To realize that is really something!

In these interactions, something new emerged in Aaron’s understanding of his current experience of anxiety and loneliness and he could place these feelings in relation to a pivotal childhood memory. Although Aaron and I realized that his mother was depressed, the extent and impact of her emotional absence had not been fully appreciated. I felt good about this Motivational Systems Theory from the Inside 155

sequence, as Joe told me that when something new emerges or the clinical process deepens, I will know I am on the right track. On the other hand, Joe also taught me that when something I do or say activates a disruption in Aaron’s state, my participation needs to be acknowledged. An example of this occurred at moments when I found some of Aaron’s expressions of vengeance-seeking toward hurtful others threaten- ing (Carr, 2006 a) and I would subtly withdraw from full emotional engagement with Aaron’s feelings. He would feel my absence quite painfully. From my supervision, I knew the importance of fully exploring Aaron’s affective responses to such moments in order to provide understanding in depth. My willingness to shoulder my responsibility for the part I played in Aaron’s experience of disappointment and hurt and then to respond empathically to his feelings proved to be an important aspect of our analytic engagement. Thus, Aaron was no longer left with the terrible feeling that he must take all the blame for what he senses is wrong between him and a needed other.

Identifying Emerging Themes Joe taught me how to listen in order to be able to identify and engage emerging themes to help bring them alive in an analysis. In the supervision sessions, Joe had a gift for describing Aaron’s experience in emotionally rich, evocative language that expanded my understanding of my patient. Further, Joe framed Aaron’s experience from within a developmental context that deepened my appreciation of my patient while simultaneously deepening my understanding of human development. I found Joe’s formulations enlightening, as he put Aaron’s experience into words that captured their richness and complexity. An example of this relates to the prior vignette of Aaron’s experience with his mother while she was ironing and ignoring him and he was trying to connect with her. In subsequent discussion with Joe, he pointed out how the mother’s paralysis and abandonment during this crucial developmental period created a breakdown in Aaron’s expectations of mutuality and responsiveness from others as well as in his capacity to be

Downloaded by [New York University] at 04:57 12 August 2016 responsive to the needs of others. Joe would also offer suggestions about what he might say in a particular clinical moment, which provided me a way to think about communicating what I might want to say, including the words, tone, and affective quality. The idea was not to mimic Joe but to fi nd my own communicative style. In a way, my supervision provided me with a deep immersion in an emotionally rich language that I could learn and use with my patients. An example of this involves Aaron telling me a dream that he found deeply disturbing. In the dream, he is taking his dog to a training session. He was told by a bitchy woman (he associated to his mother) to put his beloved dog to sleep. Aaron was too afraid to challenge the woman even as he knew his wife and 156 E.M. Carr

nephews would be devastated, as they loved the dog. In the dream, Aaron felt he had no choice, injects the dog, and kills him. Then the head trainer returns, is horrifi ed, and is able to bring the dog back to life. In the dream, Aaron said that he felt such guilt, shame, and worried the dog would be permanently damaged. It was the end of the session and I felt strongly that I needed to respond and said,

This reminds me of what you felt growing up – that you had to follow your mother’s orders even if they were to your detriment. In the dream, your wife and nephews love your dog. I believe that you are the beloved dog that is saved but that you are also worried that following your mother’s orders as a child has permanently damaged you, even as our work together is bringing you back to life.

Aaron replies: “It’s what we’ve spoken about so many times. Can I for- give myself for following my mother’s orders? I know I can’t forget about it.” When Joe and I discussed the dream, we both agreed with the themes I mentioned – Aaron’s wish to be saved by a powerful, idealized self-object and his fears that his mistreatment has left him damaged. We also recognized that the dream image of the dog beloved by the wife and nephews demonstrated an important expansion of Aaron’s relational experience.

Disorganized Attachment and Fear in the Transference A central theme that emerged in the treatment related to Aaron’s attachment experience. As Aaron was the victim of severe childhood abuse, Joe and I came to think of him, at least in part, as fi tting the disorganized attachment category – the category that is described as fear without solution. Joe cautioned me to be mindful of Aaron’s propensity for becoming frightened and to accept Aaron’s way of being attached to me. I have described this as “attachment at a distance” (Carr, 2008 ) as Aaron was very cautious about acknowledging any attachment needs directed toward me. At times, he could

Downloaded by [New York University] at 04:57 12 August 2016 tell me that I seemed to understand him and “get” what he was feeling, but going further was diffi cult. Aaron told me, for example, that he could not get close to me or to any other human but could only safely get close to his beloved dog. Joe felt this was an important communication about Aaron’s extreme vulnerability that I should both recognize and acknowledge. As Joe explained it, Aaron’s fearful expectation of me grew out of his abusive, neglectful childhood experiences. Over time, Joe believed that Aaron would become more open and trusting through his alternative sense of me as a reliable, empathic collaborator. Also, Joe thought that Aaron’s love for his dog was an important signifi er of his capacity to love and to be loved. As such, Joe felt this was a Motivational Systems Theory from the Inside 157

positive prognostic indicator. When Aaron’s dog died sometime later, he was able to express genuine grief to me. According to Joe, Aaron’s greater capacity to experience grief and to share it with me was a signifi cant step forward. I found Joe’s way of identifying these moments and framing them as indications of a positive therapeutic trajectory helped to sustain me during many diffi cult and discouraging moments in Aaron’s analysis. As our analytic interaction evolved, in one aspect of our shared experience, I remained a dangerous-other who could hurt Aaron. Simultaneously, in another aspect of our experience, I was the empathic-other who could appreciate the full force of his fears and his vulnerability. As mentioned, Aaron would tell me that it was impossible to ever trust me because if you can’t trust your own mother, one needs to remain forever vigilant to guard against getting hurt. I have indicated times when my emotional withdrawal adversely affected him. Over time, I became able to deeply appreciate Aaron’s sense of danger regarding my potential to hurt him (despite my good intentions) while simultaneously empathizing with both his longings and his fears. Joe thought that the discrepancy between Aaron’s percep- tions of me-as-dangerous versus his sense of me-as-reliable, empathic collaborator would provide the essential building blocks for a change process. Indeed, Aaron and I were eventually able to construct a safe way of being together and he began to express a growing sense of trust in me as well as a new view of himself as a strong and capable man.

Developmental Perspective on the Vitalizing Aspects of Aversive Experience Another important theme that emerged in the analysis relates to the way Aaron sought out aversive experiences as a way to vitalize himself. For example, Aaron would tell me about numerous instances in which he would pick a fi ght in order to feel alive. Aaron had become hooked on a version of the affective intensity that he related to his “crazy family.” Joe viewed Aaron’s addiction to intensely negative affect states as a desperate attempt

Downloaded by [New York University] at 04:57 12 August 2016 to overcome his deep sense of emptiness. Aaron both enjoyed and was troubled by his outbursts. Interestingly, in our interactions, he was very rarely provocative and never nasty. However, with strangers who have irked or injured him and at times with his wife, he would really let loose. In exploring numerous interactions in which Aaron became enraged, I found Joe’s perspective very helpful in expanding my empathic understanding of Aaron and his experience. Essentially, Aaron grew up in a family devoid of attuned responsiveness to his feelings and needs. Further, Aaron’s father erupted in frightening rages and physically attacked him. His interactions with his mother were frequently negative and highly affectively charged. Aaron became hooked on replicating the intense, 158 E.M. Carr

dysphoric affects of his family. In the analysis, Aaron and I came to appreciate how rage served to protect him against helplessness in the face of injury and also served as a source of needed exhilaration. Over time, this helped Aaron become able to deeply grieve his painful childhood and helped to free him from the tyranny of trying to fi ll the empty spaces through destructive outbursts.

Generosity and Generativity Joe has given me a coherent, “user-friendly” frame for engaging analytically while simultaneously supporting me to develop my own unique ideas and my own analytic identity. Over the many years of supervision, our process of working together changed. Initially, he was the teacher and I was the learner, soaking up all he had to offer. As I developed, I was able to articulate my understanding of the analytic process as well as to formulate and discuss my own ideas. I found that I wanted a different, more collaborative relationship with Joe in supervision. Joe responded to my evolving learning needs and in the fi nal phase of our supervision, we spent many satisfying hours sharing ideas and reactions. Throughout my supervisory experience, I found our collaborative engagement captured the excitement and fun of learning at its very best. Joe has encouraged my scholarship and my writing by inviting me to present my work at conferences and in Psychoanalytic Inquiry . As I have taken this up, Joe has consistently been in the background cheering me on. I remember a conversation we once had when I spoke to him about how much he means to me personally. Essentially, I told him that he was a father fi gure to me. This is especially important to me, as I had lost my father during childhood, as Joe knew. I remember him welcoming my heartfelt feelings and movingly responding, “Of course. After all, what could be more fatherly than providing guidance and supporting you?” I am extremely grateful to Joe for all he has taught me, for his generosity to me and for our relationship which has evolved into an enriching

Downloaded by [New York University] at 04:57 12 August 2016 friendship.

Bibliography Carr , E. (1997 ), Building emotional resilience: Integrating clinical and empirical fi ndings. Presented at the 20th Annual International Conference on the Psychology of the Self, Chicago, IL. Carr , E. ( 1999 ), Wounded but still walking: One man’s effort to move out of shame. Psychoanalytic Inquiry , pp. 289 – 308. Carr , E. ( 2006a ), On knowing and using myself: Developing a psychoanalytic state of mind . Psychoanalytic Inquiry , pp. 738 – 750 . Motivational Systems Theory from the Inside 159

Carr , E. ( 2006b ), Shame and abuse: A contemporary self psychological relational perspective. Presented at Symposium ’06: Committee of Psychoanalytic and Psychotherapeutic Publications and Organizations, New York, NY. Carr , E. ( 2008 ), Leaping to safety: A psychoanalytic journey. Presented at the 31st Annual International Conference on the Psychology of the Self, Baltimore, MD. Lichtenberg , J. (1983 ), Psychoanalysis and Infant Research. Hillsdale, NJ: The Analytic Press . Lichtenberg , J. ( 1989 ), Psychoanalysis and Motivation . Hillsdale, NJ : The Analytic Press . Lichtenberg , J. ( 2005 ), Craft and Spirit . Hillsdale, NJ : The Analytic Press . Lichtenberg , J. , Lachmann , F. , & Fosshage , J. (1992 ), Self and Motivational Systems . Hillsdale, NJ : The Analytic Press . Lichtenberg , J. , Lachmann , F. , & Fosshage , J. ( 1996 ), The Clinical Exchange . Hillsdale, NJ: The Analytic Press . Lichtenberg , J. , Lachmann , F. , & Fosshage , J. (2002 ), Spirit of Inquiry. Hillsdale, NJ : The Analytic Press . Lichtenberg , J. , Lachmann , F. , & Fosshage , J. ( 2011 ), Psychoanalysis and Motivational Systems: A New Look. New York : Routledge. Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 PART IV Professional, Artistic, and Familial Partnerships Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 14

RUNNING WITH JOE

Frank Lachmann , Ph.D.

Joe’s creativity has no bounds. He thinks creatively, he talks creatively, and he writes creatively. The fi rst of Joe’s creative ideas that I discovered was model scenes. We bonded over model scenes in our fi rst joint publication. So here is a model scene of my relationship with Joe. It was not our fi rst meeting but it typifi ed our time together. One day, a number of years ago, Annette, Joe, and I went to the Metropolitan Museum of Art in New York to see a show of Spanish paintings. To get to the exhibition room we had to go through several halls of the museum. I thought we would walk at a normal clip through the halls to get to the exhibition we had planned to see. Well, we did walk at a reasonable rate but as we did, Joe gave us a running commentary on the art we were passing – Greek statues, Etruscan ceramics, Renaissance paintings. He not only identifi ed artists, styles, and historical contexts, but he offered comments on comparisons within the styles and cultures. Of course when we arrived at the Spanish art, Annette and I sheepishly thought we might rent an audio guide, but we opted for Joe’s lively erudite commentary instead.

Downloaded by [New York University] at 04:57 12 August 2016 That’s only one side of Joe but it typifi es his extraordinary fund of knowledge that he can tap into at a moment’s notice. It’s the same Joe who presides over the four yearly meetings of our Creativity Group in his home in Bethesda. Every year we pick an author, read four books by him or her, and a biography. A member of the group then gives a paper on the book under discussion. Then Joe, never having heard the paper, offers an off-the-cuff, brilliant synthesis, critique, and discussion of the paper that leads into the group discussion. Please note, I am not using the word “brilliant” loosely but very pointedly. So now, we have 164 F. Lachmann

Joe, not only as an art connoisseur but with an incredibly broad knowledge of literature as well. It’s the same Joe who has come up with – so far – four ideas for books that he, Jim Fosshage, and I have co-authored. Each of these books has built on previous ones and no sooner has the printer’s ink dried on one book than Joe has already begun formulating the next. I, on the other hand, have barely understood all that Joe has created in the previous book when he is off and running again. I, fascinated by his ideas, try to keep up. It’s not easy, but it is fun, exciting, and what if I am a little out of breath, I wouldn’t have it any other way. To art and literature we now add psychoanalytic knowledge and, you will have to take my word for it, extraordinary clinical acumen. It’s the same Joe with whom Annette, Charlotte, and I have traveled. That Joe would be the “tour guide” on our trip through Sicily should come as no surprise. But he also knows food and especially wine. To watch Joe “taste” a wine before the rest of the diners are served is another incompar- able experience. I have seen wine tasters go through the motions of looking at, smelling, swishing, and then tasting the sample of wine that a waiter has poured for their approval. Not Joe. He really knows what he is looking at, smelling, and tasting and when he approves of a bottle it is with the incredibly wide-ranging knowledgeable background that he brings to all of his judgments, for example, to his choice of sculptures and photographs that he buys. All this leads me to ask, Joe, don’t you do anything in half-measures or superfi cially? So Joe, keep running, I don’t mind being in breathless pursuit of your ideas. Some people have to avoid mental deterioration as they get older by doing math exercises or crossword puzzles. Knowing you, Joe, running after you, works better, and it’s much more fun. Downloaded by [New York University] at 04:57 12 August 2016 15 THE LICHTENBERGS AS ART COLLECTORS

Interview with George Hemphill

Sandra G. Hershberg , M.D.

May 10, 2011 Hemphill Fine Arts Gallery

SH: George, how did you meet Charlotte and Joe Lichtenberg? What were the circumstances around your coming together? GH: I was working at the Middendorf Gallery in the Dupont Circle neighborhood of Washington, D.C. and the Lichtenbergs had an interest in collecting sculpture. They had collected pieces through the gallery and then came to the conclusion that sculpture was going to pose certain issues and problems; how do you store all that work and display some of it, and then the increasing pricing for certain sculptors’ work was limiting. I was the director of photography at the gallery so I suggested that Joe take a look at a history of photography book which he then, being the scholar that he is, consumed entirely and we were off to the races. My relationship with the Lichtenbergs has been educational for me and quite enjoyable and a wonderful friendship. SH:

Downloaded by [New York University] at 04:57 12 August 2016 How did things evolve after that? It sounds like their background in sculpture was something you took into account. GH: Well I think they had a feeling for sculpture and through sculpture, three-dimensional objects. And then I think they put into their interest in photography that interest in spatial description. Particularly in the beginning of their collecting photographs, it would be apparent that in the subject matter of the photograph, whether it was a landscape or an architectural edifi ce or a portrait or a group of humans in an activity, there was always the sense of dramatic space, or the three-dimensionality of the object itself. 166 S.G. Hershberg

So I could see not sculptural characteristics in reality, but I could see an interest in the description of space. I think their collecting interests broadened from that point, but it is something that I see as the line that connects what others might see as disparately different photographs. SH: That’s interesting. So that is one of the red threads that you felt. GH: It is interesting to take guests there or be there at the house when Joe shows the collection and then to run into a collector or curator later and have a conversation and mention that Joe and Charlotte’s interest in collecting had begun to a certain extent in sculpture and that you could see that in the collection itself, and see a kind of light bulb go off in the person’s (guest, collector, or curator) head. SH: From there, in terms of the evolution of the relationship and your role with the Lichtenbergs, how did that develop in terms of broadening your mutual interests? GH: Well, my interest in photography is from the perspective of the dealer, and the curatorial work that I do in my own gallery is with intention extremely ecumenical. Joe and Charlotte’s collection fi rst and foremost seems to be something they relate to emotionally. So often my situation with collectors like Joe and Charlotte is learning them. The history of photography is not so great that it is something you can’t grasp after a period of time. And then as new things introduce themselves into the photo world, the art world, they are added into your knowledge of it. What is interesting is that Joe’s collection in terms of dates is thorough, stretches across the greater expanse of the history of photography including nineteenth century work and reaching all the way into very contemporary work. And it is not relegated into only black and white photographs, but involves color and in some cases involves variations in approaches to the mediums.

Downloaded by [New York University] at 04:57 12 August 2016 So to be more direct about answering your question, more often than not after the beginning, there were occasions in which I suggested looking at certain things. But Joe was an adventurer and he went to shows regularly wherever he was. Not only in Washington but in New York or San Francisco, and his travels in Europe. He always made time to go to see photo galleries and museum shows. And that was never exclusively of photography. He often went to see other shows in museums as well. So he kept a vital relationship with the visual language of art which informed collecting. So we could talk about him as a photo collector, but really he is an art collector that special- izes in collecting photographs. The Lichtenbergs as Art Collectors 167

SH: I have gone with Joe to galleries and museums, and he is quite a guide. GH: He is passionate! And it is fun! I think they are private collectors by the way you use those terms or those words, but they have never been anything except generous when it comes to sharing the collection with people. Any time I have had a new employee, the fi rst thing that comes out of Joe’s mouth is, “You should visit Charlotte and me at the house and I will take you through the collection.” So he has a generous spirit. I think he has a certain political or civic consciousness. SH: Even though Joe may write and do certain things individually, he always engages in groups, bringing people in, and he enjoys that dialogue. In talking about the private collection over time, and also the range of work, we were wondering what would you say were the highlights of the collection? GH: There are photographs within the collections which the authorities would point out are highlights of the collection. And anyone who has studied photography can identify the superstars and signifi cant fi gures in the history of photography. The way Joe and Charlotte collect, is fi rst emotional. The collection has lesser-known or even anonymous photographers and is consistent with collecting purely for aesthetic reasons. Sometimes the most meaningful or signifi cant photograph in a collection may be the least famous. It may be the least valuable, but may be the most meaningful. SH: I know they have strong relationships to individual photographs, and I have my own personal favorites. Do you feel there are any gaps in Joe’s collection as you look at it from your perspective? GH: Well, that is a question that comes up in conversations between Joe and me. Downloaded by [New York University] at 04:57 12 August 2016 How does this new addition to the collection fi t in? You are asking a dealer here [laughs]. There is always room for more. Are there gaps? I never walk into the house and feel like there is a space on the wall that needs to be fi lled. Or why don’t they have this or that? But they also don’t have a collection that is purely linear in nature. Once again their collection is based on aesthetic appreciation of a photograph, its formal qualities, and then the emotional relationship they have to the content. I don’t know that there are any gaps other than we may say, “I have never heard this opera before. I love this opera.” 168 S.G. Hershberg

SH: What role do you fi nd Joe has, and what role do you fi nd Charlotte has in forming the collection, or how have you seen them work together? GH: Well, I think that Joe is more the captain of the ship and Charlotte the fi rst mate. Charlotte has veto power. Because he is a conceptual thinker, Joe is always adding to the idea of what he might add to the collection. I think that Charlotte is much more intuitive and emotional about what she likes. But you know, the person who can say no often holds the greatest amount of power [laughter]. SH: One thing that is interesting to me in knowing Joe as an analyst and what he brings to his analytic conceptualizations, and now hearing you talk about what he brings to the study and collection and pleasure of photography, is that they are the same processes, the same Joe moving in another discipline. GH: Yes! SH: Is the process you have gone through with Joe and Charlotte similar to that with others who collect, or different? GH: I think there are different types of art dealers. There are art dealers whose primary strategy is they display a range of objects that are a representative of that dealer’s taste. And their pitch, so to speak, is that you should have that same taste. The way I have operated in my gallery is that there is a … Life is a rich pageant of experiences and there are so many different wonderful things, and there are so many different wonderful things in art, and there are so many wonderful things within photography. It is not my desire to have you replicate what I think is good taste, but rather for you to have me guide you through as best I can to the richest experience relative to what your Downloaded by [New York University] at 04:57 12 August 2016 interests are. Working with someone like Joe is great fun because he has an adventurous mind and we can pretty much go any place together. He is not playing catch-up to me. And he is not necessarily frightened of certain content. He may not acquire it, Charlotte might veto it. But he can go there intellec- tually and he can appreciate the reasons that a photograph was made. So my relationship and how our relationship has developed is not any different than the relationship that might develop between two people who partner at something. I, because it is my specialty, am exposed to so much more than any others other than those in the profession. As a dealer I see things fi rst. The Lichtenbergs as Art Collectors 169

I see the behind-the-scene process of how art comes to the public. I often see how the photographs are made, or what the subject matter ambitions might be. I have people who bring artists to me. I have correspondence, for example, with photographers who are working in the Middle East in combat. I have emails from them about what they are doing. So it is not that I feel superior by any intellectual effort. It is just that where I am is at the intersection of a lot of activity in the art world. So when I see things that seem like they might be of interest to Joe, I direct him there. But for many years now, I would say for the last ten years, I have by and large not acted as a dealer with Joe, but as an advisor. And very often the situation is that he has found a photograph, and he brings either the image to me or he asks me questions about it. I give him what I know about the context of the photograph so he is better prepared to make a decision. With other clients, I am often bringing the photograph to them and I am also giving them the situation or the context around it and some idea about its value relative to the market. My conversations with Joe are not necessarily about bringing a photograph to him, but about a photograph he is interested in and I might say these are the strengths and weaknesses by comparison to other photographers’ work. SH: Has he ever brought someone to your attention whose work you didn’t know? GH: Yes, he has. SH: Do you fi nd in your experience that the professional life of the collector has a bearing on what he chooses? GH: Yes. For better or worse, we live in a city, Washington, D.C., where the notoriety of the city nationally and internationally, is about politics. But the true industry here is by and large law. The major law fi rms and the personality type which gravitates to the law which is text bound, not visual in

Downloaded by [New York University] at 04:57 12 August 2016 nature, and/or people who have chosen to represent the interests of others and are not necessarily conspicuous about their own representation. So they are not expressive individuals. It is not easy for them to buy art work which is at the core of who they are and which may reveal a weakness, a strength, or a preference. Almost every collector we deal with is passionate about their career so the career can’t help but be refl ected in the work that they have purchased. But that is not often easily seen on the most intimate level, but sometimes it is seen in generalities. For example, in the late 1970s into the early 1980s, law fi rms grew at a rapid pace. The fi rms’ collecting was dominated by abstract painting acquisitions. At fi rst this struck me as odd – that the 170 S.G. Hershberg

three-piece-suits were building collections that at the time could be diffi cult for the greater part of their staffs to appreciate. Then it became clear that the reason they were buying abstract work was because there was a great body of work being made here in Washington, particularly in the 60s and 70s, that led to other work in the 70s and 80s, color fi eld work that was without reference to anything in the real world. You couldn’t see a tree, a boat, a cloud, it was color and gesture and stains. But it became clear that the reason they were interested in that work beyond its beauty was that it was diffi cult to determine what it actually said in a specifi c way. You couldn’t say this painting was Democratic, Republican, Conservative, Liberal, gay, straight, Jewish, Catholic, Western, Eastern, whatever. It was not there to be read. And that was a quintessential lesson about how people collect in this city, at least for a period. It has changed a great deal. As the demographics have grown younger, how people collect has changed signifi cantly. I wouldn’t say with Joe that I look at the work and say this is someone who is involved in psychology, because many of the pieces are more or less abstract in nature. A sand dune photographed by Weston is not something that has overt psychological reading like a portrait. So I would not say it is refl ected in that sense. I would say it refl ects Joe and Charlotte in personality, at least not in a professional way. That said, we are working with a collector now who is a modernist furniture dealer and objects that he is buying are from a particular time that refl ects a certain kind of design sensibility. So there is one person that directly refl ects a career. For the most part, people buy it because “I like it,” and that is a refl ection of their personality but it is often an oblique relationship. And I can tell you comic stories about collectors. We worked with a particular couple and they only wanted landscapes. And after numerous presentations with no sales, the husband sidled over to me and said, “You know my wife can’t stand the color blue.” Obviously there are paintings that have skies in them that are not blue, but by and large they do have blue. So that is a personality quirk. That is the refl ection of a personality, I think maybe a damaged personality, but all the same [laughing]. Downloaded by [New York University] at 04:57 12 August 2016 SH: I understand that Joe and Charlotte’s collection is at the Phillips. How did that happen? GH: Well, Joe had been open about, open with museum curators and at some point they had spoken to Joe and Charlotte before they spoke to me, but I was approached by the development director at the Phillips – it’s got to be fi ve, six, maybe seven years ago – and asked if maybe the Lichtenbergs might be interested in donating work to the Phillips collection. My answer The Lichtenbergs as Art Collectors 171

was, “You have to ask them.” That is really my relationship to them. I try to be as helpful as possible to the Phillips, and it is a wonderful place for it to go. And it is great for the Lichtenberg collection to go to a museum that had some photographs in its collection, but nothing to the extent of what Joe and Charlotte are donating to the Phillips. Museums that collect photographs usually have longer histories of collecting photographs, had an intent to collect photographs, and went at it in a particular way. The Phillips collection has never been a collecting museum. SH: So it makes a really important contribution to the … GH: If you look at the other museums in town … the Hirshhorn has never had a curator of photography so they never focused on photography as a medium. But the photographs they own are usually photographs that are conceptual in nature made by artists who used multiple mediums. The National Gallery has slowly and methodically built their collection on the basis of whom they think are the most important American photographers. These museums have collected certain artists or they have collected in an encyclopedic fashion. The Corcoran, along with the Metropolitan Museum in New York, were collecting at the beginning of photography. I say the beginning but really around 1875 and after. So for example, Muybridge’s Albums of Animal Locomotion were acquired simultaneously at the Met and the Corcoran as they were published. What is distinctive about the Phillips’ gift is, and what is so really wonderful for Joe and Charlotte and all the rest of us on their team, is that almost every other photo donation that goes to a museum, I don’t want to say gets buried, but it certainly gets shuffl ed into the deck of a much larger collection. Their donation makes a signifi cant statement and becomes a statement for the museum about photography. SH: Yes. So the context is very deep. With Joe being a psychoanalyst, and “listening with the third ear,” is there Downloaded by [New York University] at 04:57 12 August 2016 something about “seeing with the third eye?” Joe is unusual in many ways as an analyst, as a collector, and as an individual. Do you think there is anything about his ability to refl ectively look that informs his acquisitions? GH: Well, there are two types of collectors. There is the kind that wants to make their environment feel nice. Sometimes they buy extraordinarily important work to make their environment feel right. They are basically buying to decorate their homes. It is the movie set of their life. And there are other collectors, and Joe and Charlotte fi t into this category, they get up from the 172 S.G. Hershberg

table and stand in front of an artwork and study it, they are consumed into it, they are engaged intensely. Joe and Charlotte open up to a photograph and this is a different relationship than it being part of the set of your life. They read the artwork like a book. And I believe that is a unique characteristic. I have worked with collectors that have truly amazing artworks and they show them off well. But there are collectors who are able to stop the self and absorb. In a way, it is a communication with the artist through the artwork. It requires a kind of animism, being willing to play the game. It is being in the fl ow of the artwork. SH: That state. GH: It really is a state. A meditative state or maybe it is an intellectual exercise. But it is absorbing or engaging and it requires much more intense effort than it does to decorate your home. But also that goes to something else and this is really the crux of Joe and Charlotte as collectors. I don’t know that they have some enormous sympathy for artists. And that is really kind of besides the point, at least with what I am about to say. What Joe does, what Joe and Charlotte have, is as rare as what it is to be an artist, which is an ability to see differently. And I know this as a dealer that there are few people who come in the gallery who are the equal receiving talent of the sending talent of the artist. Those are people that we need to take care of in a particular way. We are all capable. But some of us for whatever reasons have been given this gift of being able to see art a certain way, or see art with the same intensity as those who make it. So I have always felt like there was a kind of … it is not Darwinian in the sense of survival of the fi ttest. It is that other part of Darwinism, it is a level of cooperation and complexity between the maker and the receiver. And so what is interesting about art is to stand right in the middle of that point of intense collaboration between the viewer and the artist. Joe and Charlotte occupy that special place. Downloaded by [New York University] at 04:57 12 August 2016 SH: Well, that is very beautifully said. Are there any other thoughts or observations? GH: No. That’s all I got in my head [laughing]. PART V Motivational Systems Theory Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 16 FROM LICHTENBERG: THREE CONTRIBUTIONS TO THE THEORY OF THERAPY

Lawrence Friedman , M.D.

In its broad mandate, the whole world of mind is the subject of psychoanalysis, and analysts usually pick their favorite continent to colonize. I do not know another theorist who, like Lichtenberg, has been drawn to the full scope of analytic inquiry (which gives his unique publication, Psychoanalytic Inquiry, its right to the title). And, more signifi cantly, this is not the result of a grandiose ambition to punch in on every question – to cover the waterfront, so to speak – but rather because he has been succes- sively entranced by each question that leads outward from each problem, and is happily blessed with the required freshness, stamina, and enthusiasm to pursue it (with energy left over to promote the imagination of colleagues and students). Because he is involved so deeply in each component question, his syntheses have more plausibility than we fi nd in the sort of impatient synthesis that looks fi rst to the grand summary, and commissions the steps that will lead up to it. For the same reason, the horizons he explores are not selected by animus; he doesn’t choose one avenue in order to shut down another. Because of its richness and fi delity to experience at each level, his

Downloaded by [New York University] at 04:57 12 August 2016 model will, I think, be usable even by analysts who are wedded to their own style. They may highlight certain facets of his model, experimenting with his insights in various combinations, just as he responds to different saliencies in his patient. (For example, analysts who like his way of blending general themes with momentary urgencies may try out their own ratios of large dramas vs. particular sub-programs. Or they may put more emphasis on the interplay between systems, preserving a “defense” orientation while still heeding Lichtenberg’s principle of equal respect for the specifi c needs, strains, and satisfactions in each system.) 176 L. Friedman

It is hard to fi nd a human subject matter that Lichtenberg has not studied in some detail, and correlated with other subjects. We will each be grateful to him for contributions that touch most particularly on our own pressing questions. For myself, I am particularly grateful for his work on three, interrelated problems, which I shall call the problem of the miscellanousness of brain systems, the problem of the main meaning of patients’ actions , and the problem of therapeutic action of psychoanalytic treatment. “Lichtenberg” is a work in progress (in life, I think, as well as research). I do not pretend to take into account here the enormous detail and sophistication of his developing theory, a daunting task that I hope others will undertake. I will be dealing, rather, with the large aspects and general nature of his project. Practicing analysts look for the meaning of a patient’s words and actions. Since “meaning” is a problematic term both as to its target and its claim, the search for meaning is always an unsettled project. Analysts take different stands on the issue. An analyst may think there are always many meanings in what the patient says and does, or that there are no pre-existing meanings before negotiation, or that there are, at least, false meanings to be avoided. Or an analyst may go about his business without giving it a worried thought. But since practitioners are always in a position of responding to an intentional agent before them, the selection of meanings is always an explicit or implicit problem. Participation in action over time automatically confronts us with a perceptual decision regarding main meaning. I say this rather presumptuously, but it is, after all, just a nod to the hermeneutic aspect of every human encounter and, most self-consciously, to every human science. Many psychoanalytic theorists have tangled with this question, but only a few have worked out a rationale for prioritizing a main meaning in the patient’s display. Broad admonitions to attend to the affect, or focus on defense are scant help in defi ning the thrust of the patient’s intention. Even more specifi c formulas, such as reading the patient’s meaning out of the analyst’s reaction (countertransference or enactment) do not say how the analyst’s reaction itself should be read. The responsibility for teaching how to Downloaded by [New York University] at 04:57 12 August 2016 sort meanings is therefore left to an apprenticeship where one acquires habits through didactic analysis, supervision, and case conferences. It is a sensitive subject: No matter what habits an analyst acquires, he doesn’t want to think that he carries a stencil into his offi ce and uses it to smother the ailing,fl fl uctuating, unpredictable signs of life in his patient. But Lichtenberg is one of the few analysts to offer explicit clues to what might be called the immediate teleology of the patient’s momentary movement. And Lichtenberg does it by correlating specifi c affects with a specifi c theory of motivation. It is at once a major contribution to the fi eld, a major challenge that demands a response from colleagues, and a prime paradigm for focusing on this issue, not to Three Contributions to the Theory of Therapy 177

mention a substantial grid for understanding process (and for understanding misunderstandings). Lichtenberg’s clue to the main meaning of a patient’s action is a non-arbitrary division of motivations correlated with observable patterns of simpler developmental stages, and organized by demonstrably separate neurophysiological systems. But there is a gap to be fi lled. Motivation is one thing and motives are another. Biological motivations are general, causal mechanisms. How do we get from a system to (for example) a particular wish ? This is an agonizing question for Freudian theory in recent years as it tries to decide whether to digest or spit out certifi ed neurophysiological entities, wet structures, and specifi c circuits (the new faculty psychology, if you will). I call this the problem of the miscellaneousness of mind, because at the same time that new neurophysiology gratifyingly validates circuits of psychoanalytic interest, the brain is discovered to be a pile of bundled life forms tossed on top of one another produced by fortuitous evolutionary challenges, pasted over, at best, by a post-hoc story-line. It is a far cry from the single- (or perhaps polyphonic-) track Freudian mind. Nor is the contrast primarily a matter of esthetic preference.

Physiological Miscellany and Unitary Mind Freud’s theory is a way of speaking about separate types of interest and control (thresholds, levels of refi nement, structures, fantasies, and ideas) within a single, personalized mind. While these are more or less stable “parts” of a single mind, each “part” has a bit of the same purposefulness that we attribute to the whole mind. Philosophers who lack Paul Ricoeur’s (1970 ) sophistication may criticize this as confusing two modes of explanation, effi cient cause and fi nal cause, cause and reason, fact and meaning, blind structure and anthropomorphic element, etc. And newer terms of the argument have arisen as modern ego psychology took on the responsibility of elaborating Freud’s ( 1937 ) late reminder that the various “parts” of the mind are really just aspects – albeit non-arbitrary aspects – of a single mind. But the

Downloaded by [New York University] at 04:57 12 August 2016 tendency of contemporary neurophysiological and developmental psychodynamic research has been to emphasize the separateness of systems within the brain, and that sort of dissection is not at all the same thing as abstract- ing semi-purposeful aspects of mind (“structures”). To be sure, neurophysiological systems don’t stand alone; they have networks of their own, and they enter into various coordinations (as is inevitable with sub-systems of any organism), but, just as we can discuss the circulatory system separately from the pulmonary system, and can name a renal system and then a lymphatic system, so these brain systems can be coordinated with distinct behaviors and affects, and they have the sort of categorical distinctness that allows us to consider them as natural parcels. (I believe that “parcellizing” is a term 178 L. Friedman

used by neurophysiologists.) Dazzled by this galaxy of systems, we may come to regard Freud’s account of the single path of mind as, at best, a Creation myth, and at worst, a Just-So Story or a pineal theory of the Soul. In either case, a new faculty psychology impatiently drums its fi ngers, waiting for the call to deconstruct the psychoanalyst’s unscientifi c sense of his patient as a person rather than an organism. Thus enlightened, tomorrow’s psychoanalysis might shape up as sophisticated habit-training focused on bits and pieces of circuitry. This is another way of saying that Freud’s unique, meticulous instruction in how to acknowledge the intentionality of a person (a “he” or “she”) while at the same time regarding him as a biological mechanism (an “it”) – this recipe is threatened by today’s dispersion of mind into assorted cerebral mechanisms. Against this possibility, Lichtenberg’s way of putting parts of mental functioning back into the unitary person is a strategic bridge to a happier psychoanalytic future. How does he do that? I think Lichtenberg’s solution is to give each homeostatic, biological system’s set-point a human (meaningful) history that imprints its personal sensitivities and determines its shifting relationship with other motivational systems and the rest of experience. In principle, it is not so far from Freud’s schema. Each system starts out like a Freudian instinct representative, and develops in a similar way, inasmuch as biological impetus sprouts biographical form by means of Piagetian (1951) assimilation and accommodation with outside reality. Both theories yoke impersonal, organic reactivity to dramatic, personal meaning. The most general, organic strivings are gradually shaped by their history of successes, frustrations, and sensitivities, and experiences with early care-givers, which gives motivational systems their learned styles of effectiveness and their relative priority among fellow “drives,” all blended together by a unifying “self” equilibra- tion. A particular motivational system has a relative salience among other motivations in a confi guration that characterizes the personality, and it also has fl uctuating prominence as the person encounters certain kinds of challenge. As for long-line interests of the whole person, Lichtenberg’s “model scenes” illustrate the prominence of a given motivational system (with its Downloaded by [New York University] at 04:57 12 August 2016 associated affect), in cooperation with other motivations, and at that point in the story we have reached the (Freudian) reunion we were looking for, namely, the refi nement of primordial urge into elaborated, interpersonal drama. With that bridge, Lichtenberg has met the challenge of recapturing the wholeness of a divisible mind. It is, after all, a single person with idiosyncratic meaning who draws on a variety of standard biological incentives to makes his way through time. Of course, this is not Freud’s theory. What is discarded is a developmental line that spins a varied mental world out of the fewest possible ingredient variables. Between the two theories, evidence from biology surely favors Three Contributions to the Theory of Therapy 179

Lichtenberg’s multiplicity. But that is not my concern here. My question is how the analyst’s acceptance of that multiplicity tints his view of the patient. As I indicated, the worry is that patients would be seen as biological organ- isms rather than persons. I have suggested that Lichtenberg shows how to avoid that conclusion: The motivational systems do not “mechanize” the mind, because life experiences (and interaction among the systems) ultimately drench the separate motivations in the intentionality of the whole person, just as happened to Freudian “structures.” Look at it this way: People are constantly engaged in monitoring others’ momentary motivations on a multitude of dimensions, and they would put themselves in mortal peril if they failed to do that. Nobody except the most egregiously dogmatic caricature of a Freudian analyst ever charted just the vicissitudes of sex and aggression on his screen. It would be impossible to pick up the gist of a conversation on that basis, or interact coherently. What the psychoanalyst usually does is to notice many, universally recognizable shapes, and read out of them a secret, underlying story which, in turn, may be organized schematically under abstract headings, such as sex and aggression. Imagining an organismic principle of mental functioning, he brushes aside the patient’s immediate intentions, and thus immunizes himself from his patient’s control, often regarding it as a deliberate distraction. He thinks: “If I were to give the patient’s myriad pushings and pullings and shades of affect the same sort of open-ended read-out I give a novel, I’d be at the mercy of the patient-author.” He feels the need to interpose a conceptual screen in front of the patient, giving himself the freedom to organize his overall reaction and govern his response. Now, what Lichtenberg has done is to take the varied phenomenology of action that all of us perceive all the time, and by triangulating between biological forms and early developmental types of physical and emotional reaction, sort the evidence into recognizable forms and affects that have empirical claim to be “natural kinds.” With these in mind, a therapist can focus on the acute, real-time effort of a patient without automatically reacting to it, but also without dismissing it as a mere disguise for an invariant, life-long meaning (perhaps a single, organizing life fantasy). This analyst is Downloaded by [New York University] at 04:57 12 August 2016 not comparing his patient to a network of Aplysia neurons “bound” together by joint, electrical oscillation. But he can nevertheless see the patient as an organization of built-in, biological necessities. In this way, Lichtenberg provides for the unique psychoanalytic double-vision which must take in both the patient’s intentional meaning and the organic mechanism that drives it. We should note in passing that Lichtenberg is pointing to a fl ow of aspir- ing action. What we are asked to see is a reach, an exercise, an action by the patient, and not some dispassionate “communication.” As I will mention below, that aspect of his theory gives him a head-start on a theory of therapeutic action. 180 L. Friedman

Well, what about the specter of habit-training? Lichtenberg’s underlying theory of effectiveness does imply a kind of retraining of organic habit. (We may wonder whether some such element can ever be escaped, no matter how non-directive the therapy.) But what’s important is that, just as a Freudian analyst thinks of a superego but deals with the ego, Lichtenberg may think about motivational systems, but is always dealing with a person. And what’s even more important, he knows he is dealing with a person even when he’s thinking of motivational systems. In contrast, a habit-trainer who fancies himself to be tinkering with some specifi c habits is blind to the personal relationship that this posture sets up, and so the human drama that is playing out will be at once inadvertent and defi nitive. The aspect of retraining in Lichtenberg’s treatment does not pull the analyst into an enactment as a parent or disciplinarian, because the retraining is an automatic consequence of the analyst being, willy-nilly, a diffi cult as well as a strangely gratifying and unusually empathic interlocutor (more a sparring partner than a coach). Together with his empathy, attentional selectivity, recontextualizing responsiveness, and the patient’s self-righting, plus a few other factors – all of them familiar to most analytic theories of therapy – the analyst’s quota of reserve does the work of retraining without his assigning growing-up lessons.

The Patient’s Main Meanings Since despite his encompassing curiosity Lichtenberg is above all a dogged explorer of analytic treatment, one of his major contributions is to address the fi rst concern of every practitioner, which is to fi gure out what is the main point of what the patient is doing or saying. As Lichtenberg notes, one can pull myriad meanings out of any humanly signifying event, and that’s good enough for everyday life or even appreciating a novel. But a therapist is supposed to act therapeutically, and that means non-randomly. And a therapist can’t dodge justifi cation the way a philosopher might, saying (like Humpty Dumpty) that he can decide for himself what he wants “meaning” to mean, which, as it happens, always turns out to be the one that justifi es

Downloaded by [New York University] at 04:57 12 August 2016 his preferred response. (“I defi ne Psychoanalysis as dealing with Sex and Aggression, so don’t bother me about Main Meanings.”) That won’t do, because patients aren’t pictures on a wall. Patients are engaged in doing something to a therapist, and the latter needs to know what that is without waiting for philosophers to adjudicate the problem of Meaning. (We can no more postpone a “semantics of desire” [Ricoeur, 1977 ] than we can wait until we have a sabbatical to decode the semantics of our native language.) We must decode demands and strivings in real time. Whether confi dent or questioning, intuitive or deliberate, every analyst must make subtle decisions about what in the material is most signifi cant. One might even say that Three Contributions to the Theory of Therapy 181

the force of a treatment is largely the result of the analyst’s notion of main meaning. Obviously this question is not resolved by the rule that an analyst picks out the unconscious determinant of a behavior since that merely shifts the question to the main meaning in the unconscious. However, the analyst’s notion of the sort of meanings that can lurk in the unconscious – sex and aggression, envy and repair – will infl uence his selection of main meaning. These are general aids. Lichtenberg suggests that developmentally basic and neurophysiologi- cally correlated motivational systems, each distinct in its own right, offer a non-arbitrary basis for selecting categories of meaning. These types of meaning have visible affect tags. Motivational systems operate to balance a person at a moment, so the patient’s momentary shift in affect alerts the analyst to a shift in main meaning. These are meanings that are, by defi n- ition, involved in effort, they are organismic tendencies , affecting balance and imbalance, so they are unarguably germane to the analytic therapist. Since each motivational system has evolved in its own time for its own specialized reason, these systems do not cluster into the sort of grand complementary polarities that fi gure in romantic images of Man’s nature, such as the struggle between life instincts and death instincts, or even, in their nuance, sex and aggression. Replacing such cosmic pairs, the multiplicity and matter-of-factness of motivational systems will probably account for most of the practical impact this schema has on practice. A practitioner, mindful of so many assorted possibilities, will be less inclined to massage patients’ communications into his own favorite meaning, or fi nd himself inexorably “compelled” by the swelling force of “evidence” to conclude that he was – fancy that! – right all along. Lichtenberg’s analyst will be a little less unknowingly swept into the tempting long-line dramas that blur the shy hint of shifting vital interests of the moment. Moreover, Lichtenberg’s spot- light on affects, with their powerful, “naked” infantile forms, will pick up nuances glimmering in the moment within the complex matrix of maturity. Within those large orchestrations, the analyst may learn from Lichtenberg to hear more acutely the fi ne-tuning of the instruments. This, in turn, is Downloaded by [New York University] at 04:57 12 August 2016 likely to reduce the suggestive element in treatment. No longer drumming his fi ngers for a reassuringly standard life-defi ning fantasy, an analyst who responds to a large number of relatively unrelated “atomic” meanings will necessarily be less authoritarian because he is less author -itarian. I should like to emphasize the mobility that this enforces on the analyst. Although Lichtenberg neglects no element of the analytic symphony, least of all a patient’s long-line concerns and familiar (and valued) ways of dealing with them, his work is a powerful reminder of the kinetics of analytic treatment. It is in the melody of movement along the time-line of process – that is, the temporal shape of on-going interaction with the analyst (traced in the 182 L. Friedman

patient’s mind) – that the larger themes – the life fantasies, for instance – exhibit their essence, since their essence is the way they function over time, presenting now one subordinate aim and now another. It is the fl uctuating ways of dealing with the world that shows what the long-line drama (or fantasy) actually is. The timelessness of the unconscious has to do with its indestructibility not its stillness. Even the most orthodox notion of fantasy refers to dramatic action, and that means that a “single” fantasy is tied up with a great variety of tactical movements. A repertoire of tactics undergirds the grand strategies that we freeze into the name of “ a” fantasy such as the Oedipus Complex (taking into account the spread of a fantasy over time, some prefer to think of a fantasy as a “script” rather than a scene, but that term doesn’t quite capture the range of invention necessary to perform in unforeseen contexts). A sense that the patient’s complex life plan is what it does to and with the exigencies that come its way – alertness to the many types of success and failure patients can experience at each moment – a recognition that specifi c affects are self-readings on a whole panel ofassorted gauges which measure the success and failure of life-tools – these orientations make for a supple analyst who can jump the hermeneutic rut when the moment is ripe. But an emphasis on real-time movement also raises questions. Yes, there is nothing more important than the actual fl ow of effort and desire in the hour. If the patient’s real-time movement isn’t acted on, why would anything change in treatment? But what if an analyst is bewitched by the exciting dance of vivid moments (cf. Boston Change Process Study Group, 2010 )? Won’t he be thrown off the spoor of an infl uential long-line fantasy he should be tracking? If the patient is allowed to “lead,” moment by moment, will he ever enlarge his familiar repertoire? Isn’t that one of the quandaries of therapeutic action? Let’s consider the theory of therapeutic action that is embedded in Lichtenberg’s model.

Therapeutic Action

Downloaded by [New York University] at 04:57 12 August 2016 There are, I think, fi ve principle features of Lichtenberg’s theory of action.

First Feature: A Patient’s Meaning is Expanded by His Own Effort While under Strain. The analyst’s efforts help. But what changes meaning is the patient’s own activity. Patients do not principally present a “communication,” and get back a gloss on it from their analyst. Patients try for something; they try to meet a challenge. And the fate of their trying (which includes their analyst’s response) expands their meaning. Here, “expanding their meaning” is not Three Contributions to the Theory of Therapy 183

the same thing as adding new ideas. Rather, it amounts to enticing new, signifi cant twists in the on-going history of each motivational system and the record of their interactions. Attempts to communicate understandings in treatment do have value. For one thing, they help to defi ne mutual goals. But it is the patient’s attempt to reach those goals that forges new meaning. (Cf. Vygotsky, 1933 ; Piaget, 1951 .) I can picture theories of therapeutic change falling into three categories: There is the Nutrient Theory, according to which the patient makes his own changes, provided that the analyst relieves distress and provides safety. Then there is the Resonating Theory, which says that meaning expands when the analyst parabolically refl ects some undeveloped nucleus of meaning already lurking within the patient. Finally, there is the Lattice Theory, which says that regardless of whether the analyst’s effort to produce new meaning is the same as the patient’s, as long as it is not an egregious mis- identifi cation the patient will fi nd it a useful scaffold on which to build his own different meaning. Characteristically, Lichtenberg has synthesized these. The patient makes the meaning in the course of his activity. And the patient’s activity is fostered by the analyst’s own struggle to identify the patient’s meaning.

Second Feature: Hope Starts Progress, and Difﬁ culty Keeps It Going. If effort builds meaning, then new effort must be encouraged. (Analytic theory has always said as much.) What are the incentives? Lichtenberg says that there is not just one incentive that draws patients forward. Every kind of gain that can be had from another person is a lure. For example, since the search for attachment is always more or less active, whatever brings the patient closer to the analyst will be a lure, and that includes the apparently neutral motivation to understand oneself and make progress in the work. Analysis is not an activity of Pure Reason. But since effort is what makes new meaning, Lichtenberg reminds us that lures will be therapeutic only if

Downloaded by [New York University] at 04:57 12 August 2016 there is some sort of distance to overcome. Distance or abstinence modifi es the analyst’s beckoning closeness just as his empathy modifi es his refl exive response to the patient’s aversive and aggressive actions. Distance is the freedom the analyst gives himself to register other things than what the patient dictates. Even the empathist who doggedly tracks the patient’s perspective is free to look at the patient differently than the patient demands, and that is an obstacle to at least some of the patient’s efforts. Treatment provides an array of lures with built-in diffi culty, and the diffi - culty lies within and between both parties. The frustrations analysts prescribe for their patient have been famous (some say infamous). There’s the old abstinence, and the disputed neutrality, 184 L. Friedman

and the famous fence around the transference playground. But Lichtenberg reminds us that if the analyst wishes to encourage the patient, the analyst, too, has to subject himself to trouble. The analyst is obliged to pick out standard shapes from the infi nite possibilities, but he can’t take the easy route. If he makes clichés out of his patient’s living meanings, his distance will be too great, and it will discourage the patient from offering anything new. Furthermore, the analyst must be exquisitely affected by his patient’s actual, momentary sensitivity, and not simply settle for the bookish stories he learned in his Institute, but he can’t just relax into that kindly responsiveness; he needs to use his analytic knowledge, or he will not relate strivings that are active in the relationship to others in the background, or sense the price the patient is paying for stubbornly valued patterns of behavior. The analytic partners make trouble for each other. The analyst’s uncom- fortably restrained impressionability meets the patient’s uncomfortable effort to push through the restraint and get his point across. Strain on both sides is the sign of continued effort to form new, individualized meaning.

Third Feature: The Analyst’s Theory Is Already an Inﬂ uential Attitude. Different theories make for different outcomes, for instance, by promoting different types and ratios of closeness and distance. In the analyst’s hands, theory is not just a more or less accurate picture; it is a cause of happenings. It gears the meaning-machinery up or down. Aside from the goodness or badness of a theory, we may ask: What is the practical effect of believing it while practicing? I have already referred to the huge impact an understanding of Lichtenberg’s theory would have on the fl ow of process. But now I turn to the overall mind-set and self-image of the analyst as it suffuses and defi nes the proceedings. Ordinarily we don’t ask how our theory prejudices our view, since, of course, it simply allows us to see what’s really there. What we do is ask how some hated rival’s detested theory distorts his practice (“It spares him dealing with the hostility”). But Lichtenberg forthrightly asks about the effect of all theories,

Downloaded by [New York University] at 04:57 12 August 2016 including his own, making him one of the few to recognize that no theory is just a description. How would Lichtenberg’s theory infi ltrate practice? I would say that Lichtenberg’s theory will give the analyst a little more of a natural science self-image, combined with the usual humanistic posture. This treatment would have less of the dreamy quality that some analysts create, and much less of the linguistic decoding drill. A Lichtenbergian analyst will not “come on” to his patient as a seer. Though his imagination will draw on all of his esthetic sensibilities and life experiences, he will not, as compared to some therapists, think of himself primarily as engaged in a form of literary criticism. Here psychoanalysis looks like a practical endeavor rather than a relativistic hermeneutics, because it gives Three Contributions to the Theory of Therapy 185

a constitutive role to organic strain in the creation of meaning. These features will have their impact on the event (although as we know, every capable analyst automatically creates a somewhat different milieu for each patient).

Fourth Feature: Treatment Is a Pay-as-you-go Affair. Since it is effort that changes meaning, the pattern of success and failure is constantly “teaching” a lesson (as well as feeding the organism’s innate tendency to correct lop-sidedness and pull it all together). Lichtenberg’s knowledge of infant development here places him among the few theoreti- cians to acknowledge that there is a sense in which nothing in treatment is merely preparatory. We don’t get to arrange somebody else’s experience in chapters.

Fifth Feature: An Exploratory-assertive System Can Function Non-verbally. There is one corollary of the Exploratory-Assertive system that is especially signifi cant for theory of action. Even by just naming such a system, Lichtenberg joins those analysts who have referred to an independent (“ego”) aim that is distinct from passionate motives. That would support the idea that a patient can work at analysis in a way that is not entirely an enactment. Most – but not all – analysts count on such a motive, but not every version of psychoanalytic theory supports the idea. An Exploratory-Assertive system is also a capacity that we might mature by simply being engaged in treatment even without explicit recognition. One imagines it “learning” from tangling with a somewhat un-amenable analyst. Since the problem the patient is trying to master is at least as much the relationship with the analyst as the nature of his mind, and since the relationship is partly designed by the analyst, I like to think of that as the effect of an enacted metaphor (cf. Friedman, 1988 ). Downloaded by [New York University] at 04:57 12 August 2016

Personal Reﬂ ection Lichtenberg is an intimidating model as a researcher of therapy. He is current and competent across the board in both the “understanding” and the “explaining” types of human sciences, in human development and psychology, the humanities, the neurosciences, psychoanalytic theory and practice. He is both creative in imagination and respectful of the full range of thinking in this huge subject, and he is unusual in refusing to smooth out or ignore the complexities of the picture, or wrap it up and rest on his laurels. 186 L. Friedman

Among all his many pursuits, I carry his image with me as the very exemplar of untiring investigator in the deep subject of talking treatment, asking how it’s done, and what it draws on, scanting no clue, kicking aside no competing truth, embracing complexity but never dodging hands-on instruction in clinical vignettes, acknowledging wisdom where it is found, and stubbornly pushing on to answer questions left over from his last answer. It’s a remarkable oeuvre, a remarkably honest exploration, and a remarkable person.

References

Boston Change Process Study Group. (2010 ). Change in Psychotherapy. A Unifying Paradigm . New York : W.W. Norton. Friedman , L. (1988 ). The Anatomy of Psychotherapy . Hillsdale, NJ: The Analytic Press , pp. 506 – 523 . Freud , S. (1937 ). Analysis Terminable and Interminable . S.E. 23:216 – 253 . London : Hogarth Press , 1964. Piaget , J. (1951 ). Play, Dreams and Imitation in Childhood, tr. G. Gattegno and F. M. Hodgson . New York : W.W. Norton , 1962. Ricoeur , P . (1970 ). Freud and Philosophy , tr. D. Savage . New Haven, CT: Yale University Press . Ricoeur , P. (1977 ). The question of proof in Freud’s psychoanalytic writing . J. Amer. Psychoanal. Assn ., 25 : 835 – 871 . Vygotsky , L. ( 1933 ). The role of play in development. In M. Cole , V. John-Steiner , S. Scribner , and E. Souberman (Eds.), Mind and Society , pp. 92 – 104 . Cambridge, MA : Harvard University Press , 1978. Downloaded by [New York University] at 04:57 12 August 2016 17 THE CENTRALITY OF MOTIVATIONAL THEORY IN PSYCHOANALYSIS Motive/Intention as the Basic Unit for Understanding Psychological Life

James L. Fosshage , Ph.D.

With great pleasure I write this contribution for a book compiled as a tribute to Joseph Lichtenberg for his prolifi c, invaluable contributions to psychoanalysis. Motivation is a central and compelling issue for psychoanalysis. Integrating infant and developmental research, contemporary psychoanalytic and motivational theory, Joe Lichtenberg wrote a seminal volume on motivation, Psychoanalysis and Motivation (1989 ), positing fi ve motivational systems. His motivational model, in my view, was, and continues to be, the most empirically grounded, complex and comprehensive motivational theory extant in psychoanalysis. In 1990, Joe asked Frank Lachmann and myself to join him in writing a book on technique based on his motivational systems theory. Our fi rst book, Self and Motivational Systems: Toward a Theory of Technique, was published in 1992. Several years later, Joe suggested that we closely track a case of his, illustrating and further elaborating the clinical principles anchored in motivational systems theory. This book, The Clinical Exchange: Technique

Downloaded by [New York University] at 04:57 12 August 2016 from the Standpoint of Self and Motivational Systems, was published in 1996. Following this volume, the impetus for recognizing the importance of the therapeutic relationship in therapeutic action was gaining considerable momentum in several arenas in psychoanalysis, specifi cally in the ongoing development of relational approaches, including contemporary self psychology, and in the further integration of cognitive science, particularly the emergent focus on the implicit system and “implicit relational knowing” (Stern et al., 1998 ). While each three of us had, and have, great conviction about the contribution of the ongoing implicit and explicit analytic 188 J.L. Fosshage

relationship to therapeutic action, we felt that at the core of the relationship was implicit and explicit communication in which the spirit of inquiry played a pivotal role and needed to be amplifi ed. We proceeded with a third book on these topics, A Spirit of Inquiry: Communication in Psychoanalysis (2003). In 2009, Joe proposed that we update his original motivational systems theory in keeping with the development and integration of systems theory, cognitive science, neuroscience, and infant, developmental and dream research. Our fourth book, Psychoanalysis and Motivational Systems: A New Look, was published in 2011 . Throughout this time, each of us, in addition, have written independently on a wide range of psychoanalytic subjects. The purpose of this chapter is to provide a brief historical and conceptual review of motivational theory within psychoanalysis, creating a context for understanding the emergence, further development and assessment of motivational systems theory. In addition, I attempt to extend our work by bringing up to date a motivational principle that is overriding in our work, that is, the concept of developmental motivation.

A Conceptual Review of Motivation and Its Importance What do we mean by motivation and why is it important? “In everyday usage, motivation is the answer to the questions ‘what do I want to do ?’ and ‘why do I want to do it?’ ” (Lichtenberg, Lachmann and Fosshage, 2011 , p. xiii). Motivation is always operative in our lives, for motives or intentions (equivalent terms) are primary in “directing” and giving meaning to our thoughts and actions. Motivation refers generally to “the process of initiating, sustaining and directing psychological or physical activities” (Goldenson, 1984 ). Phenomenologically motivations are experienced in a shifting kaleidoscope of desires, urges, aims and strivings. Motives or intentions refer to an experiential sense of seeking (experientially feeling directed toward) goals and taking action to achieve those goals (Lichtenberg, 1989 , 2002 ; Boston Change Process Study Group, 2008 ; Fosshage, 2011a). Cognitive scientists (Bruner, 1986 , 1990 , 2002 ) assert that motives are

Downloaded by [New York University] at 04:57 12 August 2016 the “basic mental unit” for understanding human behavior. In other words, we best understand and explain the generation of specifi c human thoughts, feelings and behavior at a micro-process level by identifying underlying intentions or motives. In a similar vein, the Boston Change Process Study Group ( 2008 ) wrote:

… intention is the fundamental psychological meaning. Sequences of intentions give motivated human behavior its psychological existence, coherence, and fi nally its meaning … Intentions fi t into larger movements of orientation and directionality given by motivational systems. (pp. 129–130) Motivational Theory in Psychoanalysis 189

So important are intentions in understanding human behavior that “intention detection centers” in the brain have been identifi ed that are activated when a person infers an intention of another person (Ruby and Decety, 2001 ). And the mental process itself by which we parse “human behavior into intentions and motives is considered a mental primitive, in the sense that it appears to be an innate mental tendency necessary for adaptation in a social world of other motivated beings” (Boston Change Process Study Group, 2008 , p. 129). We can be conscious of our motives or not. Not being aware of our intentions might be attributed to implicit processing, fl uidity of unconscious to conscious processing or the result of protective operations. As with all thinking, motives or intentions generate dreaming, which can be viewed in part as a continuation of implicit processing at night. Thus, it is not surprising that a theory of motivation forms the core foundation of every psychoanalytic approach (Fosshage, 2011a ). It fundamentally shapes our developmental view of a person from infancy to senescence. It addresses the “why” questions concerning human thought, behavior, experience and meaning. Motivational theory, whether articulated or left implicit, serves in the clinical arena as the organizing fulcrum and underpin- ning of our understandings, explanations and interventions.

A Brief Historical Review of Motivational Models in Psychoanalysis Relatively early in the historical development of psychoanalysis Freud ( 1920) had formulated a dual drive model: a sexual drive, for the preservation of the species, and aggression, for the preservation of the individual. In the days of closed systems of energy dynamics and instincts, Freud’s theory was anchored in notions of biological instincts, “being driven,” drive dis- charge, drives aiming at objects. Reacting to Freud’s biologically based conceptualization, Jung ( 1953 , 1959 ) formulated what he referred to as a psychological model of motivation and posited an overarching striving to realize the potentialities of the

Downloaded by [New York University] at 04:57 12 August 2016 Self (the unconscious organizing principle of personality). He was the fi rst to formulate what in the second half of the twentieth century became referred to as a self-actualization motivational model and, recently, what I have termed a developmental motivational model (Fosshage, 2011a ). In a similar ground-breaking departure from Freud’s drive model, Fairbairn ( 1952 ) posited that psychic energy is object seeking and that the goal of human motivation is to establish and express one’s self in relationships, an attachment motivational model, later used by American Relational theorists. The neo-Freudians also emphasized attachment strivings and were among the fi rst to develop a theory that aggression, instead of a drive, is a reaction to 190 J.L. Fosshage

frustration. Bowlby ( 1969 , 1973 , 1988 , 1989 ) posited an evolutionary-based attachment biological/behavioral system and, subsequently, formulated his theory of fi ve biological/behavioral systems: attachment, exploratory, parenting, sexual and eating systems. His theory catalyzed the well-known attachment research that has provided the empirical basis for the developmental importance of attachment and establishment of attachment patterns (Ainsworth, 1969 ; Main, 2000 ). Similar to Jung, Kohut (1984 ) posited an overarching striving “to realize” the self and “its nuclear program” (p. 42), a developmental motivational model that led clinically to picking up on the “leading edge” (Miller, 1985 ; Tolpin, 2002 ; Lachmann, 2008 ) of the patient’s communications, that is, what the patient is striving for. Based on infant and developmental research, clinical observation and contemporary theory, Lichtenberg (1989 ) formulated motivational systems theory involving fi ve and, later, seven motivational systems (Lichtenberg, Lachmann and Fosshage, 2011 ), the physiological, exploratory/assertive, attachment, caregiving, affi liative, sexual/sensual and aversive motivational systems. To accentuate their particularity, the caregiving and affi liative systems, originally part of the attachment system, have been identifi ed as separate systems in acknowledgement of their importance. Motivational systems theory considerably broadened the range and specifi cation of motivations operating in our lives. Bollas ( 1989 ) formulated the “destiny drive,” what I view as a developmental motivational model. Greenberg (1991 ) posited a dual motivational model of effectance and safety. Similarly, Ghent ( 2002 ) argued that “two types of needs, those organized around maintaining homeostatic safety and those that tend toward expansion of function, are always operating in some degree of dynamic balance” (p. 799). And recently, integrating developments in neuroscience, systems theory, infant research, dream research and contemporary psychoanalytic theory, I (Fosshage, 2011a ) delineated the evidence for an updated conceptualization of an overarching developmental motivation (to be discussed). Downloaded by [New York University] at 04:57 12 August 2016 The Changing Tides of Motivational Theory Motivational theory, either explicitly or implicitly, has been central in psychoanalysis throughout its history. Drive theory has remained etched in classical psychoanalysis, although its dominance has receded somewhat with the development of ego psychology. Certain assumptions emanating from drive theory – for example, aggression is viewed as “bedrock” rather than as a reaction, that is, a reaction to frustration or threat – have become so inculcated in psychoanalysis at large that they often implicitly pervade contemporary relationally based (using the term Motivational Theory in Psychoanalysis 191

broadly) clinical formulations (Lachmann, 2000 ; Fosshage, 2003 , 2010 ). Outside of classical psychoanalysis, new and innovative motivational models, as previously mentioned, have been formulated that, in my view, have increased the possibilities for more comprehensive understanding of human motivation. With earlier beginnings and gaining momentum in the 1980s has been the ongoing transition from intrapsychic to relational models, what is referred to as the “relational turn.” Greenberg and Mitchell ( 1983 ) delineate:

The most signifi cant tension in the history of psychoanalytic ideas has been the dialectic between the original Freudian model, which takes as its starting point the instinctual drives, and a comprehensive model initiated in the works of Fairbairn and Sullivan, which evolve structure solely from the individual’s relations with other people. Accordingly, we designate the original model the drive/structure model and the alternative perspective the relational/structure model. (p. 20)

Within drive/structure theory, instinctual drives are central in generating psychological structure. Postulating within an objectivist epistemology that drive driven fantasies distort reality lays the groundwork for the intrapsychic generation of psychic structure and experience and, in turn, minimizes the psychologically shaping infl uence of “external” relational experience. In contrast, relational theory emphasizes how psychological structure emerges and develops “solely” (Greenberg and Mitchell, p. 20) from relational experience. Except for a few, for example, Greenberg (1991 ) and Ghent (2002 ), the American Relational theorists do not directly address motivational theory (Fosshage, 2003 ). Although motivations are amply invoked in clinical depictions and discussions, Relational theorists perhaps warily view motivation as intrapsychic, still associated with the drive/structure, intrapsychic model. When motivation is addressed, motives are viewed, not as housing endogenous features, but as solely emergent within relational experience.

Downloaded by [New York University] at 04:57 12 August 2016 For example, Mitchell ( 1993 ) delineates this perspective:

All personal motives have a long relational history. If the self is always embedded in relational contexts, either actual or internal, then all important motives have appeared and taken on life and form in the presence and through the reactions of signifi cant others (p. 134)

While Mitchell focuses on how motives emerge within and are shaped by relational contexts, he does not directly address genetic or hard-wired preferences. With the emphasis on the intersubjective (Atwood and Stolorow, 192 J.L. Fosshage

1984; Stolorow, Brandchaft and Atwood, 1987) or relational (Mitchell, 1988) fi elds as generative of psychological structure, biological givens are minimized (Fosshage, 2003 , 2011a ). The postmodern impulse, in my view, underplays “human essences” (Teicholz, 1999), for the perspective emphasizes the relational fi eld as primarily constitutive of the individual. Perhaps the pendulum needed to swing far past the middle in order to extricate us from the dominance of the drive/intrapsychic model and, in its stead, to place relationships as primary in formative experience. Yet, the pendulum, from my perspective, needs to return and create a new middle, incorporating both constitutional and relational factors that are empirically evidenced in the fi elds of neuroscience, cognitive science, infant research and systems theory (Fosshage, 2003 ). Individually (Lichtenberg, 1989 , 2002 ; Lachmann, 2000 , Beebe and Lachmann, 2002 ; Fosshage, 2003, 2010) and together (Lichtenberg, Lachmann and Fosshage, 2011 ), Lichtenberg, Lachmann and I attempt to address this issue. It is interesting to note that within this psychoanalytic arena marked with these tensions between intrapsychic and emergent relational models, Lichtenberg (1989 ), grounded in infant research, psychoanalytic theory and clinical work, set out “to defi ne motivational systems that exist in early infancy, persist in altered forms throughout life, and characterize observable changes in motivational dominance in an analytic session” (p. 60). He was intent on forging a new motivational model that did not have the problematic aspects of drive theory and, yet, did not have the drawbacks of the then newly emerging relational theories that, for the reasons stated above, typically left their theory of motivation implicit. In his fi ve systems Lichtenberg posited, with considerable empirical backing, fi ve innate needs and innate response patterns, the genetic features with which we begin life. He then tracked the emergence and development of these basic needs and initial response patterns within relational experience to become functional or dysfunctional motivational systems. Lichtenberg’s inclusion of both genetic factors and their development within relational fi elds created a new model of motivation that overcame many of the problems of drive theory and the intrapsychic model, on the one hand, and the lack of explicit motivational theory in relational theories, on the other. Downloaded by [New York University] at 04:57 12 August 2016 Lichtenberg’s parsing development into originally fi ve, now seven, different systems has provided a complexity and nuance in assessment of motivations within experience without overwhelming those of us who use it as a theoretical backdrop in listening and tracking the unfolding of intentions. As Lichtenberg (1989 ; Lichtenberg, Lachmann and Fosshage, 2011 ) has pointed out, we have a choice with regard to parceling out and categorizing motivational experience. Too few categories limit us clinically in making important distinctions in intentional experience and hamstring the clinician in understanding complex motivational experience. Too many categories become unwieldy and lose usefulness in capturing thematic motivated experience. Motivational Theory in Psychoanalysis 193

What Are the Most Recent Developments in Motivational Theory? Recent developments in neuroscience, infant research, cognitive science and non-linear dynamic systems theory contribute signifi cantly to motivational theory. We increasingly understand what a baby brings genetically into his or her relational systems world and how cognitive and psychological development occur within relational systems. Over the past two decades, systems or complexity theory, originating in physics, chemistry and math- ematics, has been applied to the biological sciences and, most relevant to our considerations, to cognitive and psychological development (Thelen and Smith, 1994 ). Most would agree that the development of a person is a vastly complex, multivariable interactive process of genetic, neurobiological and environmental elements (see Siegel, 1999 , for a neuroscience perspective).

Observations based on systems theory have revealed three general patterns involving these elements: 1) frequently the complexity of interaction prevents differentiation of constitutional and environmental elements; 2) many developmental features that were previously seen as driven by an inherent, genetically based design are unpredictable (non-linear) developments emergent out of the interplay of genetic, neurobiological and environmental factors; and 3) recognition of previously unseen primitive aspects of certain functions within the baby (biological givens present at birth) that later emerge non-linearly into more mature functions. (Fosshage, 2011a , p. 90)

For example, “infants show elements of abstract numerical thought, a complex naïve physics, and ‘theories’ of causality. There is a common core, a continuity, in the thinking of babies and adults” (Thelen and Smith, 1994 , p. 22).1 On the basis of neuroscientifi c evidence, Edelman ( 1992 ) concludes

Downloaded by [New York University] at 04:57 12 August 2016 that hard-wired “values” or “biases” differentially weight and categorize experience in keeping with adaptation and survival requirements. These “biases” refer to innate preferences, “tendencies to seek (act) and guides for such actions” (Lichtenberg, 2002 , p. 843). For example, Sander’s (1977 , 1980 ) observation that during an “open space” when physiological requirements are satisfi ed, the infant will spontaneously explore the environment. This suggests an innate preference for exploration (Lichtenberg’s, 1989 , exploratory/assertive motivational system). Edelman suggests that there are at least 100 hard-wired “values” or “biases.” It is likely that a host of endogenous and exogenous factors contribute to the shifting priority of these “values.” 194 J.L. Fosshage

In light of these developments, Lichtenberg, Lachmann and I (2011 ) have just completed updating the conceptualization of motivational systems theory in Psychoanalysis and Motivation: A New Look. In this volume, we move “away from an original tilt toward an intrapsychic focus and toward an intersubjective focus based on nonlinear dynamic systems or complexity theory” (p. xvii). By intrapsychic tilt we mean that originally Lichtenberg ( 1989) conceptualized “needs,” along with innate response patterns, as discrete biological givens that began the developmental process within relational fi elds to become functional or dysfunctional motivational systems. Instead of needs, we turn to Edelman ( 1992 ) and see infants as beginning life guided in their action choices by evolution derived “biases” or “values.” “The evolved values and the intentions and goals (motivational systems) that derive from them remain operant as strong dispositions throughout the life cycle” (Lichtenberg, Lachmann and Fosshage, 2011 , p. 63). “Motives are not simply givens; they emerge and are cocreated and constructed in the developing individual embedded in a web of relationships with other individuals” (p. xiii). Thus, our “new look” at motivational systems theory attempts to integrate the most recent empirical fi ndings and theoretical considerations in neuroscience, cognitive science, infant research and systems theory along with clinical observations and research. Motivational systems theory aims to identify the shifting of affects, intentions and goals within the multiplicity of mental states. We have extended the number from fi ve to seven motivational systems, expanding the specifi - city and range of motivational systems of affects, intentions and goals. Over the years we have become more aware of the frequent interplay of different motivational systems. For example, exploratory/assertive intentions are often present whether attachment, caregiving, sexual/sensual or affi liative strivings are in the forefront. An overall concept of a “striving to grow” offers considerable clinical utility. Picking up on the “forward” or “leading edge” of the patient’s articu- lations (Miller, 1985 ; Tolpin, 2002 ; Lachmann, 2008 ), that is, allying with the patient’s strivings to grow, has proven in the clinical arena to enhance considerably a patient’s efforts to grow and a sense of personal agency. Downloaded by [New York University] at 04:57 12 August 2016 While self-psychologically-oriented psychoanalysts and psychotherapists, including Lichtenberg, Lachmann and myself, posit and clinically use a concept of an overall striving to grow, expositions based in systems theory have not addressed it. For this reason, I (Fosshage, 2011a ), in an independent effort, recently garnered evidence from neuroscience, cognitive science and systems theory to update our conceptualization of what I have termed developmental motivation. On the basis of this integration I posited that developmental motivation refers

to an overarching inherent tendency in human beings to grow or develop, meaning to expand in function, to self-organize with Motivational Theory in Psychoanalysis 195

increasing complexity in keeping with basic and evolving motivational values or preferences. While exploratory activities can easily be viewed as expanding in function, similarly moments of withdrawal for self-regulatory purposes, sleep for physiological regulation, or aggressive bolstering of assertion, when successful, also enhance a sense of agency and vitality. (p. 12)

Contributions of Motivational Systems Theory In updating our theory, I believe that motivational systems theory is the most current (in terms of incorporating the latest empirical fi ndings and contemporary systems theory), complex (seven motivational systems) and comprehensive (that is, covering a wide range of motivations) motivational model extant in psychoanalysis at this time. It provides a theory on which to build further in light of future empirical fi ndings and theoretical advances. Clinically, motivational systems theory provides a theoretical backdrop for listening and identifying the unfolding of intentions and goals and their interplay in seven motivational arenas. Based on relational experience, thematic patterns are established in motivational domains that can be vitalizing or devitalizing. From a self-psychological perspective, selfobject experience refers to a particular affect state characterized by a sense of self cohesion, personal agency and vitality. Kohut’s (1984 ) mirroring, idealizing and twinship selfobject needs all fall within the attachment, affi liation and caregiving arenas. Achieving aims on a moment-to-moment (or longer-term) basis in every motivational domain creates selfobject experience. For example, a successful exploratory-assertive experience with its attendant effi cacy pleasure is vitalizing, even when relational selfobject experiences are in the background. “Conceptually broadening the pathways to selfobject experiences facilitates understanding a wider range of experience and helps to overcome the tendency to view relationships as always in the forefront of selfobject experience” (Fosshage, 1994 . p. 6). This does not minimize the importance

Downloaded by [New York University] at 04:57 12 August 2016 of relationships in our lives, but accentuates the variety and complexity of motivational experience and its contribution to selfhood. This expansion of the range of possible vitalizing, as well as devitalizing, experiences and how successful, as well as unsuccessful, functioning in each motivational domain contributes to vitality, personal agency and self-cohesion is, for me, a major contribution of motivational systems theory that enhances our empathic grasp of a person’s positive and negative experiences. When implicit and explicit devitalizing (organizing) patterns are established, these patterns are gradually changed through the establishment of refl ective awareness of the patterns that, in turn, incrementally creates a 196 J.L. Fosshage

capacity to intercede and deactivate the pattern. Simultaneously, new relational experience occurring in the analytic and other relationships creates over a period of time new, more vitalizing attitudes or organizing patterns (Fosshage, 2005 , 2011b ).

Clinical Illustration I wish to close with a poignant illustration of the complex interplay of motives and aims and their relationship to an overarching developmental motivation or striving to develop, maintain and restore a vital, positive sense of self. A few years ago a highly intelligent man in his mid-thirties came to see me. He was an assistant professor at a well-respected university. While he had been relatively successful as a young academician, he was plagued by self-doubt and anxiety that emerged most painfully during and following his lectures. He typically felt quite critical of himself and never felt fully engaged when he gave his lecture. Upon the completion of his lecture, he, more often than not, walked away feeling defl ated and that he was a failure. Under these circumstances, he became “driven” to pick up a woman with the aim of engaging in sexual relations with her. His active pursuit of a woman and frequent success in achieving his aim momentarily overcame his defl ation and revitalized him. The revitalization, however, was of short duration, lasting at best until the next lecture was approaching. In the wake of experienced failure in work that engaged exploratory/assertive, attachment and caregiving motives, he turned quickly to the sexual motivational arena – where he had previously experienced considerable, reliable success in his life – to compensate and restore his self-esteem. Through a close tracking of this experiential cycle in treatment, we discovered that he entered lectures with expectancies of failure. These expectancies had a paralyzing effect, shutting down his affect (for example, his enthusiasm for the topic) and relatedness to his students. We were then able to track the development of his expectancies to repetitive experience with his

Downloaded by [New York University] at 04:57 12 August 2016 highly critical and “impossible to please” father. In contrast, these expectancies did not get activated in his relationships with women. Relationships to women had been far more successful, based on a closer relationship with his more nurturing mother. Refl ectively illuminating the patient’s negative expectancies with regard to work gradually enabled him to intervene and suspend (deactivate) them, creating suffi cient space to create positive, affi rming experience within the analytic relationship, the analytic work and his teaching. As he was able to suspend and gain freedom from these expectancies, he was affectively more enthusiastic and present in his lectures and related to his students. As his lectures continued to improve and become more vitalizing, he gradually no Motivational Theory in Psychoanalysis 197

longer needed the rush of new sexual conquests and became much more satisfi ed in his primary relationship with his partner that involved attachment, sexual, exploratory/assertive and caregiving motives. Motivational systems theory posits that each motivational system evolves within relational systems to become functional or dysfunctional systems. The development of each motivational system, thus, contributes to the development and vitality of an individual. Motivational systems theory broadens and legitimizes a range of motivations, overcoming the tendency toward clinical and theoretical reductionism when using a unitary model.

Closing with a Personal Note We are indebted to Joe Lichtenberg for his seminal contributions to psychoanalysis. Joe is immensely knowledgeable, creative, synthetic and incredibly prolifi c. Not only is he full of ideas, he selectively picks up on new ideas, reaches out to their authors and begins a dialogue. Not long after I published my fi rst paper on dreams in 1983, Joe called me to discuss with keen interest the new organization model of dreams that I had set forth. Our discussions began. I have always been impressed with his deep grasp of theoretical and clinical issues and his openness, enthusiasm and further development of novel ideas. I express my deep gratitude to Joe for his invitation and opportunity to join him and Frank Lachmann in further delineating clinical guidelines and motivational systems theory. As early as my undergraduate work in psychology, I became convinced of the central importance of motivational theory in personality and psychoanalytic theories. Thus, I found a deep resonance with Joe and his development of motivational systems theory. In our work together, Joe provided the overall guiding light for our joint endeavors. We completed one book and, soon afterward, Joe began formulating ideas for our next book. At times there was, and is, scarcely a chance to take a respite. I have always joined in because Joe’s ideas have felt so cogent, even though it means squeezing in more with the demands of my

Downloaded by [New York University] at 04:57 12 August 2016 own writing projects. Not only does Joe easily and ably conceptualize a book, he also has the knack of dividing up the chapters to capture each of our particular interests. From my perspective, the reason that Joe, Frank and I have worked so well together is related to our prioritization of clinical work, openness to new ideas, commitment to an empirically grounded development of theory and, more generally, to our similar sensibilities. Our collaboration has and continues to provide a deep source of intellectual expansion and mutual pleasure. And, perhaps most important, it has led to the development of an increasingly complex motivational model and its signifi cant technical guidelines for understanding and facilitating the therapeutic encounter. 198 J.L. Fosshage

Note 1 Systems theory and Edelman’s neuroscience are elaborated in my recent chapter, entitled “Development of Individuality Within A Systems World” (Fosshage, 2011a ).

References

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JOSEPH LICHTENBERG’S INFLUENCE

Alan Kindler , MBBS FRCP(C)

I have known Joe Lichtenberg since the fi rst annual Self Psychology meeting in Chicago in 1978. I know this because I still possess the notes from the workshop he gave at that conference: “Transmuting Internalization and Developmental Change.” I was a newcomer to Self Psychology, as were most who attended that meeting. I was near the end of my psychoanalytic training in Toronto and had been introduced to Kohut’s ideas by Howard Bacal, who had stealthily included them in his seminars on British Object Relations Theory (which was radical enough in those days). The controversy aroused by these ideas was nowhere more apparent than in my class at the Institute where Otto Kernberg reigned supreme over the world of narcissism. Those of us who had been swayed by these new heresies were vigorously criticized by our classmates and vice versa. Our learning became alive with curiosity inspired by the novelty of controversy. Freshly emerged from this scholarly tumult, I chose, at that fi rst conference, a workshop on transmuting internalization because it seemed to offer so much at the time as a way of explaining the curative process of

Downloaded by [New York University] at 04:57 12 August 2016 psychoanalysis as well as what might happen in the course of normal development. I discovered later that Joe was one of Kohut’s trusted “friendly” critics from outside the “inner circle” and had been invited to discuss this topic on that basis. He had recently written and presented on “the development of the sense of self and of the object,” and on the “developmental line of Narcissism.” And friendly critic he was. Joe began:

The subject of our workshop, transmuting internalization and developmental change, is an intriguing concept of great theoretical and 202 A. Kindler

practical signifi cance. Unlike many well worked out subjects discussed at meetings, our topic deals with a concept that is in a relatively pre- liminary stage. Thus I regard this workshop as our opportunity to conduct an exploration, drawing upon all aspects of our analytic experience, sorting out the known and accepted from the undiscovered and controversial.

I revisit that workshop in some detail because it was a magnifi cent illustration of the quintessential Joe Lichtenberg, “sorting out the known and accepted from the undiscovered and controversial.” Further, he posed fi ve questions to focus his discussion, a style that we have come to recognize as his approach to many theoretical issues. His questions proceeded to organize the theoretical constructs under consideration in new ways, including possibilities derived from the disciplines of contemporary psychoanalysis and developmental studies. When I review the notes from that workshop, generously provided by Joe in response to my request immediately following the workshop, I see the mind of the man who had produced, and who has continued to produce, a magnifi cent ongoing critique of all psychoanalytic clinical theory and its relationship to the rapidly evolving understanding of human development. How prescient are the following thoughts about the contextual or intersubjective basis of the concepts under consideration:

When we speak of overstimulating gratifi cations, or traumatic frustrations vs. optimal frustrations, we are referring to a context of self-in- need interrelated experientially with an object-in-response. When we speak of transmuting internalizations occurring in situations of optimal frustrations, we may shift our focus from the source of the need to the spirit and appropriateness of the response, but we always implicitly are referring to both. (Notes from Lichtenberg’s workshop 1978 )

A detailed examination of this presentation from the late 1970s, never Downloaded by [New York University] at 04:57 12 August 2016 published, reveals the careful “sorting out the known and the accepted from the undiscovered and controversial.” This, I believe, has been a powerful theme in Joe’s work and has been of enormous value to psychoanalysts who are open to such a critical examination of theory and practice. The arrival of Joe’s major monograph in 1989, Psychoanalysis and Motivation , heralded the start of his enormous infl uence on psychoanalytic thought and practice. Embedded as it was in the new world of the observed infant coupled with the evolving approaches of Self Psychology, Joe’s motivational systems opened up our understanding of the clinical process in new ways, breaking free from the limits imposed by the theories of the day, including the theories of Self Psychology. Understanding clinical events as Joseph Lichtenberg’s Inﬂ uence 203

emerging from multiple systems of motivation, one or more of which is operating to some degree, in the foreground or background of the subjective experiences of both participants, fostered the emergence of major new perspectives on the psychoanalytic process. The links between the interactions within the psychoanalytic relationship, and those of past relational events were now based on known realities established through direct observations of early parent-infant interactions, as well as those occurring in later life. Understanding of here and now events, both normal and pathological, was no longer based on models hypothesized retrospectively from adult events, usually pathological, occurring in the context of treatment. The “observed infant” swept the “clinical infant” away so that separation was replaced by attachment as a key element of healthy and pathological development, the details of “lived moments” replaced fantasies of early events as shap- ers of current expectations and needs, and the details of “lived moments” as remembered or enacted were evaluated according to models of normal development derived from empirical studies. My favorite of Joe’s many creative ideas, as a clinician and as a teacher, is his concept of “Model Scenes” which carries this understanding into a highly usable approach to life events, both “here and now” and “there and then.” The creative co-construction of these events, by patient and analyst, illuminates their signifi cance by opening them up to detailed understanding and the appreciation of their profound infl uence in shaping subsequent experience and behavior. I cannot resist illustrating this wonderful concept with an example from supervision. A patient recalls, as her earliest memory, waking up in the hospital after her tonsillectomy at the age of 3. As she awoke she saw her father standing near her crib. She spoke immediately to reassure him: “It’s alright, Daddy. It’s alright.” When we juxtapose our own assumptions and expectations of the “normal” developmental moment in which the scared child cries and is comforted by the parent, we begin to understand how, for this person, the early attachment needs had been reversed (avoided) and she had become a source of comfort to others. This interactive pattern operated at the deepest levels of her relational expectations and responsiveness. Joe’s construct of the “Model Scene,” elaborated Downloaded by [New York University] at 04:57 12 August 2016 by his motivational systems theory, has powerfully facilitated this kind of exploration of interactive events. No longer confi ned to “primal scene” or “oedipal” events, the contemporary analyst may consider virtually any relational event from this perspective, to enormous advantage analytically. One of the important challenges of Joe’s motivational systems theory is a pedagogic one. Despite its value clinically and its coherence theoretically, it is a “hard sell” to students in training programs. Many of them fi nd the details overwhelming and fi nd the application of the theory diffi cult to absorb. I suspect that this problem has something to do with the broad conceptual basis of the constructs. Joe draws on the research of many disciplines apart from clinical psychoanalysis. Many students are drawn to approaches 204 A. Kindler

more closely based in clinical events, more “experience-near,” such as Heinz Kohut’s theories of Self Psychology. I have found that it helps to proceed very slowly with students new to this approach and to introduce some of the ideas gradually, starting with a brief overview, using the paper1 that Joe wrote summarizing his ideas, along with some clinical material I had used to illustrate the application of his motivational systems approach. This paper emerged from an annual Self Psychology conference in Washington when I was a discussant of Joe’s paper in one of the plenary sessions. It seems to work well with beginners because it looks closely at the clinical events and how they might be conceptualized using the motivational systems approach. I think there is a need for more clinical material to grab the attention of students at the earlier levels of experience so that they can absorb the approach more readily. Another cooperative effort between Joe and myself, this time with the assistance of Frank Lachmann, occurred one Sunday morning over breakfast at my house, where both were my guests. The question came up as we settled into our coffee: “What is the essence of Self Psychology these days?” I think I was the one who posed the question. After a brief thoughtful silence, Joe began to list the elements of contemporary Self Psychology weaving in some of his own contributions from motivational systems theory. I started writing down the suggestions as they came, eventually establishing a list of about 12–14 items. Over the next week or so, we played around with the list by email and asked for input from others, including Jim Fosshage and Shelley Doctors. As we fi nished breakfast and I held up the list of items we had constructed, Frank Lachmann whimsi- cally proposed that it be called “Kindler’s List.” And so it is (see Appendix A). I fi nd it a useful summary of how things stood theoretically in about 2006. I am sure it needs modifi cation already and I hope it will continue to change as our ideas shift and new ones emerge. It is a useful snapshot of Self Psychology theory for students as well as more experienced practitioners struggling to stay abreast of the shifts in theory. I value it particularly because of how it originated in that wonderful breakfast moment with my two professional heroes. Downloaded by [New York University] at 04:57 12 August 2016 I could not think of a more fi tting tribute to Joe Lichtenberg than the one that Lawrence Friedman ( 1989 ) wrote in his “advance praise” for Psychoanalysis and Motivation (Lichtenberg, 1989 ). He lists Joe’s three major areas of accomplishment in producing this particular book, but I think the list applies to much of Joe’s extraordinary creativity. His readers might admire “his drawing a unifi ed theory of motivation from both psychoanalysis and the new infant research,” or “his fi nding a proper place in theory and practice for all our competing psychoanalytic viewpoints,” or “his truly pioneering way of identifying the shifting types of need expressed by a patient from minute to minute.” Joseph Lichtenberg’s Inﬂ uence 205

Joe’s theory of motivation continues to grow in number (there were seven at last count) and complexity. He continues to weave our contemporary psychoanalytic theories together utilizing the Complexity theory as an overarching model. In so doing he embraces the latest ideas from Relational and Intersubjectivity theory and practice. And the detailed study of psychoanalytic process remains of primary consideration in demonstrating the practical relevance of all theoretical advances. We psychoanalysts have made enormous progress since I had the good fortune to meet Joe in Chicago in 1978. Transmuting Internalization has disappeared from our explanatory models of the curative process, thanks substantially to Joe’s creative critique. The concept of the selfobject, the central idea of Kohut’s Self Psychology, has been altered profoundly by Joe’s critical appraisal. I believe it is now defi ned as Joe proposed, as a quality of subjective experience, in which the individual feels vitalized and cohesive. Although earlier conceptualizations persist, I think we no longer think of the selfobject as a person, a thing, or a function as was so familiar in Kohut’s era. But the understanding of human motivation has expanded dramatically along with our formulations about the curative process and the nature of developmental change. Joe Lichtenberg has been, and continues to be, at the forefront of our expanding and deepening understanding of the human mind, its normal development, pathological expressions, and participation in the healing process of psychoanalysis.

Appendix A

The Essentials of Contemporary Self Psychology: Kindler’s List2 1. Self Psychology privileges the patient’s subjective experience. To this end it maintains a perspective that at all times privileges the patient’s point of view. The therapist’s goal is to engage and illuminate subjective experience so that aspects of it may be transformed. 2. Rather than attending solely to the subjective world of the patient, con-

Downloaded by [New York University] at 04:57 12 August 2016 temporary Self Psychology appreciates that the subjectivities of both patient and therapist, along with their impact on one another, must be considered to fully comprehend the therapeutic process. 3. The focus on understanding subjective experience has given rise to two fundamental concepts to capture its essential elements. These are the “Self” and the “Selfobject experience.” The Self (or subjective sense of self) refers to the person’s experience of his/her own unique subjectivity which may vary in its qualities of cohesion, agency, continuity, and vitality. A selfobject experience is one in which the person experiences himself/herself to become more cohesive and enlivened. 206 A. Kindler

4. Selfobject experiences are of various kinds including mirroring (affi rming, approving), idealizing (strengthening, calming), or twinship (sameness, like-mindedness). Many other kinds have been described and the possibilities are endless. These experiences may exist in the foreground (conscious) or background (non-conscious unless disrupted) of the relationship with the therapist. 5. To apprehend the subjective experience of an individual at any time, we pay particular attention to affect. Hence, affect is key to our understanding of subjective experience. This includes the affect actually being experienced and the affect being sought. 6. In addition to recognizing the power of affi rming aspects that contribute to hope (selfobject experiences) the therapist also explores expressions of aversiveness when selfobject needs are not met. 7. Emphasis is placed on positive (leading edge) strivings that are found alongside maladaptive or problematic decisions (choices). 8. We attend closely to the self-regulating and self-righting qualities of problematic behavior for the individual while still recognizing its problematic impact on others. 9. Disruption-repair sequences are explored in an experience-near manner (empathically) because they provide opportunities to understand the patient (and therapist and their relationship) in greater depth. This often includes the precise nature of the selfobject needs being frustrated and the repetitive patterns of response to these frustrations (selfobject failures). 10. Careful attention is paid to the sequence of events in the patient-therapist interaction (the “what happens next?” in the therapeutic process), particularly as it applies to the patient’s subjective experience (sense of self) as it provides an essential guide to the effect of the therapist’s participation at any moment. 11. Knowledge of past lived experiences is used to help understand present clinical experience (for example, exchanges, events, enactments) rather than the opposite as has been the practice in more traditional models. Hence there is a strong developmental perspective in which the Downloaded by [New York University] at 04:57 12 August 2016 co-construction of model scenes makes developmental experiences alive and current. 12. In order to explore who we have become to the patient (precisely how we evoke the patient’s experience of us) the therapist tries to accept the patient’s attributions as a point of departure for inquiry. 13. Contemporary Self Psychology acknowledges a wide range of shifting motivations (needs for attachment, physiological regulation, sensual and sexual experience, assertion and exploration, and aversiveness) along with the fundamental need to sustain, protect, and strengthen the vulnerable self. Joseph Lichtenberg’s Inﬂ uence 207

Notes

1 Lichtenberg, J. and Kindler, A. (1994). A Motivational Approach to the Clinical Experience. J. Amer. Psychoanal. Assoc ., 42: 405–420. 2 This work in progress was initiated by Alan Kindler, Joe Lichtenberg, and Frank Lachmann at a Sunday breakfast in Toronto in 2005. Further contributions have been made by Jim Fosshage and Shelley Doctors. More contributions are welcome.

References

Friedman , L. (1989 ). Advance Praise for Psychoanalysis and Motivation . Hillsdale, NJ : The Analytic Press . Cover Blurb. Lichtenberg , J. (1978 ). Notes from Workshop given at the 1st Annual Self Psychology Conference, Chicago. Lichtenberg , J. ( 1989 ). Psychoanalysis and Motivation . Hillsdale, NJ : The Analytic Press .

Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 PART VI Developmental Theory Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 19 RECONSIDERATIONS ON INFANT DEVELOPMENT THEORY

James S. Grotstein , M.D.

Preface Reading Joseph Lichtenberg’s (2008 ) “The Oedipus Complex in the 21st Century,” I was deeply impressed both by the breadth of his approach and by the multi-disciplinary expansion of his perspective. I immediately thought of his earlier similar attempts in Psychoanalysis and Motivation (Lichtenberg, 1989 ) in which he beautifully and credibly demythifi es and demystifi es psychic agency and psychic determinism. He liberates the infant (and his des- cendant, the adult) from the non-human garb of narrow, rusted theory to the three-dimensional spirit of aliveness and realness. Put another way, in his view the infant is a more active, alert, and object-seeking individual from birth than we have hitherto realized. On a similar note Hartmann (1939 ) seemed to have felt similarly in regard to exclusive emphasis on the drives when he long ago proposed the concept of adaptation . However, this profound and evocative concept lamentably never made much headway in subsequent psychoanalytic thinking – except in Erikson’s (1959 ) application of it in his Identity and the Life Cycle. Erikson linked adaptation with infantile Downloaded by [New York University] at 04:57 12 August 2016 sexual development and its expansion and maturation in ego development and the life cycle. Lichtenberg reminds me of Hartmann and Erikson in his creative and imaginative pragmatism.

My Theme I should like to follow in Lichtenberg’s pragmatic and expansive mode, as best as I can, to review some of the more salient psychoanalytically related infant development theories with the prospect of adding some “harmonics” 212 J.S. Grotstein

to their basic melody and integrating them together as differing perspectives (“camera angles”) of a grander organic and organizing function, one which is the template for one’s attainment of serenity and fulfi llment in the face of fortune and equanimity (transformation in O, 1 Bion, 1965 , 1970 ) in the face of misfortune.

Brief Background When Freud hypothesized the genetic foundations for infant development in health and disease, he originated a scientifi c tradition in which impulse-driven events in infancy and childhood were to be considered as causative factors in future development. Chaos theory states it very well: “Unusual sensitivity to initial conditions.” Freud ( 1893 ) initially placed the emphasis on the early occurrence of sexual traumata, but soon afterward he shifted his theory of causation to unconscious (sexual) phantasies in general and to the existence of the Oedipus complex in particular (Freud, 1897 ). A few years later, Freud ( 1905 ) categorized early mental life into successive phases of increasing maturation organized around the unfolding of autoerotism: oral (passive followed by active), anal (active followed by passive), phallic (urethral then continuing into the Oedipal phase). It has not been signifi cantly noted, parenthetically, that Freud ( 1905 ) conceived that the onset of autoerotism followed the infant’s experience of being weaned from the breast (p. 222). Finally, in 1920 he formulated another source for instinctual drives, the death instinct, which postulated the existence of primal aggression, initially toward the self and then defl ected onto or into an object. From then on psychoanalytic theory has been to one extent or another the concept of the per- emptory life and death instincts, included in whose sway were autoerotism and its successor, the Oedipus complex. Abraham (1924 ) later took up Freud’s developmental concept and added his own concept of the epigenesis of, fi rst, part-object and then whole-object relations, which accompanied the successive autoerotic stages. The next major contribution to the theory of infant-child development was made

Downloaded by [New York University] at 04:57 12 August 2016 by Klein in her conception of the paranoid-schizoid (1946) and depressive positions (Klein, 1935 a), that inclusively overarched the autoerotic and part-object developmental protocol with a more affective as well as drive notation of the epigenesis of omnipotent narcissistic mental and emotional life with part-objects evolving to the infant’s acceptance of a non-omnipotent inter-dependent mutual relatedness with whole objects. What characterized all the aforementioned developmental protocols was the consideration that they were the prime operational templates that organized mental life. They were mythical-biological (e.g., Oedipus complex) and phantasmal (unconscious phantasies), which owed their provenance to the instinctual drives. In the dialectic of nature versus nurture the former was long to hold sway Reconsiderations on Infant Development Theory 213

over the latter in how analysts thought about theory and technique. If early trauma had occurred in a patient’s clinical history, for example, most analysts might have deliberated on how the trauma affected the patient in regard to affecting or even derailing the sacred developmental protocol, that is, “oral fi xation,” and “anal fi xation.”

Linear, Non-linear, and Helical Models of Developmental Progression and Regression

Developmental Progression When we speak of infant developmental progression, we customarily think in terms of a linear progression, that is, a → b → c. Infant mental life, like childhood and adult mental life, does not exist in a predictable vacuum, however. It is subject to the continuous, innumerable infl uences imposed upon it from the outside world of objects as well as from the objects and part-objects of the world of psychical reality. These superimposed infl uences transform the linear vector of development into a forward-moving helical vector of both predictable and unpredictable progression.

Developmental Regression When I speak here of regression, I am not referring to the concept as it is traditionally used in psychoanalytic theory and technique, a state in which the patient becomes more infantile and dependent upon the analyst, with the unconscious presumption that she is returning to a more infantile or childhood state of being. It is my vision that in every moment of incremen- tal developmental change forward, changes also occur in a three-hundred sixty degree arc, that is, changes occur laterally as well as retrospectively. Put another way, the oral component of one’s mental life becomes retrospectively as well as retroactively more developed and more mature as well as becoming sophisticated enough to join up with its Oedipal destiny. Bion Downloaded by [New York University] at 04:57 12 August 2016 ( 1962) spoke of “alpha-function-in-reverse” (p. 25) to encode the phenomenon of method-in-madness experiences in psychotic patients. I am extending his concept to normal development.

Fairbairn and Primary Object Relatedness Exceptions to this trend soon became apparent in the protocols put forward by Fairbairn ( 1944 ), Bion ( 1962 ), Winnicott ( 1963 ), and Bowlby (1969 ). The imposing importance of defective nurture – and with it, trauma and neglect – were now to come to the fore. First of all, the role of the caretaking 214 J.S. Grotstein

object (mother and father) was beginning to rival the importance of the drives and their derivatives. Fairbairn (1944 ) put it well when he stated that the only importance that could be assigned to orality was its role as a chan- nel for the infant’s need for his mother’s breast (1944 [1952, p. 86]). He also came up with a developmental protocol that specifi ed the epigenesis of the infant’s experience of immature dependency to mature dependency, traversing in the meanwhile the intermediate transitional zone that lay between them. His whole metapsychology was based on the outcome of the caretaking object’s treatment of the infant, that is, the worse the object’s treatment of her or his infant, the more the bad aspects of the former became split-off, internalized, and pathologically identifi ed with. Thus, the object was of key importance, and autoerotism became a series of techniques of relating to the object. Fairbairn (1944 ) was the only theorist to create a psycho-anatomical structure for these part-objects, which he termed “endopsychic structure.” His theory of development was contrary to those of other psychoanalytic developmental theorists. He posited that the infant is born as an “Original Ego” that related from the beginning to an Original Whole Object (not a “part-object”). With the onset of repeated, signifi cant, and critical failures two fatal separations (splits) take place: (a) one with the original whole object, which becomes split into a “Rejected (part-) Object” and (b) leaving the remaining Original (whole) Object as an Ideal (-ized) (part-) Object. Meanwhile, the Rejected Object becomes split again into a Reject ing Object and an Exciting Object. Concordant splits of the Original Ego also take place into: (a) a Central Ego, which now relates to the Ideal Object, (b) an Anti-libidinal Ego “Internal Saboteur”), now relating to the Rejecting Object, and (c) a Libidinal Ego relating to the Exciting Object. The Central Ego, in alliance with the Ideal Object, directly represses the other sub-structures, while the Anti-libidinal Ego, in alliance with the Rejecting Object, indirectly represses the Libidinal Ego and its relationship with the Exciting Object. The concept of endopsychic structure becomes a valuable model with which the analyst may account for pre-Oedipal pathology (good breast versus bad breast, envy, archaic superego) or Oedipal pathology directly Downloaded by [New York University] at 04:57 12 August 2016 (the Oedipus complex directly, the later moral superego). I should like to indicate how Fairbairn’s schema can account for Lichtenberg’s secure and insecure attachment scenarios in regard to the distinction between sensuality and sexuality in the pre-Oedipal and Oedipal situations. A continuation of a relationship between the Original Ego and the Original Object presupposes that the infant has experienced a secure attachment with its care-giving objects and that a healthy distinction exists between sensuality and emerging sexuality. The former occupies consciousness and the latter unconsciousness. Insecure attachment sensuality becomes infused with erotic (not pure loving) sensuality (the libidinal ego’s relationship with Reconsiderations on Infant Development Theory 215

its Exciting Object) and is doubly forbidden by the Central Self and the Rejecting Self. That is the structure of the forbidden Oedipal relationship. If one reunites the Rejecting and the Exciting Objects, one develops the paradoxical image of the Devil, who both lures one into evil and then punishes him for allowing himself to be misled. This is the picture of perverseness, which originates with the Libidinal Ego’s quest for love from an ungiving mother or father (see Ogden, 2010 for an interesting and unique reading of Fairbairn’s endopsychic structure).

Bonding and Attachment Bowlby (1969 , 1973 , 1980 ), who, like Fairbairn, identifi ed himself with the school of Object Relations as part of the Independent Group of the British Psychoanalytic Society, was to have a dramatic impact on both psychoanalytic and lay thinking when he put forth his clinically proven concepts of bonding and attachment. Though trained as an analyst, he functioned as a social anthropologist in his observations of the infant-mother relationship. His concept about bonding (mother’s relationship to the infant) and attachment (the infant’s relationship to the mother) defi ned the affective as well as neural and physiological “glue” that bound mothers and infants together. It is, I believe, no exaggeration to state that mental health as well as psychopathology, can ultimately be considered as direct outcomes of the quality and function of bonding and attachment between mothers and infants. Freud ( 1905 ) states the following:

Psycho-analysis tells us that there are two methods of fi nding an object. The fi rst is the “anaclitic” or “attachment” one, based on attachment to early infantile ego and fi nds it again in other people. (p. 222)

Bonding/attachment constitutes a critical determinant in the unfolding of Klein’s (1935 b, 1946 ) paranoid-schizoid and depressive positions and Bion’s

Downloaded by [New York University] at 04:57 12 August 2016 ( 1962 ) container ↔ contained – and occupies a “troika” with them.

Klein’s Concept of Infantile Development In her earlier papers Klein (1950 , 1959 ) essentially followed Abraham’s ( 1924) extension of Freud’s concept of infant development in regard to autoerotic maturation (Freud, 1905 ) and their respective and corresponding part-objects. First, she conceived of an archaic Oedipal phase occurring in the second oral stage that was characterized by part-object relations and which constituted the “feminine phase” (“matriarchal”) of the Oedipus 216 J.S. Grotstein

complex (Klein, 1928 ). Second, she dismissed the existence of primary narcissism. The importance of primary narcissism for classical analysts lay in their belief that the infant had no mental life or object-relationships until their separation from the object, when secondary narcissism and then the Oedipus 2 complex develops each predicating an object relationship (Heimann, 1952 , p. 145). Later, Klein superimposed a second developmental agenda atop her autoerotic one, that of the non-linear, iterative concept of the paranoid-schizoid and depressive positions. This latter developmental scenario has now become prominent in many analytic schools. At three weeks postnatally, according to Klein (1946 ), the infant begins to develop anxieties of persecution – feeling persecuted by external bad part-objects into whom the infant had just projected his/her intolerably painful emotions and had thereby transformed them into part-objects comprising the object used as part-object (breast) and the infant’s painful emotions, especially consisting of hate, envy, and greed, which now threaten and persecute the infant. Put succinctly, “badness” is felt to be located outside. As the infant begins to encounter the depressive position at four months of age, according to Klein (1935 a, 1946 ), (s)he begins to feel sorrow and guilt retrospectively for all the putative (phantasied) damage done to the breast. The infant now feels more individuated and separate from the object and also realizes that the object-used-as-part-object has now become a whole object and thus a separate subject in her own right. At the same time autoerotic (part-object) experiences are now becoming whole object interpersonal and intersubjective experiences where love, hate, loss, and acknowledgment of dependency matter. The “Positions” seem to alternate within one over a lifetime.

Bion’s Contribution Bion, infl uenced as well as being analyzed by Klein, accepted her concept of the paranoid-schizoid and depressive positions and then elaborated upon them. Klein ( 1955 ) believed that the two positions alternated between

Downloaded by [New York University] at 04:57 12 August 2016 each other throughout one’s life but that in early infantile mental life the paranoid-schizoid position came on line before the depressive position, at approximately three weeks of age, whereas the latter emerged at approximately four months of age. Bion (1970 ) came to believe that the infant was born into both positions but the paranoid-schizoid was more prominent at fi rst until the infant achieved individuation and separation from the object. What he seemed to be implying was that each position was bound to the other in an oppositional and complementary functioning, that is, they comprised a binary-oppositional structure (Lévi-Strauss, 1958 ). He then went on to modify the concept of the “Positions,” as he began to think of them, in yet another way. Believing that the very terminology of each was seemingly Reconsiderations on Infant Development Theory 217

too pathological-sounding and only should apply to psychopathology, he renamed the paranoid-schizoid position as “faith” and the depressive position as “security.” In other words, he believed that the normal infant (pre- supposing good maternal containment, that is, attachment) was able to have faith that “everything will eventually be all right. I’m not in real danger now” when (s)he is confronted by frustration or trauma. It is of some interest that Bion, who, in World War I, had been nomi- nated for the Victoria Cross (VC) but was, because of military red-tape, awarded the Distinguished Service Order (DSO), had early in his psychoanalytic career, quietly but courageously defi ed the Kleinian, hermetically sealed dogma about not interpreting traumatic factors of external , only internal (psychical) reality that may have affected the patient’s well-being as an infant. 3 What Bion ( 1959 , 1962 ) fatefully theorized were: (a) pro- jective identifi cation, rather than being solely a pathologically aggressive attack against the part -object breast-mother, also constitutes a normal and necessary form of pre-lexical, emotional communication between the infant and his mother, and the reverse; (b) the communicative link between infant and mother came to be known as the phenomenon of container ↔4 contained ; (c) Bion postulated that, and this constituted his “crossing of the Rubicon,” the ultimate causative factor that he had observed and/or intu- ited in the psychotic patients he had treated and observed all experienced infantile mental catastrophes, which in turn were caused by a fateful and psychological fatal interaction between the infant’s normal need to express (project) his emergent emotions (in)to his mother, and his mother’s failure to be a competent (“good enough”) container for these emotions. Bion goes on to hypothesize that this mother (caretaker) is a “ whole object, not a part -object mother,” that is, “whole object” meaning separated from the infant and externally, objectively real . That was the deviation from con- temporaneous Kleinian dogma, not to mention Orthodox Freudian dogma, until the latter evolved into Classical Ego Psychology, and the former into London post-Kleinianism. Bion went on to describe the malevolent psychic transformation of this whole-object maternal image that took place within the abjectly demor- Downloaded by [New York University] at 04:57 12 August 2016 alized infant’s mind. The mother who could not contain her infant’s projected emotional outcries was (a) fi rst thought by the infant to be hating him for emoting (projection in reverse), thereby being transformed into a hateful, sadistic mother; (b) the infant then “raises the ante,” so to speak, by ratcheting up his anguish into blood-curdling screams, which he thereupon (c) projects into his image of his now already hateful and sadistic mother, along with projecting omnipotence and omniscience as well; (d) since the infant’s initial attempt to communicate with (project into) mother for containment and wisdom about himself and his emotions – so that eventually he can feel safe enough to feel (recognize and own) these emotions, his communicative enterprise with mother constitutes a “lexithymic” (knowledge 218 J.S. Grotstein

about one’s emotions) function in the service of curiosity and wisdom about oneself; (e) the now “bad-enough, non-containing mother (in reality)” has been malevolently transformed into an “obstructive object ,” one who will- fully attacks wisdom and curiosity in the infant by attacking his (remaining) links (Bion, 1959 ) with good objects and good aspects of the obstructive object; (f) the infant now feels stupid ; his curiosity , in the meanwhile, has now become split-off and translocated to (projectively identifi ed into) his obstructive-object mother; (g) has become arrogant in her malignant espousal of a perverse and arrogant form of “curiosity,” a curiosity without the joy in fi nding out. Bion concludes that when stupidity, arrogance, and curiosity occur in the patient’s clinical material over time, the erstwhile occurrence of an infantile catastrophe may be assumed. When Bion revealed his concept of container ↔ contained, he believed that the mother’s capacity for containment takes place when she is in a state of (a) “ reverie ” (sleepy receptive wakefulness, EEG theta rhythm), and employs (b) her unconscious capacity for “alpha-function ,” which term Bion uses as a analogical model for dreaming . In brief, Bion believes that mother’s alpha-function and reverie fundamentally comprise her capacity for containment and that alpha-function intercepts and “metabolizes” and mental- izes her infant’s inchoate, emergent, not yet processed emotions, which Bion ( 1962) terms beta-elements, and transform them into alpha-elements, the fundamental element for dreaming, feeling, thinking, and remembering.

Weaning: Actual and Symbolic In what I call Freud’s ( 1905 ) “fi rst Kleinian paper,”5 he states the following:

At a time at which the fi rst beginnings of sexual satisfaction are still linked with the taking of nourishment, the sexual instinct has a sexual object outside the infant’s own body in the shape of his mother’s breast. It is only later that the instinct loses the object, just at the time, perhaps, when the child is able to form a total idea of the person

Downloaded by [New York University] at 04:57 12 August 2016 to whom the organ that is giving him satisfaction belongs. As a rule the sexual instinct becomes auto-erotic [italics added], and not until the period of latency has been passed through is the original relationship restored. There are thus good reasons why a child sucking at his mother’s breast has become the prototype of every relation of love. The fi nding of an object is in fact a refi nding of it. (p. 222)

From the above citation, I derive the following hypotheses: Freud is alluding to the weaning process (actual and/or symbolic) which termin- ates the infant’s sensual relationship with the breast-as-part-object (his own Reconsiderations on Infant Development Theory 219

possession) and his discovery of the mother as a whole object. In the meanwhile the infant becomes autoerotic as a default phenomenon, and his thus new-found autoerotism, born as it is from the withdrawal of the breast (weaning), allows him to use the now eroticized organs of his own body as a consolation. Weaning heralds the attainment of the depressive position.

The Second Self The concept of a second self lies at the beginning of the history of psychoanalysis. A careful reading of Groddeck’s ( 1923 ) The Book of the It would lead one to believe that he had a second self in mind, not the instinctual-drive self of Freud. The concept of the second self constitutes one of the hidden orders of psychoanalytic prehistory, but it is too long a story for this presentation (see Grotstein [1984 ] for an in-depth study of this phenomenon). Here, I would just merely like to touch on some salient aspects of it that are relevant to the theme of infant development. Winnicott (1963 ) spoke of the (a) passive (being) object-related infant who was associated with the holding mother and (b) the object-using infant who related to the breast-mother. The former is, as I see it, the anlagen to that aspect of the later self that is autonomous and independent of the object-needing self. Bion (1992 ) created the idea of a normal infantile (and subsequent) twinship comprised of a “nar- cissist” (individual self) and a “socialist” (a gregarious and/or group self, p. 122). I shall illustrate an application of this twinship in the phenomenon of infantile envy. Klein (1957 ) states that the infant invariably experiences envy of the good, satisfying breast because it reminds him of his/her dependency and the vulnerability associated with it. Envy can also be understood as the fi rst developmental stage of competitive rivalry between the infant and the breast-mother. In other words, (a) the infant who accepts the fact of his dependency comprises an object-using infant, whereas (b) the infant who envies and attacks the breast for its superiority (because of its goodness and his ineluctable need for it) comprises the independent infant whose pride is injured by any reminder of his/her inability to fend for him/herself. Downloaded by [New York University] at 04:57 12 August 2016

Entelechy and Conatus Once I came across the concept of entelechy, I wished in retrospect that Freud had been aware of it. I believe it corresponds to exactly what Freud had in mind by the id, and more. Entelechy, fi rst proposed by Aristotle, designates the activation of one’s inborn potential possibilities (Damasio, 2003 ). It is the master plan for one’s future development. The adult is the entelechy of the embryo as the oak tree is the entelechy of the acorn. Entelechy is experienced as the developmental force that both pushes us forward and pulls us 220 J.S. Grotstein

into our future. When a girl arrives at puberty, for instance, she all too suddenly encounters her future body and mind now at her doorstep for her to accept and adjust to. Some may revert to anorexia nervosa to forestall their future. I believe that entelechy is that developmental force which constitutes a formidable content of the repressed. Conatus, fi rst conceived of by Spinoza (Damasio,2003 ), designates that inherent regulatory function that seeks to guarantee the survival of the identity of the organism, that is, self-sameness, during trauma or change. I associate it with the adaptive aspects of the death instinct, which may attack one’s links to objects that are felt to be too painful to relate to. In brief, it is “dying” in order to stay alive.

Summary I have highlighted the essential psychoanalytic protocols of infant development with the aim of extending their reach and of adding some “harmonics” to their basic nature.

Notes 1 “O” is Bion’s (1965 , 1970 ) arbitrary designation for the Absolute Truth about an Ultimate, Infi nite, and Impersonal Reality. It is an objectless domain beyond sensible reach or contemplation. One cannot ever know it; one can only become it. 2 Freud’s ( 1913 ) version of the Oedipal phase, unlike Klein’s, was that it was (a) whole object, not part -object, (b) occurred in the late phallic phase, not late oral, and was patriarchal in hegemony, not matriarchal. 3 In all fairness this statement needs modifi cation. Klein and her followers always considered the effects of the impingement of externally realistic factors, but they always regarded them as if they looked at them from within the unconscious, not from consciousness (Grotstein, 2009 ). 4 I use the reversible arrows icon to designate the reversible nature of this interactive function. 5 Arguably, his second was Mourning and Melancholia (1917), and his third was Beyond the Pleasure Principle (1920). Downloaded by [New York University] at 04:57 12 August 2016

References Abraham , K. (1924 ). A short study of the development of the libido. In: Selected Papers on Psycho-Analysis. London : Hogarth Press , 1948, pp. 418 – 501 . Bion , W.R. (1959 ). Attacks on linking . In: Second Thoughts. London : Heinemann, 1967, pp. 93 – 109. Bion , W.R. ( 1962 ). Learning from Experience . London : Heinemann. Bion , W.R. ( 1965 ). Transformations: Change from Learning to Growth. New York : Basic Books . Bion , W.R. ( 1970 ). Attention and Interpretation . London : Tavistock Publications . Bion , W.R. ( 1992 ). Cogitations . London : Karnac . Bowlby, J. (1969 ). Attac hment and Loss. Vol. I: Attachment. New York : Basic Books . Reconsiderations on Infant Development Theory 221

Bowlby, J. (1973 ). Attachment and Loss. Vol. II: Separation Anxiety and Anger . New York : Basic Books . Bowlby, J. (1980 ). Attachment and Loss. Vol. III: Loss: Sadness and Depression . New York : Basic Books . Damasio , A. (2003 ). Looking for Spinoza: Joy, Sorrow, and the Feeling Brain. New York : Harcourt. Erikson , E. (1959 ). Identity and the life cycle. Psychological Issues. Volume 1. New York : International Universities Press. Fairbairn , W.R.D. (1944 ). Endopsychic structure considered in terms of object-relationships . Psychoanalytic Studies of the Personality. London : Tavistock, 1952, pp. 82 – 136. Freud , S. ( 1893 ). On the psychical mechanism of hysterical phenomena: a lecture. Standard Edition , 3: 25 – 42 . London : Hogarth Press , 1962. Freud , S. ( 1897 ). Extracts from the Fliess paper: Letter 71 (October 15). Standard Edition , 1:263–265. London : Hogarth Press , 1966. Freud , S. (1905 ). Three Essays on the Theory of Sexuality . Standard Edition, 7: 125 – 245 . London : Hogarth Press , 1953. Freud, 1913 [1912–13]. Totem and Taboo . Standard Edition , 13:1–161. London : Hogarth Press , 1955. Freud , S. (1917 ). Mourning and Melancholia . Standard Edition, 14: 237 – 260 . London : Hogarth Press , 1957. Freud , S. (1920 ). Beyond the Pleasure Principle. Standard Edition , 18:3–66. London : Hogarth Press , 1955. Groddeck, G.W. ( 1923 ). The Book of the It . New York : Mentor Books . Grotstein, J. (1984 ). Autoscopy: the experience of oneself as a double. Hillsdale Journal of Clinical Psychiatry , 5 (2): 259 – 304 . Grotstein, J. (2009 ). “…But at the Same Time and on Another Level…” Psychoanalytic Technique in the Kleinian/Bionian Mode. Vols. 1 and 2. London & New York : Karnak Books. Hartmann , H. ( 1939 ). Ego Psychology and the Problems of Adaptation. New York : International Universities Press , 1958. Heimann , P. ( 1952 ). A contribution to the re-evaluation of the Oedipus complex – the early stages . Int. J. Psycho-Anal ., 33 : 84 – 92 . Klein , M. (1928 ). Early stages of the Oedipus confl ict . In: Contributions to Psycho-Analysis, 1921–1945. London : Hogarth Press , 1950, pp. 202 – 214 . Klein , M. ( 1935a ). A contribution to the psychogenesis of manic depressive states. In: Lov e, Guilt, Reparation and Other Works . London : Karnac Books, 1992, pp.

Downloaded by [New York University] at 04:57 12 August 2016 262 – 310 . Klein , M. ( 1935b ). Mourning and its relation to manic-depressive states . In: Contributions to Psycho-Analysis, 1921–1945. London : Hogarth Press, 1950, pp. 311 – 338 . Klein , M. (1946 ). Notes on some schizoid mechanisms . In: M. Klein , P. Heimann , S. Isaacs , & J. Riviere (Eds.), Developments in Psycho-Analysis . London : Hogarth Press , pp. 292 – 320 . Klein , M. (1950 ). Contributions to Psycho-Analysis (1921–1945). London : Hogarth Press. Klein , M. ( 1955 ). On Identifi cation. New Directions in Psycho-Analysis: The Signifi cance of Inner Confl ict in the Patterns of Adult Behavior . London : Tavistock , pp. 309– 345 . Klein , M. ( 1957 ). Envy and gratitude. In: Envy and Gratitude and Other Works, 1946–1963 . New York : Delacorte , 1975, pp. 176 – 235 . 222 J.S. Grotstein

Klein , M. ( 1959 ). The Psycho-Analysis of Children . London : Hogarth Press . Lévi-Strauss , C. (1958 ). Structural Anthropology. (Trans.) C. Jacobson & B. Grundfest . London/Harmondsworth : Schoepf/Penguin , 1968. Lichtenberg , J. ( 1989 ). Psychoanalysis and Motivation . Hillsdale, NJ : The Analytic Press . Lichtenberg , J. ( 2008 ). The Oedipus complex in the 21st century. In: Sexuality and Sensuality Across the Divide of Shame, pp. 21– 49 . New York: Taylor & Francis . Ogden , T. (2010 ). On three types of thinking: magical thinking, dream thinking, and transformative thinking . Psychoanalytic Quarterly , 79 : 314 – 347 . Winnicott , D. (1963 ). Communicating and not communicating leading to a study of certain opposites. In: Maturational Processes and the Facilitating Environment . New York : International Universities Press , 1965, pp. 37 – 55. Downloaded by [New York University] at 04:57 12 August 2016 20

PLAY, SEMBLANCE, AND SELF

Russell Meares , M.D.

It is a great honor and pleasure to be asked to write about the contribution of Joseph Lichtenberg to psychoanalytic thought. My subject is play, concerning which we wrote two joint papers (Meares and Lichtenberg, 1995 ; Lichtenberg and Meares, 1996 ). Joe was kind enough to tell me that my book, Metaphor of Play (1993), had stimulated him to develop further his thoughts on this subject. A reciprocal effect, created by his “motivational systems model” (Lichtenberg, 1989 ), infl uenced my own work, leading me to conceive of play as a primary drive (Meares and Coombes, 1994 ).

Lichtenberg’s Thoughts on Play It was in Joe’s Psychoanalysis and Infant Research (1983) that his thoughts on play revealed the emergence of a new voice in psychoanalysis. It spoke in a way quite different to the turgid, shut in, and monotonous formulations of the old ego-psychology, the clanking prose of which mirrored the mechan- Downloaded by [New York University] at 04:57 12 August 2016 ical nature of the apparatus itself. Lichtenberg’s style implicitly announced a return to fundamentals, to what William James had called “the open air of human nature” (James, 1909 , p.17). The style was lucid and straightforward; the work scholarly but uncluttered. The fundamental upon which Lichtenberg focused was the scene created by the mother with her child, out of which, he sensed, emerges the experience of self. It was the development of this state of mind that Lichtenberg strove to understand. His approach to this quest was new. It was open and without preconceptions based on psychoanalytic theory. He was a pioneer in using the plethora of mother-infant data that quite suddenly began to 224 R. Meares

appear in the late 1960s, a time when a paradigm shift was occurring in the psychological sciences, a movement which mirrored the larger changes occurring in the social and political atmosphere of the West (Meares, 2004 ). Lichtenberg (1998 ) was one of the fi rst in the therapeutic world to see that this growing body of data provided a way of reconceptualizing psychoanalysis so that it was based on scientifi c observations and could offer more effective guidelines for treatment. What he offered was a new way of looking at things, a shift from a pathology-based theory of development towards one in which there is a striving towards vitality, well-being, and sense of selfhood. He conceived this state not as a structure but as a dynamism, a system both “fl uid and multidimensional” which necessarily grows in the context of a relationship. Lichtenberg states that the infant observations from researchers such as Stern, Brazelton, Sander, Stechler, the Papouseks, Emde, Trevarthen, and Beebe allow us to “jettison the incorrect assumption that development consists of stages of a pathological nature (for example, autism and undifferentiation) and replace it with a schema of relatedness beginning at birth and progressing in an intersubjective context” (Lichtenberg, 1998 , p.17).

Other Theoretical Contributions on Play Although play was not among the topics of the main subject matter of Joe’s 1983 book Psychoanalysis and Infant Research it was a recurring underlying theme. Before proceeding with the subject of play it is necessary to say what is meant by the term. The complexity of the activity is implicit in the multiple defi nitions of the word given by theOxford English Dictionary ( 1971). There are 17 main meanings for the noun and 36 for the verb. From these defi nitions we extracted four main clusters of meaning which suggest the essence of play. They are (i) a form of movement which is brisk and free, as in the play of light or the play of thought, (ii) an activity which gives pleasure or amusement, (iii) an activity which may involve imitation, as on the stage, and (iv) an activity which may result in music. We pointed

Downloaded by [New York University] at 04:57 12 August 2016 out that these are the main elements of the early interplay between mother and child (Meares and Lichtenberg, 1995) which Trevarthen ( 1974 ) called a “proto-conversation.” Trevarthen emphasizes the “musicality” of this relatedness (Powers and Trevarthen, 2009 ). A defi nition of play derived from these four clusters of meaning excludes certain forms of rule-based games in which playfulness and spontaneity may be a disadvantage and in which, at least at times, a grim and unpleasurable atmosphere prevails. Lichtenberg’s main interest, as expressed in his 1983 publication, was in play as semblance. In an interesting way, he pondered its relationship to symbolization. Behaviorism in the mid twentieth century considered play of no value in an adaptive sense. It was thought of as “cheesecake,” to use the notorious Play, Semblance, and Self 225

expression of Pinker (1997 ) in discussing that form of play we call art. It seems to have no obvious purpose. He meant that it gives pleasure but is not essential to the human condition. So liberal and psychodynamically minded a psychologist as William McDougall believed that play had no other function than the burning off of excess energy (McDougall, 1933 ). In standard ego-psychological texts, play was seen as defensive, as sublimation or denial (Brenner, 1974 ). In the late nineteenth century, however, it was evident to a number of writers that play has purposes of larger moment. Karl Groos (1898), a follower of Darwin, pointed out that play occurs among many animal species. It must, therefore, have some survival value. Groos believed that play in young animals is rehearsal of activities which are necessary to the animal’s adult existence. For example, a kitten pounces on leaves as a prelude to its later role as a hunter. A more signifi cant contribution came from James Mark Baldwin ( 1897 , 1906 ). Baldwin (1906 ), like Lichtenberg, was struck by the signifi cance of play as semblance, which Baldwin called the “made-believe” element (1906 ). He described the paradoxical nature of play (its real/unreal and serious/ non-serious qualities), which is allied to a sense of freedom, what he called the “don’t-have-to feeling” (1906 ). Most importantly, however, Baldwin saw play as a necessary means to the development of self. He emphasized the role of imitation in this process so that, speaking for the child, “My sense of myself grows by imitation of you, and my sense of yourself grows in terms of my sense of myself. Both ego and alter are thus essentially social, each is a source and each is an imitative creation” (Baldwin, 1897 , pp.338–339). The second sentence is on the way to the view, which is an essential aspect of Lichtenberg’s (1983 ) thesis, that self is a double game, the outcome of an interplay between child and caregiver. Baldwin’s pioneering work on the development of self was largely forgot- ten in the aftermath of what Harter (1983 ) called the “radical behaviorist purge” that followed World War I. Elements of it, however, persisted in the work of Piaget who was strongly infl uenced by the ideas of Baldwin ( 1897 , 1906 ) and Pierre Janet, who he continued to call “my professor” to the end of his life (Bringuier, 1980 , p.3). Piaget also, although in a limited way, saw Downloaded by [New York University] at 04:57 12 August 2016 play as important in the development of self. His principal focus was that kind of playing behavior which he called symbolic play, and which I believe is the immediate and necessary precursor to the fi rst appearance in human life of self as William James described it (Meares, 1993 ). Piaget wrote that the child needs to

have available to him an area of activity whose motivation is not adap- tion to reality but, on the contrary, assimilation of reality to the self. Such an area is play, which transforms reality by means of assimilation to the needs of the self. (Piaget, 1966 , p.492) 226 R. Meares

Piaget did not pursue Baldwin’s innovative suggestion that the origins of self are social. This neglect provoked criticism from Vygotsky (1962 ) who was born in 1896, the same year as Piaget. Like Piaget, he was infl uenced by Baldwin, in particular by the “law” Vygotsky (1962 ) and Luria (1987 ) attributed to both Baldwin and Janet, that those events which we in adult life experience as “inner” had their fi rst forms in the “outer” world as activities and sensations (see Van der Veer and Valsiner, 1994 ). Luria (1987 ) supposed that “the highest forms of mental life and conscious behaviour” are a “product of social development” (p.805). Vygotsky died in 1934. His ideas had minimal infl uence in the West until the time of the paradigm shift, around 1970, when once again the concept of “self” became a respectable subject of scientifi c inquiry and, at the same time, mother-infant interaction emerged as a major fi eld of study. It seemed an awareness had arisen that, in some way, “self” evolved through the child’s engagement with the nurturing environment (Meares, 1993 ). Lichtenberg ( 1983) was one of the fi rst to combine these two emergent areas of research.

Role of Play in the Development of Self Before considering the role of play in the development of self, it is necessary to understand Lichtenberg’s view of this state of mind as expressed in his 1983 work. Self is an elusive subject, a philosophical, psychological, and scientifi c minefi eld littered with academic prejudices and ideological dogmas that shift with the intellectual atmosphere of the times (Collins, 1998 ). An example of the vagaries in the conceiving of self is manifest in the work of the eminent philosopher, Charles Taylor. His magisterial The Sources of the Self (1989), consistent with the mid century zeitgeist, excludes the great process philosophers James, Bergson, and A.N. Whitehead but makes multiple references to minor fi gures of the same era, such as T.E. Hulme 1924( ), whose philosophy was considered “harder.” With a change of zeitgeist, however, Taylor (2002 ) reinstates James as a main spokesman for the self. Lichtenberg deftly weaves his way through this minefi eld, without confron-

Downloaded by [New York University] at 04:57 12 August 2016 tation, but making his own position clear. While acknowledging that his friend Stern (1985 ) wants to place the emergence of self early in infancy, Lichtenberg (1983 ) “leans to the belief that what is crucial is the sense of self – a later development – and that self and object as psychoanalytic terms are tied up in the whole problem of representation and symbolic process” (pp.29–30). The journey towards this stage of development includes movements of increasing differentiation and integration. Differentiation is shown in increasing self and object differentiation (p.56) and a growing sense of agency, for example, self as “director.” Integration is shown in an emergent layering of awareness. An important stage of this evolution is what Lichtenberg (1983 ) calls “self-as-a-whole” Play, Semblance, and Self 227

(p.114) when, we might say, the “me” is formed (Meares, 2000 ). This mile- stone occurs at about 18 months when the child recognizes his image in a mirror or photo (Amsterdam, 1972 ; Lewis and Brooks-Gunn, 1979 ). Beyond this lies the zone in which the “critical inside” (Lichtenberg, 1983 , p.145) is conceived and “refl ective awareness” is achieved (p.146). This is the stage of the “ ‘mental’ self” (p.146). With these somewhat throw-away and anti-doctrinaire remarks, Lichtenberg is in accord with the views of William James (1890 ). The “mental” self, involving a refl ective awareness of inner life, is equivalent to the Jamesian “duplex self,” a double awareness made of knower and known. This point in the child’s development is signaled by the momentous discovery of secrecy at about the age of four (Meares and Orlay, 1988 ; Meares, 1993 ). It can be seen as the birth of “myself.” Play is an essential element in the process of integration leading to this amplifi ed state of mind (Meares and Lichtenberg,1995 ). The form of play which fosters integration and sets going the process of symbolization is of a specifi c kind, which mirrors the “shape” and movement of the Jamesian self. In what follows, I develop the argument Lichtenberg and I put forward in 1995.

Meares and Lichtenberg Collaborations: Play and Its Role in the Development of the Emergent Sense of Self within the Context of the Mother-infant Relationship Although we did not know it at the time, we were following the Baldwin–Janet principle, taken up by Vygotsky and Luria, which suggests that the fi rst form of self is to be found in the outer world, as activity. The Jamesian self has two outstanding characteristics. First, it has a stream-like shape, moving in a non-linear, apparently capricious and wandering way. The kind of activity which is similar to these movements of mind is play, as in the fi rst cluster of Oxford English Dictionary meanings. The second outstanding characteristic of self is its doubleness. This is a state, however, that is lacking in the infant, whose sense of personal existing is adualistic. The other pole of the nascent

Downloaded by [New York University] at 04:57 12 August 2016 duplex self is provided by the caregiver, usually the mother, in a kind of play involving a particular kind of conversation. This characteristic interplay enables her to be felt by the child as part of her child’s unifi ed experience. She behaves in a way which has the qualities of semblance and resemblance in a special form of relatedness. The trajectory towards “internalization” of this relatedness, and most particularly its feeling, begins at birth. The mother might welcome her new baby with “hello,” the word drawn out with a rising infl ection. She is playing a game, giving a semblance of conversation, pretending the baby knows what she says and can talk to her. In this game, she also plays the part of the baby, speaking for him (Kaye and Charney 1980 ; Kaye, 1982 ). She doubles for the infant. Quite soon at 228 R. Meares

about 2–3 months, the baby is able to play his own part in a conversation conducted by means of facial expression, gesture, and the sound of the voice. In this proto-conversation (Trevarthen, 1974 ), the mother’s role is a resembling meaning that she shows in her face and in the contours of her voice, the “shape” of her baby’s experience. Her behavior is analogical, where an analog, in the original meaning of the word, is something which has a proportion or shape similar to another thing. In a way, she has a picturing function, representing the baby’s immediate experience. Winnicott (1974 ) likened the mother’s face to a mirror. In that an analog can be conceived as the primordium, the fi rst form of the symbol, we might say that the mother’s face in the proto-conversation is the child’s proto-symbol (Meares and Jones, 2009 ). The maternal response has an emotional effect, creating a positive affect through the sense of “fi t” between the expressions of one human being to another (Meares, 1993 ). This effect is bidirectional, creating a fi eld of “fellow-feeling” (Meares, 2000 ) and, presumably, contributing to the essential feeling at the core of self which James (1890 ) has likened to “warmth and intimacy,” both words conveying the notion that this fundamental feeling includes the sense of someone else who is related to us in a way we might call intimate. Towards the end of the fi rst year of life, the play of semblance and resemblance takes a new turn in which the child fi guratively appropriates the role of the double through imitation. He is both himself and someone else at the same time. Lichtenberg (1983 ) sees this sembling activity of the child as the beginning of more truly imaginative play. Since imagination gives us the power to create another world, which is our own and different from public reality, this is an important step towards selfhood. Indeed, Sartre ( 1948) believed imagination to be the distinguishing feature of human consciousness. At about 18 months, symbolic play begins. This apparently solitary behavior refl ects a further appropriation or internalization of analogical relatedness (Meares and Jones, 2009 ). The emergence of symbolic play is predicted not by the mother’s responses to distress activities but to non-distress Downloaded by [New York University] at 04:57 12 August 2016 (Bornstein and Tamis Le Monda, 1997 ); that is, when she amuses herself, enjoying her child without awareness, in the usual case, that she is unknowingly doing what is necessary to the child’s psychological development. In both distress and non-distress situations she is empathic, but what she does with her empathy differs in these two situations. In the fi rst case, she rep- resents, in her facial expression and the contours of her voice, the baby’s experience, at that moment. In the latter case, she does something to relieve the distress. In symbolic play, the child chooses physical things to represent elements of his/her personal story, the beginning of the narrative self as Lichtenberg ( 1983 ) points out. In making these choices, the child demonstrates analogical thought. The things have shapes which resemble the Play, Semblance, and Self 229

elements of the story, so that drinking glasses lying on their sides are rabbit burrows and white paper napkins rolled into balls are the rabbits. They are analogs. Furthermore, although the child is apparently alone, the particular kind of relatedness involving a sense of fi t is still part of his experience but now much more nearly internal. Piaget (1959 ) makes this clear in a beautiful description:

What he says does not seem to be addressed to himself but is envel- oped with the feeling of a presence, so that to speak of himself or to speak to his mother appear to him to be the same thing. His activity is thus bathed in an atmosphere of communion or syntonization. (p.243)

The special relatedness which began to evolve from the fi rst moments of life has now a different form, akin to the later inner conversation. The scene of symbolic play is in accord with Lichtenberg’s 1983 view, which I share; that it is play with others, whether the other is outer or inner or both, that has a developmental value in terms of the emergence of self.

The Continuing Relationship between Play and Sense of Self Cohesion through the Life Span: Therapeutic Implications The development of self continues, under favorable circumstances, over the whole life. This is indicated by increasing well-being associated with enhanced prefrontal activity (Williams et al., 2006 ) which is necessary to dualistic consciousness (Meares, 1999 ; Meares, Stevenson, and Gordon, 1999 ). Such further development, it must be supposed, depends upon new conversations which are not merely interactions, but which create a sense of connection and a shared experience arising in the “open space” (Lichtenberg, 1983 , p.118), between the conversing dyad. The aim of Lichtenberg’s 1983 endeavor in tracing the development of self in childhood and its relationship to play was driven by the implicit

Downloaded by [New York University] at 04:57 12 August 2016 assumption that, through his study of empirically gathered data of child development, certain principles could be derived concerning the necessary environmental provision for the growth of self. His second assumption was that these principles apply not only to the generation of self in childhood but also later in life, to those people in whom the early development of self has been impeded and stunted. Stunted, in this sense, implies a narrowness of consciousness, a “stimulus entrapment” (Meares, 1993 , 1997 ), in which psychic life is in thrall to the environment, leading to a “chronicle” style of conversation (Meares, 1998 ). It also implies a relative failure of the sense of unity of psychic life, of the cohesion and continuity which Kohut (1971 , 1977 ) saw as a cardinal 230 R. Meares

feature of self. A main inference that emerges from Lichtenberg’s project is that these disturbances may be a consequence of the individual’s defi cient experience, in early life, of the form of relatedness necessary to the generation of cohesion. This kind of interplay between mother and child might be called “analogical relatedness” (Meares and Jones, 2009 ). Its central feature is the mother’s “picturing function” in which she shows the semblance, or “shape,” of the child’s immediate emotional reality in her face and voice. A second main inference is that a therapeutic form of relatedness based on the principles derived from the generational style of mother-infant interplay should play a major part in structuring the therapeutic conversation with those (damaged) individuals suffering from chronic feelings of alienation and disconnectedness, not only from others but also from themselves. It is important to note that the therapist’s play-like behavior in this engagement does not refer to playing around, to play therapy or the like. It refers to a particular state of mind, in which secondary process is not dominant. Using the language of the time, Lichtenberg ( 1983 ) calls the play style of thought, “primary process.” He proposes, against prevailing orthodoxy, that primary and secondary processes are not stratifi ed, the latter following the former, but that “they exist as parallel organizations.” The “primary process” mode of thought, involving the analogical and “metaphoric properties” of language, is concerned with the “integration of parts into a complex whole” (p.228). It is thus necessary for cohesion.

Concluding Remarks Although expressed in a non-revolutionary style, Lichtenberg’s formulation was of a somewhat revolutionary kind. It was against the traditional notion that the patient’s expressions should be transformed into secondary process. The problem with such an approach is that the therapeutic conversation remains stuck in the stimulus entrapped, linear mode of a chronicle. Something different is required, an interplay in which, as it were, a conversation is going on between two right hemispheres, the right hemisphere

Downloaded by [New York University] at 04:57 12 August 2016 being particularly associated with the shaping of experience and its feeling core (Meares, Schore, and Melkonian, 2011). Finally, the richness and complexity of Joseph Lichtenberg’s thoughts on play and self cannot be encompassed in this brief space. They are the fruits of an intellectual openness which is allied to his own capacity to play, manifest in his way of living which includes an interest in art and literature. The capacity of mind which allows Lichtenberg to enter areas of thought beyond the borders of psychoanalysis and to think things out anew, to give them fresh form, gives them the vital quality of “lived experience” (Lichtenberg, 1998 ) which is the basis of his approach to psychotherapy. Play, Semblance, and Self 231

References

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Williams , L. , Brown , K. J., Palmer , D. , Liddell , B. J., Kemp , A. H., Olivieri , G., Peduto , A. , and Gordon , E. (2006 ). The “mellow years”: neural basis of improving emotional stability over age . Journal of Neuroscience , 26 : 6422 – 6430 . Winnicott , D. W. ( 1974 ). Playing and Reality . Harmondsworth, UK : Penguin . Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 PART VII Attachment Research and Implications for Treatment Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 21 THE ATTACHMENT PATTERNS OF THERAPISTS Impact on Treatment Alliance, Therapeutic Process and Outcome

Diana Diamond , Ph.D. and Sidney J. Blatt, Ph.D.1

Attachment concepts and research have enlarged, expanded and sharpened the lens through which we view the therapeutic process and relationship. They guide our therapeutic interventions, help us to understand patients’ communications and defi ne the nature of their diffi culties or pathology (Diamond, Stovall-McClough, Clarkin & Levy, 2003 ; Mills, 2005 ; Wallin, 2007 ). Following Bowlby (1988 ), a number of clinicians and clinical researchers have explored how internal working models of attachment or general- ized expectations about others and beliefs about the self may profoundly infl uence the therapeutic relationship, activating the attachment system of both the patient and the corresponding caregiving system of the therapist in ways that affect therapeutic alliance, transference and countertransference dynamics. Joseph Lichtenberg (Lichtenberg, Lachmann & Fosshage, 2011 ) has been a pioneer in delineating how attachment and caregiving are among the most fundamental of the seven motivational systems. Each motivational system is characterized by emergent and co-constructed affects, intentions and goals, each in dialectical tension with each other and each operating at

Downloaded by [New York University] at 04:57 12 August 2016 both the unconscious (or implicit procedural) and conscious (explicit) levels. Lichtenberg ( 1999 , 2003 ) hypothesized that the two systems of attachment and caregiving, overlapping though conceptually and empirically distinct, are both activated in therapeutic situations often in complementary or opposing ways. He has shown how “the more experiential categories of attachment research – secure, insecure, disorganized … offer working analysts a descriptive dynamic language for organizing specifi c transference phenomena” (Lichtenberg, 1999 , pp. 653–654). In addition, he suggested that the illuminating lens of attachment theory and research allows us to recognize variations in clinical process including: 1) The constricted 238 D. Diamond and S.J. Blatt

idealizing state of mind of the Dismissive patient that creates an arid wall shielding the patient from pain that must be fully explored; 2) the confused and confl icted state of mind of the Preoccupied patient who gets lost or overwhelmed in inchoate anger at attachment fi gures so that he/she remains desperate to please, necessitating both containment and confrontation; and 3) the fragmented state of mind of the Unresolved patient, who may appear intact but experiences past loss or trauma as he/she becomes fearful and dissociated in ways that compromise, even momentarily, his/her refl ective and cognitive capacities (Lichtenberg, 2003 ). To date, the focus of much clinical research and thinking on attachment has been on how the patient’s attachment representations affect the therapeutic process and relationship. A logical next step is to investigate how the attachment representations of therapists might affect their discourse and interventions with their patients, and/or their countertransference responses. Therapists with secure attachment representations are more likely to be autonomous and fl exible in their responses to patients, both mirroring or challenging their patients’ attachment state of mind sensitively and empathically as the situation warrants; therapists with dismissive attachment representations may distance themselves from diffi cult patients and or respond with cognitive, rational interventions, while therapists with preoccupied attachment representations might experience feelings of guilt and fear or be emotionally overreactive to their patients. Finally, therapists with lack of resolution of loss and abuse may either shy away from exploration of trauma in patients, or focus on trauma to the exclusion of all else, missing the ways in which trauma may be congealed into character traits that also must be analyzed. In analyzing patient-therapist transactions, Foelsch and Diamond (2008 ) found that even secure therapists may move from being refl ective and reactive to being more rational with dismissing patients, while they move towards being more reactive and refl ective and less rational in their interventions with preoccupied patients. In this chapter, we review and critique a major study by Schauenburg et al. (2010 ) on the impact of patient-therapist attachment patterns using Lichtenberg’s motivational systems theory as a guide. The time has clearly Downloaded by [New York University] at 04:57 12 August 2016 come, as Lichtenberg and others have pointed out, for therapists not only to turn the attachment lens onto their own states of mind with respect to attachment, but also to refl ect on the representations that they hold of their patients, how these are a product of the intersubjective transactions in the session, and their impact on the treatment process.

The Schauenburg Study: Population and Methodology Schauenburg and colleagues ( 2010 ) investigated the attachment status of therapists and its impact on therapeutic alliance and outcome in a multimodal The Attachment Patterns of Therapists 239

inpatient psychotherapy program with a broadly psychodynamic theoretical framework. The 31 therapists, recruited from the staff of two major teaching hospitals in Germany, were primarily psychodynamically oriented (38 percent psychodynamic; 32 percent psychoanalytic; 19 percent systemic family therapy) with some still in postgraduate psychodynamic psychotherapy training (37.8 percent). They were between 26 and 54 years old and gender was equally distributed, with professional experience ranging from 1 to 25 years. The patients, who ranged in age from 18 to 71 years (M=34.58, SD=11.30) were in multimodal inpatient treatment for 6–12 weeks. This included two hours per week of either individual psychodynamic or CBT therapy, and group therapy, art and body therapy, and in some cases EMDR or trauma focused therapy for 6–12 weeks. The majority of the patients had multiple diagnoses including affective disorders (55.6 percent), anxiety disorders (35.7 percent), adjustment disorders (19.4 percent), somatoform disorders (16.9 percent), obsessive-compulsive disorders (6.6 percent) and psychotic disorders (5.8 percent), with a substantial number also diagnosed with co-morbid personality disorders. Patients completed assessments of symptoms and interpersonal problems at the beginning and end of therapy, and evaluated the therapeutic relationship. Attachment of therapists was assessed with the Adult Attachment Interview (AAI; George, Kaplan & Main, 1996 ), a semi-structured one hour plus interview designed to assess the individual’s current representation of his or her early attachment experiences and their impact on current functioning. The AAI consists of 18 questions that inquire about the patient’s early relationships with primary caregivers including experiences of separation and reunion, and asks the individual to refl ect on why his/her parents behaved the way they did and how his/her relationship with his/ her parents has changed over time. The technique has been described as having the effect of “surprising the unconscious” (Main, Kaplan & Cassidy, 1985 , p. 3) and allowing numerous opportunities for the interviewee to elaborate on, contradict or fail to support previous statements. Interviews are classifi ed into one of fi ve attachment categories: secure, preoccupied, dismissing, unresolved for loss and trauma, and cannot classify (Main & Downloaded by [New York University] at 04:57 12 August 2016 Goldwyn, 1984 ). In addition, Schauenburg and colleagues rated the therapeutic alliance with the Helping Alliance Questionnaire (HAQ; Bassler, Potratz & Krauthauser, 1995 ), which consists of 11 items that assess the relationship with the therapist. The HAQ was administered at the end of treatment, thus allowing the individual to retrospectively draw on his or her experiences of the treatment process. Therapeutic outcome was assessed with three measures: 1) the symptom checklist (SCL-90R) given at the beginning and end of treatment; 2) the level of symptomatic distress as assessed by the mean score of the Global Severity Index (GSI); and 3) the patient’s perception of his or her interpersonal 240 D. Diamond and S.J. Blatt

functioning was assessed on the Inventory of Interpersonal Problems (IIP) (Horowitz, Strauss & Kordy, 2000 ), a self-report measure that assesses interpersonal problems on a circumplex structure around dimensions of dominance and affi liation (with domineering interpersonal behavior at one pole and nonassertiveness at the other) and nurturance versus coldness (excessive concern for others at one pole and an inability to feel love and concern for others at the other pole). The mean IIP score assessed interpersonal distress (Alden, Wiggins & Pincus, 1990 ). A global measure of the patient’s impairment was derived from the sum of the therapist’s assessment of the patient’s psychological, sociocommunica- tive and physical impairment rated on four-point scales. This global measure provides an assessment of the patient’s impairment from the therapist’s perspective and has good concordance with similar measures (Schepank, 1995 ). The AAI dimensional ratings of therapists’ security versus insecurity were used to predict alliance and outcome (measured by the IIP, GSI and IS of the SCL-90) through multiple regression techniques (HLM).

Attachment Patterns of Therapists One of the most interesting fi ndings of Schauenburg et al. (2010 ) was the way in which the distribution of therapists’ attachment representations con- verged or diverged with that of clinical and nonclinical groups. Interestingly enough, while this group of therapists tended to be classifi ed with slightly more security in attachment than did the general nonclinical population, therapists showed a higher degree of lack of resolution of loss and trauma and preoccupied attachment status, but less dismissing attachment status than did the general nonclinical population. Over half of the therapists (61 percent) were classifi ed with secure attachment representations and the majority of the therapists with insecure attachment representations were preoccupied (9.7 percent insecure preoccupied), with only a few therapists (6.5 percent) classifi ed as insecure/dismissing. Surprisingly, 22.6 percent of the therapists had unresolved/disorganized attachment patterns. Most not-

Downloaded by [New York University] at 04:57 12 August 2016 able is the low level of dismissing attachment which Schauenburg and colleagues attribute to the fact that psychodynamic therapists have been found to be more sensitive to separation and to be more affectively expressive with and about their patients, whereas cognitive therapists have a lower need for affection and expression of feelings in relationships (Arthur, 2000). Comparable patterns were also noted on dimensional scores derived from AAI subscale ratings. On security versus insecurity, therapists ranged from high security to moderate insecurity scores. The dismissive versus preoccupied dimension was skewed in the direction of preoccupation, with no high dismissive scores. These therapists’ attachment security versus insecurity was not related to gender, profession, age or level of therapeutic experiences. The Attachment Patterns of Therapists 241

Over 30 percent of the therapists tended to have preoccupied attachment scores on the continuous ratings and categorically to be classifi ed as Unresolved and lacking resolution of loss and trauma. These AAI classifi cations of Preoccupied or Unresolved do not necessarily mean clinical disorder or distress, although these classifi cations have been associated with clinical groups (Levy et al., 2006 ; Steele & Steele, 2008 ; Bakermans-Kranenburg & van IJzendoorn, 2009 ). The cognitive and linguistic characteristics from which these classifi cations are derived are thought to reveal patterns of defense and affect regulation in the context of attachment relationships, and hence they have important implications for clinical process. The narratives of secure therapists are clear, concise, coherent and relevant following Grice’s maxims (Grice, 1975 ; Main, Hesse & Goldwyn, 2008 ), demonstrating the capacity to actively monitor thought processes and refl ect on intentional mental states of self and other. Preoccupied therapists, on the other hand, show some diffuse passivity or confl icted anger and are overly concerned with enlisting the approval or agreement of the patient; while dismissing therapists tend to be disconnected from the patient and his/her diffi culties, or acknowledge the patient’s diffi culties, but with little depth or empathy. Therapists with a lack of resolution of loss or trauma, however, are at risk for emotional blocking, incoherence, moments of dis- connection or dissociation and a loss of contact with the patient when the treatment process stimulates the therapists’ memories about loss or abuse (Mills, 2005 ). The fact that Schauenburg and colleagues found that over 20 percent of their therapists were rated as unresolved with respect to loss and trauma is important because the other insecure classifi cations, while showing discourse characteristics that violate some of Grice’s maxims of relevance, quantity, quality and manner, do not necessarily show disorganization or disorientation of thought processes or lapses in the monitoring of reasoning and discourse when discussing experiences of loss or abuse as do those classifi ed as Unresolved (Hesse & Main, 2000 ). The implications of these fi ndings, however, may be modifi ed to some degree depending on the secondary attachment classifi cation of these unresolved therapists; that is, all Downloaded by [New York University] at 04:57 12 August 2016 individuals who receive a primary classifi cation of Unresolved are also given secondary classifi cation of secure, dismissing or preoccupied. It is this secondary classifi cation that is thought to illuminate the underlying dominant attachment pattern that may be obscured by lack of resolution of trauma or loss in response to a few AAI questions. Given the relatively high rates of insecure and disorganized attachment states of mind among inpatient therapists in the Schauenburg study (2010 ), we need to ask whether there might be something potentially facilitative or even creative for their therapeutic work in the momentary lapses in discourse and reasoning noted on the AAI. This is certainly the case for certain artists, fi lmmakers and/or writers, whose early losses and traumatic 242 D. Diamond and S.J. Blatt

experiences may inform the imaginative structure of their work, and spear- head their attempts to fi nd creative resolutions (see the works of Ingmar Bergman, Maya Angelou, among others). There has been much focus on the importance for psychodynamically trained clinicians to demonstrate the capacity to describe negative, adverse and even traumatic childhood experiences coherently and with “forgiveness, balance and humor” (Main & Goldwyn, 1984 , p. 137) – qualities that Halpern ( 2003 ) has identifi ed as factors that one looks for in applicants for psychoanalytic training. Such a capacity to talk coherently about negative experiences, past losses and/or traumas on the AAI and be able to put them in perspective has been termed “earned secure” (Rossmann, Padron, Sroufe & Egeland, 2002 ). However, renewed focus on the therapist’s subjectivity converges with attachment fi ndings such as those by Schauenburg and colleagues to suggest further investigation of how psychodynamic work might represent a creative force for the resolution and overcoming of attachment insecurity and disorganization in therapists as well as patients. Interestingly enough, despite the signifi cant minority of therapists classifi ed with insecure and even disorganized attachment, Schauenburg and colleagues (2010 ) found that, contrary to their expectations, the therapist’s attachment representations did not have any direct impact on the patient-therapist alliance. That is, security or insecurity of the therapist, as measured by the continuous AAI scores, did not directly impact the major outcome measure: the therapeutic alliance rated retrospectively by the patient at the end of the treatment. However, the security of the therapist was associated with better alliance and outcome with more severely disturbed patients, patients who endorsed high levels of interpersonal distress prior to therapy on the Inventory of Interpersonal Problems (IIP) (Alden et al., 1990 ) and who reported more symptomatic distress as measured by the GSI of the SCL-90. These fi ndings suggest that insecure therapists may be good enough therapists with higher functioning patients, but that with severely disturbed patients, security of attachment in the therapist is an essential aspect of positive therapeutic relationship and outcome. Several aspects of secure states of mind within therapists may be par- Downloaded by [New York University] at 04:57 12 August 2016 ticularly important in work with more severely disturbed patients to form good therapeutic alliances. First, secure attachment is characterized by attentional fl exibility; that is, the capacity to be able to spontaneously discuss attachment-related experiences, regardless of how diffi cult, painful or confusing. Thus, security of attachment not only involves certain discourse characteristics of coherence, clarity and relevance, but also the capacity to maintain a collaborative stance and shared focus with the other (inter- viewer/therapist) (Main, Goldwyn & Hesse, 2003 ; Main et al., 2008 ). It also involves the capacity to monitor one’s own thinking (metacognitive monitoring) or to refl ect on intentional mental states of self and others, while The Attachment Patterns of Therapists 243

accepting the diversity and change of representational states, of one’s own and those of others. Therapists with more secure attachment representations thus have a greater capacity for establishing and maintaining a consistent collaborative stance with patients, and for tolerating patients’ negative affect. These fi ndings highlight the links between two aspects of the therapeutic alliance identifi ed by Hatcher and Barends 1996( ): 1) purposive mutual or confi dent collaboration; and 2) idealization, and its opposite, devaluation, or the capacity to express and manage hostility in therapy. More interper- sonally impaired and distressed patients have diffi culty with both the therapeutic bond and the purposive shared collaborative aspects of the alliance, and thus the therapist’s security is more important in order to maintain a collaborative stance and productive focus on patients’ diffi culties. Furthermore, an important aspect of the alliance, as Safran (1993 ) has pointed out, is the capacity to repair ruptures in the therapeutic relationship. Such alliance ruptures are of course more likely with patients who manifest high levels of interpersonal distress or preoccupied attachment states of mind (Eames & Roth, 2000 ), rendering the therapist’s level of security more salient for maintaining the alliance in the face of negative transference. A recent study by Rubino, Barker, Roth and Fearson ( 2000 ) regarding the infl uence of therapists’ self-reported attachment styles on the way they manage confl icts within the therapeutic alliance, showed that insecure therapists tended to respond less empathically in situations of rupture with insecure patients.

The Signiﬁ cance of Therapist Attachment Security for Clinical Work with Severely Disturbed Patients The Schauenburg study is one of the fi rst to assess therapists’ attachment representations with the AAI and their impact on outcome and alliance demonstrating the positive impact of therapists’ attachment security on the treatment of severely disturbed patients. The major implication of the study

Downloaded by [New York University] at 04:57 12 August 2016 is that more securely attached therapists seem better able to recognize and respond to the multiple, contradictory and unintegrated internal working models of attachment that characterize more severely disturbed patients. In a randomized clinical trial of 90 borderline patients in Transference Focused Psychotherapy, Dialectical Behavior Therapy and supportive psychodynamic treatment, Levy et al. ( 2006 ) found that a majority of the patients had either Unresolved (33.3 percent) or Cannot Classify (18.3 percent) (with 5 percent secure, 28.3 percent dismissing and 15 percent preoccupied) as a primary attachment classifi cation. This indicates that well over 50 percent of the sample had multiple states of mind with respect to attachment, a phenomenon that would have major impact on the treatment process. More 244 D. Diamond and S.J. Blatt

disturbed patients, who have multiple insecure attachment representations, are likely to change more rapidly from a dismissing, devaluing stance to a preoccupied stance, requiring the therapist to tolerate this switch and to adjust therapeutic interventions accordingly. It requires a secure therapist to shift strategies from deactivating to hyperactivating depending on the stage of the treatment as well as the patient’s attachment organization. It requires a secure therapist to comprehend fully the insecure patient’s often complex and contradictory representational states with respect to attachment by experiencing in the self through concordant or complementary countertransference the attachment states of mind that are disavowed in the patient. Insecure therapists, particularly those with preoccupied and unresolved attachment representations, will be less likely to maintain such a dual monitoring of their own internal worlds and the internal worlds of their severely disturbed patients. A group of studies, particularly by Dozier and her colleagues (Dozier, Cue & Barnett, 1994 ; Tyrrell, Dozier, Teague & Fallot, 1999 ), now demonstrate that secure therapists fl exibly adapt complementary or counter-complementary styles in order to challenge the patient’s attachment representations and characteristic defenses. That is, secure therapists may momentarily become more dismissing with preoccupied patients or more preoccupied with dismissing patients when they deem it appropriate to move the treatment process forward by challenging the patients’ resistances and defenses. By contrast, insecure therapists are more likely to mirror and reinforce patients’ attachment state of mind by overfocusing or overempathizing with the emotional distress of preoccupied patients, or by becoming hyperrational in response to the patients’ deactivating strategies (Slade, 2008 ). The lack of main effects of therapists’ attachment representations on therapeutic alliance and outcome may be the consequence of the attachment system of the therapist not being activated in the patient-therapist relationship because the patient is not an attachment fi gure for the therapist. The therapist is not seeking safety or security from the patient, even though some of our patients may indeed be older and wiser than we are (Charles Gardner, personal communication, January 15, 2010). Also, Downloaded by [New York University] at 04:57 12 August 2016 therapists may develop internal working models of their patients that are not necessarily linked to the therapists’ representations of their own early attachment fi gures. It is also possible that “attachment states of mind” are traits that are manifested across a wide variety of interpersonal situations. Considerable research indicates the stability and continuity of attachment patterns, as well as the conditions under which they are likely to change; for example, adverse life events like death, loss, or new positive attachment relationships like marriage or therapy (Benoit and Parker, 1994 ; Waters and Hamilton, 2000 ). But many individuals, particularly those with insecure states of mind, The Attachment Patterns of Therapists 245

may have different attachment representations or classifi cations for different fi gures (Main, 1991 ; Diamond, Blatt & Lichtenberg, 2003 ). Furthermore, there may be some latent secure attachment representations to secondary attachment fi gures even in those with insecure and/or disorganized attachment that are obscured by the emphasis on overall attachment classifi cation in research assessments, but which may emerge in the clinical arena. Indeed both Ammaniti (1999 ) and Lichtenberg ( 1999 ) have hypothesized that without such latent secure models of attachment relationships, the majority of severely disturbed patients would be untreatable. In addition, therapists do not necessarily manifest their primary attachment states of mind in their work with patients, but might rely on their work ego or “second self” (Schafer, 1983 ) that might buffer the emergence of an insecure attachment state of mind with the patient. According to Schafer, the second self integrates one’s own personality into the constraints necessary to develop an analytic situation, and “on this basis a special kind of empathic intimacy, strength, appreciation and love can develop in relation to analysands” (p. 291). Lichtenberg, Lachmann and Fosshage (2011 ), on the other hand, would defi ne this capacity as a manifestation of the exploratory assertive motivational system that is linked to play and self-expression. Thus it is possible that the therapist is sustained by “the exploratory interest and assertiveness in pursuit of effi cacy and competence” (p. 22) – one of the goals and intentions that comprise the exploratory assertive motivation system that may buffer insecurity in the attachment system. In addition, following Lichtenberg’s multifaceted motivational systems map with its lines of con- vergence and divergence among the systems, the caregiving system, with its distinct focus on the “intentions, needs, desires and mind states of an other, with relative suppression of self-interest” (Lichtenberg et al., 2011 , p. 20), may be successfully activated even in insecurely attached individuals. Just as insecure mothers may have securely attached infants, the insecure therapist may be able to create a secure attachment climate for the patient, offering empathic support and safety that he/she did not personally experience. Thus, attachment patterns in the therapeutic dyad, like motivational systems, are not only dependent on the attachment status of each mem- Downloaded by [New York University] at 04:57 12 August 2016 ber of the dyad, but are to some extent co-constructed and unfold in an intersubjective context. As part of a large longitudinal study investigating changes in attachment (on the AAI), mentalization and symptomatology in borderline patients in psychodynamic psychotherapy (TFP), patients’ and therapists’ representations of each other and of the therapeutic relationship were assessed in ten patient-therapist dyads through the Patient-Therapist Adult Attachment Interview (PT-AAI) (George et al., 1996 ; Diamond et al., 2003 ) that is modeled after the AAI. Examination of therapeutic outcome and process of two patient-therapist pairs with identical AAI and PT-AAI ratings indicated very different treatment 246 D. Diamond and S.J. Blatt

trajectories and outcome (Diamond and Yeomans, 2008 ). Both therapists were secure with respect to the patient and showed a high level of Refl ective Function, while both patients were unresolved/preoccupied on the AAI and PT-AAI. However, one therapist found the work with the patient, although stormy and diffi cult, to be gratifying and even captivating, while the other therapist felt despairing and increasingly disconnected from the patient. That is, each patient-therapist dyad has its own unique characteristics that are not revealed just by knowing the attachment states of mind of both participants.

Conclusion Findings from the Schauenberg and colleagues study ( 2010) indicate that while the attachment status of the therapist may not be the main factor in treatment outcome, it is useful to understand the aspects of self that may be secure or insecure, preoccupied or dismissing, and how they are expressed in the therapy, particularly in perceiving and understanding patients and in establishing and maintaining a treatment alliance with different types of patients. Over a decade ago, Lichtenberg (1999 ) predicted that the assessment of the individual’s discourse on the AAI represented an “ ‘enactive’ procedural intrusion into speech” (p. 657) as a way of understanding, at the level of syntax, the implicit relational procedures of the attachment motivational system that infuse our discourse including the therapeutic discourse. Schauenberg and others have provided empirical affi rmation of Lichtenberg’s idea that such enactive procedures are expressed in the AAI assessment of therapists as well as patients and do indeed shape the therapeutic relationship and process. Schauenberg and colleagues establish that the therapists’ attachment security is a signifi cant moderator of therapeutic outcome and alliance, particularly for patients with severe pathology. These fi ndings provide empirical verifi cation of Lichtenberg’s theory of the signifi cance of attachment as a fundamental motivational system that is basic in human interactions. Although the therapists’ attachment status had no direct impact on thera-

Downloaded by [New York University] at 04:57 12 August 2016 peutic outcome and process, other attachment systems such as caregiving and exploration or assertiveness may play a role in therapeutic transactions and outcome with more severely disturbed patients. These patients challenge the therapists’ attachment security, calling into play other motivational systems that interact with each other. As Lichtenberg has observed,

each system organizes and self stabilizes as a loose assembly of categorized experiences having similar but not identical affects and purposes ….dialectical tensions can result in the activation or deactivation of dominance of the individual’s mental state by one or another motivational system. (Lichtenberg et al., 2011 , p. 30) The Attachment Patterns of Therapists 247

An understanding of how attachment dynamics infuse the therapeutic process enables the therapist to track the motivational systems of the patient through verbal associations and nonverbal bodily communications, while shifting among his or her own multiple self-states that may be activated by different motivational systems.

Note 1 This is the last paper that Sid Blatt and I wrote before he died on May 11, 2014. Sid, Joe Lichtenberg and I collaborated on a number of Psychoanalytic Inquiry issues dedicated to attachment theory and psychoanalysis. In this last paper in tribute to Joe, Sid and I decided to take up the issue of patient-therapist attachment, a topic so central to Joe’s work.

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Foelsch , P. , & Diamond , D. (2008 ). The Impact of Attachment Status on the Therapeutic Process in Borderline Patients. Paper presented at the conference “Indung und Entwicklung.” Sponsored by the 59 Jahrestagung des Deutschen Kollegiums fur Psychosomatische Medizin (DKPM) and 16 Jahrestagung der Deutschen Geseellschaft fur Psychosomatische Medizin und Arztliche Psychotherapie (DGPM). Frieberg, Germany, March 15, 2008. Gardner , C. ( 2010 ). Personal communication, January 15, 2010. George , C. , Kaplan , N. & Main , M. ( 1996 ). Adult attachment interview (3rd ed.). University of California at Berkeley, Unpublished manuscript. Grice , H. P. ( 1975 ). Logic and conversation. In P. Cole and J. L. Moran (Eds.), Syntax and Semantics (Vol. 3), pp. 41 –58 . New York : Academic Press . Halpern , J. ( 2003 ). The capacity to be an analyst: A contribution from attachment research to the study of candidate selection . International Journal of Psychoanalysis , 84 : 1605 – 1622 . Hatcher , R. L. , & Barends , A. W. ( 1996 ). Patients’ view of the alliance in psychotherapy: Exploratory factor analysis of three alliance measures. Journal of Consulting and Clinical Psychology , 64 : 1326 – 1336. Hesse , E. , & Main , M. ( 2000 ). Disorganized infant, child, and adult attachment: Collapse in behavioral and attentional strategies . Journal of the American Psychoanalytic Association , 48 : 1097 – 1127. Horowitz , L.M. , Strauss , B. & Kordy , H. (2000 ). Inventar zur Erfassung Interpersonaler Probleme (IIP-D) . Deutsche Version (2nd ed.). Gottingen, Germany : Baltz . Levy , K. N., Meehan , K. , Kelly , K. M., Reynoso , J. , Weber , M. , Clarkin , J. & Kernberg , O. (2006 ). Changes in attachment patterns and refl ective function in a randomized control trial of transference-focused psychotherapy for borderline personality disorder . Journal of Consulting and Clinical Psychology , 74 : 1027 –1040 . Lichtenberg , J. D. ( 1999 ). Discussion . In D. Diamond & Blatt , S. J. (Eds.) Attachment research and psychoanalysis I: Theoretical considerations . Psychoanalytic Inquiry , 19 (4): 647 – 661 . Lichtenberg , J. D. (2003 ). A clinician’s view of attachment theory and research: A discussion of the papers in three issues of Psychoanalytic Inquiry . Psychoanalytic Inquiry , 23 (1): 151 – 206 . Lichtenberg , J. D. , Lachmann , F. M. & Fosshage , J. L. ( 2011 ). Psychoanalysis and Motivational Systems: A New Look . Philadelphia, PA : Taylor & Francis . Main , M. ( 1991 ). Metacognitive knowledge, metacognitive monitoring, and singular (coherent) vs. multiple (incoherent) models of attachment: Findings and direc-

Downloaded by [New York University] at 04:57 12 August 2016 tions for future research. In C. Parkes , J. Stevenson-Hinde & P. Marris (Eds.), Attachment Across the Life Cycle , pp. 127 – 160 . London : Routledge . Main , M. , and Goldwyn , R. ( 1984 ). Adult attachment scoring and classifi cation systems. University of California, Berkeley, Unpublished manuscript. Main , M. , Goldwyn , R. & Hesse , E. (2003 ). Adult attachment scoring and classifi cation systems. University of California, Berkeley, Unpublished manuscript. Main , M. , Hesse , E. & Goldwyn , R. ( 2008 ). Studying differences in language usage in recounting attachment history: An introduction to the AAI. In H. Steele and M. Steele (Eds.), Clinical Applications of the Adult Attachment Interview, pp. 31 – 69 , New York : Guilford Press. Main , M. , Kaplan , N. & Cassidy , J. ( 1985 ). Security in infancy, childhood, and adulthood: A move to the level of representation . In I. Bretherton and E. Waters (Eds.), The Attachment Patterns of Therapists 249

Growing points of attachment theory and research . Monographs of the Society for Research in Child Development, 50 (1–2, Serial No. 209): 66 – 107 . Mills , J. ( 2005 ). Treating Attachment Pathology . New York : Jason Aronson . Rossman , G. I , Padron , E. , Sroufe , A. & Egeland , B. ( 2002 ). Earned secure attachment status in retrospect and prospect. Child Development , 73 : 1204 – 1219 . Rubino , G. , Barker , C. , Roth , T. & Fearon , P. (2000 ). Therapist empathy and depth of interpretation in response to potential alliance ruptures: The role of therapist and patient attachment styles . Psychotherapy Research , 10 : 408 – 420 . Safran, J. (1993 ). The therapeutic alliance rupture as a transtheoretical phenomenon: Defi nitional and conceptual issues . Journal of Psychotherapy Integration, 3 : 33 – 49 . Schafer , R. ( 1983 ). The Analytic Attitude . New York : Basic Books . Schauenburg , H. Buchheim , A. , Beckh , K. , Nolte , T. , Brenk , K. , Leichsenring , F. , Strack , M. & Dinger , U. (2010 ). The infl uence of psychodynamically oriented therapists’ attachment representations on outcome and alliance in inpatient psychotherapy . Psychotherapy Research: Theory, Research, Practice, Training, 20 : 193 – 202 . Schepank , H. ( 1995 ). Der Beeintraechtigungssschwere-Score [The Impairment Score]. Goettingen, Germany: Beltz. Slade , A. ( 2008 ). The implications of attachment theory and research for adult psychotherapy: research and clinical perspectives. In J. Cassidy and P. Shaver (Eds.), Handbook of Attachment: Theory, Research and Clinical Applications (2nd ed.), pp. 762 –783 . New York : Guilford Press . Steele , H. , & Steele , M. (2008 ). Ten clinical uses of the Adult Attachment Interview. In H. Steele and M. Steele (Eds.), Clinical Applications of the Adult Attachment Interview , pp. 3 – 30 . New York : Guilford Press . Tyrrell , C. L., Dozier , M. , Teague , G. B. & Fallot , R. D. (1999 ). Effective treatment relationships for persons with serious psychiatric disorders: The importance of attachment states of mind . Journal of Consulting and Clinical Psychology, 67 : 725 – 733 . Wallin , D. ( 2007 ). Attachment and Psychotherapy . New York : Guilford Press . Waters , E. , & Hamilton , C. E. ( 2000 ). The stability of attachment security from infancy to adolescence and early adulthood: General introduction . Child Development , 71 (3): 678 – 683 . Downloaded by [New York University] at 04:57 12 August 2016 22 ATTACHMENT, DYADIC INTERACTION, AND AGGRESSION

Frank Lachmann , Ph.D. and Beatrice Beebe, Ph.D.

Empirical infant research exists as a fi eld entirely separate from adult treatment. However, the fi ndings have contributed greatly to our understanding of the nature of communication and of attachment in adult treatment. Beginning in the 1970s with the seminal work of Lou Sander (1977) and Dan Stern ( 1985 ), gradually a group including Joe Lichtenberg, Ed Tronick, Karlen Lyons-Ruth, Beatrice Beebe, and Frank Lachmann saw that these fi ndings could reshape psychoanalytic developmental theory and the theory of therapeutic action in adult treatment. Some of these theorists operated in the domain of face-to-face mother-infant communication, some in the domain of attachment research, some in adult treatment, and some in the fi elds of infant research and adult treatment. In this chapter we fi rst compare two different streams of infant research: (1) a dyadic systems view of mother-infant face-to-face communication, and (2) infant attachment. We then consider early disturbances in face-to-face communication and in infant attachment that are relevant to understanding aggression in adult treatment. Finally we offer two clinical illustrations that connect the two streams of infant research to aggression in adult treatment. In Transforming Aggression (Lachmann, 2000 ) massive early experi- Downloaded by [New York University] at 04:57 12 August 2016 ences of deprivation, abuse, neglect, and assaults on the developing sense of self were understood to lead to a specifi c organization of aggression. Then, aggression as a reaction to current circumstances may become the dominant form of affect expression. And so when either an analyst or a patient feels angry or detached, these are typically understood to be “reactions.” Specifi cally, Lichtenberg, Lachmann, and Fosshage ( 1992 ) referred to “the need to react aversively through antagonism or withdrawal (or both)” (p. 1). As analysts, we then seek the broader context in which such aversive reactions are evoked and organized. Aggression can also be eruptive, bursting forth like a volcanic eruption. The context, in this case, is not commensurate Attachment, Dyadic Interaction, and Aggression 251

with the extent of violence that has been expressed. This kind of aggression appears to be grossly disproportionate, even unrelated to the circumstances in which it is expressed. Thus aggression can appear to be innate or drive-like . These two forms of aggression, reactive and eruptive, lie on a continuum that is differentiated at the extremes by both context and degree, but is less differentiated toward the center of this range. Both forms can serve to reduce tension or to increase feelings of aliveness. Eruptive aggression can override other affects that are intolerable to the person, such as shame, anxiety, hopelessness, helplessness, or feeling devalued. In that case, rather than serving as a response to specifi c circumstances, aggression bursts forth dis- proportionately to its context, and surprising its target. When we encounter such eruptive aggression in our practice, it is often associated with trauma, in paranoid personalities, or histories of insecure attachment.

The First Stream: Dyadic Systems View of Mother-infant Face-to-face Communication The fi rst stream of infant research studies face-to-face communication. It takes as its starting point the mother-infant face-to-face exchange when infants are 3–4 months old. A central contribution of this research is its documentation that mother-infant interaction is a continuous, recipro- cally coordinated process, co-created moment-to-moment by both partners (Beebe and Lachmann, 1988 ). Each partner affects the behavior of the other, often in split-seconds (Beebe and Stern, 1977 ), but not necessarily similarly, symmetrically, or equally. This interactive regulation goes on simultaneously with processes of self-regulation in each partner. The dyadic system is defi ned by the ways that both self- and interactive regulation co-construct the nature of the communication. This work sees the infant as an active contributor to the exchange, an infant with a remarkable range of engagement as well as disengagement behaviors (Brazelton, Kozlowski and Main, 1974 ; Stern, 1985 ). Face-to-face communication in the early months of life sets the

Downloaded by [New York University] at 04:57 12 August 2016 trajectory of relatedness. In our prior work we have used empirical infant studies to enrich our understanding of face-to-face communication, both in early development and in adult treatment (Beebe and Lachmann, 2002 ; Lichtenberg, 1983 ; Lichtenberg, Lachmann and Fosshage, 2010 ). We formulated three principles of salience, life-long principles of the organization and transformation of experience relevant to both infant research and adult treatment. These principles of salience are ongoing patterns of self- and interactive regulation, disruption and repair of ongoing regulations, and heightened affective moments (Beebe and Lachmann, 1994 ; 2002 ; Lachmann, 2008 ; Lachmann and Beebe, 1996a , 1996b ). The three principles further specify 252 F. Lachmann and B. Beebe

how face-to-face dyadic regulations may work and how internalizations may be co-constructed both in mother-infant exchanges and in adult treatment. These principles are relevant to both verbal and nonverbal modes of regulation.

The Second Stream: Research on Infant Attachment The second stream of infant research uses the Ainsworth Strange Situation (Ainsworth, Blehar, Waters, and Wall, 1978 ), an outgrowth of the work of John Bowlby (1969 ), to assess 12–18-month infant attachment. This research uses an entirely different paradigm, at a different stage of development than four-month face-to-face communication. Attachment research evaluates whether a secure base is in place using the Ainsworth “Strange Situation” paradigm, a series of separations and reunions with the mother in a laboratory setting. Security involves a balance between being able to use the mother as a secure base in times of threat, and once comforted and reassured, being able to return to exploring the environment. This concept of a secure base is similar to Kohut’s ( 1981 ) concept of the “empathic human milieu.” The Strange Situation thus taps fear, assessing how the infant manages the threat of separation, and the process of reunion (Cassidy, 1994 ; Sroufe, Egeland, Carlson, and Collins, 2005 ; Steele and Steele, 2008 ). In contrast, the four-month face-to-face paradigm is organized around play, with no other goal than mutual enjoyment (Stern, 1985 ). Attachment research demonstrates the effect of the parent, particularly her sensitivity, and of the coherence or collaboration of the parent-infant dialogue, on the infant’s “internal working model” of attachment (De Wolff and van IJzendoorn, 1997 ; Lyons-Ruth and Block, 1996 ; Lyons-Ruth and Jacobwitz, 2008 ; Main and Goldwyn, 1985 ). Internal working models can be transmitted across generations. Recent research has demonstrated that one-year attachment status predicts the young adult’s attachment status at age 21 (Grossmann, K.E., Grossmann, K., and Waters, 2005 ; Lyons-Ruth, 2008 ; Steele and Steele, 2008 ). This lifespan research shows the power of the

Downloaded by [New York University] at 04:57 12 August 2016 internal working model of attachment.

The Two Streams of Infant Research Generated Different Contributions to Adult Treatment The fi rst stream, studies of mother-infant face-to-face communication, challenged the prevailing concept of direct links among transference, a model of the mind, and the reconstruction of a patient’s early development (Lachmann and Beebe, 1992 ). But empirical infant research on face-to-face communication encouraged further movement away from a one-person psychology Attachment, Dyadic Interaction, and Aggression 253

model. The mind is dyadic and dialogic from the beginning of life (Beebe, Knoblauch, Rustin, and Sorter, 2005 ; Trevarthen, 1998 ). Just as the infant co-constructs his world with caregivers from the beginning, even as a fetus, the analytic relationship is also co-constructed by both partners, through the self- and interactive regulation of each. The data of this fi rst stream led to an emphasis on the contributions of analyst and patient to the organization of the transference and the ongoing treatment process, rather than conceptu- alizing transference primarily as a direct display of the patient’s unresolved confl icts. Among the major contributions of attachment research to clinical practice is the recognition that when a patient recounts his or her history, it is not so much the extent of pathology that it refl ects but rather the coherence of the story. Work on meta-cognition and refl ective functioning can be restated as “the adult’s capacity to step back and consider his or her own cognitive processes as objects of thought or refl ection” (Main,1991 , p. 135, cited in Slade, 1999 ). A central focus is incoherence in the discourse based on experiences that cannot be spoken about. The analyst’s attention to coherence and collaboration in the therapeutic dialogue is an important addition to the more usual approach of “free association.” In free association the focus is not on coherence and a lack of coherence is a refl ection of unconscious fantasies that may connect the manifestly “incoherent” associations. Each of these streams addresses different slices of the pie of early development. The researchers in each stream concern themselves with what eventually makes for optimal and nonoptimal face-to-face interactions, loving and angry relationships, and secure and insecure attachments. The differences between the two streams become clearer when viewed historically. They are rooted in different backgrounds, different professional contexts, and most important, they brought different “curiosities” to bear on their subject.

Historical Contexts of the Two Streams of Infant Research The images and metaphors from the world of dance and music have greatly

Downloaded by [New York University] at 04:57 12 August 2016 infl uenced the study of mother-infant face-to-face communication. Dan Stern’s friend, the choreographer Jerry Robbins, can be found dancing in Dan Stern’s ideas. Stern studied communication between mothers and infants as if it were a pas de deux. Trevarthen’s ( 2002 ) interest in music is evident in his work on the origins of musical identity and in adducing evidence from infancy for musical social awareness. Jaffe (Jaffe, Beebe, Feldstein, Crown, and Jasnow, 2001 ; Jaffe and Feldstein, 1970 ) also used the musical metaphor, “rhythms of dialogue,” to describe the interaction rhythms of vocal- izing and pausing, in both mother-infant and adult communication. This stream of research examines gaze rhythms at and away from the partner’s face (Beebe et al., 2008 ), rhythms of hand movements (Trevarthen, 1999 ), 254 F. Lachmann and B. Beebe

vocal rhythms (Jaffe, Beebe, Feldstein, Crown, and Jasnow, 2001 ), as well as rhythms of facial and vocal affect, orientation and touch (see Beebe and Lachmann, 2014 ). The central focus of this research is always on how the two partners coordinate their interaction rhythms. In the stream of attachment research, Bowlby was infl uenced by Spitz’s ( 1945) reports of infant mortality and hospitalism. Bowlby himself made similar observations. Spitz’s work alerted the world to the dangers of neglecting maternal nurturing and care, necessities for the infant’s emotional as well as physical survival. Until the time of Spitz, psychoanalytic theories were built on the importance of the father. Spitz taught psychoanalysts about the contributions of the mother to the survival and psychological growth of the infant. Infl uenced by two World Wars, the stream of attachment research focused on how the infant manages to survive. Bowlby’s ( 1969) ground-breaking proposition was that the attachment behavioral system, designed by evolution, optimizes the likelihood that the neonate will survive. Moreover, Bowlby (1969 ) developed the concept of the infant’s working model of attachment. This concept shifted the child’s internal landscape to mental representations that were derived from patterns of interactions with a caregiver. Main, Kaplan and Cassidy (1985 ) elaborated this perspective. The child comes to anticipate what the caregiver will do next and responds accordingly. Hence working models provide an internal “map” as to what can be expected in an interaction with a caregiver. Although attachment research considers what each partner, child and adult, brings to the encounter, a moment-by-moment co-constructed model of interaction is not at the core of its research paradigm, in contrast to mother-infant face-to-face communication research. Attachment research focuses on what the growing child needs from the partner, and how this need is, or is not, met. In investigating the origins of attachment, the pre- dominant research paradigm investigates the infl uence of the mother’s sensitivity during the early months of life on the infant’s attachment status at one year (De Wolff and van IJzendoorn, 1997 ). Downloaded by [New York University] at 04:57 12 August 2016 Toward an Integration of the Two Streams of Infant Research So far we have suggested that attachment theory and dyadic systems theory approach early development from different perspectives. We do not propose that one is superior to the other, but rather that the contributions of the two differ and can be integrated. The two streams of research have come together in studies that use 4-month face-to-face communication to predict 12-month attachment status (Beebe and Lachmann, 2014 ; Leyendecker, Lamb, Fracasso, Scholmerich, and Larson, 1997 ). Much happens early in Attachment, Dyadic Interaction, and Aggression 255

the fi rst year, in the face-to-face exchange, that sets a trajectory that biases development toward secure vs. insecure attachment, and toward different forms of insecure attachment (avoidant, resistant, and disorganized). Using the perspective of attachment research, the concept of the internal working model focuses our perspective toward a one-person view of the internal organization of the person’s attachment-related representations. There is value in recognizing the power of the internal working model in organizing relational experiences and, at times, in over-riding the contribution of the partner. On the other hand, the internal working models of mother and infant shape the ongoing experiences and working models of each. Thus internal working models are co-created and open to revision. The work on “at-risk” children and the consequences for their later development are clinically useful (Mayes and Cohen, 1996 ). In these dyads, psychoanalysis can make its most profound impact in recognizing the connection between these early attachment patterns and the later development of aggression-related psychopathology. In alerting us to the nature of the dyads that organize insecure attachments, we are able to understand better the evolving transference and countertransferences in our work.

Implications for Adult Psychotherapy The distinctions between the two streams of infant research not only refer to the differences in their research orientations but also to differences in clinical implications. With reference to our earlier discussion of reactive aggression, let’s look at two treatments, one conducted from an avowed attachment theory perspective by David Wallin (2007 ; Slade, 2009 ) and the other, a treatment conducted by Lachmann (2000 ), illustrating a self-psychological approach, infl uenced by the dyadic systems view of the face-to-face communication research stream. The point of the comparison is to illustrate that the two streams of infant research lead to fundamental clinical differences. Wallin ( 2007 ) proposes that the clinical material of one of his patients fi ts

Downloaded by [New York University] at 04:57 12 August 2016 the concept of an avoidant attachment style. An infant avoidant attachment style in the Strange Situation at one year is predicted by a dismissive maternal relational style in the Adult Attachment Interview, taken in the last trimester of pregnancy (Fonagy, Steele, and Steele, 1991 ). Wallin (2007 ) states,

Just as avoidant infants display little distress in the Strange Situation while elevations in their heart rate and stress hormones tell a different story (Fox and Card, 1999 ) … our dismissing patients are reluctant to feel emotions that might spur them to connect deeply to others, and even more reluctant to express such emotions. Yet only through making an emotional connection with these patients can we actually 256 F. Lachmann and B. Beebe

engage them in the kind of relationship that makes change possible. The key here is to follow the affect. (p. 211)

Wallin then demonstrates that such an emotional connection can be made when the therapist “confronts” the dismissing, belittling, or denigrating patient with a self-disclosure. To illustrate Wallin’s ( 2007 ) attachment-based psychotherapy perspective, a portion of his case is offered:

A female patient told me in our fi rst session that her relationships with men always fell apart. Because, “I never met a man I couldn’t fi nd fault with.” Early in our work, not very surprisingly, she began to fi nd fault with me. Her impression, she complained, was that I was cold and unsympathetic. She added that this was troubling to her, looking ahead, because “leopards don’t change their spots.” At this point, I said to her something like the following: “I’m sure you remember telling me you wanted to work with a male therapist to get some insight into how you relate to men. I’ll bet if we look at what’s going on now between the two of us here we might very well get some insight into what goes on in your relationship with men out there. I say that because it may be that you are on the verge of repeating with me the very pattern you say has doomed your relationships with other men.” These words caught her attention, prompting an exploration of the possible parallels between her experiences inside therapy and out. (pp. 202–203)

Wallin assumed that his patient brought her internal working model into the relationship with him. He confronted her with the similarity between her stated goals for seeking therapy and her behavior with him that they now might profi tably explore. The patient immediately became more engaged with Wallin. We do not know how the therapy proceeded as a result of

Downloaded by [New York University] at 04:57 12 August 2016 Wallin’s interventions. Shifting our perspective on this vignette to the dyadic systems stream of infant research, how might we explore the process of the co-creation of the patient’s experience? We might investigate, “How did it happen between us that you began to feel that I was cold and unsympathetic, and that your future with me looked bleak because I, like a leopard, cannot change?” At a later time in the treatment of this patient, Wallin (2007 ) reported that to his

empathic overtures, she responded as if I were actually an adversary toward whom she was becoming increasingly contemptuous. After 20 Attachment, Dyadic Interaction, and Aggression 257

minutes or so of this futile and frustrating exchange I told the patient (with a bit of an edge) that I was beginning to feel quite exasperated with her, that this was not my customary response to her, and that we needed to understand exactly what was going on here. A little taken aback, the patient collected herself. She then admitted that her relationships at home and at work were regularly marred by her tendency to be contentious and sometimes, bullying. (p. 214)

We infer that in reaction to Wallin’s “edge” and exasperation the patient became more self-refl ective and cooperative. She accepted what Wallin said, at face value, and revealed more about her internal working model, her dismissive attachment style. She is clearly attached to Wallin at this point and trusts him by revealing her contentiousness and even her bullying. This is a brief vignette and that is all we are told about this treatment. Wallin’s patient manifested aggressive reactions (contempt and belittling) with no expectation that she would be heard and understood, since “leopards don’t change their spots.” Essentially Wallin treated her as though the entire organization of the exchange was contained within her: that she was responding to him according to her internal working model. His inevitable contribution to the exchange was not recognized or explored. Wallin assumed that his empathic overtures toward his patient should be heard, experienced, and accepted by her as such. He assumed that his exasperation and frustration were normal human responses when one’s empathy is met with belittling and contempt. Focusing on his possible contribution to the interaction was not part of his treatment approach reported in this vignette. Indeed, the patient responded positively and became affectively engaged with Wallin’s disclosure of his frustration, and the treatment proceeded. My patient (Beebe and Lachmann, 2002 ; Lachmann, 2000 ), Clara, had a relational style that resembled Wallin’s patient. She was perpetually at least mildly angry, and often hostile with a contemptuous and belittling manner. This manner is illustrated in our dialogue as she described a pivotal incident

Downloaded by [New York University] at 04:57 12 August 2016 in her life. When Clara was eight years old, she was given a horse as a gift by her parents. She did not take proper care of the horse, the horse became too frisky, broke a leg, and had to be put down. To Clara this meant that she was a horse killer, destructive and bad from an early age on, akin to Wallin’s bullying patient. To spare her the pain of being present when her horse was put down her parents arranged a picnic. Clara knew the picnic was a ploy and she was in confl ict: to stay with her horse or to go with her parents and let them feel they were good and protective. She went on the picnic and felt that she betrayed her horse. When she told me this story, I commented that she was left alone, given sole responsibility for the care of the horse, at a very young age, and with no parental guidance or supervision. All of 258 F. Lachmann and B. Beebe

this was true and was my attempt to place the event in a broader context. I thought my comment was “empathic.” I articulated how I imagined she felt and connected these feelings to her relationship with her family. She became enraged and contemptuous. Based on this and similar “misattunements” on my part, she accused me of having a problem with aggression and suffering from “terminal optimism.” At this point in the treatment she told me that she needed to have me accept her as a killer and as bad. In this instance we negotiated. I said I could accept her as a killer but not as bad. I had empathized by imagining how Clara as an eight-year-old might have felt, alone and unguided. But to Clara the important part of the experience was her betrayal of the horse. She left the experience feeling like a killer and a bad person. My empathy felt to her as an exoneration and rekindled her feeling of betrayal of her horse. So she had to reject my “empathy.” Clara’s response to my empathy, and Wallin’s patient’s response to his empathy, were co-created. Both Wallin and I believed that our approaches to our patients were informed by empathy for their predicaments, but, obviously, neither patient shared our views. I believe that, unless the patient feels “empathically understood,” as therapists we cannot claim that empathy was operating. Yes, we can assume that both patients walk around with a readiness, an internal working model, that is activated easily and prompts them to be dismissive and denigrating towards others. But that did not prompt me to respond to Clara by describing to her how she made me feel. Rather we explored how I made her feel. Clara heard my “empathy” as my inability to deal with her aggressive side, and my own. To feel accepted by me, her aggressive side had to be recognized. In contrast, she experienced my interventions as denying or sanitizing her aggression. Clara’s parents had imposed a pretense of “everything is nice and fi ne” on the life of the family, with regard to her horse, and more generally with regard to her father’s alcoholism and philandering. Calling herself a killer meant to Clara that she was not collaborating with her family in their falsifi cations. Never again was she going to join them in concealing any “truths.” She was not going to subject herself to living the deceptive life that her family led and that she had Downloaded by [New York University] at 04:57 12 August 2016 been required to live as a child. To Clara my empathy felt like her experience in her family where anger was not permitted. She told me that there was a particular chair in their living room. Whenever any of the children fought or said an angry word they were required to sit in that chair until they could acknowledge that they no longer felt angry. Then they could get off the chair. When Clara’s horse had to be killed, her parents said they wanted to take her for a picnic in the country. She knew that this was a ploy to get her out of the house so that she would not witness the putting down of the horse. She was in a quandary. Should she stay with her horse out of a sense of Attachment, Dyadic Interaction, and Aggression 259

loyalty, or go with her parents and let them feel that they were good, protective parents? She knew how important that was to them. She went with her parents, and she betrayed her horse and her sense of honor. The lesson she took from this experience was: if people are kind and considerate to you, it is out of their self-interest, so don’t trust it. The co-creation in the case of Clara consisted of my interventions being experienced as normalizing her murderousness. So her rage erupted. Retaining her conviction that she was a killer was self-affi rming. She assured herself that, this time, she had maintained her integrity in the face of pressures to act like a well-brought-up, well-mannered lady. The 11-year analysis of Clara contained numerous incidents that I could have dealt with along the lines of “I am feeling frustrated and exasperated …” but I did not, for two reasons. First, if I do feel frustrated, I consider this my unique response and try to examine it on my own. Generally that dispels feeling frustrated with the patient. In fact I enjoyed my work with Clara despite her many many awesome challenges, and I generally looked forward to seeing her for her thrice weekly appointment. And second, I learned from Clara that there was a more fruitful way to go. For example, during one period of the treatment she would quite frequently say to me, “Yesterday I said something very important here, do you know what it was?” At a moment like that I can barely remember my name. Sometimes I would guess and I would be wrong; sometimes I would guess and I would be right. But soon l learned that the content was not the issue. The issue was, why she asked the question. It turned out she had felt closer to me in the previous session. And feeling closer to me evoked a sense of danger. She might then relax her vigilance and be drawn into a self-betrayal. By asking me that question (and this worked) she reassured herself that I did not remember, and that her feelings of closeness to me were either spurious or not shared by me. Then she could feel safe. To be more accurate, we learned much later that she both wanted me to have her in mind, but neither she nor I should openly acknowledge it. Like Wallin’s dismissive patients, Clara was reluctant to feel and express emotions that might prompt her to connect with me. Wallin advised that Downloaded by [New York University] at 04:57 12 August 2016 only an emotional connection can make for change. To do so: follow the affect. So far we are in agreement. He followed his patient’s aggression, her hostile denigration. I followed Clara’s shame over her self-betrayal and her compliance with parental pressures which she packaged as aggression. Dan Stern (2004 ) quoted William Blake’s phrase of fi nding “the world in a grain of sand.” That is, by carefully unpacking a moment in time, one can fi nd in it the dynamic themes of a person’s life. Wallin and I both averted an impasse, but we unpacked the grains of sand differently. How do we decide which affect to follow? We (Beatrice Beebe and I) fi nd the stream of infant research that emphasizes the dyadic co-creation of experience more compatible. 260 F. Lachmann and B. Beebe

References Ainsworth , M. , Blehar, M. , Waters , E. , and Wall , S. ( 1978 ). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Lawrence Erlbaum Associates . Beebe , B. , Badalamenti , A. , Jaffe , J. , Marquette , L. , Helbraun , E. , Andrews , H. , and Ellman , L. ( 2008 ). Distressed mothers and their infants use less effi cient timing mechanisms in creating visual expectancies. J. Psycholinguistic Research , 37 (5), 293 – 307 . Beebe , B. , Knoblauch , S. , Rustin , J. , and Sorter , D. (2005 ). Forms of intersubjectivity in infant research and adult treatment. New York : Other Press . Beebe , B. and Lachmann , F. ( 1988 ). The contribution of mother-infant mutual infl u- ence to the origins of self- and object representations. Psychoanalytic Psychology, 5 , 305 – 337 . Beebe , B. and Lachmann , F. (1994 ). Representation and internalization in infancy: Three principles of salience . Psychoanalytic Psychology , 11 , 127 – 165 . Beebe , B. and Lachmann , F. (2002 ). Infant research and adult treatment: Co-constructing interactions . Hillsdale, NJ : The Analytic Press. Beebe , B. and Lachmann , F. (2014 ). The Origins of Attachment. New York : Routledge. Beebe , B. and Stern, D . ( 1977 ). Engagement-disengagement and early object experiences . In N. Freedman and S. Grand (Eds.), Communicative structures and psychic structures (pp. 35 – 55 ). New York : Plenum Press . Bowlby, J. ( 1969 ). Attachment and loss . New York : Basic Books . Brazelton , T.B. , Kozlowski , B. , and Main , M. (1974 ). The origins of reciprocity. In M. Lewis and L. Rosenblum (Eds.), The effects of the infant on its caregiver (pp. 49–70) . New York : Wiley . Cassidy, J. (1994 ). Emotion regulation: Infl uences of attachment relationships. Monographs of the Society for Research in Child Development 59 (2–3, Serial No. 240), 2228 – 2249 . De Wolff, M. and Van IJzendoorn, M. (1997 ). Sensitivity and attachment: A meta-analysis on parental antecedents of infant attachment. Child Development , 68 , 571 – 591 . Fonagy , P., Steele , H. , and Steele , M. ( 1991 ). Maternal representation of attachment during pregnancy predicts the organization of infant-mother attachment at one year of age . Child Development , 62 , 891 – 905 . Fox , N.A. and Card , J.A. ( 1999 ). Psychological measures in the study of attachment . In J. Cassidy and P.R. Shaver (Eds.), Handbook of attachment theory, research and clinical applications (pp. 226–245) . New York : Guilford Press . Downloaded by [New York University] at 04:57 12 August 2016 Grossmann , K.E. , Grossmann , K. , and Waters , E. ( 2005 ). Attachment from infancy to adulthood: The major longitudinal studies. New York : Guilford Press. Jaffe , J. , Beebe , B. , Feldstein , S. , Crown , C. , and Jasnow , M. ( 2001 ). Rhythms of dialogue in infancy. Monographs of the Society for Research in Child Development , 66 (2, Serial No. 264), 1– 132. Jaffe , J. and Feldstein , S. ( 1970 ). Rhythms of dialogue. New York : Academic Press . Kohut , H. ( 1981 ). On empathy. In P. Ornstein (Ed.), The search for the self, Vol. 4 (pp. 525–536) . Madison, CT : International Universities Press. Lachmann , F. (2000 ). Transforming aggression: Psychotherapy with the diffi cult-to- treat patient. Northvale, NJ : Aronson. Lachmann , F. (2008 ). Transforming narcissism: Refl ections on empathy, humor, and expectations . New York : The Analytic Press . Attachment, Dyadic Interaction, and Aggression 261

Lachmann , F. and Beebe , B. ( 1992 ). Reformulations of early development and transference: Implications for psychic structure formation . In J. Barron , M. Eagle , and D. Wolitzky (Eds.), The interface of psychoanalysis and psychology (pp. 133–153) . Washington, D.C. : The American Psychological Association . Lachmann , F. and Beebe , B. (1996a ). Three principles of salience in the organization of the analyst-patient interaction . Psychoanal. Psychol ., 13 , 1 – 22 . Lachmann , F. and Beebe , B. ( 1996b ). The contribution of self- and mutual regulation to therapeutic action: A case illustration . In A. Goldberg (Ed.), Progress in self psychology , Vol. 12 (pp. 123–140). Hillsdale, NJ : The Analytic Press . Leyendecker , B. , Lamb , M. , Fracasso , M. , Scholmerich , A. , and Larson , D. (1997 ). Playful interaction and the antecedents of attachment: A longitudinal study of Central American and Euro-American mothers and infants . Merrill Palmer Quarterly , 43 , 24 – 47 . Lichtenberg , J. (1983 ). Psychoanalysis and infant research . Hillsdale, NJ: The Analytic Press . Lichtenberg , J. , Lachmann , F. , and Fosshage , J. (1992 ). Self and motivational systems . Hillsdale, NJ : The Analytic Press . Lichtenberg , J. , Lachmann , F., and Fosshage , J. ( 2010 ). Psychoanalysis and motivational systems: A new look . New York : Routledge . Lyons-Ruth , K. ( 2008 ). Contributions of the mother-infant relationship to dis- sociative, borderline, and conduct symptoms in young adulthood. Infant Mental Health Journal , 29 (3), 203 – 218 . Lyons-Ruth , K. and Block , D. (1996 ). The disturbed caregiving system: Relations among childhood trauma, maternal caregiving, and infant affect and attachment. Infant Mental Health Journal, 17 , 257 – 275 . Lyons-Ruth , K. and Jacobvitz , D. (2008 ). Disorganized attachment: Genetic factors, parenting contexts, and developmental transformation from infancy to adulthood. In J. Cassidy , and P. Shaver (Eds.), Handbook of attachment: Theory, research and clinical applications (2nd edition), pp. 666 – 697. New York : Guilford Press. Main , M. and Goldwyn , R. ( 1985 ). Adult attachment classifi cation system. Unpublished manuscript, University of California, Berkeley. Main , M. , Kaplan , N. , and Cassidy , J. (1985 ). Security in infancy, childhood, and adulthood: A move to the level of representation . Monographs of the Society for Research in Child Development (50, Serial No. 209). Mayes , L. and Cohen , D. (1996 ). Children’s developing theory of mind. J. Amer. Psychoanal. Assn ., 44 , 117 – 141 . Sander , L. ( 1977 ). Identity and the experience of specifi city in the infant-caretaker

Downloaded by [New York University] at 04:57 12 August 2016 system and some aspects of the content-context relationship . In M. Lewis and L . Rosenblum (Eds.), Interaction, conversation and the development of language (pp. 153 – 156 ). New York : Wiley. Slade, A. ( 1999 ). Attachment theory and research. In J. Cassidy and P. Shaver (Eds.), Handbook of attachment: Theory, research and clinical applications (pp. 575–594). New York : Guilford Press . Slade, A. (2009 ). Book review: Attachment in Psychotherapy. Psychotherapy Theory, Research, Training , 46 , 270 – 271 . Spitz , R. (1945 ). Hospitalism: An inquiry into the genesis of psychiatric conditions in early childhood . The Psychoanalytic Study of the Child , 1 , 53 – 74 . Sroufe, A , Egeland , B. , Carlson , E. , and Collins , W. ( 2005 ). Placing early attachment experiences in developmental context: The Minnesota Longitudinal Study. In 262 F. Lachmann and B. Beebe

K.E. Grossmann , K. Grossmann , and E. Waters (Eds.), Attachment from infancy to adulthood (pp. 48–70) . New York : Guilford Press . Steele , H. and Steele , M. ( 2008 ). Clinical application of the adult attachment interview . New York : Guilford Press. Stern , D. ( 1985 ). The interpersonal world of the infant . New York : Basic Books . Stern , D. ( 2004 ). The present moment in psychotherapy and everyday life . New York : Norton Press. Trevarthen , C. ( 1998 ). The concept and foundations of infant intersubjectivity. In S. Braten (Ed.), Intersubjective communication and emotion in early ontogeny (pp. 15–46) . Cambridge, MA : Cambridge University Press. Trevarthen , C. ( 1999 ). Musicality and the intrinsic motive impulse: Evidence from human psychobiology and infant communication. Musicae Scientiae (Special issue 1999–2000) , pp. 155–215. Trevarthen , C. (2002 ). Origins of musical identity: Evidence from infancy for musical social awareness. In R. MacDonald , D. Hargreaves , and D. Miell (Eds.), Musical Identities (pp. 21–38) . Oxford : Oxford University Press . Wallin, D. ( 2007 ). Attachment in psychotherapy. New York : Guilford Press. Downloaded by [New York University] at 04:57 12 August 2016 PART VIII Clinical Papers Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 23 FILLING THE ENVELOPE What Joe Lichtenberg Has Done for My Psychoanalytic Theory and Practice

Judith Guss Teicholz , Ed.D.

[I] f an analyst assumes the privilege of ignoring … his … contributions to … the [analytic] exchanges, the analysis cannot succeed. (Lichtenberg, 1998 , p. 18)

This was one of the lessons that Joe Lichtenberg (1998) took from his own fi rst experience on the couch. His “lived experience” crystallized into an abiding commitment to recognize “a schema of relatedness beginning at birth and progressing in an intersubjective context” (p. 18) – a commitment manifest in his writings, teachings, and clinical work. But Lichtenberg’s commitment to recognizing life-long relatedness in an intersubjective context in no way diminishes the central position of a unique sense of self in his thinking with all the individual’s motivations. In fact in his co-authored writings the concept of selfhood now includes seven motivational systems (Lichtenberg, Lachmann, & Fosshage, 2011), almost every motivation ever put forth across all psychoanalytic theories. It is above all this inclusiveness – the generosity of Lichtenberg’s

Downloaded by [New York University] at 04:57 12 August 2016 theorizing – that fi rst attracted me to his writings and that keeps me waiting for each subsequent publication where I can count on fi nding new integrations of cutting-edge research into an ever-expanding yet cohesive theoretical whole. Most of his writings also include thoughts on the clinical implications of his theoretical revisions, with guidelines and illustrations of how we might best interact with our patients. Lichtenberg’s expansive approach to theory-building yields a complexity that has drawn him to nonlinear dynamic systems theories. He suggests that within the complexity of any system lies a tension between order and chaos (Lichtenberg, 2009 ). He embraces this tension, accepting the chaos while contributing to new levels of organization in the minds of his students, readers, and patients. 266 J.G. Teicholz

Lichtenberg’s contributions have included research, theory, metatheory (Lichtenberg, 2009 ), technical principles, and clinical illustrations. In each of these areas he has distilled an enormous complexity of information and yet his writings remain crystal-clear and persuasive. His books are accessible yet fi lled with meaning and insight.

Motivations in Development and Treatment My introduction to Lichtenberg came with his 1989 Psychoanalysis and Motivation . In his view experience was understood in terms of self and relationship – attachment, affi liation, and assertion/exploration. Sensual and sexual needs were seen as basic but not necessarily “driven” toward “dis- charge.” The aversive response did not refl ect primary aggression but was reactive to threat. Lichtenberg urges parents and analysts to affi rm the full spectrum of these naturally occurring motivations as they emerge in any encounter, providing a cohesion-enhancing experience in which all motivations can be included in the developing sense of self. His motivational theory helps us fi nd meaning in our patients’ behavior while we remain attuned to shifting intersubjective contexts and the patient’s unique history. Beyond empathic inquiry there are diverse opinions concerning the analyst’s direct affi rmation of a patient’s motivations. But many who seek psychoanalysis have suffered early environmental defi ciencies of such affi rmation and at some point in treatment these defi cits may come alive as an issue between patient and analyst. The patient may feel his motivations are shameful and that the analyst’s affi rmation could ease the shame. There is an interweaving of the patient’s here-and-now longings for affi rmation and the analytic exploration of their historical antecedents in which such longings were not met. Lichtenberg’s emphasis on the individual’s need for affi rmation of his motivational life suggests that the analyst has a role to play both in understanding the patient’s historical need for affi rmation and in the “provision” of at least implicit affi rmation of motivations as they emerge in the

Downloaded by [New York University] at 04:57 12 August 2016 here-and-now. For many patients it is only after experiencing such acceptance in the analytic relationship that their earlier defenses against certain motivations will diminish enough for those strivings to emerge in treatment where they can be explored, modifi ed, and eventually expressed toward new life goals and relationships. The longing for affi rmation of motivations is just one instance of the need for recognition and acceptance of all affective experience emerging in the analytic encounter. The empathic exploration of motivational and other aspects of experience can provide a dual “corrective” for the patient in which new self-understanding and new relational experience are ultimately integrated. Lichtenberg et al.’s (2011) roster of motivations prepares Filling the Envelope: Lichtenberg Impact 267

analysts to encounter the full range of human strivings in their patients and fosters analytic empathy with motivations that might otherwise be uncomfortable for some analysts to bear.

Technical Guidelines Just as Lichtenberg et al. have studied the vast array of infant behavior and distilled from their observations a roster of seven human motivations (Lichtenberg, 1989 , 1998 ; Lichtenberg et al., 2011) so too have they explored a wide variety of analytic interactions, identifying ten therapeutic principles (Lichtenberg et al., 1996 ; Lichtenberg, 1999 ), all of them essential but which I can address only selectively here. These principles are compatible with Self Psychology but also with many other psychoanalytic approaches because of the meta-theoretical level at which they are formulated. Although the authors do not explicitly include in their therapeutic principles the process of disruption and repair (Kohut, 1977 ; Lachmann & Beebe, 1996), this process may be implicit in the Lichtenberg et al. principles of co-creating “model scenes” and “disciplined spontaneous engagements” as long as they are followed by mutual empathic exploration of the interactions. Two other Lichtenberg et al. principles – the analyst’s persistent efforts to see things from the patient’s viewpoint and to wear the patient’s attributions – may also engender repair following the disruptions that inevitably occur in any ongoing treatment relationship. I have found four of the principles to be particularly useful in my work. These include fi lling the narrative envelope, wearing the patient’s attributions, co-creating model scenes, and participating in spontaneous disciplined engagements, all intimately related in the clinical setting. For instance the “narrative envelope” refers primarily to the patient’s history while the “wearing of the patient’s attributions” refers to the here-and-now of the analytic relationship. But while working to fi ll the narrative envelope with details of the patient’s past, the analyst might also become aware that the analytic couple is enacting aspects of the patient’s early experience in the

Downloaded by [New York University] at 04:57 12 August 2016 here-and-now through the unwitting co-creation of a model scene or spontaneous disciplined engagement. When such engagement is somehow hurtful to the patient the analyst must address her own role in the interaction which often includes “trying on” and “wearing” the patient’s attributions. This process can diminish the patient’s negative sense of his own contribution often affording him relief from a life-long sense of responsibility for the most painful aspects of his formative relationships. If patient and analyst make further links between here-and-now interactions and resonant aspects of the patient’s earlier experience the patient may be able to integrate past and present in a way that fi lls the envelope adding affect, meaning, and greater cohesion to his ongoing narrative. 268 J.G. Teicholz

Such opportunities for the patient to feel the links in vivo between his past history and the here-and-now can strengthen his sense of continuity and cohesion as well as feelings of connectedness to his own affective experience and his analyst (Teicholz, 2009 ). Thus the co-creation of model scenes and spontaneous engagements, the analyst’s wearing of the patient’s attributions, and the dyadic fi lling of the narrative envelope are all part of an interwoven cluster of interactions that can amplify each other’s therapeutic impact. I also see a special place for the Lichtenberg et al. principle of discerning a patient’s specifi c affect (Lichtenberg et al., 1996 , p. 92). When an analyst can affi rm ascendant motivations in a patient’s experience while accurately discerning the patient’s feelings, the analyst takes a giant step toward seeing things from within the patient’s experience – itself one of the ten technical principles. These innovations concerning motivation and technique are enhanced by Lichtenberg’s (1999) comments on the complexity of the individual psyche as a nonlinear dynamic system forming a larger and more complex system as it becomes part of an analytic dyad. In keeping with this complexity Lichtenberg’s analytic voice balances authoritative confi dence with open-minded humility such as when he acknowledges our “essential understanding of the analytic endeavor … based probably on non-linear, affective factors … not yet fully appreciated” (1999, p. 735). In fact the greater our recognition of complexity the more we must accept some degree of uncertainty and expect to live with an ongoing tension between order and chaos. But to the extent that we keep in mind Lichtenberg et al.’s roster of motivations and technical principles we are able to bring some sense of order to the necessary chaos of our infi nitely complex and multi-faceted engagements.

Clinical Applications of Lichtenberg’s Model Although Lichtenberg et al. have provided generous clinical material I offer

Downloaded by [New York University] at 04:57 12 August 2016 two vignettes to suggest how their ideas have been clinically generative for me. The fi rst comes from my treatment of “Monty” who reported a dream I interpreted as attributing certain undesirable qualities to me. In my interpretation I “wore the attribution” making possible a discussion that Monty would not otherwise have felt comfortable having with me. I think patients often make negative attributions to their analysts in disguised form through their dream-work when they would not allow such thoughts into their waking associations. In our interpretations of these we need to signal our willingness to recognize and wear those attributions no matter how well-disguised.1 Filling the Envelope: Lichtenberg Impact 269

Monty Monty’s mother died in childbirth and he was raised by his young widowed father who in addition to the shock and grief of suddenly losing his wife turned out to suffer from bipolar illness, undiagnosed until Monty’s adolescence. The father’s mood swings ranged from near-catatonic depression to acute hostility most of which was directed toward Monty. Even as a toddler Monty’s father attacked him for being too demanding and left him alone in the house for hours at a time. During Monty’s last year of high school his father told him of these early childhood abandonments. Given this background Monty became suicidal whenever I made even minor changes in our schedule. From his standpoint every vacation I took was a murderous self-indulgence on my part. In his third year of treatment Monty was no longer suicidal but was still sensitive to my departures. He started feeling anger toward me rather than wanting to kill himself in my absence. He said he could never get better if every time he started working on something important I went off and left him alone. Two days after I had informed him of an upcoming vacation he reported the following dream:

I was driving my truck on a bright sunny day. I suddenly skidded out of control ending up off the road and turned completely around in the wrong direction. I must’ve hit a patch of black ice and I just sat there, stunned.

Because Monty reported this dream during the same week that I had announced a vacation and because his distress about my impending absence included references to his father’s frequent abandonments, I understood the black ice in his dream to represent the sudden threat that my vacation meant to him. With this understanding in mind I said to him:

I am the black ice. You thought you were fi nally on safe ground with me but I’ve become slippery and dangerous again, throwing you com-

Downloaded by [New York University] at 04:57 12 August 2016 pletely off course. Monty, I’m so sorry that my comings and goings are this painful for you and that my behavior is so reminiscent of your father in his most unreliable and frightening aspects.

Because at this point Monty’s sense of abandonment was paramount I took a small leap to put together Monty’s waking perception of me as an irresponsible and abandoning analyst with the image of the slippery and dangerous black ice in his dream. Since I did not appear in the dream and the negative qualities were not attributed to me explicitly, it was only through the dream interpretation that I was able to own the slipperiness 270 J.G. Teicholz

and danger of the black ice. I thus sought out his negative attributions and interpreted them from their disguised form in the dream, enabling me to “wear” them. My interpretation helped Monty link the dream-feelings of being disoriented, endangered, and thrown off-track with his waking feelings of being abandoned by me. I wanted him to know that I recognized the pain my vacation was causing him, leaving him turned completely around in the wrong direction as in his dream. My willingness to see myself as sharing the dangerous qualities of the black ice was important to Monty because he had grown up feeling responsible both for his mother’s death in childbirth and his father’s mental illness. His repeated experiences of having me take responsibility for my part in our interactions served to counter his expectation that whenever problems arose between himself and another, he would be the one to blame. By wearing the attribution – or by accepting my responsibility for Monty’s pain in the here-and-now while also actively linking the current experience to his father’s repeated abandonments I suggested to Monty that just as he was not responsible for his feelings of abandonment and anger now with me he had not been responsible for the bad feelings between himself and his father. This exchange did not fi ll the narrative envelope with new material but its repeated iterations helped Monty feel less damaged by the envelope’s “contents” while creating new understanding between us. It also helped Monty make more sense of his suffering and enabled him to move toward its diminishment.

Myles My second vignette involves a series of interactions with my patient “Myles,” a delightfully brilliant, witty, but rage-fi lled thirty-fi ve-year-old (never-married) business executive I initially saw just twice a week. Myles had been the second of fi ve children with an older sister and three younger brothers. The death of his older sister from cancer, when Myles was fi ve years old, had been one of several childhood traumas for which Myles felt

Downloaded by [New York University] at 04:57 12 August 2016 responsible and guilty although he had in no way caused her illness nor could he have done anything to fi x it. The interactions I shall describe followed upon Myles’s request during his third year of treatment for a regularly scheduled third weekly session. I did not expect to have an open hour for several months but told Myles that in the meantime I would call him as cancellations came up to see if he could take the available times. Myles said he would like me to do that. He did not reveal any hurt feelings at the time of this interchange but I later thought he might indeed have been hurt by my not having an extra hour for him immediately. I often only much later became aware that something I said or did had slighted him. I also knew that his unacknowledged Filling the Envelope: Lichtenberg Impact 271

hurt feelings engendered rage in him, bringing his aversive motivations into ascendancy. Additionally Myles sometimes had organizational diffi culties that interfered with his follow-through on personal tasks including the returning of phone calls. It turned out that I received some cancellations soon after the session in which Myles and I had discussed adding a third weekly session. I called and left a message telling him of the hours that had opened up in the coming three-week period. But anticipating that he might have trouble calling me back I told him in my message that I would keep open the proposed hours for a three-day period but if I did not hear from him by midnight of the third day I would assume he did not want the available times and I would fi ll them. I did this in order to protect myself from having to keep the times open for him indefi nitely (which had happened between us on a previous occasion), and also to protect him from feeling shamed by his rudeness or ineptness if he failed to call me back (this had also happened previously). Three days passed and indeed I heard nothing from Myles. On the evening of the fourth day, I called him and left a message that I was sorry the times I had offered did not work for him but we would talk further about scheduling in our next meeting. I then offered to a supervisee the hours I had earlier offered to Myles. The next morning, before I even heard back from the supervisee I found a voicemail message from Myles telling me he had just listened to both my messages for the fi rst time: the message in which I offered him the available hours and the message four days later in which I took them back. He explained he had been traveling unexpectedly and had not picked up his messages for four days. He was angry that I had not kept the hours open for him because he would defi nitely like to use them. He said I had acted “unfairly” because of my “excessive effi ciency.” I heard in Myles’s accusations exactly the kinds of attributions I imagine Lichtenberg refers to when he suggests that as analysts we should “wear” what our patients attribute to us. I also wondered if I had somehow participated in a “model scene” with Myles, resulting in a painful experience that was only too familiar to him from his childhood. I therefore called him back telling him I thought he was right that I had acted out Downloaded by [New York University] at 04:57 12 August 2016 of an excess of effi ciency and that under the circumstances I would try to retrieve whatever hours he wanted of those I had given away so that he could have them. I hoped by these actions on my part to (co)create an intersubjective climate in which Myles might be able to explore his current feelings as well as their historical antecedents – a necessary condition, I thought, for our process to go forward at this point. I especially wanted to give Myles the benefi t of the doubt in this round of interactions because I knew he had suffered a childhood in which his good intentions had repeatedly been misunderstood and then punished by others. I thought we had perhaps unwittingly re-enacted such a sequence of events in our misfi red scheduling efforts and 272 J.G. Teicholz

ill-timed phone calls. In talking about this later with Myles it seemed my concerns had been well-founded. But as it turned out, his experience of expressing his anger at me and then having his feelings not only validated but also benignly acted upon by me, seemed to become a positive turning point in his treatment. I was indeed able to retrieve for him the hours I had fi rst offered to him and then given away; and this action on my part seemed to have an immediate benefi cial impact on Myles. Perhaps it was because my behavior was so transparently “on his side” in this case but for the fi rst time he was able to experience something I did as refl ecting some warmth and caring toward him. In subsequent sessions we were able to explore the entire episode more fully as well as to explore Myles’s tendency, until that point, not to follow through on certain commitments. We came to understand that some large part of his past behavior toward me had had something to do with his wanting to hide his longings for a positive connection with me out of his expectation that he would be rejected, abandoned, or punished. We continued to fi ll in the narrative envelope which over time came to “contain” his repeated experiences of childhood neglect, abandonment, rejection, and even sometimes abuse at the hands of his chronically exhausted, harassed, and explosive mother, who angered easily. We also came to a shared understanding of the anger and ambivalence that sometimes contributed to his “organizational diffi culties.” In subsequent months he increasingly began to take on more creative projects and somehow to bring them to successful completion. We had already been fi lling the envelope with the details of Myles’s history as we went along. But Myles had never before had the capacity to hold in mind his own past experience or to make sense of it. After the interactions just described he began for the fi rst time to make explicit spontaneous links between his behavior and feelings in the treatment relationship and certain painful experiences of childhood that he had previously either disavowed or reported without affect. These experiences included a passionate love/ hate relationship with his divorced mother who had thrown him permanently out of the house when he was eight years old, sending him to live with Downloaded by [New York University] at 04:57 12 August 2016 his estranged and devalued father while she allowed Myles’s three younger brothers to continue living with her. Around this time in his treatment he also began for the fi rst time to discuss his childhood experiences with his brothers, who now corroborated his feeling that the parenting they had endured as children had been neglectful, erratic, and sometimes abusive. In both his mother’s and father’s households Myles had been left on his own or had been given responsibilities beyond his maturity and then had been punished when he inevitably failed to live up to the unreasonable expectations. When I asked Myles to return my phone call and to let me know whether or not he wanted any of the extra session-times I had offered, I wondered Filling the Envelope: Lichtenberg Impact 273

when I did not get a call back from him whether my request for a call-back might have evoked in him the kind of negative emotional response that the earlier demands from his parents had once aroused – demands which had often felt so incomprehensible to him and undoable that they evoked in him an almost automatic refusal. He felt easily controlled and his reaction to being asked to do anything was often a rage-fi lled and venomous outburst which he could not contain, followed by guilt and grief for his aggressive words or behavior. Looking at these details of Myles’s unique history and psychic organization, one additional Lichtenberg technical principle comes to mind having to do with the analyst’s understanding that the patient’s aversive motives and behavior are communicative expressions that need to be explored in much the same way as we explore any other communicative expressions (Lichtenberg et al., 1996 ). Certainly one way to see Myles’s initial failure to return my phone call in a timely fashion – and to understand his angry telephone message to me after I had given the initially offered session times away – was as an expression of “aversive motives” on his part that we could explore. But based on my earlier experience with Myles I also had reason to believe that if he had indeed felt hurt by my actions he would especially need to receive something very tangible from me by way of apology and rec- ompense before he would be able to explore his own feelings and behavior. And I myself felt highly motivated to provide him with the extra time that a third session would afford us so that we could work together toward a better understanding of these events and the welter of his unacknowledged feelings. At the same time, working from within a framework of (self psychological) intersubjective nonlinear dynamic systems theory, I do try to keep in mind that “aversive motives” arise primarily in situations that feel threat- ening to the individual’s sense of self. Thus any exploration of a patient’s (apparently) aversive motives must include a process for exploring the intersubjective threat that has triggered such motives in the fi rst place. More specifi cally the process must include the analyst’s self- exploration toward the goal of better understanding what she has done to threaten the patient’s Downloaded by [New York University] at 04:57 12 August 2016 sense of self, thereby evoking his aversion. My thinking about Myles in this regard was that his original request, to add a third session per week to our schedule, had entailed an unusual reaching-out on his part and was likely accompanied by a feeling that he had exposed longings in relation to me that were usually buried or disguised. This in itself would have evoked in him a sense of vulnerability that he most of the time vigorously avoided feeling. But I also believe that the fact of my not having had an immediate third hour available to him had exacerbated this already unwanted feeling of vulnerability leaving him feeling even more than usually raw and exposed. 274 J.G. Teicholz

In other words I felt that Myles had stretched himself emotionally to ask for a regularly scheduled third hour. And when I did not have one immediately available he had perhaps felt rebuffed (consciously or unconsciously) and understandably had diffi culty accepting the ad hoc extra session-times that I offered him. On top of all this, he may also have felt insulted by the limited time-frame I gave him within which to give me an answer concerning the extra session times. It was for all these reasons that I wanted delib- erately to stretch my self by trying to reverse the consequences of my own actions, hoping to retrieve for him one or more of the session-times I had offered and then withdrawn, even though it meant fi nding a different time for the candidate whose regular supervision-hour I had also been trying to reschedule. There was probably one additional technical principle infl uencing my behavior in these events, a principle of my own, devolving from Kohut’s (1982) admonition that it is not the mother’s empathy, per se, that helps the child feel understood but rather the mother’s actions , guided by her empathy. Of course our actions as analysts or therapists must also be examined with an eye to staying within the therapeutic “frame” and avoiding emotional impingement on our patients – ideas that are perhaps relevant to Lichtenberg et al.’s (1996 ) concept of “disciplined spontaneous engagement.” In disciplined spontaneous engagement I would say that we place an equal emphasis on discipline and spontaneity or perhaps that there is a dialectical tension between these two values. We could look at the entire sequence of my interactions with Myles as a disciplined spontaneous engagement in which the two of us were playing our respective parts. But in keeping with Lichtenberg et al.’s ( 1996 ) fi nal technical principle perhaps the single most important action on my part, during and after these events, was that I closely monitored “the sequence of [my] interventions and the patient’s response” (p. 93) in order to discern the impact of my words and behavior on Myles. I can report based on this monitoring that the sequence of interactions between us – as well as our further explorations in subsequent sessions – did seem to have a positive effect on Myles’s attitude toward the treatment and on his ability to make use of Downloaded by [New York University] at 04:57 12 August 2016 it, with some of his most troubling experiential and behavioral problems gradually diminishing in the months following the entire episode. Meanwhile I imagine that had I not done anything as obviously concili- atory as re-instating as I did the availability of the hours I had offered and then taken away, Myles likely would have withdrawn from me and from the treatment, feeling humiliated by his vulnerability and unbearably guilty about his anger. I was aware that numerous earlier relationships in his life had come crashing to a halt, never to be resumed, after his feelings had been hurt and his rage triggered. I was also aware that I was Myles’s fourth analyst, each prior treatment having ended because his therapist had unwittingly hurt his feelings without adequate repair. Filling the Envelope: Lichtenberg Impact 275

Concluding Remarks Stepping back now to look at both clinical vignettes I believe that in each I participated in an enactment evoking a “model scene” from the patient’s life. In other words in these interactions I inadvertently expressed some aspect of my uniqueness in an idiosyncratic response to my patient, and this response on my part had resonated with something that had been repeti- tively painful in the patient’s formative relationships. Or, to use another of Lichtenberg et al.’s ( 1996 ) phrases as mentioned above, I had participated in a disciplined spontaneous engagement. What makes these engagements (I hope) qualify as “disciplined” rather than “wild” is that in every case my intention was to facilitate the analytic process and enhance the therapeutic valence of our relationship while continuing to monitor and be guided by the ways in which my patient seemed to be affected by my words, behavior, or unconscious attitudes. In my treatment of Monty, whose father had repeatedly abandoned him, perhaps I had exhibited a certain unnecessary callousness in announcing my vacations because it was so hard for me to face my own feelings about hurting him and letting him down. And with the ever-procrastinating Myles perhaps I had indeed exposed a tendency in myself toward unfairness and hyper-effi ciency when I tried to get closure with him concerning what hours I was going to have available to offer to other patients or supervisees. Both my patients registered the hurt I had caused them and were able to express their anger, either directly as Myles did in his telephone message, or through dream-thoughts as did Monty. But in both cases also I was able to wear their attributions after the enactment – a move that seemed to open the door to my patients’ further associations and to a deepening and expansion of their emotional expression in the treatment relationship. This process in turn made it possible for us to fi ll in and to enrich the patients’ narrative envelopes in more affectively meaningful ways than before. I also continued in my abiding efforts to provide a reliable frame in a safe and friendly ambience, to identify and explore the specifi c affective experience of my patients, and to see our interactions from my patients’ points of view. Meanwhile I kept monitoring

Downloaded by [New York University] at 04:57 12 August 2016 the emotional impact on each patient of my words and actions and was able to be guided in our future interactions by what I had learned through these ongoing observations of my own participation and my patients’ responses. I like to imagine that these ways of interacting with my patients have been in keeping with Lichtenberg’s signifi cant life’s work in our fi eld.

Note 1 In considering the meanings of a dream I listen not only to the patient’s associations after she has reported the dream but also refl ect back on what has been said prior to the dream-report, treating it all as associative material. 276 J.G. Teicholz

References Kohut , H. (1977 ). The Restoration of the Self. New York: Internat. Universities Press . Kohut , H. (1982 ). Introspection, empathy, and the semi-circle of mental health. Internat. J. Psycho-Anal ., 63 : 395 – 407 . Lachmann , F. & Beebe , B. (1996 ). Three principles of salience in the organization of the patient-analyst interaction . Psychoanal. Psychol ., 13 : 1 – 22 . Lichtenberg , J. ( 1989 ). Psychoanalysis and Infant Motivation. Hillsdale, NJ : The Analytic Press . Lichtenberg , J. (1998 ). Experience as a guide to theory and practice. Journal of the American Psychoanalytic Association, 46 : 17 – 36 . Lichtenberg , J. ( 1999 ). Listening, understanding, and interpreting: Refl ections on complexity . Int. J. Psychoanal ., 80 : 719 – 737 . Lichtenberg , J. ( 2009 ). Refl ections on a contemporary psychoanalytic metatheory. Internat. J. Psychoanal. Self Psychol , 4 : 414 – 431 . Lichtenberg , J. , Lachmann , F. , & Fosshage , J. ( 1996 ). The Clinical Exchange: Techniques Derived from Self and Motivational Systems. Hillsdale, NJ : The Analytic Press . Lichtenberg , J. , Lachmann , F. , & Fosshage , J. ( 2011 ). Psychoanalysis and Motivational Systems: A New Look. New York : Routledge . Teicholz , J.G. ( 2009 ). Marian Tolpin: Forward edge thinker, clinician, and teacher. International J. Psychoanal. Self Psychol ., 4 (Supplement): 47– 54. Downloaded by [New York University] at 04:57 12 August 2016 24 WHAT I LEARNED FROM JOE

Estelle Shane , Ph.D.

My discussion of Joe Lichtenberg’s contributions to psychoanalysis will center almost exclusively on his direct infl uence on me and on my own growing clinical and theoretical understanding. That this is a personal appreciation of Joe’s infl uence, however, in no way mitigates Joe’s national and international importance to the fi eld. I have understood since the mid-1980s that Joe’s writings would infl uence and change forever how psychoanalysis was to be understood and practiced across the wide theoretical spectrum of psychoanalytic thought. Nevertheless, I choose to illustrate how particular seminal ideas of Joe’s transformed my own clinical approach. To begin, picture this scene. Art Malin and I (1985) had volunteered to introduce Psychoanalysis and Motivation in manuscript form (published in 1989 ) to the highly classical Los Angeles Psychoanalytic Society and Institute, the American-affi liated psychoanalytic Institute that has now become a part of the New Center for Psychoanalysis in Los Angeles. We had wanted to open the seminar to all candidates and members, but the attend- ance was restricted to only advanced candidates and members. The ideas in

Downloaded by [New York University] at 04:57 12 August 2016 Joe’s work were so new and different, and his conceptualization so fresh, that the Institute felt the introduction to Joe’s perspective should be limited to those who had already had some mainstream psychoanalytic education. Indeed Joe’s book was challenging even to that audience; we found ourselves reading and discussing the material as if we were reading the Torah, line by line. Everything was examined, explained, and taken very seriously in the seminar by these classically trained clinicians. We explored together the meaning of motive; why we could now recognize fi ve motives instead of two; the meaning of system and how Lichtenberg distinguished system from function; and what was meant by the assertion that the fi ve motivational systems identifi ed by Lichtenberg could be traced in brain and body and that 278 E. Shane

they could be distinguished at birth. Lichtenberg’s conceptualizations were not just a set of postulates; rather, they were ideas that could be “proven” as addressed by June Hadley in the concluding chapter of Psychoanalysis and Motivation. The seminar group wondered together where all the clinical material had come from. How had one clinician seen, done, and understood so much? We all came to feel awe for this man who knew so much, and who, as he later entitled an article published in JAPA (1998), had used “experience as a guide to theory and practice” with such incredible effect and to such conceptual advantage. I was a classically trained graduate of the Los Angeles Psychoanalytic Institute who had been deeply infl uenced by self psychology. Increasingly, I found that I was a budding integrationist. It is no wonder, then, that what attracted me most to Lichtenberg’s approach was his strategy of drawing together the best that each theory had to offer regarding motive, meaning, and development. Using his model I was required neither to deny altogether the undeniable presence and importance of sexuality and aggression in my patients, nor to imagine that these were always and inevitably their main motives: conceptual room was made also for consideration of the need for physiological regulation, for attachment requirements, or for exploration and assertion, each system serving as an equally likely driving force for the individual in a given clinical moment. I was convinced by Joe’s use of the aversive motivational system as inborn potential coming into play in the individual or system whenever another legitimate motive was denied access. This seemed to me a remarkably useful clinical as well as theoretical concept. Moreover, and perhaps most revolutionary in psychoanalytic thought, I learned that certain problematic conditions, such as eating and sleeping disorders, could be more readily approached by the clinician by keeping in mind the patient’s need for physiological regulation. This was for me, and I think for most of my colleagues, a completely novel idea at the time. In fact, it proved immediately helpful with my patient, Jan. Downloaded by [New York University] at 04:57 12 August 2016 My Work with Jan and Lichtenberg’s Inﬂ uence Jan was referred to me by another therapist whose treatment of Jan had reached an impasse. That therapist thought that my being a woman and a self psychologist might prove helpful to the patient in a way that the work with him had not. After working with Jan analytically for a number of months, I was fi nding it uncommonly diffi cult to get my clinical bearings with her, and she could not get to a point where she could feel comfortable with me. It was not for any of the more ordinary reasons that might have tripped me up at that time. Jan presented no unreasonable demands, was What I Learned from Joe 279

neither hostile nor aggressive, and did not view me in the transference in any problematic ways. In fact, the nature of our transference relationship was puzzling but did not yet appear problematic. I had become accustomed to the slowly unfolding selfobject transference that characterized work with a self-disordered patient, and Jan, it would seem, could be best understood in that light. I took it for granted that the attachment motivational system would emerge as the most prominent need for attuned responsiveness. Yet I found myself not knowing how to engage in the relationship with her, and she could not get to a point where she could feel comfortable with me. Our process had involved her repeating to me over and over through word and gesture her unhappy state, much as she had done with her previous therapist. I listened mainly in silence as she described feelings of emptiness, rest- lessness, and deep unhappiness, but her experience was that no matter how hard she tried, her words did not articulate her feelings and I was of no help. What Jan knew for sure was that she was inexplicably unable to remain at home, feeling compelled to rush out of the house as soon as possible every day to avoid the sense of utter, empty despair she felt when alone at home. She shopped, lunched with friends, or played cards, but it was all without meaning to her, and worst of all, it doomed her children, whom she loved, to return home from school to an empty house, or at any rate to a house without her being there to welcome them. Jan felt so bad about that. She also felt bad about delaying going to bed at night, staying away from her husband until very late. He was furious with her. He could not understand that going to bed for her meant lying awake, watching him sleep, being the only one in the house who remained awake, awake and anxious. Everyone important in her life, her children and her husband, ended up feeling deserted and neglected by her. Yet, despite the fact that she consciously longed to be a better, more affectionate and present mother, and a better, more affectionate and sexual wife, she felt so alarmed by the thought of staying home alone during the day or going to bed at night, she had to leave. She wanted to be home for her children, and she wanted to be in bed with her husband, but she just could not. This was the only narrative Jan was able to construct in order to describe her problem. She could not, she said, utilize Downloaded by [New York University] at 04:57 12 August 2016 her previous therapist’s interpretations that the reasons for her behavior were buried deeply within her, that she was somehow afraid of her own sexual urges, or that it was anger, anger at her children and her husband, that kept her from meeting their needs. She did not feel anger; she only felt helpless to care for them as they needed to be cared for. She knew something was the matter with her, which is why she agreed to try therapy again with me. As her analyst, I was at a loss. My ordinary way of being with a patient was to listen attentively and to respond empathically. I thought that through this process the patient would not only come to feel understood, but that a selfobject transference would emerge, conveying a sense of connectedness and secure attachment, or, at the least, a sense of being held by me. 280 E. Shane

The problem was that Jan did not feel understood, nor did she feel held or connected, and neither did I. I felt puzzled by some absence between us. Something was missing for her, and for me as well. Just being there as an attentive though quiet presence was not helping, and continuing to abandon Jan to her own free associations was not helping either; it was casting her once more, as her previous therapy had done, into a state of feeling alone, lonely, and misunderstood. I could see that. Despite my intellectual understanding and appreciation for Joe’s ideas, I did not fully comprehend that what I thought was empathy in my listening stance, was not empathy at all; it conveyed to Jan only that I was not in touch with her, that I was distant, unfeeling, and unresponsive to her pain, and she felt left alone by me. She needed more from me, beginning with my having a real grasp of what she was suffering from. She was not suffering from some hidden, shame-fi lled emotion or set of emotions, but from having had to exist now in the present and for so much of her life in a painfully dysregulated state. While I had given voice to this unfulfi lled need, I had not taken it seriously asthe problem, the central problem for her in and of itself. It was only then, as Joe’s ideas about expanding the range of motivational systems, along with his process approach, became alive to me as more than theory, that I could fi nally convey to Jan my understanding of her. Consistent with Joe’s style, I began to more assertively engage with Jan, to speak to her of her experience of the sleep state itself as a need that was constantly frustrated. I inquired about what it was like for her to go to sleep, or to try to go to sleep. I pointedly held her to this experience despite her sense that this was superfi cial, rather than to encourage her wider associations to the meanings of sleep, as she had been taught to do in her previous therapy. Jan was at fi rst annoyed with my new approach, feeling that by my taking her “surface” complaint as the message, by not exploring more deeply into its symbolic meaning, that I must be giving up on her, at least analytically. In the end we both discovered that our sustained inquiry into her sleep experience helped. She realized only then, through our process, and, para- doxically, to her own amazement, that she believed she never really slept, that the entire night was experienced by her as a state of panic. Speaking Downloaded by [New York University] at 04:57 12 August 2016 of it to me, feeling I was taking her seriously, she could fi nally allow herself to contemplate aloud just what it was like. She would lie there forever, assaulted by a single fear, which was that she would not be able to sleep, and then she would not. She had no other fears or preoccupations, at least consciously; it was just her life-long fear of sleeplessness, the attendant loneliness of that self-state, and then, at times, a nameless, meaningless panic followed. She always feared becoming anxious because panic might follow. In fact, that was what she woke up with in the morning, a sense of immi- nent panic, a threat that persisted until she left the house, when at least she could breathe freely. When I asked her why she had never described all of What I Learned from Joe 281

this to me before, Jan said that she did not think it was “psychological,” that it was only “physical,” and therefore “it did not belong in analysis.” This, at least, is what she thought her earlier analyst had believed, who, after all, had referred her to a psycho-pharmacologist so that she might be prescribed sleeping pills that did not help either. She then had followed her psychopharmacologist’s instructions to never take naps during the day but to stay active, and not go to bed at night until she felt ready. She was always exhausted but knew that no one, not her husband nor any of the doctors she consulted, could either understand or help her. No one took it as a serious complaint. She then told me that she feared I was another who did not understand or help, that she would go through the motions of exploring her psychic life with me, without hope that she would get relief. And Jan had been right. I had not understood the psychological importance of the physiological requirement for sleep, with all its affective components, until I was exposed to Joe’s thinking. By providing Jan with an experience of having a signifi cant other concerned about her, who would remain with her as we worked together to understand this basic physiological need and its psychological ramifi cations, she was offered a chance to master the capacity to sleep, a developmental task that had not previously been conquered because no one in her life had taken this need seriously, neither in her childhood nor in her adulthood. No wonder Jan had developed an aversion to sleep, and, concomitantly, to being alone. Sleeplessness created in her not just anxiety, but too often, a full-blown panic state. As Joe has emphasized, for some, the discrete affect of anxiety does not remain anxiety, but moves toward panic, just as the discrete affect of anger can move toward rage. Without assiduous attention on the part of the caregiver to the child’s affective experience of any and all physiological need states, without, that is, attention to the regulation of that experience, the child’s emotional life can be experienced as an ongoing nightmare. For Jan, her nights were always like that, so that the prospect of having to go to sleep held unbelievable terrors that then became dissociated but could emerge with force. Before my deliberate exploration of her experience, all of this remained out of her awareness, notable only by restless anxiety at the pro- Downloaded by [New York University] at 04:57 12 August 2016 spect of being home-and-bed-bound. Because I was a developmentalist, and because I had learned from Joe about the variety of motivational systems that operated within the dyad, all of them legitimate in their own right, I found I could work with Jan in this way without having to worry that I was not being “analytic,” and could reassure Jan in that regard, as well. Through the selfobject transference that emerged, I became a sleep-regulating other of enormous signifi cance. And this story has a happy ending. Jan’s sleep disorder abated and she ultimately became free to function as the mother and wife she always had wanted to be. I can imagine how obvious all of this might seem today, but then, when 282 E. Shane

self psychology was just emerging and Joe’s work on motivational systems was not yet known, it was anything but obvious, to me and to the group of classically trained analysts who were studying Joe’s book in the seminar with Art Malin and me. Physiological regulation and the psychological aspects thereof, the attachment system, the exploratory-assertive motivational system, the sexual/sensual motivational system, and the aversive system had all provided the clinician with new avenues for understanding a given patient’s needs. Now, with the more recently identifi ed systems of parenthood and sensuality (Lichtenberg, Lachman, and Fosshage, 2010 ), these opportunities have extended the possibilities for optimal responsiveness to the patient’s emotional states and motivational needs. I myself do not use the motivational systems as the way to organize the patient’s material, or to determine what in a particular instance the patient wants or needs. My own attraction to a complexity sensibility makes me less sympathetic to any kind of automatic approach to the patient. That said, whenever a patient and his or her needs seems inexplicable to me, whether only at moments or for longer periods of time, calling motivational systems theory to mind can be extraordinarily helpful, actually invaluable, as I have illustrated in the above case example.

The Importance of Process in Psychoanalytic Work Another signifi cant aspect of Joe’s thinking is his recognition of the importance of process, as set apart from structure, in analytic work (Lichtenberg, 2005 ; Lichtenberg et al., 2010 ). As Lucyann Carlton (2007 ) has written, all theories have both structure and process components, but contemporary theories are more heavily weighted with process components, whereas traditional theories are more heavily weighted with structure components. Process theories speak to a conception of psychological life and of therapeutic change as nonlinear, unpredictable, variable, and changeable, whereas structure theories speak to a conception of psychological life and therapeutic change as more linear, more predictable, less variable, and more unchanging.

Downloaded by [New York University] at 04:57 12 August 2016 Lichtenberg ( 2005 ) has identifi ed three processes that, he notes, are a part of both development and psychoanalysis. The fi rst is self-righting based on an inherent tendency to rebound from states of disequilibrium or impairment, a self-righting capacity that extends to both patient and analyst as each moves away from their mutual, affective involvement in the therapeutic hour, to their other occupations and engagements. Both patient and analyst must restore by self-righting their individual capacities for exploration and attachment after inevitable disruptions in the analytic process. Self-righting, then, pertains to both in the dyad, individually and interactively. The second process Lichtenberg identifi es is shared expanding awareness, his replacement for the traditional one-person model in which the analyst What I Learned from Joe 283

offers insight to the patient through interpretation. Expanding awareness in the two-person model derives from the two individuals in the dyad sharing affective experiences in the context of the exploratory-assertive motivational system. Lichtenberg’s third process is described as the rearrangement of representational schemas, that is, changes in the way the sense of self, signifi cant others, and events, together with their interactions and emotions, are all symbolized. Self-righting, shared expanding awareness, and rearrangement of representational schemas are all processes that emerge in the psychoanalytic exchange, moving across the variety of psychoanalytic theories. They all speak to nonlinearity, unpredictability, and changeability in analysis. Process is an inherent feature of a systems sensibility where self-organization emerges out of the dialectic tension that adheres between system-instability and system-stability, between the fl exibility necessary for change on the one hand, and the coherence necessary for ongoing function on the other. Shared expanding awareness and rearrangement of representational schemas reveal the living nature of the system, while self-righting restores necessary order to it. Like Joe, I am drawn to contemporary theory, and, in particular, to both process and systems theoretical formulations. Process theory, with its focus on the nonlinearity, the unpredictability, the uncertainty, and the changeability of human life, facilitates for me a profound shift in my attitude as a clinician, an attitude that therapeutic change can happen, though we cannot be sure when, how, and even to whom that change will occur – whether it be to the patient, to the analyst, or to both. For me, then, process theory provides hope. And systems theory conveys not only the same optimism, but speaks to me importantly of my own effi cacy; it conveys in its mutuality of infl uence and intentionality that, as an analyst, I am implicated in whatever change is effected, that whatever emerges, it emerges out of the dyad, not out of one or the other participants. Joe’s exploratory-assertive motivational system, with its pleasure in effi cacy, conveys my own sense that being an active, interested listener to the patient, and an initiating presence in the Downloaded by [New York University] at 04:57 12 August 2016 process, is more than analytically appropriate. As demonstrated in the case of Jan, it offers a deeper, richer experience and a more effective pathway to healing.

References Carlton , L. (2007 ). Making Sense of Self and Systems in Psychoanalysis: Summation Essay for the 30th Annual International Conference on the Psychology of the Self. IJPSP , 4 : 313 – 329 . Lichtenberg , J. D. (1989 ). Psychoanalysis and Motivation. Hillsdale, NJ: The Analytic Press . 284 E. Shane

Lichtenberg , J. D. (1998 ) Experience as a Guide to Psychoanalytic Theory and Practice . JAPA , 46 : 17 – 36 . Lichtenberg , J. D. (2005 ). Craft and Spirit: A Guide to the Exploratory Psychotherapies . Hillsdale, NJ : The Analytic Press . Lichtenberg , J. D. , Lachmann , F. M. , & Fosshage , J. L. (2010 ). Psychoanalysis and Motivational Systems: A New Look . New York : Routledge, Taylor & Francis Group . Downloaded by [New York University] at 04:57 12 August 2016 25 THE DYING THIRD The Impact of the Loss of the Remaining Parent 1 and Subsequent Adoption

Linda Gunsberg , Ph.D.

Introduction In interviewing Joe and having several communications with Charlotte for this book, Charlotte spoke of a major parental decision that she and Joe made upon the illness and death of their friend, Ping Pao. She said that before Ping Pao’s surgery, he had asked Joe and Charlotte if they would take in his children should he die (his wife had recently passed away). Ping Pao did die in surgery. His children, 13-year-old William and 18-year-old Maryland, were living with relatives. Charlotte said,

At that point Ann and Amy were out of the house and we were really enjoying just being the two of us. And I said no at fi rst [in discussions with Joe and their two daughters]. I was 55 years old. I wasn’t young. I had just stopped working and I was a little, maybe depressed about that. Maybe I was thinking is this all there is going to be?

Charlotte continued, Downloaded by [New York University] at 04:57 12 August 2016

One night William came over for dinner because we were always in touch with them. And Joe asked, “Have you decided which relative you are going to live with?” And he [William] put his head down and said, “I can’t even think about it.” And then I talked to Maryland and she cried and she said, “Why can’t anything work out right?” And I thought, I can’t stand here and let these kids go down the drain and I went to Joe and I said, “I’ve changed my mind.” Ann, Joe and Charlotte’s older adopted daughter, vocalized very strong feelings about this situation and said to her mother, “Well, wouldn’t you want 286 L. Gunsberg

someone to take care of us if you died?” She was horrifi ed that I had said no at fi rst. But it was a good thing that I did because I worked my way through a lot of the possibilities and by the time I did, I was ready. And it is one of the best things we ever did.

Charlotte’s recounting of how William and Maryland came to be part of their family brought one of my child therapy cases vividly to mind.

Psychotherapy with Thirteen-Year-Old Rebecca Rebecca was approximately William’s age when she began individual psychotherapy with me. Her mother was already ill. Rebecca began treatment on a twice weekly basis and the treatment spanned a period of three years. In the fi rst year, the treatment followed a more traditional individual child psychotherapy model, with occasional collateral sessions with her mother.2 However, as her mother’s illness progressed during the second year of treatment, more family members, including the babysitter, and Rebecca’s uncle (her legal guardian), sought consultations with me. Originally the therapy was directed towards the usual school problems (issues with peers and teachers), budding fl irtations with boys, concern about her mother, and tangles with both her mother and her babysitter. When Rebecca’s mother became progressively ill in the second year of therapy, the treatment took on the quality of triage services. As the therapist, I was preoccupied with time, wondering what work needed to be done prior to her mother’s death, and how best to help Rebecca psychologically approach this premature ending of her mother’s life. In addition, Rebecca started to voice concerns about where and with whom she would live after her mother died. Rebecca’s uncle was surprised by the rapid deterioration of his sister’s health and was honest in conveying that he had hoped that Rebecca’s mother would live much longer before he would have to become more directly involved. Rebecca became preoccupied with supply- ing a backpack with survival supplies she would need at the point when her

Downloaded by [New York University] at 04:57 12 August 2016 mother passed away. When her mother was hospitalized, Rebecca began to refuse to go to school and at several points to refuse to come to my offi ce. During these times I would go to her home for therapy sessions, which she welcomed. My patient was engaged in various aspects of her life, some privately and some publicly. As her therapist, one of my functions became helping her fi gure out when the best times were to visit her mother. Privately, without the therapist’s knowledge, Rebecca was preparing a eulogy for her mother. That was Plan A. Plan B was playing a very upbeat song about friends. At the funeral my patient made her choice. After the Rabbi conducted his ser- mon and prayers in a very solemn manner, Rebecca took out her boom-box, The Dying Third 287

previously concealed, and blasted a song about the lasting power of friendship. The boom-box was her voice and the song’s words became her eulogy. After the funeral, Rebecca started to slip even further. To others, including myself, she talked about reading books that helped teenagers with grief and loss, and spent time on the internet talking to her friends. She was less able and/or interested in seeing her friends in person. She spent time on the computer creating a house, deciding which furniture to incorporate, moving the furniture around, and deciding which people should compose the family. In addition, she adopted neo-pets and fed them, not letting them die. She would miss school for periods of time and would not want to bathe or shower. She was losing interest in the outside world. At this time, she refused to come to her therapy sessions as well. I conducted her therapy sessions in her home. She did agree to go out with me on excursions and I let her choose where she wanted to go. Rebecca chose to go to Central Park to visit the statue of Balto, a dog that had been honored for bringing emergency medical supplies to children in need in remote regions of Alaska.3 Each activity and excursion offered me a glimpse into how Rebecca was processing her mother’s illness and death, and gave me an opportunity to understand what positive experiences and memories she was trying to hold onto regarding her time with her mother. She expressed the desire to visit her mother’s grave, study the same fi eld as her mother, and attend the same college as her mother. Remembering positive experiences with her mother was both diffi cult emotionally yet also kept her going. Many of these feelings and sentiments were expressed through her writing. About a year after her mother died, she wrote:

It’s been over a year now, but sometimes I feel she’s not really gone, other times, I remember that she’s never coming back, and the times right in between I try to fi ght against the reality of it all. I tell myself that she will come back. I started thinking that the time she was watching over me would be when I look straight into the sun and feel its warmth without it causing any pain for my eyes. That moment came when I was camping. One morning, I looked up to the sun and Downloaded by [New York University] at 04:57 12 August 2016 found that I was able to stare straight into it. It was cold out but when I looked into the sun, the cold atmosphere vanished. Then, I knew that it was her. She was there, she was telling me to keep my chin held up high. Telling me not to worry, she was there to help. She’d be with me all the way until the day I join her up there in the sky.

Rebecca’s already exhibited sleep diffi culties worsened after her mother died. Again not mentioned directly in treatment, I was told that she would stay up at night to touch and hold her mother’s books. These books were precious to her to some extent because they were also precious to her 288 L. Gunsberg

mother. She was concerned that when she would have to one day move from her house, these books would no longer be available to her and that they would be packed up and kept in a storage facility. She felt that it was her responsibility to take care of these precious possessions of her mother and also wanted these books near her since they made her feel that her mother was still alive and walking around in the house. Her nights were tortured:

It’s not like anyone cares. No one even bothers to notice. They can’t see through the shell to the lost and lonely soul inside. They can’t share the pain, the joys, the mishaps. Speaking out at last, and no one’s there to hear. Finally fi nding a voice different from the rest, yet never being called upon to lend a sound. It’s been forever, since someone’s been there to encourage the heart and soul to explore the world. Have adventures, and let out thought. Opening up to the chance, the moment, to shine in another’s eyes. The place is stolen. Friendship is at stake. Taking pity on the thief, the criminal, who is a friend. Never knowing which friendship will end. Will it cease? Will it end forever? Is it over? Do not ask until it is fi nished. Backs are turned. Forever is tomorrow, tomorrow is forever. Betrayals are caused, chaos is born into life. The soul is wandering. It’s destiny is death. The path is fi lled with lives, taken, slaughtered, massacred, destroyed. No one can return, for death has its grasp around life. Another friend, trying to pull all knowledge, belief, hope, away. The soul will not attempt new life. The soul will remain lost and wandering in an icy world forever. All its hope, faith, and belief, are fading away, into the frozen depths of eternity’s garden of death.

After her mother’s death, Rebecca continued at the school she knew and had attended for years. Her uncle, who lived in another city, visited her frequently and invited her to spend weekends with him.4 However this arrangement was not good enough. She lacked the warmth and sense of belonging to a caring family. She secretly desired to live with her uncle but Downloaded by [New York University] at 04:57 12 August 2016 when people asked her, including me, with whom she wanted to live, she would not answer. It was as if she had not yet come to terms with the reality that her mother had died, and that her mother and she did not live in their home together. In addition, she was afraid of potential rejection if she stated with whom she preferred to live. Nevertheless, it was very clear that she had the specifi cs of this already worked out in her mind. She sank even further into her retreat from the outside world and suicidal thoughts were actively expressed. It was clear that two times a week therapy could not hold her nor could her home environment, as it was, hold her. The Dying Third 289

Now came the time to discuss with family members the next steps in planning for Rebecca. And Rebecca helped me with my work in this regard. She had a dream:

Two elephants disguised as horses were boarding at a barn owned by her uncle. The elephants were found by her uncle at a shelter along the highway. At the barn, one elephant gets loose. She [Rebecca] rides the elephant through a bunch of fi elds and over high jumps and back to the barn. Later, one of the elephants gets ill from a change in the water. My uncle and I help the elephant and it gets better.

Rebecca, in her usual fashion, writes the dream down and offers possible associations, by starring the important elements of the dream. First, the elephants look like horses and are actually disguised as horses. She then responds to the adoption theme of the elephants coming from a shelter and one of her pets at home being adopted. She remarks on how her uncle could help the elephant recover.5 Then Rebecca indicates her desire to ride again, in other words, the elephants were disguised as horses and she wants to ride horses again and she wants to go to the zoo again. These associations expressed her desire to get back into life in a positive way. Also, she wanted to adopt a dog from a shelter. And most importantly, she sees her uncle as helping her recover and wishes to be adopted by him. I felt now I had what I needed to call in the uncle and his wife to let them know that occasional visits had to now be replaced with constant care and love from them. When they came to my office, with Rebecca’s permission, I read them her dream and her associations and, with a lot of tears, they agreed to take Rebecca to live with them full-time. It was at this point that I knew that the therapy with me was over because Rebecca would be moving too far away to continue. But more importantly, as her therapist I knew I had accomplished my main responsibility to her, which was to make sure that she was “adopted” by a good family. Occasionally I would get reports from her uncle and aunt about how Downloaded by [New York University] at 04:57 12 August 2016 she was doing and although she improved tremendously just by being taken in by them, her concerns and processing of the loss of her mother continued. It is interesting that in Rebecca’s case, her uncle was ready to “adopt” her much earlier, and her aunt remained ambivalent until Rebecca’s mental health seriously declined. Similarly, Joe was ready to “adopt” William and Maryland much earlier, and without the ambivalence Charlotte has to work through. 290 L. Gunsberg

The Dying Third I have been very impressed with intersubjectivity theory’s contribution of the “third” and “thirdness.” This contribution has helped me immensely in understanding the co-created space between two people, that is, the subjectivity of one person, the subjectivity of the second person, and the co-created intersubjectivity between these two people. This concept applies not only to the analytic relationship, but also to the relationship between any two people, including the fi rst relationship between a mother and her baby. I see this work as clearly related to Winnicott’s ( 1971 ) concept of transitional space. Samuel Gerson ( 2009 ) picks up with Andre Green’s (2004 ) concept of the “Dead Mother” by introducing the concept of a “live third” and a “dead third.” Gerson defi nes a “live third” as

the other whose engaged recognition and concerned responsiveness to the individual’s experience creates livable meaning. Livable meaning refers to the recognition and responsiveness from the other both on an external level and the internalized representational level. The “dead third” is conceptualized as the loss of a “live third” upon whom the individual had previously relied upon, had entrusted with faith, and in relation to whom or which, had developed a sense of personal continuity and meaning. (p.1343)

This loss is experienced both on the external level and, even more importantly, on the internalized representational level. For Rebecca, her ill mother could no longer be a reliable and predictable third, nor could the therapist in a twice weekly therapy be the constant, predictable anchor and person that Rebecca urgently needed in order to survive both on the external level and the internalized representational level. I would like to offer a bridge concept, “the dying third.” The “dying third” refl ects the intermediate space between the “live third” and the “dead

Downloaded by [New York University] at 04:57 12 August 2016 third.” My work with Rebecca helped me understand the need for a concept refl ecting this intermediate third. Her mother was intermittently, and sometimes with diminished capacity, available to Rebecca during her illness and while she was “passing through life” (Boss, 1999 ; Barnard, Towers, Boston, & Lambrinidou, 2000 ). She could at times be that other person to respond to Rebecca’s experience, create livable meaning, and be a positive mirror for her daughter. However, her mother’s physical and mental deterioration during this period before her death stimulated elements of death and negativity that she could not be protected from, particularly at night. “Dead” refers to the absence of the other person not only in reality but also on an inner representational level. It is as if the person who remains alive has no one and is empty, lost, and alone. Gerson (2009 ), referring to The Dying Third 291

the work of Marcelo Vinar (2005 ), states, “The worst anxiety is not connected to the loss of the object, but to the absence of its representation” (p.315). Gerson expands Green’s metaphor of the “Dead Mother” by saying that the “dead third” means that there is a

traumatic withdrawal of provision and care from those sources whom we have either relied upon in the past or have come to expect nurturance in the future … The trauma occasioned by being in relation to a living other person or social entity who has become “dead” to the individual extends beyond the external loss and involves severe damage to internal psychological structures. (pp.1350–1351)

Gerson continues to state that the space of the dead mother is a haunting presence of ghosts that can never be banished (Fogel, 1991 ). These phan- toms and ghosts also exist for the adopted child who has been separated from the birth mother (Lifton, 1988 , 1994 , 2007 , 2010 ; Gunsberg, 2010 ). These hungry ghosts then become a primary identifi cation bringing into centrality fantasies and identifi cations fueled by destruction. My concept of the “dying third” as an important transitional internal space allows for intermittent positive mirroring and, for Rebecca, intermittent sunshine and warmth. Memories of earlier experiences connected to sunshine, warmth, guidance, and nutrients from her mother can rest here if not destroyed by the negative imagery and representations that also inhabit this place. The hope is that this intermediate space can integrate positive and negative aspects of the lost mother and positive and negative memories of the co-created space between mother and daughter. This possibility of integration, however fragile, may save this co-created space from becoming dissociated. Hopefully, with time, and good psychotherapy and environmental supports, this intermediate space can become more integrated and available internally as a different kind of hopeful transitional space. That is, the “dying third” might have a chance of being saved from becoming the “dead third” in that it remains an accessible, acceptable, fl exible, and fluid Downloaded by [New York University] at 04:57 12 August 2016 co-created space that can survive and be sustained even after the physical loss of an important person. Rebecca’s positive connections with her uncle and aunt offer more support for this possibility. That is, in reality there are people that she already believes can provide her with a loving environment within which she will fl ourish and, in her own words, she will not die of a disease because of “the change in the water.”

Some Further Thoughts To my knowledge, Joe and Charlotte Lichtenberg did not need a therapist to help them reach their decision to embrace William and Maryland Pao as part 292 L. Gunsberg

of their family. However, the fi nal catalyst seemed to have been Ann’s (their elder adopted daughter) question to her mother, “Well, wouldn’t you want someone to take care of us if you died?” In my opinion, Joe and Charlotte saved William and Maryland, just as Rebecca’s uncle and aunt saved her from spiraling quickly down a path towards either suicide or psychosis. This path was turned around by their understanding and compassion for her as a result of important therapeutic interventions on behalf of Rebecca by her therapist, and by Rebecca herself, whose wishes were conveyed in her dream about adoption. Intersubjectivity theory encourages self-disclosure. Although I never dis- closed to Rebecca or any member of her family my own personal experiences with death and dying, my work with her reactivated the loss of my own grandmother when I was 12 years old and for the fi rst time went to a funeral and burial at a cemetery. This experience had a lifelong impact on me. My grandmother’s death, experienced at approximately the same age Rebecca lost her mother, made me keenly aware of the passage of time, which remains a central theme in my life. It was only later, when writing this commentary, that these associations about my grandmother, which were otherwise unavailable to me yet were directing me, became consciously available.

Notes 1 I would like to thank Sandra Hershberg, M.D. for introducing me to the concept of the third, and for her helpful suggestions regarding this paper. 2 Rebecca’s father was unknown and thus never entered her life. 3 In January 1925, Alaskan doctors feared a deadly diphtheria epidemic would spread among the children of Nome. Medicine to stop the outbreak existed, but doctors needed to travel nearly a thousand miles to Anchorage to retrieve it. With no trains running that far north and the only available airplane sidelined by a frozen engine, the best chance of transporting the medicine across the icy tundra was by sled dog. More than 20 sled teams coordinated to make the trip through blinding snow and sub-zero temperatures. On the fi rst of February, the package was handed off to the fi nal team. Led by Balto, the team covered 53 treacherous miles back to Nome in 20 hours. Newspapers and radio around the world fol- Downloaded by [New York University] at 04:57 12 August 2016 lowed the trek, fascinated by the brave team whose efforts eventually helped end the epidemic. Balto became a national hero. Just 10 months after the successful mission, a statue of Balto by animal sculptor Frederick G. R. Roth was dedicated in Central Park. 4 After her mother’s death, Rebecca lived with an elderly family member whom she hardly knew. 5 About a year and a half prior to her mother’s death, Rebecca drew a picture of her pets and stated that she had a fi sh that died because of the water change. The water change had to do with her taking her pet with her on vacation to another location where the water was different. The Dying Third 293

References Barnard , D. , Towers , A. , Boston , P. , & Lambrinidou , Y. ( 2000 ). Crossing Over: Narratives of Palliative Care . New York : Oxford . Boss , P. ( 1999 ). Ambiguous Loss: Learning to Live with Unresolved Grief . Cambridge, MA : Harvard University Press. Fogel , G. (Ed.). (1991 ). The Work of Hans Loewald: An Introduction and Commentary . Northvale, NJ : Jason Aronson . Gerson , S. (2009 ). Memory, mourning, and witnessing in the aftermath of the Holocaust . International Journal of Psychoanalysis, 90 : 1341 – 1357 . Green , A. (2004 ). Thirdness and psychoanalytic concepts. Psychoanalytic Quarterly, 73 : 99 – 135 . Gunsberg , L. ( 2010 ). An invitation into the ghost kingdom. Psychoanalytic Inquiry , 30 : 102 – 110. Lifton, B. J. (1988 ). Lost & Found: The Adoption Experience . New York : Harper & Row . Lifton , B. J. (1994 ). Journey of the Adopted Self: A Quest for Wholeness. New York : Basic Books . Lifton , B. J. (2007 ). The inner life of the adopted child: Adoption, trauma, loss, fantasy, search, and reunion. In Handbook of Adoption: Implications for Researchers, Practitioners, and Families, D. Brodzinsky & J. Palacios (Eds.), pp. 418 – 424 . Thousand Oaks, CA : Sage . Lifton , B. J. (2010 ). Ghosts in the adopted family. Psychoanalytic Inquiry, 30 : 71 – 79 . Vinar , M. (2005 ). The specifi city of torture as trauma: The human wilderness when words fail. International Journal of Psychoanalysis, 86 : 353 – 375 . Winnicott, D.W. ( 1971 ). Playing and Reality . London : Tavistock . Balto reference: http://www.centralparknyc.org/visit/things-to-see/south-end/balto. html Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 PART IX Selected Contribution of Joseph D. Lichtenberg Downloaded by [New York University] at 04:57 12 August 2016 This page intentionally left blank Downloaded by [New York University] at 04:57 12 August 2016 26 FREUD AND KOHUT

What Lasts, What Fades

Joseph D. Lichtenberg

Kohut Memorial Lecture International Association of Psychoanalytic Self Psychology 2005 Baltimore, Maryland

I was asked by a friend of mine, Curtis Bristol, who had been one of the people I taught ego psychology to when I was the big teacher in our group of ego psychology, “I understand you are interested in something called self psychology.” I rapidly and proudly acknowledged, “yes.” And he said the meeting is going to start in about two minutes, but would you mind telling me what that is? So that became a rather thick “now moment” as to how to respond to that. So I had an inspiration of the moment which was, self psychology is all those things you are doing, but don’t tell your supervisor. So my talk is essentially about what lasts and what fades. And my fi rst thought is that there is in that story two things. One is that there is a way of doing things that somehow has a general consensus. The general consensus changes as to what that is but nonetheless there is a frame. There is some way of constituting ourselves and what we do with patients, and that lasts. The form of it may change but the idea that there is a frame lasts. And hopefully something fades, which is that we now tell our supervisors Downloaded by [New York University] at 04:57 12 August 2016 those very things, and with some degree of pride about them. So that old prohibition fades. Now how did we get into this business? Essentially we owe our present being and what we are to two women and three men. The fi rst woman is Anna O. and she said to her doctor, Dr. Breuer, “Listen to me,” and he did. A pretty amazing thing. So he, Breuer, got interested in what happened as he listened, and saw changes and remarkable things that happened. So he told his friend, Sigmund Freud, and now another person listened. Freud listened and got very interested in what was happening and wanted to do something with it. Not just have it as an experience. 298 J.D. Lichtenberg

So that started us on the whole process of listening. Then time went on and how we listened, what we listened to, and how we sort of insisted that we knew what we were doing when we listened and interpreted led another woman, Miss F., to say to another analyst, Heinz Kohut, “Why don’t you just listen?” And he started to listen and he started to recognize that when his listening enabled him to give her an idea that he heard, that he understood, that he could see things from her point of view, there was a huge change in the whole process. What lasted was listening, what changed was how to listen and what to listen for and that is with us to this day. But when an analyst, a theoretician analyst, listens at any time he will make certain guestimates about what is going on. And Freud made some guestimates. Interestingly, his fi rst guestimate was that people he was hearing had been traumatized, and that something that was a consequence of that trauma was that they had emotions that were not accessible to them. He called them strangulated affects. And he thought that if they could be brought into awareness, symptoms would disappear. And then he made a wrong turn. And the wrong turn was to say, if I really listen to what these people are telling me and the traumas that they are describing, they have gone through hell as children and that can’t be. I mean can it be that all these parents and all these diffi culties are around in this world, even in my own world, even with my own good mommy and daddy? Can’t be, it’s all distortion. So he said, okay, it’s something else. So where does the distortion come from? And like a good scientist he borrowed from the science of his day, which was then hot on energy, Helmholtz and Einstein. And of course to this day we are interested in energy, but not as the paradigm for us as analysts. So he made a wrong guess. Just consider what psychoanalysis would have looked like if he had stayed with affect and trauma. It would have shortened our journey a heck of a lot, I think. Okay, so that was one wrong guess along the line. Then we move up a little bit to Heinz and we say well, what were some of his early guesses? Well, one of his early guesses was that all of the data that was going to be useful to self psychology had to come out of clinical experience. That is, it had to be derived from that which could be observed in a clinical setting. Downloaded by [New York University] at 04:57 12 August 2016 This was a way of saying get all of these borrowings from physics and all of that other stuff out of here, it’s what is going on in this room and let’s stay in this room. Well, that was a restriction that fortunately he didn’t hold too tightly to, because immediately people like Michael Basch, Dan Stern, and myself, who were all together in 1980 in Boston, said infant studies, my god, there is information that is so relevant. And that was a change. What moved, what faded, was Kohut’s prohibitive idea. And what remains is a tremendous back and forth informational exchange from the study of infants to the study of what we do every day in our clinical work. That was then a second important change. Freud and Kohut: What Lasts, What Fades 299

Now Heinz also made another guess which was that there would be a lot of explanatory use in borrowing the idea of structure from ego psychology, structures of the mind, except we are not going to have macro structures in ego and superego, we are going to have another kind of structure, self structure. We are going to unify, integrate, and talk about self and talk about it as a structure, something with a slow rate of change. That’s what a structure meant. And that also seemed to some of us – for example, I remember Ernie Wolf and myself talking at the Cape and saying, you know what self psychology is, it is about experience, and if we’re going to talk about a self, it’s a self experience, how one experiences one’s self in relation to others. So that became then a second turning point at least for some of us to redefi ne things from self and selfobject as if they are just fi gures into the sense of self, the experience. And into something called a selfobject experience, which is either vitalizing or soothing or responsive to some need or another that then alters the state of a person hopefully for the better. So that was another bet and that was another way of changing something, the restriction about structure. Now what has then happened is that experience doesn’t seem like a big enough casement and it doesn’t have a kind of large enough explanatory power. So what happened then is we borrowed, many of us coming from different ends of the whole spectrum, from systems theory and started to think in terms of systems. And so, systems becomes a very complex thing. What is a system? A system is something that self organizes, tends toward becoming self stable, but is also under a great deal of dialectic tension either within the parts of the system or with other systems which then force it to change, which then means there are potentialities for reorganization. That’s essentially in a few words what a system is. So if you then take the idea of, well, you can then say one system A leads to B. Patient says, I’m angry with you and you say, what are you angry with me about? And the patient says I’m angry with you because you canceled yesterday’s hour. And it sounds like it is a linear progression. But what we discover is that that is very rarely the answer to what is going on. That Downloaded by [New York University] at 04:57 12 August 2016 what’s going on is operating at that level but also at a nonlinear unpredictable level so therefore we introduce the idea of non-linear systems, which at times can be linear. So that is a whole other way of thinking about and looking at our fi eld which changes it and introduces so many other ways to think about and talk about our fi eld on a broader scale and allows us to connect up with science in a much broader way. And of course, the neurophysiology that we are also using and learning about is also using systems theory so that we are able to be more conversant with other areas in a very useful way. Okay, so the bet on structure I think has faded. And the bet on systems is what’s with us particularly now. Now a consequence of all this is that we 300 J.D. Lichtenberg

have introduced so many different languages into our fi eld that going from room to room as I have done in this meeting is like a tower of Babel. I mean the number of languages we all speak is just absolutely mind-boggling! So it’s been one of my particular hobbies, so to speak, to try and take some of the more complex things that are talked about in ways that are ten words to describe anything with each word being very long. I try to talk in ordinary language and I am going to try out on you a little bit some ordinary terms which I think have to do with what we are listening to with each other and our theory and what we are listening to with our patients. Three of these terms have to do with (the letter) “I” and one is an “R ” and one is a “C.” The “I” is infl uence . Much of what we are talking about has to do with how one infl uence is playing out on something. That is, we are talking about, for example, by saying an intersubjective system we are saying there is an infl uence going back and forth in a dyad. One person is infl uencing the other. And as they build their infl uence back and forth they build something further which is the space between, that which they have created between. And that infl uences them both as to how they will then proceed. So that infl uence is one of the broadest ideas. Much of what can be looked at is a question of what is infl uencing the past is also infl uencing the present. Well of course it is, but how? So as we try to study things, we are really trying to study the nature of infl uence in all kinds of ways. Now I will add to that that both Freud and Heinz made a bad bet. And the bad bet was that you could start with an adult and understand what a baby was about. And that was a very bad bet. And so people like Dan Stern and Beatrice Beebe and many others, and I’ve certainly been a part of that, have tried to look from the bottom up to try to understand things such as development as something to be observed. But there again the infl uence, and then we will use the term linear – it’s not linear, it’s non-linear. There is a huge amount of unpredictability that comes when you start from the bottom up as to whom we get to be at any point. So this again introduces another way of looking at things. Okay, the second “I” word I’m going to throw at you is inference . This is the least used of the words. This has to do with the idea that at any given Downloaded by [New York University] at 04:57 12 August 2016 moment in a given clinical situation you are making inferences about what’s going on with your patient, what’s going on with you, and your patient is making inferences about what’s going on with him or her, and what’s going on with you, and those inferences are going to play out in all kinds of ways. Some of them are explicit. You can fi nd them, some of them are right in front of your nose. And some are very hard to grab a hold of but they nonetheless govern. We are cognitive beings as well as affective beings and as cognitive beings we are always making inferences. And so some of the most important inferences that are made are made very early when a child will say: my Freud and Kohut: What Lasts, What Fades 301

mommy is angry with me. Why? What did I do? Well, I’m a bad boy, that’s my inference. Or, I’m not a bad boy, she’s a mean mommy, she’s not being nice to me today. Now the consequences are going to be very different. If I conclude I’m a bad boy, I’m going to live with one way of living and have all kinds of strategies as to what to do with that inference I’ve drawn. And if I conclude she’s a mean mommy, I’m going to have another set of strategies about what I do. And if I conclude my analyst is having a bad day today, then I’m going to have one set of inferences and if I conclude I’m being defensive today, I am going to work with another set of inferences. And so inferences are happening all the time and they are unpredictable. It’s hard to know; you cannot predict which way the darn thing is going to go at any moment. People will show repetitive patterns in which the tendency will be there, but at some moment it will not be there. Because we also have fl exibility. If we didn’t have fl exibility, we could not be treated. So that’s my second “I.” My third “I” has to do with intention . There’s a joke that he who collects the most toys wins. Well I’d say he who can read intention wins. He who can read the intentions of himself and others wins at poker. He who can read intentions of himself and others wins at safety, how to be safe in the world. He who can read the intentions of others can treat others. So it is very important that we have some way of reading the intentions of others. In Dan’s talk, he mentioned an early intention detecting center. So we come equipped with possibility. Now an awful lot of the complex talk about mentalization, about the origins of empathy, about whether you can or cannot sense into the mind of another and whether and to what degree we are picking up affect that is coming into us which should give us an idea of intention, all fi t into the question of can I guess, can I make any kind of reasonable assessment about what is the intention of my patient when my patient says in words, I hate you or I love you? What’s the intention? That’s what will tell us what is really going on. The words are a component of an intention communication but they can’t be taken at the literal level. So what I’ve tried to do is introduce useful schema for talking about Downloaded by [New York University] at 04:57 12 August 2016 different kinds of intentions. And I’ve said that when you look at various situations, one set of intentions will have to do with how do I keep my body going, how I operate physiologically? How do I protect and regulate and operate in some way so that my body remains in a pretty good state? And so I’ve called that a set of intentions or motivations that have to do with a physiological system. I’ve also suggested that one of the most important things we have is a set of intentions that has to do with essential intimacy connections with others. Here I have borrowed from attachment research. Look at the question of why do people get together. What is it that makes one person want to connect with another? 302 J.D. Lichtenberg

Now Bowlby gave an answer that since there is a risk of danger at all times, and a risk of loss, people get together for safety. They get together to establish a way of being with each other that produces a safe base. Okay, that makes good sense. But that’s just how to not be in trouble. Kohut said that people get together so that one can mirror the other. Both can share something of their common humanity and one can feel that respect and admiration of the other that makes both feel good. Okay, those are all posi- tives. So there is a second answer, to have positive experiences is Kohut’s suggestion as to how come there are attachments, why people get together. And Bowlby’s answer is for safety. And I will add another one, I think people get together for informational exchange. I think we are in this room largely together for communal connections, an affi liative link to one another, but also for informational exchange. So I think people get together so that we know one another by being informed. I want to know who you are. You want to know who I am. And if I’m your baby I have got to know who you are and I have got to have you know who I am. So the informational exchange about us in terms of all kinds of information, what’s my physiological need and state, is terribly important. And so on. So the informational exchange is one that I would add to that grouping of safety, and selfobject experience. Now people are also primed to want to fi nd out what’s going on. Every baby scans around to pick up what’s going on. What is in my environment? What is happening? And before long, the baby asks why? And before long, answers because. And before long, wants somebody to say because and explain. So the idea of an exploratory system, a system that says, what’s it all about?, is a powerful system and the initiative to follow in that system is a part of what you are all doing right now in trying to make sense of the stuff that I’m telling you now. But we explore in terms of our own preferences and some of us have preferences that lead us to be analysts and some of us have preferences that lead us to go into space. Both are preferring but we are showing a preference of a very different nature as to what we choose to explore. Okay then, I said we have a tremendous need for the initiative. We have Downloaded by [New York University] at 04:57 12 August 2016 to be aversive to be able to get on in the world and to be able to communicate to other people what it is that we need at any time, and especially, what we don’t need at any time so that we can orient ourselves and orient others. And all of these are operating in a reciprocal system of mutual infl uence but not equal infl uence. And the last system is, and I make the distinction which I regard as extremely important, a need for sensual enjoyment, and a need for sexual excitement. And I think that when Jim Fosshage and Dan Stern were playing the “I love you” game, when Jim puts his arm around Dan’s shoulder, that’s a sensual experience. It’s a lovely experience. It’s an experience that Freud and Kohut: What Lasts, What Fades 303

everyone wants to have. These guys are not, I don’t believe in any way likely to go out and have an orgasmic experience based on what has just happened. But, if you misread your patient’s intention when your patient says, you know I am getting fond of you, meaning if you take another misdirection Freud took and interpret that everything sensual is aimed toward orgasmic experience, then you will do your patient a great deal of harm because you will not allow your patient to talk about the sensual experience that everyone needs to have; the hug, the fondness, the touch. So people like Jim, Dan, and I are trying to bring this back into focus so it can be used within a treatment situation; to recognize that initiative, what it means, and how it is placed. Okay, the next one is the “R” idea of regulation . Regulation again is a borrowed term, something that’s often used in biologic studies. But it is a very useful concept and it is especially useful when we talk about affect states, because many of our patients have a terrible time regulating either an addictive proclivity in order to get some kind of affective experience, or when they begin to have a discrete affect they can’t contain. Anger doesn’t stay anger, it tends to move towards rage. Anxiety doesn’t stay anxiety, it tends to move towards panic. Or happiness can move toward a euphoric denial of danger. So there are many affects we need to look at in terms of how well we and the patient can help infl uence one another to recognize the need for regulation. The problem that there is in the given moment is the actuality of regulating between the two people. And so that becomes another one of my ordinary English words that applies to what we are up to. The last term I will mention is the “C,” communication . I am going to suggest my own view, which is that I think communication is a potentially broad term useful for understanding a lot of things within that term. I think a lot of what we have been hearing at this conference and others is how we are operating at a verbal level to communicate because we are symbol-using people. Or to put it another way, we are primates who use symbols and therefore are different from other primates. And second of all, at the same time as we are talking and communicating at symbolic levels – and speech is not the only symbol system, music is a wonderful symbol system, math- Downloaded by [New York University] at 04:57 12 August 2016 ematics is another complex and interesting symbol system, there are a lot of symbol systems – but we are also communicating at all kinds of other levels and at any moment there is an infl uence on what is happening on both levels; at the verbal level, at the non-verbal action-like level, whether you want to call it enactment or what. It is going on all the time. One infl uence is from one’s prior experiences as they are playing out in the context of infl uences from others and the environment. I have time for a quick story. I was given a referral in a fashion that I don’t think that most of us would like to have. I was called by a psychologist, a very experienced woman in our community, and she said, 304 J.D. Lichtenberg

Joe, I want to refer a patient to you. This is a woman who has had two or three unsuccessful tries with very good analysts so she gave up on analysis and she came to me. I started her in psychotherapy and we seemed to be getting along but she just couldn’t connect with people. I put her in a group and this was the fi rst time I had the experience that the group, after a while, didn’t want her to be a part of the group. So she said, and I told her, there may be some people who can’t be treated. But you can have a last chance. If he [Joe Lichtenberg] can’t treat you, you can’t be treated.

So that’s not a way to get a patient. So I walk out into my waiting room and there is this very attractive young woman, very nicely dressed, smiles pleasantly, comes into the consulting room, sits down, starts to tell me her story in a very pleasant and related way. And I am sitting there with this other information in the back of my head thinking, “Something doesn’t add up here. This is very strange.” Well, I am very motion sensitive and a bird fl ew by the window and I glanced over to the window and when I glanced back, this lady had crumbled. She just was not there. I was startled and I said, “Were you bothered when I looked away? Did that upset you?” And she looked up at me and said, “yes.” And I said, “Oh, I guess when we were making eye contact before it was helping and holding” and she said, “oh yes.” So then we started and I found out that she and her mother could not make eye contact. Her mother would invariably look away from her face and she would look away from her mother’s face. But this treatment started at that moment, knowing that from then on, we could keep track of the whole thing. The treatment worked out very very well. The woman is married and is a very successful person. I think her other treatments were sometimes helpful, but no one ever dealt with this essential problem of breach in communication. We were communicating, we lost it. What happened that we lost it and how we were going to regain it, to me was a very useful thing. So I think that communication looked at as a theory word used on a broader scale includes words, such as non-verbal, and also in each person a Downloaded by [New York University] at 04:57 12 August 2016 level of something that’s infl uencing communication that cannot be brought into awareness, a non-conscious aspect. And I think that how this is playing out is what Dan’s work and the Boston group’s work is giving us huge information about – the moment to moment aspects of this. The interdigitating intentions of trying to grasp hold of one another, of trying to regulate what we are doing with one another, while also trying to explore the meaning of the interaction and communication as well as the inferences that are being drawn, allow us a huge way of looking at a big puzzle. So when we think about what lasts and what fades, the signifi cance of listening and sensing into the world of others is not only what lasts. It is Freud and Kohut: What Lasts, What Fades 305

what orients and organizes us as self psychologists. And it can be done in all kinds of ways. For example, dance people do remarkable things in terms of being able to sense into the other by using motion and not words as a way of interconnecting. So there are many different ways, but that’s what we are about. I will conclude with another story and my story is this. Self psychology had gotten off the ground and a very exciting thing was being planned by Evie Schwaber and Sam Kaplan in Boston in 1980. A thousand people came. There was a book to be written about it, which Sam Kaplan and I co-edited from all of the people who were there. Of course Evie was there, Dan Stern was there, Beatrice Beebe was there, Ernie was there and I had the task of giving the fi rst case, an analytic case presented by a “self psychologist.” Well, this was a little bit weird because I had never been trained in Chicago, I had no supervision with Heinz, or anyone else in a direct sense. I had had a rather unusual self psychological analysis which was after three analyses, one of which was like a self psychology analysis with a candidate when I was a very young person, then a horrible experience with one of the world’s most famous analysts, and then another experience with a very good man, a fi ne, good, kind man whose oedipal interpretations were all right and whose good intentions towards me were always there. And he said, “get off the couch. You have graduated!” And so I had my merit badge and was now an analyst in the most classical institute in America, right here at the Baltimore Psychoanalytic. So I knew there was a lot of work to be done. Somebody gave me a book to read and write a review for a journal. The book was The Analysis of Self . I read the book and I said something I have never said about anything else I had reviewed. I said, “This is a classic.” And in the meantime not only was I gaining the information from the book, but I was doing a hell of a lot of very useful self analysis based on the stuff in the book. So in one sense I had a self psychology self analysis of sorts. I said to somebody, I think it was Evie, “Why me, given that there are all these people in Chicago, all of whom had the right background and the right credentials and I have none of the above?” She said, Downloaded by [New York University] at 04:57 12 August 2016 Well, that’s exactly the point. If you will be a part of it and if you say it’s worth doing, there are people outside of our group that might listen because you have the positions of prestige in the American Psychoanalytic and you have the sort of broader reputation.

So I swallowed and said “okay, okay.” I wrote up my case and I liked what I wrote. I felt I had something useful to say. And if anyone wants to read it, you can fi nd it in the book that we put out at the time (Lichtenberg and Kaplan, 1983 ). And I was sitting down 306 J.D. Lichtenberg

getting ready to go up and give my talk. I was sitting with my daughter Ann who is sitting over here now. I was sitting here, Ann was there, and Heinz was on the other side of Ann. And you know, I’m not generally anxious, very anxious. I can do this kind of thing. You can see I can get up here and talk. But I was terribly anxious. Because this was something … I didn’t know what the hell was going to happen given my lack of credentialed stuff. So, I get up and my daughter Ann who was emotionally very sensitive to me, picked up my affect, and it was very clear that she saw her daddy as being anxious and more so than usual. And Heinz leaned over, tapped her on the hand and said, “Don’t worry, don’t worry, your daddy will do just fi ne.” What lasts is that. What lasts is that Heinz picked up the emotion, saw it from within my state of mind, Ann’s state of mind, responded directly to that and just was there, at that moment, in that moment, just right, and I heard it with my ear as I was moving toward the podium and that was a very sustaining thing. What lasts is this. The Heinz Kohut that is in my mind, that I carry in my mind, is partly from out of a book. But the fi gure and the immediacy is from that moment; that man who picked that up. And so, what I carry in my mind, and I will tell you it’s what we carry in our minds about our own analysts, about our parents, and about our patients that matters. The patient in our mind is the one who is being treated as well as the one who is being treated that we are talking to. So the patient in my mind is me, from that experience was me, and the analyst in my mind was Heinz who made that very empathic comment. And it turned out that I stopped being so anxious, and I gave my talk. Ernie was one of the discus- sants and Ernie said, “Very nice case, it shows well how self psychology can work.” And the other discussant was Nick Treurniet who said, “Very nice case, shows exactly how a classical analyst works.” And so the tower of Babel was right there in front of us! Thank you all for listening.

Reference Lichtenberg , J. and Kaplan , S. (Eds.) ( 1983 ). Refl ections on Self Psychology . Hillsdale, NJ : The Analytic Press . Downloaded by [New York University] at 04:57 12 August 2016 EPILOGUE

Linda Gunsberg , Ph.D.

A full reading of this book and exposure to this psychoanalyst and man, Joseph D. Lichtenberg, offers us the opportunity to understand that psychoanalysis will always stay alive if the spirit of inquiry is the goal of treatment. As Joe has said, the spirit of inquiry is a co-created spirit of investigation that is at its best a collaboration and joint endeavor. It is not a skill, but rather it is an orientation or a way of being (Interviews with Joe Lichtenberg, this volume). If the analyst is capable of creating this kind of dialogue and open space between him/her and the patient, the patient over time will identify with the analyst’s excitement in a co-created spirit of inquiry. The capacity to open up thinking so that it remains creative, playful, fl exible, and not critical of either collaborator, promotes growth (Lichtenberg, 2009, 2013). This spirit of inquiry has been created by Joe with his patients, supervisees, friends, wife, colleagues, and collaborators, and with the issue editors at Psychoanalytic Inquiry. It also has guided his parenting and grandfa- therhood. According to Charlotte, “Joe is a very good father and is very good with children. They [the grandchildren] like to sit on his lap and talk”

Downloaded by [New York University] at 04:57 12 August 2016 (Charlotte Lichtenberg discussions, April 17–18, 2010). I know personally that talking with Joe never is boring, always leads to a new place, and is mutually created. I know that when I walk away from a conversation with him, I am revitalized and have the belief and conviction that I am perceived as a creative thinker and have even greater confi dence in my ability to think. If the spirit of psychoanalytic inquiry is the goal of treatment, such issues as when is the ideal time to terminate, whether the patient and analyst have the same expectations of the patient and of the treatment (Mitchell, 1993 ), and disappointment in the treatment, take a secondary place to the primary achievement, which is the ability to think creatively and collaboratively and gain hope that this ability will endure even after treatment ends, and with 308 L. Gunsberg

people other than one’s analyst. So the way I would like to look at “what lasts and what fades” is that what lasts is the spirit of inquiry and what fades are despair, hopelessness, and paralysis. I would also like to add to the beautiful metaphor of “what lasts and what fades” that which “emerges.” What emerges, in my view, is a sustained capacity for hope. Casement (1991 ) expresses the idea of unconscious hope needing to be contained by the analyst for the patient until the patient is ready to own it and take responsibility for it. That is, during the most troublesome and troubling times in treatment, the patient needs to immerse himself in despair. The experience of despair is diluted if the emotional experience of hope is also present. Thus, the analyst must be able to hold both the patient’s despair and the patient’s hope. A patient of mine has gone through such periods of despair that she has contemplated suicide, feeling that there is no reason to continue to live. She has been alienated from her children as a result of parental alienation1 which can become activated in a marriage and particularly at the point of separation and divorce. She has not seen or heard from her children for many years. Like others who have been parentally alienated, she makes the motions of living in the real world, but feels deadened inside as a result of such traumatic loss. There are times when I feel I do not know what to do or what to say. My silence at moments like these has signaled to her that it is her turn to take the lead. My silence gives her the space to resurrect some hope and actually develop new direction for her life even if she never sees her children again. Although these periods of movement are neither con- solidated nor continual, they are returned to more frequently than before. This raises the question of how she has experienced the treatment as being hopeful and helpful. To me, Casement (1991 ) offers the answer in that even at points when the analyst or therapist is herself feeling despair, holding the hope for the patient is also holding the hope for the treatment and for the therapist. Another patient who has been in and out of treatment with me for more than 30 years, leaves treatment and must remain out of treatment in order to prove to herself that she has improved. In order to achieve this, she avoids Downloaded by [New York University] at 04:57 12 August 2016 situations that have previously gotten her into trouble. As a result, her life, her thinking, and her ability to take in the world become severely restricted. Coming back into treatment numerous times can be understood that what she still is missing is the internalization of the spirit of inquiry. Until she feels she can grasp this and hold on to it on her own, she comes back because she needs to collaborate in this joint endeavor in a very real way until she begins to feel that she owns the spirit of inquiry and that no one can take it away from her. At this point, after coming back into treatment four or fi ve times, she now feels she possesses the capacity for the spirit of inquiry, and wants to go it alone. It is now something that is hers, that she owns, that she Epilogue 309

delights in. First, the patient needs to have a successful experience of inquiring together before inquiring on one’s own. She was convinced I possessed this spirit of inquiry. Her reluctance to own this herself was complicated by her fear that owning the capacity for the spirit of inquiry was inevitably associated with losing me. Sandy and I would like to thank Joe, Charlotte, George Hemphill, and all the contributors who have not only witnessed Joe’s spirit of inquiry, but have taken it in in their own personal ways. It is apparent that many of our contributors have been infl uenced by the hope generated in treatment as a result of this orientation towards inquiry in treatment. George Hemphill has commented on Joe’s spirit of inquiry in the world of art, sculpture, and photography. That is, the spirit of inquiry becomes the compass of one’s approach to life in general. All of us would like to thank Joe for this.

Note 1 Parental alienation involves a myriad of statements, activities, and behaviors on the part of one parent which serve to annihilate the good feelings the child feels towards the other parent. The child is not permitted to have two parents; rather, one parent prevails and the other parent is discarded. Children most vulnerable to these parental strategies are those who have not successfully negotiated the developmental tasks of the separation-individuation process.

References Casement , P. (1991 ). Unconscious Hope . In Learning from the Patient, pp. 293 – 307 . New York : Guilford Press. Lichtenberg , J. ( 2009 ). The (and This) Analyst’s Intentions. International Association of Relational Psychoanalysis and Psychotherapy, Madrid, Spain. Paper Presentation. Lichtenberg , J. (2013 ). Refl ections of My Career as a Psychoanalyst. Unpublished paper. Mitchell , S. (1993 ). The Dialectics of Hope. In Hope and Dread in Psychoanalysis , pp. 202 – 231 . New York : Basic Books . Downloaded by [New York University] at 04:57 12 August 2016 CONTRIBUTORS

Beatrice Beebe, Ph.D. has, for over 40 years, devoted herself to the study of mother–infant communication using video microanalysis. Her primary professional affi liation has been the New York State Psychiatric Institute, College of Physicians and Surgeons, Columbia University. Dr. Beebe has applied her research fi ndings particularly to the psychoanalytic treatment of adults. She teaches at various psychoanalytic institutes in New York City, was previously on the faculty of Ferkauf Graduate School, Department of Psychology, Yeshiva University (1976–1992), and independently trains lab assistants and Ph.D. dissertation students who have joined her research group.

Jay L. Bisgyer, M.D. (Retired) is formerly Clinical Associate Professor of Psychiatry, Georgetown University School of Medicine. He is Founding Member, Institute of Contemporary Psychotherapy in Psychoanalysis, Washington, D.C., and Faculty Member, Washington Center for Psychoanalysis.

Sidney J. Blatt, Ph.D. (Deceased) was Professor and Chief of the Psychology

Downloaded by [New York University] at 04:57 12 August 2016 Section of the Department of Psychiatry at Yale University (1963–2011). He conducted extensive research on personality development, psychological assessment, psychopathology, psychotherapeutic outcomes, and mental representation. He’s best known for his empirically supported theory of normal and pathological development involving two interdependent personality confi gurations of self–defi nition and relatedness. Dr. Blatt was a Visiting Fellow or Professor at a number of institutions including the Hebrew University of Jerusalem where he served as the Sigmund Freud Professor. He was the recipient of many awards including the Otto Weininger Award for Distinguished Contributions to Psychoanalysis. Contributors 311

Melvin Bornstein, M.D. is Training and Supervising Analyst, Michigan Psychoanalytic Institute, and Professor, Departments of Psychiatry and Neurosciences, Wayne State University. He is Editor of Psychoanalytic Inquiry.

Elizabeth M. Carr, APRN, MSN, BC is Founding Member and Director Emeritus, and Training and Supervising Analyst, Institute of Contemporary Psychotherapy and Psychoanalysis, Washington, D.C. She is also a Faculty Member, Minnesota Institute of Contemporary Psychotherapy and Psychoanalysis, and Associate Editor of Psychoanalytic Inquiry.

Diana Diamond, Ph.D. is Professor, Doctoral Program in Clinical Psychology, City University of New York. She is also Senior Fellow, Personality Disorders Institute, Weill Medical Center at Cornell University. Dr. Diamond is a major contributor to attachment theory research.

James L. Fosshage, Ph.D. is Past President, International Association for Psychoanalytic Self Psychology. He is Adjunct Clinical Professor of Psychology, New York University Postdoctoral Program in Psychotherapy and Psychoanalysis, where he was Co-Founder of the Relational Track. Dr. Fosshage is Co-Founder, Board Director, and Faculty and Supervisor, National Institute for the Psychotherapies, and Founding Faculty Member, Institute for the Psychoanalytic Study of Subjectivity, both in New York City.

Lawrence Friedman, M.D. is Clinical Professor of Psychiatry, Weill–Cornell Medical College. He is also Faculty, Institute for Psychoanalytic Education, New York University Medical School.

James S. Grotstein, M.D. (Deceased) was Clinical Professor of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles. He was Training and Supervising Analyst, New Center for Psychoanalysis, Los Angeles. Dr. Grotstein was a Member of the International Psychoanalytic Association and The American Psychoanalytic Association.

Downloaded by [New York University] at 04:57 12 August 2016 Linda Gunsberg, Ph.D. is a psychoanalyst and forensic expert. She is Founder and Chair, Family Law and Family Forensics Training Program, Washington Square Institute, New York City since 1997. Dr. Gunsberg is Co-Chair, Psychoanalysis and the Law Discussion Group, American Psychoanalytic Association. She is a Consulting Editor of Psychoanalytic Inquiry, and is Co-Editor and Contributor to two volumes, Fathers and Their Families , and A Handbook of Divorce and Custody .

George Hemphill is the owner of the art gallery Hemphill Fine Arts, Washington, D.C. 312 Contributors

Sandra G. Hershberg, M.D. is a psychoanalyst and adult and child psychiatrist. She is Director of Psychoanalytic Training, Founding Member, and Training and Supervising Analyst, Institute of Contemporary Psychotherapy and Psychoanalysis, Washington, D.C. Dr. Hershberg is Training and Supervising Analyst at the Washington Center for Psychoanalysis. She is an Associate Editor, International Journal of Psychoanalytic Self Psychology, and a Consulting Editor of Psychoanalytic Inquiry .

Alan Kindler, MBBS FRCP(C) (Deceased) was a Member, Institute for the Advancement of Self Psychology, Toronto, Canada, International Association of Psychoanalytic Self Psychology, Toronto Institute of Contemporary Psychoanalysis, Toronto Psychoanalytic Society, and Toronto Institute of Psychoanalysis.

Frank Lachmann, Ph.D. is Founding Faculty Member, Institute for the Psychoanalytic Study of Subjectivity. He is Adjunct Clinical Professor, New York University Postdoctoral Program in Psychotherapy and Psychoanalysis. Dr. Lachmann is an Honorary Member of the American Psychoanalytic Association, Vienna Circle for Self Psychology, and William Alanson White Institute.

Joseph D. Lichtenberg, M.D. is a major contributor to the fi eld of psychoanalysis in the areas of psychoanalytic technique, motivational systems theory, and the integration of infant observation and attachment theory with adult treatment. He is a Founding Member and Director Emeritus, Institute of Contemporary Psychotherapy and Psychoanalysis, Washington, D.C. Dr. Lichtenberg is Past President, International Association of Psychoanalytic Self Psychology, and Editor-in-Chief, Psychoanalytic Inquiry and Psychoanalytic Inquiry Book Series.

Russell Meares, M.D. is Professor Emeritus of Psychiatry, Sydney University, Sydney, Australia. He has served as Foundation President, Australian and New Zealand Association of Psychotherapy. Dr. Meares is Honorary Visiting Professor in Psychiatry, Westmead/Cumberland Hospital in Parramatta, Australia. He was awarded Distinguished Psychiatrist of the Year (2007), University of California, Los Angeles. Dr. Meares is Co-Founder with Robert Hobson of the Conversational

Downloaded by [New York University] at 04:57 12 August 2016 Model of Psychotherapy, and author of two books, Intimacy and Alienation and Metaphors of Play .

Rosemary Segalla, Ph.D. is Founding Member, Director Emeritus, and Consultant for Group Leadership, Institute of Contemporary Psychotherapy and Psychoanalysis, Washington, D.C. She is Faculty Member, Group Training Program, Washington School of Psychiatry, and Council Member, International Association of Psychoanalytic Self Psychology. Contributors 313

Estelle Shane, Ph.D. is Training and Supervising Analyst, and Faculty Member, Institute of Contemporary Psychoanalysis and The New Center for Psychoanalysis. She is also a Faculty Member, Department of Psychiatry, University of California, Los Angeles. Dr. Shane serves on the Editorial Board, International Journal of Psychoanalytic Self Psychology and is Consulting Editor of Psychoanalytic Inquiry . She is Past President, International Association of Psychoanalytic Self Psychology, and Advisory Board Member, International Association of Relational Psychoanalysis.

Judith Guss Teicholz, Ed.D. is Faculty and Supervising Analyst, Massachusetts Institute for Psychoanalysis. She was Clinical Instructor in Psychiatry and Psychology, Harvard Medical School at Massachusetts General Hospital (1997–1999). Dr. Teicholz is Editorial Board Member, International Journal of Psychoanalytic Self Psychology , and Reviewer, Psychoanalytic Dialogues.

Ernest Wolf, M.D. (Retired) is formerly Associate Professor, Department of Psychiatry, Northwestern University of Medicine, and Training and Supervising Analyst, Chicago Institute of Psychoanalysis.

Leon Wurmser, M.D. is a Training Analyst at The Contemporary Freudian Society, Washington, D.C. Downloaded by [New York University] at 04:57 12 August 2016 NAME INDEX

Note : Biographical information for Joseph D. Lichtenberg is in the Name Index while his psychoanalytical theories and approaches are in the Subject Index. Abraham, K. 212 , 215 Benoit, D. 244 Adland, M. 31 Beres, D. 7 Ainsworth, L. 30 Bergman, I. 242 Ainsworth, M. 30 , 190 , 252 Bergson, H.-L. 226 Alden, L.E. 240 , 242 Bernstein, L. 62 Alexander, F. 59 Bibring, G.L. 59 Ammaniti, M. 245 Bing, J. 22 Amsterdam, B. 227 Bion, W. R. 10 , 212 , 213 , 215 , Anderson, R. 24– 26 , 36 , 59 216 – 18 , 219 Andrews, H. 253 Bisgyer, J. xviii , 6 , 51 , 111 , 117 , 119 – 23 Angelou, M. 242 Bisgyer, L. 122 Aristotle 219 Blatt, S.J. xviii , 237 – 47 Arlow, J. 7 Blehar, M. 252 Arthur, A.R. 240 Block, D. 252 Arthur, H. 21– 22, 25 , 31 , 45 – 46 , Bollas, C. 190 50 , 58 , 96 Bornstein, M. xviii , 38 – 39 , 107 , Atwood, G. 191 – 92 132 – 36 , 228

Downloaded by [New York University] at 04:57 12 August 2016 Boss, P. 290 Bacal, H. 136, 201 Boston Change Process Study Group Badalamenti, A. 253 182 , 188 , 189 Bakermans-Kranenburg, M. 241 Boston, P. 290 Baldwin, J.M. 225 , 226 , 227 Bowen, M. 7 Barends, A.W. 243 Bowlby, J. 190, 213 , 215 , 237 , 252 , Barker, C. 243 254, 302 Barnard, D. 290 Brandchaft, B. 192 Barnett, L. 244 Brazelton, T. B. 224 , 250 Basch, M. 298 Brenk, K. 238 – 47 Bassler, M. 239 Brenner, C. 7 , 33 , 225 Beckh, K. 238 – 47 Breuer, J. 297 Beebe, B. xviii , 141 , 192 , 224 , 250 – 59 , Bringuier, J.-C. 225 267 , 300 , 305 Bristol, C. 26 , 147 , 297 Name Index 315

Brooks-Gunn, J. 227 Fosshage, J.L. xviii , 34 – 38 , 80 , 92 , Brown, K.J. 229 112 , 139 , 141 , 142 , 150 , 153 , 164 , Bruner, J. 188 187 – 97 , 204 , 237 , 245 , 250 , 282 Bruschweiler-Stern, N. 187 Fox, N.A. 255 Buchheim, A. 238 – 47 Fracasso, M. 254 Buechler, S. 146 Freud, A. 59 , 60 Freud, S. xviii-xix , 7 , 17 , 59 , 60 , Cader, G. 89 – 90 93 , 108, 120 , 132 , 133 , 135 , 138 , Card, J.A. 255 177 – 78 , 189 , 212 , 215 , 218 , 219 , Carlson, E. 252 297 – 98 , 300 , 303 Carlton, L. 282 Friedman, L. xviii , 51 , 175 – 86 , 204 Carr, E.M. xviii , 152 –58 Casement, P. 308 Gabbard, G. 59 Cassidy, J. 239, 252 , 254 Galler, F. 26 , 136 , 147 Charney, R. 227 Gardner, C. 244 Clarkin, J. 237, 241 , 245 Gardner, H. xvii–xviii Cohen, D. 255 Gedo, J. 44 Collins, R. 226 George, C. 239 , 245 Collins, W. 252 Gerson, S. 290 –91 Coombes, T. 223 Ghent, E. 190 , 191 Cooper, A. 59 Goldenson, R. 188 Cortina, M. 18 Goldwyn, R. 241 , 242 , 252 Crown, C. 253 , 254 Gordon, E. 229 Cue, K. 244 Gourevitch, S. 139 Gray, P. 26 , 29 Damasio, A. 219 , 220 Green, A. 290 – 91 Darwin, C. 225 Greenberg, J. 190, 191 Davis, M. 68 Grice, H.P. 241 De Wolff, M. 252 , 254 Groddeck, G.W. 219 Decety, J. 189 Groos, K. 225 Demarest, L. 117 , 119 , 120 Grossmann, K. 252 DeWald, P. 59 Grossmann, K.E. 252 Diamond, D. xviii, 237 – 47 Grotstein, J.S. xviii , 211 – 20 Dinger, U. 238– 47 Gruenthal, R. 18 Doctors, S. 204 Grünberg, K. 8 Dozier, M. 244 Gunsberg, L. xviii , xix , 3 , 124 – 25 , 285 – 92 , 307 – 9 Eames, V. 243 Guttmacher, M. 30 Edelman, G.M. 193 , 194 Egeland, B. 242 , 252 Hadley, J. 278 Ellman, L. 253 Halpern, J. 242

Downloaded by [New York University] at 04:57 12 August 2016 Emde, R. 133 , 224 Hamilton, C.E. 244 Erikson, E. 211 Harmann, H. 211 Erlbaum, L. 39 Harris, A. 55 Harrison, A. 187 Fairbairn, W.R.D. 189 , 213 , 214 – 15 Harter, S. 225 Fallot, R.D. 244 Hartmann, H. 7 , 121 Fearon, P. 243 Hatcher, R.L. 243 Feld, B. 18 Heimann, P. 216 Feldstein, S. 253 , 254 Helbraun, E. 253 Ferro, A. 10 Helm, F. 147 Finesinger, J. 6, 121 Hemphill, G. xviii , 165 – 72 Foelsch, P. 238 Hersh, E. 147 Fogel, G. 291 Hershberg, S.G. xvii–xix , 111 , Fonagy, P. 255 144 – 50 , 165 – 72 316 Name Index

Hesse, E. 241 , 242 Lewis, M. 227 Hilkert, F. 111 , 147 Leyendecker, B. 254 Hill, L. 24 , 31 , 107 – 8 , 121 , 122 Lichtenberg, C. ix , xvii , xviii , 22 , 31 , Horowitz, L.M. 240 44 , 52 , 62 , 75 , 80 – 83 , 84 – 5 , 90 , Hulme, T.E. 226 122 , 124 – 25 , 165 – 72 , 285 – 86 , 289 , 291 – 92 , 307 Inderbitzen, L. 26 Lichtenberg, J.D. x , xvii–xix ; adoption of Ann and Amy 63 – 66, 69 ; adoption Jacobwitz, D. 252 of William and Maryland (Ping Pao’s Jaffe, J. 253 , 254 children) 44 , 65 – 67 , 77 – 78 , 285 – 86 , James, W. 223, 225 , 226 , 227 289 , 291 – 92 ; ambition to go to Janet, P. 225 , 226 , 227 medical school 5– 6 ; analysis with Jasnow, M. 253 , 254 Russell Anderson 24 – 26, 59 , 103 ; Jones, S. 228 , 230 analysis with Helen Arthur 6 , 21 – 22 , Jung, C.G. 189 25 , 31 , 44 , 45 – 46 , 50 , 58 , 96 , 103 ; analysis with Hans Loewald 22 – 24, Kainer, R. 139 , 140 25 , 45 – 46 , 53 – 54 , 58 – 59 , 103 ; Kaplan, N. 239, 245 , 254 approach to background research Kaplan, S. 305 10 – 11 ; arrangements for interviews Katan, M. 59 , 60 xvii , xviii , 3 , 4 ; art collection of the Kaye, K. 227 Lichtenbergs 20 , 81 – 83 , 147 – 48 , Kelly, K.M. 241 165 – 72 ; at the Baltimore Institute Kemp, A.H. 229 129 ; Aunt Minnie (Mindelle) 13 , Kernberg, O. 8, 201 , 241 67 –71 , 72 ; being a grandparent Kindler, A. xviii , 36 , 99 –100 , 201– 6 78 – 79 ; changing views on being Klein, M. 8 , 10 , 138 , 212 , 215 – 16 , an analyst 96 – 98; childhood care 217 , 219 and support 12 – 16 , 52 , 85 – 86 ; Knoblauch, S. 253 collaboration with Joe Slap 32 ; Kohut, H. xviii–xix, 26 – 27 , 36 , collaboration with Lachmann and 120 – 22 , 138 – 39 , 190 , 195 , 201 , 204 , Fosshage 34 – 38 ; communication 205 , 229 – 30 , 252, 267 , 298 – 300 , of ideas 16 – 17 , 57 – 58 ; creativity 302 , 305 – 6 seminars 18 – 19 , 129 – 31 , 163 – 64 ; Kordy, H. 240 dealings with major fi gures in Koslowski, B. 250 the discipline 33 – 34; decision to Krauthauser, H. 239 become a psychoanalyst 5– 6 ; early Kris, Ernst 7 , 121 education 86 – 87 ; editorial direction of Psyc hoanalytic Inquiry xviii–xix, Lacan, J. 10 38 – 40 , 51 , 105 – 7 , 109 , 124 – 25 , Lachmann, F. xviii , 18 , 34 –38 , 80 , 133– 36 ; experience at Baltimore 92 , 112 , 139 , 141 , 142 , 150 , 153 , Institute 108 – 9 ; experience at medical 163 – 64, 187 – 88 , 190 , 191 , 192 , school 6 ; experience at Spring

Downloaded by [New York University] at 04:57 12 August 2016 194 , 197 , 204 , 237 , 245 , 250 – 59 , Grove state hospital 5 – 6 , 21 , 45 , 267 , 282 105 ; extended family 68 – 73 ; father Lamb, M. 254 (Samuel Lichtenberg) 72 , 73 – 74 , Lambrinidou, Y. 290 85 ; friendship and collaboration Lampl-de Groot, J. 59 with Ping Pao 22 , 29 – 32 , 44 , 77 – 78 ; Larson, D. 254 graduation as an analyst (1960) 25, Laub, D. 147 26 ; grandparents (maternal) 13 , 15 , Lazar, S. 147 16 , 22 – 23 , 24 , 46 – 50 , 59 , 67 , 69 , 70 , Leichsenring, F. 238 –47 74 , 75 – 76 , 102 , 124 ; grandparents Leitch, W. 88– 89 (paternal) 72 , 73 , 74 – 76 ; infl uence Levi, D. 147 of Kohut 26 – 27 ; infl uences from Lévi-Strauss, C. 216 own psychoanalyses 103 – 5 ; interest Levy, K.N. 237, 241 , 245 in literature 17 – 19 , 129 – 31 , 163 – 64 ; Name Index 317

Kohut Memorial Lecture (2005) Melkonian, D. 230 11 – 12 , 297 – 306 ; life as an only child Miller, J. 190, 194 12 – 16 , 50 – 52 ; marriage to Charlotte Mills, J. 237 , 241 xviii , 22 , 31 , 44 , 52 , 62 , 80 – 83 , 84 – 5 , Mitchell, S. 191 , 192 , 307 90 , 124 – 25 ; medical school 117 , Moraitis, G. 144 119 – 23 ; mother (Hortense Davis) 14 , Morgan, A. 187 15 , 68 , 69 , 70 – 71 , 76 , 83 – 85 ; Navy Mosher, P. 146 experience (1943–46) 5 , 6 – 7 , 15 , 62 , 87 – 89 , 119 – 20 ; non-suspicious clinical Nahum, J. 187 approach 112 – 13 ; on growing older Nolte, T. 238 – 47 79 – 80 ; on the traditional training Novey, S. 22 , 45 – 46 institutes 108 ; parents’ divorce 12 , 70 , 74 ; parents’ separate remarriages 53 ; O’Neill, E. 5, 61 , 129 photograph collection 20 , 147 – 48 , Ogden, T. 215 165 – 72 ; playing with ideas 8 – 10 , Olivieri, G. 229 12 ; questioning the prevailing ideas Olsen, C. 147 7 – 10 , 16 , 108 ; range of creative Orlay, W. 227 interests 163 – 64 ; reading Freud as Ornstein, A. 141 a teenager 5 ; religion 74 – 76 ; sailing Ornstein, P. 8 , 136 , 141 89 – 90 , 122 ; serendipitous situations Ottinger, E.A. 147 30 , 38 – 39 ; setting up the ICP&P xviii , 109 – 12 , 121 , 122 , 138 – 43 , 148 – 50 , Padron, E. 242 152 ; teaching approach 8 , 61 , 101 – 3 , Palmer, D. 229 152 – 58 ; things learned from patients Pao, P. 22 , 29 – 32 , 77 , 285 97 – 98 ; training at Baltimore Institute Papousek, H. 224 6 , 7 , 22 – 23 , 28 – 29 , 46 , 108 – 9 ; Uncle Papousek, M. 224 George 13 – 15 , 16 , 67 ; use of theater Parker, K.C. 244 metaphor 94 ; values transmission by Pasternack, S. 147 analysts 43 – 44 ; work routine 11 – 12 , Peduto, A. 229 16 – 17 ; working from home 41 – 43 ; Piaget, J. 178 , 183 , 225 – 26 , 229 writing as self-supervising 105 ; writing Pincus, A.L. 240 , 242 process 11 – 12 , 16 – 17 Pinker, S. 225 Liddell, B.J. 229 Plato 130 Lifton, B.J. 291 Potratz, B. 239 Loewald, H. 22 – 24, 25 Powers, N. 224 Loewenstein, R. 7 , 121 Pulver, S. 59 London, N. 136 Luria, A.R. 226 , 227 Reynoso, J. 241 Lyons-Ruth, K. 187 , 250 , 252 Richards, A. 146 Ricoeur, P. 177 , 180 Main, M. 190, 239 , 241 , 242 , 245 , 250 , Robbins, J. 253

Downloaded by [New York University] at 04:57 12 August 2016 252 , 253 , 254 Rossmann, G.I. 242 Malin, A. 141 , 277 , 282 Roth, A. 243 Malin, N. 141 Roth, T. 243 Manchen, Ä. 59 Rubino, G. 243 Margolis, M. 136 Ruby, P. 189 Markowitz, E. 28 Rustin, J, 253 Marquette, L. 253 Mayes, L. 255 Safran, J. 243 McDougall, W. 225 Sander, L. 133, 187 , 193 , 224 , 250 McLaughlin, F. 22 Sandler, J. 59 , 94 McLaughlin, J. 33 Sartre, J.-P. 228 Meares, R. xviii , 37 , 223 – 30 Schafer, R. 245 Meehan, K. 241 Schauenburg, H. 238 – 47 318 Name Index

Schepank, H. 240 Teicholz, J.G. xviii , 192 , 265 – 75 Scholmerich, A. 254 Thelen, E. 193 Schore, A. 230 Tolpin, M. 141, 190 , 194 Schwaber, E. 305 Tower, L. 59 Searles, H. 7 , 31 Tower, S. 22 , 23 , 26 Segal, H. 59 Towers, A. 290 Segalla, R. xviii , 18 , 110 – 12 , 138 – 43 , 148 Treurniet, N. 306 Selye, H. 120 Trevarthen, C. 224 , 228 , 253 Shane, E. xviii, 141 , 145 , 277 – 83 Tronick, E. 187 , 250 Shane, M. 141 , 145 Tuerk, I. 6 Shappard, B. 142 Tyrrell, C.L. 244 Siegel, D. 193 Silver, D. 133 Valsiner, J. 226 Silvers, D. 139 , 148 Van der Veer, R. 226 Silvio, J. 147 van IJzendoorn, M.H. 241 , 252 , 254 Slade, A. 244, 253 , 255 Vinar, M. 290 – 91 Slap, J. 32 , 60 , 81 Vygotsky, L. S. 183 , 226 , 227 Smith, H. 59 Smith, L. 193 Waelder, J. 59 Socarides, D. 36 Waelder, R. 59 Sorter, D. 18 , 253 Waelder-Hall, J. 34 , 55 Spinoza, B. 220 Wall, S. 252 Spitz, R. 28 , 254 Wallin, D. 237 , 255 – 57 , 258 , 259 Sroufe, A. 242 , 252 Wangh, M. 7 Stechler, G. 224 Waters, E. 244 , 252 Steele, H. 241, 252 , 255 Weber, M. 241 Steele, M. 241 , 252 , 255 Weigert, E. 146 Sterba, R. 33 – 34 Weston, B. 20 , 170 Stern, D.N. 33 , 133 , 187 , 224 , 226 , 250 , Whitehead, A.N. 226 251 , 253 , 298 , 300 , 301 , 304 , 305 Wiggins, J. S. 240 , 242 Stevenson, J. 229 Will, O. 7 , 31 Stolorow, R. 8 , 34 , 36 , 150 , 191 – 92 Williams, L. 229 Stovall-McClough, C. 237 , 245 Wine, B. 139 , 148 Strack, M. 238 –47 Winnicott, D.W. 213 , 219 , 228 , 290 Strauss, B. 240 Wolf, E. xviii , 6 , 36 , 51 , 117 – 18 , 119 , Sullivan, H.S. 7 , 107 , 191 120 , 121 , 141 , 299 , 305 , 306 Wurmser, L. xviii , 129 – 31 Tamis Le Monda, C. 228 Wyner, D. 18 Taylor, C. 226 Teague, G.B. 244 Yeomans, F.E. 246 Downloaded by [New York University] at 04:57 12 August 2016 SUBJECT INDEX

Note: Joseph D. Lichtenberg’s psychoanalytical theories and approaches are in the Subject Index while his biographical information is in the Name Index.

adaptation 211 253 – 54 ; infant attachment 252 – 53 ; adoption 125, 285 – 92 ; clinical vignette mother-infant communication (Rebecca) 286 – 89 , 290 – 92 ; dead 251 – 52 , 252 – 53 ; motivational third 290 – 91 models of attachment 189 – 90 ; styles Adult Attachment Interview (AAI) 239 , of attachment 255 – 59 240 – 42, 245 – 46 , 255 attachment patterns of therapists: affects 181 assessment instruments 239 – 40 ; aggression: and early experiences infl uence on the therapeutic 250 – 51 , 255 – 59 ; insights from infant relationship 237 – 47; Schauenberg research 250– 51 , 255 – 59 ; reactive study 238 – 47 ; signifi cance with and eruptive types 250 – 51 ; views severely disturbed patients 243 – 46 of 189 – 90 attachment theory: integrating with aggression-related psychopathology 255 dyadic systems theory 254 – 55 American Psychoanalytic Association autoerotism 212 , 214 , 215 – 16 , 218 – 19 144 , 146 autonomous psychoanalytic American Relational theorists 189 , 191 institutes 146 – 47 anal fi xation 213 aversive experience: vitalizing aspects

Downloaded by [New York University] at 04:57 12 August 2016 analyst: awareness of own biases of 157 – 58 55 – 56 ; infl uence of own gender 55 ; infl uence of personal experience behaviorist view of play 224 – 25 93 – 96 ; infl uence of theoretical Berkshire Psychoanalytic Institute 144 approach on outcomes 184 – 85 ; biological/behavioral systems main meaning of patient’s (Bowlby) 190 words and actions 176 , 180 – 82 ; bonding and attachment 214 transference 93– 94 brain systems: miscellaneousness of anorexia nervosa 220 176 , 177 – 80 art collection of the Lichtenbergs 20, British object relations theory 201 , 215 81 – 83 , 147 – 48 , 165 –72 attachment 183 ; and bonding 214 ; chaos theory 212 and caregiving motivational child therapy: clinical vignette system 237 ; and infant survival (Rebecca) 286 – 89 , 290 – 92 320 Subject Index

clinical infl uence of Lichtenberg’s ego psychology 7 – 8 , 9 , 17 , 26 , 129 , model: clinical vignette (Monty) 133 , 152 , 177 , 217 , 225 268 – 70 , 275 ; clinical vignette (Myles) empathy 148 270 – 75 ; clinical vignette (Jan) enacted metaphor 185 278 – 82 ; Estelle Shane 277 – 83 ; Judith enactment 176 , 180 , 185 Guss Teicholz 265 – 75 endopsychic structure 214 – 15 cognitive science 188 , 193 , 194 – 95 entelechy 219 – 20 collaboration and Joseph Lichtenberg: ethical mind xviii art collection with George Hemphill exploratory-assertive system: 165 – 72 ; as a supervisor 158 ; between non-verbal functioning 185 therapist and patient 242 – 43 , 253 , 307 ; in medical school 6 ; with face-to-face dyadic regulation Joe Slap 32 ; with Lachmann and 251 – 52 , 252 – 53 Fosshage 34– 38 , 92 , 141 , 163 – 64 , fantasies 182 187 – 88, 192 , 194 , 197 ; with Mel female psychopathology 133 Bornstein 127 ; with Ping Pao 29 – 30 , free association 253 31 – 32 ; with Rosemary Segalla Freudian theories: challenges to 138 110 – 12 ; with Russell Meares 227 – 29 friendship: with Jay Bisgyer 119 – 23 ; Committee for Nominating with Linda Gunsberg 124 – 25 ; with Supervising and Training Analysts Ernest Wolf 117 – 18 (CNSTA) 145 – 46 complexity theory 193 , 205 gender issues 55 – 56 conatus 220 General Adaptation Syndrome countertransference 93 , 176 , 237 (Selye) 120 couples therapy training at ICP&P 142 Global Severity Index (GSI) 239 , creating mind xviii 240 , 242 creative structures: creativity seminars group psychotherapy 139 ; training 18 – 19 , 129 – 31 , 163 – 64 ; development program 148 of Psychoanalytic Inquiry xviii–xix, 38 – 40 , 51 , 105 – 7 , 109 , 124 – 25 , habit-training 180 133 – 36 ; development of the Institute Helping Alliance Questionnaire of Contemporary Psychotherapy (HAQ) 239 and Psychoanalysis (ICP&P) hope: sustained capacity for 308 xviii , 109 – 12 , 121 , 122 , 138 – 43 , 148 – 50 , 152 ; development of the ICP&P see Institute of Contemporary psychoanalytic training program Psychotherapy and Psychoanalysis 141 – 42 , 144 – 50 ; supervision idealizing transference 23 , 27 of motivational systems theory imaginative play 228 – 29 learning 152– 58 implicit analytic relationship 187 – 88 infant development theory 133 , 185 , dead third 290– 91 211 – 20 ; bonding and attachment

Downloaded by [New York University] at 04:57 12 August 2016 death instinct 220 214 ; conatus 220 ; developmental depressive position 215 , 216 – 17 , 219 progression 213 ; developmental developmental motivation 189 , 190 , regression 213 ; effects of defective 194 – 95 , 196– 97 nurture 212 – 15 , 217 – 18 ; developmental psychology 153 endopsychic structure 214 – 15 ; Dialectical Behavior Therapy 243 entelechy 219 – 20 ; infantile envy 219 ; disciplined mind xvii primary object relatedness 213 – 15 ; disorganized attachment 156 – 57 role of play 223 – 30; second self 219 ; dream research 188 , 189 , 190 views of Freud 212 – 13 ; weaning drive theory (Freud) 189 , 190 , (actual and symbolic) 218 – 19 191 , 192 infant research 27 – 29 , 32 – 33 , 124 , 188 , dyadic systems theory: integrating with 190 , 193 – 95 , 202 – 3 ; and aggression attachment theory 254 – 55 in adult treatment 250 – 51 ; dying third 290 – 91 implications for adult psychotherapy Subject Index 321

255 – 59 ; infant attachment 252 – 53 ; mother-infant relationship insights for adult treatment 250 – 51 , 223 – 24 , 227 – 30 252 – 53 ; integrating attachment motivation, conceptual review 188 – 89 and dyadic systems theory 254 – 55 ; motivational systems theory 8 , 37 , 56 , maternal nurturing and infant 112 , 122 , 176 – 77 ; analyst’s view survival 253 – 54 ; mother-infant of the patient 177 – 80 ; attachment communication 251 – 52 , 253 – 54 and caregiving 237 – 38 ; contribution instinct theory 133 to psychoanalysis 195 – 96 , 202 – 6 ; Institute for the Study of Subjectivity, introducing to students 203 – 4 ; New York 147 patient’s main meaning 176 , 180 – 82 ; Institute of Contemporary seven motivational systems 153 , Psychoanalysis, Los Angeles 147 190 , 192 , 194 ; teaching of 152 – 58 ; Institute of Contemporary theory of therapeutic action 176 , Psychotherapy and Psychoanalysis 182 – 85 ; work of Lichtenberg, (ICP&P) xviii, 109 – 12 , 121 , Lachmann and Fosshage 187 – 88 , 122 , 152 ; birth of 138 –43 , 148 ; 190 , 192 , 194 , 197 couples therapy training program motivational theory: centrality in 142 ; founding principles 139 – 40 ; psychoanalysis 187 – 97 ; changing tides psychoanalytic training program in psychoanalysis 190 – 92 ; clinical 141 – 42 , 148 – 50 ; training programs illustration 196 – 97 ; conceptual review 141 – 42 , 148 – 50 of motivation 188 – 89 ; historical intention of the patient: defining review 189 – 90 ; recent developments 176 , 180 – 82 , 188 – 89 see also 193 – 95 ; relational turn 191 – 92 motivation International Association for narcissism 121 , 122 , 138 , 201 , 219 Psychoanalytic Self Psychology narcissistic injury 22 – 24 , 26 – 27 , 109 121 , 143 narrative self 228 – 29 interpersonal psychology 7 neo-Freudian motivational interpretive sequence 154 – 55 theory 189 – 90 intersubjectivity 8 , 148 , 150 , 191 – 92 , neuroscience 188 , 190 , 193 – 95 202 , 290 – 92 neurosurgery 121 intrapsychic confl icts 152 non-linear dynamic systems theory 193 intrapsychic model 192 Inventory of Interpersonal Problems object relations theory 133 , 201 , 215 – 16 (IIP) 239 , 240 , 242 Oedipus complex 211 , 212 , 214 – 16 oral fi xation 213 Kohut Memorial Lecture, 2005, by J.D. Lichtenberg 297– 306 paranoid-schizoid position 215 , 216 – 17 parental alienation 308 libido theory (Freud) 132 patient: analyst’s view of 177 – 80 ; coherence of recounted history 253 ;

Downloaded by [New York University] at 04:57 12 August 2016 main meaning of patient’s words and incentives to keep going 183 – 84 ; actions 176 , 180 – 82 main meaning of words and actions Massachusetts Institute for 176 , 180 – 83 ; self-analysis 57 ; striving Psychoanalysis, Boston 147 to grow 194 – 95 , 196 – 97 meta-cognition 253 Patient-Therapist Adult Attachment mind: Freud’s theory of 177 – 80 ; Interview (PT-AAI) 245 – 46 miscellaneousness of 176 , 177 – 80 ; penis envy 133 qualities required to thrive and lead photograph collection of the xvii–xviii Lichtenbergs 20, 147 – 48 , 165– 72 model scenes 163 , 178 , 203 physiological miscellany and unitary mother, death of, clinical vignette mind 177 – 80 (Rebecca) 286 – 89 , 290 – 92 play: and sense of self-cohesion mother-infant communication through the life span 229 – 30 ; 251 – 52 , 252 – 53 and the development of the self 322 Subject Index

223 – 24 , 225 – 27 , 229 – 30 ; and the self-analysis 26 – 27 ; by patients 57 mother-infant relationship 223 – 24 , self-cohesion through the life 227 – 30 ; behaviorist view 224 – 25 ; span 229 – 30 defi nitions 224 ; ego psychological selfobject experience 148 , 195 , 205 , 206 view 225 ; imaginative play 228 – 29 ; self psychology 8 – 9 , 23 , 121 , 133 , Lichtenberg’s thoughts on 223 – 30 ; 138 – 41 , 148 , 187 – 88 , 194 , symbolic play 224 , 226 , 227 , 228 – 29 ; 195 ; essentials of (Kindler’s therapeutic implications later in life List) 204 – 6 ; infl uence of Joseph 229 – 30 ; views and theories on 223 – 26 Lichtenberg 201 – 6 post-Kleinianism 217 self-realization motivational model 190 post-traumatic stress disorder 120 self-supervising 105 prefrontal lobotomy 121 Skype sessions 42 – 43 , 99 , 113 primary object relatedness 213 – 15 spirit of inquiry 307 – 9 process theory 282 –83 “Strange Situation” paradigm psychoanalysis: co-creation of (Ainsworth) 252 , 255 another infl uence 112 ; compared stress response 120 to psychotherapy 100 – 1 ; effects of subjectivity 133 inferences during 92 – 93 ; effects of supervision during psychoanalytic successes and failures 185 ; goals for training 98 – 100 , 101 – 5 , 152 – 58 54 – 55 ; history of 132 – 36 ; identifying supervisor role 98 – 100 , 101 – 5 emerging themes 155– 56 ; interpretive symbolic play 224 , 226 , 227 , 228 – 29 sequence 154 – 55 ; intrapsychic focus symptom checklist (SCL-90R) 239 , 96 ; issues that remain unresolved 240 , 242 91 – 92 ; Lichtenberg’s theoretical synthesizing mind xvii-xviii contributions 175 – 86 ; pluralism systems theory 188 , 190 , 193 , 194 – 95 of models 146 ; process of 92 – 96 ; treatment goals 92 theoretical contributions of Joseph Psychoanalytic Inquiry journal Lichtenberg 175 – 86 xviii–xix , 38 – 40 , 51 , 105 – 7 , 109 , therapeutic action theory: fi ve principles 124 – 25 , 133 – 36 176 , 182 –85 psychoanalytic training program therapeutic alliance: infl uence of 144 – 50 ; at ICP&P 141 – 42 ; alternative therapist’s attachment status 237 – 47 ICP&P model 148 – 50 ; dissatisfaction therapeutic relationships 187 – 88 with the traditional system 144 – 47 ; third/thirdness (in intersubjectivity founding of ICP/ICP&P 148 ; theory) 290 – 91 Members-in-Training 149 ; search for training analysts: evaluation and a new alternative 147 – 48 assessment process 144 – 47 psychobiography 61 training and supervising analyst role 149 psychological model of motivation training Institutes 144 (Jung) 189 transference 93 –94 , 184 , 237 psychosomatic medicine 120 Transference Focused Psychotherapy

Downloaded by [New York University] at 04:57 12 August 2016 psychotherapy compared to 243 , 245 psychoanalysis 100 – 1 transmuting internalization 201 – 2

refl ective functioning 253 unconscious 182 relational approaches in University of Maryland Medical School psychoanalysis 187 – 92 117 – 18 , 119 – 23 reporting Institutes 132 respectful mind xviii value judgments: transmission by analysts 43 – 44 second self 219 self: development through play 223 – 24, What Lasts, What Fades (Kohut 225 – 27, 229 – 30 ; meanings of Memorial Lecture by J.D. 226 – 27 ; positive sense of 196 – 97 Lichtenberg) 297 – 306 self-actualization model 189 writing as self-supervising 105