The Patient Speaks: a Phenomenological Exploration of the Patient's Experience of Psychoanalysis

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The Patient Speaks: a Phenomenological Exploration of the Patient's Experience of Psychoanalysis Loyola University Chicago Loyola eCommons Dissertations Theses and Dissertations 2020 The Patient Speaks: a Phenomenological Exploration of the Patient's Experience of Psychoanalysis Katherine Williams Follow this and additional works at: https://ecommons.luc.edu/luc_diss Part of the Social Work Commons Recommended Citation Williams, Katherine, "The Patient Speaks: a Phenomenological Exploration of the Patient's Experience of Psychoanalysis" (2020). Dissertations. 3832. https://ecommons.luc.edu/luc_diss/3832 This Dissertation is brought to you for free and open access by the Theses and Dissertations at Loyola eCommons. It has been accepted for inclusion in Dissertations by an authorized administrator of Loyola eCommons. For more information, please contact [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. Copyright © 2020 Katherine Williams LOYOLA UNIVERSITY CHICAGO THE PATIENT SPEAKS: A PHENOMENOLOGICAL EXPLORATION OF THE PATIENT’S EXPERIENCE OF PSYCHOANALYSIS A DISSERTATION SUBMITTED TO THE FACULTY OF THE GRADUATE SCHOOL IN THE CANDIDACY OF THE DEGREE OF DOCTOR OF PHILOSOPHY PROGRAM IN SOCIAL WORK BY KATHERINE M. WILLIAMS CHICAGO, IL MAY 2020 Copyright by Katherine M. Williams, 2020 All rights reserved. ACKNOWLEDGEMENTS My graduate education was conducted as a dual student at two institutions simultaneously, at Loyola University Chicago School of Social Work where I was a doctoral student and at the Chicago Psychoanalytic Institute where I am training to be a psychoanalyst. These years of training have been the most arduous but the also the most vitalizing of my life. My deep desire to train as an analyst while working on a dissertation become a reality on a cold November morning as I sat in David Terman’s M.D. office discussing my future. David with clarity and enthusiasm suggested I pursue my professional goals. His enthusiasm soon combined with a commitment to support me in my training process. On the long journey of training David has been my mentor, clinical supervisor and member of my dissertation committee. When I think of David my heart overflows with gratitude and deep affection when I think of the many ways in which he always believed I could complete the task and was always ready to support me. Many others contributed their energies to promote my journey. I was fortunate to have a committee comprised of scholars and master clinicians. Dr. Marcia Spira not only served as the chair of my committee but has been supporting me in many practical ways for years as I navigated the complex path between the university and the Institute and at times she functioned as a type of diplomatic envoy between the two institutions most notably in assisting in the process of transferring academic credit from the institute to the university. Dr. Nora Ishibashi readily agreed to be the methodologist on my committee and her knowledge as an anthropologist, social worker, clinical researcher and clinician was endlessly helpful in the iii research process. I have come to depend on Nora’s encouragement in my research and clinical work. Dr. Terry Northcut understood my need to be an analyst way back in my first MSW class with her. Terry encouraged me and provided endless support all along the journey including inviting me to do my practice teaching in her classroom. I want to take this opportunity to thank the many individuals in my academic home Loyola University Chicago, School of Social Work and my clinical home Chicago Psychoanalytic Institute for training and mentoring me. At Loyola thanks to Dr. James Marley for mentoring me in the treatment of psychotic patients. Thank you to Dr. Philip Hong for teaching me so much about research and for being a model of academic integrity, Dr. Susan Grossman for encouraging my clinical research aspirations, Dr. Brian Kelly for providing me a model of how to be a qualitative researcher, Dr. Marta Lundy for introducing me to the joys of teaching and to Dean Stephanie Chapman for providing me opportunities to teach and for providing guidance along the way. I also want to thank the following faculty for providing me with excellent doctoral level course work that assisted me in formulating my research agenda: Dr. John Orwat, Dr. Julia Pryce and Dr. Katherine Tyson McCrea. I am also grateful for the many years of exposure to the social justice values that a Jesuit education provided and I try to live up to what I think of as Loyola’s secular motto of “seeking knowledge in service of humanity.” At the Chicago Psychoanalytic Institute want to thank the president Erika Schmidt LCSW, a social worker, for her tireless efforts in running the Institute. I also want to iv acknowledge the professional staff of the Institute in particular the following: Allison Chandler, the Director of Education, who expertly assisted in the transfer of elective credits from the Institute to Loyola. I also want to thank Christine Susman for all the support and for functioning as the memory of the Institute which was helpful to my research. Also want to thank John Leonard, the Institute librarian who provided me with research support and endless encouragement. I want to thank the faculty of the Institute who invested so much of their time in my training. In particular, to my supervisors: Dr. Dennis Shelby who is not only an outstanding clinical supervior but has often acted as an informal fifth member of my dissertation committee. Dennis was always willing to talk me through challenging research problems. Thanks also to my supervisor Jorge Schneider M.D. who is a deeply empathic and supportive supervisor and thank you to David Terman M.D. for supporting me in being truly responsive to patients. Thank you to Ruth Yanagi, M.D. who has functioned as my analytic mother and like all good mothers encourages me to take on challenges and to do more. Thank you to David Garfield, M.D. for affirming my need to work with acute patients and being my clinical guide in how to do the work. I want to thank Robert Galatzer-Levy M.D. for taking a walk with me years ago at the annual APsaA meeting in New York City where I expressed wanting to do a quantitatively based clinical outcomes study but was struggling to formulate a plan how best to do this. Bob responded by saying: “there is not much that is interesting in the numbers you might want to think of another way.” That comment provided the catalyst for me to engage with a qualitatively based research design for this dissertation. I want to thank the many other Institute faculty members for mentorship and training: Michael Hoit, M.D., Paul Holinger, M.D., Mark Levey, M.D., Barbara Rocah, M.D., Brenda Solomon, M.D., Arnold Tobin, M.D., Clifford Wilkerson, v M.D., Dr. Molly Witten, Karen Martin LCSW, Dr. Elizabeth Feltman, Elizabeth (Lisa) Lennihan LCSW, James Fisch, M.D. James Wilson, M.D., Dr. Christine Kieffer, Dr. Ann Kaplan, Anne Schlachter LCPC, and Dr. Jonathan Lear for teaching me so much about Freud and thank you to Dr. Frank Summers whose writings and focus on the experiencing subject has been instrumental in how I ultimately approached clinical outcome research. Also want to thank the late Dr. Lewis Aaron, taken from us to soon, for encouraging my research and to Glen Gabbard, M.D. for always being willing to speedily answer my questions with clarity and insight. A big thank you to the candidates and in particular my cohort at the Chicago Psychoanalytic Institute. Training would be so much more difficult and lonely were it not for the support and camaraderie of this group. I want to in a special way thank my dear friend and colleague Dr. Sidney Miller for being a companion on the journey. Thank you also to Theo Pintzuk, LCSW whose help was instrumental during the data collection phase of this research. Also want to acknowledge and thank our distant analytic training colleagues who have enriched my training experience. Your commitment to training and psychoanalysis has inspired me. I want to thank my late father, Stephen John Williams, for being my first intellectual mentor and first Freud teacher. Thank you to my patients, both past and present, because of you I wake up each morning with a sense of purpose. You each live in a part of my heart that belongs only to you. I also want to thank close friends, Sue Campbell and Garry and Astrid Brown for all the years of support and friendship. Thank you to my two dogs, Marsport Sigmund Freud (“Ziggy”) and Marsport Winston Churchill for their love, devotion and teaching me to live in the moment. You are my experience of Paradise. This dissertation would not have been completed without the daily support of two extraordinary individuals in my life, my husband Dr. Steven Timm and my analyst Scott Davis, vi M.D. Steven has for the better part of my life sustained me with love, friendship and companionship as we have built a life together. With Scott I discovered that analysis can be a transcendent experience and our deep connection endures through the joys and challenges of life. The journey continues and life is rich with meaning. Finally I want to thank the participants to this study: Brenda, Debbie, Paul, Pearl, Ruby, Sally, Shelly, Jennifer, Jim and John. Your stories live inside me and I am committed to having your voices heard. vii Dedicated to my husband, Dr. Steven Timm and to my analyst, Scott Davis, M.D. In offering a contrasting viewpoint that regards experiencing as the key to human existence, psychoanalysis becomes an alternative worldview that places the highest value not on any measurable outcome, but on the realization of potential on awareness and expansion of experience.
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