the Winter/Spring 2014 AMERICAN Volume 48, No . 1 PSYCHOANALYST Quarterly Magazine of The American Psychoanalytic Association
Story Tellers INSIDE TAP… Bob Pyles Election Results...... 4 Once upon a very, very long time in human The answer is none. If you want to know history, the storyteller was “the keeper of the what this is all about, go find the sickest per- National Meeting keys” in terms of human culture and expe- son on the ward and sit with him or her for rience. We have gradually departed from as long as you can stand it.” Semrad went on, in NYC...... 8 –13 those roots and in so doing have certainly “What you have to understand is that what lost our “mind” and perhaps our soul as well. may seem to be bizarre symptoms to you Sixth Annual My first experience in the art of the mas- do not seem at all bizarre to them. In fact, Art Exhibit...... 14 ter storyteller was when I had the good they have evolved these symptoms as a way fortune to have William Faulkner as a writer- of coping with impossible family situations. Sovereign Right in-residence during my years at the Uni- These symptoms represent a creative adap- to Privacy...... 21 versity of Virginia. The first book we were tive endeavor. They are a work of art as assigned was The Sound and the Fury. The first much as any other work of art. Your job, and 90 pages of this remarkable book consist of your only job, is to appreciate all these won- Annual Meeting what is quite literally free association in the derful stories you are going to be hearing.” in Chicago ...... 24 mind of a retarded young man. I struggled Those words of wisdom have never left me. with reading and re-reading it, knowing I was At the 2013 National Meet- going to be tested on it. However, after dis- ing of our Association we had cussing it with Faulkner, I finally got the idea. a double treat that I am sharing I re-read it once again and just let the affect with you in this issue of TAP. and the wonderful words flow over me like a We had our own Newell warm wave, and I understood. Fischer, past president of our A few years later when I started my psy- Association and a supervising chiatric residency at Mass Mental Health in and training analyst at the Boston, we were greeted by a legendary Center for Psychoanalysis in teacher of national fame, Elvin Semrad. On the Philadelphia. Newell has writ- first day Semrad gathered all 22 of us resi- ten a marvelous book, entitled dents in his office. We had been to our wards Nine Lives, about nine of his and knew that we were going to be taking psychotherapy patients. Full of care of 50 of what were certainly the most compassion, he recounts the disturbed people I had ever seen. Semrad stories of his patients and the smiled his Buddha-like smile and said, “Well I psychodynamic process that guess you’re all wondering what articles you helped to heal them. The book should be reading to help you in this work. has been very well received by the public, the media, and was certainly well received in his presentation. [See “Nine Lives: Bob Pyles, M.D., is president of the American A View from Within,” page 3.] Psychoanalytic Association. Continued on page 3
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 1 CONTENTS: Winter/Spring 2014 THE AMERICAN PSYCHOANALYTIC ASSOCIATION President: Robert L. Pyles Nine Lives: A View from Within Newell Fischer President-Elect: Mark Smaller 3 Secretary: Ralph E. Fishkin Treasurer: William A. Myerson Executive Director: Dean K. Stein 4 APsaA Elections
THE AMERICAN PSYCHOANALYST 5 Can We Survive? Lee I. Ascherman and Elizabeth Brett Magazine of the American Psychoanalytic Association Editor 7 Ho w We Can Be Possessed By A Story That Cannot Be Told Janis Chester Stephen Grosz Film Editor Bruce H. Sklarew Special Section Editor 8 2 014 National Meeting Michael Slevin Editorial Board Brenda Bauer, Vera J. Camden, T he Psychoanalyst As Artist: Sixth Annual Psychoanalytic Leslie Cummins, Phillip S. Freeman, 14 Maxine Fenton Gann, Noreen Honeycutt, Art Show Robert L. Welker Sheri Butler Hunt, Laura Jensen, Navah Kaplan, Nadine Levinson, A. Michele Morgan, Julie Jaffee Nagel, Marie Rudden, Hinda Simon, Vaia Tsolas, Poetry: From the Unconscious Sheri Butler Hunt 19 Dean K. Stein, ex officio Senior Correspondent Jane Walvoord APsaA Awards Third Annual Undergraduate Essay Prize: 20 Photographer Caroline Beaton “To the Lighthouse and the Oedipal Triangle” Mervin Stewart Manuscript and Production Editors Michael and Helene Wolff, 21 Politics and Public Policy: Sovereign Right to Privacy Technology Management Communications of Americans, Patients and Clinicians Graham L. Spruiell The American Psychoanalyst is published quar- terly. Subscriptions are provided automatically to members of The American Psychoanalytic Asso- 22 Candidates’ Council: A Fresh View Navah C. Kaplan ciation. For non-members, domestic and Cana- dian subscription rates are $36 for individuals and $80 for institutions. Outside the U.S. and Canada, rates are $56 for individuals and $100 for institu- 23 COPE: Candidates’ COPE Study Group: tions. To subscribe to The American Psychoanalyst, Challenges of Training Navah C. Kaplan and Phoebe A. Cirio visit http://www.apsa.org/TAPSUB, or write TAP Subscriptions, The American Psychoanalytic Association, 309 East 49th Street, New York, New York 10017; call 212-752-0450 x18 or 24 Come to Chicago: APsaA 103rd Annual Meeting e-mail [email protected]. June 6–8, 2014 Kimberlyn Leary Copyright © 2014 The American Psychoanalytic Association. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by 25 L ots to Do and See in Chicago in June Kathleen Carroll any means without the written permission of The American Psychoanalytic Association, 309 East 49th Street, New York, New York 10017. Film: Must the Artist Fall in Love with Death? 27 ISSN 1052-7958 Jean Cocteau’s Orphée Lissa Weinstein and Bruce H. Sklarew, Film Column Editor The American Psychoanalytic Association does 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. 1 • Winter/Spring 2014
narratives, but I will tell you about the most Nine Lives: A View from Within vivid moments and hours I spent with these Newell Fischer people and the times that were most alive and real for me. Though their past histories A reporter condition and to shed light on the process and surrounding life events helped me came to my and the struggle we confront daily in psy- understand the moments we shared, such office a year ago choanalytic treatments. background was once removed from my to interview me Below is an excerpt from the Introduction immediate experience. It was my contact for an article in to Nine Lives. with these nine people that was intense, the Philadelphia I have worked as a psychiatrist and psycho- rewarding, and unforgettable. City Paper. This analyst for nearly 50 years and I have con- Reflecting the human condition, these indi- young woman sulted on and treated hundreds of patients. viduals struggled in life, largely with painful seemed sophis- I have never met an Alien—someone who inner conflicts and battles with childhood ticated and intel- was beyond the boundaries of human under- fantasies and traumata. However, the resolu- Newell Fischer ligent. She knew standing. Every person is unique, every case tions they came to did not work for them. I was a psychoanalyst and despite the many offers mysteries and surprises, but the com- They were left with emotional pain and pat- pithy New Yorker magazine cartoons, she was mon thread reflecting the human condition terns that were self-defeating and compro- amazed and bewildered when she saw my has always been visible. Some presentations mised their potential for living a fuller life. analytic couch. She thought psychoanalysis at first appear extreme or even bizarre, but Continued on page 6 and the use of the couch were abandoned the underlying conflicts and the haunting around 1940. demons my patients bring, I know “in my I wrote my book Nine Lives: A View from bones” because they reflect shared human Story Tellers Within in an attempt to convey to the lay- conundrums. Unfortunately, for some, these Continued from page 1 person some of our therapeutic work as challenges lead to emotional dysfunction, analysts and to underscore the profound great pain, and suffering. The second value of intensive psychoanalytic treatment. treat was by I did not want to write “fairy tales”—that is, IN THE FOOTSTEPS OF HARRY STACK Stephen Grosz that all our patients gain insight and live hap- SULLIVAN AND WALT C. KELLY who discussed pily ever after—but to convey some of the The well-known American psychiatrist, his book as part experiences, pain, and struggles that unfold Harry Stack Sullivan, worked with very ill psy- of the Presiden- in our offices. chotic patients for many years and emerged tial Symposium, Mystification, idealization, and derision from the experience observing, “Man is more also telling the have often characterized the view of our human than otherwise.” Stated less elegantly stories of his efforts. Whereas some of these attitudes and paraphrasing the comic POGO, “We patients. It is enti- Bob Pyles represent transferential distortions, our have met them [our patients] and they are us.” tled The Exam- highly touted “splendid isolation” and our If we look deeply into another person’s eyes ined Life: How We Lose and Find Ourselves. obtuse jargon (shorthand codes), have con- we see ourselves. Sometimes that which we Grosz has been a practicing psychoanalyst for tributed to this perception. These views of see leads to a sense of kinship. At other times, more than 25 years and teaches at the Insti- what we do therapeutically and who we the reflection can be frightening, promote tute of Psychoanalysis in London. This is his are as mental health professionals have not interpersonal detachment and self-alienation. first book and has received glowing reviews. been helpful. Nine Lives is an attempt to Introspection, immersion, sensitivity, and a bit It is a Sunday Times of London best seller and better understand aspects of the human of courage will help the reader recognize has been named a 2013 Book of the Year himself in the clinical material to be presented. no fewer than 15 times by critics at leading Such recognition may be enlightening. publications, including the New York Times. Newell Fischer, M.D., APsaA past president, To shed light on the human condition and [See “How We Can Be Possessed by a Story is clinical professor of psychiatry, University to underscore how we all share this condi- That Cannot Be Told,” page 7.] of Pennsylvania School of Medicine; tion of being human, I will tell you the sto- Both Fischer’s and Grosz’s books are mar- psychoanalyst of adults, children and ries of nine patients (carefully disguised for vels of human warmth and clinical intelli- adolescents; training and supervising confidentiality) whom I have treated in gence. They are certainly a must read for any psychoanalyst, Philadelphia Psychoanalytic intensive insight-oriented psychotherapy. psychoanalytic training program as well as Center; and past president, director of Their stories are dramatic and valuable. Of for the general public. I invite you to enter psychiatry, Institute of Pennsylvania Hospital. course, I can only relate fragments of their their world.
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 3 Training and Supervising Analyst Appointments Announced By the Board on Professional Standards January 15, 2014 2014 National Meeting, Waldorf Astoria Hotel
Training and Supervising Analysts Neal Spira, M.D. Child and Adolescent Supervising Analysts Nancy Blieden, Ph.D. Chicago Institute for Psychoanalysis The Cleveland Psychoanalytic Center/ Hanna Perkins Center Child-Focused Program Michigan Psychoanalytic Institute Geographic Rule Supervising Analysts Devra B. Adelstein, LISW, BCD Andrea Celenza, Ph.D. Salman Akhtar, M.D. Boston Psychoanalytic Society and Institute Florida Psychoanalytic Institute Beatrice B. Griffin, LISW, BCD Margarita Cereijido, Ph.D. Stephen B. Bernstein, M.D. Ruth L. Hall, M.A. Washington Center for Psychoanalysis Florida Psychoanalytic Institute Judith L. Pitlick, M.A., LPCC Sally A. Davis, Ph.D. Richard G. Honig, M.D. Carl J. Tuss, LISW, LPCC, LICDC Center for Psychoanalytic Studies (Houston) Western New England Institute for Psychoanalysis Barbara U. Streeter, M.S., LPCC-S Ethan M. Grumbach, Ph.D. Daniel H. Jacobs, M.D. Lorraine Weisman, M.A., LPCC-S New Center for Psychoanalysis (Los Angeles) Florida Psychoanalytic institute Oscar F. Hills, M.D. Geographic Rule Child and Adolescent Western New England Institute for Psychoanalysis Child and Adolescent Supervising Analysts Supervising Analysts H. Randall Matthews, M.D., Ph.D., J.D. Alexander D. Kalogerakis, M.D. Silvia M. V. Bell, Ph.D. Center for Psychoanalytic Studies (Houston) New York Psychoanalytic Society and Institute San Diego Psychoanalytic Society and Institute Joanne Naegele, M.A., LPCC-S Pamela Meersand, Ph.D. Jill M. Miller, Ph.D. Cleveland Psychoanalytic Center Columbia University Center for Denver Institute for Psychoanalysis Psychoanalytic Training and Research Robert M. Smith, M.D. Charles E. Parks, Ph.D. New York Psychoanalytic Society and Institute Jill M. Miller, Ph.D. Western New England Institute for Psychoanalysis Washington Psychoanalytic Center
2014 Nationalelections Meeting PRESIDENT-ELECT Richard Lightbody—351 Harriet L. Wolfe—873—Elected
TREASURER-ELECT Peter Kotcher—214 William A. Myerson—914—Elected President-elect Treasurer-elect Harriet L. Wolfe William A. Myerson COUNCILORS-AT-LARGE-ELECT Michael J. Gundle—Elected David V. Orbison Robert A. Paul—Elected Fredric T. Perlman Sandra C. Walker
Councilor-at-large-elect Councilor-at-large-elect Michael J. Gundle Robert A. Paul
4 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 FROM THE BOARD ON PROFESSIONAL STANDARDS
Can We Survive? Lee I. Ascherman and Elizabeth Brett
“Can we survive?” is the blunt question OTHER EXPLANATIONS asked by many of our institutes and mem- What do the IPA components share bers. There are many survivals in question— that might explain the worldwide crisis the survival of psychoanalysis as a profession, regarding survival of psychoanalysis? the survival of the Board on Professional We identify a number of cultural forces Standards, and the survival of the American in the Western world that may contrib- Psychoanalytic Association as we know it. ute to the crisis. These include major We also must contend with the definition of economic and health care funding survival. When does survival entail adapta- changes and vast cultural shifts empha- 2. Enabling consultation from the Com- tion for preservation, and when does survival sizing quick interventions and evidenced- mittee on New Training Facilities entail adaptation or evolution of an entity based credibility; evidence that is difficult for (CNTF) to provide longitudinal, indi- barely recognizable from its original meaning. analysts to produce easily given our emphasis vidualized guidance to institutes seek- These are tough questions that reflect our on privacy and a treatment that does not ing assistance in securing their futures tough times. Our debates would be purely conform well to standardized protocols. Our by reinvigorating practice environ- academic if the challenges we face were not presence in professional mental health train- ments and candidate recruitment about survival. ing programs has diminished, with some nota- 3. Establishment of the Committee on ble exceptions that have proven successful. Outreach, Growth and Development THE INTERNATIONAL PERSPECTIVE— Analytic career patterns have also changed. as an alternative portal for consulta- THIS IS NOT JUST AN AMERICAN Many contemporary analysts have multiple tion on reinvigorating practice envi- PROBLEM professional identities and commitments, ronments and candidate recruitment. The International Psychoanalytical Asso- affecting their level of involvement in psycho- 4. Financial consultation ciation (IPA) has for many years recognized analysis. Other cultural and generational shifts 5. Leadership consultation for directors the problem of “graying” throughout their contribute to expectations of more con- of institutes and centers constituent components. Recent data sug- tained work commitments balanced with 6. Collaboration with the Society Presi- gest that in almost every IPA society there is time for family and avocations and less dents Meeting an unmistakable shift in the average age of emphasis on longitudinal commitments of 7. Consultation on practice development members and the average age of candidates depth to those we treat. Significant student 8. Website and social meeting consultation from younger to older. Rare exceptions to debt reflecting the exponential rise in tuition 9. Regional training/long distance learn- this trend include groups from Central and from earlier education dissuades some intim- ing consultation modeled on success- Eastern Europe who experienced a resur- idated by the cost of training and insecurity ful regional child analytic programs gence of interest in psychoanalysis after about future earnings. Despite these obsta- 10. Initiatives to develop scholarship the fall of the Iron Curtain. While we must cles, some younger professionals looking for opportunities for candidates still take seriously our internal debate about depth and longitudinal experiences with 11. Continued collaboration with ACPE, educational standards, the data suggest those we care for find a career in psycho- Inc. efforts to gain Department of there is something more afoot contributing analysis an attractive alternative. Education recognition of analytic train- to the challenges our profession is facing. The Board on Professional Standards has ing programs While some have alleged that it is our established the following initiatives to respond standards, the certification system, or the to the acute challenges faced by some of WE MAY HAVE DIFFERENT FATES training analyst system that has placed a our institutes. While all of our institutes and members face stranglehold on our survival, these cannot 1. The immersion requirements for the challenges we have highlighted, at present explain the international downturn in efforts training analyst appointment have we are not all on the same trajectory. About to promote psychoanalysis. been adapted to include a reduction one-third of our institutes are reliably main- of postgraduate hours to 3000 from taining classes of respectable size and do not 3600. These hours can now include experience the acute gap in certified mem- control cases’ hours that continue past bers and training analysts. About one-third of Lee I. Ascherman, M.D., is chair of graduation. These adaptations con- our institutes have mobilized with or without the Board on Professional Standards tinue to honor our obligations to IPA consultation to turn their fortunes around. and Elizabeth Brett, Ph.D., is secretary. requirements. Continued on page 30
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 5
Nine Lives unwelcomed To expand on these themes, it is best and Continued from page 3 symptoms, and most direct to first tell you the stories of are often the some of the people who have come to me Understanding their dysfunction tells us first and the for treatment, how I understood their strug- much about being human and about our- only treatment gles and how I worked psychotherapeutically selves. Comparable to a finely synchronized modality to help them. and oiled machine, when the apparatus is not offered. In such The patients described in this volume functioning well, we are more aware of how 20-minute ses- include, a woman caught in a life endanger- it works. Cases of pneumonia force us to sions on alter- ing pattern of repeated pregnancies with learn more about infectious processes and nate weeks, the strangers followed by multiple induced the mechanics of breathing. Listening care- therapist has to abortions; a woman hating her skin color; an fully to a child’s nightmares can tell us much be sure he is executive sleepwalking through life; a sad about his unspeakable worries. looking at the woman caught up in a delusional marriage; In telling these stories, I also want to correct clinical chart, check if the medica- a mother terrified of her infanticidal urges; reflect and describe through example an tions are causing any untoward side effects, a self-loathing teenager; a young boy seeking important therapeutic approach that puts a quickly ask how things are going, and then out bullies to beat him up, and a girl starving premium on the in-depth understanding of confirm the time of the next scheduled visit. herself to gain self-control. It is my hope that Nine Lives will convey some of the complexities of the human … when the apparatus is not functioning well, condition and underscore the valuable we are more aware of how it works. contributions psychoanalytic thinking and therapy provide. the individual’s inner world. The treatment A few patients can be seen for longer ses- was guided by an effort to unearth and sions and more frequently, but such cases are Certified in understand those forces and structures the exception. Unfortunately this McTherapy Psychoanalysis within the individuals that were causing them also prevails in private psychotherapy prac- By the Board to hurt or to be caught up in self-defeating tices, again driven by economic forces and and destructive life patterns. The in-depth social pressures. On Professional analytic therapy that I will describe is time These are the two themes in my narrative: Standards consuming, requires a certain personal sen- (1) an effort to heighten our appreciation of sitivity and a deep level of immersion. This the complexities of the human condition, and January 15, 2014 psychoanalytic approach is based on the (2) an attempt to underscore the importance conviction that if a person has a greater of therapy that aims to understand the human Adult understanding of himself, and the factors condition and the deeper dynamics of dys- Jamie C. Cromer, M.S.W., LCSW that are causing his dysfunction, this self- function. These themes are inextricably linked. New Orleans-Birmingham knowledge will be crucial in stimulating per- In intensive insight-oriented psycho Psychoanalytic Center sonal growth and in reducing psychic pain. therapy, the primary goal is to ameliorate Ethan Grumbach, Ph.D. emotional dysfunction and to promote per- New Center for Psychoanalysis AN ALTERNATIVE TO sonality growth. In addition, the investigation Jane D. Hanenberg, Ed.D. PRESSURE DRIVEN TREATMENT of the inner world provides a vital avenue to Boston Psychoanalytic Society & Institute In the present age of seeking immediate better understand the human condition and gratification, of fast food, takeout dinners, better appreciate those inner forces and Cynthia B. Playfair, M.D. Center for Psychoanalytic Studies drive-through religious affiliations and e-mail psychic structures that promote health and (Houston) courtships, efforts to do in-depth, intensive, the conflictual elements that lead to dysfunc- Patricia A. Plopa, Ph.D. and lengthy psychotherapy may be out of tion. If the opportunities for pursuing such Michigan Psychoanalytic Institute fashion. My students, psychiatrists-in-training, insight-oriented approaches become greatly Louis J. Roussel, Ph.D. tell me that they are required to interview diminished by societal pressures, we not San Francisco Center three patients an hour. Therapy is driven by only compromise our ability to treat patients for Psychoanalysis the pressures from insurance and reim- in distress but also we lose an avenue to Ronnie M. Shaw, M.S., R.N., C.S. bursement systems. Medications, primarily learn about who we are as thinking, feeling Denver Institute for Psychoanalysis tranquilizers and anti-depressants, suppress human beings.
6 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 THE EXAMINED LIFE
After one particularly tumultuous week, How We Can Be Possessed By Peter stopped coming to his sessions. I wrote to him, proposing that he talk to me about A Story That Cannot Be Told his decision to end his treatment, but I Stephen Grosz received no reply. I contacted the psychiatrist, who told me I want to tell you a story about a patient Peter that Peter had stopped seeing her too. who shocked me. attended all of Two months later, a letter arrived from When I was first starting out as a psycho- his sessions, Peter’s fiancée, informing me that he had analyst, I rented a small consulting room in and was almost taken his own life. She explained that, during Hampstead. One of my earliest patients was never late. After the month leading up to his death, Peter had a young man named Peter. He was undergo- several months, grown increasingly disturbed and withdrawn. ing treatment at a large psychiatric hospital he left hospital The family had held a funeral at West London nearby. Three months before we met, Peter and was able to Crematorium the week before. She wrote hid in the cupboard of a local church, where return to his life. that she was grateful for my attempts to help he tried to kill himself by taking an overdose But increasingly, him. I sent a letter of condolence to her, and Stephen Grosz of various drugs and then slitting his wrists. in our sessions, then informed Peter’s psychiatrist. He also stabbed himself in the neck, chest I felt him disappear to a place I couldn’t find, I’d known that Peter was a high-risk patient. and arms with a small knife. He was discov- let alone understand. “You’ve been silent a When I took him on, I’d enlisted the help of ered by a cleaner. Although she was fright- long time—can you tell me what you’ve been a supervisor, an experienced psychoanalyst ened, the cleaner held him as they waited for thinking about?” I asked in one session. who’d written a book on suicide. He had the ambulance. “Who did this?” she asked “A holiday in Devon—when I was a child,” repeatedly pointed out to me the many ways him. “Tell me, who did this to you?” he replied. in which Peter seemed to idealize death. The consultant psychiatrist at the hospital There was a long pause. Could he tell me Now I went to see him again, anxious that asked me if I would see Peter five times a more? He replied that he was not thinking there was something I’d missed. My supervi- week for psychoanalysis. She felt that daily about anything in particular, he was just think- sor tried to reassure me. “Who knows?” he therapy, together with a weekly meeting with ing about being alone. said. “Being in analysis with you might have her, was Peter’s best chance for recovery, for I had the thought that he wanted to be kept him from suicide for the past year.” Still, returning home to his fiancée and to his work. away from me, on holiday from analysis, and Peter’s death disturbed me greatly. Of course, Peter was 27 and worked as a structural told him so. “Could be,” he replied. I knew that we all have the capacity to act in engineer. Before he was hospitalized, he and It was as if Peter was trying to protect self-destructive ways, nevertheless I had a his fiancée had bought a one-bedroom flat himself from my intrusiveness, as if he was kind of faith that the desire to live was more outside London. He had been having difficul- complying with the conventions of analysis— powerful. Now, instead, I felt its fragility. Peter’s ties at work and was anxious about money— being on time and answering my questions, suicide made me feel that the battle between but none of this seemed to explain his violent for example—but in such a way as to pre- the forces of life and death was far more attack on himself. Part of my job, then, was to vent any meaningful connection developing evenly pitched. work with Peter to identify the causes of his between us. He seemed to have little faith in Six months later, I received a message on suicide attempt—if we couldn’t understand our talking. my answering machine. I heard the unmis- the forces that had pushed him to attack But I did learn that Peter had a history of takable sounds of a public telephone—the himself, there was every reason to think it making friends and then turning on them. In pips, the coins falling—and then Peter’s would happen again. his professional life too he had quietly gone voice: “It’s me. I’m not dead. I was wonder- Peter was tall and lanky, but carried himself about his work, then suddenly get into a ing if I could come and talk to you. I’m at my as some depressed people do, shoulders row with his boss and quit. This had hap- old number.” hunched forward, head down. His manner pened several times. I tried to use this infor- The instant I heard Peter’s voice, I felt faint, was depressed too—he spoke haltingly, with mation to show Peter that he seemed to have confused. For a moment I persuaded myself little eye contact. Once positioned on the two psychological positions open to him— that the answering machine was malfunction- couch, he hardly ever moved. acquiescence or blowing everything up. He ing, that I was listening to a very old message seemed to agree, but I never felt this idea from Peter that had never been erased. And Stephen Grosz, M.A. (Oxon.), is a training was meaningful to him. And soon this pat- then I laughed—out of anger, out of relief. and supervising analyst of the British tern was enacted in the analysis. Peter went And because I was stunned. Psychoanalytical Society. from going along with me to mocking me. Continued on page 18
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 7 2014 National Meeting
Award Winners from the 2014 National Meeting January 2014
CORST Essay Prize in Psychoanalysis Ralph E. Roughton Paper Prize and Culture Avgi Saketopoulou, Psy.D., for her paper: The Committee on Research and Special Training “Developmental Considerations in Mourning (CORST) presented the award to Ann P. McMahon, the Natal Body When Working Analytically with Ph.D., for her essay “The Power of Processes: Transgender Patients.” The Integration of Engineering, Psychoanalysis and Education.” Edith Sabshin Teaching Awards Adam Goldyne, M.D.—San Francisco Center Distinguished Contributor Award for Psychoanalysis Steven Levy, M.D., for his 10-year tenure as Editor Luba Kessler, M.D.—Psychoanalytic Association of JAPA of New York Stephanie McEwan, Psy.D., J.D.—New Center Distinguished Service Award for Psychoanalysis Stephen Sonnenberg, M.D., for his leadership as Kathleen R. Miller, Ph.D.—Baltimore Washington Chair of APsaA’s Committee on Public Information, Center for Psychoanalysis Coordinator of the Social Issues Division, and as the Jonathan Schindelheim, M.D.—PINE Psychoanalytic first Head of the Education Department. Center Paul Schwaber, Ph.D.—Western New England Educational Achievement Award Psychoanalytic Society Carrie Catapano, L.C.S.W., Head of School, Anna R. Schwartz, M.D.—Columbia University Center Leon Hoffman, M.D., Chief Psychiatrist, and the for Psychoanalytic Training & Research, and the West End Day School of New York City Association for Psychoanalytic Medicine (NY) David Stevens, Ph.D.—Denver Institute for Award for Excellence in Journalism Psychoanalysis Laura Tillman, Pacific Standard, for “What Does It Richard F. Summers, M.D.—Psychoanalytic Center Take for Traumatized Kids to Thrive?” which appeared of Philadelphia in May 6, 2013 issue. Nancy C. Winters, M.D.—Oregon Psychoanalytic Institute
Honorary Membership 2013 Scientific Paper Prize Jack Barchas, M.D. Anna Bucheim, Roberto Vivani, Henrik Kessler, Beatrice Beebe, Ph.D. Horst Kächle, Manfred Cierpka, Gerhard Roth, Jeffrey Berman, Ph.D. Carol George, Otto F. Kernberg, George Bruns, Frank Lachmann, Ph.D. Svenja Taubner—“Changes in Prefrontal-limbic Jonathan Shay, M.D., Ph.D. function in major depression after 15 months of Robert Stolorow, Ph.D. long-term psychotherapy” PLOS ONE 7 (3): e33745. Estela V. Welldon, M.D., D.Sc. (Hon), F.R.C. Psych 2013 Undergraduate Essay Prize Helen Meyers Traveling Psychoanalytic Caroline Beaton, B.A., from Colorado College, for Scholar Award her paper “To the Lighthouse and the Oedipal Triangle: Dorothy Holmes, Ph.D. Impotence, Erotic Degradation and the Oedipus Complex from Freudian and Self-Psychological Poster Session Award Perspectives.” Katie C. Lewis, M.A., Kevin B. Meehan, Ph.D., Jane G. Tillman, Ph.D., Nicole M. Cain, Ph.D., 2014 Courage to Dream Book Prize and Philip S. Wong, Ph.D., for their poster “Impact John Burnham, Editor, for his book After Freud Left: of Object Relations and Impulsivity on Persistent A Century of Psychoanalysis in America (Univ. of Chicago Suicidal Behavior.” Press, 2012)
8 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 2014 National Meeting
Photos by Geralyn Lederman, Mali Mann, and Philip Valentini
Robert Stolorow
Jonathan Shay and Bob Pyles
Beatrice Beebe
Frank Lachmann and Bob Pyles
Jeffrey Berman and Bob Pyles
Jack Barchas Estela Welldon and Bob Pyles
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 9 2014 National Meeting
Photos by Geralyn Lederman, Mali Mann, and Philip Valentini Highlights of the Executive Council Meeting
The Executive Council deliberated and approved The Council also two governance related issues, two important position heard an update statements, and organizational issues affecting APsaA from a new Task internally and externally at their recent January meet- Force on Governance ing in New York. and Bylaws. The task The APsaA auditors were authorized to complete the force is charged with fiscal year 2014 audit. In addition, the Council received addressing the feasi- news that FY 2014 ended with a $137,525 operating bility of rewriting surplus. A new Affiliated Study Group—the Lexington APsaA’s bylaws. The (Kentucky) Psychoanalytic Study Group—was approved. task force will func- tion as a “think New Position Statements Approved tank,” attempting to The following organizational position statements incorporate the views Syd Arkowitz in Executive Council were approved: of members as much A new position statement on race-based violence and as possible. racial profiling from the Social Issues Department and And finally, the Executive Council heard from Will a revision of a position statement from the Committee Schweitzer, a senior editor at Sage Publications, JAPA’s on Gender and Sexuality on gay, lesbian, bisexual, and publisher. In 2013 JAPA’s circulation increased an incred- transgender people serving in the U.S. military. ible 17 percent, which defies the trend in peer-review journals. Prior to joining Sage, JAPA’s total circulation New Expanded Membership Pathway Continues was just over 4,800 copies and, now—seven years later— As at the previous three Executive Council meet- JAPA’s circulation is just over 10,300. More importantly, ings, there was a historic moment when the Executive the journal is available to millions of end users in 8,000 Council approved seven new APsaA members who libraries and discoverable by just a few keystrokes in were joining the Association through the Expanded over 120 countries around the world. It is expected that Pathway membership process. The membership had JAPA sales in 2013 will approved this change in the bylaws in June 2010 and exceed a half-million these were the fourth set of applications from analysts dollars and revenue who were not trained at either an APsaA institute or an to APsaA continues to IPA institute. increase every year.
Otto Kernberg
David Falk and Leigh Tobias
Richard Tuch and Warren Procci
10 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 2014 National Meeting
Photos by Geralyn Lederman, Mali Mann, and Philip Valentini
Plenary Speakers Bonnie Litowitz, Warren Poland, and Mark Smaller
Plenary
Fred Griffin and Harriet Wolfe
Betsy Auchincloss and Eslee Samberg
BOPS
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 11 2014 National Meeting
Photos by Geralyn Lederman, Mali Mann, and Philip Valentini
Malkah Notman, Miriam Tasini, and Ruth Fischer
Monisha Akhtar, Peter Rudnytsky, and Gennifer Lane Briggs
Warren Procci, Bob Pyles, Jim Pyles, and Janis Chester
12 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 2014 National Meeting
Photos by Geralyn Lederman, Mali Mann, and Philip Valentini
The Waldorf
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 13 SIXTH Annual Psychoanalytic Art Show
Robert L. Welker
The Sixth Annual Art Show Herbert Hoover Suite with artistic perspectives varying of the American Psychoanalytic from highly representational to the surreal to abstract. Association was held at the Exhibiting artists were: Graciela Abelin-Sas, Rosa Aurora 2014 National Meeting on Fri- Chavez-Eakle, Newell Fischer, Richard Honig, Lee Jaffe, Anna day, January 17, from 9:00 a.m. Janicki, William Kenner, Ellen Kolansky, Valerie Laabs-Siemon, to 5:00 p.m. The show was ini- Mali Mann, Paul Mosher, Judith Pitlick, Raymond Raskin, tiated and developed by Jon Arnold Richards, Cheryl Seaman, Moisy Shopper, Helen Meyer whose absence this year Stein, Victoria Todd, Sebastian Zimmerman, and me. Special was felt by all. thanks to APsaA’s Carolyn Gatto without whose support Although unconscious pro- and guidance the show could not have gone on. Robert L. Welker cesses involved in creativity— its complex dynamic functions and myriad forms of CARTOON CAPTION CONTEST expression—become apparent to analysts in the course of The Cartoon their scholarship and clinical work; opportunities to view Caption Contest and discuss original artwork with analytically-informed art- was a delightful ists are rare. That is why I volunteered to organize the art addition to this show in Jon’s stead, and why I support its continuance. year’s art show; Twenty artists, an enriching mix of first-time exhibitors choosing three and veterans, invested considerable effort transporting and winners from displaying their art, a collective feat for which I am most the 87 witty sub- appreciative, and engaged in lively conversation among missions proved themselves and with the steady stream of viewers. Discus- equally difficult and entertaining. Victoria Todd provided the sion ranged from artistic techniques and materials to psy- watercolor cartoon and awards for winners, cards from her chological inspirations to personal experience of presenting Standard Edition of SigiCartoons. one’s intimate creations publicly. Many viewers, moved by First Place: the enthusiasm of the event, shared digital images of their “On that note—let’s stop for today.” Kay Levine art on cell phones and electronic tablets. Out of the individual uniqueness and diversity of exhibits Second Place: and exhibitors emerged a cohesion that took on qualities of “Pink Freud and the Light Side of the Moon.” Jessica Brown an affable salon or forum. Black and white and color photo- Third Place: graphs, watercolors, pastels, acrylics, collages, oil paintings, “The title of Tootem and Taboo is first conceived of.” Alan Kessler jewelry, wood carvings, and stone sculptures adorned the Given that a picture may still be worth a thousand words—notwithstanding the ease of making tails appear Robert L. Welker, Ph.D., is a psychologist and psychoanalyst to wag dogs by digital editing—I will let the photos of your in private practice in Milwaukee, Wisconsin. colleagues’ artwork speak for themselves.
To view a larger sample of color digital images of exhibitors’ work go to http://www.flickr.com/photos/robert_welker_elements/ and open the set labeled APSA Art Show.
14 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 Psychoanalyst
Lee Jaffe “Shadow”
Ellen Kolansky “The Painted House”
Judith Pitlick “Mother and Child”
Arnold Richards “Woman in China”
Rosa Aurora “Real”
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 15 Psychoanalyst
Sebastian Zimmerman “Jamieson Webster”
Mali Mann “Modigliani’s Woman Repainted”
Robert Welker “Fireworks Storm”
Newell Fischer Paul Mosher “Brigita” “View of Manhattan from Pebble Beach, Brooklyn”
16 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 Psychoanalyst
William Kenner “Riders” Cheryl Seaman “Essence”
Bowls by Moisy Shopper Photo: Mali Mann
Valerie Laabs-Siemon “Kunta Hora” Jewelry by Raymond Raskin Photo: Mali Mann
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 17 THE EXAMINED LIFE
Possessed By A Story Peter told me that his dad didn’t remem- I believe that all of us try to make sense of Continued from page 7 ber much, just that it was a terrible, unhappy our lives by telling our stories, but Peter was time, an unhappy marriage. “My mother possessed by a story that he couldn’t tell. That evening, when I wrote to the con- cried, she kept saying that she was sorry,” Not having the words, he expressed himself sultant psychiatrist to tell her that Peter Peter said. “She was only 20 when I was by other means. Over time I learned that wasn’t dead, I did what many people do born and no one was there to help her. She Peter’s behavior was the language he used to when they’re angry: I made a joke. “Unless said that sometimes she felt she was just speak to me. Peter told his story by making there are payphones in hell,” I wrote, “Peter going crazy.” me feel what it was like to be him, of the is still alive. He left a message on my answer- anger, confusion and shock that he must have ing machine earlier today, asking for an felt as a child. appointment.” The author Karen Blixen said, “All sorrows Peter came to see me the following week. can be borne if you put them into a story or In a matter-of-fact way, he told me that he, tell a story about them.” But what if a person not his fiancée, had written to inform me of can’t tell a story about his sorrows? What if his death. He’d also intercepted my condo- his story tells him? lence note. “It was touching,” he said. Experience has taught me that our child- “Oh, that is interesting,” my supervisor said. hoods leave in us stories like this—stories we “It’s surprising this doesn’t happen more never found a way to voice, because no one often. When you think of all those adoles- helped us to find the words. When we can- cents who say ‘you’ll be sorry when I kill not find a way of telling our story, our story myself’—you’d think more of them would tells us—we dream these stories, we develop fake it.” We decided that I should only take symptoms, or we find ourselves acting in Peter on again if I felt he was really prepared ways we don’t understand. to make a serious commitment. Two years after Peter left his message on After several meetings, Peter and I agreed my answering machine, we agreed to stop to resume his sessions. Ultimately, his disap- his psychoanalysis. I thought there was more pearance and return proved helpful, because work to do, but he felt that it was time. it clarified something that we had never All of this happened many years ago. Since understood: his need to shock others. then Peter hasn’t asked to meet again, but I In the sessions that followed it slowly did run into him recently, at the cinema. We became clear that Peter enjoyed thinking recognized each other across the lobby. about the distress he caused when he sud- Her confession gave Peter some relief. Peter said something to the woman he was denly quit work or ended a friendship. He’d For as long as he could remember, he had standing with and they walked over. He blown up the analysis twice—first when he felt afraid. He told me that it helped to know extended his hand and then he introduced quit and then, a second time, when he faked that he was frightened of something. For a me to his wife. his suicide. In the first phase of his analysis, I small child, violence is an overwhelming, hadn’t realized just how attached Peter was uncontrollable and terrifying experience— to violently upsetting others. But why? and its emotional effects can endure for a Peter’s parents had divorced when he was lifetime. The trauma becomes internalized, [Excerpted from The Examined Life: two and his mother had remarried soon it’s what takes hold of us in the absence of How We Lose and Find Ourselves by after. During this second phase of his analy- another’s empathy. So why did Peter turn on Stephen Grosz. Copyright © 2013 by Stephen Grosz. With permission of the sis, Peter sought out his biological father and those close to him? publisher, W. W. Norton & Company, Inc.] spoke frankly with his mother. He discov- Peter’s behavior made it clear that he ered that his mother had been having an couldn’t allow himself to feel weak. Depen- A bestseller in Great Britain; translated into affair with the man who became his stepfa- dence for him was dangerous. Peter’s story more than 20 languages; The Examined ther, and that his father and mother both might be summed up as, “I’m the attacker Life was described by Michiko Kakutani, in drank heavily. He also discovered that the who traumatizes, never the baby who is hurt.” the New York Times, as sharing “the best first two years of his life were very different But Peter also felt bound to turn on himself. literary qualities of Freud’s most persuasive from the story he’d been told. His mother When Peter assaulted himself in the church, work…a series of slim, piercing chapters and father both admitted that they couldn’t he enacted this same story. As he told me, that read like a combination of Chekhov cope and had been violent with him when “I thought—you pathetic little crybaby. I can and Oliver Sacks.” he was a baby. do this to you and you can’t stop me.”
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From the On a plane heading East Like an icebreaker through this lonely life You travel Unconscious Fearlessly friending whoever’s about Sheri Butler Hunt poetry Getting on beyond making do Mining opportunities as they present So different are we Richard Tuch, dean of training at the New Center for My fellow traveling partner By sheer happenstance Psychoanalysis, Los Angeles, has been published in TAP before, Upgraded were we with his poem “Marriage’s Promise?” This current poem, Out of the bowels of coach To sit side by side “On a plane heading East,” speaks to something we have all In near luxury And freely converse encountered. The sharing of intimate space with strangers, while About, you know, whatever zooming along above 30,000 feet, a bit of a captive audience. In free dialogue It was all quite unexpected His poem speaks to the best possible outcome of such intimacy— Though not by you finding something of a kindred spirit. Seeing that your life’s composed Of just such encounters Tuch is also a training and supervising analyst at the New Center As I came to learn During our flight together for Psychoanalysis, LA, and the Psychoanalytic Center of California, On that pre-Thanksgiving night and clinical professor of psychiatry at the David Geffen School You reached out to me In ways I would never do of Medicine, UCLA. Into my all too shy soul Mercifully providing me A momentary sense of companionship During an otherwise impersonal flight On that dark and cold November night Heading East To be with those We love Some flight-long conversations prove ghastly The product of sheer circumstance Held captive by those who are needly Who seize upon any chance To borrow an ear That’s not freely lent Oblivious to how unwelcomed And tortuous Such chatter can be Thankfully spared of that fate By your ample intellect And the fact we instantly recognized likeness In one another That spans generations You provided great entertainment For which I say “You’re very welcomed” Sheri Butler Hunt, M.D., is an adult training and consulting analyst And, of course, and a child consulting analyst in the child division at the Seattle “Thank You” Psychoanalytic Society and Institute. A published poet and member of My fleeting companion TAP’s editorial board, she welcomes readers’ comments, suggestions, By sheer happenstance. and poetry submissions at [email protected]. —Richard Tuch
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 19 UNDERGRADUATE ESSAY PRIZE
APsaA Awards Third Annual Undergraduate Essay Prize: “To the Lighthouse and the Oedipal Triangle” Caroline Beaton
can both rescue Mrs. Ramsay from her sup- Following Heinz APsaA’s Committee on Psychoanalysis and posed senselessness and allow himself to be Kohut’s under- Undergraduate Education, co-chaired by attracted to her. standing of Tragic Michael Shulman and Naomi Janowitz, is In line with Freud’s assertion that every Man as one pleased to announce it has awarded its Third hysterical symptom is accompanied by some motivated by the Annual Essay Prize to Caroline Beaton of Colo- degree of “compliance” and “participation of desire to restore rado College for her essay “To the Lighthouse Caroline Beaton and the Oedipal Triangle: Impotence, Erotic both sides,” To the Lighthouse presents Mrs. a cohesive self, I Degradation, and the Oedipus Complex from Ramsay as a necessary, though likely unwit- suggest that James and his father may rees- Freudian and Self-Psychological Perspectives.” ting, enabler of these dynamics. Mrs. Ramsay tablish their self-object connection with each The author summarizes her essay: acknowledges that she “did not like, even for other, and consequently diminish both their a second, to feel finer than her husband” and Oedipus complexes and erotic degradation In “To the Lighthouse and the Oedipal Triangle,” defers to Mr. Ramsay in all her judgments. dynamics with Mrs. Ramsay and Cam, during I use Freudian and self-psychological models of Ironically, Mrs. Ramsay’s collaboration in miti- their journey to the lighthouse. On the other the Oedipus complex and erotic degradation gating her husband’s psychical impotence hand, Woolf’s ambiguous ending may indi- to explore the Ramsay family’s psychical impo- facilitates James’s Oedipus complex. The loser cate that, despite their journey, the men do tence and fragmentation in Virginia Woolf’s of an Oedipal battle and without undivided not overcome their Oedipal triangle. novel. The “Oedipal triangle” refers both to the female affirmation of his own manhood, James Regardless of whether they rectify their intricate, ambivalent relationship between is cast out, castrated, and destined to repeat impotence through improved self-object rela- mother, father, and son and to the connections these same erotic degradation patterns with tionships by the novel’s end, the Ramsay’s’ between their Oedipal conflicts, degradation Mrs. Ramsay herself or a replacement, such as journey to the lighthouse signifies a quest for dynamics, and psychical impotence. his sister Cam, after Mrs. Ramsay dies. coherency that renders them Tragic Men in Freud argued that unresolved Oedipus Seen through a Freudian lens, it appears their final acceptance of the inevitability of complexes stimulate feelings of powerlessness, that James’s and his father’s Oedipal rivalry failure. Mr. Ramsay’s maxim, “We perished, emptiness, and incompetency—in a word, activates and then exacerbates their psychical each alone,” and James’s realization, “We are impotence—thereby giving rise to erotic impotence. The men degrade Mrs. Ramsay driving before a gale—we must sink,” reflect degradation dynamics by which the male and Cam to remedy their feelings, but these their coming to terms with their ultimate seeks to degrade and then rescue his sex dynamics prove ineffective because they powerlessness and death. Yet in their accep- object to convince himself of his superiority reengage the Oedipal situation and because tance of mortality, a kind of existential impo- and restore his masculinity. The first part of Mr. Ramsay’s and James’s need for female sex tence, Mr. Ramsay and James can finally find my essay points out how Mr. Ramsay and objects to restore their masculinity signifies peace with their identities and completeness. James’s Oedipal rivalry for Mrs. Ramsay’s dependence, which is counter to their desire “To the Lighthouse and the Oedipal Trian- affirmation and affection worsens their psy- for wholeness and autonomy. gle” attempts to supplement traditional chical impotence and increases their need Oedipal interpretations of the Ramsay family to degrade and then “save” her to ensure INNER FRAGMENTATION, with an appreciation of self-psychological their dominance and potency. Mr. Ramsay PSYCHIC IMPOTENCE pursuit of integration that encourages recog- degrades his wife by persuading himself of In the second half of the essay, I turn to self nition of a multi-faceted, multi-problemed, her simplicity and ignorance. After internally psychology to propose that Mr. Ramsay and multi-healing self. Furthermore, by placing satisfying his need for superiority, Mr. Ramsay James’s insufficient self-object relationships, Freud’s notion of psychical impotence along- in combination with their Oedipal conflicts, side Kohut’s concept of fragmentation, the Caroline Beaton, B.A., graduated from cause their inner fragmentation, a concept essay encourages the possibility of consider- Colorado College with an English major akin to psychical impotence. Mr. Ramsay and ing that soul precedes sexuality. The paper and psychoanalysis minor. Currently living in James lack self-object relationships with ultimately unifies some dichotomous aspects Vancouver, she is applying to graduate English each other as well as with Mrs. Ramsay, of Freudianism and self psychology toward a programs, hoping to continue integrating whose frantically scattered attention does broader understanding of the Oedipus com- psychoanalysis with literature, and aspires to not allow her to remain with either long plex and its constituents in psychoanalytic teach and undertake psychoanalytic training. enough to give them a sense of worth. theory and literature.
20 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014
POLITICS and There is not much that APsaA’s Commit- tee on Government Relations and Insurance PUBLIC POLICY (CGRI) or other clinicians can do to address malware on credit card readers or to curb Internet corporations about their use of Sovereign Right to Privacy of information they collect from customers. Nor is there much CGRI can do about sur- Americans, Patients and Clinicians veillance of citizens by the Department of Graham L. Spruiell Justice or NSA, or misleading statements by the president, except to affirm that all citi- Psychoana- clinician-patient contract since Hippocrates. zens—especially patients—have a right to lysts await the The promise of privacy underlies trust in privacy guaranteed by the U.S. Constitution, implications of one’s doctor and in one’s government. and that government surveillance without a the Affordable warrant or judicial order represents a gross Care Act (ACA) MORE THAN WORRISOME violation of that right. as it unfurls in It is worrisome that credit card readers at fits and starts. Target get hacked with malware, breaching DEFENDING PRIVACY AND Psychoanalysts sensitive information of 100 million customers, PRIVATE PRACTICE sometimes and another worry that Google, Yahoo, and In this respect, CGRI has a responsibility to speak as if we Amazon keep tabs on personal information of jealously defend patient privacy and the right Graham L. Spruiell are the only their customers and sell that information with- to freely contract in private practice accord- clinicians affected by significant changes in out customer consent. It is a quantum leap of ing to professional ethics. Despite reassur- health care, when in fact it is a concern for all worry however, when the Justice Department ance from some of our members, CGRI Americans, clinicians and patients. Psychoana- listens in on personal telephone conversations objected vehemently to the elimination of lysts, who have witnessed the false promises of reporters and their contacts without a war- the consent requirement in HIPAA which of managed care organizations and pre- rant, or NSA conducts surveillance of Ameri- allowed transmission of personal health ferred provider organizations to improve cans on the Internet, telephone conversations, information without patient consent for bill- the quality of care and to reduce costs, now business transactions, and text messages ing, treatment, and health care operations. wait to see if the ACA can fulfill its promises, without proper oversight by the Foreign CGRI efforts initially succeeded when hoping, despite dwindling reimbursements Intelligence Surveillance Act (FISA) court. President Clinton at the end of his term and increasing insurance reviews in the fee- But trust goes by the wayside when the reinstated the consent requirement largely for-service model, there will be a viable path President of the United States on 37 separate due to the advocacy of Bob Pyles and Jim for psychoanalysis. occasions promised American citizens that they Pyles as well as other privacy groups, all of But health care is only one shining scale could keep their doctors and insurance, when whom predicted that the removal of the on the dragon of societal transformation he knew that millions of Americans could not. consent requirement would spell the end of wherein privacy is subjected to balance test- On one of those occasions President Obama patient privacy. Both of the Pyles brothers ing and pragmatic analysis. The privacy of explicitly said, “No matter how we reform received commendations from President customers in relation to corporations and, health care, I intend to keep this promise: If Clinton for their patriotism. President more important, the privacy of citizens in you like your doctor, you’ll be able to keep George H.W. Bush initially agreed with Pres- relation to the government are both under- your doctor; if you like your health care plan, ident Clinton about the removal of the con- going similar transformations. The penumbral you’ll be able to keep your health care plan.” sent requirement and briefly referred to references to privacy in the Constitution refer Upon being confronted about this misstate- himself as the “privacy president,” but he to the citizen’s right to privacy in relation to ment, President Obama made a further mis- then eliminated the consent requirement, the government and are an essential part of statement when he said, “Now, if you have or resulting in the loss of patient consent and the social contract; but it is fair to say privacy had one of these plans before the Affordable ownership (regulatory control) of personal has also been the essential principle in the Care Act came into law and you really liked health information. Consequently, our gov- that plan, what we said was you can keep it if it ernment for the first time in history could Graham L. Spruiell, M.D., is co-chair hasn’t changed since the law passed,” when in lawfully disclose personal health information of the Committee on Government Relations fact he did not originally include that stipula- without patient consent, contradicting a and Insurance and a member of the Program tion. Imagine that in the United States it would central tenet of consent in the Constitution in Psychiatry and the Law, Beth Israel be up to the president to determine whether and medical ethics. Deaconess Medical Center, Boston. citizens could keep their doctors or insurance. Continued on page 31
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 21
Our mutual interest to enlarge our pro- fessional organizations is thus served by enrolling candidates in APsaA. andidates’ council Our treasurer Jamie Cromer has been working on the CC budget. She also serves as the candidate representative to the American Psychoanalytic Foundation. This year, Jamie has been engaged in C to contribute material celebrating their applying for certification. You can read her A Fresh View experiences of candidacy and the value article in the current edition of the Candi- that psychoanalysis has brought to their date Connection where she describes a Navah C. Kaplan lives and professional growth. contemporary experience of the certifi- The co- As president of the Candidates’ Council cation process. editors of the of APsaA, I focus more particularly on the Secretary Gennifer Lane-Briggs has Candidate enormous contributions APsaA makes to been assiduously compiling a candidates’ Connection, candidate education and to developing an directory of the names of all Candidates’ Marian Mar- analytic identity. Despite the political roil- Council members, which comprises its gulies and ing and the shouting that sometimes bursts officers, chairs of committees and repre- Holly Crisp- from the lines of a listserv post, APsaA sentatives of each institute to the CC. She Han, and I remains not just a good-enough parent to has been painstakingly contacting the insti- think hard candidates. It is an exceptional one. In my tutes with the earnest request that each about the contribution to the issue, I highlight some one designate a candidate representative Navah C. Kaplan organizing of the work being done by candidate to attend our Candidates’ Council meet- theme we leaders who chair the many committees ing during the APsaA National Meetings. select for each edition of the newsletter. of the APsaA Candidates’ Council (CC). I We are hoping her efforts pay off so that We look for something of primary impor- invite all candidates to come to the APsaA the majority of institutes will be repre- tance to candidates, and this has been National Meetings and to attend our sented at our next CC meeting. reflected in themes from the recent past meeting of the Candidates’ Council. We Gennifer has engaged with the chair of such as the supervisory experience, the will orient you to help you navigate the our Digital Media Committee, Anton “widening scope” of patient selection for program and learn of opportunities to get Babushkin, to develop ways of using tech- analysis and, most recently, creativity and involved in the Association. nology to promote candidates’ profes- candidacy. Since our last issue came out, an Candidates’ Council officers have been sional interests. Most recently, Gennifer APsaA political divide has found expres- involved in various projects over the last has taken on the role of chair of the Men- sion in a lawsuit, with one component of year. President-Elect Phoebe Cirio has torship Committee. She will be conduct- the organization in legal dispute with been working to revive the Committee on ing the follow-up to this pilot program another. I believe most candidates struggle Psychoanalytic Education (COPE) Candi- begun by our immediate past CC presi- to locate their own opinion on the many dates’ Study Group [See “Candidates’ dent, Hilli Dagony-Clark. weighty matters under debate, and it may COPE Study Group: Challenges of Training,” I have begun to visit candidate organiza- feel like the arguments continue a thread page 23]. She and I have liaisoned with tions at institutes local to me in the north- with a long tail in the historical past, diffi- the International Psychoanalytical Studies east corridor for informal dialogue in the cult and time-consuming for those newly Organization (IPSO) vice-president for nature of a focus group. I exchange infor- arrived to follow. North America, Marco Posadas of Can- mation, telling candidates about APsaA’s Candidates are engaged in learning to ada. We aim to forge a stronger connec- many programs and the benefits of candi- be psychoanalysts today. Which brings me tion between our two organizations, thus date membership, and I ask for candidate back to the theme of the latest newsletter. expanding the opportunities for collabora- impressions of APsaA. I ask what candidates We proposed a counterpoint to the per- tive work among candidates from a national want of a professional organization and haps necessary but rather depressing to an international arena. Marco is eager how informed they are about what APsaA expressions of the problems we face in our to help us grow our candidate member- offers candidates. My hope is such dialogue profession. We decided to ask candidates ship because he correctly notes that every will provide information useful in the effort to offer their own, fresher visions of the APsaA candidate member is automatically to recruit candidate members. field. The editors broadly invited candidates enrolled in IPSO membership as well. Continued on page 23
22 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014
Angela Retano of the newly renamed Policies and Procedures Committee has rewritten the docu- COPE ment that was previously called our Bylaws. The new Policies and Proce- dures document is now posted on Candidates’ COPE Study Group: the APsaA website in the Candi- dates section. She has worked dili- Challenges of Training gently, through many revisions, to create a document that summarizes Navah C. Kaplan and Phoebe A. Cirio the function of every CC office and committee and the duties of those Candidates Ideas candidates generated included study- so engaged. Anyone interested in now have a ing the impact of age at entering candidacy; learning about the many commit- Committee on the pursuit of omnipotence or becoming tees of the CC now has a guide. Psychoanalytic an analyst to overcome childhood moments Sabina Preter, who chairs the Education of uncontainment by a needed parent; the CC Scientific Paper Prize/Writing (COPE) Study use of supervision, including impasses and Workshop, announced there was Group on Chal- the variety of supervisory experiences; the no prize winner this cycle. She lenges of Train- experience of and impact of boundary viola- has therefore organized a Writing ing. Our study tions and boundary crossings in our devel- Workshop conducted by JAPA associate editors. They selected the Phoebe A. Cirio group has a des- opment as analysts; how we chose our writings of a candidate and showed ignated number training analyst; the complexities of our rela- how a work-in-progress may be of 12 members, who are expected to make a tionships with our fellow candidates; and developed into a publishable paper longitudinal commitment to attend group psychoanalysis as a Jewish way of thinking, through editorial feedback. meetings and contribute to the work. Similar including making meaning from miniscule bits Sarah Lusk, chair of the CC Pro- to every APsaA COPE study group, our of information. The idea of studying the gram Committee, organized two group will focus on a topic relevant to psy- development and/or acquisition of an analytic wonderful sessions geared towards choanalysis and will aim to make an educa- mind garnered the most enthusiasm among candidates for the recent APsaA tional contribution that advances the the group members. National Meeting. Each session featured a renowned analyst and discipline and/or psychoanalytic education. The study group is chaired by Phoebe candidate. At our second meeting in January 2013, Cirio, co-author of this article and president- You can read more about the during the APsaA National Meeting at the elect of the Candidates’ Council, who projects of the various committees Waldorf Astoria, we considered the objec- assumed her responsibilities in January 2014. in the current Candidate Connection tives we were going to set for ourselves. Her goal is to facilitate the group members’ newsletter online. Our committees We began our meeting by brainstorming for efforts to design an approach to the topic always welcome new members ideas inspired by the title of our study group. and begin implementing a work plan that who are seeking opportunities to Specifically, what did we think were the “chal- involves each member and results in an edu- plunge into the wide world of the APsaA Candidates’ Council. I am lenges of training” facing candidates today? cational product. easily reached by anyone who has Candidate members of the study group must make a commitment to attend the questions, wants more information Navah C. Kaplan, Ph.D., is a graduate or has an idea useful to the Candi- of the New York Psychoanalytic Society study group when it meets during the dates’ Council. Email: navahckaplan@ and Institute. She is president of the APsaA APsaA national meetings, usually twice a gmail.com Candidates’ Council. Her private practice year—in January in New York and in June in includes psychoanalysis and psychotherapy. changing locations across the United States. Editor’s Note: In addition, there may be scheduled confer- You can read the entire issue of the Phoebe A. Cirio, M.S.W., is in private ence calls during the year to exchange ideas Candidate Connection by visiting practice in St. Louis. She is currently an and progress with the project. Any candi- http://www.apsa.org/Portals/1/docs/ advanced candidate in adult psychoanalysis publications/ACNews/ at the St. Louis Psychoanalytic Institute date interested in joining the study group ACNewsJanuary-2014.pdf and an advanced candidate in child and or learning more is encouraged to contact adolescent psychoanalysis at the New the chair at [email protected] or at Orleans-Birmingham Psychoanalytic Center. 314-862-0345.
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 23 Annual Meeting in Chicago
APsaA is looking outward. This spring’s Come to Chicago University Forum is focused on psychoana- lytic engagement with the challenge of severe APsaA 103rd Annual Meeting weather and climate changes.
June 6–8, 2014 NEW PROGRAMS Kimberlyn Leary In addition, the June 2014 meeting inaugu- rates several new programs. “Psychoanalysis APsaA has reconfigured the Annual The meeting Here and Now,” moderated by Hans Agrawal, Meeting in June in accord with your recom- takes place over showcases a set of short TED-style talks by mendations. After much debate about the three days, largely APsaA members and invited guests, followed future of the spring meeting, the Association over a weekend, by an evening social event. Nancy Kulish will is experimenting with ways to meet the June 6–8, making chair our first Clinical Plenary, where Al Margu- needs of clinicians in today’s world. it possible for lies will offer in-depth clinical reflections on a
The June 2014 meeting will be held at the colleagues to Kimberlyn Leary patient treated over many years, across shifts in Palmer House in Chicago, a city conveniently attend to their psychoanalytic thinking and as the analyst con- accessible to colleagues on both coasts. The practices and still participate in popular solidated his own expertise. Clinical Field Stud- Palmer House, a classic and comfortable events like the Plenary Sessions, Two-Day ies uses a two-day format to engage analysts in venue, is close to the Chicago Art Institute Clinical Workshops, Symposia, Special Pro- the work of intervening in communities. and the Loop. grams for Trainees, and a large portfolio of Discussion Groups with member generated WORKSHOPS content that many attendees feel are the The Program Committee is also pleased to Kimberlyn Leary, Ph.D., M.P.A., is the life blood of our conferences. As always, sponsor three workshops aimed at helping chair of the APsaA Program Committee, the spring meeting also hosts the Ticho lec- analysts build and expand their base of pro- chief psychologist at the Cambridge Health ture, which features Christine Kieffer this fessional operations. Prudy Gourguechon and Alliance, and an associate professor at year, followed by a reception for all confer- Jeff Lieb will conduct a workshop on helping Harvard Medical School. ence attendees. Continued on page 26
24 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 Annual Meeting in Chicago
for its creative Lots to Do and See in Chicago in June “pig inspired” Kathleen Carroll cuisine. For a more traditional This year’s annual meeting, June 6–8, will Rodin). If you are looking for a fine dining meal, try Quar- again be held in Chicago. Home base for our experience, visit Terzo Piano, located in the tino, Italian small meeting will be the historic Palmer House Modern Wing. Alternatively, Caffé Moderno plates, located Hotel, at the corner of State and Monroe offers the perfect outdoor location for a on North State Streets, walking distance from the Chicago quick bite or glass of wine in Griffin Court. Street. If you are Institute for Psychoanalysis. Originally built as feeling particu- a wedding present from retail magnate Pot- GREEK MARBLE, TIFFANY GLASS, larly hungry and Kathleen Carroll ter Palmer to his bride Bertha Honoré, the AND PURPLE PIG would like to try Palmer House has been reconstructed twice Continue your walk north along Michigan Chicago cuisine, make a trip to the Billy Goat since. It is only blocks away from Millennium Avenue. You will pass the People’s Gas Build- Tavern made famous by the iconic SNL Park and the Art Institute. ing, a classic example of Chicago architecture, sketch with John Belushi and Dan Ackroyd. Millennium Park, first planned in 1997, at 122 South Michigan (once the tallest build- Alternatively, a takeaway slice of Chicago’s covers about 24.5 acres of parking lots and ing on this block). The marble in the entrance deep dish pizza after a long day of confer- railroad tracks. An open bridge directly was quarried from the same source as the ences may be the best course of action. connects the park with the Art Institute of Parthenon in Athens. Today it houses the Chicago. You will find evidence of the Art Chicago Institute for Psychoanalysis, head- BIKE AND BOAT TOURS Institute’s influence throughout the park, quartered on the 13th floor. Similar historic If this is not your first trip to Chicago, and from the many public pieces, including landmarks, including the old Chicago Public you are interested in exploring new neigh- “Cloud Gate,” locally referred to as the Library, share our neighborhood. The Chicago borhoods, consider taking a “City Bike Tour.” “Bean,” and an interactive multimedia foun- Public Library is the nation’s first and most The “Friendly Neighborhoods Tour” or the tain and tower display. The park also houses comprehensive free municipal cultural venue, “Bike at Night” options allow you to visit such the Jay Pritzker Pavilion designed by Frank crowned by a dome made of Tiffany glass. If neighborhoods as Lincoln Park or Hyde Park. Gehry. The Chicago Symphony Orchestra you would like more information concerning If you would prefer to travel by foot, consider frequently performs in this venue, and many Chicago’s history, this building now houses a walk along the river, about 10 blocks west Chicago residents and visitors make use of the Chicago Cultural Center, which offers free of Millennium Park. The Riverwalk is perfect the lawn for picnics during the performance. information on current events in Chicago as on a warm day. For a more comprehensive For information on the many free and public well as free musical performances. Of the architectural tour along the river, take a boat concert events, visit the website link for the more popular performances are “Juicebox,” tour. The boating tours allow you to explore Jay Pritzker Pavilion Schedule, which will be for children, and the “Sunday Salon,” featuring both the Chicago River and some parts of posted on the Millennium Park page in May: various classical music artists. Lake Michigan, traveling as far as Navy Pier. http://www.cityofchicago.org/city/en/depts/ If you are more interested in Chicago’s If short on time, you may find this the most dca/supp_info/millennium_park.html. architecture than its cultural heritage, visit efficient method for viewing the city. If you decide to explore the Chicago Art the Chicago Architectural Foundation down Try an enjoyable evening in the nearby Institute, be sure to visit the French Impres- the street at 224 S. Michigan Avenue. Enjoy theater district, for fine dining and theatrical sionists. The Art Institute is home to “A Sun- walking tours of Chicago’s most famous performances. Many Chicago residents prefer day on the Grande Jatte” by Seurat, as well architectural locations, such as the Modern the critically acclaimed Goodman Theatre, as a number of others. Many of these world- Skyscrapers Tour, or see Frank Lloyd Wright’s while others like the off-Broadway produc- renowned paintings come from the private homes in suburban Oak Park. tions at the Oriental Theater. During our collection of Bertha Honoré Potter, who dis- While you are touring along the landmarks conference, the Goodman Theatre will be covered Renoir and Monet before the rest on Michigan Avenue, take a shopping break. performing “Ask Aunt Susan,” a comedy writ- of the world caught on (she also posed for Visit Macy’s, the former Marshall Field’s build- ten by Seth Bockley. The Oriental Theater ing, which retains most of the original struc- houses a permanent production of “Wicked,” ture. Those of you traveling with children, try and “Motown The Musical” will also be show- Kathleen Carroll, B.A., is a recent Colorado the Water Tower Place, home to the Ameri- ing this June. Any of these performances will College graduate, volunteering for the can Girl Place and Lego Store. certainly be a terrific way to fill the evening current president of the Chicago Institute for We suggest you enjoy a meal during your and round out your Chicago experience. Psychoanalysis. She manages a non-profit touring at one of the several restaurants We hope you enjoy your stay in the city. called “Grow” that assists college students within the Loop. The Purple Pig on North Please feel free to contact us with questions to create peer-based mental health support Michigan Avenue is perfect for an experi- or recommendations for food, entertainment, groups on their campuses. mental palate. This restaurant is acclaimed and more at [email protected].
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 25 New Members 2014 National Meeting Waldorf Astoria Hotel, New York
Active Members Bliss I. Rand, M.D. Andrew Kopelman, M.D. Dina Abell, M.D. Eric Rankin, Ph.D. Andi Lyn Kornfeld, LMFT Devra B. Adelstein, M.S.W., LCSW Marilyn Rifkin, LCSW Hamin Lee, M.D. Mary L. Ayre, M.D. Anne E. Rocheleau, Ph.D. Evan Leibu, M.D. Ayelet Barkai, M.D. Alicia A. Rojas, M.D. Shirley C. Malove, M.S.W. Donna Bentolila, Ph.D., LCSW Kathleen Ross, Ph.D., LCSW Deborah Manegold, M.D. Alice M. Bernstein, Ph.D. Jeffrey A. Seiden, Psy.D. Sonya Martin, M.D. Howard M. Bliwise, M.D. Wendy Selene, LCSW Maria G. Master, M.D., J.D. Kaye Bock, M.S.W., LCSW Ruth H. Shorr, M.A., LCPC Rachel McBride, Psy.D. Deisy C. Boscan, Ph.D. Gabrielle H. Silver, M.D. Kathleen Molly McShane, M.D., MHP Nancy Butler, M.D. Charles Stowell, M.D. Manuela Maria Menendez, Psy.D. Russell B. Carr, M.D. Barbara Streeter, M.S., LPCC-S Christopher Miller, M.D. Sun Ju Chung, M.D., Ph.D. Jeffrey Thomas, M.S.W., LCSW Andrei G. Moroz, M.D. Alain Cohen, Ph.D. Theodore R. Treese, M.D. Larry Mortazavi, M.D. Michele Cohen, LCSW, FIPA Lorraine Weisman, M.A., P.C.C. Robert Glenn Mowbray, Psy.D., M.F.T. Jamie C. Cromer, M.S.W., LCSW Laura A. Westen, Ph.D. Dhipthi Mulligan, M.D. Cathryn Cunningham, M.D. Randi E. Wirth, Ph.D. Lucy Prager, LCSW M. Carole Drago, LICSW Nilufer E. Yalman-Chanin, Ph.D. Noah P. Rahm, Psy.D. Laura Esikoff, M.A. Lyn Yonack, M.S.W. Carolyn J. Ratner-Fitzgerald, Psy.D. Eran Feit, M.D. Lorenzo Resca, Ph.D. Jan L. Fretland, LCSW Candidate Members Gail Richman, M.A., LCPC Luke Hadge, Ph.D. Richard Angle, Ph.D. Joshua Richmond, M.P.W. Roderick S. Hall, Ph.D. Elissa N. Baldwin, Ph.D., LCSW Silvia Rodriguez, M.A. Ruth L. Hall, M.A. Nicholas Bartlett, Ph.D. Paul Schwartz, M.D. Talia Hatzor, Ph.D. Kristen Beuthin, LMFT Rebecca Schwartz, Ph.D. Claudette M. Heisler, Ph.D. Patricia Boguski, M.A., L.C.P. Emilie C. Sfregola, Psy.D. Mark A. Hokamp, LCSW Sarah Bullock, M.S.W. Virginia N. Shropshire, M.S.W., LCSW Christine Jacobek, Psy.D. Margarita Cala, M.D. Svetlana Simovic, M.D. Angelica Kaner, Ph.D. Heath Canfield, D.O. Tamara Smith, P.C.C. Todd Kline, M.D. Anna Chung, Ph.D. James South, Ph.D. Mina Levinsky-Wohl, M.D., LCMHC Barbara Cohen, Psy.D. Jephtha Tausig-Edwards, Ph.D. Judith Felton Logue, Ph.D. Lee Damsky, Ph.D. Gregory J. Villalba, LCSW James M. Mason, M.F.T. Radhika Dani, M.D. Richard C. Walters, M.A. Monique Masse, M.D. John F. Egger, M.D. Jonathan Weiss, M.D. Donald McDevitt, M.S., LCPC R. Robert Eskuchen, Jr., M.D. Valerie Wevers, LPCC Jill McElligott, L.S.W. Claudia Feldman, Psy.D. Kristin Whiteside, Ph.D. Paula Moreci, M.S.W., LCSW Lauren Gumbiner, M.S.W., LCSW Micki Wierman, M.A. Tehela Nimroody, Ph.D. Sharon E. Harp, M.S.W. David J. Williams, M.D. A. Johan Noordsij, M.D. Gina Joy-Reyes, Psy.D. Garret Wyner, Ph.D., Psy.D. Sule Ozler, Ph.D. Rania Kanazi, M.S.W., LCSW Lazaro Zayas, M.D. Daniel Plotkin, M.D., M.P.H. Kiana Keihani, Ph.D. Harry Polkinhorn, M.A., Ph.D. Vijay V. Khilanani, M.D. Academic Associate Member Karen Proner, M.S. Hannah Kliger Peltz, Ph.D., LCSW Kuan-Yu Chen, M.D.
Come to Chicago Stefan Reich will engage colleagues in an inter- Today’s “Find a Therapist”) and social media to Continued from page 24 active workshop of adaptive leadership, illumi- expand their practices. Each workshop will be nating how to meld analytic concepts with offered twice, over the course of the June meet- analysts to develop a footprint as a public intel- ideas from leadership consulting to create ing, to maximize opportunities for participation. lectual. This hands-on workshop will focus on opportunities for consulting and teaching. A Come to Chicago! Engage with colleagues, the mechanics of writing letters to the editor third workshop, offered by Will Braun and update your referral network, develop new and blog entries using psychoanalytic experi- Geralyn Lederman is oriented to strengthen- skills to use your psychoanalytic knowledge, ence as a framework for commentary. Join- ing the capacity of analysts to use microsites and extend your base of operations. Be part of ing us from Peru, by way of Cambridge, Mass., (like APsaA’s “Find an Analyst” and Psychology shaping the future of psychoanalysis.
26 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014
F I L M
Must the Artist Fall in Love with Death? Jean Cocteau’s Orphée Lissa Weinstein Bruce H. Sklarew Lissa Weinstein Bruce H. Sklarew, Film Column Editor of the stairs. The surfeit of doorways, por- tals, and stairs and the numerous camera The word mythos describes a spoken nar- Conceived in the traumatic aftermath of angles from which they are filmed serve to rative that is altered, inevitably each time it is occupation during WWII, the film locates its present the descent into Hades as a journey retold. Myth functions as a pre-text; hence its underworld in the bombed out ruins of St. into the labyrinth. similarity to the dream. Manifest versions are Cyr, exploring the nature of Eros in a world The dead Cegeste rises as if alive to be communicated as written (or filmed) texts, permeated by death and destruction. initiated into the “other world,“ leaving through which we ascertain the underlying By transforming Death into a character Orpheus to wonder whether what he sees is latent unconscious structures. Myth, like the rather than an abstract concept, Cocteau dream or reality. Orpheus observes as Death, Janus-faced ego, turns outward to connect allows us to observe the usually silent per- her henchman and Cegeste exit through the with society, as well as the interior. mutations of Thanatos. By altering the mirror, the door through which Death comes A most generative archetype, the legend affective heart of the myth so that the rela- and goes. Orpheus faints, awakening next to of Orpheus bears multiple meanings as par- tionship between Orpheus and Death is a puddle that reflects his image and is driven ticular strands are altered to fit individual central, Cocteau is able to study the transfor- home by Heurtebise. expressive needs and shifting historical con- mation of loss into more integrated states of Cocteau’s Orpheus, close to Narcissus, texts—a story of undying love, a metaphor selfhood, the route from narcissism to gen- shows little interest in devoted, bourgeois for the pain of relinquishing an absent object, erativity, the role of subliminatory outlets in Eurydice, who tries unsuccessfully to tell him a depiction of the permeable boundary binding the death instinct and the journey she is pregnant. Instead, Orpheus is enamored between our world and death, a meditation into the unconscious as a necessary prereq- of the poems that stream from the radio in on the creative process. uisite to creativity. the princess’s Rolls Royce, betraying both his In Orphée, we find Cocteau’s lifelong pre- Cocteau’s Orpheus, a staid bourgeois poet wish to be near her and to own the phrases occupation with the myth as an expression of whose inspiration failed him, is scorned by he believes will “astonish” the bohemians. the artist’s search for creative rejuvenation the avant-garde, who prefer the inscrutable The poems emerge from the other world through the “beyond”; Orpheus, poet and verses of the young Cegeste. Orpheus first in exact repetitions, their invariance repre- priest who, Christ-like, returns from the dead. glimpses the coldly elegant princess, “Death,” senting the intrusion of death’s stasis into through a window in the Café des Poets. language. Unbeknownst to Orpheus, Death Inexplicably drawn to her, he obeys when comes to his bedroom nightly to watch Lissa Weinstein, Ph.D., is an associate she summons him to her Rolls Royce after him sleep. professor in City College’s doctoral clinical Cegeste is killed by two leather-coated The transcribed poems that Orpheus sends psychology program and a graduate motorcyclists. The car rushes toward a twi- to his editor turn out to have been written by of the New York Psychoanalytic Institute. light countryside, its radio offering enigmatic the dead Cegeste. The police call Orpheus Her film papers have appeared in Projections, messages from the beyond. into the city for questioning. The filmed city is Projected Shadows, Psychoanalytic The landscape, shot using negative film, reminiscent of a De Chirico painting, its omi- Inquiry, Psychoanalytic Psychology proposes death as an inverse reality, a realm nous arches offering passage into the unknown. and Rivista di Psicoanalisi. of dark reflections. Heurtebise, Death’s Spotting the elusive princess, Orpheus pursues Bruce H. Sklarew, M.D., an associate chauffeur, is filmed from the back seat, as he her as she moves in and out of the dark soli- editor and co-founder of the award-winning looks into his rearview mirror. The theme tude; she remains an obscure object of desire. Projections: The Journal for Movies of reflections and reversibility continues at The labyrinthine streets anticipate the and Mind, organizes the film programs Death’s chateau; Death’s henchman carry descents to the underworld reminding us that at meetings of the American Psychoanalytic Cegeste upstairs, the scene first shot from death penetrates the “upper” world, always Association and has co-edited two books below with Orpheus looking up and then present even when hidden by noisy Eros. on psychoanalysis and film. with Orpheus looking down from the top Continued on page 28
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 27
Jean Cocteau’s Orphée Heurtebise, aware of Death’s fascination with Passing through the mirror, the two men Continued from page 27 Orpheus, accuses the princess of having killed careen past shattered doorways, burnt out Eurydice in order to have him for herself. In walls, and half-window jambs to find Death Eurydice’s death will similarly involve pas- an all-too-human rage at Heurtebise’s accusa- before a harsh tribunal, on trial for her trans- sages through doors and portals. Heurtebise, tion, Death loses her ability to pass smoothly gression of arranging Eurydice’s death with- seeing Eurydice run down by Death’s cyclists, through the mirror, leaving it shattered on her out “orders.” The judgment: Orpheus can carries her to her bedroom. The princess return to the underworld. Heurtebise offers leave with Eurydice provided he does not enters through the mirror followed by Ceg to accompany Orpheus into the underworld look back or tell what he has seen. Orpheus este, who keeps Orpheus from interfering by to retrieve Eurydice, aware that Orpheus is wants only to be with Death, who has con- transmitting repetitive nonsensical “poetry.” more enamored of Death than his wife. fessed her love for him to the judges. After Orpheus and Eurydice return to the upper world, the scene is comical, more like the French slang for a bored lover (he can’t stand to look at her anymore) than eternal love. Tormented Eurydice arranges her own death; Orpheus’s famous look back takes place in the car’s rear view mirror. When the bohemians who blame him for Cegeste’s disappearance attack, Orpheus submits, welcoming his fate. He descends again to the underworld, where the Prin- cess awaits. Transformed by desire, she is now subject to the painful affect of long- ing. Yet Death conspires to undo what has taken place. With Heurtebise’s help, she “labors” to strangle Orpheus; her pained ecstatic expression suggests birth. Now, their love will exist only in the poetry he will cre- ate—their child. Orpheus’s death in the underworld signals his return to life. Orpheus and Eurydice awaken as from a midsum- mer night’s dream, in what appears to be a parody of heavenly ecstasy while Heurtebise and Death will face an even deeper circle of hell where unimaginable torments await. Continued on page 29
28 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014
Death undergoes the more profound superior to dialogue in Death’s “orders” from transformation from narcissism to genera- decoding its multiple levels unknown superiors mimic tivity. Her chilling demeanor vanished, she of meaning and reference. the pyramidal structure sacrifices herself for Orpheus’s immortality. The interpenetration of of the resistance, while Like timeless Eros, she believes their love opposites drives the narra- expressing the inherent has always existed; Orpheus’s description of tive structure—itself con- unknowability of the drive. her as “burning like ice” is a well-known rep- structed out of fragments The tribunals copy the resentation of desire from Sophocles. Thus that do not always cohere. Communist purges after Cocteau reaffirms the inextricable tie of Although Orphée is auto- France’s liberation while still Thanatos and Eros in creativity. biographical, it captures representing the judgmen- Film offered Cocteau the ideal medium to much of the beauty of the tal punishing superego. examine death, creativity, and the unknown. original myth. Like Orphée, Both the underworld and In film, people are both present and absent, Cocteau struggled with his the creative, generative a parallel to the underworld where the dead place in French literature. aspects unconscious share exist in itinerant forms while their immobile His mixing of modern con- an absence of time and dis- remains are buried. Film’s technological tricks text with mythical allusions created a film tance, lack “whys and reasons,” and equate allowed him to represent the reversibility of both real and supernatural, mimicking the opposites. Both are storehouses of memory time; vanishings by fade-out and materializa- confrontation of ordinary life with the invisible and repetition. It is Cocteau’s genius to have tion by fade-in became visual metaphors for mysteries that feed creativity. While its overt shown us the interpenetration of the under- reversing death. Montage worked to depict form is a thriller, a French gangster movie world, with its lost inhabitants mired in the non-sequential, dreamlike narrative. melded with a war/resistance drama, it is an delusion and invariant repetitions, and the Opposites form the core of the film: pres- immortal thriller with every image a conden- “heavenly” ending scene, to suggest that the ence and absence, contrasts of light and dark, sation. Death’s Rolls Royce is simultaneously a mirror that births the self also opens the and the doorways that mark the boundaries conveyance across the River Styx; her head- portal of death. His magnificent images of between zones of life and death. These quarters in the ruins of St. Cyr condense paradox remain long after the dialogue fades images form the visual poetry of the film, Hades and the hell of German occupation. from memory.
THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014 29 FROM THE BOARD ON PROFESSIONAL STANDARDS
Can We Survive? model professional association best prac- 7. The reason for separating education Continued from page 5 tices.” While his presentation and the discus- and membership functions is for the sion that followed are too lengthy to include very circumstances we find ourselves They have gone from grave states to renewed in its entirety, we have highlighted below key in. The pressure to lower standards in enthusiasm reflected in sizable new classes points he made relevant to our professional order to recruit more student and after years of drought. But of concern, about and organizational crisis: graduate members leads to a slow ero- one-third of our institutes are vulnerable to 1. A certificate of graduation is not certi- sion of quality. This erosion is increas- very uncertain futures. Many of these have fication, and would carry no external ingly visible to outsiders. The profession a “lost generation” of members who have credibility as such. becomes less rigorous and less credible not pursued certification or training analyst 2. Certification is a credential that should to others. careers. be promoted in our representation of After an inquiry from one of our mem- We have also noticed important trends. ourselves to the public and other pro- bers as to why we are bothering with these Our youngest institutes often are our small- fessions, and we have undercut our- issues when our profession is in such crisis, est and tend to be among the most vulnera- selves as a profession by not doing so. the question was reframed to Chung as ble. Institutes more substantially integrated He knows of no profession that does “What would happen to us if we ‘took our into university and medical centers tend to not have certification. hands off the wheel’ and relinquished cred- be in the healthiest category. Institutes with 3. Although accrediting agencies and cre- ible credentialing and accreditation func- internal acrimony or which have faced trauma dentialing bodies should have proce- tions?” His response was “You will die as a tend to struggle, especially without assistance. dures for taking and considering input profession.” He elaborated that successful Importantly, despite the challenges we are from practitioners and the public, fed- professions include a rigorous, standard- facing, the national numbers of matriculating eral rules and non-governmental best ized education system and a credentialing candidates are and have been stable during practices include firewalls to prevent process to give a final stamp of approval on the last 10 years. the governing boards of professional/ the graduate. The dilution of credentialing trade associations from having undue and accrediting becomes part of a larger THE ROLE OF STANDARDS influence that might jeopardize the process eroding the general significance of IN OUR PROFESSIONAL AND independence of accrediting agencies evaluation and standards of competence. ORGANIZATIONAL CRISIS and credentialing bodies in making deci- The difficult work of articulating, assessing In the face of threat groups tend to battle, sions in the public interest. and ensuring levels of competence gives either against the external threat or among 4. Modern professional organization struc- way to increasingly diffuse, unformulated each other. It is not coincidence that our con- tures demand that credentialing and and unexamined goals for professional flicts over standards crescendo as our exter- accrediting bodies be firewalled for skills, conduct and identity. Chung pointed nal threats mount. There is always a fantasy in autonomy if they remain a part of the out that while every professional group groups that if Jonah can be found and thrown membership organization or are fully believes that it is an exception, that it does overboard, the seas will calm. In the context externalized into three organizations: not need to demonstrate that it has high of clamor by some that certification, the credentialing, accrediting and member- standards, when that task is ignored, the training analyst system, and our standards are ship. The latter model has been the group begins to operate at lower and to blame and against the backdrop of serious expectation of the Department of Edu- lower levels of functioning, and ultimately questions about the place of educational cation since October 1991. fails to distinguish itself from other treat- functions in our organization, the Board on 5. Multiple standards and levels of creden- ments and professions. Professional Standards invited an expert on tialing and accreditation detract from any professional organization structures, Dr. Ulric profession’s ability to credibly and effec- CONCLUSION Chung, to inform us on these matters. Chung tively advocate for that profession to the Chung’s words are sobering. We can is not a clinician or attorney but is nationally public, government, licensing boards, destroy the messenger or listen and think recognized for his knowledge of professional insurance industry, and modern health carefully. If we continue to fight each other organizational structures. His goal was to care table. In a later discussion, Chung within our organization any victory will be impart information relevant to the serious stated, “You have to know who you are pyrrhic. Alternatively we can work together questions we face and not to sway us one to represent yourself or advocate…if to thoughtfully consider how in these peril- way or the other. He was aware that a pri- you are everyone you are no one.” ous times we can adapt while still preserving mary objective of APsaA’s Strategic Plan is to 6. Every group believes they are different the knowledge and skills that define our pro- “move to a governance structure, operations, enough for these modern expectations fession and by doing so, survive as a credible and policy and procedures consistent with to not apply to them. profession in the modern era.
30 THE AMERICAN PSYCHOANALYST • Volume 48, No. 1 • Winter/Spring 2014
Sovereign Right Our own Deborah Peel of Patient Privacy In an effort to restore trust in the trans- Continued from page 21 Rights stated in her blog, “All purchases and formed health care system, Jim Pyles has writ- subsequent sales of personal health records ten a letter to Congressman Joe Pitts (R-PA) The prediction of the Pyles brothers has are hidden from patients.” She stated further, in behalf of APsaA supporting the Health largely come to pass as it has become clear “Despite claims that the data sold is ‘anony- Exchange Security and Transparency Act of that the HIPAA Privacy Rule was no longer mous,’ computer science has long established 2014 that would require notification of about patient privacy but had morphed into that re-identification is easy.” patients in the event of breaches of person- a rule about unconsented disclosures. True, IMS Health Holdings boasted, “We have ally identifiable information through federal HIPAA technically protected patient privacy one of the largest and most comprehensive exchanges. That bill has already passed in the in certain respects, but while the front door collections of health care information in the House of Representatives and is expected to was bolted tightly, the back door was left ajar, world, spanning sales, prescription and pro- pass in the Senate. and what was intended to be the “floor” of motional data, medical claims, electronic Sixty million Americans have had their per- privacy protection for patients has become medical records and social media. Our scaled sonal health information breached since the “ceiling.” Such is the case in Hawaii, where and growing data set, containing over 10 pet- 2005, 21 million since September 2009. We pharmaceutical companies, insurance compa- abytes of unique data, includes over 85 per- are certain that there will be breaches in the nies, and employers pressured legislators to cent of the world’s prescriptions by sales exchanges. When those breaches occur, it will forgo stronger state laws in lieu of less restric- revenue and approximately 400 million com- be in the backdrop of wider societal con- tive HIPAA regulations. prehensive, longitudinal, anonymous patient cerns about the loss of privacy in relation to Since HIPAA went into effect, patient pri- records.” Such data mining companies profit corporations and the government, affording vacy has continued to be degraded. In Sorrell from information derived from patients with- an opportunity for CGRI to reintroduce the v. IMS Health Inc. (2010), the United States out their knowledge and without compen- Patients’ Bill of Rights. Our aim is to reinforce Court of Appeals for the First Circuit con- sating them, which should be considered a trust in health care by recognizing sover- cluded that a Vermont law banning data min- form of confiscation and a violation of the eignty of patients to contract freely with clini- ing companies from selling prescription sovereign rights of patients and clinicians. cians without sacrificing privacy. information to pharmaceutical companies Again, anonymity is a was unconstitutional. This decision was term that had more appealed to the United States Supreme meaning before the I n M emoriam Court in 2011 by the state of Vermont, but computer age. the Supreme Court upheld the decision of David W. Allen, M.D. Meyer S. Gunther, Stephen L. Post, M.D. the First Circuit and agreed that the Vermont EXCHANGES April 1, 2012 M.D. April 6, 2011 November 23, 2013 law limited the right to free speech of the EXEMPTED Carol C. Austad, M.D. John Paul Pratt, M.D. data mining companies, arguing that since FROM HIPAA July 4, 2013 Peter Hartocollis, May 22, 2012 the government already had access to this The inevitable dis- M.D., Ph.D. Martin S. Bergmann, September 24, 2013 Edwin F. Price, M.D. information for purposes of research, indus- trust of patients when Ph.D. April 5, 2011 try should have similar access. they realize that their January 22, 2014 Irene N. Harwood, Psy.D., Ph.D., M.S.W. David Emerson Reiser, This begs the question about why the gov- personal health infor- Richard S. Blacher, December 11, 2013 M.D. ernment should have access to such data to mation is being sold in M.D. August 12, 2013 conduct research without patient consent the marketplace will January 16, 2014 Bernard S. Hellinger, M.D. Lois L. Schwartz, M.D. and is contrary to the Nuremberg Code, be exacerbated when C. Martel Bryant, M.D. January 5, 2012 October 26, 2012 which largely forms the basis of the Code of they learn that the October 26, 2013 Roy K. Lilleskov, M.D. Barbara A. Torpie, Federal Regulations issued by HHS to govern federal health insur- Sanford I. Cohen, M.D. November 11, 2013 M.D. federally funded human subject research. ance exchanges are September 18, 2013 April 21, 2013 Here the research interests of the govern- not subject to the Sydney M. Lytton, James F. Dyde, M.D. M.D. Herbert Wieder, M.D. ment and the commercial interest of data suboptimal privacy November 16, 2013 July 31, 2013 July 13, 2013 mining companies trump the right of patients. protections of HIPAA, Sanford Gifford, M.D. Charles E. Magraw, John P. Witt, M.D. Consequent to this decision, in January of and if there is a December 19, 2013 M.D. January 4, 2014 this year one such data mining company, IMS breach of medical Saul Glasner, M.D. December 30, 2013 Sheldon Wolfe, M.D. Health Holdings, announced it would begin records on federal January 28, 2011 Henry F. Marasse, August 17, 2013 selling stock on the New York Stock Exchange. exchanges, patients Ghislaine Godenne, M.D. Harry B. Woods, M.D. It along with other listed corporations are would not be notified M.D. May 3, 2012 July 14, 2013 deriving significant revenue from the sale of unless “harm” could November 23, 2013 personal health data to over 5,000 clients. be demonstrated.
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