the FALL/WINTER 2005 AMERICAN Volume 39, No. 4 PSYCHOANALYST Quarterly Publication of The American Psychoanalytic Association

New Orleans Center Carries On INSIDE TAP... After Katrina Special Section: Michael Slevin Psychodynamic Hurricane Katrina hit New Orleans and the Many, New Orleans analyst Elsa Pool adds, Diagnostic Gulf Coast with a powerful force at the end of are in places where they cannot work at all. Manual ...... 12–16 August 2005. Levees were breached, flooding While Harper is back in New Orleans, in Octo- Consideration and large areas of New Orleans. Most residents ber Pool was seeing analytic patients four days Mortality ...... 18 able to evacuate the city did so. a week in Baton Rouge and three days a week Three months later (as TAP goes to press), in New Orleans. Her husband, Douglas Pool, The Bylaw Amendment the New Orleans Psychoanalytic Center is still works during the week in a hospital in Gulf- on Certification . . . . . 20 disrupted. The building sustained little damage port, Mississippi, and on weekends sees patients and its first floor library and administrative in New Orleans. College Mental Health . . 24 office are intact. But its members have been The center has suffered a loss of its recent scattered. They took up temporary residence momentum. A “self-examination and change A Conversation with family and friends throughout the state of process” begun after the last site visit about about Candidate Louisiana and in locations as far apart as Maine four years ago, Harper reports, resulted in Recruitment...... 28 and Oregon, Wisconsin, North Carolina, Ten- the dissolution of the separate institute and APsaA Fellows . . . . 30–32 nessee and Florida. A number migrated first to society and creation of a psychoanalytic center Houston,Texas. Families have placed their chil- (TAP 38/4). The new center was established in dren in new schools and will not be returning to an attempt to create a community New Orleans until school breaks in January or of clinicians, scholars, and lay people May. Three displaced analysts have been hired by who share an interest in psycho- the psychiatry department of the University analysis. There was only one class of Alabama in Birmingham Medical School. of members, all of whom were Patients have also dispersed. The abrupt equally enfranchised. This, according cessation of contact has been very difficult, to Harper, expanded and revitalized Lee Ascherman, a Birmingham analyst affili- membership. ated with the New Orleans Institute, notes. In The first board, comprising ana- the initial weeks, cell phones and e-mail were lysts, psychotherapists and lay peo- down. Most analysts have been able to find ple, met through the summer, right most patients, he says, but it has been a long up to the week of Katrina, involving process. According to Randolph Harper, pres- most of the full membership in var- ident of the center, no analysts are working ious aspects of the work to come. full time. At best, analysts have resumed only With this “energy we didn’t have 40 to 60 percent of their previous caseloads. before,” Harper says, a rich and enticing schedule of training and

outreach programs was planned. Schmaltz, MODIS Land Rapid Response Team Photo: NASA/Jeff Michael Slevin, M.A., is editor of TAP. Continued on page 6

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 1 CONTENTS: Fall/Winter 2005 THE AMERICAN PSYCHOANALYTIC ASSOCIATION President: Jon Meyer 3 Keeping Our Eye on the Ball Jon Meyer President-Elect: K. Lynne Moritz Psychoanalysis in the University Beth J. Seelig and Eric J. Nuetzel Secretary: Prudence Gourguechon 5 Treasurer: Warren Procci 8 January Program Features Damasio and Fonagy Plenaries Executive Director: Dean K. Stein Glen O. Gabbard 9 New York and All That Jazz Charles D. Levin Exploring New York through the World of Mark Rothko THE AMERICAN PSYCHOANALYST 10 Publication of the Chris Broughton American Psychoanalytic Association Editor SPECIAL SECTION Michael Slevin Psychodynamic Diagnostic Manual Member, Council of Editors 12 Greenspan Spearheads Creation of Psychodynamic Diagnostic of Psychoanalytic Journals Manual Lynn Stormon Associate Editor and International Editor Christine Ury The Psychodynamic Diagnostic Manual: An Overview 14 National Editor Nancy McWilliams, Robert S. Wallerstein, and Stanley I. Greenspan Prudence Gourguechon Contributions of Psychodynamic Concepts in Identifying 15 Editorial Board Mutative Factors in Intensive Treatment Sidney J. Blatt Thomas Bartlett, Brenda Bauer, International TAP Edited by Christine Ury Vera J. Camden, Maxine Fenton Gann, 17 Sheri Hunt, Laura Jensen, Consideration and Mortality Ellen Pinsky Jack Miller, A. Michele Morgan, 18 Caryle Perlman, Marie Rudden, 20 Supporting the Bylaw Amendment on Certification Jonathan House Hinda Simon, Gittelle Sones, Opposing the Bylaw Amendment on Certification Beth J. Seelig Lynn Stormon, Julie Tepper, 20 Jane Walvoord, Robert S. White, 22 The Task Force on Reorganization Makes a Proposal: Dean K. Stein, ex officio Now It’s Up to You Robert M. Galatzer-Levy William D. Jeffrey, Consultant Los Angeles and Southern California Societies and Institutes Merge Paul Mosher, Consultant 23 Michael and Helene Wolff, R. James Perkins Technology Management Communications, 24 Complex Mental Health Issues Lead More College Students Manuscript and Production Editors to Seek Counseling Lorraine D. Siggins The American Psychoanalyst is published quar- Bringing Basic Freud to the Whole Student Body Shela Fisk terly. Subscriptions are provided automatically 25 to members of The American Psychoanalytic 26 Wisconsin’s Forum on Psychology of Racism Creates Dialogue Association. For non-members, domestic and with Minority Community Jan Van Schaik Canadian subscription rates are $32.50 for indi- viduals and $75 for institutions. Outside the U.S. Science and Psychoanalysis: Vive la Différence Robert Michels and Canada, rates are $52.50 for individuals and 27 $95 for institutions. To subscribe to The American 28 A Conversation about Candidate Recruitment: Psychoanalyst, visit http://store.yahoo.com/ How Enticing Ethnic Cuisine Can Change Your Institute Dottie Jeffries americanpsych/subscriptions.html, or write TAP Subscriptions, The American Psychoanalytic 29 A Call for Proposals Selma Duckler Association, 309 East 49th Street, New York, New York 10017; call 212-752-0450 x18 or e-mail 30 APsaA’s Excellent New Fellows for 2005-2006 [email protected]. Poetry: From the Unconscious Sheri A. Hunt 34 Copyright © 2005 The American Psychoanalytic What Are the Data? Robert L. Welker Association. All rights reserved. No part of this 35 publication may be reproduced, stored in a 36 Living the Questions in Sacramento John A. Booth retrieval system, or transmitted in any form or by Politics and Public Policy: Totem and Taboo: any means without the written permission of The 38 American Psychoanalytic Association, 309 East The IPA “Standards” Debate Robert Pyles 49th Street, New York, New York 10017. On Psychodynamic Psychotherapy for Psychiatric Residents Paul Tiger 39 ISSN 1052-7958 40 Reading, Writing, and Therapy: Psychoanalysts in Schools Jeffrey H. Golland and Bruce Sklarew The American Psychoanalytic Association does not hold itself responsible for statements made in 41 The Press Taps APsaA Expertise on Confidentiality of Therapists’ The American Psychoanalyst by contributors or Records Dottie Jeffries advertisers. Unless otherwise stated, material in The American Psychoanalyst does not reflect 42 One Hour a Month for Advocacy and Mental Health Dean K. Stein the endorsement, official attitude, or position of Membership: Tool of the Trade: The Analytic Couch—Discounted The American Psychoanalytic Association or The 43 American Psychoanalyst. Debra Steinke

2 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 FROM THE PRESIDENT

changes we need have a lot more to do with Keeping Our Eye on the Ball organizational effectiveness than with not- Jon Meyer for-profit corporation law. At the heart of those facilitative changes are the board of We are almost through another political yet to mount a directors’ functions. In modern corporate season. Having been immersed in politics for national adver- structure, the board of directors gives you the the last decade, I know the processes inti- tising campaign needed financial, fundraising, public relations, mately and feel proud to be involved. However, that says other- lobbying, legal, and business skills. If we think if some feel turned off because politics is less wise. There is of our Association as a family, then it is time to their taste, I would just ask them not to drop consensus about to welcome new, experienced, and talented out. At the end of the season, we need to the importance members to the family. come together to deal with the psychoanalytic of using media environment’s unfavorable climate report. outlets to say we 21ST CENTURY BOARD OF DIRECTORS We take that climate report seriously and are alive and well, We can be proud that our current gover- Jon Meyer are doing a lot to move psychoanalysis forward. but we don’t have nance has gotten us to this critical juncture, In the advocacy priority, we have the Oxford the fundraising, public relations, and business but our present governance only made sense agreement putting ethics into business oper- resources to mount a successful campaign. when we were smaller and internally preoc- ations; the RICO settlements making man- cupied, with no competition or challenges— aged care answer for predatory practices; FACING FACTS scarcely the current circumstance. Now, our the proposed Ethics Based Medicine Act of Our situation can be summarized in three board of directors is the Executive Council 2005, defending privacy in the tradition of simple facts. with 58 councilors, largely chosen by and rep- Hippocrates and asking Congress to join with Fact 1: Our challenges expand like ripples resenting societies. I have been part of that us; and the HIPAA suit in the United States from the common belief that psychoanalysis body since 1993 and it has been my home Court of Appeals for the Third Circuit raising is dead. within a home. I have grown up in the Coun- constitutional issues about medical privacy. Fact 2: To be effective, we must be smart in cil, recognize that it has carried us a long way, In the education priority, we have the Ticho choosing actions and interventions. and speak of it with pride and respect. It is an Memorial Lecture, the first foundation sup- Fact 3: Effectiveness is dependent upon institution that has laurels to rest on, not the ported lecture in the Association’s history; having necessary skills and resources at our least of which is that it had the wisdom to planning for a 21st century scientific program; fingertips. begin a reorganization process. I believe the the exploration of “no-strings” pharmaceutical support for our scientific program; and the BOPS efforts to further improve the reliability If we think of our Association as a family, and validity of certification in the service of continuing education and career development. then it is time to welcome new, experienced, As important as these efforts are, we have much more to do. For example, we have an and talented members to the family. excellent national lobbying campaign, but we need a state effort. As developments in New York, New Jersey, and Vermont demonstrate, I don’t think there is any doubt about those Council, along with our members, will have the the very definition of psychoanalysis is depen- facts: Our challenges are vast, we have to wisdom to see it through. dent on state coalitions, lobbying, and political be smart to meet them, and, to be smart, we There will be many debates and different action. We have had our successes—Con- need more specialized help. This is where views, but I don’t think we can get around necticut, Pennsylvania, and California—and the rubber meets the road and our two what might be called “fact number four”: Our we are getting smarter, but we are not out of strategic initiatives come together. Stated sim- difficult environment requires a smaller, stream- the woods. We are working at outreach, but ply and directly, being smart is strategic plan- lined, and yet democratic board of directors, we are always at a disadvantage because of a ning; getting more of the right kind of help is elected directly by the members and respon- pervasive belief, even among those who should reorganization. Strategic planning has devel- sible to the membership, with minority seats know better, that psychoanalysis is passé and oped our priorities and brought us face to for essential extra-analytic talents and expe- inconsequential, if not frankly dead. We have face with long-range planning, tough choices, rience. To put it from a slightly different per- and the critical need for help. To get that spective, we need a board of directors that can Jon Meyer, M.D., is president of the American help, we need to reorganize, and not just in a raise money as well as oversee its expenditure. Psychoanalytic Association. token manner. As I have said before, the Continued on page 4

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 3 Eye on the Ball Continued from page 3 Contacting the National Office These ideas move us away from the usual and familiar, but if we are to thrive and not just survive, we must think outside the box. We The American National Office have come a long way but we can’t go the Psychoanalytic Voice Mail Extensions rest of the way without help from outside of Association Alex Gino x18 psychoanalysis. All this is not easy for anyone. In fact, the 309 East 49th Street Chris Broughton x19 Council is asked to have extraordinary wisdom New York, NY 10017 Brian Canty x17 and take the difficult step of considering its Debra L. Eder x21 Phone: 212-752-0450 own future, looking beyond itself to the years Sherkima Edwards x15 ahead. I believe the Council is up to the task. Fax: 212-593-0571 Tina Faison x23 As members, we have the final vote and I Carolyn Gatto x20 believe we are up to the task. E-mail: [email protected] We all need to discuss and understand the Dottie Jeffries x29 implications of a thorough reorganization. Danise Malqui x28 In New York, there will be time set aside for Nerissa Steele x16 World Wide Web Site: you to meet with the Executive Committee, Dean K. Stein x30 http://apsa.org/ the Steering Committee, and me so we can talk Debbie Steinke x26 about these far-reaching changes. We have a Lyvett Velazquez x12 lot of discussion ahead of us and I look forward to seeing you.

Call for Submissions

The Committee on Research and Special Training (CORST) announces the 2006 CORST Essay Prize in Psychoanalysis and Culture for essays on psychoanalytically informed research in the biobehavioral sciences, social sciences, arts and humanities.

The essay should be no more than 30 pages in length and should neither have been published nor submitted for publication. The CORST Essay Prize is open to anyone regardless of institutional status or affiliation. The winning essay will be presented at APsaA’s Winter 2007 Meeting and will be reviewed for publication by the Journal of the American Psychoanalytic Association (JAPA). The winner will receive a $1,000 prize.

Entries are due September 1, 2006. Please e-mail your submission to: [email protected] and [email protected]

For more information, contact Vera J. Camden, Ph.D., Chair, CORST Essay Prize, 216-407-7931 http://www.apsa.org/ctf/corst/announce.htm

4 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 FROM THE BOPS CHAIR

Emory. Perhaps Psychoanalysis in the University many examples Beth J. Seelig and Eric J. Nuetzel of such institute- university col- In 1919 in “On the Teaching of Psycho- for cultivation and some are already bearing laboration exist. Analysis in Universities,” Freud wrote: fruit. This is the time to strengthen existing The point is that partnerships with universities and form new we need much In the investigation of mental ones. The Committee on Research and Spe- more institute- processes and intellectual functions, cial Training represents one such effort. university collab- psychoanalysis pursues a specific Another is APsaA’s 10,000 Minds Project, oration to foster method of its own. The application Eric J. Nuetzel which is developing a coordinated set of the growth and of this method is by no means con- efforts to increase the exposure of under- development of psychoanalysis in the 21st fined to the field of psychological graduates both to psychoanalytic ideas and to century. disorders, but extends also to the the benefits of psychoanalytically informed There is great interest in psychoanalysis solution of problems in art, philos- treatment (TAP 39/2). Even more needs to within various parts of the academic com- ophy, and religion. In this direction be done to strengthen the links between munity. Well-known scholars in the humanities it has already yielded several new our institutes and academic communities on and the social sciences utilize psychoanalytic points of view and thrown valuable the local level. Increasing the number of concepts in their work. Psychoanalytic stud- light on such subjects as the history alliances between analysis and other disci- ies programs attract numerous highly inter- of literature, on mythology, on the plines will lead to the generation of new ested students. Neuropsychoanalysis, a new history of civilizations, and on the knowledge, as well as increase the number of area bridging psychoanalysis and neuro- philosophy of religion. Thus the gen- those appreciative of, knowledgeable about, science, has emerged. In this atmosphere, eral psychoanalytic course should and interested in psychoanalysis. This will analysts as collaborators, co-investigators, and be thrown open to the students of inevitably result in more people seeking out co-teachers have been welcomed in graduate these branches of learning as well. psychoanalytic treatment and psychoanalytic schools and schools of law and business, in The fertilizing effects of psycho- education. addition to departments of psychiatry. To analytic thought on these other dis- give a few specific examples, psychoanalytic ciplines would certainly contribute PRECEDENTS researchers such as Peter Fonagy, Mark Solms, greatly towards forging a closer link, Such efforts have a long history in places Howard Shevrin, and Drew Westen have in the sense of a universitas litera- such as the Columbia University Center, the forged alliances with the neurosciences and tum, between medical science and NYU Institute at the New York University with academic psychological research. Dis- the branches of learning which lie Medical Center, the Denver Psychoanalytic tinguished neuroscientists such as Damasio, within the sphere of philosophy and Institute in the University of Colorado Med- Edelman, Kandel, Sacks, and others have the arts. ical Center, the University of North Car- become increasingly appreciative of how Freud’s vision is essential to bear in mind olina-Duke University Institute, and the Emory Freud’s early insights are compatible with as our profession evolves. We live at a pivotal University Institute. These psychoanalytic modern knowledge of the brain and how it moment, a time of great opportunity and institutes were developed within their respec- works. To quote Eric Kandel, co-recipient of great challenge. Some of our members have tive university’s medical schools. The New the Nobel Prize in Medicine, in his 1999 arti- full practices and some struggle. Some are York Psychoanalytic Institute has recently affil- cle in the American Journal of Psychiatry,“Biol- engaged in teaching in institutes and in other iated with Mount Sinai School of Medicine, to ogy and the Future of Psychoanalysis: A New academic settings, while others worry that their mutual benefit. The Emory institute, in Intellectual Framework for Psychiatry Revis- psychoanalysis may be dying. association with the Graduate School of Arts ited”: “…the biology of the next century is, in There is no doubt that our profession is and Sciences, developed a unique psycho- fact, in a good position to answer some of the being challenged. Freud’s notion of a univer- analytic studies program with over 30 grad- questions about memory and desire,… these sitas literatum provides us with a cornucopia uate students in the humanities currently answers will be all the richer and more mean- of potential solutions. Various fields of inter- enrolled. In St. Louis, a joint research project ingful if they are forged by a synergistic effort disciplinary scholarship are presently ripe between the institute and Washington Uni- of biology and psychoanalysis. In turn, answers versity’s Department of Psychology is well to these questions and the very effort of Beth J. Seelig, M.D., is secretary of the underway. In addition, the development of providing them in conjunction with biology, Board on Professional Standards. academic centers that could support psycho- will provide a more scientific foundation for Eric J. Nuetzel, M.D., is chair of the analytic scholarship and empirical research psychoanalysis.” Board on Professional Standards. is being actively pursued in St. Louis and at Continued on page 7

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 5 HURRICANE KATRINA

Katrina video conference. The Louisiana State University HELPING TRAUMATIZED CHILDREN Continued from page 1 psychiatry residents want to start a teleconfer- New Orleans Psychoanalytic Center APsaA encing course soon. To provide video and tele- members Joy and Howard Osofsky, in New These inaugural year plans included child and conferencing equipment and to help defray Orleans, and Lee Ascherman, in Birmingham, adult programs in psychoanalysis, a psycho- fixed costs, application is being made for a grant are working long hours to help states provide therapy training program, teaching of Louisiana from the APsaA psychoanalytic foundation. systemic help to displaced and traumatized State and Tulane University PGY III residents, Some center members who have returned children. outside speakers such as Ralph Roughton and to New Orleans met in early November at the Ascherman has been working with the Peter Rudnytsky, who would have appeal to center and were joined by other members in Alabama State Departments of Education and the larger New Orleans mental health and a conference call to plan a support group Public Health. He is working to reach chil- university communities, special lectureships effort and treatment and referral services as dren in need, and, through the children, their on the arts in collaboration with the New part of an outreach effort for the New Orleans parents. The schools are seen as the anchor Orleans Museum of Art—and more. community post-Katrina. point for displaced families. The school sys- All of this has been interrupted, and it is There is hope that programs picking up on tems, he reports, have been very receptive to unclear when the center will be up and running. the inaugural year efforts could begin next absorbing and not segregating these children. Because of fixed expenses, it is in the red at September. Harper says,“We have to recover Yet they have provided opportunities for the this time. Fundraisers, which had been planned, personally, we’ve got to kind of feel our way, children to gather together in group work are not possible. One of the center’s two fourth- get grounded” first. Ascherman says, “We’re and to process their experiences. The chil- year candidates has begun a reduced course still in the event.” But Harper, Ascherman, dren, he points out, went home Friday before load by phone. Two second-year psychotherapy Pool, and others emphasize that the energy the hurricane with no awareness that that students were hoping to soon begin classes by behind the new psychoanalytic center remains. Continued on page 7

APsaA Pitches In To Help Colleagues Recover from Hurricane In response to Hurricane Katrina, the American Psychoanalytic Association requested donations from members for the American Red Cross and for the Association’s Psychoanalytic Assistance Fund (PAF). By mid-November, $20,692 had been donated to the Red Cross through APsaA. The PAF had received $52,606 in donations. As part of its relief efforts, the PAF has awarded a block grant of $75,000 to the New Orleans Psychoanalytic Center (NOPC) for distribution. In mid-September, International Psychoanalytical Association President Claudio Eizirik made an international appeal to all IPA members for contributions to the Red Cross and to the Psychoanalytic Assistance Fund. Contributions in solidarity and sympathy with New Orleans colleagues have been received. These are to be relief funds for both IPA and APsaA colleagues in the affected area. An appeal for funds posted on the Association listserv of APsaA, written for the PAF and the New Orleans Psychoanalytic Center, stated in part: In the years preceding World War II, the Psychoanalytic Assistance Fund (PAF) was established to assist the resettlement of colleagues fleeing Europe. The fund has continued to the present as a resource to aid analysts facing unanticipated financial hardship. Hurricane Katrina, which struck New Orleans, and Hurricane Rita, which struck nearby on the Gulf Coast, have created another kind of disaster for our colleagues in these areas. While they are safe, they have become displaced without time to prepare for relocation. Many have lost or have severely damaged homes and offices. All but the few who are employed by institutions have had an abrupt loss of income. In addition, they now face expenses related to reestablishing housing while maintaining their existing financial obligations in the devastated region. The grants and loans criteria set up by the PAF, to be implemented and funds dispersed by Lee Ascherman and Fred Griffin in Birmingham (who are New Orleans center analysts close to the scene) are as follows: • Grants of up to $5,000 are available to analysts or candidates in the affected area who are members of APsaA or members of IPA who have not had significant employment income outside of their practice following Hurricane Katrina. Although recipients of these grants are under no obligation for repayment, it is hoped that they may in turn contribute to the PAF as they are financially able. • Interest free loans of up to $3,000 are available to other members of the New Orleans Psychoanalytic Center, such as members of the psychotherapy training program, who are not members of APsaA or the IPA. Repayment of these loans may be later excused if financial circumstances so warrant. The generosity of the members of APsaA, now and in the past, is helping our New Orleans colleagues cope with the tragedy of the aftermath of Hurricane Katrina. (Contributions to the Psychoanalytic Assistance Fund should be made out to the American Psychoanalytic Association, with PAF-Hurricane Relief written in the memo line. The APsaA address is 309 East 49th Street, New York, NY 10017.) (Twenty-eight members of the New Orleans Psychoanalytic Center can be reached through a Yahoo group set up by NOPC analyst Molly Rothenburg: [email protected])

6 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 would be the last time they would be together University empirical research. The mutual resentment in their schools with their teachers and their Continued from page 5 between analysts and biological psychiatrists peers. Now they are in new locations coping has been destructive. Unfortunately, some with anxiety about property and about par- OPPORTUNITY FOR ALLIANCES analysts’ feelings of suspicion have extended ents’ unemployment. One might ask why all institutes have not to a mistrust and devaluation of academia in The Osofskys evacuated only briefly. Both forged alliances with universities. Not all psy- general. In order to take advantage of new Joy and Howard Osofsky had relationships choanalytic institutes are geographically situ- opportunities, we must turn our attention with the state Office of Mental Health and the ated in areas with major universities, but most from past battles and work to forge new cre- Department of Education. Joy Osofsky is coor- are. Not all universities have departments ative alliances. dinating the child and youth initiative for the with faculty members who are interested in The opportunity is ripe to form alliances education and training of school personnel psychoanalytic approaches to research and/or between analysts and non-analyst scientists dealing with the 189,000 displaced children in scholarship. Yet even in areas in which there and scholars. Analysts can find receptive part- Louisiana. She has worked on intervention, would be great potential for new alliances, ners, if they are open to the idea of reaching supervision, and coordination with providers in there is frequently reluctance on the part of out. Psychoanalysis, an effective clinical tech- local communities to “build resilience” amongst the psychoanalysts. One reason may be mis- nique as well as a powerful interpretive frame- children. trust of academia. Historically, institutes have work, is inherently interdisciplinary. We need Howard Osofsky, who has an extensive been connected with university departments to forge partnerships with academics in related background in the area of disaster, terrorism, of psychiatry. In many such departments, analysts disciplines. If we embrace the opportunity to and mass violence, has been working with the have been marginalized, or pushed out entirely, realize the full interdisciplinary potential of state Office of Mental Health to address the as academic psychiatry became more centered psychoanalysis, we will foster a psychoanalytic crisis needs of the state. C. Ray Nagin, the on psychopharmacology, neuroscience, and renaissance in the 21st century. mayor of New Orleans, has asked Osofsky for help concerning the mental health needs of the police and fire department personnel and the city emergency medical system. The work University Forum Plans Interdisciplinary with first responders has been difficult and Programs and Special Concert challenging. Most police officers responded heroically. But it was extremely hard for them An interview with Glen Gabbard, APsaA program chair, in TAP (39/2) highlighted to not be able to protect the city or rescue some creative and innovative programming agendas. One “out of the box” activity trapped residents. Many were on site for 15 is the University Forum (UF), which aims to build bridges in both directions between days in the same uniforms; 80 percent suffered academia and psychoanalysis, to show academics that psychoanalysis is very much damage to their homes; and their families alive and relevant, to demonstrate to psychoanalysts that we have much to learn were often displaced. Osofsky has been par- from our academic colleagues, and to recruit trainees and patients from academia. ticularly involved with the systemic issues of University Forums on mother/daughter relationships and on terror and torture have providing for the needs of the many children been presented. The University Forum for the Winter 2006 meeting,“Gender in of first responders now housed on the cruise Cultural Contexts: Psychoanalysts and Cultural Theorists,” which will consider Sally ships docked in the port. Over 400 children Potter’s film, Yes, features academics Peggy Phelan, Afsaneh Najmabadi, and Giuliana are now living with their parents on the ships. Bruno and will be moderated by psychoanalysts Adrienne Harris and James Hansell. Day care, respite care, and transportation to In order to ensure that the University Forum will continue to attract distinguished good schools are being provided. academics, the UF Subcommittee of the APsaA Program Committee has organized The relief work, Howard Osofsky notes, is applied psychoanalysis, drawing on Bowlby’s a benefit concert for the upcoming January APsaA meeting to address the problem work on attachment and loss during World of insufficient funding for panelists’ travel and lodging. This concert will be held Friday, War II. At that time, it was considered humane January 20, 8:00 p.m., at historic Steinway Hall, 109 West 57th Street. Louis Nagel, to evacuate children to the countryside away internationally renowned concert pianist and Steinway Artist, will play a recital. from the London Blitz, even though it meant All proceeds go to cover expenses for academic presenters at the forum. The recital separating them from their parents. But the will be followed by a reception and tour of the historic pianos of Steinway Hall. children who thrived best were those who Attendance is limited to 75 people. Admission is $75/person. You may send your remained with their parents in London. The check now, payable to APsaA and mailed to University Forum Concert, American Osofskys are working to “help these trauma- Psychoanalytic Association. tized families [in New Orleans] who are trying Stanley Coen, M.D., and Julie Jaffee Nagel, Ph.D. very hard to cope.”

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 7 JANUARY PROGRAM

dialogue with great success. Therefore, we January Program Features will once again feature a debate between Jay Greenberg and Robert Michels on the subject Damasio and Fonagy Plenaries of “Red, Blue, and You: The Analyst in a Social Glen O. Gabbard Context.”

The program of the Winter 2006 Meeting, The Saturday ENTICING MENU OF SYMPOSIA Wednesday, January 18-Sunday, January 22, morning panel We will have a special presidential sympo- in New York City, will feature two plenary will be entitled sium on Saturday at noon until 1:30 p.m. to addresses. The popular writer and eminent “Race, Culture, provide an overview of the new Psychody- University of Iowa neurologist Antonio Dama- and Ethnicity in namic Diagnostic Manual that has just been sio will receive a presidential award on Friday the Consulting published [see page 12]. Jon Meyer will chair morning and deliver an award lecture entitled Room.” Chaired this symposium, which will feature comments “The Neurobiology of Emotion: Taking Stock.” by Kimberlyn by Stanley Greenspan, Robert Wallerstein, Later that same day, Peter Fonagy of The Uni- Leary, it will fea- and Otto Kernberg. versity College, London, will present the second ture Dorothy In the noon slot on Friday, there will be Glen O. Gabbard plenary, entitled “A Genuinely Developmental Holmes, Donald three symposia. One is “Expressions of Feeling Theory of Sexual Enjoyment and Its Implica- Moss, and Henry F. Smith as panelists. Because in Mark Rothko’s Paintings” chaired by Janice tions for Psychoanalytic Technique.” of the popularity of last January’s format of a Lieberman and featuring the artist’s son, two-hour panel followed by one-hour break- Christopher Rothko, as the presenter. The pop- CHILD PANEL MARKS out groups, this panel will once again follow ular research symposium at this meeting will FREUD’S ANNIVERSARY that model so the audience members can be be “Biological Analyses of Mothering: Widen- As usual, five panels will be featured at the active in small group discussions after listening ing the Scope of Psychoanalytic Understand- meeting. In recognition of the fact that the to the speakers for two hours. ing,” chaired by Robert Waldinger, co-chaired meeting is taking place during the 150th anniver- sary of Freud’s birth, our child panel will focus Many analysts have been profoundly affected by the impact of on the recent release of documents about Lit- tle Hans from the Library of Congress. Harold Hurricane Katrina. Hence, we will also provide a special symposium Blum will chair the panel, which will feature in the Friday time slot where our members and colleagues can Judith Chused, John Kafka, and John Munder discuss their experiences in the aftermath of the tragedy. Ross as panelists, and Peter Neubauer as dis- cussant. Jennifer Stuart will be the reporter. The Saturday afternoon panel takes up a by Stuart T. Hauser, and featuring Linda Mayes QUARTET OF DIVERSE PANELS current controversy in psychoanalytic insti- and David Reiss as presenters. The four panels focusing on adult psycho- tutes throughout the country: “Multiple Mod- Many analysts have been profoundly affected analysis are highly diverse. The Friday after- els in Clinical Practice: A Bane or Blessing?” by the impact of Hurricane Katrina. Hence, we noon panel is “What Use Is Consciousness? A Sydney Pulver will chair the panel, and the will also provide a special symposium in the Clinical Neuroscience Roundtable,” chaired three panelists will be Fred Pine, Ron Britton, Friday time slot where our members and col- by Edward Nersessian. Damasio will join that and Sander Abend. Clinical material will be leagues can discuss their experiences in the panel, along with several other leading thinkers presented by Linda Spero. Dale Panzer will aftermath of the tragedy. More details will follow. from the neurosciences and psychoanalysis: serve as reporter. In addition to the Presidential Symposium, Wilma Bucci, Bonnie Litowitz, Arnold Modell, The final panel on Sunday morning,“Teach- three other symposia are featured Saturday at and Bernard Baars. Daria Colombo will serve ing Psychoanalysis in an Era of Epistemological noon. Harvey Rich will interview the respected as reporter. Anguish: Where Do We Go From Here?” will French psychoanalyst, Marilia Aisenstein, in a be chaired by Elizabeth Auchincloss. Panelists symposium entitled “Lobbying Government— Glen O. Gabbard, M.D., is chair of the will include Judith Yanof, Lawrence Inderbitzin, French Style: A Conversation with Marilia Program Committee. He is also Brown Donnel Stern, and Justin Richardson, who will Aisenstein.” Stephen Kerzner will chair a sym- Foundation Chair of Psychoanalysis and also serve as reporter. posium,“Working with the Grieving Child: A professor of psychiatry at the Baylor Critical Partnership,” with Bruce Sklarew as College of Medicine in Houston, and RED, BLUE DIALOGUE presenter. Finally, Nancy Chodorow will chair joint editor-in-chief of the International In recent meetings, the Program Committee “The Woman Patient and the Woman Analyst, Journal of Psychoanalysis. has returned to the format of psychoanalytic Continued on page 11

8 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 JAZZ IN NEW YORK

New York and All That Jazz Charles D. Levin

Unlike my hometown, which hosts a superb young man himself joined us in the line to jazz festival every summer, New York City just keep his mother company. The queuing in the is JAZZ, the place for it, year-round, nonstop, street passed pleasantly in conversation with the best there is. If the great players don’t the Puerto Ricans and soon we found a table always grow up in New York, they get there near the stage, in sight of Rubalcaba’s fingers. eventually, and they stay, because this is one of The point of this story is that we were com- the few towns where you can play every night. pletely blown away—two unsuspecting analysts Of course, New York has been the capital from Montreal—by the music. After the show, city of all the major art forms except film we chatted briefly with Rubalcaba himself on since the 1920s, but its jazz scene has a par- the sidewalk outside the club while he waited ticularly endearing quality: no media hype or for his lift home. We then made a beeline to elite chic; just the music, played live by the the 24/7 Virgin Megastore on Times Square and surprisingly humble souls who somehow make bought every Rubalcaba CD we could find. their living at this intricate and passionate craft. That night we were inspired by an extraor- So, if you crave densely-packed musical dinary combination of personal modesty and experience and plan to be in New York for the musical brilliance, but I would say now that Greenwich Village is a natural focus for jazz APsaA meeting this January, you might want to although Gonzalo Rubalcaba is an exceptional crawling: Blue Note (131 West 3rd St), Fat Cat consider organizing a tour of Manhattan jazz individual, similar blends of unpretentious (75 Christopher St., formerly Small’s), 55 Bar spots—especially if budget is a factor in your charm and sheer talent are typical of the (55 Christopher St.), and even Zinc Bar (90 travel plans. New York jazz scene. More often than not it is West Houston St., if you want to go interna- Birdland is probably the most expensive possible to meet the musicians after they tional and rough it a bit). Notable on the venue at $30 a head (sometimes more) plus perform, and sometimes they will make a Upper West Side is Smoke (2751 Broadway, $10 cover charge. If you think that’s pricey, point of mingling with the audience as it files at 106th St.), named after the popular film by compare it to the cost of a Broadway musical. out into the bustling night. This is certainly novelist Paul Auster, who frequented this bar’s At 315 West 44th Street, not far from Broad- true of the Iridium, 1650 Broadway, at 51st previous incarnation, Augie’s, when he was a way, Birdland takes its name from Charlie Street, (where you can hear the legendary student at Columbia. I should also mention “Yardbird” Parker, though it’s no longer at Les Paul every Monday night), and a majority Jazz at Lincoln Center, an interesting and con- the original 52nd Street address where, for of the clubs, bars, restaurants, and cafes where troversial education/performance complex example, John Coltrane’s hypnotic “Live at jazz music is featured in New York. founded by Wynton Marsalis. Birdland” album was recorded. Perhaps the most famous of them all is the There is really no end to jazz in Manhattan. Among jazz aficionados, the current location Village Vanguard at 178 Seventh Avenue South If you want to know who’s playing where and lacks the gritty intimacy of the original, but at West 11th Street, which celebrated its 70th when, with phone numbers, Google the indi- this judgment is relative, as the following anniversary last February. This is a historic site vidual clubs, or go to BigAppleJazz.com, anecdote illustrates. When my wife and I first (Charlie Mingus’s broken light bulb is still Gothamjazz.com or www.allaboutjazz.com. In visited Birdland, the Cuban pianist Gonzalo hanging from the ceiling, unreplaced), so one print, try Steve Dollar’s Jazz Guide New York City Rubalcaba was scheduled to play with his expects a tourist trap, but the atmosphere, (ISBN 1-892145-19-7). New York itself offers trio. We had no idea who Rubalcaba was or though electric, is unimposing. The $30 admis- a host of jazz periodicals (many of them free) any inkling of his musical stature. We caught sion includes a $10 drink credit, though unfor- containing informative articles on the current the last set that night and while we waited to tunately the wine list is not like the Iridium’s, jazz scene, with all the weekly listings. get in, we chatted with a Puerto Rican woman which offers cru classé and lots of good Cali- If you want intellectual background on jazz who turned out to be the proud mother of fornia cabernets. And if you haven’t had a music, consult John F. Szwed’s Jazz 101: A Rubalcaba’s new 21-year-old bass player. She chance to eat, there’s no food at the Van- Complete Guide to Learning and Loving Jazz.On told us all about her son’s devotion to musical guard; but the intensity of the aesthetic expe- the cultural history of jazz age New York, see education and hours of practice. Then the rience, the quality of the musicianship, the Ann Douglas, Terrible Honesty: Mongrel Man- intimate press of the 123-seat full-house, and hattan in the 1920s. And if you are an audio- Charles D. Levin, Ph.D., is a supervising the excellent acoustics will act on you like the phile-connoisseur, check out the Jazz Record and training analyst at the Canadian Institute hungry baby’s hallucinatory gratification in Center (236 West 26th Street (between Sev- of Psychoanalysis in Montreal. Chapter 7 of The Interpretation of Dreams. enth and Eighth Avenues).

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 9 THE WORLD OF MARK ROTHKO

New York. As his reputation and canvases Exploring New York through grew, so did his need for more workspace, and in his studio on 53rd Street (near his Sixth the World of Mark Rothko Avenue apartment, now the site of the Hilton Chris Broughton Hotel), above a glass manufacturing shop, he created his early “classic” canvases of the early One of the highlights of the Scientific Pro- ROTHKO IN NEW YORK to mid ’50s. gram for the Winter 2006 Meeting, January During a painting career that spanned five After a studio on West 61st Street was 18-22, in New York is a presentation about decades, Mark Rothko lived and worked in demolished, and replaced with Fordham Uni- the seminal New York School painter, Mark many different areas of New York City. In versity buildings, an unheated former YMCA Rothko, by his son, psychologist Christopher the ’30s and ’40s, he lived in a number of gymnasium on the Bowery became the place Rothko. You won’t want to miss this excep- small apartments in Manhattan and Brooklyn. where he turned to a darker palette. Here he tional program. This article introduces some also took on his first commission, creating his background on Rothko’s New York and pro- enormous—in size and number—Seagram vides another way to explore the city during Murals for the Four Seasons restaurant on the meeting. Park Avenue (although the paintings were never installed). ROTHKO’S ART At the age of 57, Rothko was celebrated The art of Mark Rothko is powerful. To a with a retrospective at the Museum of Modern viewer open to the experience of spending Art in New York in 1961, further solidifying time in front of one of his large paintings, it his stature as a master of modern art as the can elicit emotions ranging from ecstatic joy exhibition traveled and was seen in six cities to profound sadness. Through the careful cal- throughout Europe. ibration of color, shape, scale, and measurement, An Upper East Side First Avenue loft over Rothko was able to create an experience of a five-and-dime store served as a studio for empathy through art. His colors—fiery yel- a time in the early ’60s. It was here that his lows, velvety blacks, earthy reds, and a spectrum Harvard Murals were conceived and cre- of others—seem to pulse and glow with an ated, well known paintings in the art world inner light. There are people who cry in front that, alas, are rarely seen because of their of his work. Rothko took pride in the fact that fragile condition. there were people who broke down in front His last studio was a 19th-century carriage of his work. house on East 69th Street. In this space he Ultimately Rothko felt that silence was the created his last mural commission, a group perfect response to his art. When the noise of monumental, dark paintings for what is and speed of the city gets to be too much, the now known as The Rothko Chapel in Houston. Mark Rothko in his West 53rd Street studio. meditative act and intimate experience of stand- Photograph by Henry Elkan. Copyright ©2005 He also made his final paintings here, many of ing in front of one of Mark Rothko’s paintings by Kate Rothko Prizel and Christopher Rothko. which were done in a somber palette of black can bring us back into the quiet contemplation and gray. Sadly, it was also here that Rothko of the human drama. If you leave your pre- While teaching art to children in Brooklyn ended his life in 1970. conceptions behind and allow the light within and for a brief period working for the WPA Brooklyn, the Bowery, Midtown, Harlem, these paintings to pulse before you, the large (a depression-era federal work program that the Lower and Upper East Sides—Rothko’s areas of color to envelope you, and gaze upon included artists) to support and feed himself, was the quintessential story of New York in the human touch that Rothko has left every- he searched for a language in which to paint. the 20th century, a Russian immigrant child where in his paintings, the experience can be Early paintings were in a representational who became an artist who flourished against profound and powerfully moving. expressionist vein, followed by a period of the textures of New York. working through surrealist techniques and Chris Broughton is APsaA’s registration mythological subjects. ROTHKO IN NEW YORK MUSEUMS coordinator and a working artist. He holds Later, in the late ’40s and early ’50s, Rothko The city has changed a lot since Rothko an M.F.A. from Yale and has received many taught at Brooklyn College, while he and his walked the streets of New York, and many of awards, including the Louis Comfort Tiffany contemporaries—in their studios as well as in the buildings he occupied have been razed Foundation Award. Broughton is represented in coffee shops and bars—helped shift the cen- to make way for the skyscrapers that now New York by the Senior & Shopmaker Gallery. ter of the art world from Paris to postwar Continued on page 11

10 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 THE WORLD OF MARK ROTHKO

Whitney Museum of American Art 945 Madison Avenue at 75th Street In 1998 the Whitney held a retrospective of Rothko’s work. I saw the show at least eight times and was always able to find a painting that knocked me out. When I would return to the same painting to replicate a previous expe- rience, it would offer something completely different. This is the wonder of Rothko’s work. Currently at the Whitney in an exhibition called “Landscape,” there is one dark Rothko painting from the 1950s. Four Darks in Red, 1958

Solomon R. Guggenheim Museum 1071 Fifth Avenue at 89th Street The Guggenheim, which held the first posthumous retrospective of Rothko’s paint- ings in 1978, does not have one hanging as of this writing. However, the museum does have four excellent Rothko paintings, any of Cityscape. (Note the landmark Flatiron Building on the far left.) Artwork by Mark Rothko. which could be hanging at the time of the Copyright ©1998 by Kate Rothko Prizel and Christopher Rothko. Winter Meeting. dominate Midtown Manhattan. But you can still galleries there is one black and gray painting catch the pulse of Rothko in New York along from the last year of his life. the stretch of Fifth Avenue known as Museum 1. Second Floor: Untitled, 1969-70 January Program Mile. In the museums that dot this part of 2. Fourth Floor: Slow Swirl at the Edge Continued from page 8 New York, the great paintings of Mark Rothko of the Sea, 1944 can be experienced close to the places where Then and Now: A Conversation with Malkah 3. Fourth Floor: No. 5/No. 22, 1950 they were created. Notman and Carol Nadelson.” (dated verso 1949) Please note that museums do rotate and A special symposium Saturday evening 4. Fourth Floor: No. 3/No. 13, 1949 change the work in their galleries from time from 5:15-6:30 p.m. will showcase the cele- to time. The paintings listed below are hang- brated Mexican tenor, Rolando Villazon, who Metropolitan Museum of Art ing in their respective museums as TAP goes will talk about his personal analysis and its 1000 Fifth Avenue at 82nd Street to press. effect on his performing. Julie Jaffee Nagel In 1951, Rothko and 17 other artists posed will chair. “Meet the Author” will focus on for a photograph featured in Life magazine, Museum of Modern Art (MoMA) Stanley Coen’s book, Affect Intolerance in which focuses on their refusal to participate 11 West 53rd Street between Fifth Avenue Patient and Analyst, and will be chaired by in the Metropolitan’s contemporary competi- and the Avenue of the Americas Melvin Lansky. The two discussants are Salman tion. The artists, and this notorious photo- In the ’50s, when Rothko had a studio on Akhtar and Paul E. Roberts. graph, came to be known as “The Irascibles.” 53rd Street near the Museum of Modern In addition to these events, we are very Now the works of many of these artists are Art, he visited often and would spend hours pleased that Robert Pinsky, the former U.S. gathered at the Met in the modern art wing of in front of Henri Matisse’s painting, The Red poet laureate and Dante translator, will dis- the museum, including three by Rothko. The Studio, purchased by MoMA in 1949. You can cuss his poetry in the in-depth format Friday three paintings include a bright, classic painting see this painting today at MoMA on the fifth afternoon from 2:00-4:00 p.m., with Stanley from the 1950s, a dark single rectangle paint- floor, and then see work Rothko was making Coen chairing. There will also be the usual ing from the 1960s, and one of his transitional around this time. One painting is from his informative discussion groups and seminars for “multiform” paintings from the 1940s. mythological/surrealist period of the early trainees, and we are certain that every mem- 1940s, two paintings are from his early classic 1. No. 13 (White, Red, on Yellow), 1958 ber and attendee will find many stimulating period of two or three floating rectangles 2. No. 21 (Multiform/Untitled), 1949 events suited to his or her taste. We welcome of luminous color, and in the contemporary 3. Untitled, 1964 suggestions for future meetings.

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 11 PSYCHODYNAMIC DIAGNOSTIC MANUAL

approaches, we would have little understanding Greenspan Spearheads Creation of of the deeper levels of relationships, feelings, thoughts and fantasies, conflicts, coping, and Psychodynamic Diagnostic Manual defensive operations. And yet, in recent years, Lynn Stormon with the advances in neurobiology and neuro- science, there has been a de-emphasis on these Reversing a decades long trend in mental LS: What in- insights. It seemed timely for the major organ- health care heralded by the publication of spired you to izations representing depth psychology to work the DSM-III, which supports a narrow focus undertake the together to systematize current knowledge and on symptoms and behavior, may seem like an daunting task of emerging advances to rebalance our under- impossible task. The publication of the Psy- spearheading the standing of human functioning with an appro- chodynamic Diagnostic Manual (PDM) this win- creation of a psy- priate focus on all dimensions of the human ter, however, may well have a far-reaching chodynamic diag- mind. We were very fortunate to have many of impact on the way mental health is concep- nostic manual? the leading clinicians and researchers who have tualized and mental illness is treated. SG: There is a made seminal contributions to this knowledge The creation of the Psychodynamic Diag- growing trend in base agree to participate in this collaborative nostic Manual took several years and the the United States, effort and bring it to fruition. Stanley Greenspan cooperation of a 40-member task force spear- and around the headed by Chairman Stanley Greenspan. To set world, to view human functioning in progres- LS: As you note, psychoanalysis has arguably this monumental work in motion, the heads of sively more reductionistic ways. For example, been the most organized of the depth psy- the major psychoanalytic organizations agreed along with the very helpful discovery of the chologies. At the same time, the history of the to form a steering committee with an inter- value of medication for certain mental health psychoanalytic movement has been marked by national purview, which included Barbara disorders many years ago, there has been a divisiveness. Can you tell me about the process Berger, National Membership Committee on tendency to try to explain many mental health of bringing together the various professional Psychoanalysis in Clinical Social Work; Jaine L. disorders in strictly biological terms. Advances groups to form the steering committee and var- Darwin, Division of Psychoanalysis (39),Amer- in neuroscience and cognitive neuroscience ious work groups? ican Psychological Association; Ruth S. Fischer and Jon Meyer, American Psychoanalytic Association; Stuart G. Shanker,York University; The publication of the Psychodynamic Diagnostic Ronald Turco, American Academy of Psycho- Manual (PDM) this winter, however, may well have a analysis; and Daniel Widlöcher, International Psychoanalytical Association. far-reaching impact on the way mental health is Nancy McWilliams and Robert Wallerstein conceptualized and mental illness is treated. volunteered to serve as associate chairs and, together with Greenspan, worked with the ongoing efforts of five work groups and nu- have provided valuable insights into how the SG: Rather than get caught up in the par- merous consultants. In the following phone central nervous system functions, but have ticular language of one or another school of interview, Greenspan described what inspired led to views of the mind and brain as an organ thought, we came at it from the point of view this effort and what was involved in bringing made up of many modules with insufficient that each theoretical orientation or school of psychodynamic practitioners together to form emphasis on the way in which the different thought was like a microscope where the focus a common cause around creating a comple- components of the brain and mind work is on a different facet of the phenomena in mentary system to the DSM and ICD series— together to create the psychological processes greater detail. Most theoretical orientations one that focuses on the full range, depth, and that constitute a full human being. have offered very valuable insights. Problems complexity of mental functioning. The field of depth psychology, of which psy- have arisen when a theory becomes the all- choanalysis has been the most systematic and encompassing theory. If we can look at differ- Lynn Stormon, Ph.D., is a postdoctoral organized investigative approach, has contributed ent theories as lenses or microscopes, each one research fellow in the Department of Psychiatry enormously to our understanding of both the having a relative advantage in looking at one at Upstate Medical University and an adjunct surface and the deeper levels of the human facet of experience, then we can, as we did, use psychologist at Colgate University’s Counseling mind. Depth psychology has had an enormous phenomenologically-based descriptions to cap- Center. Stormon participated on the PDM impact, not only on therapeutic practice but also ture the best insights, even though some of us steering committee as an APsaA Public Service on how we define the very nature of human tend to follow one or another theory. Psychology Intern. functioning. Without depth psychological Continued on page 16

12 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 PSYCHODYNAMIC DIAGNOSTIC MANUAL

Views from the Steering Committee

The completed PDM is a compilation of international contributions from psychodynamically informed clinicians, educators, and researchers in psychiatry, psychology, and clinical social work working in concert. This unique collaboration has resulted in a volume that offers a fuller context for understanding and explanation of diagnostic issues, underpinned by outcome research. The special meaning for clinical social work is that the PDM provides an excellent resource for the inclusion of a biopsychosocial perspective in diagnosis, a core value of this discipline. The opportunity to include not only symptoms but also social and emotional issues, personality patterns, and neurobiological information makes available an evaluative process that enriches the more categorical approach of the past. —Barbara Berger Past President, National Membership Committee on Psychoanalysis in Clinical Social Work

The Psychodynamic Diagnostic Manual is a major accomplishment, which impacts the analytic community in several ways. The process of producing this manual has brought together members from many analytic homes nationally and internationally to collaborate on something that transcends any political differences. The solid outcome research which is included in and underlies the PDM provides us all with the data needed to maintain our support of the right kind of evidence-based practice, an issue non-psychodynamic groups use to take pot shots at analytic thinking. The idea of a publication which makes it possible for us to train the next generation of clinicians to consider the whole person, one who has an inner life that motivates a list of symptoms, guarantees a continued interest in and support of psychoanalytic thinking. —Jaine Darwin Past President, Division of Psychoanalysis (39),American Psychological Association

The Psychodynamic Diagnostic Manual is of critical importance because the DSM series has become a textbook of clinical understanding and treatment selection in addition to simply a guidebook of nomenclature. We believe that a rational and comprehensive statement of the psychodynamic approach to nomenclature, which also implies an integrated approach to diagnosis and clinical understanding, is needed to complement the current, strictly descriptive, approach. We are involved in education and reaching out to the minds of clinicians from all professional backgrounds and the PDM is a major step in that outreach. —Jon Meyer President,American Psychoanalytic Association

We are at a critical juncture in the treatment of mental illness and developmental disorders. There are considerable pressures, not simply economic and political, but also emanating from a highly influential body of academics whose thinking is grounded in genetic determinism, to embrace a biomedical model of mental functioning. Clearly what was needed was someone who combined a mastery of our current knowledge of mental and neurobiological processes with exceptional vigor, clarity, and determination to lead an international effort to reverse these worrying reductionistic trends. Thanks to Stanley Greenspan and the extraordinary group of psychologists, psychiatrists, cognitive scientists, social workers, and other mental health professionals who came together under his leadership, we have a work that marks a new dawn in the treatment of mental health disorders. In the years to come, we will look back on the publication of the PDM as a turning point in our efforts to understand the full range of social, emotional, cognitive, and communicative capacities that constitute healthy mental functioning. —Stuart G. Shanker Director,The Milton and Ethel Harris Research Initiative

I was very happy to work with Greenspan and the steering committee to write a document about psychoanalytic clinical classification. With a group of French-speaking people, I have prepared a document about suitability for psychoanalytical treatment. As past president of the International Psychoanalytical Association, I am very happy to see that several members of our association are strongly involved in this project. —Daniel Widlöcher Past President, International Psychoanalytical Association

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mental function- The Psychodynamic Diagnostic ing, including relationships, Manual: An Overview emotional regu- lation, coping Nancy McWilliams, Robert S. Wallerstein, and Stanley I. Greenspan capacities, and self-observing The Psychody- that the therapeutic relationship is the major abilities. Just as namic Diagnostic predictor of outcomes. They further show healthy cardiac Manual (PDM) that treatments that focus on isolated symp- functioning can- Robert S. Wallerstein is a diagnostic toms or behaviors are not effective in sus- not be defined framework that taining gains or addressing complex personality simply as an absence of chest pain, healthy describes the patterns. mental functioning is more than the absence whole person— Created through a collaborative effort of the of observable symptoms of psychopathology. both the deeper major psychoanalytic organizations (the Amer- It involves the full range of human cognitive, and surface lev- ican Psychoanalytic Association, the Interna- emotional, and behavioral capacities. els of an individ- tional Psychoanalytical Association, the Division That a full conceptualization of health is the Nancy McWilliams ual’s personality of Psychoanalysis (39) of the American Psy- foundation for describing disorders may seem and emotional and social functioning. It em- chological Association, the American Acad- self-evident, and yet the mental health field phasizes individual variations as well as com- emy of Psychoanalysis, and the National has not developed its diagnostic procedures monalities. This framework opens the door to Membership Committee on Psychoanalysis in accordingly. In the last two decades, there has improvements in diagnosis and treatment of Clinical Social Work), the PDM diagnostic been an increasing tendency to define mental mental health disorders and to a fuller under- framework systematically describes: problems more and more on the basis of standing of the functioning and development of • The continuum from healthy to disor- presenting symptoms and their patterns, with the mind and brain. The goal of the PDM is to dered personality functioning overall personality functioning and levels of complement the DSM and ICD efforts in cat- • Individual profiles of mental functioning, adaptation playing a minor role. The whole aloguing symptoms and behaviors. including patterns of relating, compre- person has been less visible than the various The PDM is based on current neuroscience hending, and expressing feelings; coping disorder constructs on which researchers and treatment outcome studies (discussed in with stress and anxiety; observing one’s attempt to find agreement. the research section) that demonstrate the own emotions and behaviors; and forming Recent reviews of this effort raise the pos- importance of focusing on the full range and moral judgments sibility that such a strategy was misguided. depth of emotional and social functioning. • Symptom patterns, including differences in Ironically, emerging evidence suggests that over- For example, research on the mind and brain each individual’s personal or subjective simplifying mental health phenomena in the and their development shows that the pat- experience of his or her symptoms service of attaining consistency of description terns of emotional, social, and behavioral The PDM was developed on the premise (reliability) and capacity to evaluate treatment functioning involve many interconnected areas that a clinically useful classification of mental empirically (validity) may have compromised working together, rather than in isolation. health disorders must begin with an under- the laudable goal of a more scientifically sound Treatment outcome studies point to the standing of healthy mental functioning. Mental understanding of mental health and psycho- importance of dealing with the full complex- health involves more than simply the absence pathology. Most problematically, reliability and ity of emotional and social patterns and show of symptoms. It involves a person’s overall validity data for many disorders are not as strong as the mental health community had Nancy McWilliams, Ph.D., is visiting professor of clinical psychology at the Graduate School of hoped they would be. Allen Frances, chair of Applied & Professional Psychology, Rutgers University; senior psychoanalyst at the Institute for the DSM-IV American Psychiatric Association Psychoanalysis and Psychotherapy of New Jersey; president-elect of the Division of Psychoanalysis Task Force, commented in The New Yorker (39), American Psychological Association. magazine that the reliability hoped for has not Robert S. Wallerstein, M.D., is emeritus professor and former chair of the Department of been realized and that, in fact, the reliability Psychiatry, University of California, San Francisco; emeritus training and supervising analyst among practicing clinicians is very poor. Con- at the San Francisco Psychoanalytic Institute; former president of the American Psychoanalytic sequently, in moving towards DSM-V, the APA Association and the International Psychoanalytical Association. Task Force is reported to be shifting towards Stanley I. Greenspan, M.D., is clinical professor of psychiatry and pediatrics, George Washington a more dimensional, rather than purely cate- University Medical Center; chair of the Interdisciplinary Council on Developmental and Learning gorical, approach. Disorders; and supervising child psychoanalyst at the Washington Psychoanalytic Institute. Continued on page 19

14 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 PSYCHODYNAMIC DIAGNOSTIC MANUAL

resilience (Blatt and Zuroff, 2005). Pretreat- Contributions of Psychodynamic ment levels of perfectionism interfered with therapeutic progress, particularly in the latter Concepts in Identifying Mutative half of the treatment, because these patients disengaged from the therapeutic process Factors in Intensive Treatment (Zuroff et al., 2000) and from their social rela- Sidney J. Blatt tionships external to the treatment process (Shahar et al., 2004) as they approached the (Editor’s Note: Sidney J. Blatt was invited to pre- data from the pre-established termination date (after 16 pare this article as part of this special section to NIMH-spon- weeks of treatment). exemplify the thorough empirical investigations sored Treatment The quality of the therapeutic relationship behind the Psychodynamic Diagnostic Manual) for Depression in these brief treatments, as assessed at the Collaborative end of the second treatment session, how- Results from empirical investigations of Research Pro- ever, moderated significantly the negative therapeutic process and outcome in intensive gram (TDCRP; impact of pretreatment personality charac- psychodynamic treatment of both outpatients e.g., Elkin, 1994), teristics (i.e., perfectionism) on treatment and of seriously disturbed, treatment-resistant a landmark ran- outcome, especially at midlevels of perfec- inpatients, as well as from investigations of Photo: Braxton McKee domized clinical tionism (Blatt, Zuroff et al., 1996). These find- Sidney J. Blatt brief outpatient treatment of major depres- trial comparing ings, consistent with the recent emphasis on sion, demonstrate that therapeutic process 16 weeks of two forms of brief, manual- the importance of the therapeutic relationship variables and patient characteristics are major directed psychotherapy (CBT and IPT) with in the treatment process (e.g., Krupnick et al., contributors to therapeutic outcome. These medication (Imipramine) and a double-blind 1996; Norcross, 2002; Wampold, 2001), sug- important process and patient dimensions placebo, indicate that primary among the gest that efforts to identify empirically based are best conceptualized from a psychoanalytic determinants of therapeutic outcome is the treatments (EBTs) require a much more perspective, and lead to several conclusions quality of the therapeutic relationship that complex view of the treatment process including the need for a psychodynamic diag- patient and therapist establish very early in beyond evaluating the effects of particular nostic framework. the treatment process (at the end of the treatments in reducing focal symptoms. First, evaluation of therapeutic progress must go beyond assessment of symptom reduction as the primary measure of out- Results from empirical investigations of therapeutic process come and include assessments of decreased and outcome in intensive psychodynamic treatment of both vulnerability to stress and the development of outpatients and of seriously disturbed, treatment-resistant enhanced adaptive capacities (Blatt and Zur- off, 2005), including the development of more inpatients, as well as from investigations of brief outpatient mature and adaptive representations (i.e., cog- treatment of major depression, demonstrate that therapeutic nitive-affective interpersonal schemas) of self and others (e.g., Blatt, 1992; Blatt and Auerbach, process variables and patient characteristics are major 2001; Blatt and Ford, 1994; Blatt and Shahar, contributors to therapeutic outcome. 2004; Blatt, Stayner et al., 1996; Fertuck et al., 2004; Vermote, 2005), especially changes in the content and structural organization of these second treatment session) and the patients’ Rather, these findings indicate that the in- representations (see also Mayman, 1967; Urist, pretreatment personality characteristics (Blatt vestigation of the factors that contribute to 1977; Westen, 1991). et al., 1995; Blatt, Zuroff et al., 1996; Zuroff et therapeutic change in brief and long-term, Second, extensive further analyses (see al., 2000), especially their pretreatment level intensive psychodynamic therapy requires a the summary in Blatt and Zuroff, 2005) of of perfectionism. Specifically, the extent to differentiated view of patients, therapists, and which the patient perceived the therapist as the treatment process in order to address Sidney J. Blatt, Ph.D., is professor of concerned and empathic and lower pre- complex questions like what kinds of treat- psychiatry and psychology, chief of the treatment levels of perfectionism both inde- ment are most effective with what kinds of Psychology Section, Department of Psychiatry pendently predicted significantly greater patients, in what kinds of ways, and through at Yale University, and on the faculty reduction of symptoms and of vulnerability what types of therapeutic mechanisms (Blatt, of the Western New England Institute to depression, as well as a significantly greater Shahar and Zuroff, 2002). of Psychoanalysis. increase in adaptive capacities and stress Continued on page 16

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 15 PSYCHODYNAMIC DIAGNOSTIC MANUAL

Intensive Treatment aggressive), types of defensive organization relevant evaluations and for the investigation of Continued from page 15 (avoidant versus counteractive), and predom- aspects of the treatment process. A systematic inant character style (e.g., emphasis on an psychodynamic diagnostic framework informed ROLE OF PERSONALITY object versus a self orientation, and on affects by current research, such as the anaclitic- CHARACTERISTICS versus cognition). In these formulations, conti- introjective distinction, has the potential to In further investigations of processes that nuity is maintained among normal psycholog- contribute to a new generation of research contribute to therapeutic change, we have ical development, variations in normal character that will further clarify, refine, and hopefully been especially interested in the role of patient or personality organization, and different forms improve our therapeutic efforts. personality characteristics, informed by psy- of psychological disturbance. Even further, con- chodynamic formulations. In particular, we tinuity is maintained within the two primary [Editor’s Note: The reference list for this article found that distinction between anaclitic and clusters or configurations of disorders so path- as well as a more comprehensive bibliography introjective forms of psychopathology (e.g., ways of potential regression and progression as can be obtained by contacting the author via Blatt and Shichman, 1983) have enabled inves- well as the nature of therapeutic change can be email at [email protected] or by visiting his tigators to systematically introduce distinctions more fully understood and appreciated. Web page at http://info.med.yale.edu/psych/ between types of patients into the investigation The psychodynamic distinction between ana- faculty/blatt.html] of therapeutic process and outcome (e.g., Blatt clitic and introjective forms of psychopathology, and Felsen, 1993; Cronbach, 1953). The valid- between patients preoccupied with issues of ity of the anaclitic-introjective diagnostic dis- interpersonal relatedness or with issues of self- Greenspan Interview tinction has been demonstrated by extensive definition (e.g., issues of self-worth and control), Continued from page 12 recent research on depression (see summary has enabled investigators to identify two groups in Blatt, 2004) and personality disorders (e.g., of patients that are differentially responsive, This effort has been in progress over the last Levy et al., 1995; Morse, Robins and Gittes-Fox, possibly through different mechanisms, to dif- few years through the energy and creativity of 2002; Ouimette et al., 1994). In contrast to ferent types of therapy. Though, as noted above, the leaders of the major psychoanalytic organ- increasing criticism of the DSM in terms of its introjective patients (those with elevated scores izations and a number of their outstanding lack of a cohesive unifying theory, the forced on perfectionism) did relatively poorly in brief members. Nancy McWilliams and Bob Waller- demarcation between normal and pathological treatments for depression, introjective patients stein, associate chairs, have been instrumental through arbitrarily defined threshold values, were particularly responsive to long-term inten- in nurturing it along. The presidents of all the excessive concerns with manifest symptoms sive psychodynamic treatment (Blatt, 1992; Blatt main psychoanalytic organizations as the steer- and signs, a high degree of overlap or “comor- and Ford, 1994; Blatt and Shahar, 2004; Fer- ing committee, and in consultation with their bidity” among presumed distinct disorders, tuck et al., 2004; Vermote, 2005). These research organizations, suggested members for work failure to consider possible relations among studies also indicated that anaclitic patients groups on adult and child disorders, including various disorders and their links with varia- were responsive primarily to supportive inter- infancy and early childhood, personality patterns tions in normal personality development as personal or relational dimensions while intro- and disorders, profile of mental functioning, well as to considerations of etiology and ther- jective patients were responsive primarily to and symptom patterns with an emphasis on apeutic intervention (Blatt and Levy, 1998), the interpretative or explorative aspects of subjective levels of symptoms. We also formed various forms of psychopathology in the ana- the treatment process. Also, anaclitic and intro- a work group on research to systematize the clitic and introjective configurations are viewed jective patients appear to change in different empirical basis of the psychodynamic approach. as interrelated forms of maladaptation that ways, in aspects most relevant to their per- This process has led to the Psychodynamic occur in response to serious disruptions of sonality organization. Anaclitic patients change Diagnostic Manual, also known as the PDM. the normal integrative, dialectic development of primarily in the quality of their interpersonal The expected date of publication is Winter interpersonal relatedness and self-definition relationships and in their representation of 2005-2006 and people can preorder copies (Blatt, in press; Blatt and Blass, 1996). self and other, while introjective patients change online now (http://www.pdm1.org). Psychopathology emerges as individuals, at primarily in the frequency and intensity of different developmental levels, become pre- clinical symptoms and in their cognitive efficacy LS: What particular groups do you hope to occupied with a distorted one-sided effort to (Blatt and Ford, 1994). reach? establish and maintain satisfying interpersonal In summary, our findings about the impor- SG: The PDM is intended to be of help to all relations at the expense of the development of tance of patient characteristics, such as the professionals and students who practice psy- self-definition or of a sense of self-definition at anaclitic and introjective personality configu- chotherapy and psychoanalysis and other men- the expense of interpersonal relatedness. The rations, and their interaction with aspects of the tal health professionals and students who are anaclitic-introjective distinction derives from treatment process, underscore the importance interested in understanding the full range and psychodynamic considerations including dif- of establishing a systematic psychodynamic depth of human functioning. The audience is the ferences in instinctual focus (libidinal versus diagnostic framework for conducting clinically entire mental health community.

16 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 international Edited by Christine Ury TAP Introduction with the Web sites of the component institu- I believe it is fair to say that, in spite of the tions and authors, participation in forums on enthusiastic efforts of the International Psycho- specific subjects and in shared research, analytical Association to consistently increase requests for specialist advice, and access to information to our entire membership about The American Psychoanalytic Association distance learning material. what is going on in psychoanalysis all over the collected money for the American Red Cross The virtual library is intended to strengthen world, important gaps remain in this information. and for its own Psychoanalytic Assistance Fund. the intra- and inter-institutional links between This has been even truer regarding the efforts of The PAF, established before World War II to members who feel isolated in their own psy- the American Psychoanalytic Association to help colleagues fleeing Europe resettle, con- choanalytic institutes. What is also hoped for is communicate our views and developments to tinues to aid analysts facing unanticipated finan- that the virtual library will provide a tool to the international psychoanalytic community. cial hardship. In mid-September, International promote a much needed dialogue between Under these circumstances, I think the present ini- Psychoanalytical Association President Claudio psychoanalysts, other mental health profes- tiative from the American Psychoanalytic Asso- Eizirik made an international appeal to all IPA sionals, and the public at large. ciation, under the leadership of Jon Meyer, to members for contributions to the Red Cross There will be no charge for use of the virtual increase two-way communications between the and the PAF. library. International Psychoanalytical Association and It is unclear when the New Orleans center An interdisciplinary group of psychoanalysts, the American Psychoanalytic Association is a most will be back on its feet. Center president Ran- library specialists, and computer technicians in welcome step to strengthen our collegial relations. dolph Harper hopes programming can begin Argentina has been working for the past two The objective of this “International TAP” col- next September. years on the virtual library. The Pan-American umn is to provide information to the American Health Organization provided technical exper- psychoanalytic community about developments Liaison Group tise, computer software technology, and free in international psychoanalysis, to further open A joint liaison group of representatives of the training of personnel. the doors to the IPA’s efforts to reach the American Psychoanalytic Association and the American membership. This initiative also will Confederation of Independent Psychoanalytic The Ambulatorium: help the international psychoanalytic community Societies (CIPS) has been formed. Both groups Vienna Outpatient Clinic to become better acquainted with new initia- have very similar standards of psychoanalytic The Viennese psychoanalytic clinic is putting tives and developments in North America. I education and practice, and are participants together a project that will establish contact strongly urge our friends and colleagues in all in the North American Psychoanalytic Con- with several groups of professionals to inter- the three regions to include the “International federation (NAPsaC). Among other issues, the est them in psychoanalysis as a successful TAP” in your regular sources of information group is concerned about the threat of the low treatment of patients with personality disor- about what is new in American psychoanalysis. standard psychoanalytic licensing being pro- ders, and as a conceptual tool for under- I hope that it will presently foster mutual under- moted state by state by the National Associa- standing complex mental states. Many of the standing and involvement of all of us. tion for the Advancement of Psychoanalysis targeted professional groups, such as teachers, —Otto F.Kernberg, M.D. (NAAP). A new liaison group has also been journalists, politicians, and sociologists are President, International Psychoanalytical formed between APsaA and the free-standing interested in what psychoanalysis has to offer Association, 1997-2001 IPA institute, the New York Freudian Society. to the public. The project will promote psy- choanalysis from different points of view through conferences, clinical workshops, a APsaA News International News lecture series, and increased contact with the Hurricane Katrina Latin American Virtual Library media. It is hoped that it can be up and run- Hurricane Katrina forced members of the of Psychoanalysis ning in time for the 150th anniversary of New Orleans Psychoanalytic Center to evac- The Federation of Psychoanalytic Societies Freud’s birth next spring. uate the city. Although the institute building of Latin America (FEPAL) is in the process of The Viennese outpatient clinic, founded in was not damaged, the members scattered to creating a virtual library of psychoanalysis. The 1991, was modeled after the former Ambula- the four corners of the United States. By goal is to digitalize all psychoanalytic literature torium of the Viennese Psychoanalytic Soci- November, analysts at best had resumed 40 to from the FEPAL associations so that it is avail- ety that operated successfully from 1926 until 60 percent of their previous caseloads; some able, at no cost, for online users. The literature its liquidation by the Nazis in 1936. The earlier were located where they could not work at all. will comprise not only journals, but also pre- clinic, with full support from Freud, provided sentations, workshops, symposiums, debates, free and low-fee treatment. Christine Ury, D.Ps., is associate editor congresses, research projects, and monographs The clinic now sees mostly patients with and international editor of TAP. She is a from all the psychoanalytic societies and insti- borderline and narcissistic personality disor- faculty member at the Canadian Institute tutes in Latin America. ders and can treat these patients without fee of Psychoanalysis and has a private Different online operations will be possible: because of a contract with the national health practice in Montreal. data base searches, access to plain texts, links insurance companies.

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 17 DEATH OF AN ANALYST

I was able then to say, calmly and with tremen- Consideration and Mortality dous sadness,“This must be hard for you, too.” Ellen Pinsky He nodded very slightly and said,“In many ways.” Although he didn’t give me his answer until When my therapist, S. Joseph Nemetz, sud- that he had not understood me. Possibly, both the next time we met, I knew then what he denly died at the end of May in 1994, I felt of us were right. I came to wonder later would likely say and began to prepare myself for lonelier than ever in my life. I turned for com- whether I had in fact been quite clear, but it. I think I had really known the answer from the fort to the same places I’ve turned all my life: that his usually exquisite capacity to hear me beginning, maybe even before he did, and my to people and to books. The first were wholly had in this particular matter broken down: wish not to hear what I already knew explained satisfactory, the second only partly so. Conceivably, he wished not to hear me. I have my impetuous rush to fill with words any space The safety net provided by friends and fam- wondered whether his deafness to my hints for an honest exchange with him. My uncon- ily was strong, flexible, and reliable. So too came from his intuitive understanding that, if scious hope was to keep both of us from re- was the professional net: Nemetz’s colleagues I were to ask, he would have to say,“No”— flecting; but he didn’t give up that responsibility. and friends offered themselves immediately the answer he would be compelled, as I now Near the start of our next meeting, he said and generously, and at every point they pro- understand, to give. With the refusal, I would, that given the nature of my own losses and the ceeded wisely, all in the face of their own con- if I wanted analysis enough, move to another power of analysis, and given the good possibility fusion and grief. therapist. I believe that he cared very much that he might die before the work was done, I can’t say the same for the comfort I got about me, enjoyed his work with me, and analysis with him was not a good idea. He said, from reading. In turning to books, I also had preferred that I not leave him. if I wanted analysis, he would help me arrange it. two accustomed directions to take: First, I could go to literature, which has cushioned and In the body of papers on the illness and death of the therapist, buoyed me since I was small; second, I could go to psychoanalytic theory, an interest only nine instead of comfort or insight, I found avoidance, confusion, years old, though an avid one. condescension, self-delusion, and dissimulation. In literature I found what I needed. In psycho- analytic theory, not only did I not find what I needed, but what I did find outraged and dis- He did not answer my request right away. I knew that given his love for the work, and comfited me. In the body of papers on the ill- He told me that, because of his age, he was especially for that work from behind the couch, ness and death of the therapist, instead of cautious about beginning new analyses. When his decision was not easy. But I also knew in a comfort or insight, I found avoidance, confusion, I asked if our nearly four years of work together hazy way that it was his commitment to the condescension, self-delusion, and dissimula- made no difference, he answered that of course work, and to me, that led to the decision. tion. The subject of the therapist’s mortality it did, and that he would need some time to I asked him if he had ever changed his mind itself seemed to inspire avoidance and disarray. think about it. Over the next 10 days I argued about anything, and he replied, quickly and But perhaps most remarkably, nowhere did I my case, growing more excited and hopeful as very gently,“I once decided not to be a cow- find the voice or perspective of the patient. the days passed and he did not refuse. boy.” As was often true in my time with him, Joseph Nemetz’s professional conduct, in Several minutes into our fifth meeting after I my laughter was part of the power of the retrospect, serves as an implicit critique of the had first asked to begin analysis, I was speaking moment: Few people have ever looked less inadequate professional literature regarding the with an animation every minute moving closer like a cowboy. My tears and rage followed. central matter of the therapist’s mortality. When to pleased assumption: I would have my wish. I But I didn’t fully understand his words for a he suddenly died, I had been working with him remember that he lifted his hand lightly, several long time. Many months after his death, I did in an intensive psychotherapy for almost four inches off his knee, in a gesture that stopped understand that Nemetz was telling me far years. I had asked several weeks earlier, in April, me dead—a “Whoa!” to a racing horse. The more than, “No, I can’t be your analyst.” He if we could talk about my beginning analysis. very long silence lasted perhaps five seconds, was telling me that, however much he might wish Nemetz was surprised by my request, and I, and then he spoke quietly: “There’s more than to give me what I wanted, he could not change by his surprise; I thought I had made many less- one person in this room to be considered.” his mind because any other decision would be than-subtle hints about analysis. I told him I I was speechless. At that moment and in that wild and incautious. His refusal was clearly dic- thought I had been reasonably clear; he replied pause, I caught a clear glimpse of him, per- tated from the start—although it was not easy haps for the first time in 10 days, so hard had for him to accept it—by his understanding of and Ellen Pinsky, Psy.D., is a candidate I been working to obliterate him in order to respect for the power of the analytic process, for at the Boston Psychoanalytic Society have what I wanted. I saw something then his own human limitations, and for me. With that and Institute and is in private practice about what he might feel, what he might wish, decision he looked squarely at the ending of his in Cambridge, Massachusetts. and what this decision might mean for him. Continued on page 19

18 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 lifework, and of his life. Holding to the highest to leave me thinking. This time it was a ques- ideals of his profession, he was guarding my tion; his last words to me were,“What have I safety. He had the capacity to bear the respon- done to make you think I don’t understand sibility of “No,” and with it, to bear responsibility how disappointed you are?” for the pain he caused me and, I believe, caused I paused and said,“I’ll think about it, and I’ll let himself. At the moment he spoke, it was to you know Monday morning.” I stood up and left remind me that there are always two individual, him with my usual tagline when he went away mortal people in the consulting room, and in to meetings: “Have a good time, learn some- that quiet reminder is located the most essen- thing, and cross the street very carefully.” He tial principle guarding the patient’s safety. collapsed without warning on Sunday in the A few weeks later, on a Wednesday in airport in Philadelphia, and he died six days later, mid-May, the hour came to a close. I remained apparently never regaining consciousness. angry at him. He was going away for the weekend to a conference in Philadelphia. He (This article originally appeared in the Winter often ended an hour with something intended 2004 issue of Threepenny Review.)

PDM: An Overview has been able to offer clear operational crite- Continued from page 14 ria for a more comprehensive range of human social and emotional functioning, as described The psychoanalytic tradition has a long his- by Westen, Shevrin, Shedler, Blatt, Dahlbender, tory of examining overall human functioning in and others in the PDM research section. The a searching and comprehensive way, with an challenge has been to systematize these emphasis on both dimensionality and context of advances with a growing body of rich clinical mental problems. Nevertheless, the diagnostic experience in order to provide a widely usable precision and usefulness of psychoanalytic framework for understanding and specifying approaches have been compromised by at least complex and subtle mental phenomena. two problems. First, until fairly recently, in an The PDM uses a multidimensional approach attempt to capture the full range and subtlety of to describe the intricacies of the patient’s human experience, psychodynamic accounts functioning and ways of engaging in the ther- of mental processes have been expressed in apeutic process. It begins with a classification competing theories and metaphors that have, of the spectrum of personality patterns and at times, inspired more disagreement and con- disorders found in individuals. It then describes troversy than consensus. Second, there has a “profile of mental functioning” that permits been difficulty distinguishing between specula- a clinician to look in more detail at each of tive constructs on the one hand, and phenom- the patient’s capacities. This is followed by a ena that can be observed or reasonably inferred description of the patient’s symptoms, but on the other. with a focus on the patient’s internal experi- In recent years, however, having developed ences as well as surface behaviors. The PDM empirical methods to quantify and analyze covers adults, as well as infants, children, and complex mental phenomena, depth psychology adolescents.

To order a copy of the Psychodynamic Diagnostic Manual (PDM) Visit the Web site at http://www.pdm1.org for ordering information and more details. Or send a check or money order to: Psychodynamic Diagnostic Manual (PDM), 10125 Colesville Road, Suite 194, Silver Spring, MD 20901. Phone: 301-789-1660. $35.00 USD, plus shipping and handling (domestic, add $6.00; international, add $10— 2-4 wks; $20—10-12 days). $45.00 USD, special hardback edition, plus shipping and handling as above. Available, Winter 2005-2006.

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 19 BYLAWS

allusive brevity.) We encourage graduates of Supporting the Bylaw Amendment IPA institutes in the U.S. (institutes not part of APsaA) to join our Association. None of on Certification these IPA institutes has certification as a Jonathan House requirement for appointment as a TA or SA. So, even colleagues who have been TAs for Under our current bylaws, the certification For our institutes, added flexibility will per- decades, who themselves are members of requirement for appointment as training ana- mit acceptance of some well qualified candi- APsaA, who have analyzed those we seek to lyst and supervising analyst cannot be waived dates in treatment with uncertified colleagues. recruit as members, cannot serve on BOPS. for any reason. The “local option” amend- Throughout the country, there are respected Nor can they enrich our institutes by becom- ment will allow institutes, if they wish, to colleagues who meet all other criteria for ing supervisors or analysts of our candidates appoint as TAs and SAs colleagues who meet TA/SA appointment but have not been certi- unless they go through our certification all other requirements, local and national, but fied. Their analysands who want training often process. Our local institutes cannot take have not been certified. go to non-APsaA institutes rather than switch advantage of what these colleagues, our fellow The potential benefits are important. analysts. This has been an issue at institutes members, have to offer. across the country. Even institutes with no Within the wider analytic communities— difficulty recruiting classes could benefit from local, national, and international—disagree- Jonathan House, M.D., is a training and a bigger applicant pool. ments can be generative or destructive, or supervising analyst at the Columbia University For our national organization, it will help both. It is revealing to contrast our experience Center for Psychoanalytic Training and recruitment of individuals and facilitate affilia- of theoretical disagreements with our dis- Research where he serves on the Curriculum tion of IPA institutes. agreement about certification. Theoretical ori- and the Progression Committees and is For our local institutes, it will increase avail- entation is, wisely, not prescribed by our bylaws. co-chair of the Freud course. able resources. (Here space limitation requires Continued on page 21

employing its only national evaluation tool, the Opposing the Bylaw Amendment certification examination, as part of its national evaluation of potential TAs through its BOPS. on Certification As a national organization with a major Beth J. Seelig educational mission, APsaA has an obligation to perform due diligence in evaluating local This winter, the membership of the Ameri- organization, the educational mission, and is educational programs on the national level. can Psychoanalytic Association is being asked neither “local” nor merely an “option.” Candidates are required to be analyzed as to consider and vote on a bylaw amendment, Why is the “local option” bylaw dangerous part of their psychoanalytic education. There- often misleadingly described as the “local to our national educational mission? BOPS fore,APsaA has an obligation to assess poten- option” amendment, which would forbid the currently already effectively utilizes its existing tial TAs nationally, just as curricula and other Board on Professional Standards (BOPS) from option of waiving certain requirements in in- aspects of candidate education are nationally requiring any form of certification for service as dividual circumstances. This proposed bylaw reviewed. These tasks are assigned to a body— training and supervising psychoanalyst (TA/SA). would permit individual institutes, but not our BOPS—consisting of institute representatives, Altering our bylaws to explicitly prohibit BOPS national organization, to either require certifi- each institute autonomously selecting two from nationally requiring certification for TA/SA cation or waive it, so that non-certified analysts representatives, called fellows. The decisions service attacks a core mission of our national could become TAs. This argument and its corol- of BOPS are our institutes’ group decisions, lary, that analysands of such non-certified ana- arrived at and voted on democratically. Insti- lysts might become candidates, is attractive tutes, collectively, want certification as a national Beth J. Seelig, M.D., is professor of but extremely misleading. In actuality, under standard for TA appointment. psychiatry and behavioral sciences and the guise of providing needed flexibility, the BOPS is presently actively studying and director of the Psychoanalytic Institute, Emory bylaw would impose a new rigidity. Far from improving both the TA system and certifi- University. She is secretary of the Board on being merely an “option,” to be exercised locally, cation examination, including the possibility Professional Standards and councilor-at-large the bylaw would remove an option nationally. of recommending periodic re-certification. of the Executive Council of APsaA. APsaA would no longer retain the option of Continued on page 21

20 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 BYLAWS

Supporting the Bylaw appointment in every institute, while permitting each institute to maintain How to Participate in Amendment that standard if it wishes. APsaA’s Scientific Program Continued from page 20 2. Permits institutes to elect non-certified TA/SAs to serve as fellows of BOPS. Scientific papers for oral presentation must be no longer The curriculum of each institute inevitably 3. Permits the chair of BOPS to appoint than 22 pages, double-spaced; longer has a theoretical orientation, which tends to non-certified members to BOPS papers (40 pages maximum) are change over time as a result of generative committees. considered for pre-circulation and differences. Differences about certification That’s it! Three modest, circumscribed small group discussion. Include an have been, on balance, more destructive than changes. abstract and submit eight copies. JAPA generative. The amendment does not elimi- To prevent possible misunderstanding, here has first claim on any paper accepted nate certification but, by making it optional, is what the amendment, for better or worse, for presentation or pre-circulation. will diminish the destructive effects of our does not do: Panel proposals must be submitted differences. Locally, choice about certifica- 1. Does not eliminate the TA system. in writing (two pages maximum, two tion will be analogous to choice about theo- 2. Does not change the certification copies). Each proposal should contain retical emphases in the curriculum. Ideally, process. a description of the format, the local option will transform certification from a 3. Does not eliminate BOPS’s authority to objective of the panel, and names of possible participants (chair, panelists, source of destructive divisiveness into a source set national standards for appointment discussant, if any). The Program of generative difference. A more modest but as a TA. Committee usually chooses panels more certain hope is that it will diminish 4. Does not alter any other of the seven cri- one year in advance. national bitterness and allow some institutes teria used by BOPS to evaluate applicants Discussion group proposals must to open things up a little bit. proposed for TA/SA status. be submitted in writing (two pages 5. Does not eliminate an individual insti- maximum, two copies). The Program WHAT THE AMENDMENT DOES tute’s power to require certification as a Committee chair selects new AND DOES NOT DO prerequisite for TA/SA appointment. discussion groups based upon their Local option does three things: 6. Does not eliminate the requirement that subject matter vis-à-vis material 1. Prohibits BOPS from including certifi- every candidate be analyzed by a TA. covered by existing groups. cation as a prerequisite for TA/SA I hope you vote “yes” on local option. Symposia explore the interface between psychoanalysis, society and related disciplines, attempting to demonstrate how psychoanalytic recognize the need for national standards Opposing the Bylaw thinking can be applied to non- and a national certification for their individual psychoanalytic settings. Symposia must Amendment practitioners that has meaning for the pro- be in talking points format, 10 to 15 Continued from page 20 fession and which should be expectably minutes per presentation (no papers required for those entrusted with educating read), with a minimum of 15 minutes The reliability of the certification procedure is future colleagues. for audience participation with being researched. Substantial and extremely There is another quite different but also emphasis on audience interaction. well received changes have recently been essential problem with the “local option” Submit a brief (two pages maximum) made in both certification and the national amendment. APsaA is in the middle of a major proposal outlining rationale, program standards for TA appointment. Work contin- reorganization. The bylaws of our organization format, and suggested speakers. ues to increase flexibility while maintaining are being reviewed and rewritten. All admin- The deadline for submission of panel proposals is October 1 for the reasonable assurance of TA experience and istrative structures within the organization Winter Meeting and March 1 for the qualifications. Although there has been ongo- are subject to revision. The proposed new Annual Meeting. The deadline for all ing controversy regarding certification, when administrative structure and bylaws will be other submissions is May 1 for the polled, the majority of our members support voted on by our membership. This bylaw Winter Meeting and December 1 national certification with improvements. This would have the effect of making a radical for the Annual Meeting. proposed amendment opposes this expressed (and realistically irrevocable) change in the Address correspondence to Glen wish of our membership by attempting to nature of our organization at a time when the Gabbard, Chair, Program Committee, preemptively prevent our BOPS from employ- big picture is being re-considered in a holistic c/o The American Psychoanalytic ing any form of national certification. Taking way. Please consider carefully before casting Association, 309 East 49th Street, this step is also contrary to the accepted your vote. The nature of our organization is New York, New York, 10017. practice of other healing professions, which at stake.

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 21 There is no reorganiza- The Task Force on tion that would meet the wishes of all the strong Reorganization Makes a Proposal voices in our organi- zation. This diversity Now It’s Up to You of opinion was rep- Robert M. Galatzer-Levy resented on the task force. Even APsaA is your organization. The Task Force The Board of Directors will include major after struggling on Reorganization worked mightily to create representation elected directly by the mem- with the issues for a a proposal for a new APsaA governance. Every bers, several members elected by the Coun- long time, significant differences APsaA member has received a copy of the cil of Societies, the officers of APsaA, a of opinion remained among task force report and it is available online. We hope that representative of the Council of Institutes members. Our report reflects the majority you will help ensure that APsaA works well and (optionally) three outside directors with opinion of the best way to proceed in the best and represents you well. special expertise needed by APsaA. It would interest of APsaA and psychoanalysis. It also The task force tried to design a governance include several directors, elected by the mem- describes concerns about and disadvantages that is both effective and representative of bership, whose jobs would be to oversee of our ultimate recommendations as well as APsaA’s members. We hope members will APsaA’s major divisions. The Council of Soci- considerations of alternative proposals. Its goal read our report thoughtfully and come to eties, in addition to electing several members is to lay out our thinking so that members can their own conclusions based on its merits. of the board, would coordinate societies’ come to an informed decision when it comes time to vote.

WHAT THE REPORT TRIES TO DO We are not trying to “re-invent the Association,” AND WHAT IT DOES NOT TRY TO DO The task force was charged to design a gov- to determine its future course, or to empower ernance for APsaA. Governance specifies how a particular point of view. Our proposal attempts to do the organization’s work, not what that work is. Governance should help get things to create an arrangement in which, if the done and reflect the members’ wishes. It should not dictate what is to be done. APsaA is a membership so chooses, changes of many kinds changing organization with changing goals and projects. Governance should facilitate and cer- are possible. We want APsaA’s energies to tainly not impede these changes. At the same focus on its tasks, not its governance. time, governance must address the particular tasks APsaA is likely to encounter. Practically, this means that it should be clear who makes what decisions and decision mak- The task force report addresses some of interests and receive reports from APsaA’s ing should be appropriate for the situation. APsaA’s most controversial issues. If adopted, committees. The Council of Institutes will There should be checks and balances to it would create a small, representative Board oversee psychoanalytic education in APsaA ensure that decisions are made fairly and well, of Directors with great authority. It would institutes but play little direct role in APsaA’s but these should not make it unduly difficult dramatically alter the roles of the Council, governance (i.e., it will contribute a single to take action. For example, we recognized BOPS, and the officers. (The successor of member to APsaA’s Board of Directors). The that APsaA will likely want to change its the Council would be named the Council of Council of Institutes, as a subsidiary corpora- membership criteria from time to time, but we Societies and BOPS’s successor, the Council of tion, will have significant autonomy from also recognized that such changes could Institutes.) APsaA, while at the same time it will include change the entire character of the Association, strong representation from APsaA in the form so we designed a procedure in which the cri- of APsaA representation on its board, eligibility teria could be changed by a majority vote of Robert M. Galatzer-Levy, M.D., chairs of all APsaA members to serve on its board the Board of Directors and the membership the APsaA Task Force on Reorganization. of directors and committees, and the capacity because major changes need to be under- He is a training and supervising analyst of APsaA’s Board to discharge the board of taken with caution. at the Chicago Institute for Psychoanalysis. the Council of Institutes. Continued on page 23

22 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 LOS ANGELES MERGER

change. Alongside the excitement of starting Los Angeles and Southern California something new was always the awareness that our psychoanalytic homes would cease Societies and Institutes Merge to exist, places where we had learned our R. James Perkins craft and found lasting professional and per- sonal relationships. A new entity, the New Center for Psycho- organization, revitalized by the synergy of a Following the vote in principle to combine, analysis, will replace the two venerable mem- merger. A vote in principle by both mem- there was a de facto merging of important bers of APsaA that have co-existed in Los berships to combine led to an implementation functions, establishing joint institute and Angeles for more than 50 years. The committee charged with recommending a psychotherapy classes and their associated “crosstown rivals” had recruited and trained model for the new organization. A final, bind- committees, which have been running quite their own candidates and put on scientific ing vote was held in May 2005, expressing smoothly for the past three years. The expe- and social programs with little shared activi- overwhelming support for the merger and rience of working together successfully was ties or membership. For years, the idea of creating the New Center for Psychoanalysis. crucial in building trust and confidence in the process and in one another. There is now considerable excitement about There is now considerable excitement about the the opportunity to build a psychoanalytic opportunity to build a psychoanalytic organization organization that better reflects the needs of its members, its candidates, and the commu- that better reflects the needs of its members, nity. To this end,the New Center for Psycho- its candidates, and the community. analysis, while continuing the tradition of analytic training of the highest caliber, will also sponsor a broader application of psychoanalytic combining these two rather similar organiza- The process was not always a smooth thinking. With a strong foundation, we hope to tions had been mentioned, but each was func- one. At various points, there was under- tap into the academic and cultural passions of tioning well and cherished organizational standable resistance to change, with appre- our diverse membership, sponsoring programs identifications made the idea seem un- hension in each group about the “other,” that will both foster more active participation necessary and unappealing. and infighting within each group about the within and further widen the scope of psycho- Over time, however, new institutes ap- advisability of making such a sweeping analysis in the community. peared on the scene, reflecting theoretical niches and the medical exclusivity of the past. In some cases, these new entities were formed The Task Force on Reorganization Makes a Proposal by groups that had split off, taking members Continued from page 22 and their candidates with them. So while interest in psychoanalysis has remained strong We are not trying to “re-invent the Asso- WHERE FROM HERE? in Los Angeles, the market share of the two ciation,” to determine its future course, or We very much hope that each member original organizations gradually became smaller. to empower a particular point of view. Our will read and think about our proposals. Before Recruiting became more competitive and proposal attempts to create an arrangement the proposals are transformed into bylaws membership rolls began to decrease due to in which, if the membership so chooses, language, we may refine them based on further aging and attrition. The result for both groups changes of many kinds are possible. We want feedback of members. After the January Meet- was shrinking coffers and decreasing vitality APsaA’s energies to focus on its tasks, not its ing our proposals will be drafted by our attor- as the financial and human resources to run governance. neys into specific bylaws proposals for the their various and often parallel programs were Our current bylaws include great detail about members’ vote. stretched thin. a variety of matters not ordinarily included in We hope that discussion will focus on the By the late ’90s, the idea of merger was bylaws and apparently designed to set APsaA merits of the proposals. We believe that APsaA finally being taken seriously. A joint committee policies. We believe bylaws should be simple, will be best served if members calmly step explored the feasibility of combining to create clear statements about how to run the Asso- back and consider the proposals. We hope a larger, financially robust psychoanalytic ciation, not means to cement policies in place they will ask not only whether the proposals or to address every possible contingency that satisfy their particular concerns, but rather R. James Perkins, M.D., is supervising might face the Association. Our goal is to write whether they are “good enough” so that and training analyst at the New Center for bylaws that everyone can understand and use APsaA will work more fairly and effectively if Psychoanalysis in Los Angeles. to accomplish APsaA’s missions. they are adopted.

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 23 COLLEGE MENTAL HEALTH

genetic, anatomi- Complex Mental Health Issues cal, and physio- logical changes Lead More College Students that are still taking place during this to Seek Counseling period. Lorraine D. Siggins For instance, recent studies at College students and the lives they lead universities. Though the suicide rate on the National In- are a source of much interest and curiosity. college campuses is roughly half the suicide stitute of Mental Lorraine D. Siggins Usually this is directed toward their social and rate in the population at large for the 19 to Health (NIMH) sex lives, their academic achievements and 25 age group, many colleges are address- using imaging techniques have shown that career choices, their initiation rites, and their ing these tragic events by increasing access the brain continues to develop until the mid- athletic achievements. More recently, this inter- to counseling and mental health services twenties. During this time, there is a consoli- est has been directed towards their mental to try to reduce the number further. dation of neural pathways, which is necessary health concerns. Frequently, these issues have These points raise many questions. Why, for the optimal adult functioning of the higher been front-page news. Many newspapers and for example, would there be an increase in the level abilities of judgment, mature decision magazines in the last several years have number of students coming to college coun- making, and the ability to integrate paradoxical featured articles about the increasing number seling and mental health services? How are we and contradictory material. This continuing of students coming to college mental health to account for the increase in severity of illness? development contributes to the difficulty we services, about student drinking patterns, There are no definitive answers to these have in making definitive adult diagnoses in and student suicide. Some of the statistics questions, though several are frequently men- this late adolescent age group. cited are: tioned. One is that there has been a decrease The difficulty of diagnosis is compounded by • The 2004 National Survey of College in the stigma associated with obtaining mental the genetic unfolding of major mental illness, Counseling Directors states that 85 per- health care. Thus, students feel free to go to which, as we know, first occurs during the cent of the directors of counseling serv- campus services for help. A second reason years 17 to 25. Thus, when we see a sopho- ices have reported an increase in severe mentioned is that there has been improved more who seems “confused” and has loose psychopathology in the students they treatment of depressed students in high school. associations, we may be seeing the develop- are seeing. These students are now completing high mental regression and uncertainty of an ordi- • Most of these directors have seen a 50 school and going on to college, which they nary sophomore who next year will seem percent increase in the number of stu- would not have been able to do before. well put together; or one might be seeing dents coming to their services, and in Another reason offered is the effect of the what, a year later, will turn out to be a major many instances, the numbers have doubled change in family structure, often with inade- mental illness. Also, what may seem like a col- over the last five years. quate childcare available. This may adversely lege prank one year, turns out to be a mania • 92 percent of counseling center direc- affect genetically vulnerable children. the next. It is extremely important to keep an tors saw an increase in the number of open mind about diagnostic issues as devel- students coming to college already on MIND AND BRAIN IN TRANSITION opment unfolds, both psychologically and phys- psychiatric medications. The growth of these problems means that ically. This is also an important consideration in • The American College Health Associa- we, as analytic clinicians, will increasingly be prescribing medications. tion survey of students in 2003 indicated seeing troubled college students. When we In clinically assessing a patient in this college that 40 percent of students at least once are consulted in such situations, there are impor- age group and, particularly, in undertaking during the year had felt so depressed that tant considerations we should attend to during any intensive therapy, we, as analysts, should it was difficult to function. the assessment, and in recommending an on- be cautious in assessing the material as it • There have also been prominent accounts going treatment. We need to keep in mind the emerges, and in coming to an understanding of suicides that have occurred among stu- psychological vulnerability of students during of the students. This is a very exciting time in dents on the campuses of prestigious these years. The transition from home to college students’ lives, and it is a privilege to be work- to an independent adult life, and the necessity to ing with them during these important transi- Lorraine D. Siggins, M.D., is psychiatrist-in- negotiate many complicated developmental tional years. At the same time, we do need to chief at Yale University Health Service, clinical issues, are phenomena psychoanalysts are famil- be alert to the genetic, physiological, and professor of psychiatry at the Yale School of iar with. Along with these crucially important psychological complexities of this period if Medicine, and training and supervising analyst psychological developmental tasks, however, it we are to facilitate the students’ development at the Western New England Institute. is also important to keep in mind some of the and understanding.

24 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 EDUCATION

ACCEPTED IN MED SCHOOL Bringing Basic Freud to the It was this experience, plus the appeal from the undergraduate students, that led Whole Student Body us to redesign the course once again and Shela Fisk approach Stanford Medical School with the offer to teach the course there. It was Several years ago as a candidate, I grew tales. We also use contemporary movies to recently accepted as a preclinical elective for tired of being asked because of my training: illustrate trauma and psychosis. January 2006. The chairman of the Stanford “Do people really still practice psychoanalysis?” The course, now in its third year, continues Curriculum Committee, an internist, said in I decided to do something about this ques- to be popular. The online catalog and hard his reply to me: “I want to take this course tion and approached Stanford University’s copy catalog combined reach over 4500 peo- myself.” As a preclinical elective, the course Continuing Studies Department to propose ple in the San Francisco Bay Area. There are will be open to any Stanford University Med- a survey course about psychoanalysis. Several now three additional psychoanalytic courses ical student, undergraduate, graduate, resi- of my analytic colleagues helped me design being taught through Stanford’s Continuing dent, or fellow. and also taught in the course, which had a Studies during the year, which generates much The course, which is supported by a grant waiting list the first year it was offered. As I needed publicity for psychoanalysis. from the American Psychoanalytic Founda- watched these students, who had no previ- Our course has led to requests for consul- tion, has the same basic design and teachers as ous knowledge about psychoanalysis, crowd tation, speaking in other Stanford courses, and the Continuing Studies course, but will in addi- around the instructors during the breaks and an appeal from some undergraduates to have tion cover psychosomatic symptom forma- after the course, I was convinced that this was the course available to them. Most of the stu- tion, the role of dreams in medical illness, and a good means of introducing psychoanalysis dents in the course already have graduate trauma that results in physiological symptoms. to others and also dispelling the myth of the cold, aloof analyst. Sam Chase, an experienced and enthusias- More importantly, we envision that some of these tic teacher in the first course, helped redesign students will become intrigued with the mind and the course before its second year so that it had a more coherent form. The revised course was analysis and thus will pursue careers as analysts. entitled “Freud’s Models of the Mind: the Mys- teries of the Unconscious.” Aimed at teaching basic psychoanalytic concepts to the lay pub- degrees. Many of them have been scientists, Our goal is to inform physicians about the lic, it starts with an overview of Freud’s life engineers, and others who were initially very relationship between the mind and psycho- and his culture and then goes on to review his skeptical about the “science of the mind.” somatic conditions so that they may make basic theories, using his writings as well as Since many of the instructors use current referrals with a sense of hope rather than recent writings to explain the concepts cov- neurophysiology to explain some of Freud’s exasperation. More importantly, we envision ered. The lecturers (who now include Wendy original hypotheses and others use clinical that some of these students will become Stern, Jonathan Dunn, Barbara McSwain, examples that everyone has some experi- intrigued with the mind and analysis and thus Chase, and me) cover Freud’s structural model, ence with, these skeptical scientists are at least will pursue careers as analysts. dreams, trauma, memory, neurosis and psy- more open to the idea, if not persuaded, that All the instructors in this course have chosis, and a contemporary application of the these theories are more than just conjecture. been very generous with their time and their theories to the clinical situation. The readings This in turn stimulates many more questions commitment to its development. The writing extend from some of Freud’s papers to fairy that keep all of the teachers thinking and read- of this article reflects our combined efforts ing more extensively in order to accurately even though it is in the first person. The address these difficult questions. courses followed the same path. They began Shela Fisk, Ph.D., is a clinical psychologist Chase and I have been invited to lecture in with my vision, but without the help of other and psychoanalyst in private practice in a course that was a part of the students’ living colleagues, particularly Sam Chase, they Palo Alto, California. situation. It was a cultural survey course that would not have developed and expanded as J. Samuel Chase, M.D., a psychiatrist and briefly covered Freud’s works and his clinical they have. psychoanalyst in private practice in San thinking. We had dinner with the students, Wendy Stern, one of the teachers, states, Francisco, contributed significantly to the each of us at a different table with about 10 “It was an undergraduate course such as this conceptualization and writing of this article. students each. These eager students kept us one that inspired me to become an analyst.” Both are members of the San Francisco talking nonstop until their faculty intervened We hope some of our students will one day Psychoanalytic Institute and Society. and announced that it was time for the lecture. say the same.

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 25 NAACP

his talk,“Reconciling the Truth about Racism in Wisconsin’s Forum on Psychology the U.S.: What Can We Learn from South Africa’s Truth and Reconciliation Commission?” of Racism Creates Dialogue with The presentations were followed by a spir- ited dialogue with the audience in a town hall Minority Community meeting facilitated by Keith Murphy, a nation- Jan Van Schaik ally syndicated radio talk show host. The event was broadcast live on WMCS, a popular local A few years ago, a West African resident in After explor- urban radio station and was filmed by public my advanced psychotherapy course told me ing various con- TV. Over 150 people attended the forum. how fascinated she was by the psychoanalytic tacts over the The audience was an ethnically and racially material that we were reading. I asked if she next year, I part- diverse cross-section of the community, includ- had considered analytic training. She retorted, nered with G. ing NAACP members, religious leaders, politi- “As a black woman from Africa, who in Mil- Communications, cians, analysts, psychotherapists, educators, and waukee would ever come to see me for a marketing firm other local residents interested in the topic. analysis?” Sadly, I realized that she had a point. involved in event Audience members were enthusiastic, viewing Shortly thereafter, I read that the NAACP planning for the the dialogue as a positive step in healing Mil- had scheduled its national convention to be in NAACP conven- waukee’s racial divide. Jan Van Schaik Milwaukee July 2005. I thought a public forum tion. With the Following the forum, there was a gallery on the psychology of racism timed to coincide help of G. Communications’ CEO, Brandon walk through an exhibit on “Artists Interrogate with the NAACP convention could provide an Adams, a vision began to take shape. We Race and Identity,” with each panelist choosing opportunity for useful dialogue between psy- planned a three-hour “Forum on the Psychol- a work of art to discuss in depth. The gallery choanalysts and the minority community. After ogy of Racism” for July 8, 2005, at the Mil- walk offered an opportunity for a more inti- considering many ideas about what could be waukee Art Museum. I was able to obtain mate discussion on the psychology of racism. accomplished with such a forum, I distilled my thoughts down to five talking points as I sounded out leaders in the black community As an organization, APsaA is seeking to redress the institutional about their ideas on a public dialogue. The racism that has pervaded the mental health profession. talking points were as follows: • As experts in understanding the psy- chology of human behavior and feelings, funding from the American Psychoanalytic The next day, at a special scientific meeting psychoanalysts have much to contribute to Foundation, the Wisconsin Psychoanalytic of the Wisconsin Psychoanalytic Society, Kliger, studying the psychology of racism. Foundation, the Wisconsin Psychoanalytic Soci- Tharps, and I facilitated a discussion of racial • Minority populations are underserved by ety, and G. Communications. Three APsaA issues in the therapeutic setting using a film, The psychotherapists and psychoanalysts. members, Paula Kliger from Detroit, Mark Color of Fear, as a catalyst. This film is a powerful • Minorities are underrepresented in our Smaller from Chicago, and Sandra Walker exploration of racial attitudes among seven profession. APsaA is committed to increas- from Seattle, as well as a local psychotherapist ethnically diverse men. The 30 people who ing diversity among trainees. on our foundation board, Quincy Tharps, attended the meeting found the discussion • As an organization, APsaA is seeking to agreed to be the forum panelists. helpful in furthering their work with patients redress the institutional racism that has At the forum, Tharps set the stage by dis- from different ethnic or racial backgrounds. pervaded the mental health profession. cussing sociocultural aspects of racism that We are exploring ways to keep the momen- • Milwaukee is one of the most segregated affect all members of society, focusing on the tum going. Local public TV plans to broadcast urban areas in the country. We want to unique racial picture of Milwaukee. In a pres- an edited version of the forum. Additionally, do our part to improve this unfortunate entation entitled “Race from the Inside Out,” talks are underway for a possible national situation. Walker discussed the internalization of racism. broadcast. We are also considering offering Kliger focused on how racist attitudes are con- psychoanalytically informed diversity training veyed and passed on through mutual recipro- and psychoanalytic discussions of movies and Jan Van Schaik, M.D., is a training cal exchanges between individuals in her paper, plays that have racial themes. Meanwhile, and supervising analyst at the Wisconsin “Racism: It Takes Two—The View from Within.” Tharps is networking with local religious lead- Psychoanalytic Institute and an assistant Smaller provided an analytic perspective on ers to continue this important dialogue. Next clinical professor of psychiatry at the Medical the Truth and Reconciliation Commission in year, we plan to have another society meeting College of Wisconsin. South Africa and its relevance for our culture in devoted to racial issues.

26 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 SCIENCE and Further, human infants show gender-linked preferences in the direction of attention Psychoanalysis (human faces vs. mechanical toys) when they are only one day old! There are more complex gender differ- Vive la Différence ences in responses to separation, responses to Robert Michels stress, and in the impact of drugs on memory. At this point, the data do not lead to a new Psychoanalysis divergent reproductive behavior. This pro- comprehensive formulation so much as shake has long been vided a biologic basis for gender specific the old one. interested in behavior in mating. One example of these differences: The mem- the differences Now new research has added yet another ory of emotionally distressing stimuli correlates between men perspective. The brains of men and women with activation of the amygdala. However, in and women— are different; these differences are present men it is the right amygdala; in women the left the mental dif- from birth. They involve areas of the brain amygdala. Furthermore, if this activation is damp- ferences—and that are not associated with reproductive ened by drugs, memory is affected. However, has been a major behavior and they seem to be associated with the effect is different in men and women; in men participant in behavioral differences that have little to do the central theme of the memory is impaired Robert Michels the dialogue and with mating. In this model anatomy may still be (right brain), in women the memory of the controversy that destiny, but it is neuroanatomy rather than peripheral details (left brain). This has implica- have surrounded this subject from before genital anatomy and it affects non-conflictual tions for the response to trauma, the nature of Freud until the current president of Harvard. capacities as well as mating behavior and asso- traumatic memories, and the way in which one Freud’s most well-known formulation was ciated fantasies. might approach their treatment. clear—the essential psychological differences between the sexes could be traced to their reactions to the discovery of genital differ- Psychoanalysis has long been interested in the differences ences. Anatomy was destiny—the anatomy between men and women—the mental differences— of the genitalia and the psychological responses and has been a major participant in the dialogue and to it. Men and women had the same brains, but different developmental experiences. controversy that have surrounded this subject from before One modification of this model added a Freud until the current president of Harvard. social or relational theme, a theme that be- came widespread in psychoanalytic thinking. The critical experiences that differentiated The new findings are largely based on new Males and females are different, and that boys from girls were not only their own psy- methods of studying brains, positron-emission includes psychological differences. These dif- chological responses to the discovery of their tomography (PET) and functional magnetic ferences may stem from early developmental genitalia, but also, and more important, their resonance imaging (fMRI) as well as more tra- experiences with their bodies, from social parents’ response. Mothers and fathers behave ditional neuroscientific and psychologic tools. learning in response to their parents, from differently with sons and daughters, and the They have demonstrated differences between the effects of hormones on gender specific response to those differences led to gender men and women in both gross and micro- behavior, and now we can add from differences differences in psychology, differences that were scopic brain anatomy, differences that correlate in their brains and behavioral repertoires that not closely tied to mating behavior. with areas of the brain that contain the high- antedate all of these others. The implications A second modification came from bio- est concentration of sex hormone receptors of these findings for developmental psychology, logic research. Sex hormones were found to during development. psychopathology, the process of psychoanaly- affect the hypothalamus and thereby organize There are also studies of behavioral differ- sis, and the limits of psychoanalysis are yet to ences that seem to point to constitutional be explored. Robert Michels, M.D., is Walsh McDermott rather than acquired differences that are The new neurobiologic findings are reviewed University Professor of Medicine and linked to gender. For example, baby mon- by Larry Cahill of the Department of Neuro- Psychiatry at Cornell University. He is training keys mimic humans in their preference for biology and Behavior and the Center for Neu- and supervising analyst at the Columbia “gender appropriate” toys, and in monkeys it robiology of Learning and Memory of the University Center for Psychoanalytic Training seems unlikely that what is gender appro- University of California, Irvine, in the Scientific and Research. priate has been learned from social attitudes. American, May 2005.

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 27 CANDIDATE RECRUITMENT

A Conversation about Candidate Recruitment How Enticing Ethnic Cuisine Can Change Your Institute

Dottie Jeffries

Preface: In many ways, New York University and he gave me the chance to do it. I came to (NYU) Psychoanalytic Institute’s current the position with several things in mind: One, recruitment strategies are very much in keep- I would be proactive; two, I would address the ing with the spirit in which the psychoana- lengthy interview process, which I believe hin- lytic institute came to be at the NYU School of dered more than helped; and three, I would Medicine. market the career opportunity at hand. Chairman emeritus of the NYU School of Medicine and professor of psychiatry Robert DJ: Where did you begin with your new recruit- Cancro was instrumental in getting a psycho- ment endeavors? analytic institute to the school. “I had trained in SW: As you may know, the NYU Psycho- my residency with many of the analysts who analytic Institute has a close relationship with were at the psychoanalytic institute at SUNY the Department of Psychiatry at the NYU Downstate in Brooklyn and appreciated very Medical Center. We were aware, however, much the contributions of analytic thinking Sylvia Welsh, chair of the Admissions that many of the residents thought the insti- to my education. Around 1977, these analysts Committee of the NYU Psychoanalytic Institute tute was filled with cold, stodgy people. The were thinking of relocating their institute to residents were actually scared of some of the Long Island Jewish Medical Center in Queens. candidate morale is healthy, and open houses analysts. Sensing an opportunity to alter this But I was thinking otherwise,” Cancro said. are well attended. perception, I met with the director of resi- Already on faculty at the NYU School of dency training, Carol Bernstein, and told her I Medicine, Cancro felt that having a psychoan- INTERVIEW WITH INSTITUTE had an idea of doing monthly dinners at my alytic institute at the school was paramount to ADMISSION CHAIR home for residents where we might discuss a comprehensive curriculum for the Depart- We recently interviewed Sylvia Welsh, any topic of their choice. ment of Psychiatry.“I thought it very important chair of NYU’s Admissions Committee. The I thought these events would be more in a biologically oriented department of psy- institute now has 20 applicants. Since Welsh successful if we held them in a loose envi- chiatry to get an understanding of the dynamic took over as chair of admissions three years ronment in which the residents would feel mental functioning beyond the synapse. I ago, NYU has had somewhere around the free to talk about clinical or other issues they wanted our residents well prepared for their same number of applicants (about 20) each felt were important to their experience as practices by giving them knowledge that went year and from that pool of applicants NYU psychiatric residents. These dinners, at which beyond the chemistry of the human being. now has 10 candidates in the second year class the director of the institute and two or three The presence of a psychoanalytic institute and 12 in the third. Most likely, there will be other faculty members would also be present, would facilitate exactly that,” Cancro recently about 13-15 in the new first year class for the would be open to all residents. Furthermore, remarked in an interview with TAP. fall of 2005. I made it clear to the residents from the “So over dinner at a Chinese restaurant I courted the institute and convinced them that a home in Manhattan at the NYU School of The number of applicants has risen significantly, candidate Medicine would provide a mutually beneficial morale is healthy, and open houses are well attended. location.” Today, the NYU Psychoanalytic Institute is vibrant with change. And we’re not just talk- DJ: How did it happen that you became very first dinner that I did not want them to ing about NYU’s well-designed course cata- admissions chair? feel obligated to come every month. They log. We’re talking about candidate recruitment. SW: I’m a big proponent of psychoanalytic could come to as few or as many as they The number of applicants has risen significantly, training and psychoanalytic practice as a career wished and would always be welcome. path. Knowing this, a recent director of the As it turned out, there were few opportu- institute (Bob Fischel) asked me what I wanted nities for the residents to gather informally, Dottie Jeffries is director of public affairs for to do at the institute. I said I would be inter- so these dinners held great appeal to them. the American Psychoanalytic Association. ested in chairing the Admissions Committee Continued on page 33

28 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 AMERICAN PSYCHOANALYTIC FOUNDATION

Replication: Can the program be a model A Call for Proposals for other programs at other psychoanalytic Selma Duckler institutes, societies, and foundations? Fundraising: Will this program and APF The American Psychoanalytic Foundation We anticipate a larger working budget this year, funding lead to new funding sources for this (APF) in its 11th year has completed a dra- and want your involvement and your financial and other programs? matic change and, with a unanimous vote of support through contributions to APsaA. We Creative and Original: Is the program inno- both the APF board and the APsaA Executive are your foundation, and we hope that you vative? Does it show promise of findings or Council, became a Committee of the Ameri- will think of us as a resource for programs that services that could be utilized in psychoanalytic can Psychoanalytic Association in 2005. may not fit with other funding sources. fields or other disciplines? Before Dean K. Stein began his position as When considering making a funding request Continuing Education Credit: Will your APsaA executive director, the APF board to APF you might ask these questions about program give CE credit to other mental health invited him to do a critical analysis of how your program: professionals and to other groups? well APF was realizing its mission and goals. Community Outreach: Does your pro- We have a Web site at www.cyberpsych.org/ These included raising funds and awarding gram broaden the community’s knowledge of apf/. However, proposals to APF should be grants to promote a better understanding of psychoanalytic ideas as well as provide a valu- e-mailed to Dean Stein at [email protected]. psychoanalysis and encouraging effective and able service? He will let you know if your proposal fulfills the innovative dissemination of psychoanalytic National Focus: Will your program develop conditions we require for consideration. ideas and services to the public. and contribute to knowledge and service We hope to receive your project submission After substantive research on APF financial beyond its local community? in the near future. records, goals, and abilities, consulting individ- ually with each member of the board, and immersing himself in APF’s past history, Dean When a Family Member is Gay: Stein suggested that APF become a committee of the APsaA corporation. Stein realized that The Third Generation fundraising and administrative tasks could be done more efficiently by APsaA staff. Thus, the Six years ago, with the support of Ralph Roughton, a discussion group was begun APF Committee could devote itself to making by three analysts who were parents of gay and lesbian children. Our original purpose grant awards in service of its mission. was to identify and examine the special challenges analyst parents faced in learning to After a year’s efforts,APF gifted the Associ- accept their children’s sexual identities. We were already aware that the pathologizing ation more than $500,000 and started to of homosexuality in our analytic training had made it more difficult for us to accept our think about our new direction. children’s being gay and to help them as they came out to the world. Many members The new APF Committee plans to take a worried about how we would be viewed by our colleagues, and how public knowledge proactive role in funding proposals. We want that we had gay children would affect our professional reputations. Many of the senior to encourage groups and individuals to apply members of the group had kept their children’s sexual identities secret from their for support for many varied programs and colleagues for decades. In discussing our family lives together, we analysts were needs. And we want to educate ourselves “coming out.” about what is going on all over the country in Beginning at our first meeting, a candid and intimate dialogue evolved among analyst psychoanalytic outreach. parents and our gay and lesbian colleagues. Over the years we have learned a great deal At our committee meetings, we are inviting from each other and learned new ways of thinking about ourselves and our children. various groups involved in active outreach pro- We have also gained new appreciation of the complexity of child development for all grams to make short presentations about their sexual orientations. The membership of the group has remained open and spouses work. These are not requests for funding, but are and adult children have attended. Other analysts interested in these subjects have intended to help APF become knowledgeable often participated. about what is actually going on in outreach, Several years ago, Sydney Phillips and Susan Vaughan described the particular challenges how it is funded, and how it is received. they faced in becoming parents and in parenting. This year they will again present and We invite and encourage all of you who we will focus on the third generation of the gay families, the grandparents. Our discussions meet our guidelines to explore what APF include personal and clinical vignettes as well as a more theoretical exchange of ideas. can do for you and to apply for APF grants. We invite you to join us. If you have any questions or want to contribute to the group, please call me (215-878-2191) or Susan Rosbrow-Reich (617-489-3363). Selma Duckler is acting chair of the —John Frank American Psychoanalytic Foundation.

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 29 APsaA FELLOWS

APsaA’s Excellent New Fellows for 2005-2006

The American Psychoanalytic Association Fellowship Program is designed to provide outstanding early-career mental health professionals and academics, the future educators and leaders in their fields, with additional knowledge of psychoanalysis. The 17 individuals who are selected as fellows each year have their expenses paid to attend the biannual national meetings of the American Psychoanalytic Association during the fellowship year and to participate in other educational activities.The biographies below introduce this year’s excellent group of American Psychoanalytic Association Fellows. We enthusiastically welcome them to APsaA.

Brenda Bauer, M.S., psychopharmacology with Joel Braslow, a psy- in Los Angeles and stud- is a clinical fellow at the chiatrist and historian at UCLA. He is very ied psychology and reli- Karen Horney Clinic interested in comparative studies of psycho- gious studies before (KHC) in New York. She therapy and what they reveal about generic graduating from Boston is a doctoral candidate and specific curative factors. His other research University with a B.S. in in clinical psychology at interests include the neurobiology of early psychology. He recently the Wisconsin School of attachment, anxiety, and fear conditioning; pre- earned his M.S.W. from Professional Psychology ventive efforts in psychiatry; psychosomatics; Smith College School in Milwaukee (WSPP). Brenda Bauer and biomedical ethics, in particular ethical for Social Work. Dávila’s Mark Dávila Her dissertation concerns defining and quan- issues raised by human clinical trials. clinical interests are in gender development tifying the degree to which psychodynamic/ and sexual orientation. His thesis examining psychoanalytic interventions are present in Lois W. Choi-Kain, the role of attachment in the safer sex prac- cognitive behavioral process. Meaningful psy- M.D., M.Ed., is a fourth- tices of gay men won the Joan Laird Thesis choanalytic outreach to the next generation year resident at the Prize for Excellence in Lesbian, Gay, Bisexual of clinicians and scholars is a particular pro- Massachusetts General or Transgender Studies and was nominated fessional interest. Her outreach efforts have Hospital-McLean Adult for the Eleanor Clark Thesis Prize at Smith included speaking to college-bound AP high Psychiatry Residency. College. Prior to his clinical training, he worked school students in Milwaukee public schools, Born in South Korea, she as an administrator and researcher at the teaching first-year medical students about immigrated to the U.S. Harvard-MIT Division of Health Science and human development, and providing Marquette with her family at an Lois W. Choi-Kain Technology. His publications are in biomedical University undergraduates with a psychoana- early age. She completed her B.A. at Harvard engineering education. lytic perspective on development, learning, College. With a focus on psychoanalytic, fem- and behavior. As a graduate student, she was inist, and postmodern theory, she wrote a Anne Duroe, M.A., instrumental in developing APsaA’s Associate thesis on anorexia nervosa. At the Harvard M.S.W., is in her second Program for Students and Residents and was Graduate School of Education, she studied year of a post-M.S.W. appointed to the Steering Committee, repre- the influence of culture on identity formation. fellowship at the Uni- senting Associate Programs. She went on to earn her M.D. at Thomas Jef- versity of Michigan’s Psy- ferson University. Currently, as an American chological Clinic, where Anthony Charuvastra, Psychiatric Association/Substance Abuse Men- she supervises social M.D., is currently a tal Health Services Administration Fellow, she work students and leads fourth-year psychiatry is working on a cultural curriculum that pro- case conferences in a Anne Duroe resident at UCLA. He motes understanding of cultural/racial identity psychodynamic training program. She gradu- hopes to start a child formation and the impact of discrimination, ated from Smith College with a bachelor’s psychiatry fellowship in marginalization, and immigration. She plans to degree in history, and earned a master’s degree 2006. At Brown Univer- pursue a career in academic psychiatry and in the history of art and a master’s in social sity as an undergraduate, hopes to continue to integrate analytic ideas work from the University of Michigan. Anne’s he worked with Anne Anthony Charuvastra into her research work. art historical research on early 20th century Fausto-Sterling on the study of intersexuality, artists’ examinations of modern subjectivity and obtained a B. A. in the history of biology. Mark Dávila, M.S.W., is a clinical social work contributed to her interest in psychoanalysis. After attending medical school at Brown, fellow at the Cambridge Hospital in the Pro- Her clinical interests include the psychody- he has continued his historical work, currently gram for Psychotherapy in Cambridge, Mass- namics of trauma, and the influence of cultural looking at the history of schizophrenia and achusetts. Dávila attended Occidental College Continued on page 31

30 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 APsaA FELLOWS and racial difference on transference/coun- Andrew Jen, Ph.D., is Anita R. Kishore, tertransference dynamics. on the core faculty in M.D., is a child and the master of arts pro- adolescent psychiatry Sinten Gurac, M.A., gram in psychology at fellow at the Yale is a teaching assistant at Antioch University-Los Child Study Center in the English department Angeles, where he New Haven, Conn. at Lehigh University, serves as director of She graduated from Bethlehem, Pennsylva- the child studies spe- Wellesley College with nia. She graduated from cialization. He is also a Andrew Jen a B.A. in psychology Anita R. Kishore Istanbul University,Turkey, licensed psychologist in private practice. He and earned her M.D. from the University of where she received both completed his clinical training in psychology at Pittsburgh School of Medicine. She recently a bachelor’s degree and Sinten Gurac St. John’s Child and Family Development Cen- completed her general psychiatry residency an M.A. in English. She is currently working ter, the Los Angeles County Department of at Western Psychiatric Institute and Clinic on her Ph.D. dissertation—a study of the early Mental Health, and the Federal Bureau of in Pittsburgh. Kishore has done research poetry of T.S. Eliot through the lenses of Prisons and held a post-doctoral fellowship at in cognitive neuroscience, specifically on Melanie Klein’s and Ronald Fairbairn’s object NASA. His primary interests include multi- implicit, or unconscious memory. She is relations theories. Her interest in psychic pain cultural competence training for psychother- interested in the interface between cognitive and emotional conflict has its roots in litera- apists, and the process of cross-cultural neuroscience and psychoanalytic models of ture. Aesthetic manifestations of such psychic psychotherapy. In addition to his professional the unconscious. phenomena encouraged her to investigate work in clinical psychology, he holds a master’s the nature and origin of these feelings, and degree in East Asian studies from Stanford, and Duncan MacCourt, this led to a growing interest in psychoanalysis. has an active interest in creative writing, for J.D., M.D., is currently a By discovering more about psychoanalysis, which he has won several awards. He is cur- fellow in psychosocial she hopes to sensitize her eye and ear to rently working on a novel. oncology at the Dana “psychologic signs,” and understand what these Farber Cancer Institute/ psychic telltales reveal about human nature and Megan Jessiman, Brigham and Women’s emotional suffering. Ph.D., is completing Hospital in Boston. He premedical studies at is a graduate of Har- Eva Ihle, M.D., Ph.D., Columbia University. vard College, where he Duncan MacCourt is a second-year child She received an A.B. in majored in English and developed an interest and adolescent psychi- English literature from in psychoanalysis by studying literary theory. atry fellow at the Uni- Princeton University, an He attended Harvard Law School, where he versity of California, San M.A. in philosophy of took courses in psychiatry and the law and Francisco, interested in religion at Yale Divinity Megan Jessiman psychoanalysis and the law, and the University pursuing an academic School, and a doctorate in philosophy of edu- of Pennsylvania Medical School. He recently career. Toward that goal, cation at Teachers College, Columbia Uni- graduated from the residency program at she is continuing re- Eva Ihle versity. Her studies in all three settings have Cambridge Hospital. His interests involve the search training that she started as an under- posed the question of how human beings law and psychoanalysis, psychoanalytic con- graduate, conducting research in behavioral construct meaning from experience, which cepts of pain, literary theory, and psychoana- neuroscience during her clinical training. Her has increasingly led her to the study of psy- lytic theory. current project probes the neurochemistry choanalysis and psychotherapy. Since 2004 underlying social interactions in songbirds. At she has done research at the inpatient and Robert McLay, Ph.D., the University of Southern California, she outpatient psychiatry units of New York-Pres- M.D., is an attending obtained a B.S. with honors in biology. Her byterian Hospital. Her current writing applies psychiatrist, lieutenant senior thesis project investigated the influ- her knowledge of philosophy of education commander in the ence of gonadal steroids on the developing to current discussions of the role of the train- Navy, and the research songbird brain. She received an M.D., as well as ing analysis in psychoanalytic education. She coordinator for mental a Ph.D. in neurobiology, from the University of wonders whether, in the debate between health at Naval Medical Chicago. She hopes to integrate the varied psychoanalytic approaches to psychiatry ver- Center, San Diego. He facets of biological psychiatry (such as basic sus more “scientific” neurological approaches, received his B.A. and Robert McLay research and psychotherapy) into a unified we have underestimated the truth value of the an M.A. in writing from Johns Hopkins, his construct of the mind. noumenal. Continued on page 32

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 31 APsaA FELLOWS

2005-2006 Fellows Gabriella Serruya- Vaia Tsolas, Ph.D., Continued from page 31 Green, Psy.D., works completed her clinical as a trauma services psychology doctoral dis- M.D. and Ph.D. in neuroscience at Tulane therapist for children sertation on feminine University, and completed his psychiatry res- at the Children’s Crisis jouissance at the Derner idency at Naval Medical Center San Diego. Treatment Center in Institute of Advanced He is the author of 47 research publica- Philadelphia. She re- Psychological Studies at tions, and has also published creative work cently graduated from Adelphi University, Gar- in magazines and literary journals. He has Widener’s clinical psy- Gabriella Serruya-Green den City, New York, as Vaia Tsolas received numerous awards for research and chology doctorate program, where she well as her internship at Montefiore Medical medicine, including the National Institute of defended a dissertation entitled “Maternal Center in the Bronx, in 2005. She is currently Mental Health outstanding resident award Post-Traumatic Stress and Reflective Function a post-doctoral fellow at Fordham University for 2004. He is interested in evidence-based as Predictors of Disorganized-Type Child Counseling Center. She is also beginning her approaches and neurophysiological mecha- Attachment.” Serruya-Green has a special psychoanalytic training at Columbia Univer- nisms for mental health treatment, particu- interest in the effects of direct or indirect sity Center for Psychoanalytic Training and larly stress-related disorders. His interest in trauma on the development of attachment Research. She has made numerous presenta- psychodynamic psychotherapy stems from a patterns, internal object representations, and tions, including twice at the American Psycho- personal enjoyment of doing such work, and affect-regulation in young children. She won logical Association, Division 39, and once at the an interest in advancing evidence-based the 2003 Student Essay Competition spon- International Bi-Logic Group. In 2005, Tsolas approaches in the field. sored by Division 39 of the American Psy- published her first article in Psychoanalytic chological Association for her essay entitled Review 92(2), “The Other of the Body and Diane E. McLean, “Enchantments and Hauntings: Encounters the Language of the Margins.” Before beginning M.D., Ph.D., M.P.H., is a with the Magic of the Unconscious.” She has a her doctoral training, she worked as a school first-year resident in theoretical and clinical interest in the psycho- psychologist in New York schools. the child and adoles- logical understanding of fantasy as an agent of cent psychiatry pro- creativity and growth, versus a means of denial Jason A. Wheeler, gram of Columbia and and avoidance. Ph.D., recently com- Cornell Universities. pleted his Ph.D. in clini- She graduated from Jennifer Shannon, cal psychology at the Harvard with an A.B. Diane E. McLean M.D., is a child and ado- New School for Social in history and science, and then received an lescent psychiatry fellow Research in New York M.P.H. and Ph.D. in epidemiology from at the University of City, where he won the Columbia. She received her M.D. from the Washington in Seattle. Outstanding M.A. Grad- Weill Medical College of Cornell Univer- She graduated from the uate Award in psychol- Jason A. Wheeler sity and completed her general psychiatry six-year B.A./M.D. pro- ogy. His dissertation on knowledge and residency at Columbia University/New York gram at the University authority in therapy and supervision inte- State Psychiatric Institute. Prior to medical of Missouri-Kansas City Jennifer Shannon grates analytic philosophy and psychoanalytic school, she was an assistant professor at and completed a year of research in the child theory. He has just begun work as a psychol- Columbia University and the Albert Ein- and adolescent psychiatry department at ogist with the personality disorders program stein College of Medicine and conducted UCLA’s Neuropsychiatric Institute. She at St. Luke’s-Roosevelt Hospital. Wheeler also research on stress and trauma, especially recently completed her general psychiatry has an interest in psychotherapy of psychoses relating to asthma and to adverse preg- training at the University of Washington and from his inpatient training at North Central nancy outcome. She is currently an Ameri- has a strong interest in a psychoanalytic Bronx Hospital. Born in England, he came to can Psychiatric Association/Bristol-Myers approach to therapy as well as in research. New York in 1999. Before his doctoral stud- Squibb Fellow in public psychiatry. In addition She is the recent recipient of a pilot award to ies, Wheeler received an M.A. in philosophy to residency, she is the co-director of Posi- study the use of metformin as a treatment from the University of Leeds, where he held tive Exposure, a non-profit organization that for obesity in children and adolescents on a British Academy studentship, and was uses photography and video interviews to atypical anti-psychotics. She also presented a research fellow in psychiatry at the University challenge stigma associated with genetic workshop at the last American Psychiatric of Hull. He has published on clinical psy- conditions. Association convention on the SSRI and sui- chopharmacology, evolutionary psychology, cidality controversy. and psychological ethics.

32 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 CANDIDATE RECRUITMENT

A Conversation from an April date of application, let’s say, to a As a result, most of the applicants we accept Continued from page 28 July notification seemed unduly long. decide to train with us and we have found We also needed to assess the admission that satisfied candidates themselves are the Attendance ranged from 10-20 persons. The interviews. While there is a need to assess the sources for new referrals. atmosphere became quite collegial rather than applicant’s analyzability, I nonetheless felt that one dominated by figures of authority. It goes the interviews were being conducted too much DJ: Have your admissions procedures affected without saying that a lot of humor and good cui- like consultations for analysis rather than for the quality of NYU’s classes? sine (especially a variety of ethnic menus) go a admissions to a training program. And, in the SW: The quality of the classes these past long way towards creating a successful gathering! current “buyer’s market,” I felt our interview- three years is phenomenal. Being more liberal I would tell the residents: “Even if you want ers should be aware that the applicants were in admissions has not led to getting inferior to write prescriptions all day, analytic training evaluating us as much as we them. people—quite the opposite. A very different will make you a better psychiatrist. It’s going to And another change. I made it part of my kind of person is coming in—smart, related, help you regardless of what you decide to job to shepherd the applicants through the independent, outspoken. In my mind, they are do.” I am very clear psychoanalytic training is entire application process. If they felt uncom- the future of psychoanalysis. indispensable to their “career tool kits.” fortable, for whatever reason, with a particu- lar interviewer, I wanted to know about it so DJ: Is the increase in the number of applicants DJ: Did you evaluate your institute’s applica- that I could address their concerns. I wanted the result of your efforts alone? tion process? them to know from their first contact with our SW: In no way can I take credit alone SW: I wanted to change from start to fin- institute that this was a place sensitive to their for all that’s happened in the last three ish the experience of applying to become a needs and interested in what they had to say. years. Many others at the institute have been candidate at NYU. I felt that three interviews Now the process of applying to our insti- involved. were not necessary. And the duration of time tute is a user-friendly, positive experience. Continued on page 34

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 33 A Conversation From the Continued from page 33

1. The psychiatry department rightly in- Unconscious sisted we do supervision on site. As a Sheri A. Hunt poetry result, residents saw us on “campus” more often and this provided us the Joy Kurland’s poem,“The Ayes Have It,” is like moving one’s mind in and out of a flex- opportunity to forge better relationships ible psychological Rubik’s Cube composed of facets of the self. The sensation is like that with them. of an intriguing self puzzle, in which it is possible to rearrange the picture by alterations in 2. NYU’s psychotherapy program has been perspective. The poem undulates with these self aspects as they come in and out of focus. a tremendous success. Among our appli- The result is an intriguing poem that seems simultaneously self-contained, refreshingly cants each year are several who have un-self conscious, and delightfully open-ended. completed this program. Joy Kurland, M.Ed., Ed.S., is a Psychotherapy Associate in APsaA. She is also a member of the Association for Psychoanalytic Thought, which is associated with the Baltimore- 3. NYU’s Fellowship Program is also a Washington Institute, where she is finishing the fellowship program. Kurland’s clinical resounding success. Invariably, applicants work is as a licensed professional counselor. She is in private practice with her husband, come from this audience. who is a clinical psychologist, in Martinsburg,W.Va. Kurland considers her poem to be an 4. Many of our faculty also teach and super- extension of her interest in the intersection of psychoanalysis and Buddhism. This poem vise at other residency training programs was previously published by the Bhavana Society in The Bhavana Magazine,Vol. 16, No.1, and in clinical settings around the city Winter 2005, and is reprinted here with permission. and Long Island. 5. NYU’s open house—this is another program that has undergone change, thanks to the initiative of Deborah THE AYES HAVE IT Huntington, the institute’s administra- tive director. She suggested we expand NoSelf eyed the number of open houses from two The various I-s annually to three. Wine and cheese Projected on its view. events are held on a weekday evening; Screening—sifting—sculpting all qualified mental health professionals They return repeatedly are invited. We use a nice room at the With a rhythm and will of their own. new medical center. And we make sure Accompanied by friends: that the analysts on hand like such Memory, sensation, action, consequences socializing and can relate well to other A karma then to be endured by all people in this type of venue. Deservedly or not. We’ve had people leave the open houses They’re a package of sardines with applications in hand. You can’t ask for These I-s in a tin of time. much more. Can I say aye to them all? Assent implying only the inevitability DJ: Overall, what’s the assessment of your Of their march—entrance/exit—across the stage. skills? Leaving Who to tell the tale? SW: I’ve got a big mouth and I’m a pro- Leaving Who free? moter of change. Probably my enthusiasm Words fail then … and abiding belief in the efficacy of analysis —Joy Kurland help considerably. Our approach to candidate recruitment is an institute-wide team effort. I encourage and deeply value independence of thought and expression to facilitate a progressive environ- Sheri A. Hunt, M.D., is a candidate at the Seattle Psychoanalytic Society and Institute in ment. I’m forward looking. And I count myself both the adult and child training programs. A published poet and member of TAP’s editorial lucky to be at an institute in which I am given board, she welcomes readers’ comments and suggestions at [email protected]. the freedom to promote change.

34 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 DATA

Students were taught that experience per se What Are the Data? was an unreliable source of information, that Robert L. Welker introspection had failed as a method of inquiry. They were taught to focus on subject matter I experienced an old, familiar sinking feel- interrogated ana- that was observable via sensory organs and ing as a member of the audience directed a lyst was thrown capable of meeting requirements of interob- question to a panelist at a recent meeting of by the word server agreement and measurability. Only the American Psychoanalytic Association. A “data” and that through this methodology could psychological seasoned psychoanalyst had presented his he would have science be advanced. position that analysis, rather than psychother- been able to It has not been determined whether these apy, was the treatment of choice for most articulate his methods of generating data will help illuminate patients he sees in his practice. The analyst said experience con- what is of most importance to psychoanaly- he would treat patients in face-to-face psy- tributing to his sis—the influence of unconscious mentation chotherapy with an agreement that they strive decision to rec- on experience and action as gleaned from Robert L. Welker to understand why the most effective treat- ommend psy- analysands’ descriptions of their experience ment, psychoanalysis, was not chosen. chotherapy to a particular person, had he of derivatives of unconscious mentation during When pressed about his convictions regard- thought of his experience as data rather than sustained and disciplined introspective inquiry. ing psychoanalysis, the analyst said,“It saved my construing data as tables and graphs of quan- One problem in applying the methods is life.” I admired his courage, his willingness to tified symptoms, behaviors, and demographic observational. Since no analyst can sensorily refer to his personal experience in the context characteristics of persons seeking treatment. observe an analysand’s experience or uncon- of a professional meeting. I was quietly review- scious mentation, the requirement of inter- ing personal benefits of my analysis when I was SCIENTIFIC STATUS observer agreement on the occurrence of alerted by the question,“What are the data?” Experimental psychologists probably know instances of the subject matter, as specified by At face value, it’s a reasonable question that more about construction of data than adher- experimentalists, cannot be attained. I had heard, and asked, innumerable times ents of other academic and professional disci- One approach to this problem is to work when I worked as an experimental psycholo- plines. This is so because of psychology’s with data that can be observed sensorily, taking gist. But, if my memory is accurate, this was the struggles to become recognized as scientific, to the analysand’s verbal descriptions as the basic first time I had heard it asked at an APsaA cast off its historical ties to mentalism, and to unit of observation. Words can be perceived meeting. The audience member pressed the gain legitimacy and status in a society placing auditorily and subjected to measures of inter- analyst about his approach and, if I recall cor- increasing value on technological progress. observer agreement about their occurrence, rectly, got him to admit that there were some persons seeking his help for whom he would not recommend psychoanalysis. Next, he asked I felt the return of an oppressiveness that had been one reason the analyst to articulate “the data” upon which he would base his decision to recommend for my departure from experimental psychology, an area where psychotherapy instead of psychoanalysis. Even- all declarative sentences must be backed by reams of data, tually, the analyst responded, “I plead igno- where data are the armaments of theoretical competitors. rance.” The interrogator returned to his seat. I felt the return of an oppressiveness that had been one reason for my departure from experimental psychology, an area where all Experimental methods and statistics are allowing their use as variables in correlational declarative sentences must be backed by required entry-level courses for undergrad- and experimental studies. The workings of reams of data, where data are the armaments uates majoring in psychology. When I taught unconscious mentation may be inferred from of theoretical competitors. I imagined that the the courses, students majoring in other areas patterns of word usage, linguistic probes of of “natural science” were encouraged to semantics, and other systematic analyses. Robert L. Welker, Ph.D., is in private take them. They learned how to operationally Another approach posits an additional oper- practice. He is chair of the Community define concepts, observe and measure phe- ation in analytic observation, and is usually Outreach Committee of the Wisconsin nomena, design and carry out correlative referred to as empathy. This approach is two- Psychoanalytic Institute, immediate past- studies and experimental investigations, dis- pronged: (1) attending sensorily to analysands’ president of the Wisconsin Psychoanalytic play data, apply and interpret various statis- descriptions of their experience, and (2) Society, and a recipient of an Edith Sabshin tical measures, and present their results most attending to our own experience of derivatives Teaching Award. convincingly. Continued on page 37

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 35 SACRAMENTO

shared aspects of their work with patients Living the Questions in Sacramento grieving the loss of close family members the John A. Booth following year. These courageous presenta- tions led to a group decision to reserve a “Since my sister’s death, I struggle to stay The questions explored so far encompass month this year to re-read and examine in present with my patients. My body is in the all phases of a psychoanalytic treatment. We detail the ideas contained in Mourning and chair, but my mind is in my garden. I took off as have puzzled over how to begin with a reluc- Melancholia. much time as I could to be with her during her tant patient, struggled with how to sustain and The group has also set aside two or three dying, and now I have to work. How can I deepen the therapeutic process in the face of Saturdays each academic year for daylong make room for my reactions to her passing various and intense midphase resistances, and case conferences, in which a group member without allowing them to intrude excessively pondered how to approach termination with presents a clinical problem to an invited con- in my clinical work?” a thriving yet reluctant patient. Providing a sultant. The invited consultants have included “I feel this woman is ready for termination, holding environment and creative play space Steve Purcell and Barbara McSwain, training but she’s not talking about it. I know she’s for therapists attempting to provide the same and supervising analysts at the San Francisco been traumatized by sudden losses, yet she’s for their patients has emerged as perhaps the Psychoanalytic Institute, and Neil Skolnick, gradually become quite attached to me. Should most important function of the group. How training and supervising analyst at the NYU I continue to wait for her to bring the issue up, we might optimally provide that space is one of Psychoanalytic Institute. In addition, Madeleine or would that be implicitly endorsing her the most important questions the group mem- Sprengnether, professor of English at the Uni- avoidance?” bers attend to during the various presentations. versity of Minnesota, was invited for an evening discussion of her book, Crying at the Movies, in which she investigates her intense Often alone in the struggle, we can have difficulty reactions to specific movies from a psycho- assessing the impact, for better or worse, of our own analytic perspective. An ongoing and, as yet unresolved, question subjectivity on our clinical interventions. is what it means to us to be an Affiliated Study Group. At the end of every year, the members gather for a daylong retreat to re- These are the kinds of questions the psy- MUTUAL BENEFITS view lessons learned and set goals for the choanalytically oriented clinician struggles with In this process of thinking and feeling following year. Consistently, the top priority daily. Often alone in the struggle, we can have together, we have benefited as much or more has been to preserve the group as a resource difficulty assessing the impact, for better or than our patients. Members have presented for learning and clinical consultation, but we worse, of our own subjectivity on our clinical case material reflecting differing theoretical have also looked at several possible ways to interventions. In order to provide a space orientations, led discussions on classic papers engage with the broader community of ther- where analysts and psychoanalytically oriented and psychoanalytic topics of current interest, apists in the Sacramento/Davis area. For ex- therapists could explore these questions and shared personal writing of a psychoana- ample, group members have gathered three together, the Sacramento Psychoanalytic Study lytic nature. As a rule, the presentations or four Friday evenings a year to discuss a Group was organized in the fall of 2002. The occur over three consecutive Fridays, with provocative movie, such as Lolita, American 15 group members include seven psychia- presenters and topics changing monthly. A Beauty, and Mystic River. We are considering trists, three clinical psychologists, and six clini- consultant, usually another group member, extending these movie evenings to the wider cal social workers. Seven of the members are attends to the group process and helps guide mental health community, perhaps with invited analysts, four of them in a consulting role. We the discussion. discussants. Consideration is also being given have met three Fridays a month, nine months Often, a particular presentation will inspire to offering seminars on contemporary psy- a year for the past three years. other members to explore different aspects of choanalytic topics. the same topic. For example, two years ago As questions regarding our identity, focus, the member quoted in the opening paragraph and goals continue to arise, we might draw John A. Booth, M.D., is a graduate of presented a moving paper she had written some encouragement from the advice given the San Francisco Psychoanalytic Institute about the death of a sister, examining the to a young poet by the German existential- and clinical professor of psychiatry at impact of this event on herself, her relationships ist Rainer Maria Rilke. “…Be patient toward the University of California Davis School with other family members, and on her clinical all that is unsolved in your heart and try to of Medicine. He has a private practice work. Supported by the group, the author love the questions themselves.…Perhaps of adult psychiatry and psychoanalysis presented the paper at a national conference. you will…live along some distant day into in Sacramento, California. Inspired in part by this paper, two members the answer.”

36 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 Developing Affiliated Study Groups

The Committee on New Psychoanalytic Centers (CNPC) continues to pursue its mandate to investigate ways of aiding the development and support of new psychoanalytic groups. CNPC is increasingly presented with new opportunities for expansion in widely diverse geographic areas not currently connected to existing societies or institutes. The efforts of CNPC to provide support and consultation to nascent study groups around the country continues to lead to the creation of new Affiliated Study Groups (ASGs), including Syracuse, New York, in January 2006 and Santa Fe in 2005, and to the further development of recently established groups in Birmingham, Alabama; Missoula, Montana; and Sacramento, California. At APsaA’s Annual Meeting in June 2005, the Executive Council approved CNPC’s proposal for an expanded criteria for establishing Affiliated Study Groups, which allows for a flexible approach to the sponsorship of new groups. The previously established application procedures permitted the creation of Affiliated Study Groups only in communities where there is at least one Active Member of APsaA in residence who would sponsor the group and be its representative to the Executive Council. The new criteria approved by the EC provide two additional routes to achieving Affiliated Study Group status: first, sponsorship by a member of CNPC, an approach currently supporting the Missoula Affiliated Study Group under the guidance of Fred Griffin; second, sponsorship by an Active Member of APsaA who either (a) lives in close geographical proximity to the group, for example, Phil Lebovitz from Chicago, who is sponsoring the Champagne-Urbana, Illinois, ASG, or (b) sponsorship by an Active Member living at a more distant location but who spends a significant amount of time in the community where the new group is being created. Sybil Ginsburg is supporting the organization of a new Affiliated Study Group in Syracuse, where she visits from her home in Atlanta, while Randall Paulsen from Boston is meeting with mental health professionals in Salt Lake City, Utah, to consider forming an Affiliated Study Group utilizing his leadership. —Katherine Fraser, D.M.H. Co-Chair CNP

What Are the Data? and to systematically assess, the nature of Getting back to my reaction at the panel, Continued from page 35 the data with which we work. The phenom- the question, “What are the data?”, can be ena of interest should determine the methods used for purposes other than promoting of our own unconscious mentation considered of investigation, not vice versa. From this per- inquiry. Ironically, the question can be asked in to be resonant to the unconscious menta- spective,“What are the data?” may be one of the service of stifling inquiry, refusing to accept tion of the analysand’s. In this schema of ana- the most important questions with which the described experience of others as worthy lytic observation, words are considered to we as analysts must grapple. of consideration if they have no graphs or serve multiple functions: to describe an A concept that was entertained years ago tables of quantified data to bolster their state- analysand’s experience, and to evoke reso- when I was working as an experimentalist ments. This usage of the question may be nant derivatives of unconscious mentation of was called ecological validity. I don’t know especially detrimental to psychoanalysis. If the analyst, which may be considered a form of whether it was ever developed systematically indeed the analyst’s unconscious resonance to data gathering unique to psychoanalysis, some into a measure of validity, but it made good that of the analysand is a hallmark of psy- would say the wellspring of psychoanalytic sense. Does the experiment pertain to phe- choanalytic observation, the described expe- data. It remains to be determined whether nomena as they exist outside the rarefied rience of the analyst may be our most direct data obtained using these operations of obser- confines of the laboratory or the research route of access to the data. From this per- vation can meet requirements of interob- protocol? When I was an experimentalist, spective, it is imperative that analysts strive to server agreement. I think requisite studies many phenomena of interest were so exten- articulate as clearly as possible their experi- could be designed and implemented, but I sively modified by adapting aspects of them ence of working analytically. would not recommend suspending psycho- to fit experimental methodology that even Data are constructed as approximate rep- analytic inquiry until the results were in. the most sophisticated of investigations bore resentations of aspects of phenomena being little resemblance, and I will add relevance, to investigated. Data per se should not be granted FOCUS ON MENTATION the topic being investigated. I propose that if the status of idealized substitutes for the phe- If we maintain a focus on unconscious a set of data seems irrelevant to how you nomena they represent. It would be a mistake mentation as our basic subject matter, we work in your practice, entertain the possibility to replace the worn out disclaimer “That’s not must find ways to articulate more clearly, that it is. analytic!” with “What are the data?”

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 37 POLITICS and charge. This division reflected almost exactly the division and discussion within the board. PUBLIC POLICY In spite of clarification of the charge by the Executive Committee, dissension continued, with the result that the work group was Totem and Taboo unable to carry out the reworking of the proposal. The IPA “Standards” Debate The work group was able to carry out Robert Pyles another portion of the charge, however, with considerable success. We were charged with The recent to introduce flexibility into their training stan- gathering information and feedback from survey of strate- dards.” In 2001, incoming president Daniel the regions and societies. What became clear gic priorities Widlöcher wrote a memorandum to all com- was that this issue aroused intense and deep revealed a star- ponent societies initiating discussion on this affect throughout the IPA. This was true tling fact. By a issue. In July 2002, the IPA Executive Council regardless of region, and regardless of which considerable approved a proposal to recognize different side of the issue a particular individual or margin, education models of training, including the classic Eitingon society represented. In general, there was is the number model practiced by most IPA societies. In addi- wall-to-wall opposition to changes in the stan- one priority of tion, however, it also recognized the “French dards and practices of the IPA in North Amer- our Association. model,” which differed from the Eitingon in a ica; Europe was divided. In Latin America, Robert Pyles Based on the number of ways, the most controversial of however, the feeling was just as strong that controversy in the International Psychoanalyt- which was a three times a week frequency. A more flexibility was required. What became ical Association, our appreciation of the cen- number of safeguards were included in the clear was that there was an enormous poten- trality of education to our profession is shared proposal, such as ensuring that the standards tial for polarization, and potential splitting throughout the world. within each country for any new group admit- within the IPA, over this issue. Probably for that very reason, there is no ted to the IPA would remain at the same level As the debate unfolded, It became clear other single issue within our psychoanalytic as those recognized by the existing groups that the most important contribution that the organizations that produces as much passion within that country. The next task was to committee could make would be to bring and conflict as a debate around educational write these changes into the IPA procedural some reason to the discussion. A commonal- standards. Our very identity as analysts seems code, for reconsideration by Council, and, ulti- ity among the reports, regardless of position, rooted in the standards by which we were mately, the members. was the absence of actual data on the issue. trained. I recently served as chair of the IPA Educa- tion Work Group, charged with looking at the possibility of creating more flexibility within Our very identity as analysts seems rooted in the our training standards. The resulting debate standards by which we were trained. devolved, as it so often does, into a torrid controversy about “frequency” of training analyses, i.e., three versus four to five times per week. The resulting controversy created a Accordingly, in March of 2004, the new This probably was a major factor in fueling the furor in the societies of our three regions of code draft was brought back to the Executive heat of the debate. North America, Latin America, and Europe, Council, now called the Board of Representa- which for a time seemed to endanger the tives. After a lengthy and heated debate, the DATA NEEDED very cohesiveness of the IPA itself. board narrowly approved the changes, but It was striking to note that neither IPA nor The issue began in 1999 when Otto Kern- stipulated that the proposal be clarified by a APsaA, in the respective 96 and 93 years of berg, then IPA president, received a request new board working group, consisting of two their existence, had gathered scientific data from the Latin American societies that com- representatives from each region. This was on our educational practices upon which to ponent societies should “have the autonomy the Education Work Group, which I chaired. base recommendations or conclusions. Amidst the growing controversy, we began to feel that Robert Pyles, M.D., is chair of the Committee FLEXIBILITY SPLIT the most important contribution of our com- on Government Relations and Insurance and The work of our committee began with a mittee would be to produce a proposal that a former president of APsaA. deep division regarding the nature of our Continued on page 43

38 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 PSYCHODYNAMIC PSYCHOTHERAPY

Successful formation of the therapeutic alliance, On Psychodynamic Psychotherapy empathic listening, and planning treatment goals, as well as old-fashioned competence, for Psychiatric Residents are necessary for successful psychotherapy of Paul Tiger any form. An important question is whether certain theories, techniques, or educational I would like to address the learning of psy- Psychiatry res- experiences best help residents master these chodynamic psychotherapy, how it is pre- idents have to non-specific factors. sented to the psychiatry resident, and how it understand what Non-specific does not mean eclectic. An differs from other forms of treatment. It is is meant by psy- earlier meta-analysis concluded that adher- important for residents to realize that psy- chodynamic psy- ence to a purity of treatment approach may chodynamic psychotherapy is not so much chotherapy, which itself be a non-specific factor related to effi- only what one does in the second or third year is related to the cacy. Could adhering to a conceptual frame- of residency, behind the closed door of the question of what work of any kind produce better outcomes? clinic with the patient on a comfortable chair is meant by psy- In the case of psychodynamic therapy this holding a Kleenex, but rather who one is—in choanalysis, or idea has an important twist. Psychodynamic Paul Tiger the clinic, on the wards, in the general hospital. what is meant by theory as it is taught in our residency empha- A psychodynamic stance can influence every psychodynamics in general. We need to know sizes three or four “psychologies”—or dif- aspect of our practice as psychiatrists. what makes this treatment different from other ferent ways of listening in psychotherapy, It is equally important to say at the outset psychotherapeutic treatments, such as CBT, with different sources of interpretation and that, in my experience, there is no easy agree- interpersonal, supportive, and brief, that psy- different, sometimes opposite, interventions ment on what is considered the practice of chiatry residents are required to learn. Also, we indicated in the same clinical situation (for psychodynamic psychotherapy. Therapists who need to know what psychodynamic psycho- example, interpreting idealization as a de- call themselves psychodynamic can have widely therapy is good for—what it can and cannot do fense against aggression or accepting it as a different approaches—both theoretical and and for whom. deficit in need of repair)! On the one hand, technical—to the same clinical problem. At a There seems to be a belief that when- this diversity is a tremendous richness and a discussion group at the last American Psy- ever the patient is talking and the resident is source of pride to our field, which speaks to choanalytic Association Winter Meeting, a table listening, psychotherapy is occurring. This the developmental history of psychodynamic of five psychoanalysts, a graduate psychologist may be true in a general way, but at some theory itself. On the other hand, it can be a and I, a psychiatry resident, could not agree on point in our training we must understand reminder of divisions in our field, the memory the definition of psychoanalysis. A sampling what this unique process is and how it can be of which we may be suppressing in our new of definitions included: “There has to be inter- so useful. ecumenism. Or it is both. But for the psychi- pretation, and the interpretations have to be atric trainee trying to learn what makes psy- used by the patient for change.” “You have to HOW DOES IT WORK? chodynamic psychotherapy unique, important, use the couch and there must be free associ- It can be discouraging for new trainees, as it effective, and a “fabulous product,” the diver- ation.” My own at the time, “A therapy in was for me, to see their professors throw up sity is a potential obstacle. which regression and transference are pre- their hands and say, “ I don’t know how this Some training analysts go so far as to say dominant.” None met with uniform approval. works, who does?” (Although I admired their that this “listening with evenly hovering atten- honesty!) tion” can leave the patient feeling like the WHAT IS IT? There are non-specific factors in effective therapist is wishy-washy or has no substance. Jon Meyer, the president of APsaA, who psychotherapy that transcend theoretical It is difficult to imagine learning psychody- was quoted recently in Psychiatric News (a orientation. A recent meta-analysis of psy- namic psychotherapy without understanding publication of the American Psychiatric Asso- chotherapeutic efficacy showed that non- the three or four psychologies of psycho- ciation), said of psychodynamic treatments in specific factors, i.e., dimensions that are shared analysis, or the way they are presented in the general,“We have a fabulous product,” and of by most psychotherapies, may account for books of the field’s great teachers. In my own psychoanalysis in particular, “For those who more of the variance in treatment outcome development as a psychotherapist, dialogue need it, it does what nothing else will do.” than specific factors. This deserves emphasis with many teachers and mentors continues in psychiatric training. Put another way, knowl- to provoke and correct my understanding of Paul Tiger, M.D., is a third-year resident edge of dynamic theory, accuracy of inter- our complex art. Learning this way means we at the Medical College of Wisconsin and pretations or just plain brilliance does not have to work harder to define and teach Affiliated Hospitals in Milwaukee. necessarily make an effective psychotherapist. exactly what our product is.

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 39 PSYCHOANALYSTS IN SCHOOLS

ANALYST-EDUCATOR Reading, Writing, and Therapy: COLLABORATION Beyond the participation of well-trained Psychoanalysts in Schools analysts, what makes these programs analytic? Jeffrey H. Golland and Bruce Sklarew Each takes as basic the importance of uncon- scious mental life, emotional development, A new psychoanalytic subspecialty has techniques developed by Dottie Ward-Wim- and the interrelatedness of social, emotional, recently been defined: the community psy- mer provide inner-city children opportunities and cognitive growth. Each, whether working choanalyst. Schools are one prominent setting to deal with their common experience of with pupils, their parents, or school staff and for this practice. Analytic work with children grievous loss associated with the multiple leaders, focuses on the meaning of behavior. began with Freud’s consultation about Little traumas of lives of poverty. Stuart Twemlow’s They differ from clinical psychoanalysis in Hans; it advanced through the creation of team’s innovative work on bullying is another that the analyst is a team member with other child psychoanalysis by Anna Freud and admirable enterprise (TAP 39/1). Identifying respected professionals, rather than an author- Melanie Klein; and it expanded its horizons the role of “bystander” and developing teach- ity imposing expertise with esoteric method- with August Aichhorn’s work with delinquent ing strategies for undermining peer toler- ology. Where clinical psychoanalysis analyzes adolescents. ance for bullying have led to improving both transference and resistance, school psycho- Analysts who work with children have the social and the intellectual climate in ele- analysts use their understanding to modify typically been involved with aberrant behav- mentary schools. Robert Pynoos works in more directly these phenomena for the ben- ior and, in schools, with special education. schools for traumatized children. In loca- efit of the children and the school community. Gilbert Kliman’s Cornerstone Project, tions such as Columbine High School, Los (Jonathan Cohen is preparing a more complete reported in TAP in 1997, is an outstanding Angeles, Armenia, and Bosnia-Herzogovina, review of psychoanalysis and education, includ- example and resulted in the prevention of his interventions have enhanced the recovery ing a critique of its limitations.) multiple foster home placements. Many pro- of students and staff, improved overall func- To promote and coordinate these many grams are geared to early intervention with tioning, and contributed to a healthy school efforts,APsaA has created a Liaison to Schools preschool children. A fine example is Don- atmosphere. Committee, co-chaired by Cohen and Stephen ald Rosenblitt’s work at the award-winning Analysts have also been involved in cur- Kerzner. This committee is developing a Lucy Daniels Center for Early Childhood riculum development. Carol Kusché and Mark database of school projects, in the hope of (TAP 39/2). Greenberg have created an approach to the generating more systematized research on Redl and Wineman were the first to “regular” classroom, Promoting Alternate analyst-educator collaboration. The committee extend psychoanalytic ideas to the general Thinking Strategies (PATHS). Elementary has also created a $1000 award, co-spon- classroom and school setting in 1957. More school teachers are trained to teach emotional sored by APsaA, the International Journal of recently, systematic approaches have been literacy as a regular “subject” along with read- Applied Psychoanalytic Studies (IJAPS), and the developed for kindergarten through high ing, math, and the rest of the standard cur- educational journal, School: Studies in Education. school years. Bruce Sklarew’s clinical/ riculum. Henri Parens made the teaching of For information about the award and sub- research collaboration with the Wendt Cen- parenting skills the core of his approach to mission guidelines, see www.csee.net. ter for Loss and Healing—the School-based providing curriculum for 5- to 18-year-olds in “Applied psychoanalysis” has been dispar- Mourning Project in Washington, D.C.—is regular school classrooms. aged by clinical psychoanalysts for far too long. one important example. Innovative group Others have developed collaborative efforts Despite his expressed wish that psychoanalytic to provide clinical consultation for pupils, fac- technique be modified for its more widespread ulty, and administration. Art Farley and Diane utility, Freud’s own “alloy” metaphor may have Jeffrey H. Golland, Ph.D., is a teaching, Manning provide a multi-tiered approach to promoted this attitude. But alloys are created training, and supervising analyst for The New supporting children’s emotional development, because they are stronger than pure elements. York Freudian Society, and clinical instructor including consultation with teachers, a thera- While research is yet to establish the strength in psychiatry at Mount Sinai School of peutic school for 3- to 8-year-olds, and parent of school psychoanalysis, Freud thought edu- Medicine. For 35 years he was a teacher assistance for children in psychoanalysis. William cation to be the most important of applications. educator at the City University of New York. Granatir, following his retirement from clinical The projects reported here should help Bruce Sklarew, M.D., is co-editor of practice at age 76, has been a volunteer school to end the false conflict between clinical Analysts in the Trenches: Streets, psychoanalyst for the past 13 years. He organ- psychoanalysis and community work, and will Schools, War Zones, former chair of ized a demonstration clinic in a Washington, surely upgrade the public image of our science APsaA’s Committee on Psychoanalysis D.C. inner-city elementary school and acted as and discipline. and the Community, and co-chair of the liaison between the highest levels of the men- (A reference list of the projects cited in this arti- Forum for the Psychoanalytic Study of Film. tal health and education systems. cle is available from [email protected].)

40 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 The result? Moffeit connected with both The Press Taps APsaA and ended up quoting Jim Pyles in his article as well as mentioning APsaA Expertise on Confidentiality Pyles commented: “I spoke with Moffeit several times, reviewed the brief on behalf of of Therapists’ Records the psychotherapist, and sent the reporter Dottie Jeffries and the attorney for the social worker who was the target of the subpoena citations to 6:45 a.m., Friday of the Seattle Meeting Public Information section of APsaA’s Web case law and suggestions for opposing the this past June. I’m still in my room at the site, as well as several related articles in TAP. discovery request.” Sheraton, trying to grab some coffee. My cell “Yes,we have several experts who can be In addition, Pyles also forwarded this brief phone is ringing.“Hi, I’m Miles Moffeit with The valuable resources for your reporting,” I and his suggestions to the National Associ- Denver Post. I’m working on a story regarding replied. “Let me get your e-mail address, ation for Social Workers. He said,“I believe a former Air Force cadet rape case and her and I’ll send you the contact names and this is another example of how APsaA can therapist. I was wondering if you have some- phone numbers.” work with other mental health associations one with whom I might speak regarding the I ran down to the meeting headquarters, to protect the right to mental health privacy. confidentiality of therapists’ records.” jumped online, and sent Moffeit the contact This also illustrates how APsaA, as in the Another testimony to the power of the information for Jim Pyles,APsaA’s legislative abortion records cases last year, can serve as Internet and what an invaluable tool it is, lobbyist, and that of Bob Pyles, chair of the a resource for others who are defending especially for smaller organizations such as Committee on Government Relations. I their rights to medical privacy.” APsaA. This reporter, in researching med- made sure Moffeit knew that Jim was en Coffee? What coffee? Who needs caffeine ical privacy online, had come upon http:// route back to Washington and wouldn’t be when our Web site has led a respected inves- www.apsa.org/ctf/pubinfo/NewsRoom/news picking up his cell phone messages for sev- tigative reporter from a major daily to seek releases/recentedito.html, a part of the eral more hours. the expertise of our Association.

Research: Help Wanted

There’s an old story from anthropology in which a Native American family was introducing everyone to a visitor. The visitor spotted a quiet figure in the background and asked,“But who is that?” The family said,“Oh! That’s our anthropologist.” Of course, there never really was a time when every Native American family had an anthropologist of its own. Likewise, there probably will never really be a time when every psychoanalyst has his or her own researcher. However, we would like to invite you to participate in our research and allow us to join your analytic work, quietly in the background. John Porcerelli and I are psychologist-psychoanalyst researchers studying changes during the course of psychoanalysis using a clinician report measure developed by Jonathan Shedler and Drew Westen. The measure, called the SWAP-200, is sophisticated and analytically informed. It is also empirically rigorous and organized so analysts and non-analysts can understand the research method and its results. In the first phase of our work, we began by comparing analysts’ SWAP-200 descriptions of patients at the beginning and at the end of analysis. Patients at the beginning of analysis had strengths, but they were also anxious, guilty, ashamed, and fearful of being rejected or abandoned. Patients at the end of analysis were conscientious and responsible, trying to live up to moral standards, and enjoying life’s challenges. In our view, the SWAP-200 provides a sound measure for studying change during psychoanalysis. Over the next 24 months, we want to recruit 100 analysts to participate in our work. Participation is open to any analyst who is beginning an analysis with an adult patient. We will ask each analyst to complete the SWAP-200 when his/her patient is in the first month or two of analysis and every six months until the analysis reaches an end. The SWAP-200 takes about an hour to complete. Please note that analysts are the research participants and patients are not identified or involved in any way. We heartily thank those who have participated in our research and those who are participating now. We also thank the International Psychoanalytical Association for its assistance in helping fund this project. If you would consider participating or have questions, please call (806-744-1803) or write me ([email protected]). —Rosemary Cogan

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 41 ADVOCACY AND MENTAL HEALTH

with them. Give them a nudge to do some One Hour a Month for Advocacy advocacy of their own. July—E-mail three letters to your elected and Mental Health officials about some other issue besides the Dean K. Stein mental health and/or privacy. Any issue at all. Demonstrate that you are not a one-issue With demanding schedules, finding time to Be sure to send the URLs to your own person. advocate for our profession probably seems a Web site, institute, society, center, and/or foun- August—Make sure your elected officials daunting task. But if the task is broken down dation. Be sure to thank them for any past (and their staff members) are on the mailing list into manageable segments, it becomes much assistance. Let them know that you have a for your local group’s newsletter as well as on easier to integrate advocacy (simply the act vested interest in your community, which com- your group’s invitation list for lectures, film of speaking or writing in support of something prises their constituents. series, and/or other programs. in which we believe) into a busy schedule of The suggested address style for Congress via September—Chances are you could drop seeing patients, teaching, and/or society-institute his/her e-mail address is: by and visit a representative or state assembly commitments. With that in mind, I propose a person in his/her office if you didn’t do that in The Honorable (your senator’s name) user-friendly device for becoming an advo- August (feel free to switch this to August). United States Senate cate entitled: One Hour a Month for Advocacy October—E-mail three letters (see April) Washington, D.C. 20510 and Mental Health. Feel free to shuffle the about issues at stake. You may not yet know Dear Senator: months around, with the following as my sug- what the issue will be, but come October gestion for a start: The Honorable (your representative’s name) there will certainly be a relevant issue at stake. January—This is the month you identify the United States House of Representatives Send a contribution to a campaign fund of a district in which you live (if you’ve not already Washington, D.C. 20515 public official whose work you support. done so); your elected representatives at the Dear Representative: November—Invite elected officials or their federal, state, and local levels; and the locations staff members to an event your local group is of their nearest local offices along with the March—Contact three family members or hosting. Be sure someone is available to per- relevant e-mail addresses, phone numbers, friends (especially in rural and sparsely popu- sonally greet and spend time with them. Or and mailing addresses. You might find the lated areas) and ask if they would like to help invite a staff member of your local official to following online resources helpful to you in in future advocacy efforts that are meaningful visit your institute. Remember, your institute or gathering the information regarding your fed- to you. Elected officials often hear from those center is a postgraduate center of higher educa- eral representatives: of us living in urban areas; so having the support tion in that official’s district.They are interested in of a few people beyond the usual urban bor- knowing about your organization. http://www.senate.gov/general/ ders insures that other representatives, gover- December—You’ve done a good job. Take contact_information/senators_cfm.cfm nors, and local legislators hear about the issues. the month off. http://www.house.gov/writerep/ April—This is usually a month to write let- Now, this is all offered with some humor and ters again to those officials you wrote to in the question can certainly be raised that you You might also find helpful the following February, but this time about immediate issues haven’t done much. But let’s be realistic about numbers in Washington, D.C.: the switchboard of concern to the profession (licensing, med- this. I estimate in your 11 hours, you’ve written for all of Congress is 202-224-3121 and the ical privacy, etc.). APsaA will periodically provide 17 letters and made 11 calls. If you extend that White House opinion line is 202-456-1111. members with action alerts on critical issues, number over the nearly 3,500 APsaA mem- Think about the issues, such as licensing, that and you are welcome to contact APsaA for bers…now the membership is acting. You are looming across the country and that may further guidance at any time. have done something active and positive with- percolate in your state if they have not already. May—Contact those family members and out impinging on your practice. You’ve taken These are issues about which you want to friends from your hour in March about writing action—and you’re far less a victim by having brief your legislators so they will have a frame or calling their elected officials on the mental done so. of reference from you, their constituent. health issues you’ve brought to their attention. Finally, you’ve gathered information, created February—E-mail three letters to your offi- Make it easy for them by sharing ideas for your own mini-network, established communi- cials. If it’s after an election year, offer your format, content, addresses, and any other help- cation, demonstrated concern in a variety of congratulations, tell them what you do and ful information you have gathered. topics, contributed to a campaign, invited some how this contributes to your/their community. June—Call or e-mail a few friends or col- elected officials into your corner of the health leagues in mental health organizations or psy- care world…and it’s very possible your endeav- Dean K. Stein is executive director of APsaA. choanalytic groups to learn what is happening ors will have made a difference.

42 THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 couch when she was unable to find a couch to her liking. Randall Scott Thomas, a furniture maker as well as the founder and designer of the Analytic Couch Company, took on the task. membershipBased upon the rave reviews of the finished product by Rising and her colleagues, a new Tool of the Trade: enterprise was born. The Analytic Couch Company offers five The Analytic Couch—Discounted styles ranging from a classic look to a more Debra Steinke cosmopolitan feel. The couches are uphol- stered in fine fabrics such as mohair, vinyl, and Seeing patients four to five times per week Analytic couches specifically designed to leather and come in various colors. The prices puts a lot of wear and tear on a psychoanalyst’s support the patient in a supine position, where range from $1,550 to $3,295. In addition, there unique tool of the trade, the analytic couch. the analysand is relaxed but not encouraged to are a number of accessories including their Perhaps you are in need of a new one or as a sleep, are rare and difficult to find in furniture “Sigfreudian” velvet throw. To view the styles candidate you are just starting your practice stores or on the Web. The Analytic Couch and for ordering information, please explore and don’t know where to purchase one. Well, Company originated with a request from APsaA their Web site: www.analyticcouch.com or call good news! APsaA is pleased to introduce a member Doane Rising for a custom-made (206) 794-1053. new member benefit—a 10% discount on The classic shapes of analytic couches are couches from the Analytic Couch Company. icons of the profession and the shape is quickly Following the debut of their couches at the recognized as a beacon of welcome to the 94th Annual Meeting in Seattle, the Analytic analysand. Your couch is an expectation imme- Couch Company was pleased to offer this diately satisfied when a new client first enters 10% discount to APsaA members. This local your office. Not only is the couch a source of Seattle company displayed its high quality, Breaking News! comfort and functional in the process; it is uniquely designed couches in the exhibit area also a valuable marketing tool. to the delight of many meeting registrants New Benefit Exclusive So if your couch is becoming a bit tattered who had the opportunity to test them. to Members around the edges, consider taking advantage of this discount. We are thrilled to offer this 10% Discount from the new member benefit and hope you find it For membership assistance, please contact helpful. As we continue to work and find new Debra Steinke, manager, Education & member benefits for you, I would be pleased Membership Services, 212-752-0450 to discuss the current benefits along with any x 26, or e-mail: [email protected]. ideas you may have.

IPA “Standards” Debate We recommended that the new working The proposal of the working group was Continued from page 38 group should be given a firm timeline and made ultimately refined and supported by the Exec- as high a priority as possible. We suggested that utive Committee, particularly by Claudio Ezirik would move the debate to be more properly the preliminary drafts of such a working group and Monica Armesto, the incoming president reflective of a scientific and educational body. could serve as a basis for ongoing discussions and secretary of IPA. Therefore, we needed to highlight our most within regions, as well as between regions, on the At the November 2004 IPA meeting in important finding: There is very little data on various models under consideration. This might Rio, the board, after lengthy debate, approved which to base a decision. We decided to rec- also be a major theme of the Berlin Congress. the motion of the Executive Committee, ommend a study of the major models of psy- Ultimately, our working group was able to which essentially agreed to “draw up a pro- choanalytic education, complete with some identify three major models within IPA: the posal as to how research into the major train- assessment of results, to be established as soon classic Eitingon, the French, and the Uruguayan ing models should be conducted.” The three as possible. We recommended that those of (similar to the French, but administered with a major identified models were also accepted. our members who are familiar with this kind of determinedly democratic involvement of the With much relief, this proposal was adopted research, as well as noted educators, should candidate). We were able to distill these from unanimously by the board and was later pre- form a new working group to make a thorough thorough reports received from 24 societies sented at the Business Meeting, where it evaluation of coherent models and outcomes. within the three regions. passed overwhelmingly.

THE AMERICAN PSYCHOANALYST • Volume 39, No. 4 • Fall/Winter 2005 43 A Celebration for Jon Meyer

Saturday, January 21, 2006 7:00 p.m. A lively and informal opportunity to honor Jon Meyer, M.D., who will end his term as President of APsaA in June 2006.

Cocktails, Buffet, Music

—Everyone is welcome—

Please come and help make it a memorable occasion. $75.00 per person or $100.00* per person *Includes $25.00 donation to The Psychoanalytic Assistance Fund The Psychoanalytic Assistance Fund is a resource for analysts in need of financial assistance.

Purchase your tickets online at http://store.yahoo.com/americanpsych/fapaforjonme.html

NONPROFIT ORG. US POSTAGE PAID ALBANY, NY PERMIT #370

309 East 49th Street New York, New York 10017