the Fall/Winter 2014 AMERICAN Volume 48, No . 4 PSYCHOANALYST Quarterly Magazine of The American Psychoanalytic Association
Forgotten INSIDE TAP…
Women Psychoanalysts at NYPSI National Meeting 1911–1961 in NYC...... 7 Special Section: Introduction Women Psychoanalysts at NYPSI. . . . . 1, 8 –9 Nellie L. Thompson
On March 11, 2014, during Women’s History Month, a panel was held at the New An Interview with York Psychoanalytic Society and Institute (NYPSI) to celebrate the lives and Bob Winer ...... 10 accomplishments of its early women members. During its first half-century women constituted 25 percent of the NYPSI membership and included such well-known Special Section: figures as Edith Jacobson, Margaret Mahler, Phyllis Greenacre, Annie Reich, Berta Bornstein, Bettina Warburg, Eleanor Galenson and Marianne Kris. The focus of the Psychoanalytic panel, however, was on three individuals, Margaret Fries, Lillian Malcove and Olga Perspectives Knopf, whose careers have receded from institutional memory over time. As Patricia on Greed. . . . . 12–19 Nachman details, Fries was an indefatigable pioneering researcher and child analyst, while O’Neil’s portrait of Malcove suggests that her art collection is a “text,” which may be read for both its personal and psychoanalytic resonances. I discuss Olga Knopf, Our Fabulous whose books reflect her unwavering belief in the equal rights of women. Fellows...... 24–26
The Story of Freud Victor Tausk’s Suicide by the International Uni- Olga Knopf and Tausk (Knopf, versity Press in 1983. Nellie L. Thompson 1969) was pub- In 1930 Knopf emigrated to the United lished, Olga States and published two books: The Art of Olga Knopf was born in Vienna in 1888, Knopf wrote a Being a Woman (Blue Ribbon Books, 1932), graduated from the University of Vienna Med- letter to Anna and Women on Their Own (Little, Brown, & ical School in 1916, and served as a field sur- Freud describing Company, 1935). Both are even-handed, geon in Bulgaria during WW I. After the war this meeting and sophisticated discussions of the educational, she specialized in gynecology and began work- a subsequent en- professional and social progress women had ing with Alfred Adler. It was as a gynecologist counter with H.L. made, tempered by an acknowledgment of that she came into contact with Victor Tausk, Olga Knopf several months the psychological barriers that may impede who brought his pregnant fiancée H.L. to her later, because she thought these contacts individual women. Knopf’s commitment to office in an effort to find a way to end her would shed light on Tausk’s suicide. Knopf’s the principle of equality is encapsulated in pregnancy. After Paul Roazen’s Brother Animal: letter was published in Kurt R. Eissler’s book, Continued on page 4
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 1 CONTENTS: Fall/Winter 2014 THE AMERICAN PSYCHOANALYTIC ASSOCIATION President: Mark Smaller 3 Membership and Recruitment: It’s About the Relationship President-Elect: Harriet Wolfe Mark D. Smaller Secretary: Ralph E. Fishkin Treasurer: William A. Myerson Executive Director: Dean K. Stein 4 Letters to the Editor A Path Forward, Part II: Institute Autonomy 5 THE AMERICAN PSYCHOANALYST Lee I. Ascherman and Elizabeth Brett Magazine of the American Psychoanalytic Association 7 2015 APsaA National Meeting Highlights Editor January 14–18 Christine C. Kieffer Janis Chester Film Editor SPECIAL SECTION Bruce H. Sklarew Women Psychoanalysts at NYPSI Special Section Editor Michael Slevin Margaret Fries Patricia Nachman Editorial Board 8 Vera J. Camden, Leslie Cummins, Phillip S. Freeman, Maxine Fenton Gann, Lillian Malcove Mary Kay O’Neil 9 Noreen Honeycutt, Sheri Butler Hunt, Laura Jensen, Navah Kaplan, 10 An Interview with Bob Winer: Nadine Levinson, A. Michele Morgan, Bruce Sklarew Julie Jaffee Nagel, Marie Rudden, Master Builder Creating Functioning Families Hinda Simon, Vaia Tsolas, Dean K. Stein, ex officio SPECIAL SECTION Senior Correspondent Psychoanalytic Perspectives on Greed Jane Walvoord Photographer 12 Introduction Michael Slevin Mervin Stewart Manuscript and Production Editors 12 Greed in the Business World Kerry J. Sulkowicz Michael and Helene Wolff, Technology Management Communications 14 The Constellation of Greed Salman Akhtar The American Psychoanalyst is published quar- terly. Subscriptions are provided automatically to The Analyst’s Greed: A Clinical Vignette Aisha Abbasi 16 members of The American Psychoanalytic Asso- ciation. For non-members, domestic and Cana- Greedy Patients Andrew B. Klafter dian subscription rates are $36 for individuals and 18 $80 for institutions. Outside the U.S. and Canada, rates are $56 for individuals and $100 for institu- Top 10 Misunderstandings about Psychoanalysis Lou Agosta tions. To subscribe to The American Psychoanalyst, 20 visit http://www.apsa.org/TAPSUB, or write TAP Subscriptions, The American Psychoanalytic 21 COPE: The Female Body Malkah Notman Association, 309 East 49th Street, New York, New York 10017; call 212-752-0450 x18 or 22 American Psychoanalytic Foundation Interview e-mail [email protected]. with a Filmmaker Linda R. Benson Copyright © 2014 The American Psychoanalytic Association. All rights reserved. No part of this APsaA’s Excellent New Fellows for 2014-2015 publication may be reproduced, stored in a 24 retrieval system, or transmitted in any form or by any means without the written permission of The Poetry: From the Unconscious Sheri Butler American Psychoanalytic Association, 309 East 27 49th Street, New York, New York 10017. Trailblazing Local Option: One Institute’s Experience Richard Tuch 28 ISSN 1052-7958 31 Changing World: The Shape and Use of Psychoanalytic The American Psychoanalytic Association does Tools Today Stefano Bolognini and Alexandra Billinghurst not hold itself responsible for statements made in The American Psychoanalyst by contributors or advertisers. Unless otherwise stated, material in The American Psychoanalyst does not reflect the endorsement, official attitude, or position of The Correspondence and letters to the editor should be sent to TAP editor, American Psychoanalytic Association or The Janis Chester, at [email protected]. American Psychoanalyst.
2 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 FROM THE PRESIDENT
First-Year Candidate APsaA membership: $30 Membership and Recruitment: Candidate registration at National Meeting: $190 (scholarships available for first meeting) It’s About the Relationship One night at the Waldorf for APsaA National Meeting: $269 Mark D. Smaller Taxi from LaGuardia, with tip: $35 On a recent experience and interests. In New York Starbucks Grande Latte: $4.30 September other words, he had utilized Making APsaA friends for life: Priceless morning I was his psychoanalytic expertise in walking up Mich- developing genuine relation- igan Avenue in ships (something we all do in our staff person in charge of membership Chicago on my our offices each day) with these newest mem- activity, reminds us our data show that if a way to meet bers of the psychoanalytic community. Develop- candidate comes to his and her first APsaA with first-year ing relationships with prospective students had meeting early on in their training, they end up candidates and facilitated their applying for and beginning psy- coming throughout the rest of their career. new students at choanalytic education. Paul matched their inter- Following Paul’s generous introduction, I Mark D. Smaller the Chicago ests and experiences with various programs at shared my recollection that I had little interest Institute for Psy- the institute: Students-At-Large, the two-year in APsaA as a first-year candidate. One day a choanalysis. While considering welcoming psychotherapy program, the Child and Adoles- faculty member asked me to substitute for him comments, it suddenly occurred to me that 25 cent Psychotherapy Program, or the traditional at a committee meeting at the New York years earlier on a sunny fall day I began my psychoanalytic track. Paul and other faculty meetings. Although uneasy, I had a “mission,” a analytic training. I recalled that first day of class members reached out, if not sought out, these reason to go to New York. Once there I met and my excitement. students and their psychoanalytic interests. other candidates from across the country. That excitement greeted me when I walked What a contrast to when I had applied in Together we formed a new Candidates’ Coun- into the conference room breakfast on this day. 1987, following the lawsuit that finally allowed cil that became what our Candidates’ Council I met new candidates and a large number of non-medical professionals access to psycho- is today. Many of those candidates I met for the students-at-large. I was immediately struck by analytic training at an APsaA affiliated institute. first time 25 years ago remain my closest the wide range of experience and background. At that time the atmosphere was more about friends and colleagues today. For example, two students had founded a psy- candidates accepting sometimes inflexible Joining APsaA, I suggested, would enrich chotherapy center, not on Michigan Avenue, “standards” of qualification and education. one’s psychoanalytic identity and career beyond but in a working class neighborhood in Chicago. Could or would we “accommodate” the huge the institute through scientific meetings, com- One graduate student from Egypt had coun- demands of psychoanalytic training? Would we mittee work, connection and friendships with seled prisoners while working on his doctorate. be “worthy” of acceptance, especially those colleagues. Knowledge of psychoanalytic edu- This diverse group included men, women, older, of us who were non-medical candidates? cation around the country would emerge, younger, social workers, psychiatrists, psycholo- Although that may have been the atmosphere along with the development of a national refer- gists, professional counselors and academics. in which I began my training, individual rela- ral network. APsaA provides outreach and A second-year candidate was there sharing tionships with teachers and supervisors were lobbying efforts in D.C. on behalf of our field, details on his new book. mostly welcoming, helpful and vital in my along with psychoanalytic social activism, the development as a psychoanalyst. latter having proved to be a foundation of my 25 YEARS LATER psychoanalytic career. As various presentations were given, other GENERATIVE EFFORTS The Executive Committee needs all your students began walking into the room where a Currently, under APsaA treasurer Bill Myer- help in recruiting. You, the membership, are class was to begin after the meeting. This hugely son’s able leadership, your Executive Commit- the best ambassadors and public relations for popular class was on neuroscience and psycho- tee, working with our Membership Committee psychoanalysis. Word of mouth recruiting analysis. How things had changed in 25 years! and the Candidates’ Council, is committed efforts through personal contact and mentor- Paul Hollinger, the outgoing dean at the Chi- to increasing our membership. Members are ing are key to our recruiting success. Merely cago Institute, with other faculty members have aging and we must be recruiting newer and informing students about membership and our succeeded in their recruiting efforts. As Paul younger members. This past fall, individual meetings in New York or San Francisco next introduced each student, he not only knew each members of the Executive Committee and June is not enough. name, but also each student’s background, Membership Committee, as well as officers of Personally inviting students to attend and the Candidates’ Council, met with new candi- participate in committee meetings and scientific dates from our institutes and centers across presentations is critical. Lunch and dinner invita- Mark D. Smaller, Ph.D., is president of the the country to encourage them to join our tions are essential to making new members feel American Psychoanalytic Association. organization. Debbie Steinke-Wardell, who is Continued on page 4
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 3
TH TO E E S D R I E T O T
R Olga Knopf T 2014
E
Continued from page 1 L her avowal that “there must be no restriction Accurate Attribution their personal views. There were also on the development of any capacity in I often rely on TAP for information numerous confusions and inaccuracies in women, no matter how little ‘feminine’ the letters about our organization, like upcoming the column by Lee Ascherman and Betsy resulting activity may seem.” meetings, conferences, and the achieve- Brett. Among them were: She wrote Women on Their Own because of ments of candidates and members. I enjoy 1. Their misuse of their self-defined her alarm at the worsening political situation reading the communications from the term “real institute choice” when a in Europe, where the rise of Fascism had president, the profiles of analysts, and the 2009 vote by the whole APsaA eradicated the progress of women in Ger- accounts of the work they do for our pro- membership has shown a majority many and Italy. While she did not envision the fession. Stories of creative outreach and in favor of actual institute choice. same threat to women in America, she felt it service in the community can be inspiring The Chicago Institute has recently was urgent that women take stock, pause and and instructive. I would be happy to hear decided that they can admit qualified analyze the lives they were leading, the prog- more about little-known aspects of candidates irrespective of whether ress they had made, and clarify their aims for APsaA’s history, the activities of inconspic- their analysts are TAs or not—a the future in order to protect and strengthen uous but crucial committees, and people’s locally-decided choice to meet their their progress. How Knopf’s views on women ideas about directions for our profession. community’s needs; influenced her clinical work is unknown, but What made me unhappy and prompted 2. An alarming suggestion to dismantle undoubtedly the realities of the outer world this letter was the column in the last issue APsaA’s advantageous Regional were present in her consulting room. that was headlined “From the Board on Association status in the IPA; and Towards the end of her life Knopf wrote Professional Standards” [See “From Fear, 3. Their apparent inability to accept a Successful Aging, published by Viking in 1975, Distrust and Loss: A Possible Path Forward,” reasonable compromise modeled on and a little known paper, “Sexual Assault: The TAP48/3, page 5]. From that headline, I the British Society’s “Live And Let Victim’s Psychology and Related Problems” in presumed that the article would include Live” arrangement of heterogeneous 1978 in The Mount Sinai Journal of Medicine. news of what our Fellows have been groups within one organization. It grew out of her participation in a research doing. I would also have expected any- I hope the editor reconsiders how project at Mount Sinai Hospital and School thing with that headline to represent the headlines are written and ensures that of Medicine whose aims were to understand whole of BOPS’s consensus about its con- all members have equal access to a bal- the myriad ways rape impacts on its victims tent and include some practical ideas anced presentation of all viewpoints in psychologically and to design ways of alleviat- about moving forward. TAP’s pages, without misassigned privilege ing the psychological trauma of rape. Instead our official organization news- from office. Olga Knopf died shortly before her 90th letter printed a position paper from two Kerry Kelly Novick birthday in 1978. The late Edward Joseph, a members misusing their offices to advance Ann Arbor, Michigan colleague from NYPSI, published an obituary of Knopf in the newsletter of the New York Psychoanalytic Society, whose closing lines Editor’s Note: Kerry Kelly Novick is correct. The BOPS column does not necessarily captured the essence of Knopf’s personality: reflect the position of the Board on Professional Standards. It is authored by the chair As a person, she was a fiercely inde- and secretary alone. In fact the column had previously been titled “From the BOPS Chair,” pendent woman with natural charm. and has returned to that title once again in this issue. Because it is a column, it is edited She had no hesitation in expressing as an opinion piece. her point of view and could accept disagreement as an inevitable part of the intellectual exchange in which she took such pleasure. Membership these students and check in with them about Continued from page 3 their training experiences and offer participation Nellie L. Thompson, Ph.D., is a historian opportunities at our upcoming meetings. and member of NYPSI, where she is the welcome and a real part of our Association and Our generative efforts are essential and a curator of the Archives and Special Collections our field. It’s about the relationship. part of what it means to be a psychoanalyst in of the A.A. Brill Library. She serves on the Following my remarks, a number of students the year 2014. A welcoming and encouraging Board of the Sigmund Freud Archives and asked for material about how to join, about what atmosphere locally and nationally can insure American Imago. social issues APsaA is addressing, and about train- the future of APsaA and our profession. Please Special Section continued on page 8 ing and related matters. I plan to follow up with join us in these efforts.
4 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 FROM THE BOPS CHAIR
Why not Live and Let Live? Why can’t our A Path Forward, Part II: institutes remain within APsaA with multiple sets of standards using IPA requirements Institute Autonomy as the minimum floorboard for all institutes? Lee I. Ascherman and Elizabeth Brett While at first glance the Live and Let Live proposal seems like the ultimate compro- In this column we continue our discussion of voluntary for those institutes and centers that mise, it has several serious flaws and unin- a proposal, now called “Institute Autonomy,” wish to have this accreditation. tended consequences. In Live and Let Live, that addresses our institutes’ longing for local APsaA would no longer have a role in APsaA, through its Board on Professional autonomy while preserving options for certifi- approving or regulating institutes. Our insti- Standards, maintains its role as the regulator cation and accreditation for those institutes that tutes would then have the same freedom as all of our institutes, attesting to the IPA that all want it. It would also preserve APsaA as a mem- other institutes in the U.S. Each institute’s rela- our member institutes follow IPA expecta- bership organization whose scientific meetings tionship with the International Psychoanalyti- tions, and imposing sanctions on those that and publications would continue, providing cal Association (IPA) would be voluntary and do not conform. This perpetuates APsaA’s the professional home we have all enjoyed. direct, as is the case for all other IPA institutes Board on Professional Standards as the Below you will find responses to a number of across the world. Each institute could also seek regulatory middleman between the IPA and questions we have received about this proposal. approval (not accreditation) from the newly the institutes, diluting direct communication We have also attempted to distinguish the externalized bodies previously functioning as between the institutes and the IPA. Live and Institute Autonomy proposal from what many COI and COCAA, but only if they wanted to Let Live also mandates that all institutes are have come to call “Live and Let Live.” do so. Similarly, with certification externalized, bound by the rules and regulations of one of any institute that wanted to promote certifi- the three IPA models. Many of our institutes A RADICAL PROPOSAL cation could do so, but no institute would be and members do not have sufficient knowl- This proposal is not Live and Let Live. It is forced to do so. Any individual who wanted edge of the expectations of these models so revolutionary it has even been deemed to seek certification could do so whether or and may find them no less encumbering or too radical by some of the very proponents not her or his institute encouraged it. disagreeable than our existing standards. In of Live and Let Live. This proposal endorses Below you will find responses to common Live and Let Live the Board on Professional the dissolution of the Board on Professional questions about this proposal. Standards remains the policeman for APsaA Standards as a regulatory body within APsaA. institutes, which must adopt a sanctioned The externalization of certification has Isn’t the Board on Professional Standards model, as a whole, whether or not the model already moved forward in planning. What is just saying if they can’t control standards, fits their circumstances. Ironically Institute now proposed is the externalization of func- they will leave? Autonomy provides far more tolerance of tions of key Board on Professional Standards No. The leaders of the Board on Professional institute differences than Live and Let Live, committees: the Committee on Institutes Standards recognize that our many institutes which demands conformity. (COI), the Committee on New Training Facil- have increasingly differing cultures, circum- Our proposal, Institute Autonomy, would ities (CNTF), and the Committee on Child stances and priorities. To give our institutes give our institutes full and true choice. Any and Adolescent Analysis (COCAA). the ultimate freedom to choose their way, institute could choose to follow all IPA These externalized entities will provide vol- APsaA must disengage from attempting to requirements for one of the three IPA mod- untary standards for psychoanalytic education enforce uniformity. This is Institute Autonomy. els or they could elect to become a free- while continuing to provide consultative ser- standing institute whose educational policies vices as requested to any institute or center, Why remove the educational body and focus reflect their circumstances and local needs. including those that may not adopt their rec- from APsaA? Don’t our institutes need a home? Their members could remain full participants ommended standards. Every institute would This proposal does not remove a collective in APsaA. Live and Let Live perpetuates the decide whether they want to voluntarily home for institutes to discuss educational Board on Professional Standards’ regulatory adhere to these standards. The Accreditation issues. It removes from that entity a regula- power and unwieldy task of overseeing their Council for Psychoanalytic Education Inc. tory role. The body that will be the heir to definition of acceptable standards. Lastly, (ACPE, Inc.) would remain the exclusive body the Board on Professional Standards can by keeping the educational standard-setting that accredits North American institutes. remain in APsaA as a creative forum to dis- body within the membership organization, ACPE, Inc. accreditation has always been cuss education, exchanging ideas and solu- the Live and Let Live proposal would main- tions to challenges. In this way, APsaA will be tain an organizational structure contrary to Lee I. Ascherman, M.D., is chair of like the European Psychoanalytic Federation modern best practice. All other modern the Board on Professional Standards, (EPF) and the Federacion Psicoanalitica de professional organizations have moved to and Elizabeth Brett, Ph.D., is secretary. America Latina (FEPAL). Continued on page 6
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 5
Institute Autonomy standard practice that externalized entities freedom to do so. Why should our institutes Continued from page 5 have a board of directors composed of be required to hold to any higher standards? members of the field and the public. Individu- The IPA expects each of its institutes to select externalize these functions so that the mem- als and training programs use what is offered one of three educational models and adhere bership organization is truly a membership on an entirely voluntary basis. An inherent to it, not mix and match. These models are the organization. By doing so, these modern principle of Institute Autonomy is the volun- Eitingon, French, and Uruguayan. APsaA insti- organizations are also in accord with Depart- tary basis of certification and the use of COI/ tutes are presently Eitingon, requiring four ment of Education requirements for the CNTF and COCAA functions, without times a week analyses and a training analyst separation of standard-setting bodies from demands to adhere to suggested standards. system. As long as the IPA requirements serve membership organizations in order to ensure This is analogous to ACPE, Inc. accreditation as the minimum floorboard for APsaA insti- their autonomy and protection from undue being entirely elective. Each institute would tutes, every APsaA institute would be required influence outside the public interest. choose what is useful to it. Individuals would to fully adhere to one of the three models. also choose whether certification is a cre- Models that do not require four times a week By externalizing certification and the functions dential they sufficiently value to pursue. analyses or a training analyst system have of the COI and COCAA, aren’t you just other requirements that may not be appealing recreating the Board on Professional Standards Some IPA institutes no longer require four but are expected. For example, the French outside of APsaA where members will not times a week analyses or a training analyst model expects candidates to complete their be able to control it? system. The Live and Let Live proposal analyses before matriculating, and a potential No. The credibility to the public of external- to use IPA requirements as the floorboard candidate does not have a guarantee of accep- ized credentialing and accreditation demands for minimum standards should be sufficient tance upon completing that analysis. The Uru- autonomy and protection from undue influ- to give those institutes who want greater guayan model has similar requirements. ence by any organization or group. It is flexibility regarding educational standards the Continued on page 23
6 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 National Meeting January 2015
The Child and Adolescent Panel, 2015 APsaA National which takes place on Saturday morn- ing, will invite the audience to think Meeting Highlights with several distinguished analysts and academicians about the devel- January 14–18 opment of intentionality and its Christine C. Kieffer importance to development in gen- eral. This panel, proposed by Molly Soon we will Mark Smaller Romer Witten, will feature (in addi- once again gather will address us tion to Witten) Arnold Modell, Phyl- at the Waldorf at the Presiden- lis Tyson and Alexandra Harrison. for APsaA’s tial Symposium National Meeting. on “Psychoanalysis and Diversity: A Means to GROUNDBREAKING PRESENTATIONS We hope you Move Forward.” As you can see, the range of In addition to large panels and plenaries, our will join us for a these sessions will enable us to look back to program will feature several other sessions conference that the past, look to the future, and also examine that will offer some groundbreaking papers promises to be what has been bedrock in psychoanalytic by leading psychoanalysts and professors and truly engaging, thought and practice. opportunities for audience participation. Christine C. Kieffer stimulating and Symposiums: First, there will be a sympo- lively—and will highlight many of the clinical, PANELS: A FRESH LOOK sium that highlights the work of Sherry Turkle: theoretical and socially relevant issues in our AT FUNDAMENTALS “Left to Our Devices: The Impact of Digital professional practice. Similarly, each large panel will explore an Conversation,” in which Turkle will assert that Having reviewed the January 2015 meet- aspect of a fundamental value of psychoana- technology affects “not just what we do but ing program, I am struck once again by the lytic thinking and work: who we are.” array of talent, expertise and capacity for Panel I, with Mitchell Wilson, Catalina William Myerson and Harriet Wolfe will innovation alongside respect for tradition Bronstein, Steven Cooper, Jay Greenberg and present a symposium that addresses the that is available to all who participate in this Lucy LaFarge, will examine how the analyst’s importance of applying psychoanalytic think- meeting. Be sure to examine the preliminary disappointment, grief and sense of limitation ing to organizations in crisis, including psycho- program that is bursting with plenary ses- affect the analytic process. analytic organizations. sions, panels, discussion groups, scientific Finally, there will be a symposium that will Panel II will focus on how collective trauma papers and the University Forum. We also offer perspectives on climate change and and transgenerational history play out in the are proud to offer programs of special inter- our psychological environment with speakers transferential field of the analytic relationship, est for candidates, students and trainees. that include Lynne Zeavin, Lindsay Clarkson, with contributions from Stephen Seligman, Here are a few of the many highlights to W. John Kress and Donald Moss. Orna Guralnik, Eyal Rozmarin, Dorothy anticipate. Innovations, organized by Bruce Sklarew, Holmes and Donald Moss. Plenaries: Adrienne Harris will be our ple- includes Joseph Lichtenberg and Peter Panel III, with Stanley Coen, Peter Gold- nary speaker on Friday morning, with an Loewenberg joining Sklarew in honoring berg, Aisha Abbasi, Rosemary Balsam and address on “’Language Is There to Bewilder Lucian Freud’s remarkable life and innovative Judith Yanof, asks the questions, “How Much Itself and Others: The Clinical and Theoretical artistic style. Needs to Change in an Analysis? And How Contributions of Sabina Spielrein.” On Friday And, of course, we can look forward to Do We Get There?” afternoon, Jonathan Lear will present a ple- such favorites as the University Forum and nary address on “The Fundamental Rule and Panel IV, “Three Analysts on Freud’s the many new and classic Discussion Groups the Fundamental Value of Psychoanalysis.” ‘Observation on Transference Love,’ ” includ- that are key ingredients of our conference, ing Ellen Pinsky, Peter Goldberg, Alison with opportunities for intimate engagement Phillips, and Sidney Phillips, reexamines the with psychoanalytic ideas as well as the phenomenon of the patient falling in love chance to meet new colleagues and enjoy Christine C. Kieffer, Ph.D., A.B.P.P., with the analyst, noting that this event is no reunions with old friends. APsaA Program Committee chair, is faculty less startling to contemporary analysts than it I urge you to explore the preliminary pro- at the Chicago Institute for Psychoanalysis was to Freud. gram and strongly recommend that you reg- and Rush University Medical School and It is noteworthy that each panel looks at ister early since many events fill up quickly. Medical Center in Chicago. She is in private crucial aspects of the interplay of the trans- I look forward to seeing you in New practice in Chicago and Winnetka. ference-countertransference field. York.
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 7 SPECIAL SECTION: WOMEN PSYCHOANALYSTS AT NYPSI
Continued from page 4 the pregnant mother-to-be. baby clinics where parents could Fries initiated a research proj- come for consultation, publishing Margaret Fries ect with pregnant women and many articles in popular maga- Patricia Nachman a follow-up of their children to zines on child rearing as well as test the hypothesis that a com- papers in pediatric, obstetric and Margaret Fries was a pioneer, even among bination of both maternal care psychoanalytic peer reviewed the small group of women in medicine in and the child’s constitution journals. She also initiated pro- the 1920s. From Barnard’s class of 1916, she accounted for the behavioral grams in schools to assist with progressed to medical school and a pediatric outcomes she observed in the child consultations, taught classes internship at the New York Infirmary for clinic. Her findings were on child development for teach- Women and Children. This internship sent her reported in “Behavioral Prob- ers, conducted seminars for law- into the homes of very poor families where lems of Children Under Three yers on divorce, the placement her interest in cultural and environmental Years of Age” in the Academy of Margaret Fries of children, and the psychological considerations developed as she sought to Pediatrics Journal, 1928. While the critical problems of prisoners. understand the total child within its family and importance of maternal care and its impact Fries also made a series of seven films, with community. After completing her pediatric on babies is recognized today, in the late 1920s the help of her husband, the photographer residency at Bellevue Hospital, Fries became and early 1930s it was only beginning to be Paul Woolf, to document the different interac- an attending physician at the New York Infir- appreciated. Behaviorism was at its peak and tions of mother-infant pairs as they related to mary, and eventually the director of the Pedi- the influence of B.F. Skinner was considerable. each other in everyday situations. Against the atric Service. During her tenure she became It was not until 1951 (20 years after Fries backdrop of the child’s culture and family engaged in research focused on children with began her work), that the World Health Orga- milieu, these films traced the child’s psychologi- psychiatric problems, and established a child nization published the groundbreaking Mater- cal and physical development over time. Fries’s guidance clinic in 1928 while working very nal Care and Mental Health by John Bowlby, interest in the role of culture in child rearing closely with Alfred Adler who introduced her which described the devastating effects of was reinforced by her correspondence and to the idea of the unconscious. maternal deprivation and emphasized that the friendship with the anthropologist Margaret Mead, and illustrated by two films on Navaho Margaret Fries was among one of the first psychoanalytic family traditions and child development she made with the Harvard anthropologist Clyde baby observers to use film for research and education. Kluckholn. Margaret Fries was among one of the first psychoanalytic baby observers to use PEDIATRICIAN TURNED infant needs to experience a warm, intimate film for research and education; followed by a PSYCHOANALYST and continuous relationship with the mother. group that includes Rene Spitz, the Robert- At this point the aim of preventing behav- Fries came to believe that psychoanalytic sons, Sylvia Brody, and Margaret Mahler. ioral problems in children became the focal training was necessary in order for her to Fries’s unwavering commitment to teach- point of Fries’s life work. She began a well gain a deeper understanding of the children ing psychoanalytic principles to parents, edu- baby clinic that provided support services and the families she was counseling. In 1930, cators, and those in the wider mental health to parents to improve their relationship with after 10 years at the New York Infirmary, community was matched by her unabashedly their babies. To her amazement she found Fries left for Vienna to undergo a personal vocal view that it was a failure in adult psy- that by a few months of age there was already analysis with Anna Freud. She treated a delin- choanalytic training that child analysis train- such an entrenched mutual patterning quent child under the supervision of August ing was not a requirement without which, between the mother and infant that an even Aichhorn, and Edith Sterba supervised her she argued, the adult patient could not be earlier intervention was needed beginning analysis of a child’s case. After returning from as effectively helped. Despite criticism from with the mother and neonate and then with Vienna, Fries completed the required course some of her psychoanalytic colleagues for work in child and adult analysis as well as her her “extra-analytic” activities, Margaret Fries own analytic treatment and became a mem- remained a forceful advocate for psychoanal- Patricia Nachman, Ph.D., is a member ber of NYPSI in 1939. ysis in her work with students, teachers, social of NYPSI, a child and adult psychoanalyst workers, pediatricians, lawyers and, above all, in private practice, the former director of REACHING BEYOND THE parents and children until her death in 1987. the Margaret Mahler Observational Nursery, CONSULTING ROOM Fries’s voice was strong and purposeful; the and former senior research scientist in the Fries became increasingly passionate and ring of her voice continues to be as true and Laboratory for Developmental Processes energetic in advancing her views on the impor- meaningful today as it was when she began headed by Daniel Stern. tant role of early intervention, establishing well her work over 90 years ago.
8 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 SPECIAL SECTION: WOMEN PSYCHOANALYSTS AT NYPSI
Selections from the collection were used Lillian Malcove to illustrate my speculations about her inner Mary Kay O’Neil world. An anthropomorphic head/amulet from the third millennium BC seemed to Lillian Malcove, a supervising and training represent man’s earliest attempts to protect analyst at NYPSI, was an avid art collector. himself, his family and possibly his tribe. This She amassed over 500 pieces of exquisite art head seemed a most fitting choice for a psy- from the Bronze Age, through the Medieval choanalyst. Family groups, such as a 1945 Period (primarily) to the Modern Era. It is Moore sculpture and funerary steles of chil- possible that the chosen era of her collection dren with parents, perhaps expressed an was guided by her inclination to explore underlying desire for the family she might man’s early history and her delight in detect- have wished for with Ormos. Families begin ing the source of her pieces. Drawing on with a relationship illustrated in Malcove’s Malcove’s personal life, her work as a psy- collection by a 1538 Lucas Cranach the Elder choanalyst and images from her collection, I painting of Adam and Eve. Other pieces may argue that Malcove’s choices as an art collec- Lillian Malcove represent her unconscious maternal wishes. tor, consciously and unconsciously, reflected For example, she collected icons that por- a deep wish to replace what she lost, a desire work of Margaret Fries (Psychoanalytic Study of trayed the tender bond between mother and to satisfy a relationship appetite and a need the Child, 1945). Renowned as a supervisor, in child. In one, Mary’s head is inclined toward to give to others. her third paper, she explored the supervisory the figure of the Christ child. She does not Malcove was born in Mogilev, on the experience in terms of the analyzing instru- look at him but her expression is introspec- Dnieper River, just outside Kiev, on June 8, ment and reflected her close association with tive not unlike the position and attitude of an 1902, the fifth child in a family of nine chil- Otto Isakower (Journal of the Philadelphia analyst towards her patient. dren, two of whom died in infancy. The family, Association for Psychoanalysis, 1975). Jewish within a Russian Orthodox culture, COMPENSATORY QUEST left Russia in May 1905 when Lillian was three INFLUENTIAL SUPERVISOR Beyond a deep wish to replace what she years old to escape pogroms and immigrated As a supervisor, Malcove focused on the had lost or missed in her life, a desire to to Winnipeg, Manitoba. Malcove, living with patient’s unconscious material and taught satisfy a relationship appetite and a need to her older sister due to family disagreements, the importance of tolerating uncertainty in give to others, there may be another deeper worked to put herself through medical clinical work. Several NYPSI psychoanalysts meaning to Malcove’s collection. Malcove school and graduated from the University of recounted how the experience of being died in 1981 at the age of 79. During her life Manitoba in 1925. supervised by her influenced them. Norman she endured the trauma of serious illness After recovering from tuberculosis, she Margolis described Malcove as his best super- (tuberculosis, encephalitis and, in the end, moved to New York to train in psychiatry and visor because she taught him “to find uncon- cancer), as well as painful personal loss. Mal- psychoanalysis. A Canadian pioneer, she grad- scious meaning in behavior”; Ted Jacobs noted cove’s collection seems to have been a way uated from the New York Psychoanalytic how in her restrained and quiet manner she for her to cope with trauma and loss. As well, Institute in 1933 and became a training and taught him to be “in touch with what was the collection demonstrates her interest in supervising analyst in 1939. For many years, unavailable to the patient and to wait because historical origins, a quest for beauty and her Malcove served on the educational committee analysis takes time and patience”; Francis human spirit. and taught the course on Universal Fantasies. Baudry commented that Malcove would “lis- It was important to Malcove that her col- She only wrote three papers: “Bodily Mutila- ten in a unique way to what was immediately lection remains intact. Why? Perhaps she tion and Learning to Eat” (The Psychoanalytic happening, replay the session and organize it was so identified with it that it came to rep- Quarterly, 1933) and a lengthy review of the as a gripping narrative about the patient’s self resent her self. She did not want her collec- and life.” tion—her self—to be fragmented. At her In 1937 Malcove married Laszlo Ormos, a death, Malcove’s generativity shone through Mary Kay O’Neil, Ph.D., is a supervising Hungarian director of documentary films, when she bequeathed the collection to the and training psychoanalyst with the Canadian who died in 1947 from a heart attack. There University of Toronto to remain intact for Institute of Psychoanalysis, representative were no children from the marriage, and others to learn from and to appreciate the on the IPA Board, formerly director of the after Ormos’s death, besides her clinical work history of art as well as its beauty, captured Quebec English Institute, member of the IPA and teaching, Malcove focused her energy in The Malcove Collection. (A Catalogue of the Publications Committee and editorial board on her art collection, which was shared with Objects in the Malcove Collection of the Uni- of the IJP. only her closest friends. versity of Toronto)
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 9 INTERVIEW WITH BOB WINER
BS: How did this unusual work develop An Interview with Bob Winer into creating innovative programs? BW: The first was a couple and family ther- Master Builder Creating Functioning Families apy training program mainly run by a group of Bruce Sklarew analysts at the Washington School of Psychiatry. Roger Shapiro was our mentor. I led this for BS: Bob, you crying if he was late coming home, fearing the more than 20 years, and it’s now part of our have been re- worst. And then, out of nowhere, one night center, run by Linda Grey, one of our graduates. sponsible for he fell to the bathroom floor and died. creating so many In my work with separating couples, I BS: Share some observations about your innovative pro- sometimes tell them it isn’t helpful to tell extensive work with couples and prognostic grams at the their children that even though their mommy indicators? Washington and daddy can’t live together, they’ll still be BW: My goal in couple work is to try to Center for Psy- their kids’ mommy and daddy, that won’t help each person get a better sense of his or choanalysis and change. It’s not helpful, because something her partner’s psychic reality. It’s not about fash- the Washington is being denied that needs to be acknowl- ioning points of agreement, it’s more about Bob Winer Psychoanalytic edged—the family is lost. I think my sense of trying to help them understand what moti- Institute. One motive for this interview is to family was desolated when my father died, vates the other. Becoming able to better men- promulgate your ideas nationally and even not through any of our faults. There was an talize the other’s experience goes a long way internationally. What got you interested in attempt to compensate with a big invest- in helping couples have a better life together. becoming a master builder? ment in our extended family, but it wasn’t In terms of prognosis, if a couple comes in BW: Two analyses later, I have some ideas the same. But I didn’t understand this for a a crisis, it’s usually possible to restore the sta- about this. The central story of my childhood very long time, and I’ve spent my life, time tus quo before the crisis. To go beyond that was that my father had rheumatic fever in the and again, trying to create families. is hard work and takes a lot of time. But the only situations that seem hopeless to me are those in which at least one member of the But I didn’t understand this for a very long time, and I’ve couple feels only contempt for the partner. spent my life, time and again, trying to create families. I’ve never seen that change.
BS: Where did your organizing take you days before penicillin. His heart valves gradu- BS: How did that contribute to creating next? ally rotted out, and it wouldn’t be unfair to new families? BW: With the encouragement of a cou- say he spent the first 11 years of my life dying. BW: In college in a course on mental ple of senior colleagues, I started a four-year Without my consciously knowing a thing health, I and a small group of classmates psychotherapy training program for clinicians, about that. I guess we were walking on thin spent four days living separately as patients which I ran, primarily in a three-year format, ice in the melting season. He went to work on wards of a state mental hospital (the kind for almost 30 years, abetted by a small loyal every day, but his youngest brother, a doctor, that had 2000 totally tranquilized chronic steering committee that stuck together all said by the end my dad couldn’t walk a block schizophrenic patients overseen by three that time. There had initially been significant without angina. I remember a family picture psychiatrists, one of whom spoke compe- resistance to its creation, a fear that it would in which my dad was grimacing. The toll on tent English). That experience empowered undermine the analytic enterprise, and it was my mother was tremendous. I remember her us to create one of the first halfway houses allowed to open on a very close vote. Many in America, Wellmet Project, and, while still of the students went into analysis and became undergraduates, we lived with patients analysts. A number of our current senior Bob Winer, M.D., a member of the from that hospital in this home. I ran it for institute faculty began their psychoanalytic Washington Center For Psychoanalysis, half a year and got my best grades that careers in this program. is co-chair of the Psychoanalytic Studies semester. It has expanded over the past 54 Program, of the Institute’s Curriculum years and functions in three houses in Cam- BS: How did your involvement in the insti- Committee, of New Directions, and bridge and Somerville today. During the tute’s management start? Close Attention. He is author of Close years after medical school, I started three BW: By now my colleagues had some Attention: A Relational View Of The group homes for people who would serious respect for me, and the head of our Therapeutic Process. become friends, the last on a 1600-acre Education Committee, Antoine Hani, made Bruce Sklarew, M.D., is the TAP film editor. estate outside Washington. Continued on page 11
10 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 INTERVIEW WITH BOB WINER me head of the Curriculum Committee, our And half the faculty complained about the BW: I worked with one of our research first appointment of a non-TA to a major supervisory and TA system: hierarchical, graduates, Marshall Alcorn, a professor in the Institute post. During my 12-year tenure, we clubby, corrupt, arbitrary, destructive. The English department at George Washington had a couple of important curriculum revi- cultural devaluation of psychoanalysis added University, to create a psychoanalytic studies sions, each of which took a few years to for- yet another layer. program for scholars. mulate, that moved the curriculum toward a I also created a psychoanalytic monthly pluralistic and integrative structure. We also BS: Did these people also have a particu- film series, based on the one run for perhaps added research study groups to the curricu- lar vulnerability to narcissistic wounds and 30 years now by Julio Szmuilowicz at the lum, and started a program of regular faculty/ feeling excluded? Toronto Psychoanalytic Society, with various candidate dinners. BW: I wouldn’t try to guess their psychol- film-buff colleagues chairing it each year. The rub was even with what I thought was ogies, but when half our analysts were feeling a really solid education to offer, we weren’t mistreated, it would have been a mistake for BS: How did your interest in writing about getting candidates. A senior colleague I really us to think this was their problem. To me, it film begin? admired suggested that maybe we had seemed to be an issue of consistent institu- BW: Like many other analytic writers, I become just a membership organization. I tional insensitivity. We accepted some peo- found it a way to explore ideas without being was upset to hear his willingness to surrender ple with reservations, we graduated some constrained by concerns about patient confi- on training. I thought it was what gave form with qualifications, we tended to see their dentiality. The Forum for the Psychoanalytic to the institute and without an educational difficulties as their personal problems. I think Study of Film, which you and Gene Gordon function we’d be a hollow vessel. I met with your question captures the tendency toward founded, gave me lots of public settings for pre- the heads of the Education Committee and arrogance that characterized some institutes’ sentations. At the time, much of the psychoan- the society, and I pushed. I raised one option, attitudes at that time. It’s changed a lot, both alytic writing about film took the form of seeing which was to leave APsaA and just be part of locally and nationally. what psychoanalysis could teach the film about the IPA, to allow us to get access to more We didn’t honor our own. As an example, what it was doing. This seemed reductive to potential candidates who didn’t want to leave our continuing education had for years con- me, operating from the position that we knew their current analyses. The society head sug- sisted of monthly dinner meetings at a hotel better what the film was really about than the gested that instead we set a really low fee for with an out-of-town guest speaker. We never director did. In my film writing, I’ve tried to see candidates’ analyses. When we brought both presented our work to each other. Fifteen what the film could teach me about the human ideas back to the Education Committee, the years ago, I initiated an annual colloquium, condition. Sometimes on the fifth or tenth vote was unanimous in favor of the low fee a daylong event at which faculty and candi- viewing I get a whole new set of ideas. option because they didn’t want to leave dates would present brief papers the group APsaA. And so, we got candidates, people would then discuss. Tom Goldman has been BS: Do you find revisiting a film similar to who never would have been able to afford overseeing the colloquium since its inception, finding more associations to the central idea analyses now could manage to train with us. and attendance has held up surprisingly well of a dream? But our faculty was drifting away. After over the years. BW: Either revisiting a dream, rethinking leaving the Curriculum Committee, I started a story my patient has told me, or trying to a Faculty Development Committee. Our first BS: Tell us about New Directions, beyond sort out again what has been happening project was to conduct in-depth interviews what Billie Pivnick wrote for TAP last year between us. In any of those contexts there’s with each of the 70 faculty members about [See “Writing Alone in the Presence of Others,” a continuing conversation that tries to their entire experience with the institute, from TAP 47/4, page 1]. expand the understanding. application, through candidacy, to the pres- BW: Sharon Alperovitz and I started the ent. The ones I did lasted three to six hours. New Directions psychoanalytic writing pro- BS: What operative methods did you Half were happy with their training and teach- gram 18 years ago, with a student class from develop for your programs? ing experiences, the other half had grievances. across the country. Three times a year about BW: In forming all these activities, I had a Surprisingly, many had had a key incident 50 students and 40 faculty meet to discuss few simple rules for myself. Be careful whom from which they had never really recovered psychoanalytic ideas on a given topic and to you recruit to administrate the program. The in terms of their affiliation with the institute. work on writing. We’ve worked with a few people have to be capable of taking initiative Half the respondents expressed concern hundred students, who have generated sub- and following through, and congenial to work about morale: We don’t connect with each stantial literature—papers, books, poetry— with. Having chosen them, trust them to do other, I don’t feel valued, it’s unfriendly with in a variety of genres. their jobs and don’t get in their way. And an in-group and an out-group, I feel like an never preempt them publicly, never feel you outsider, there’s no engagement or excite- BS: I know you’ve started some applied have to “introduce” them at a meeting, which ment, members disappear and nobody reacts. psychoanalytic programs. Continued on page 30
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 11 SPECIAL SECTION: PERSPECTIVES ON GREED
Psychoanalytic Perspectives on Greed
Introduction Michael Slevin
On greed in psychoanalysis. Freud famously broke out a cigar to celebrate a patient’s work on a dream, saying, when the patient protested there was yet more to be learned, “Don’t be greedy.” To this, a Chicago colleague said to me, “Freud just wanted a cigar.” Greed resonates as a pejorative, and relentless work can be productive. So where does one draw the line? Or, as Andrew Klafter turns it around, “What is wealth?” On the tip of many people’s tongues, when the word “greed” is spoken: rapacious Wall Street. However, in proposing a special section on the subject of “greed,” Salman Akhtar pointed out it has many Michael Slevin manifestations central to our work as psychotherapists and psychoanalysts. So he pulled together four authors, himself included, to address the subject in clinically-near contributions. After Akhtar opens up the word in its multiple meanings, Klafter writes about the patient’s greed, Aisha Abbasi presents a case about the analyst’s greed, and Kerry Sulkowicz offers a new take on greed in the business world. I hope you come away as stimulated and clinically thoughtful as I was.
Michael Slevin, M.A., M.S.W., a former TAP editor, graduated as academic associate from the Baltimore Washington Institute for Psychoanalysis, where he completed the Adult Psychotherapy Training Program. He works at Jewish Community Services of Baltimore and has a private practice.
EQUATING WORK Greed in the Business World WITH GREED Kerry J. Sulkowicz As a psychoanalyst who works in the busi- The business world has not cornered the research, for which one certainly ness world, I serve as market on greed. Those who are not inti- expects to be fairly paid but is rarely a confidant to CEOs, mately familiar with that world—including thought of as an expression of avarice. advising them on their most psychoanalysts—often assume that busi- Calling someone greedy is never a constantly evolving and ness is an inherently greedy endeavor. After compliment. It is pejorative and moral- ambiguous challenges, all, business is about making money, and isn’t istic, yet descriptive of an intense and including managing the Kerry J. Sulkowicz the overt quest for money inherently greedy? selfish desire for wealth or power. Ana- dynamics of their board This is in contrast to more seemingly noble lysts understand that these powerful urges and management team, as well as handling work, like helping patients or conducting often arise as compensation for unconscious their own emotional experiences in their feelings of emotional deprivation or loss, and roles as leaders. I am often as close as some are dynamically connected with feelings of of these people will ever get to psychoanal- Kerry J. Sulkowicz, M.D., a psychiatrist and envy. My purpose in this brief piece is not to ysis. While all businesspeople want to make psychoanalyst, is the founder and managing rehash well-trodden psychoanalytic formula- money, and generally believe that more is principal of the Boswell Group LLC, a tions about greed, but to examine its place in better, to assume they are all greedy would consulting firm based in New York. He advises the business world and to explore how our be an unfair projection of our own fantasies CEOs, boards and investors on psychological (mis)perceptions of greed may reflect back onto them. We sometimes equate work, in aspects of leadership in complex organizations. on our own profession. Continued on page 13
12 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 SPECIAL SECTION: PERSPECTIVES ON GREED which the end result is profit or in which a psychoanalytic society some years ago Another aspect of the business world that is unimaginably large sums of money are regu- about my work in the business world, one important for analysts to understand, and larly transacted, with greed, as though there analyst denounced the idea that this could enhance our empathy for those who live in it, are no other motivations for pursuing a life possibly be a form of applied psychoanalysis is that success in business, by definition, is mea- in business. and asserted instead that my work was akin sured by creating something of value. Many of This is a curious phenomenon, as most psy- to consorting with the devil, or worse, simi- the best and most successful business leaders choanalysts I know are open-minded and lar to the human experimentation con- are entrepreneurs passionately driven to cre- nonjudgmental about many other things. Yet ducted by Nazi doctors. My sense is that ate products or services that change the way the business world tends to remain rather this sort of criticism of psychoanalysts who we live or work, and the wealth this creates opaque to us, despite the fact that many consult to business has much less to do with for themselves and others is actually viewed psychoanalytic patients are in business (thus envy of perceived income inequality and as a secondary byproduct of their labors. enabling them to afford full fees), and most much more to do with envy of the freedom Executives and employees deeper inside orga- people work inside some kind of organization. to take a psychoanalytic perspective and nizations are constantly being evaluated and Analysts tend to be individualists and work apply it in some line of work outside the measured for their performance, and part of in solo practice, which leaves them rather confines of the traditional consulting room. the recognition they receive for their good baffled about what it is really like to work It also stems from a basic misunderstanding work is financial. But what matters to most of inside large organizations, which we also of what an applied psychoanalyst really does them, even more than money, is recognition assume are unfeeling, stifling bureaucracies. and the lack of training in family systems from their bosses and the feeling of belonging And we also tend to overlook the exis- theory, which is an essential tool in organiza- to a company of people they can identify with tence in the business world of what Alexis tional consulting. and take pride in. The best businesses are not de Tocqueville captured when he wrote of In any event, lest this sound like an unvar- driven by greed but by values. “enlightened self interest”—the idea of doing nished defense of the business world, I can In the wake of the financial crisis of 2008, well by doing good—which more accurately assure you that I do not see that world as free negative public perceptions of business in describes the motivations of many of my of greed and its close relative, corruption. general have largely been colored by percep- CEO clients. True, there is undoubtedly an Clearly that is not the case. Organizations are tions about Wall Street in particular, despite element of self-selection involved in my con- always greater than the sum of their parts, the fact that most businesses in the world are sulting practice, as the more narcissistic and and when corrupt individuals lead companies, not part of the financial industry, even if they therefore greedy or sociopathic ones would corporate cultures develop that are at least are dependent on it. Yet another misunder- never seek the services of a psychoanalyst, tacitly permissive of greed, if not actively standing among analysts about business- either as a consultant or a therapist. encouraging downright unethical and illegal people is that the philanthropy of wealthy The depiction of greed in Martin Scorse- behavior. Corporate cultures are the group- business executives can be reduced to reac- se’s recent film The Wolf of Wall Street con- scale analog of individual personality, an elu- tion formations against their guilt over their jures a prevalent caricature of business in sive yet highly useful concept that describes aggressive greediness. While this formulation popular culture, one that psychoanalysts may the consistent experience of being inside of, may apply to some, in my experience many be particularly vulnerable to believing. Psy- and interacting with, a particular organization. successful CEOs are far more emotionally choanalytic work at its best is profoundly Enron became one of the paradigmatic dedicated to doing good than they ever were generous, open-minded and helpful. But from examples of such a pernicious, greedy corpo- to the businesses that made them wealthy in the fundamental position of peering into the rate culture, and there have been countless the first place. private lives of others, the clinical encounter others in which otherwise ethical individuals In Oliver Stone’s 1987 film classic, Wall is a setup for the experience of envy, and for lose the ability to resist the unconscious pull Street, Michael Douglas’s character Gordon the distorting effects of hearing about busi- to identify with corrupt authority figures. Gekko declares, “Greed is good.” Greed is not ness exclusively through the narrow lens of But those same organizations also have good. But in emotional terms its development an individual patient’s experience, without within them other people who have the is an understandable response to certain the benefit of direct immersion into the emotional freedom and independence of early life experiences. It also turns out to be complex group dynamic system in which that mind (otherwise known as strength of char- exceedingly difficult to treat. Our awareness patient functions every day. acter) to either speak truth to power as of the psychological underpinnings of greed whistle-blowers or to protect themselves by provides valuable insights at a group level APPLIED PSYCHOANALYSIS leaving. And psychoanalysts may be uniquely that may allow us to have a greater impact Those few analysts who spend their time qualified to understand what leads some to on organizations and society at large than consulting to business leaders are often succumb to such intense group dynamic our work with those few greedy individuals tarred with the same brush as the business- pressures, while allowing others to resist this who are fortunate enough to make their way people themselves. When I gave a talk to magnetic attraction. to our consulting rooms.
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 13 SPECIAL SECTION: PERSPECTIVES ON GREED
The Constellation of Greed Salman Akhtar
Among the phenomenological morass, we open our fables told by eyes wider and discover what we call “greed” Aesop, the gifted is actually a complex set of affects, attitudes Greek story- and fantasies lumped together. teller of ancient The primary manifestation of greed is an times (circa 620 excessive and unrelenting desire to acquire BC) is the story and possess goods. Its excessive nature is of the farmer revealed by the fact that the quantity of who found a goods desired far surpasses actual need as goose that laid a well as by its exaggerated quality when com- Salman Akhtar golden egg each pared to the desires of others. Its unrelenting day. Initially jubilant at his good fortune, the nature is revealed by the fact that the indi- farmer soon felt unable to wait 24 hours for vidual afflicted by it is momentarily pleased the next egg to arrive. He imagined that the with the attainment of supplies and then goose had hundreds of eggs inside her but becomes unsatisfied, empty and inconsolable. was stingy in doling out the wealth. The While out of proportion with reality, desires farmer grew restless and wanted all the gold associated with greed are subjectively experi- fullness and cannot tolerate temporal gaps immediately. He cut the goose open but enced as “needs.” And, since psychic needs, as in the appearance of supplies; impatience is found no gold inside it. All that happened opposed to wishes, do not carry the burden the twin sister of avarice. was the goose died and the farmer lost the of intentionality, experiencing greedy desires Ingratitude is also a frequent accompani- daily nugget of riches that was assured to him. as needs confers upon them an aura of justi- ment of greed. Called the “marble-hearted In this brief tale, Aesop elegantly addressed fiability. Thus, entitlement comes to be a third fiend” by Shakespeare, ingratitude is, in the co-existence of enormous hunger, impa- feature of greed, along with excessive desire essence, a refusal to acknowledge that one tience, inconsolability, a defective sense of and inconsolability. has received goodness, love and material empathy, and ingratitude towards one’s bene- The realms in which greed can manifest supplies from others. No amount of indul- factors. It is this constellation of descriptive itself vary greatly. Food and money are the gence appears enough to the one incapable and dynamic features that are subsumed most prominent of these. Overeating that of gratitude. Inwardly measuring every favor under the rubric of greed. leaves one physically bloated but psychically against the “debt” owed to him due to child- The dictionary definition of greed is unsatisfied is a telltale sign of greed. Similarly, hood deprivation, such an individual remains “excessive and reprehensible acquisitive- an insatiable desire to amass wealth, regard- thankless to his benefactors. Constant yearn- ness.” The first qualifier, “excessive,” suggests less of its instinctual origins in oral acquisitive- ing for supplies leads to pushing others aside acquisitiveness is to be termed greed only ness or, as Otto Fenichel declared, in anal and losing contact with their needs and rights. after it exceeds a certain threshold but does retentiveness, gives evidence of greed as a This indifference to fellow human beings is not specify what that threshold is and how character trait. Sex is another area where the most likely the reason greed is deemed “rep- and by whom it has been set up. The second operation of greed is frequently discernible. rehensible.“ Moreover, such defective empa- qualifier, “reprehensible,” posits greed lacks Alongside the three primary features of thy has a boomerang effect insofar as others dignity, is perhaps immoral, and something to greed, i.e., excessive desire, inconsolability, gradually begin to avoid the greedy person. be looked down upon but does not reveal entitlement, exist certain other manifesta- He or she loses the respect of family mem- why greed deserves such derision. Left in a tions. Prominent among these are a con- bers and is ostracized. The resulting loneliness stant sense of hurry, ingratitude, defects of increases his insatiable need for love and empathy and corruption of superego func- materials goods. Salman Akhtar, M.D., is professor of tions. Hurrying is a frequent accompaniment psychiatry, Jefferson Medical College; training of greed, since to be able to wait means FOUR COMMON DEFENSES and supervising analyst, Psychoanalytic tolerating less-than-full states of body and Greed can be rendered unconscious by Center of Philadelphia; author of 72 books, mind. Waiting for supplies also implies taking defensive operations of the ego due to most recently, Sources of Suffering: Fear, turns, sharing with others, and believing in moral condemnation from within and/or due Greed, Guilt, Deception, Betrayal, and a less than magical regeneration of goods. to the need to safeguard a lofty self-image. Revenge (Karnac Books, 2014). The greedy individual insists upon sustained Continued on page 15
14 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 SPECIAL SECTION: PERSPECTIVES ON GREED
Four common defenses deployed against manifestation of greed. To the analyst’s efforts. Silence greed are repression, reaction formation, be sure, factors other than is found unbearable and splitting, and projective identification. By the greed (e.g., mental pain, speaking useless. In such an use of repression, longings felt to be greedy unbearable amounts of environment, the potential are sent into psychic exile, but hints of greed loneliness) can play an etio- for negative therapeutic continue to appear in parapraxes and dreams. logic role in such develop- reaction is great and the Moreover, the individual who has repressed ments but greed is often analyst might be better off his own greed feels exquisitely uncomfort- at their center. The same is focusing upon what did not able at encountering the attitude in others true of the patient’s hatred happen in the course of the and might even equate their healthy appe- of the analyst’s other patient’s development than tites with avarice. Reaction formation against patients; the analytic breast what did. greed can give rise to unrelenting generosity, is not allowed to feed any- which involves excessive and incessant giving one else. Needless to say, ANALYTIC GREED to others. the patient’s greed extracts It is also helpful to Another distortion occurs when self-rep- a heavy toll from the ana- remember the patient is resentations tinged with greed are held in lyst’s poise and patience. not alone in bringing the abeyance via the mechanism of vertical split- The risk of moral judgment becomes great hues of greed into the clinical situation. The ting. As a result, the individual alternately acts under such circumstances. This risk can only analyst contributes to it, too. An excessively out the contradictory attitudes of being be avoided if the analyst holds on to the austere style of intervening on the analyst’s greedy and being not greedy. He seems ratio- awareness that lurking behind the patient’s part can stoke the fires of greed in the nal and well regulated in his appetites and inconsolable hunger is the void of despera- patient. Such co-creation needs to be then, to everyone’s surprise, suddenly turns tion and feeling utterly unlovable. acknowledged, rectified, and then handled in greedy. Sequestered avarice of this sort can The hunger for more coupled with intense an interpretative manner. On a gross level, also undergo projective identification and oral aggression makes internalization and the analyst’s greed becomes evident via an lead to the perception of others being greedy. retention of good objects (including the ana- exorbitant fee, ostentatiously decorated When this happens, desires and demands of lyst) difficult. Prognosis is better for patients office, overly-packed clinical schedule, and others are looked at with suspicion; even if who are consciously aware of their greed refusal to consider retirement even upon those wishes are, in fact, realistic. At times, and can even muster a bit of self-reflective becoming old and infirm. Sadly, none of these attributes are rare among psychoanalysts and seem to have become more pervasive as …lurking behind the patient’s inconsolable hunger is the analytic patients become scarce, insurance companies shirk reimbursements, and the void of desperation and feeling utterly unlovable. monetary wellspring of academia dries up. On a subtler level, the analyst’s greed is stirred up in response to the patient’s seduc- others (especially the spouse and children) humor about their malady. Prognosis is worse tion, the idealization of interpretive prowess, are unconsciously manipulated to live out when the patient is oblivious to his greed and and from what I call “interpretive greed.” one’s own repudiated greed. Scorn and con- its destructive impact upon others. Analytic Dedicated to analytic work and idealizing of tempt can then be directed at them. The work in such cases has to continually oscillate interpretation as the centerpiece of his clini- deposition of one’s greedy self-representa- between affirmative and interpretive inter- cal enterprise, the analyst might interpret tion onto others can also result in uncanny ventions. On the former front, the analyst excessively, too deeply or prematurely. The empathy with their acquisitiveness and fear of must empathize with and validate the fact is the analyst has to make choices of not being devoured by them. patient’s agony and desperation. On the lat- only what to address in a session but also All this impacts upon the clinical situation. ter front, the analyst must point out the sado- of what to leave untouched. Such titration of Manifestations of the patient’s greed can be masochistic destructiveness in the patient’s dosage, timing and even the very offer of crude or subtle and include struggles over reducing his interventions to excrement: interpretation is what makes analytic work payment of fees, sensitivity to the slightest inert, offensive, and useless. Both maneuvers forever challenging. Adam Limentani’s quip lateness of the analyst, wishes for longer and are ultimately aimed at helping the patient that “psychoanalysis is an art and for this rea- more frequent sessions, and frequent con- transform his greed into appetite. However, son it needs discipline” is pertinent in this tact-seeking between appointments (e.g., by this work is not easy. The patient often mis- context. The art consists of both interpreting phone, email). Malignant erotic transference, construes overtures of validation and alliance and not interpreting. Interpretive appetite is with its characteristic coercive quality, also is a as throwing crumbs and mercilessly devalues good, analytic greed is not.
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 15 SPECIAL SECTION: PERSPECTIVES ON GREED
Mrs. B crossed the boundary from being rich The Analyst’s Greed: (which she already was, having inherited money from her parents’ estate) to being A Clinical Vignette independently wealthy. She had never been Aisha Abbasi interested in having children and said she had never regretted being childless. The Greed is a ubiquitous human phenome- incompetent at thought of looking after a constantly needy non. Since psychoanalysts are human beings, worst and me- little creature had been abhorrent to her, we too can feel greedy. Greed can be mani- diocre at best.” and she felt she would not have handled the fested in many ways. A young analyst with a She felt that situation well. Her husband had not objected family to support might feel greedy for none of them to this decision, stating that with all the trav- patients to bolster her income; a very senior had been able to eling he was required to do, it would be hard analyst might be greedy for patients and help her with her for him to be a father. supervisees, because her work with them lifelong recurrent Mrs. B said she struggled with an underly- fosters a feeling of being needed and having depression. Its ing sense of depression all the time, even something useful to give at a time in her life source was un- though she functioned well in many areas of Aisha Abbasi when much else is being lost. Analysts can clear to her, and her life. She wanted to take care of this sometimes feel greedy about making inter- medication had helped only temporarily. She problem before she got much older, because pretations in their haste to show the patient had been widowed for about seven years she had a sense that if left unaddressed, it what the analyst has understood about the and currently had a “gentleman friend” she would make old age (when other challenges patient (and to feel helpful and admired) enjoyed spending time with, but did not feel would come her way) even more difficult. whether or not the patient is ready to hear it. ready to make a major commitment. Her three previous analytic treatments had There are many examples of the manifesta- involved an analysis of seven years’ duration tion of greed by an analyst. Some are very FROM UNWANTED CHILD followed by two psychotherapies, at a fre- subtle, and there may be theoretical differ- TO INDEPENDENT WEALTH quency of two or three times a week, each ences about whether or not a particular Over time, Mrs. B revealed that her child- for four to six years. From her description, it stance or behavior on the analyst’s part hood had been marked by her mother’s seemed the treatments had largely focused should even be labeled greed. Some are postpartum depression after giving birth to on her feelings about her father’s frequent more overt, and most analysts would agree her. This had not happened after the births absences from her life and the pain of her that something was going on with the analyst of Mrs. B’s sister and two brothers, who mother’s disengagement. and in the analyst/patient dyad. I will describe were much older, ranging in age from 14 to I suggested that given the lifelong depres- a brief clinical vignette to illustrate my own 20 years her senior. Mrs. B suspected that sion she wanted to fully understand, her pre- sense of greed, as it manifested itself in my she had not been planned and had arrived vious treatment, and her wish to improve her work with a patient, and how I came to after her mother assumed she was done emotional understanding of herself an ana- understand it. having children. lytic treatment five times a week would be a Mrs. B* was an elegant, beautifully coiffed Mrs. B’s father had been a successful and useful way to proceed. She readily agreed, woman in her late fifties who came to see me innovative businessman, who was loving Continued on page 17 early one spring day, after returning from her toward the children when he was not out of winter home in Arizona. She had been given town for meetings or visiting the sites of his my name by her boyfriend’s analyst and had ongoing projects. Her older sister helped heard I was an “excellent analyst.” She needed look after her, as did a housekeeper who an excellent analyst, she said, because “so worked for the family during the week. Her many of the ones I’ve previously had were mother’s depression, lack of engagement, and subsequent difficulty in being able to attend to Mrs. B’s emotional needs, combined with Aisha Abbasi, M.D., is a training her father’s lack of physical presence, had left and supervising analyst at the Michigan scars on Mrs. B’s functioning. Psychoanalytic Institute and the current In her twenties she married a wealthy, president there. She is the author of somewhat older man who, like her father, The Rupture of Serenity: External was often away and, like her mother, was Intrusions and Psychoanalytic emotionally disengaged when physically Technique, (Karnac Books, 2014). present. When he died seven years earlier,
16 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 SPECIAL SECTION: PERSPECTIVES ON GREED saying that her gentleman friend (who had might be the only analyst who found analysis extremely helpful) had encour- could provide it. I was, in this aged her to consider it and that she was way, getting rather caught up eager to start. in a sense of my specialness and importance as her future THE CUSTOMARY FEE analyst, which was also unusual Then something unusual happened. As I for me. Intrigued by these began to discuss the treatment framework ideas, I decided to set her fee with her, it was easy to discuss matters at my usual rate and see what related to frequency, appointment times, my came up in the treatment and cancellation policy and vacations. However, in my mind. when I broached the fee I found myself in It did not take long for me a dilemma. As Mrs. B was very wealthy, I to discover that Mrs. B’s debated charging her more than my custom- beautifully composed external persona dis- most from their mother. The sister was 20 ary fee. At that point in my career, this had guised an internal self that felt damaged, ugly years her senior. I then realized that I had not never been a serious issue with any other and unwanted. She was hungry—indeed let myself put together, what I had heard patient, although many years later, I experi- greedy—for my time, attention and love, all from her at our initial meeting, about the ages enced a similar urge with a very wealthy male of which had been in scarce supply from her of all her siblings. It made sense that Mrs. B patient and could not sort out the determi- mother and father. This was something she would want to be 20 years older; this might nants of it on my own and sought consulta- had learned to hide from others during have given her the best her mother had to tion with a colleague. I generally worked her childhood, and it had not been fully offer, before other children came along, life within a certain fee range, and revised the expressed or deeply worked through during aged her, and depression claimed her few range every two to three years. I had heard her previous treatments. I keenly felt the emotional reserves. I was struck now by the from colleagues that if they treated an espe- yearning within her to have more, the sense curious “coincidence” that I had considered cially wealthy patient they raised the fee. that she deserved more, and her wish to be adding an extra $20 per session to her fee. Was this an example of how much we unconsciously understand about our patients, I had heard from colleagues that if they treated an and may express in an almost enacted form, before its meaning can be fully and con- especially wealthy patient they raised the fee. sciously felt, articulated and understood? In the vignette described above, I wanted to do something with my patient that I had Their reasoning was that for such a patient, very special to another person and, in par- never been tempted to before. I felt greedy the analyst’s customary fee might seem a ticular, to a person who was special in some in a way that was new for me. Against the mere pittance and have no major financial way (as she had expressed about me as an background of my particular life history, impact on the patient; treatment, therefore, analyst and as I experienced her and her and Mrs. B’s, and our individual vulnerabilities, would not be valued. I wondered whether wealth). I could feel this and understand it, we pulled at each other in ways that were my resistance to this approach was based on because I had felt something similar when I not immediately understandable. Initially, I reason or masochism, and decided that to had the urge to charge her an unusually high was only aware of the wish to charge her increase the high end of my fee range for a fee. My greed for her money now allowed more. It took me a while to understand that wealthy patient did not make sense and me to understand her greed for time, love she, on the other hand, had come to see me would be inauthentic. and specialness with me. It became clear to with the wish to have as much of me as pos- Why, then, was I feeling greedy about me that in my unusual thought of wanting sible, and then some. I believe it was in an money with Mrs. B? What did it mean that I more than the usual fee from her, I had been effort to ward off a realization of this “greed” wanted to raise the bar, just for her, by $20 a warding off awareness of her wanting more in her that I began to feel greedy in a con- session? And what was it about Mrs. B that than the usual analytic attention from me. crete way: a rather overt example of greed in had aroused my hitherto slumbering greed the analytic setting and the significance of try- about money with a patient? I also found A MEANINGFUL NUMBER ing to understand and contain it, rather than myself thinking that she had had three previ- At a much later period in her analysis, Mrs. act upon it. ous treatments, and had come to me with a B shared that she had always wished she very high opinion of my “excellence” as an could have been the first child in her family, *The patient’s identity has been masked to analyst. She would need a lot of help, and I like her sister, who had probably received the protect her privacy.
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 17 SPECIAL SECTION: PERSPECTIVES ON GREED
Greedy Patients “Who is wealthy? Andrew B. Klafter The one who is satisfied with his portion.” Melanie Klein, RELENTLESS PURSUIT in her famous OF MORE —Rabbi Simon Ben Zoma, conceptualization In the classical analytic Pirkei Avot 1:4 (second century) of envy, did not literature, early deprivation devote the same and/or an unsatisfactory level of attention resolution of the oral phase are implicated in and basic worth as a person. Patients with to the phenom- causing a lifelong inability to achieve a sense narcissistic problems are often also greedy in enon of greed. of satisfaction. This leads to a constant crav- their quest for accomplishments and achieve- While envy may ing for more—more money, more food, ments in order to compensate for an inner be more de- more clothing and more possessions. The sense of depletion and defectiveness. There- Andrew B. Klafter structive, greed developmental task of the oral stage is, largely, fore, they may be intensely driven for publica- is arguably more basic to the human condi- the person’s ability to come to terms with tions, awards, headlines or association with tion. The Merriam-Webster Dictionary defines the fact that he cannot have whatever he rich, powerful and famous people. greed as a selfish and excessive desire for wants, whenever he wants it. Therefore, seen more of something than is actually needed. through the lens of classical theory, greed can DESPERATE DEMANDS FOR LOVE All of us, at some point in our personal lives, be understood as an inadequately tamed Psychoanalytic authors of various eras have encountered greedy people. Robert expression of oral libido. and theoretical orientations have described Waska, in several psychoanalytic papers, The fundamental conundrum of greed is greed, normal and pathologic, in our desires has described the subjective experiences of that the emptiness and hunger that fuel greedy for love and affection. Sigmund Freud recog- relentless craving and emptiness in patients wishes are never satiated. After what is wished nized that our desires for love and affection who are consumed by greedy desires. for has been acquired, the same emptiness can be greedy. In discussing his treatment of In the consulting room, a variety of patients and hunger now stimulate a fear of losing what Dora, Freud described the sibling rivalry as a with various forms of psychopathology can has just been obtained. As a result, greedy form of “greed for love” in the sense that the present with insatiable, problematic greed. patients are reluctant to share with others. child resents having to share the affection They share a set of painful feelings associated They have trouble negotiating fairly, not just and attention of his or her parents with with their inability to achieve satisfaction and with professional colleagues but with friends other children in the family. Elizabeth Zetzel, a sense of desperation as they are perpetually and lovers. They may resent the analyst’s fees, in her well-known categorization of hyster- overwhelmed by their desires. There is no and indeed may resent spending money in ics, described patients who are incapable of single psychoanalytic formulation that can general. The advent of self-psychology pro- tolerating the fact the analyst has any rela- explain this common, complex human prob- vided a new framework for understanding tionships or meaningful connections with lem. Rather, each person’s unique unconscious greed. Wealth and material possessions in other people. In her opinion such patients fantasies, defensive styles and core conflicts, our society represent power and success. are unanalyzable. patterns of object relations, attachment styles, Therefore, patients who are narcissisti- Nearly 50 years later, our sense of who and self-representations must be considered cally vulnerable due to their depleted self- can be helped with analytic treatment has in order to arrive at an understanding of how representations often struggle with greedy greatly widened in scope. To the contrary, and why greedy desires have become a cen- desires. While they may superficially resemble most analysts would now see greediness and tral problem in their lives. A brief discussion patients who have difficulties with oral possessiveness in love relationships as a of three different manifestations of greed will regression, the underlying dynamics and fan- major life problem serious enough to war- illustrate the range of psychodynamics that tasies of narcissistically driven greed are dif- rant psychoanalytic treatment. When people mediate overwhelming, insatiable desires. ferent. Rather than coping with early physical cannot tolerate their lovers’ friendships or and material deprivation, narcissistic patients attachments to their family of origin, this Andrew B. Klafter, M.D., is a psychiatrist are dealing with a flimsy sense of intrinsic typically becomes a major source of distress and psychoanalyst in Cincinnati. He serves worth as a person. They seek validation and for everyone involved. Both borderline and on the teaching faculty of the Cincinnati admiration. Fine clothing, fancy cars and other hysterical patients can be extremely greedy Psychoanalytic Institute and University accoutrements of material success are in their attempts to forge enduring connec- of Cincinnati Residency Training Program. sought, not primarily for the intrinsic pleasure tions to their love objects, in their real lives He resides in Cincinnati with his wife and they provide but because they serve as rep- as well as with their analysts. Ronald Britton four daughters. resentations of one’s success, importance, Continued on page 19
18 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 SPECIAL SECTION: PERSPECTIVES ON GREED distinguishes between the greedy love hys- patients who are easily slighted, terical and borderline patients often express paranoid patients who feel attacked in the transference. In his view, hysterical and cheated, as well as patients deal- patients demand the total devotion of the ing with intense competitiveness analyst and will not tolerate the possibility and aggression. that the analyst has an erotic relationship Ultimately, patients with inordi- with anyone else in the world; borderline nate greed are suffering significantly patients demand a total, constant, unfaltering in various aspects of their lives due intersubjective merger and cannot tolerate to their inability to achieve a sense of any distractions or inconsistency in the ana- peace or satisfaction. They need our lyst’s attention or empathic understanding. understanding and deserve our pro- This subtle difference is important for the fessional expertise. analyst to understand as it signi- fies different forms of psychopa- thology calling for different types of interventions in treatment.
NECESSITY TO BE RIGHT I will briefly describe an addi- tional group of patients who, to my knowledge, has not been dis- cussed in the psychoanalytic liter- ature. I am referring to people who will not budge in any discus- sion or disagreement. They are greedy in that they refuse to ever concede a point, retract a position, rethink an opinion or acknowledge an opposing point of view may have merit. This includes individuals who are always more interested in winning a debate than enjoying a discus- sion or learning from someone with greater knowledge or a dif- ferent perspective. When people are greedy about their opinions and beliefs, even minor decisions about where to eat or what movie to see may lead to bitter- ness and resentment. A discus- sion between parents about how to handle an issue in the family, where both parents are moti- vated to do what is best for their children, may easily transform into a nasty argument. In my experi- ence, several very different per- sonality types may express this type of greed, including obsessive- compulsive patients who fear los- ing control, narcissistically sensitive
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 19 MISUNDERSTANDINGS ABOUT PSYCHOANALYSIS
up using psychoanalytic methods for treating Top 10 Misunderstandings war neuroses. The collapse of governments and the post WWI political and economic about Psychoanalysis chaos thwarted this vision. However, Freud went on to publish Beyond the Pleasure Prin- Lou Agosta ciple (1921) in which the mastery of trauma As a candidate Arnold Goldberg, Nathan Schlessinger and through the repetition compulsion was on at the Chicago Fred Robbins among others. the critical path to dealing with aggression Institute for Psy- and overcoming neurotic suffering. Given that choanalysis and 8. Psychoanalysis does not address our community is dealing with the return of an assistant pro- social issues such as gay rights, bullying, soldiers from two wars, psychoanalytic meth- fessor at the Illi- gender violence, and others. ods are more important than they have nois School of False. One of the few things about which ever been. Professional Psy- Freud never changed his mind was the essen- chology, I am tially bisexual nature of the human being. 5. Psychoanalysis has not progressed often approached Given the technical definition of “perversion” since Freud. Lou Agosta by members of as a developmental, pre-genital form of sexu- False. A short history of psychoanalysis the public or my students with the question, ality, it was not (and is not) a devaluing term, since Freud: Melanie Klein and Anna Freud “Why would anyone want to do psychoanaly- unless you have devaluation in your heart. ventured to learn about psychosocial sexual sis?” There are many misunderstandings of Get over it—we are all perverts now. development by talking with children rather psychoanalysis in the community. Therefore, I than theorizing. A diverse group of psycho- have written a document in response to the 7. Psychoanalysis is no longer the analysts, including Robert Fairbairn, Donald top 10 myths regarding psychoanalysis and therapy of choice given the advent W. Winnicott and Harry Guntrip, decided to hope TAP readers find it useful. of cognitive behavioral therapy (CBT). formulate human interactions in terms of False. CBT was developed by two psycho- relationships. Heinz Kohut proposed innova- 10. Psychoanalysis takes a long time. analysts, Albert Ellis and Aaron Beck, work- tions in strengthening the ego through trans- False. Freud’s shortest case, that of Katha- ing separately and at different times. CBT is formations of narcissism in treating the self rina (Freud 1893), was concluded in one day. effective due to those aspects of empathic and breakthroughs in forms of transference. His longest case lasted several years. There is listening and optimal responsiveness that room for individual variation here. Never was are the essence of psychoanalysis. If you read 4. Psychoanalysis is expensive. it truer that “your mileage may vary.” Beck carefully, the sessions are intended to It depends. One thing is definite. The most be training in CBT. That is, the work with the expensive approach is doing nothing about 9. Psychoanalysis is a movement; trainer is to teach the patient how to do personal, emotional suffering. It can cost a it is not evidence-based psychotherapy. CBT so that he or she can go back into their person a lifetime of satisfaction and fulfill- False, though it may be both. Psychoanaly- lives and apply the therapeutic distinctions, ment, do almost incalculable harm to entire sis is the father of psychodynamic psycho- reporting back periodically on the results. families, and damage whole communities therapy. Growing numbers of studies are Survivors of hard-core CBT often endorse through violence, substance abuse and providing robust empirical data support that the assessment: Absent a warm empathic lis- diverse antisocial behavior. As Freud wrote in psychodynamic methods, including psycho- tener, psychotherapy is often indistinguishable his Recommendations for Physicians Beginning analysis, are effective forms of therapy. Do from dental work—or CBT. Psychoanalysis, “Nothing in life is so expensive not let insurance companies push back as illness and stupidity.” without protest. See the works of Jonathan 6. Psychoanalysis does not treat trauma. Shedler, Barbara Milrod, David Orlinski, False. Freud’s first 18 patients experi- 3. Psychoanalysis is not the therapy enced sexual boundary violations, euphe- of choice, given psychotropic medications mistically called “seductions” in Victorian (e.g., Prozac). Lou Agosta, Ph.D., candidate and times, amongst the definitive causes of their False. In 1993 Peter Kramer published a psychotherapist in private practice in Chicago, neuroses. The decisive engagement with book entitled Listening to Prozac. This book teaches History of Psychology at Argosy trauma as a source of neurosis occurred knocked the knees out from under all forms University. He is author of Empathy in the during and after World War I, which pre- of talk therapy, without exception, and, as the Context of Philosophy (Palgrave 2010) and sented new horrors to civilians and soldiers. jewel in the crown, psychoanalysis perhaps A Rumor of Empathy (Routledge, forthcoming). An ambitious project was envisioned had more at stake and further to fall than most. See www.ListeningWithEmpathy.com whereby clinics and hospitals would be set Continued on page 27
20 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014
for closeness by fantasies of being inside her analyst’s COPE body. She also felt that closeness was more the emotions possible because as The Female Body that accompany women they shared Malkah Notman the memories. the same bodily con- So concepts figuration and sensa- The initial focus of the COPE Study Group such as “ugly” tions. At times she had the on the Female Body, integrating biological and and “strong” are fantasy that she and her psychoanalytic concepts, has developed into ideas, part of mother were in the same body. a more clinical project. We are interested in the mind, and Another patient recalled those individuals for whom the body serves as not only express memories of sexual abuse a way of experiencing and expressing memo- ideas about the by remembering physical sen- ries, affects, and relationships. We have been Malkah Notman body but also sations, which she then iden- identifying, describing and working to under- involve the neural circuitry that has to do tified as being the prickly stand patients for whom this is central. The with perception, memory and experiences. mustache of the abuser. body is often absent from clinical descriptions Recognizing the neural circuitry provides one Another patient did not at first understand that focus on the psychic reality and do not level of integration of the biological and her reluctance to brush her teeth, until it include somatic reality. We are considering the psychoanalytic. became clear that this was associated with whole body, not specifically the genitals. “Biological” contains many elements, includ- memories of oral sex. A broader concept that has evolved from ing circulatory, hormonal, neurological and ana- Many women change the shape of their our discussions is the concept of the “somatic tomical. Hormonal interactions also influence bodies to deal with sexual feelings or experi- self” as a characteristic that captures the the way we feel, and feelings influence hor- ences. Becoming fat avoids presenting oneself woman’s sense of herself and her body. We monal activity. In the group we have also con- as sexual or having sexual feelings. One patient are interested in the role a woman’s body sidered biological and psychological aspects of literally needed to create layers of fat so she plays in her self concept. The shape, size and important female body experiences, such as could begin to talk about a long and not openly functioning of the body also contribute to the pregnancy, menstruation, menopause, breast discussed history of sexual abuse. Body sensa- psychic reality. There is a reciprocal relationship development and breast augmentation. We tions contained the memories. Body feelings, between the effects of one’s self concept on have discussed the ways in which depression such as having legs that were heavy enough bodily functioning and the effect of the body’s affects female body functions. Infertility is an that they were touching served defensively. functioning on the sense of the self. For exam- example of a situation where the fact that Another patient, a successful professional ple, a self concept as strong, powerful or being the body is not functioning “as it should” has woman who was seen for many years, used identified with a particular parent can affect profound effects on self-esteem. It can create her body symptoms such as nausea to express posture—being “straight,” holding oneself tall, feelings of helplessness and failure, being affect, still needing the analyst’s help to recog- or being stooped or crouched. Size, athletic unable to fulfill a critical realization of female nize anger and panic. These patients are exam- ability, as well as being seen as beautiful, con- gender identity. Current knowledge attributes ples of people who have important somatic tribute to self-esteem. Particular characteristics about one-third of infertility problems to male components in their clinical presentation. also have meaning, such as eye and hair color. conditions, another third to female condi- We have considered the effects of acute and The representation of the body, the way tions, and one-third are either combined or chronic trauma. There is evidence that there one perceives oneself, is also determined by unknown. However, a woman may feel respon- are brain changes affecting sexual response the sensory processes of perception, the sible even if the problem is not primarily hers, in individuals who have experienced chronic visual, auditory and tactile sensations, and by since being able to reproduce is such an sexual abuse. memories, residues of one’s experiences and important part of a woman’s traditional and We are exploring ways of fulfilling the edu- historical role whether or not she actually cational mission of COPE. We thought about wants children at a particular time. developing a curriculum and a bibliography for Malkah Notman, M.D., graduate of Boston teaching about the actual physical body in clini- University School of Medicine, is clinical CASE PRESENTATIONS cal work. Our current plan is to describe several professor in psychiatry, Harvard Medical We have had a number of presentations of cases, including some that have been presented, School; faculty at Cambridge Health Alliance; patients for whom somatic issues were promi- accompanied by a bibliography related to the faculty and training and supervising nent. One patient had concrete fantasies about particular problem of each patient. We would psychoanalyst, Boston Psychoanalytic Society her analyst’s body, particularly her breasts. like to describe all aspects of the patient, psy- and Institute; and in private practice, These involved detailed daily observations of chological and somatic, and aim to integrate Brookline, Massachusetts. the analyst’s body and represented her wishes these into one coherent formulation.
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 21 INTERVIEW WITH A FILMMAKER
American Psychoanalytic Foundation Interview with a Filmmaker Linda R. Benson
Garrick Duck- was thinking both about my own analysis ler is a third-year and the clinical dilemmas I was faced with as candidate at the a relatively new clinician. I knew as an innova- San Francisco tor she would perhaps appreciate the nov- Center for Psy- elty of form, but I had no idea her response choanalysis, who would be so ebullient. She then encouraged received his MFT me to begin to think of making more with Garrick Duckler from the Wright the idea, as there would be more and more Institute and his “presenting problems” since film and new Ph.D. in English media were ways of keeping alive ideas and GD: I’m uncomfortable with the idea of language and lit- therapeutic dilemmas that, she felt, would “promoting psychoanalysis” as if psychoanaly- erature from the engage a broad array of thinkers, therapists, sis is something one could (or should) believe University of Chicago. Drawing upon his philosophers and teachers. in, like “promoting democracy.” It sounds like experience as both a college instructor and a good idea, of course, but can lend itself to mental health clinician, Duckler has written, LRB: When you started on “Presenting misuse and do a disservice to the sophistica- illustrated and narrated a unique set of short Problems,” did you have any thoughts about tion of what so many of the thinkers have films (hand-drawn animation and mixed the economics of putting a video together? worked so hard to preserve. If I’m doing any media) that present various psychological Did you consciously think about seeking out promoting, it is that psychic life (and the pur- dilemmas for discussion groups and class- grants? When did that occur? suit of what is considered therapeutic) is far rooms. I conducted this interview because GD: No, I didn’t have much of a sense of more complex and layered than most people his grant proposal to support this project how to fund, distribute, market or produce a consider, and that psychoanalysis provides impressed the American Psychoanalytic video. It was not my strength. Elisabeth was some important and interesting ways to cap- Foundation as the kind of innovation we wish very good, as she put it, at wearing various ture that complexity. The biggest expense by to encourage. hats. She ran a production company called far is time. Time not only in making the films Caversham Productions, which now sadly is but also in dissuading myself this is a pointless LRB: When did you first get the idea for no more because of her death. The films had endeavor in which I’ll just wind up illustrating your project “Presenting Problems”? What limited distribution through Caversham, but psychoanalytic concepts in some banal way was the turning point or moment when you in various ways, I am learning that side of that will defeat the whole tension between felt you were on to something? this venture along the way. The films have knowing and not knowing. GD: I didn’t make these films with the appeared in many festivals and have won sev- explicit purpose of using them in discussion eral awards, but there hasn’t been any out- LRB: You talk about your relationship to groups. At least initially, they were ways for right marketing plan of action, which would Elisabeth Young-Bruehl. How did you meet me to portray certain types of psychological probably be of enormous benefit, but writing, her? You sound like a “go-getter.” Do you struggles that didn’t fit neatly into a category drawing, doing voice over and all the editing think more could be done within the psycho- of anxiety, depression, or the like. I brought and shooting are a fair amount of work (on analytic community to mentor people with them to a former professor of mine whom I top of an analytic practice). I wasn’t aware of good ideas? If so what? Does creativity get had always felt a deep bond with, Elisabeth funding until I heard the APsaA foundation started on its own? Young-Bruehl. I wanted to show her how I was looking for new ways to get psychoanal- GD: The idea that I’m a go-getter makes ysis out to the public. I thought analytically me laugh. Of course, as an analyst, I am always minded films by an analyst who has taught curious about what we become in the eyes Linda R. Benson, M.A., has served on classes and has a background in literature had of others, so I will let that marinate. Although the board of the American Psychoanalytic a fair chance at helping in that regard. for anyone who knows me very well, that Foundation for four years. She is an term would not be very high on the list of independent writer who specializes in health LRB: Your proposal talks about finding a descriptors. I met Elisabeth at Wesleyan and medical topics, and teaches at Wayne new way of promoting psychoanalysis. What when she taught her yearlong Freud class. State University. is your biggest expense in doing this? Continued on page 23
22 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014
It changed my life. I have no doubt I would Institute Autonomy reluctant to relinquish the belief that one not be talking with you today if I had not Continued from page 6 group can determine and enforce standards taken that class from that particular person. for all and control these standards. I was very, very lucky to be in that class. Institute Autonomy offers institutes real Later in life, I did not seek her as a mentor. and complete choice without sanctions. Insti- We all have deep connections to APsaA I sought her as a thinker whose ideas and tutes will have the right to decide if they as a professional home. Why would we responses offered something no one else accept and choose to adhere to one of the support a proposal that diminishes APsaA? did. That I would even be thought of by her three IPA models. If the requirements of these Institute Autonomy will not diminish APsaA. as a mentee still blows my mind. Perhaps models are objectionable or threaten the sur- To the contrary, it will allow APsaA to thrive. that’s how she felt about Hannah Arendt, vival of an institute, that, institute can choose Freed from the acrimonious infighting over who was her mentor, but whatever the to be freestanding. Their decision need not standards that has drained our members’ case, it still fills my heart with a bizarre sense have any bearing as to whether their mem- energy and morale for decades, we can of gratitude and disbelief that I was ever bers can remain members of APsaA. Every return to a focus on the intellectual, profes- that close to her. I sought her reaction and APsaA member could continue to remain an sional and educational interests that brought wound up with her companionship. Again, APsaA member because APsaA will be a true us to the organization. APsaA will then incredibly fortunate. membership organization free of enforcing or become a true membership organization. imposing standards on any institute. LRB: Estimate how many organizations Won’t APsaA be diminished in its capacity or audiences you have had contact with in Won’t the loss of uniform standards return us to advocate and lobby for the profession showing this video. to the days of local politics and undue influence if the institutes are more independent? GD: I have shown the films to probably 15 related to faculty and career progression? Not at all. As a membership organization to17 different audiences, ranging in numbers Moving from a national system to one of APsaA’s power to advocate and lobby comes from 20 to over 200. The responses are my greater local autonomy does create risk for a from the vitality of its membership. Freed favorite part, of course, since that is the return to undue and unchecked influence on from our internal acrimony, our membership whole point. The films are, on some level, analytic careers based on local politics. It is will grow, our finances will be more secure, entertaining to see on your own but, in some a cost and risk of relinquishing agreed upon and our energies can be directed to the criti- ways, you would be missing out on what is and enforceable standards. However, those cal policy issues around which we can unite. importantly a collective experience. Once institutes using ACPE Inc. accreditation or one person raises a question, an idea or asso- participating in an elective commitment to CHANGE, LOSS AND ADAPTATION ciation, there is another and another. The other standards may find some opportunities We appreciate that the proposal for Insti- films I think appear simple but they are rather to balance unchecked local influence. tute Autonomy touches deep emotions. It dense and even though they’re short, the is difficult for many to trust that autonomy discussions tend to be long. Doesn’t APsaA need to define membership will not diminish our professional bonds and Analysts or analytically minded people by training standards? friendships or the sense of APsaA as our are my favorite viewers because they tend Ironically, this question has been voiced most professional home. Most of us have wanted to feel comfortable associating—to their loudly by some who insist that APsaA is and to believe that, like a good parent, APsaA patients, to their own clinical struggles. There should only be a membership organization. would take care of us, protect us, and keep have been many analysts who’ve used the They remind us that institutes are not mem- us uniform despite our anger and infighting. films in classes they’ve taught so that’s always bers although each institute pays a substantial It is a difficult idea to relinquish. However, intriguing. And many of whom want to now annual fee to APsaA. Any membership organi- growth always occurs when the dissolution make their own films, which I think is a tre- zation can set membership criteria however of an existing structure catalyzes movement mendous idea and I would love to help peo- its members choose. Membership does not to a new structure and improved adapta- ple develop their own presenting problems, need to be defined by one training model or tion. Increased autonomy of our institutes since in each of us there is such a distinctive its “substantial equivalent.” We already include will not diminish professional bonds and meeting place between our own histories, candidates and psychotherapy associates friendships. Nor should it in any way dimin- personalities and conflicts and those in the among our colleagues. Would we now exclude ish APsaA as our professional home. Freed patients we treat. It has been an absolute them because of differing backgrounds or from acrimony over the enforcement of a honor to hear from so many different peo- because they have not yet graduated? Those particular educational model, it will become ple. Their responses are truly the reward that who now oppose the dissolution of the Board a much better home. We are confident that will help me to continue developing new on Professional Standards and who want to with the autonomy inherent to the Institute forms to find ways of talking about all those keep regulation within APsaA using the Live Autonomy proposal, our institutes and things in us that don’t have names. and Let Live model may themselves be APsaA can thrive.
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 23 APsaA FELLOWS
APsaA’s Excellent New Fellows for 2014-2015
The American Psychoanalytic Association Fellowship Program is designed to offer additional knowledge of psychoanalysis to outstanding early-career mental health professionals and academics, the future leaders and educators in their fields. The 17 individuals who are selected as fellows each year have their expenses paid to attend the national meetings of the American Psychoanalytic Association during the fellowship year and to participate in other educational activities. The biographies below introduce this year’s excellent group of fellows. We enthusiastically welcome them to APsaA.
Claire Brickell, M.D., process of identity formation, especially with Christopher Csele- is a staff psychiatrist respect to gender and sexuality. Growing out nyi, M.D., Ph.D., is a at the Gunderson of her work in hospital settings, she is inter- child and adolescent Residence, a McLean ested in psychodynamic approaches to treat- psychiatry fellow at Hospital-affiliated res- ment for complex trauma and for psychosis. Columbia and Cornell idential program for She is co-author, with Steven Tuber of Starting Universities, and he is the intensive treatment Treatment with Children and Adolescents a Leon Levy research of women with border- (Routledge, 2011); winner of the White Insti- fellow at Columbia Claire Brickell Christopher Cselenyi line personality disorder. tute Case Presentation Award; and co-orga- University, where he She provides individual, group, and family ther- nizer of Choice and Abundance, a conference studies dopamine signaling in the laboratory apy and medication management. She partici- at the White Institute. of Jonathan Javitch. With undergraduate pates in the Mentalization Based Treatment majors in English and biochemistry at the Training Program and the Program in Psycho- Justin Chen, M.D., University of Miami, he wrote his thesis on dynamics. Brickell received her undergraduate M.P.H., is a psychia- epic simile and developed biophysical meth- degree in molecular biology from Yale Univer- trist at Massachusetts ods to study DNA damage and repair. He sity and studied medicine at Harvard Medical General Hospital and earned his M.D./Ph.D. degrees at Vanderbilt School, where she had the opportunity to instructor at Harvard University, where he won awards for “most complete multiple international rotations in Medical School. He progress in clinical psychiatry” and “most Africa and South America. She completed an received his undergrad- outstanding Ph.D. training accomplishments.” adult psychiatry residency and a fellowship in uate degree in molecu- He then completed his adult psychiatry Justin Chen child and adolescent psychiatry at MGH/ lar biophysics and residency at Columbia University, where he McLean Hospital, where she was proud to biochemistry and literature from Yale, with a developed a passion for psychodynamic psy- have cofounded the first outpatient interper- focus on German/English Romanticism. Fol- chotherapy. Cselenyi hopes to use psychody- sonal group for adolescents at MGH. lowing a year of immunology research in namic perspectives to enrich and deepen his Germany as a Fulbright Scholar, he enrolled work with patients and in the laboratory. Jane Caflisch, Ph.D., at Yale Medical School. Chen completed his is a postdoctoral fellow residency training at MGH/McLean, where Katharine Baratz at Columbia University he served as MGH outpatient chief resident Dalke, M.D., M.B.E., is a Counseling and Psy- and developed a strong interest in cross-cul- chief resident in psychi- chological Services. She tural psychiatry, pursuing electives in Shang- atry at the Hospital of received her doctorate hai, Taipei, and Fukushima. Since then, he the University of Penn- in clinical psychology completed his M.P.H. at Harvard, focusing on sylvania. After graduat- from the City Univer- stigma among depressed Chinese-Americans ing magna cum laude in Jane Caflisch sity of New York and in primary care, and became co-chair of classical literature and Katharine Baratz Dalke her bachelor’s degree from Harvard Univer- MGH’s Psychodynamic Psychotherapy Case Latin from Haverford sity, where she studied religion and medical Conference Steering Committee. He is inter- College, she earned her M.D. and master’s anthropology. Her research investigates the ested in exploring cultural considerations in in bioethics from the Perelman School of roles of fluidity, loss and mourning in the psychodynamically oriented treatment. Medicine at the University of Pennsylvania. Continued on page 25
24 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 APsaA FELLOWS
Her clinical and academic interests include Cole Hooley, M.S.W., Benjamin Ogden, using individual and group psychodynamic is director of Social Ph.D., holds a degree in psychotherapy as well as psychopharmacol- Work and Counseling literature from Rutgers ogy to care for and support people with vari- Services for Harlem Vil- University. His research ant gender and sexuality. She has participated lage Academies. He is interests include 20th as an advocate for individuals with intersex a lecturer at Columbia century fiction, global traits and their families in publications, con- University School for literature, post-apart- ferences and national media. In addition to Social Work and a clini- heid South African lit- Cole Hooley Benjamin Ogden clinical care, Dalke is involved in medical edu- cal instructor at Smith erature, stylistics and cation and has been recognized with multiple College School for Social Work. He received linguistic criticism, psychoanalysis, and the craft teaching awards. his B.S. in social work from Brigham Young of writing. His work currently focuses on the University and his M.S.W. from Smith Col- importance of mystery to literature and psy- Benjamin Y. Fong, Ph.D., is a Harper Fellow lege School for Social Work. He is beginning choanalysis. Ogden has published widely on at the University of Chicago. He received his his fourth year in the Child and Adolescent 20th century literature, including articles on Ph.D. in religion from Columbia University, Psychodynamic Psychotherapy Program at Philip Roth, Samuel Beckett, William Faulkner where he was also an affiliate scholar at Columbia Psychoanalytic. His current pro- and Phaswane Mpe; he also has written exper- the Psychoanalytic Training Center. He is fessional interests are the application of psy- imental forms of literary criticism. He is co- currently working on a manuscript entitled chodynamic psychotherapy with children author of the book The Analyst’s Ear and “Death and Mastery: Toward an Old Psycho- and adolescents in urban school settings, the Critic’s Eye: Rethinking Psychoanalysis and logical Foundation for Critical Theory,” which psychodynamic efficacy studies and imple- Literature (with Thomas Ogden, Routledge seeks to strengthen the psychoanalytic “foun- mentation strategies, and effective training 2013). The book has been translated into Ital- dation stone” of first generation critical the- practices. Cole currently lives in New York ian and Portuguese. He is currently an assistant ory in the hopes of rejuvenating its conception City with his wife and two small girls who professor at Stevens Institute of Technology. of interpellation and subjection in late capi- continue to be his favorite professional and talism. He has published in Psychoanalysis, personal interest. Uyen-Khanh Quang- Culture, & Society, The Journal for Cultural and Dang, M.D., M.S., was Religious Theory, and the Journal of the Ameri- Michael Nevarez, raised in California by can Academy of Religion. He has also written M.D., is a second-year her parents and mater- posts for the New York Times philosophy blog, child and adolescent nal grandmother, who “The Stone,” on Freud and neuroscience. psychiatry fellow at are Vietnamese refu- MGH/McLean Hospitals gees. She graduated Valery Hazanov, in Boston. As an under- from Harvard College Uyen-Khanh Quang-Dang Ph.D., was born in graduate, he attended in 2002. For her under- Moscow and grew up California Polytechnic graduate thesis, she received a grant to con- Michael Nevarez in Israel. He received State University, San Luis duct field research in Vietnam’s psychiatric his Ph.D. in clinical psy- Obispo, and majored in electrical engineering. hospitals and studied how Vietnamese cul- chology from Columbia After high school he volunteered on a Native ture’s perception of mental illness shaped University and his B.A. American reservation in Arizona; this expe- the psychiatric profession in Vietnam. Quang- in psychology and the rience provided inspiration for a career in Dang received an M.S. from the Harvard Valery Hazanov humanities from the medicine. After working as an engineer, he School of Public Health in 2005; her thesis Hebrew University of Jerusalem. Recently he went to Harvard Medical School and com- focused on creating new gender equality and completed his internship at the Columbia Uni- pleted adult psychiatry training at MGH/ women’s empowerment indicators for the versity Medical Center. He is a past fellow of McLean. His interests include mental health United Nations Millennium Development the Columbia University Center for Psycho- care for underserved populations and in Goals that factored in sexual/reproductive analytic Training and Research and currently school settings. He was granted the award health. She received her M.D. from New York serves as an adjunct professor of psychology for scholarly excellence in psychodynamic Medical College in 2010, and completed her at Teachers College, Columbia University, writing at MGH and also writes on topics general adult psychiatry residency training at where he teaches psychotherapy process related to mindfulness. His current research UC San Francisco this past June. Upon gradu- (his main clinical and research interest) to examines the lifetime use of defense mecha- ation she received the Edwin F. Alston Award graduate students in clinical psychology. nisms and cognitive function in older age. for Leadership in Psychiatry. Continued on page 26
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 25 APsaA FELLOWS
2014-2015 Fellows Her interests include teaching communica- Alicia Simoni, M.A., Continued from page 25 tion skills and psychosocial assessment tech- L.M.S.W., earned a niques to clinicians at all levels. master’s degree in Jessica Rollin, M.D., social work from the is a fourth-year psychia- Craig Schiltz, M.D., Smith College School try resident at Emory Ph.D., hails from the for Social Work and is University where she Midwest and early on currently working as a also received her M.D. had an interest in therapist at the Heart- Alicia Simoni She is chief resident behavior. He studied work Counseling Cen- of Emory’s Outpatient biochemistry, molecular ter in Atlanta. Her B.A. from Johns Hopkins Psychotherapy and biology and philosophy was in anthropology and women’s studies Jessica Rollin Psychopharmacology at the University of after which she completed an M.A. in inter- Craig Schiltz Training Program. Prior to medical school, Wisconsin, Madison. national peace studies at Notre Dame. Her she graduated cum laude from Yale Univer- He obtained an M.D. /Ph.D. at the University interest in the intersection of gender and sity with a B.A. in history. She worked in pub- of Wisconsin School of Medicine and Public violence led Simoni overseas to work in lishing and then found her way to medicine Health. His Ph.D. was aimed at understand- communities ravaged by war. A conviction via an interest in women’s health and work ing the neuroanatomy of motivated behav- that personal and societal transformations with midwives in Guatemala. Her interest in ior. He completed his general adult and are interconnected drives her clinical and women’s health continues. Psychoanalytic child and adolescent psychiatry training at research aspirations. Simoni’s M.S.W. thesis and psychodynamic approaches to preg- the University of California, San Francisco, examined how civilian therapists’ subjectivi- nancy and the peripartum are her interests where he developed an interest in psycho- ties manifest with service members who now, along with medical student and resident therapy and analytic/dynamic theory as a have killed in combat. Her current interests education. In particular she is committed to way of understanding behavior. Soon he will include the intersubjective implications of helping medical students and residents in start working for the San Francisco Depart- violence as well as the role of culture in psy- other specialties understand the importance ment of Public Health serving youth at risk chodynamic psychotherapy. of their patients’ internal lives as they concep- for out of home placement, providing con- tualize and treat their patients. sultation to multidisciplinary teams of clini- Lisa Weiser, Ph.D., cians at various levels of training in addition recently completed her Leah Rosenberg, to direct clinical care. postdoctoral fellowship M.D., is an attending at the New York Psy- physician at the Massa- Pernilla Schweitzer, choanalytic Society and chusetts General Hos- M.D., is a fourth-year Institute and is cur- pital in Boston where chief resident in psy- rently in private prac- she practices as a hos- chiatry at the Univer- tice in Brooklyn. She Lisa Weiser pitalist and palliative sity of California, San received her doctorate medicine consultant. Francisco. She is also a in clinical psychology from Long Island Uni- Leah Rosenberg She completed under- first-year fellow in the versity’s Brooklyn Campus, where she is now graduate degrees in philosophy and political psychodynamic psycho- a clinical supervisor and research scientist. Pernilla Schweitzer and social thought at the University of Vir- therapy training pro- She completed her internship at Lenox Hill ginia. She entered the Mount Sinai School of gram at the San Francisco Center for Hospital. She was first exposed to psycho- Medicine through the Humanities and Medi- Psychoanalysis. She graduated from Harvard analytic thinking as an undergraduate at Yale cine Program and graduated with distinction University magna cum laude in molecular University where she studied literature with after a yearlong experience in psychoso- biology and minored in French literature. She a focus on French and gender studies. Her matic research investigating the biological received her M.D. from Columbia University’s master’s thesis investigated the relationship consequences of anger expression styles. College of Physicians and Surgeons. During between issues of separation/individuation, She completed an internal medicine resi- medical school she received a Doris Duke gender role conflict, and homophobia in het- dency at Duke University Medical Center in Fellowship grant to spend one year doing erosexual males. Her dissertation and cur- 2013 and has recently finished a yearlong research on somatoform disorders, with a rent research explore how perceptions of hospice and palliative medicine fellowship focus on hypochondriasis. Other areas of childhood trauma relate to the variable at Massachusetts General Hospital and clinical interest include anxiety disorders, sub- development of object representations and Dana Farber Cancer Institute in Boston. stance abuse, and long-term process groups. shame-proneness in adulthood.
26 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014
Misunderstandings From the Continued from page 20
Kramer’s promises were abroad in the land, Unconscious even if the ultimate outcome was disap- Sheri Butler poetry pointing. In 2008 Stephen Stahl (one of America’s premier psychopharmacologists) John Samuel Tieman, Ph. D., co-chairs APsaA’s Schools Committee. He authored wrote “…antipsychotics have been on the an award-winning chapbook of poetry, A Concise Biography of Original Sin, published by market for over a decade, and only now is it becoming clear that some of these agents Bk Mk Press of the University of Missouri at Kansas City. His scholarly essays appeared are associated with significant cardiometa- in Schools: Studies In Education and his commentaries regularly appear in Vox Populi, bolic risk…and with pharmacological actions a forum for the discussion of contemporary politics. This academic year marks his that may mediate this cardiometabolic risk… 40th year as a certified teacher. He currently teaches in the St. Louis Public Schools. At first, weight gain and obesity were clearly linked to atypical antipsychotics, but more recently, increased risk for dyslipidemia, diabetes, accelerated cardiovascular disease, and premature death have been linked to Ash Wednesday certain drugs in this class as well.” Premature You will cast all their sins death indeed. into the depths of the sea. 2. The level of understanding of Micah 7:19 psychoanalysis among the general public like the old Jews in the neighborhood and college students is high. Guffaw. Think: Lost in Translation. The level once a year I carry my sins in my pockets of understanding is Analyze This and In Treat- I cast them into the Mississippi ment. Admittedly, each one compelling in its where I confess own way. See the post for a response www. ListeningWithEmpathy.com to writing more poems than prayers 1. The approach of psychoanalysis to to losing my faith to a silk nyloned thigh proposed interpretations of the patient’s issue is “Heads, I win; tails, you lose.” to ignoring the moment between dusk and night False. Even if the patient agrees with the to defeating dreams with my sleeplessness analyst’s interpretation, that is not confirma- tion of its accuracy. It could be conforming and agreeing with authority. It is only if addi- I would absolve myself if only I could remember tional relevant personal material is expressed all the murders that aligns with the interpretation that it is considered to be a confirmation (“yes”). instead I cross my brow with the ashes Oftentimes a “no” means that the interpre- of all the angels I cremated tation is incomplete or something significant —John Samuel Tieman is missing.
Editor’s Note: You can visit the author’s website Sheri Butler, M.D., is an adult training and consulting analyst and child consulting analyst at the Seattle Psychoanalytic Society and Institute. A published poet and member (www.ListeningWithEmpathy.com) of TAP’s editorial board, she welcomes readers’ comments, suggestions, and poetry to read the complete version submissions at [email protected]. of this article.
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 27 EXPEDITED PATHWAY
Martha and I Trailblazing Local Option: began discus- sions with Betsy One Institute’s Experience Brett and Dan Richard Tuch Jacobs, at the time co-chairs of the COI, and proceeded The following is an interview with Jeff Prager, co-author of to make minor changes here and the New Center for Psychoanaysis’s Expedited Pathway Richard Tuch there that would help satisfy members of COI and, ultimately, BOPS as well. Again, this was a painstaking RT: How does it feel to be at the fore- RT: When and how did the Expedited process in which more careful language front of change at APsaA, having co- Pathway come about? was introduced concerning the ways in authored the first working localized system JP: One result of our 2010 site visit from which local and national members would be for certifying members and appointing TAs COI was its recommendation that we affir- appointed to the examining committee, the at the same time? matively respond to an impending crisis in conditions under which certification from JP: I believe the New Center for Psycho- our institute. Our TA system was strained by the Association would be granted and other analysis (NCP) has found a way, with the two factors: 1) an aging population of TAs issues. At a breakfast meeting in January cooperation of the national organization, to (The average age of our TAs was 73) and 2012 at the APsaA meeting, NCP and COI move forward without promoting divisive- 2) a total lack of interest on the part of NCP reached agreement on the final form for ness at the local institute level. We succeeded analysts in pursuing certification from the the Expedited Pathway. Later that day, we in creating an APsaA-approved set of pro- Association. Otherwise, our institute was received approval from the co-chairs of cedures, known as the “Expedited Pathway,” doing quite well and, at the time, we had just BOPS, at the time Colleen Carney and Lee which “localizes” certification and appoint- admitted a first-year class of seven incoming Ascherman, for our set of procedures. We ment of training and supervising analysts. The candidates. It was clear that unless we were then off and running. kind of change NCP has pioneered—with responded through some exceptional mech- the approval of the Committee on Institutes anism, we would not be able to provide a RT: How exactly does the Expedited Path- (COI)—came about by our institute working sufficient pool of training and supervising way work? to develop a set of procedures that were analysts for our trainees. That was COI’s con- JP: There are several features of this plan acceptable to NCP members. Only then did cern, which quickly became ours as well. that make it distinctive, and very attractive to we seek approval from and obtain agreement NCP’s plan was the result of a long and our members. First, it shifts the process of from our national organization. Ours was a arduous process. At the time, I was co-dean, evaluation, in its entirety, to our own institute “bottom up” approach. along with Martha Slagerman, and together and away from New York. Second, it offers The Expedited Pathway procedures I’m we discussed with NCP members our plan to simultaneously, if one is successful in his or about to describe provide a working model provide an Expedited Pathway in response to her application, TA/SA status and certifica- that can help extricate us from the impasse the recommendation of the Site Visit Commit- tion from the Association. Certification, that’s plagued not only the Association and tee. We described this as “expedited” to indi- when it occurs, is simply ratified at the next individual members’ relation to it, but also, cate that NCP would revisit these procedures meeting of BOPS. In this instance, COI and and perhaps more important, the divisions once our developmental pathway curriculum BOPS agreed to consolidate the procedures that exist between members of local insti- was fully in place. After receiving faculty for certification from the national organiza- tutes. This set of procedures does not require endorsement, we appointed an ad hoc com- tion with application for TA/SA status at the local institutes to decide between those who mittee to draft a plan we hoped would prove local level. prefer local option—a kind of secessionist acceptable to the Association. Even more The procedures (available for anyone to impulse—and those who believe there is a important, we wanted to put into place a pro- examine) provide for a two-step process, role for the national organization in the cedure that might entice those NCP analysts designed to take somewhere between six healthy functioning of local institutes. who had not pursued TA status to consider months and a year to complete. Assuming signing up and going through the Expedited the applicant meets the necessary immersion Pathway. In 2012, we received the approval criteria for psychoanalysis, he or she appoints Richard Tuch, M.D., serves as dean of the from our Education Committee to proceed, a study group. This group consists of three or New Center for Psychoanalysis. pending approval by the Association. Continued on page 29
28 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 EXPEDITED PATHWAY four NCP TAs with whom one meets to dis- RT: With all this talk about local option, cuss the ethical, legal and professional expec- what do you make of the fact that the Expe- tations of NCP and the Association to serve dited Pathway isn’t better known? It appears as a TA/SA. Various issues are expected to that some institutes are leaning in favor of be covered that bear heavily on the duties local option—and here is a BOPS-approved and responsibilities of TA/SAs, including con- program that’s been up and running for two fidentiality, teaching while serving as a train- years. What do you make of that? ing analyst, and conditions when recusal from JP: In the preamble to our procedures, administrative activities are appropriate. In we indicate that we were seeking COI and addition, contemporary and classical journal BOPS approval of this plan for NCP only. articles on the supervisory role for TA/SAs We explicitly stated that the procedures are read and discussed. By mutual agreement were not drafted to be precedent setting of the applicant and the committee, the work and necessarily applicable to other institutes. of the study group is declared complete once We thought this explicit statement was these issues have been taken up and suffi- needed at the time to reassure both the ciently discussed. leadership of COI and BOPS that our inter- At that point, the applicant appoints two est was simply the survival of NCP and TA members of an Examining Committee, Jeff Prager responsive to the specific request of our the institute appoints a third member (sub- site visitors. ject to the applicant’s veto), and BOPS forth to take advantage of the opportunity. appoints the fourth and final member. The To date, we have attracted two applicants RT: Granted, the Expedited Pathway was Examining Committee meets with the appli- who have successfully completed the process developed by a specific institute facing a cant to discuss clinical material, case write- and have accordingly been certified and particular problem. But from what you are ups, as well as the one particular case the appointed as TA/SAs. Several more seem to saying, I wonder whether it might be some- applicant has prepared to present for his or be in the pipeline. As we had hoped, the deci- thing other institutes might want to consider her final exam. All local members of the sion-making process by which the committee adopting. committee are expected to attend each of renders its opinion, thus far, has produced a JP: I happen to think this set of procedures, these meetings, and the national representa- consensus that the applicant had met the working to the satisfaction of our local insti- tive is free to join the group for these discus- requirements being assessed. There have tute and to COI, offers a way to preserve the sions, though in practice they have tended to been no split votes. And while the BOPS rep- advantage of some national oversight in the join in only at the tail end of the process. By resentatives to each of these committees function of local institutes while respecting mutual agreement, the applicant is deemed were, at first, skeptical of the process, they the capacity of local institute members to ready and able to convene a final examina- have now endorsed it as adequate for estab- evaluate the competency of their own mem- tion during which the national member must lishing the competency of the applicant. We bers. However, we do not see these proce- be in attendance. In a three-hour exam, the are very encouraged. dures as necessarily applicable to each and applicant provides a case presentation on every institute. Similar kinds of procedures one selected case to demonstrate psycho- RT: You were recently reassessed by the might be adopted, bearing in mind the spe- analytic competency, as well as an awareness chairs of COI. How did that go? What was cific challenges faced by the particular insti- of legal and ethical issues that might have their reaction to how the Expedited Pathway tute and the specific attitudes of the local arisen in the case. Each member of the com- has been operating? membership. We tailor-made these proce- mittee has a single vote. The expectation is JP: As stipulated in the final agreement, the dures to be responsive to our own institute that consensus will develop through the approval for the Expedited Pathway was con- and its membership. Other institutes, I believe, examining process about whether the appli- tingent on the preparation of a report to the ought to do the same. cant should be passed or sent back for fur- COI in January 2014. Martha and I met with ther work. No single voting member has veto the new co-chairs of COI, Jack Solomon and RT: Thanks for filling us in on the details. power over the final decision. Ingrid Pisetsky and reported on the imple- I hope this clarifies the many questions that mentation of the program and the experi- have arisen around the country at institutes RT: How has this been working thus far? ences of those who’ve completed it. They that have become curious about what the JP: The procedures have been working were both very impressed by the procedures Expedited Pathway is and how it works. remarkably well. On the issues that matter, and, in fact, asked if we would be willing to And congratulations for having crafted such NCP cannot be more pleased, though we are circulate the procedures to other institutes a useful and elegant solution to your insti- hoping more eligible members will come faced with similar problems as our own. tute’s problem.
THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 29 INTERVIEW WITH BOB WINER
Interview with Bob event would be preempted now by the PSP). BS: Your home in Bethesda has become Continued from page 11 Specifically, I thought the clinical aspect of the center of many functional families. our psychotherapy training was weak, that BW: We do hold a lot of activities there, is a one-upping gesture regardless of how we weren’t effectively helping our students and that’s meaningful to me. You know, I tactfully it’s handled. Do this and you’ll get the grasp their patients’ psychic realities. I created a respect the people I work with, but that’s best they can give. new program, Close Attention, as an educa- why I chose to work with them. Also, I’m We shifted classes from the weekends tional experiment. What if we offered a pro- pleased I could recognize when something I to Wednesday afternoon, and set aside gram whose sole purpose was to help you get was doing for a long time wasn’t working the Wednesday evening for faculty study groups, your mind around your patient’s mind? Getting way it needed to, and I could try to rethink it, thus offering a mid-week bloc of time that your mind around the patient’s experience is like with the Close Attention program. analysts could devote to the institute. Faculty hard, hard work. I designed a whole bunch of I think our institute and center needed groups met monthly throughout the year, and formats in which one could work at that, and someone with an educational-organizational were open to everyone, with topics like art that program is now entering its third year. It’s vision to create programs. That person and creativity, group process, mentalization, been a hard sell to the clinician public, because doesn’t need to run them, but primarily panic disorder, neuropsychoanalysis, com- it’s rather stripped of formal theory teaching needs to find the right people in the organi- munity process, Melanie Klein, Primo Levi, and on the surface looks too elementary, but zation to do that. Our New Directions pro- our organizational history, couple therapy, the it’s actually making a mark on the participants. gram, as an example, has held 51 weekend seven deadly sins, and various clinical formats. conferences, each organized by a faculty The Faculty Development Committee cre- BS: You seem to always be just a bit out- member or graduate. My skill has been in ated a group to study the teaching of psycho- side the system. You’re not a TA. And you’re finding the right people to do that, then pro- analysis. This group, which Richard Fritsch and not well known nationally despite all you’ve viding only the help that person needs. I led, eventually formed a training model that done educationally. Friends ask me how I manage to do so would revamp psychoanalytic training for us. BW: I like being a bit of an eminence grise, much organizationally, and my answer is Some years earlier, David Joseph and I pro- outside the spotlight. I like creating programs always the same: delegate. posed combining the first year of teaching for and seeing them meet people’s needs. I’m psychotherapy students and psychoanalytic conflicted about public acknowledgment, eas- BS: How do you envision spending your candidates, but at a poorly attended faculty ily self-conscious. You know I’ve put off your seventies and eighties? meeting, with the opposition in high gear, this wanting to do this interview for a few years. BW: Trying to stay in shape and spend- was shot down. I was challenged at a site visit I’ve also always felt best being a bit outside ing time with my family, especially my amaz- for letting the idea fall away. With Dick Fritsch, whatever I perceive to be the establishment. ing new grandchildren. Continuing working we revisited it at this new study group and Upon entering medical school, I was one of to find the best ways to educate clinicians. after a few years of organizational work and two students out of 80 who knew we wanted And writing. negotiation we created the Psychoanalytic to be psychiatrists, and that outsiderness felt Studies Program (PSP). In capsule, the PSP comfortable to me. I was frightened by the BS: Your article on time that begins with offers a two-year curriculum for candidates, prospect of submitting to analytic training, but “Time’s arrow peers out at me from behind potential candidates, psychotherapists, and after my analyst insisted that I was trying to my awareness,” deserves reading by a wide scholars. For those interested in becoming practice analysis without a license, I relented audience. It was published in Anne Adelman analysts, it counts as the first two years of and applied. Training was not the Procrustean and Kerry Malawista’s book, The Therapist in analytic training, even if the person doesn’t bed I had anticipated. Nor were marriage and Mourning. apply for candidacy until after the program child-rearing the claustrophobic trap I feared. BW: Thanks. I did write a book that got a ends. We just finished our first year, working Quite the contrary. good reception, and I’m working on two with 20 remarkable students. It’s a way for On a few occasions I’ve been asked to other books now. The one really underway is clinicians curious about candidacy to engage apply to be a TA, and I haven’t felt tempted. I based on a set of extensive interviews Kerry with the field without the pressure of making think it means to me becoming part of a sys- and I are doing with psychoanalysts from a commitment. All the students are offered tem that I’ll find constricting, in terms of how around the world, using 30 questions about analysis on an appropriate fee basis. Dick and I view the constraining forces in institutional their work experience. We’re collecting some I will write this up for TAP or JAPA when we psychoanalysis, where the terms have been, very interesting accounts. The other book is a complete the work with our first cohort. to such a wide extent, defined. I don’t think project Marshall Alcorn and I are developing Meanwhile, I had grown dissatisfied with I’m missing out. I really enjoy the work I do with the scholars in our new program. So I our teaching content in our psychotherapy and feel I’ve gotten better at it over the years. always have much too much to do. Which, of training program (a program which in any Gotten better at creating functioning families. course, is also about something.
30 THE AMERICAN PSYCHOANALYST • Volume 48, No. 4 • Fall/Winter 2014 CHANGING WORLD
Changing World: The Shape and Use of Psychoanalytic Tools Today Stefano Bolognini and Alexandra Billinghurst
The IPA 49th Congress will take place in INTRODUCING BOSTON GROUPS groups, a “home” Boston July 22-25, 2015. We invite you to a The clinical and theoretical presentations at group within the vast congress that aims to deepen our understand- this congress are designed to show how differ- smorgasbord of the congress. Each Boston ing of where psychoanalysis is heading and the ent analysts from Europe, North America and Group will be composed of an equal number challenges and opportunities that lie ahead. Latin America think about and work through of people from each of the three regions and We are living in a fast-changing world, the questions raised above. But there will also will have a facilitator, whose role is to do just which challenges the psychoanalytic ideals be a new initiative at this congress, the Bos- that, facilitate the discussion within the group. of reflection and time for thought. The IPA ton Groups, where small, interregional groups The group should not be seen as a supervi- Congress plays a unique role in providing and of members, candidates and non-members sion group but rather a place to discuss clini- protecting such space for reflection and will be able to meet online before and during cal and theoretical material in an equal and thought at an interregional level: European, the congress to discuss the main congress intimate way, offering the chance to get to North American and Latin American analysts themes. We have aimed to distinguish the know psychoanalytic thinking in practice in can directly exchange their views. Boston Groups from the other discussion the parts of the psychoanalytic world that Working on the theme of the congress, we groups, and are convinced they will be an are unfamiliar. came up with a number of questions that our opportunity for you to participate more The groups will be created as people reg- time raises about psychoanalysis today. How directly and actively in the congress proceed- ister and announce whether or not they does a fast-changing world affect the mind, ings and to benefit from the extraordinary would like to be part of a Boston Group. The our technique and our consulting rooms? diversity of participants at IPA congresses. groups will start their work in January 2015. They will meet by Internet to discuss the material the keynote speakers have provided, We are living in a fast-changing world, which abbreviated versions of their papers. This challenges the psychoanalytic ideals of reflection and way the group will already be formed and working before they actually meet in person time for thought. in Boston. During the congress there will be a slot after the keynotes for the Boston Groups to meet in person for discussion. For How have we developed in terms of tools The idea behind the Boston Groups is to those who have not joined a Boston Group and theories? Have we more to offer today provide the possibility to meet people from there will also be larger more traditional dis- than 50 or 100 years ago? How have new other parts of the psychoanalytic world in a cussion group options provided. technologies and other changes influenced small and intimate setting, as a way of making Our hope is that the Boston Groups will our practice, and how are we answering it easier to express oneself despite possible present us with the chance to explore both these various challenges? And finally, what are language obstacles. As all who have been to how we differ and how we are alike in the the further developments in technique and an IPA congress may have noticed, the over- way we work and think in different parts of how do we deal with the impact of technol- whelming size of the conference creates an the world. By defining and redefining the ogy and high mobility in our practice? apparent tendency to stick to the people we concepts we use and the assumptions we already know. As you move about you hear make, we will be enriched by others, and also and see people chatting away in their own be given the opportunity to further discover Stefano Bolognini is a training and languages. It makes sense that we enjoy the how we think theoretically and with our supervising analyst at the Italian company of known colleagues, and we cer- patients, not only by “the experts” and the Psychoanalytical Society and president of the tainly do not want to take that joy away. people who offer their knowledge in panels International Psychoanalytical Association. However, if size and language hinder us from and individual papers at the congress but also Alexandra Billinghurst is a member also meeting “unknown” colleagues, we by our peers and colleagues in other parts of the Swedish Psychoanalytical Association would like to counterbalance that. of the world. and vice president of the International By placing people together in groups of 15 We really hope you will be part of and enjoy Psychoanalytical Association. to 21 people, we hope to create new “safe” the work of the Boston Groups.
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