PSYCHOANALYST Quarterly Magazine of the American Psychoanalytic Association

the WINTER/SPRING 2011 AMERICAN Volume 45, No. 1 PSYCHOANALYST Quarterly Magazine of The American Psychoanalytic Association

INSIDE TAP… One Hundred Years Strong Election Results. . . . . 4 Centennial Meeting in NY: Awards & Photos. . 6 –17 A Visit from Freud . . .13

The Frenkel Files . . . . 23

Analyze This: Freud and Mahler . . .25

The Analyst as Artist . . . . .26–30

Upcoming Meetings: Mexico City . . . . .33 San Francisco. . .35–38

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 1 CONTENTS: Winter/Spring 2011 THE AMERICAN PSYCHOANALYTIC ASSOCIATION President: Warren R. Procci 3 T he Years Ahead Warren R. Procci President-Elect: Robert L. Pyles Secretary: Robert M. Galatzer-Levy APsaA Elections Treasurer: Judith S. Schachter 4 Executive Director: Dean K. Stein 5 Getting To Know You: The Fellows of BOPS Colleen L. Carney and Lee I. Ascherman THE AMERICAN PSYCHOANALYST Magazine of the 6 2 011 National Meeting at the Waldorf American Psychoanalytic Association Editor Janis Chester Science and Psychoanalysis: Do Psychodynamic Treatments 18 Editorial Board Work? Andrew J. Gerber Brenda Bauer, Vera J. Camden, Leslie Cummins, Phillip S. Freeman, Politics and Public Policy: Historic Health Care Legislation Maxine Fenton Gann, Noreen Honeycutt, 20 Sheri Butler Hunt, Laura Jensen, Frederic T. Perlman and Graham L. Spruiell Navah Kaplan, Nadine Levinson, A. Michele Morgan, Julie Jaffee Nagel, From Behind The Couch: When to Sell John W. Schott Marie Rudden, Hinda Simon, Vaia Tsolas, 21 Dean K. Stein, ex officio

Senior Correspondent Letters to the Editor 22 Jane Walvoord Photographer 23 Cases from the Frenkel Files: The Learned Intermediary John C. West Mervin Stewart Manuscript and Production Editors The Affiliate Council: The Candidate Connection Carmela Pérez Michael and Helene Wolff, 24 Technology Management Communications

Analyz e This: Freud and Mahler Michael Slevin 25 The American Psychoanalyst is published quarterly. Subscriptions are provided automatically to T he Psychoanalyst As Artist: Third Annual Psychoanalytic members of The American Psychoanalytic Asso- 26 ciation. For non-members, domestic and Cana- Art Show Jon K. Meyer dian subscription rates are $36 for individuals and $80 for institutions. Outside the U.S. and Canada, rates are $56 for individuals and $100 for institu- 31 Projections: Take My Eyes Barbara Young tions. To subscribe to The American Psychoanalyst, visit http://www.apsa.org/TAPSUB, or write TAP Subscriptions, The American Psychoanalytic 33 Come to a Great Congress in Mexico City Steven J. Ellman Association, 309 East 49th Street, New York, New York 10017; call 212-752-0450 x18 or e-mail [email protected]. 34 Poetry: From the Unconscious Sheri Butler Hunt Copyright © 2011 The American Psychoanalytic Association. All rights reserved. No part of this 35 APsaA Annual Meeting Highlights publication may be reproduced, stored in a June 8–12 in San Francisco Gina Atkinson retrieval system, or transmitted in any form or by any means without the written permission of The American Psychoanalytic Association, 309 East 36 A View from the Golden Gate Gina Atkinson 49th Street, New York, New York 10017. ISSN 1052-7958 41 “Find an Analyst” Web Site Feature Upgraded Jake Lynn The American Psychoanalytic Association does not hold itself responsible for statements made in 42 Str eamlining APsaA’s Bylaws Norman A. Clemens The American Psychoanalyst by contributors or advertisers. Unless otherwise stated, material in The American Psychoanalyst does not reflect the endorsement, official attitude, or position of The Correspondence and letters to the editor should be sent to TAP editor, American Psychoanalytic Association or The Janis Chester, at [email protected]. American Psychoanalyst.

2 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 FROM THE PRESIDENT

planning process for APsaA. I have pushed The Years Ahead the plan precisely because I do see our orga- Warren R. Procci nization in a decline and thus in logical need of the structure and focus of a strategic plan APsaA meet- why I think this is happening. (I will do so in to help move us to face our problems and ings, especially subsequent communications.) For now we’ll master them. I will be communicating with all the National mark it as a significant finding which com- of you on our listservs to tell you more about Meetings in Jan- mands attention. the plan and to keep you well informed. The uary each year, The second disturbing datum is that pre- basic ideas in a strategic plan are to: always leave me liminary information from the test runs of • consensually articulate our priorities as with a most our upcoming practice survey shows very an organization consistent with our pleasant after- modest incomes among many of our col- profession, glow. Some of it leagues. While our membership decline is • develop objective strategies to support is the sophisti- no doubt a multi-determined process, the these priorities, Warren R. Procci cated ambiance income data may be related. After all, if one • then commit our resources to imple- of Manhattan, albeit my role as an officer has is not earning an appropriate professional menting these specific strategies to in recent years kept me away from the income commensurate with one’s educa- achieve these objectives, seductions of New York night life, some of it tional background and with that of one’s • and establish a process of evaluation, a is the warm comfort of the very familiar peers, might that not lead to at least some sine qua non. surroundings and elegance of the Waldorf, dissatisfaction with one’s profession and its We all hope that this kind of careful, but mostly it is the stimulation provided by professional organization? While no one broadly designed approach will help us con- the meetings themselves: the contact with enters our field confusing the financial siderably as we stare our challenges in the colleagues, thoughtful and challenging pre- rewards of psychoanalysis with those of face and seek to resolve them. sentations, and always all the knowledge of our solid enduring psychoanalytic community. It’s just simply wonderful to congregate Despite all the challenges facing our field, and they with our fellow members and other fellow psychoanalysts and discuss the profession are legion, I was optimistic as I looked around the Waldorf which we all hold so dear. at our recent meeting. I think we have the resources, This year’s meeting, our centenary, had some special treats: the presence of Jane intellectual and personal, to get a handle on our problems McAdam Freud, the sculptor and great- and to catalyze a revitalization of our organization granddaughter of our profession’s founder, two intriguing plenary sessions on social as it heads toward its second 100 years. advocacy and the influence of post-Enlight- enment thinking on our field; a number of very stimulating panels including one about investment banking, our candidates must AMBITIOUS STUDY UNDERWAY dissociation, and a most unusual symposium know that their Herculean efforts to com- The second potentially powerful event on domination and masochism. Yet despite all plete their training should at the very least is the marshaling of our organizational of these considerable savory delights, there lead to the capacity for a satisfactory pro- resources to launch a long-term, randomized were a few hints of sourness. fessional income similar to that of their outcome study of psychoanalysis as a treat- First, and quite unsettling to me, is our con- peer group. ment. The project took a big step forward at tinuing membership decline as reported to our recent meeting. This study is an ambi- our Executive Committee and Executive STRATEGIC PLAN APPROVED tious project, led by Steven Roose as princi- Council. We are down an additional 62 active I certainly do not believe that continued pal investigator, which will compare CBT, members in the last six months. Even more decline is inevitable. Many other professional psychoanalytic psychotherapy, and psycho- disturbing is that we have had over 100 resig- organizations are mired in retrenchment analysis as treatments, in a randomized clini- nations in a year. I will not discuss here exactly woes. However, I would like to balance this cal trial. Yes, we will by all means be supporting cloudy note with two hopefully salutary a major study which will clearly conform to occurrences at our meeting. The first is the the rubric “evidence based.” There was con- Warren R. Procci, M.D., is president of the approval by our Executive Council, our board siderable excitement as we discussed this American Psychoanalytic Association. of directors, of my proposal for a strategic Continued on page 4

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 3

The Years Ahead Catholic and was well aware of this egre- around the Waldorf at our recent meeting. Continued from page 3 gious instance of church misjudgment. Be I think we have the resources, intellectual and assured, I will not excommunicate anyone. I personal, to get a handle on our problems project and very much of a sense of being a do intend for us to provide all the support and to catalyze a revitalization of our organi- part of the beginnings of a “moment in his- we can to get this study off the drawing zation as it heads toward its second 100 years. tory” for our field. Indeed, one leading par- boards and into the research lab, and ulti- Hopefully, at our second centenary celebra- ticipant in the discussion came to me and mately available to help our practitioners tion, those looking back might be reminded said, “Warren, you have an opportunity to and, of course, our patients. over a toast in Peacock Alley that some signifi- avoid doing to our field what the Catholic Despite all the challenges facing our field, cant events for the enhancement of our field Church did to Galileo.” He knew I grew up and they are legion, I was optimistic as I looked began at this very meeting.

2011 Nationalelections Meeting SECRETARY-ELECT David I. Falk—429 Beth J. Seelig—583—Elected

TREASURER-ELECT Councilor-at-large-elect Councilor-at-large-elect No candidate achieved a majority of the Mark D. Smaller Graham Spruiell votes cast. Secretary-elect Beth J. Seelig A new election for the office of treasurer COUNCILORS-AT-LARGE-ELECT will be held during a special meeting William H. Braun of members on Saturday, April 16 at 3:00 p.m., in the offices of the American Laura L. Jensen Psychoanalytic Association. All members M. Carmela Pérez should have received their proxy ballot Mark D. Smaller—Elected materials in the mail shortly after Graham Spruiell—Elected March 8, 2011.

4 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 FROM THE BOARD ON PROFESSIONAL STANDARDS

Paul. This task force will be charged with the Getting To Know You challenge of exploring the many opportunities that academic communities offer us in The Fellows of BOPS recruitment, research, case finding, and col- Colleen L. Carney and Lee I. Ascherman laboration with colleagues in related fields. BOPS Fellows, especially those from insti- In October 2010, a small BOPS Strategic The Fellows of the Board on Professional tutes connected to university and medical Planning Committee met in New York to begin Standards, while sent to national meetings by centers, will be invited to participate in this to identify the challenges and priorities facing individual institutes and certainly with their task force and its mission to tap the many BOPS over the next three years. To our sur- own local interests to represent, are primarily resources found in the academic communi- prise, this group identified one factor as the brought together to serve the larger educa- ties. Other focus groups will be developed in single most important determinant of BOPS’s tional and professional interests of the national the future, each directed to study a particular success. This factor was greater communication body. This critical function within APsaA is challenge facing contemporary psychoana- with and utilization of our BOPS Fellows. Since no less important today than it was in 1946. lytic education, such as curriculum develop- October, we have learned that the role of a BOPS Fellows are the communicative link ment, faculty development, and child/ BOPS Fellow is not well defined and many between local institutes and the national adolescent psychoanalysis, to name a few. fellows themselves do not clearly know what organization. Collectively they bear the their job is. We were equally surprised to learn responsibility of overseeing the quality of psy- WEIGHING THE MERITS OF that many of our members do not know who choanalytic education and training in our 31 EXTERNAL ACCREDITATION their fellows are, and when they should direct affiliate institutes and of ensuring the availabil- In the coming months, our BOPS Fellows their questions to one of their two BOPS ity of qualified psychoanalysts to the public. will also be asked to familiarize themselves Fellows who represent their institute on the At the most recent APsaA meeting in with, and begin to discuss with you, another Board on Professional Standards. We hope that New York, the BOPS Fellows were reminded opportunity and decision facing our institutes. the following will rectify this problem. of their very important role and were This is the opportunity to apply for accredita- informed of our hope to maximize their tion by the Accreditation Council for Psycho- 1946: BOPS IS BORN; ITS CRITICAL communicative function, among themselves, analytic Education (ACPE), a topic which FUNCTION REMAINS UNCHANGED with their institute members, and with the consumed considerable time at our January In 1946 the American Psychoanalytic Asso- BOPS leadership. As most institutes are now 2011 meeting. The ACPE is an independent ciation made an historic organizational change grappling with the difficult decisions and chal- accrediting body which was formed by a in its structure, shifting APsaA from a federa- lenges posed by the implementation of the group of psychoanalysts about 10 years ago tion of constituent institutes to a membership new Standards for Education and Training in for the purpose of establishing a set of core organization made up of a group of affiliated Psychoanalysis, it is your BOPS Fellows who training standards for the psychoanalytic pro- institutes and individual psychoanalyst mem- are the most immediately available to answer fession, irrespective of an institute’s member- bers. The new bylaws at that time delegated your questions, and if they cannot, they will ship affiliation, APsaA, IPA, for example. Many matters of training standards and membership know whom to contact. A BOPS listserv has believe that accreditation by a body outside to a new Board on Professional Standards. This been established for the purpose of the of one’s membership organization, not only change, according to a document written by BOPS Fellows, as well as institute directors lends legitimacy to our own training pro- Homer Curtis in 1984, “not only avoided the and Education Committee chairs, to commu- grams, but also protects the psychoanalytic cumbersome administrative problems of ob- nicate with one another in order to facilitate profession by defining the minimum training taining the approval of an increasing number of a collaborative and relatively smooth transi- criteria required to qualify as a psychoanalyst. societies and institutes, it also acted as a buffer tion into our recently refurbished system of The collective wisdom is that such external against undue political and professional pres- psychoanalytic education. regulation could provide a safeguard to the sures on the setting and maintaining of stan- public as well as to our profession. dards.” We all know that this change did not FIRST FOCUS GROUP: UNIVERSITY These are just some of the important mat- exactly protect us from political and profes- AND MEDICAL CENTERS ters which the BOPS Fellows have to discuss sional pressures, but it did, more importantly, In addition, BOPS Fellows will be encour- with you. Please get to know them, the Fel- put in place an essential component of our aged to become active in one of several lows of BOPS. organizational structure; the Fellows of BOPS. focus groups designed to study some of the most pressing issues facing psychoanalytic Editor’s Note: In the next issue of TAP, an Colleen L. Carney, Ph.D., is chair of education today. The first to be formed is a article by Ronald M. Benson will cover the the Board on Professional Standards, and Task Force on University and Medical Center current status of ACPE. Lee I. Ascherman, M.D., is secretary. Initiatives which will be chaired by Robert

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 5 2011 National Meeting at thePhotos by MervinWaldorf Stewart and Jake Lynn

Bruce Levin and Warren Procci

Anna Yusim

Jerome Winer and Warren Procci

6 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 2011 National Meeting at thePhotos by MervinWaldorf Stewart and Jake Lynn

Stanley Possick and Warren Procci

Edith Cooper and Warren Procci

Nuar Alsadir and Warren Procci

Barbara Deutsch, Judith Yanoff and Warren Procci

Meeting of Members Awards Ceremony

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 7 2011 National Meeting at thePhotos by MervinWaldorf Stewart and Jake Lynn

John Oldham, Jeanne Harasemovitch and Warren Procci

Abraham Jankowitz and Warren Procci

Monroe Pray and Warren Procci

Ellen Schattschneider and Warren Procci

Susan McNamara, Ethan Grumbach and Barbara Marcus

8 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 2011 National Meeting at the Waldorf APsaA Awards First Undergraduate Paper Prize Michael Shulman APsaA’s first Undergraduate She completed Paper Prize has been awarded her bachelor to Lindsay Smith, who wrote of science in the paper for a class at the Uni- journalism and versity of Florida taught there bachelor of arts by English professor Peter Rud- in English at nytsky. Smith’s paper, “‘I would Florida this past not kill thy soul’: The Introjec- year. Her mention of the Good Imago in tor at Florida, Othello,” used psychoanalytic Rudnytsky, is an Michael Shulman studies of object relations to APsaA Honorary Lindsay Smith throw fresh light on Shakespeare’s tragedy. The paper Member. was chosen as the outstanding work from among eight Notice of the Undergraduate Paper Prize was mailed essays submitted for the prize from students at colleges to psychoanalytically interested faculty members at and universities around the country. 150 leading American colleges and universities last Building off the work of Janet Adelman and her year. These faculty members were identified via research influential study of object relations in Shakespeare’s Jonathan Redmond and I conducted, published in 2008 Othello, “‘I would not kill thy soul’: The Introjection of in JAPA. Publicity for the second Undergraduate Paper the Good Imago in Othello” employs the writing of Mel- Prize is planned for this spring. anie Klein in a study of envy, suspicion, and rage. The language of the play demonstrates the psychological processes of projection and introjection, cementing these abstract phenomena through its metaphor of the contaminated body as a vessel capable of containing and passing on the imagos of the central characters. As Othello continues to break down under immense psychological pressures and the splitting of imagos occurs, object relations theory provides a method for understanding the unconscious motivation of Othello to pre- serve, through the act of murder, an internalized “good” fantasy of Desdemona within himself. Smith, now a graduate student in English at North Car- olina State University, is also enrolled as an independent student at the Psychoanalytic Education Center of the Carolinas (PECC). She plans to apply to the PECC to enter its certificate program in psychoanalytic psychotherapy.

Michael Shulman, Ph.D., co-chairs APsaA’s Committee on Psychoanalysis and Undergraduate Education. He serves on the faculty of the Michigan Psychoanalytic Institute, and those of the University of Michigan and Madonna University. He is in private practice in Ann Arbor.

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 9 2011 National Meeting at the Waldorf A Small School John Samuel Tieman The Liaisons to Schools Committee is pleased to announce that the winner of Psychoanalysts Part of School Life the 2011 Educational Achieve- Child psychoanalysts B. James Bennett and Sarah ment Award is the Lindsley Rabb Bennett, also provide pro bono consultations with Park Community School of teachers, which help them understand children dealing Dallas, Texas. The award is with emotional and behavioral problems. The Bennetts given to schools that further help teachers view the children, and the student/ psychoanalytically informed teacher relationship, in a psychoanalytically informed work with pre-K through 12th manner. They are, in the words of the Lindsley Park’s John Samuel Tieman grade educators, schools, and director, Thomas Loew, “part of the fabric of the life of students. the school.” “I cannot think of any award that I am more proud of In 2010, Lindsley Park scored higher in math and than this one, which recognizes our work in supporting reading on the Texas state test than the same grade children’s emotional well-being,” Terry Ford told the level in the Dallas Independent School District. The Dallas Morning News. Ford is the executive director of campus is in the top 17 percent of Texas schools that the East Dallas Community Schools (EDCS), the par- were rated exemplary. The school attributes these ent organization of the Lindsley Park Community achievements to its vision of an education that attends School. “Since its founding in 1978, the guiding prin- to the emotional life of children. ciple of EDCS has been that emotional well-being is the key to providing our students with a foundation for The Award—A Joint Venture success,” she said. The biennial award is co-sponsored by the American The Lindsley Park Community School, which uses Psychoanalytic Association, the International Journal the Montessori approach, operates in a low-income of Applied Psychoanalytic Studies, and the educational neighborhood. Seventy percent of its students are His- journal, Schools: Studies in Education. The award goes panic. The school offers play-therapy to children deal- to work that is aligned with all of the following three ing with emotional or behavioral problems. “Children criteria: First, the work is psychoanalytically informed; may not be able to talk about their worries, so they second, it fosters psychoanalysts and educators work- communicate them through their play,” said Carol ing together and learning from each other; third, the Mason Wolfe, a licensed professional counselor, who work includes ongoing systematic learning, research, works with children during their play therapy sessions. and/or program planning. She is fluent in Spanish. “In the presence of an accept- The committee was impressed with the quality and ing adult, and through the children’s play, youngsters the range of the entries. We received entries from doc- can come to face and master previously debilitating toral students and senior analysts, from individuals and anxieties and fears. Then a child is better able to learn schools. We received applications from Israel and Tur- and work cooperatively in the classroom,” Wolfe key, from New York to California, from Texas to Michi- explained to the Morning News. gan. We sincerely wish we could have given an award to every entrant. Every applicant was an exemplar of the type of work we esteem. The large number of the entries, John Samuel Tieman, Ph.D., is an educator associate. while making it difficult to choose, made the commit- He is a widely published poet and essayist. His award winning tee grateful to all the entrants for, to put it simply, the chapbook, A Concise Biography of Original Sin, is published work they do. by BkMk Press. He teaches in the St. Louis Public Schools. Continued on next page

10 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 2011 National Meeting at thePhotos by MervinWaldorf Stewart and Jake Lynn

Our gratitude also extends to Prudy Gourguechon, part of her time to providing psychoanalytically past-president of the American Psychoanalytic Associa- informed play therapy. Ms. Mason Wolfe is a grad- tion, who, along with Stephen Sonnenberg, was instrumen- uate of the Dallas Post-Graduate Program in Psy- tal in the establishment of the Education Department. choanalytic Psychotherapy. The director of the In part, the citation for the 2011 Educational school, Thomas Loew, deserves the highest of Achievement Award reads: commendations for this collaborative work, for Lindsley Park Community School is a small, pub- his vision, and for his sensitive and insightful lic Montessori school, educating students from approach to the children and teachers. The work age three through the third grade. It serves pri- of Lindsley Park Community School, and the work marily low-income and minority students. The of all those associated with the school, is in keep- school is a member of the Alliance for Psychoana- ing with the highest standards and traditions of lytic Schools. The teachers and administrators psychoanalytically informed education. have achieved a high level of psychoanalytic sensi- The ad hoc Awards Sub-Committee was composed of tivity in both the functioning of the school and four people. Tillie Garfinkel, chair of the Liaisons to the ongoing development of teacher/student Schools Committee, is the principal of Fairland Ele- relationships. To this end, it has worked closely mentary School in Silver Spring, Maryland. Fran Mar- over the last seven years with APsaA members, tin, of Philadelphia, is a psychoanalyst in private child psychoanalysts, Sarah Rabb Bennett, practice, who has had a four-decades long interest in L.C.S.W., and James Bennett, M.D. Carol Mason education. Elijah Hawkes is principal of the James Wolfe, L.P.C., APsaA psychotherapist associate Baldwin School New York City. I was honored, truly hon- who is a full-time employee of the school, devotes ored, to chair this committee.

New Program Launched

The Psychoanalytic and Psychodynamic Teachers’ Academy—a professional development program for teachers of psychoanalysis and/or psychodynamic therapy—was initiated at the 2011 National Meeting in January. The academy provides the opportunity for clinical teachers in psychiatry residency, psychology graduate, and social work graduate programs to engage in a professional development program designed to facilitate their interest in psychoanalysis and The Psychoanalytic and Psychodynamic Teachers’ Academy psychodynamic therapy, The first group (from left): Richard Summers, chair of the Teachers’ Academy and help them increase Committee; Sergio Paradiso, Daniel Rochman, Douglas Lane, Lisa Cobourn, Melissa Grady, Rana Duncan-Daston, and members of the Teachers’ Academy their teaching effectiveness Committee, Susan Sherman and Elisabeth Schreiber. with trainees.

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 11 2011 National Meeting at thePhotos by MervinWaldorf Stewart and Jake Lynn APsaA Award for Excellence in Journalism Molly Knight Raskin’s article entitled “When Passion is effective treatments and exciting findings about the brain the Enemy,” describing borderline personality disorder, and borderline personality disorder. appeared in the July 2010 issue of Scientific American Mind Instead of jumping at the opportunity to publish it, magazine. Excerpts from her acceptance speech follow. editors pushed back. Some of the responses I received, to me, reflect just how challenging it can be to report on I want to start by thanking your distinguished group— mental health. the American Psychoanalytic Association—and the mem- One editor told me: “We’re interested in the story, but bers of your jury, for recognizing this story. In handing out only if a celebrity has the disorder. Can you get back to us this award annually, I believe you are doing a great service with someone “big” who has BPD?” There was a pause, to the coverage of mental health issues in the media. after which she said, somewhat hopefully, “What about I would also like to thank Scientific American Mind and Britney Spears?” my editor, Ingrid Wickelgren, for see- Another editor responded by ing the importance of this story. She e-mail, saying: “I see potential in this encouraged me to delve deeply into story, but bipolar is what everyone the neuroscience—hardly an easy wants to read about right now. Could task for someone without a doctoral you do a story on this instead?” degree—and she tirelessly worked to And yet another editor said that make the research clear and relevant while she liked the story, she wanted to readers. me to remove all mention of self- I would like to extend my grati- harm, which she said might cause tude to the Carter Center and to for- readers to squirm. mer first lady, Rosalynn Carter. Mrs. Finally, an editor at a national Carter has spent more than four women’s magazine simply wrote back decades fighting to reduce the to me with this: “It’s interesting, but stigma and discrimination surround- our readers only like psychology sto- ing mental illness, and encouraging ries that are ‘happy.’” Why these responses? In a word— journalists to report responsibly on Excellence in Journalism Award the topic. Warren Procci, APsaA president, presented one you are no doubt all too familiar Finally, I would like to thank the award to Molly Knight Raskin with—STIGMA. Amanda Wang—who I’m delighted to for her article titled “When Passion Although coverage of mental Is the Enemy,” which appeared in see here this morning—for having the Scientific American Mind magazine. health issues has improved slightly courage to share her story with me. over the years, it’s still a dishearten- Amanda was completely candid, sparing me no detail in ingly difficult topic to sell. Unless, of course, you are writ- what has been at times a harrowing battle with borderline ing about psychotic killers, psychiatric wards, or celebrities personality disorder. Amanda is an inspiration, now work- behaving badly. ing tirelessly, and fearlessly, to reduce the stigma of a dis- Research has shown that the majority of media por- order that threatened her life. If more people with mental trayals of mental illness are negative, and that newspa- illness could accomplish even some of what Amanda has, pers feature negative stories about mental illness at the world would be a better place. double the rate of positive stories. Why are we afraid to While it might sound unlikely as I stand here before cover mental illness with the same sensitivity, and objec- you, this story came dangerously close to languishing sev- tivity, we give to stories about other topics in health and eral times over the course of three years, and not for lack science? I’m not sure. But it’s clear that stigma is alive of persistence, or passion, on my part. and well, and that there’s much work to be done in reduc- I first began reporting this story in 2007. At the time, I ing it, so people with mental illness can seek proper treat- thought I had a journalistic slam-dunk—all the elements ment and live full lives. of a perfect pitch. The story would highlight a devastating Unlike the mainstream media so often has us believe, illness that, despite its prevalence, few people understand. people with mental illness are our co-workers, our It would offer a human portrait of a disorder that has had neighbors, our friends, and our family. Many of them are almost no sensitive, objective coverage in the mainstream have no voice, and I believe it is part of my job to help media. And, perhaps most importantly, it would outline them be heard.

12 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 2011 National MeetingPhotograph and excerpted at textthe courtesy ofWaldorf Sundaram Tagore Gallery Jane McAdam Freud’s First Solo in New York Janis Chester In celebration of the 100th anniversary of our Association, Jane McAdam Freud was a featured speaker and welcome presence. She delivered a Presidential Symposium entitled “Sigmund Freud and Jane McAdam Freud: Old Dreams New Interpre- Jane McAdam Freud tations—An Artist’s Per- spective.” In addition she and her husband, Peter Hensen, attended several parties, meeting and interacting with many members and guests. Selected works were exhibited at the Sundaram Tagore display at the Victoria and Albert Museum. A graduate Gallery, marking her first solo exhibition in New York. of the Royal College of Art, she was awarded the British The gallery hosted a private reception for the American Art Medal scholarship in Rome and the Italian State Psychoanalytic Association. Mint Prize. McAdam Freud lives and works in London Jane McAdam Freud is the great-granddaughter of and is an associate lecturer at Central St. Martins Sigmund Freud and daughter of painter Lucian Freud. School of Art. At the core of McAdam Freud’s work lies a fascina- For more information e-mail press@sundaramtagore. tion with familial lineage. Her monumental sculpture com or call 212-677-4520. Sisyphus, for instance, references the Greek myth. Freud’s theories on dreams are also important in the artist’s work. She investi- gated Sigmund Freud’s vast collection of Egyptian, Greek, Roman, and Asian antiqui- ties, which he often used to illustrate his theories. McAdam Freud found, to her surprise, that her great-grandfather collected medals, reliefs and busts, figures, and fragments, all of which are forms she had been creating for years. This overlap and the idea of ancestral links prompted a series of drawings. Jane McAdam Freud has exhibited her art widely in the United States, Europe, and Asia. Her work has been acquired by the British Museum, Berlin State Museum, National Gallery of Greece, and the National Gallery Archive of London. It is also on permanent

Janis Chester, M.D., is editor of T A P.

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 13 2011 National Meeting at thePhotos by MervinWaldorf Stewart and Jake Lynn

John Oldham, Paul Mosher, Drew Clemens and Warren Procci

Helen Gediman and Deanna Holtzman

Mervin Stewart

Inge Winer and Marcia Stewart

Jay Kwawer (William Alanson White) and Arthur Lynch (American Institute for Psychoanalysis) Barbara Rosenfeld, Miriam Tasini and Allan Compton

14 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 2011 National Meeting at thePhotos by MervinWaldorf Stewart and Jake Lynn

Georgia Nagel, Michael Groat, Vamik and Betty Volkan

Jacques and Prudy Gourguechon

Ron and Linda Benson

Bob Pyles, Dean Stein and Warren Procci

Bob Galatzer-Levy

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 15 2011 National Meeting at the Waldorf The American Psychoanalytic Association at 100— How It All Began Sanford Gifford Our Association was founded on May 9, 1911, at the Belle limiting its membership to physicians, and denouncing vue-Stratford Hotel in Baltimore. It was planned to coincide “quacks” who purported to be analysts. Neither the Inter- with the annual meetings of the American Psychotherapeutic national Psychoanalytic Association nor the American Psy- Association, to which most of the analysts belonged, repre- choanalytic Association required a medical degree for senting the pre-analytic psychotherapies of suggestion. The membership. In fact, G. Stanley Hall, Ph.D., was president in American Psychoanalytic Association was created by Ernest 1917-18. During the First World War, William A. White sug- Jones, in response to Freud’s suggestion a year before. Jones gested that our Association merge with the American Psycho- persuaded the reluctant James Jackson Putnam of Boston, to pathological Association, but Brill and Clarence P. Oberndorf serve as president, with himself as secretary. There were eight were opposed. When Brill became president of the American members. The aim of the Association was to provide a meeting Psychoanalytic Association in 1929, the controversy over lay for isolated analysts in other parts of the country. A. A. Brill analysis was at its height, and was not resolved until 1976, was not present, because he had founded the New York Psycho- with the Gaskell Report. Thus our Association finally joined analytic Society a few months before, preferring to maintain the psychoanalytic societies of all other countries in accept- an independent relationship with Freud and the International ing non-physicians as members. Psychoanalytic Association, which was founded in 1910. These are among the highlights of a workshop on the The purpose of the New York Psychoanalytic Society was history of the American Psychoanalytic Association that was very different from the American Psychoanalytic Association. presented at our last meeting on January 13, 2011. The work- Its eagerly attended monthly meetings included presenta- shop will be reviewed in upcoming issues of TAP. Nellie tions of scientific papers and lengthy discussions about Thompson reviewed the History and Archives Committee and I covered the early decades of the American Psychoanalytic Sanford Gifford, M.D., is director of Archives at the Association. Paul Mosher and Arnold Richards elucidated the Boston Psychoanalytic Society/Institute. For many years complex constitutional problems of recent years, concerning he has served as co-chairman of the History, Archives, membership, the training analyst system, and the role of the and Library Committee of APsaA. Board on Professional Standards.

16 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 2011 National Meeting at the WaldorfPhotos by Bjoern Kils 100th Anniversary of APsaA Jake Lynn Although the Associa- tion’s 100th anniversary isn’t officially until May 9, APsaA got a head start on the celebration with a Seven Who Served grand kickoff in January Presidents (from left): Warren Procci, Judith Schachter, at the 2011 National Meet- Arnold Cooper, Lynne Moritz, Prudy Gourguechon, ing. A Wednesday night Bob Pyles and Richard Fox party was dedicated to New York City honoring our centennial. APsaA’s publications, too, are highlighting the 100th Mayoral Proclamation During the party, mem- anniversary. JAPA has a tentative list of 10 titles on the APsaA president, Warren bers and other meeting docket in 2011, with many members who take a par- Procci (left), and Roger Rahtz, president of the New attendees were treated to ticular interest in the history of psychoanalysis com- York Psychoanalytic Institute the premiere of an 11-min- mitted to writing essays. ute commemorative video Harold Blum, Ted Shapiro, Arnie Richards, Steve that was narrated by Gail Saltz and produced by the Levy, Ellyn Saks, and Lawrence Friedman are a few of APsaA staff. The video is now available for viewing on the people who intend to honor the centennial with the APsaA Web site at: www.apsa.org/centennial.aspx contributions that touch on notable names and events and is available to our institutes and societies as an in psychoanalysis’ and APsaA’s history. educational and marketing tool for psychoanalysis. This year’s 2011 National Meeting Program was [See “Celebrating the Centennial,” page 16.] filled with sessions related to the centennial. Nine pan- At the 100th anniversary party, APsaA was presented els and workshops addressed the role of psychoanalysis with official proclamations from New York City Mayor in the last century, and Jane McAdam Freud, great- Michael R. Bloomberg and the New York City Council. granddaughter of Sigmund Freud, discussed her new These proclamations salute the Association and New exhibition at the Presidential Symposium on the Friday York City as the first home to psychoanalysis, since of the meeting. McAdam Freud’s exhibit was filled with Freud’s only trip to the U.S. began in New York. In the sculptures and her other works of art that draw on psy- final part of the program, all of APsaA’s former presi- choanalytic influences from her famous family lineage. dents attending the meeting were formally recognized. More activities will be planned in 2011 to capitalize A special companion centennial section of our Web on the official birth of APsaA, as well as our 100th site has been created for the anniversary at: www.apsa. Annual Meeting in San Francisco this coming June. org/centennial.aspx. The section is filled with photos from over the years, as well as an interactive time line that tracks 100 years of key events in the history of psychoanalysis in America. A computer was available all week in the Exhibitor Area for the public to explore the new section of our Web site. The commemorative video and this new addition to the Web site are also being marketed to prospective candidates and younger audiences as a public outreach tool for APsaA.

Jake Lynn is the director of public affairs for the American Psychoanalytic Association.

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 17

SCIENCE and RANDOMIZED CONTROLLED TRIALS The first source of disagreement is what Psychoanalysis different researchers and reviewers consider to be an adequately designed trial to demon- strate treatment efficacy (“efficacy” is used to Do Psychodynamic Treatments Work? refer to the benefit of a treatment in a care- Andrew J. Gerber fully designed trial, whereas “effectiveness” refers to the treatment’s usefulness in a more Psychoanalysts to improve after treatment ends. generalizable, real-world setting). Shedler are well aware Finally, nonpsychodynamic therapies cited evidence from studies of multiple types, that different may be effective in part because the including case studies, open trials, process individuals fre- more skilled practitioners utilize studies, and randomized controlled trials quently interpret techniques that have long been cen- (RCTs) while Gerber at al. focused only on the same infor- tral to psychodynamic theory and RCTs. Glenn Gabbard, John Gunderson, and mation in dissimi- practice. The perception that psy- Peter Fonagy, in a seminal 2002 paper in the lar ways. It should chodynamic approaches lack empir- Archives of General Psychiatry, point out that be of little sur- ical support does not accord with there is a “hierarchy of evidence” in psycho- prise, then, that available scientific evidence and may therapy outcome research, with case studies Andrew J. Gerber this is also true of reflect selective dissemination of on one end—capturing clinical data in rich interpreting the results of scientific investiga- research findings. detail, but with limited objective measure- tion. In the past year, one of the most widely ments and great difficulty in generalizing to read psychology journals (American Psycholo- However, in a paper from January 2011 in larger populations—and RCTs on the other gist from the American Psychological Associa- the American Journal of Psychiatry that I co- end—constrained by their nature to be less tion) and one of the leading psychiatry journals authored with James Kocsis, Barbara Milrod, rich in detail but, when done well, using care- (American Journal of Psychiatry from the Ameri- Steven Roose, Jacques Barber, Michael Thase, ful measurements and more likely to yield can Psychiatric Association) each published Patrick Perkins, and Andrew Leon, we generalizable results. These authors argue, reviews of empirical data on the efficacy of reached a more cautious conclusion: and both Shedler and we agree, that there is psychoanalytic and psychodynamic treatments. utility in all types of research but that differ- However, the papers reach disparate conclu- Existing randomized controlled ent designs are better for different questions. sions. Jonathan Shedler, author of the February trials of psychodynamic psycho- However, by including multiple forms of evi- 2010 article, “The Efficacy of Psychodynamic therapy are promising but mostly dence in his article, Shedler suggests that Psychotherapy,” in the American Psychologist, show superiority of psychodynamic evaluation of whether psychodynamic treat- summarizes his conclusions in this way: psychotherapy to an inactive comments are ”empirically supported” or “evi- parator. This would be sufficient to dence based” should take the full range of Empirical evidence supports the make psychodynamic psychother- designs into account. In addition, he cites efficacy of psychodynamic therapy. apy an “empirically validated” treat- authors, particularly Sid Blatt and Drew Effect sizes for psychodynamic ther- ment (per American Psychological Westen, who are well known to object to apy are as large as those reported Association Division 12 standards) what they perceive as the hegemony of RCTs for other therapies that have been only if further randomized con- in psychotherapy research. actively promoted as “empirically trolled trials of adequate quality Gerber et al. take a different approach. supported” and “evidence based.” In and sample size replicated findings Though we too believe in the usefulness of addition, patients who receive psy- of existing positive trials for specific non-RCTs, we are much more skeptical chodynamic therapy maintain thera- disorders. We do not yet know about (a) their ability to tell investigators peutic gains and appear to continue what will emerge when other psy- what they do not already believe to be true chotherapies are subjected to this and (b) their utility in convincing non-dynamic Andrew J. Gerber, M.D., Ph.D., is a faculty form of quality-based review. researchers and clinicians that psychody- member at the New York State Psychiatric namic treatments are as rigorous and care- Institute, the Columbia University Center If different psychoanalytic researchers, in fully tested as non-dynamic treatments, e.g., for Psychoanalytic Training and Research, leading journals, reach different conclusions, cognitive behavioral therapy (CBT) and chairman of APsaA Committee on Scientific what are readers to take away? Is there interpersonal psychotherapy (IPT). Several of Activities, and secretary of the Psychodynamic empirical evidence for psychodynamic psy- the rules of RCTs may seem at first severely Psychoanalytic Research Society. chotherapy or isn’t there? Continued on page 19

18 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 SCIENCE AND PYSCHOANALYSIS limiting and impossibly constraining to some- http://www.div12.org/PsychologicalTreatments/ ACTIVE VERSUS INACTIVE one interested in individual clinical detail: index.html). According to this task force, psy- COMPARATOR TREATMENTS 1. Diagnostic and outcome measures must chotherapy is a “well-established” empirically Researchers have long spoken of a “dodo be specified in advance and be com- validated treatment for a “specific target bird” effect in psychotherapy research, mean- pleted by non-biased raters (i.e., they population” if, and only if, the following crite- ing that when treatments are compared cannot be the subject, the therapist, or ria are met: against one another in efficacy, “everybody any individual who knows what treat- 1. At least two good between-group has won and all must have prizes” (a refer- ment the subject has been receiving). design experiments demonstrating effi- ence to the dodo bird in Lewis Carroll’s 2. Subjects must be randomly assigned to an cacy in one or more of the following Alice’s Adventures in Wonderland). Gerber et al. “experimental” treatment (in this case, ways: psychodynamic) or a comparison treat- a. Superior (statistically significantly so) ment without regard to the preference to pill or psychological placebo or to of either the subject or the therapist. another treatment. 3. Treatments must be sufficiently stan- b. Equivalent to an already established dardized or manualized such that there treatment in experiments with ade- is some way to verify that the treatment quate sample sizes. being tested is, in fact, more similar from OR one patient to another in that group 2. A large series of single case design than it is to the comparison treatment. experiments (n >9) demonstrating effi- In our recent paper we present a quality cacy. These experiments must have: rating scale for RCTs that we specifically a. Used good experimental designs and designed for measuring adherence to b. Compared the intervention to these principles, as well as other related another treatment as in 1a. ones, in psychotherapy trials. While designing an RCT so as not to spoil FURTHER CRITERIA FOR BOTH 1 AND 2: the effectiveness of the treatment is no small 3. Experiments must be conducted with task, we believe that these rules are essential treatment manuals. go one step further demonstrating that the for preventing investigators from, uncon- 4. Characteristics of the client samples overwhelming evidence from RCTs that sciously or not, seeing only the results that must be clearly specified. psychodynamic psychotherapy is an effica- agree with their original hypotheses. This is 5. Effects must have been demonstrated cious treatment comes from comparisons not to say, of course, that RCTs are somehow by at least two different investigators or of dynamic treatment versus some kind of magically free of potential bias—the risk is investigating teams. “inactive” treatment, e.g., no treatment at all, ever present and threatening in research— Interestingly, nowhere in the criteria is an some kind of “treatment as usual” in the but RCTs do significantly reduce the possibil- RCT specifically required, and even large community, or a “treatment” that was spe- ity for researcher bias. Psychotherapists (and case-series are theoretically permissible. cifically designed by the researcher to be doctors) as a community have a long and However, in practice, every treatment on the watered down and ineffective (what some sometimes embarrassing history of believing official list of “well-supported” treatments call an “intent to fail” group). In fact, of 40 in the effectiveness of treatments that, in ret- (listed on the Division 12 Web site) has had comparisons between dynamic and an rospect, were either inert or even harmful. at least one RCT. This is because it is very “inactive” non-dynamic comparator, dynamic RCTs are no guarantee that this will not hap- difficult to meet the requirements of “good treatments were superior 68 percent of pen again, but they are an important step to experimental design” without an RCT and the time and never inferior. However, of 63 make it less likely. because RCTs are so widely accepted in the comparisons between dynamic treatment The second argument for RCTs is that field. Psychoanalysts may be inclined to “stand and an “active” non-dynamic comparator they have become accepted as a “gold stan- on principle” in rejecting the necessity of (e.g., CBT, IPT, medication), there was a tie dard” in the wider medical, public health, and RCTs. But they do so in the current climate 78 percent of the time, and the number of psychotherapy communities for being essen- at their own expense. Sometimes, to get times dynamic treatment was superior tial in demonstrating the value of psychother- invited to the party, one has to follow the (n=6) did not differ significantly from the apeutic treatments. The most commonly rules, no matter how arbitrary they may number of times a non-dynamic treatment cited codification of this rule takes the form seem. In my opinion, the dominance of RCTs was superior (n=10). This distribution of of standards written by Division 12 (Clinical is not so arbitrary or harmful that it is worth results was identical when only “high-quality” Psychology) of the American Psychological making a large and self-destructive stand in trials were considered. Association (see their excellent Web site, opposition to this rule. Continued on page 22

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 19

POLITICS and reform legislation should be repealed but only 40 percent strongly favor repeal and 30 per- PUBLIC POLICY cent strongly oppose repeal. “Most Still Favor Repeal of Health Care Law, Say It Will Increase Historic Health Care Legislation Deficit,” Rasmussen Reports (Jan. 17, 2011). Frederic T. Perlman and Graham L. Spruiell THE COURTS On the legal challenge front, six states— As predicted, the House of Representa- Iowa, Kansas, Maine, Ohio, Wisconsin, and tives voted 245-189 to approve a bill that Wyoming—joined 20 other states in their would repeal the Patient Protection and lawsuit in Florida to declare the individual Affordable Health Care Act. The bill that was mandate in the health reform law unconstitu- approved was H.R. 2, the “Repealing the Job- tional. Judge Roger Vinson ruled in their favor, Killing Health Care Law Act.” All Republican declaring the entire law unconstitutional. The members voted for repeal as well as three Department of Justice is likely to appeal this Democrats who voted against the health ruling. There are now a total of 28 states reform legislation when it originally passed Frederic T. Perlman Graham L. Spruiell challenging the legislation in the courts. This the House last March. Democrats who voted is contrasted by an analysis signed by more for repeal were Representatives than 100 constitutional law profes- Dan Boren of Oklahoma, Mike sors from across the country con- McIntyre of North Carolina, and cluding that the individual mandate Mike Ross of Arkansas. Senate is constitutional. The American Majority Leader Harry Reid said that Constitution Society released a piece the bill would not be considered by entitled, “Over 100 Legal Scholars the Democratically controlled Senate. Agree on Affordable Care Act’s In fact it was considered, and the repeal Constitutionality.” Virginia’s Attorney was defeated along party lines in a General has asked the Supreme Court 51-47 vote. The Senate action followed to “fast track” this case. a repeal in the House, which generated these headlines in the Washington Post APsaA’S ROLE and The New York Times respectively: We are witnessing a time of change and “House Votes To Repeal Health-Care WHAT POLLS SHOW turmoil in the delivery of and payment for Law” and “House Votes for Repeal of Health Meanwhile polls continue to show a rather health care in our country. We have a divided Law in Symbolic Act.” evenly divided public. A recent poll just before Congress, divided states, and in all likelihood the House vote found that 40 percent of a Supreme Court case in the near future to EFFORTS WILL NOT END WITH REPEAL those surveyed favored the health reform deliberate on these matters. What can our House Republican leadership indicated that legislation and 41 percent opposed it. “Poll: Association do to influence the outcome of they would hold hearings in February on Opposition to Health Reform Eases,” Associ- new laws and regulations, and to protect our aspects of the health reform legislation that ated Press (Jan. 16, 2011). Only one in four members and our patients? APsaA will con- they believe are most objectionable. This was say they wanted to repeal the law entirely. tinue to work to maintain the right to privacy summed up in the Washington Post headline A Zogby Interactive poll found that 54 per- which is the cornerstone of any meaningful “Repeal Vote Won’t End Health Care Debate.” cent of those surveyed favored repeal while treatment, and to be sure that our members Republicans have said that they support some 43 percent did not, but 52 percent felt that and patients maintain the right to contract parts of the reform legislation and Democrats the repeal vote was a “gimmick” to satisfy the privately. Our Association will continue to have indicated that they would be willing to bill’s opponents. “Majority Wants Health Care take part in the Mental Health Liaison Group revise some of it, so the challenge will be Reform Repealed, Yet Most Say Repeal in Washington to monitor and influence legis- whether a compromise can be reached that Attempt a Political Gimmick,” Zogby Inter- lation affecting our profession and our patients would pass the House and the Senate. active (Jan. 18, 2011). More than half of so that those who accept insurance will be those surveyed (54 percent) believed that treated fairly and without discrimination. Most Frederic T. Perlman, Ph.D., and Graham L. the health reform legislation would not be importantly, we will call on you to call, write, Spruiell, M.D., are co-chairs of the Committee repealed. Another recent poll found that 55 and visit your Congressmen and other elected on Government Relations and Insurance. percent of likely voters believe the health officials to help in this cause.

20 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 FROM BEHIND THE COUCH

There are times Berkshire Hathaway* When to Sell declined 40-50 percent from a new high. John W. Schott How foolish it would have been to try to jump in and out of it. The best answer to the question, “When 2. A CLEAR to sell?” is never. If an investor exercises the MISTAKE 4. MATURED INTO OBSOLESCENCE same care in buying shares of stock in a com- The second The fourth case of when to sell is when, in pany that he/she would use if buying the reason for selling your judgment, a company has reached its whole business, then those shares might is when it is clear maturity and while still a reasonably good never be sold. The great advantage in this a mistake has company just does not meet your criteria happy circumstance is that gains compound been made. This any longer. without the penalty of capital gains taxes. occurs when a All decisions to sell are complicated by tax Indeed, if they end up in the investor’s estate, company’s for- considerations. It is far easier to make sell they have a whole new cost basis for heirs. tunes have gone decisions when trading in a tax-advantaged John W. Schott Realistically, we cannot expect to never sell awry. This is an account like a Keogh, IRA, or self-directed even though this can be a theoretical goal. extremely difficult decision for most people pension account. In taxable accounts, the Most investors will make sales during their because acknowledging an error is a painful investor must ask the question, “After I have investment careers and those sales often narcissistic injury. Many investors try to avoid paid my capital gains tax, at what rate must represent a tough decision. In fact, the aver- this through the familiar defense, “I’m waiting my reinvestment outperform my original age investor finds a sell decision much for it to get back to what I paid for it and then investment to justify my switch?” Consider an tougher than a buy decision. Buy decisions I’ll sell.” This is the psychological mechanism of investor owning Exxon stock with a cost usually occur when excess cash is present undoing as we deny our mistake and try to basis of $2 a share. If $10,000 of Exxon stock and simply represent choosing between an undo it. It is far better to act quickly when an is sold, the after tax proceeds will be $8,300 attractive new idea or adding to an existing error in judgment occurs. The use of stop- (after federal capital gains tax but NOT position. There are really only four reasons losses can help in dealing with this problem. If including applicable state taxes). I make the for selling an investment. a company does not fulfill an investor’s crite- assumption Exxon’s long-term total return ria for a permanent hold (in which case he (dividends plus capital gains) will be 9% com- 1. UNAMBIVALENT NEED would happily buy more in a market decline), pound per annum. If the investor reinvests at The first reason is the least complicated a stop-loss should be determined at the time 12% compound per annum, (by no means an and, in most instances, the least ambivalent. of purchase. A good example of an effective easily achieved rate), it will take five years just This occurs when the money is needed for use of this investment tool is in a speculative to catch up. Finally, it must be considered that another purpose such as buying a house or purchase where anticipated good news fails even in the happiest of sale circumstances, for paying for college expenses. Often this repre- to materialize. The stop point should be cho- instance selling at a big gain to purchase sents a happy event both unto itself and sen either based on the size of loss that can something long desired, there is some psy- because it is the fulfillment of a disciplined be financially and emotionally tolerated or by chological experience of loss. From the first plan. It can give satisfaction of a job well done. studying the stock’s chart and selecting a stop moment of purchasing a stock, we begin to Even so, there may be accompanying sadness point just below a key support level. imbue it with positive qualities. We identify because there can be more joy in the journey with it and its management. We derive plea- than in arriving at the destination. Unfortu- 3. A SUPERIOR REPLACEMENT sure from its success. If its price rises substan- nately sometimes a sale is forced by illness or The third reason for selling is when you tially with time, our sense of value and job failure. While the afflicted individual is believe you have found a superior invest- narcissism rises, too. Thus, when we sell, we grateful for his reserves the whole experi- ment. This is often coupled with a rise in experience some loss even under optimum ence is fraught with loss—loss of income, price of your original investment to a point circumstances. The oddest of all these loss prestige, health, and self-esteem. where you now judge it either to have ful- feelings is the lost fantasy that the stock will filled your objectives or to a point where soar after our sale. Thus, we can conclude you believe it to be very overpriced. This is a that sell decisions are often psychologically John W. Schott, M.D., is a member of the tough call because who is to say that a stock complex and must be mastered to be an Boston Psychoanalytic Society. He is director the market has overpriced might not go effective investor. and portfolio manager at Steinberg Global ahead and become even more overpriced. Asset Management. He also publishes a Furthermore, excellent long-term invest- *Schott, a member of his family, or trusts in monthly newsletter on investment psychology, ments do frequently get overpriced tempo- which they have a beneficial interest own The Schott Letter. rarily just as they are periodically under-priced. securities in this company.

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 21

TH TO E E S D R I E T O T

R Psychodynamic Treatments T 2011

Continued from page 19 L

This result is sobering, in that it argues Extending Involvement in APA I speak from considerable experience, against a clear superiority for dynamic treat- I always look forward to receiving The having been a member of the Steering ment, but is likely completely typical of psy- letters American Psychoanalyst, which is excellent Committee and the Executive Commit- chotherapy research of all orientations and in all respects. I particularly enjoyed the tee of the Guidelines Project for 12 years. something to be understood rather than recent presidential letter by my old friend During that time I often heard cries of swept under the rug. A recent review by and colleague Warren Procci. His words outrage by the psychoanalytic community Nathan Thomä of a similar number of RCTs regarding the need for a “longer-term orga- about “inadequacy” in the representation of CBT for depression, working as part of the nizational plan” rekindles my plea to most of a psychoanalytic viewpoint in many of same team as the 2011 American Journal of every president in the last many years. the clinical guidelines. The vast majority of Psychiatry paper, found that CBT studies were Namely, that both the medical members these critics were not members of the of similar quality and reached similar findings and organizational psychoanalysis were APA, and therefore not eligible to partici- vis-a-vis active versus inactive comparators. committing suicide by not joining in greater pate in the process of producing a guide- With all this said, do Gerber et al. think numbers, and more heavily involving them- line or being an expert reviewer. The that psychodynamic psychotherapy is an “evi- selves, with the American Psychiatric Asso- problem will be magnified many times denced based treatment”? The answer is that ciation (APA) and more specifically the over if currently discussed changes in the we think so, but the field has not yet done Practice Guidelines Project. My suspicion is process of creating guidelines further the work necessary to say for sure by current that this is less of a problem with our psy- reduce psychoanalytic input because of research standards. Division 12 standards chologist and other analytic colleagues and this representational problem. require that there are well designed studies their national organizations. We already have a major disadvantage showing the superiority of dynamic treatment While there have been numerous presi- in guideline production arising from a to a control (even an “inactive” one is fine) dents and distinguished psychoanalysts relatively small amount of “evidence- done by two different investigators or investi- within the APA, an enormous percentage of based research” in psychoanalysis, and to gating teams in a specific target population. our medical colleagues are not members. further isolate our field is certainly self- Though 94 RCTs of psychodynamic psycho- This contributes to a very sparse represen- destructive. Change will only occur if therapy were published between 1974 and tation in the work groups and review pro- there is a strong effort by the American 2010, no two evaluated the same variety of cess that produce clinical guidelines. These Psychoanalytic Association to influence treatment, in the same target population, in guidelines are rapidly becoming a very its physician members to expand their separate research groups. Theoretically, then, major force in psychiatric education, clinical membership and efforts in the wider psy- with one more strategically designed positive practice, insurance, legislation, litigation, etc. chiatric community. study of psychodynamic psychotherapy, this Sherwyn M. Woods, M.D., Ph.D. treatment could be added, under that diagno- sis, to the “well-established” list maintained by TAP welcomes letters to the editor. Sherwyn M. Woods is a professor emeritus Division 12. It is hard to imagine a persuasive Letters must be less than 350 of psychiatry and behavioral science at the argument why we should not invest the time words long. Letters will be printed University of Southern California, Keck School and money that this takes to accomplish. as space allows and at the discretion of Medicine, and a supervising and training In a future column I will address other differ- of the editorial board. analyst at the New Center for Psychoanaly- ences of perspective between Shedler and our sis in Los Angeles. recent paper, including the question of com- paring effect size measurements from groups of studies (aka meta-analysis) and whether the argument about “who came up with this tech- Suggested Readings nique first” is a useful one to our field. One thing seems certain, though that we Shedler, Jonathan. (2010) The efficacy of psychodynamic psychotherapy. The American can all agree on. Psychodynamic research is a Psychologist 65 (2): 98-109. rich and rewarding pursuit and its debate Gerber, Andrew J; Kocsis, James H; Milrod, Barbara L; Roose, Steven P; Barber, Jacques P; both within the psychoanalytic community Thase, Michael E; Perkins, Patrick; Leon, Andrew C. (2011) A quality-based review of and in the larger spheres of psychology and randomized controlled trials of psychodynamic psychotherapy. The American Journal of psychiatry is likely to improve the treatments Psychiatry 168 (1): 19-28. we have to offer our patients.

22 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011

CASES from the Frenkel Files The Learned Intermediary John C. West

On April 3, 2002, Gary Dietz consulted intermediary with his family physician, Dr. Zuppa because defense, which he was suffering from anxiety, depression, allows the man- insomnia, and stress. He denied any suicidal ufacturer to INFORMED CONSENT ideation. Dr. Zuppa prescribed Paxil. Eight meet its duty to Although the doctrine of informed con- days after filling the prescription, Dietz warn by warn- sent is generally considered in the context of committed suicide by jumping in front of a ing the physi- invasive procedures, it should be considered train. Six years later, the manufacturer of cian who will be whenever there is a material risk associated Paxil issued stronger warnings of an prescribing the with a treatment that may occur in the increased risk of suicide among children medication. The absence of negligence. This is just such a case. John C. West and adolescents. learned inter- The risk of suicide may be heightened with Dietz’s estate filed suit against the manu- mediary defense only fails if the manu some antidepressants, but it is not possible facturer of Paxil, SmithKline Beecham Corpo- facturer fails to warn the physician to predict with any certainty which patients ration (SBC), for products liability. SBC appropriately. If the physician has knowl- may be affected. It is simply known that the defended on the grounds of the learned edge of the warning and prescribes the risk may be greater for some patients. If the intermediary defense and its motion for sum- drug anyway, the causal connection that patient is warned of the risk but agrees to mary judgment was granted. This appeal to leads back to the manufacturer is broken. In proceed with the treatment, he or she may the 11th Circuit Court of Appeals ensued. this case, the court noted that Dr. Zuppa be deemed to have assumed the risk. Patients who fall into the class for whom the risk is increased should be warned of the risk, and the warnings should be carefully The learned intermediary defense only fails if the documented, to the extent possible. There is always a question regarding the risks for which manufacturer fails to warn the physician appropriately. warnings should be given. The test is whether the risk is material. Generally speaking, a risk is material if it is one of which the reasonable MANUFACTURER’S DUTY TO WARN expressly testified that he still agreed with patient would want to be informed, or of As a general rule, in a products liability his decision, and would have prescribed which the reasonable practitioner would nor- case premised on a failure to warn, the Paxil for Dietz even if he had been aware of mally inform the patient. If the warning was plaintiff must show that the manufacturer the warning that was issued in 2008. The given, but the warning was not documented, had a duty to warn, that the duty was court of appeals affirmed the dismissal. it often becomes a question of whose credi- breached by the manufacturer, and that The learned intermediary defense is great bility is greater: the physician who claims that harm was caused to the plaintiff by the for drug manufacturers, but it may leave the risk was disclosed or the family who manufacturer’s breach of its duty. However, physicians all alone in litigation. While it may claims that the deceased would not have in this case, Georgia law allows the learned be difficult, it is of paramount importance taken the drug had he been fully aware of the that physicians keep up with the myriad risk. The sympathies of the jury often gravitate warnings that are issued by manufacturers, toward believing the bereaved. John C. West, J.D., M.H.A., is a senior especially the black box warnings issued by Good communication is often the best risk health-care consultant with Global Loss the Food and Drug Administration. The final management tool. If there are risks associated Prevention, Inc., a Chartis company. This decision on whether the patient should take with the treatment, they should be disclosed column constitutes general advice not legal a drug should be the patient’s. The physician to the patient or family, and let the patient and advice. Readers should consult with counsel must inform the patient of any significant family decide on the advisability of the treat- for legal concerns. For questions or comments risks that pertain to the medication and let ment. Dietz v. SmithKline Beecham Corp., No. contact [email protected]. the patient, if competent, make the decision. 09-0167 (11th Cir. March 5, 2010)

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 23

The Candidate Connection Carmela Pérez Carmela Pérez

This is my last column to you as your president, since my term of office came to an end after the Affiliate Council meeting in January. It has been a pleasure to serve you for the last four years, as president-elect and president of the Affiliate Council, and I thank you for your help and support during my term. I also want to thank my excellent and hardworking Executive Committee: Hilli Dagony-Clark, Richard Grossberg, and Jamie Cromer.

UPDATED EDUCATIONAL STANDARDS Currently, there is a lot going on in the Association, and significant changes were put into effect during the June 2010 meetings. First and foremost, there is a new set of Educational Standards that allows for greater flexibility for those institutes that choose it. Very briefly, the new standards propose: an alternative “developmental” pathway to the training analyst appointment, a separation of the supervising analyst appointment from the training analyst appointment (so that they are two separate appointments), and the choice for institutes to request a waiver of the TA requirement for candidate applicants who are already in an ongoing analysis with a non-TA. It is up to every institute to decide whether they will adopt some or all of the new standards, and the Board on Professional Standards is recommending that institutes thoroughly discuss the new standards with faculty and candidates before making their decision.

FLEXIBILITY Second, the expanded membership bylaw amendment was passed. This amendment broadened the criteria for APsaA membership. As with many issues in our organization, there were two major points of view on this. The majority viewpoint felt that the criteria for membership, specifically the requirement to be a graduate of an APsaA or IPA institute was too stringent and excluded potential members who were not graduates of either. This group suggested that membership requirements be modified so that equivalence in training be the new criterion, rather than training at an APsaA or IPA institute. The minority view was concerned about how equivalence would be defined, as well as with the effect of the shift in power to a smaller group that comprises the committee. [See editor’s note below.]

AFFILIATE COUNCIL ACCOMPLISHMENTS Now, I would like to shift gears, and focus on the Affiliate Council. First, I would like to review some of the things that we have done during the last two years. • The application for affiliate membership became available online at www.apsa.org/ joinapsaa. • A welcome letter/e-mail for all new candidates, on behalf of the Affiliate Council president, was created. The letter encourages candidates to join and outlines the benefits of affiliate membership. • A calling campaign was instituted to reach out to all new candidates who did not become members of the Affiliate Council during their first year of training. • Talking points about APsaA, the Affiliate Council, and the benefits of membership were made available for use by the delegates during the affiliate membership drive. • A new Travel Grant Program was created. This program allows one candidate from each institute (who has never attended an APsaA meeting) to attend a national APsaA meeting. Continued on page 32

24 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 FREUD AND MAHLER

Mahler himself was freed to again compose. Analyze This: Freud and Mahler The Adagietto from his Fifth Symphony, one Michael Slevin of Alsop’s selections, interpreted in the program as a love letter to Alma, resonated with Like psychoanalysis, Western classical music Center and chair Freud’s understanding of the profound losses is, in some quarters, thought to be esoteric, of their Social Mahler suffered in his childhood and youth. highbrow, and elitist. Orchestras are struggling Impact Commit- Balle, who hopes to market the work to retain aging audiences and bring in the tee, organized a through her new production company, Sym- young. Marin Alsop, musical director of the Bal- block of seats phonic Stage Shows, said she wants in this and timore Symphony Orchestra, creatively reaches and a post-per- similar efforts to give access to a composer’s life out into the community and opens the doors formance recep- and work. “Knowing his struggles, demons, and to her world of composers and sound in new tion with Alsop aspirations,” she said, will deepen the “emo- ways. Last November, she presented two per- for psychoana- tional, cerebral, and visceral” experience of the formances of a music and theater program lysts and their music. But, she added, “it is available at the level titled Analyze This: Mahler and Freud. guests. Seventy- Michael Slevin at which we wish to enter and participate. seven came; a “I cringed at first,” said Silber of the por- FREUD’S LETTER TO BONAPARTE thousands seats overall were sold, and the trayal of psychoanalysis. Freud himself, com- INSPIRES MULTI-MEDIA WORK work, in Bethesda and the next night in Balti- menting to Bonaparte, had expressed surprise In 1910 Gustav Mahler, distressed by more, received standing ovations. that Mahler, so close to his mother, had mar- problems in his marriage to Alma and unable ried a woman named not Marie, his mother’s to compose, was advised by Richard von AUDIENCE AND MUSICIANS RESPOND name, but Alma. Mahler said, yes, but her full Nepallek, a Viennese psychoanalyst and rela- Richard Chavez, a psychoanalyst with the name is Alma Maria, and I call her Marie. And, tive of Alma’s, to consult Freud, who was then Washington Center, said with enthusiasm, now Walter Gropius, courting Alma while she was on vacation in Leyden. After making and can- he wanted to listen to more Mahler. It was a married to Mahler, sent a love letter intended celing three appointments, Mahler arrived in program intended and shaped as a part of for Alma by “Freudian slip” to her husband. It Leyden. For four hours he worked with Freud the 150th anniversary of Mahler’s birth and was, from the author of “Psychopathology of as they walked through the town. Ernest Jones the 100th anniversary of his death. “It was Everyday Life,” Freud’s greatest hits in the writes, “Although Mahler had no previous educational as well as beautiful,” said Georgia time warp of his developing theory and tech- contact with psychoanalysis, Freud said he Royalty of the Baltimore Washington Center nique of the early 20th century. had never met anyone who seemed to under- for Psychoanalysis. Alsop said in the question stand it so swiftly.” Fifteen years later, in a letter and answer discussion after the performance in CHILDHOOD TRAGEDY AND LIGHT to Marie Bonaparte, Freud discussed his Bethesda that the music was “Mahler’s greatest AMUSEMENT INEXTRICABLY FIXED encounter and his interpretations. Excerpts hits.“ Its portrayal of psychoanalysis “was too Alsop said Mahler “was willing to discuss from that letter, including direct quotations, formulaic,” said Mark Levine of the Washington childhood, but on his own terms, in music.” She form the backbone of Didi Balle’s elaborated Center. Yet the musicians were talking about performed excerpts that included klezmer script, which Earle Silber, a flutist and a psy- the production backstage, a sign of success. music and the sounds of cowbells—sounds choanalyst with the Washington Center for People are “wired” these days, with a “ter- from his past. Balle said, “Both of them use Psychoanalysis, said “was probably very much ribly fragmented attention span,” said Balle in material of their inner lives, of their dreams.” the way [Freud] worked at that time.” a phone interview. Working with that reality, Following the 19th century Romantic vocation One performance of the work, comprised she spent four months immersed in writing of childhood, the contours of our early years of music and actors with images from the a script for “bona fide theater actors, lights, were being redefined in the 20th century. Alma Mahler archives at the University of and costumes.” Images were projected onto Leonard Bernstein, who championed Mahler Pennsylvania, was at Strathmore Hall in the a screen behind the orchestra. Musical and brought him back into the musical reper- Washington, D.C. suburb of Bethesda, Mary- excerpts selected by Alsop, scripted com- toire, stated, “Mahler was the prophet of the land. Joanne Gold, who, as a community mentary delivered from the podium, and dra- 20th century.” Balle said, “He was the first per- member of the Washington Psychoanalytic matic scenes acted on stage were woven into son to take on the musical idea of democracy, a work that was 60 percent music and 40 the separation of the high and the low.” It is an Michael Slevin, M.A., M.S.W., a former percent text. Tony Tsendeas played Freud and interpretation perhaps in tension with that of TAP editor, graduated as academic associate Richard Pilcher played Mahler. Mezzo- Freud biographer Ernest Jones. Jones wrote: from the Baltimore Washington Institute for soprano Kristina Lewis, at the conclusion of Psychoanalysis, where he completed as a the program, sang one of Alma Mahler’s In the course of the talk [with Freud] clinician the Adult Psychotherapy Training songs. Alma, a promising composer, had been Mahler suddenly said that now he Program. He works at Sheppard Pratt and forced by Mahler to give up her work, but understood why his music had has a private practice. after his consultation he encouraged her. Continued on page 34

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 25 The Psychoanalyst As Artist:

Third Annual Psychoanalytic Art Show

Jon K. Meyer

The 2011 National Meeting of the American Psychoanalytic Association saw its third annual exhibit of members’ artistry. Previous shows had been limited to visual arts, but the exhibit this year also included fine jewelry and sophisticated wood- working. There were approximately 75 works, each one created by a member or associate of the Association or by a member of the IPA or IPSO. The premise for the exhibit was that analytic work, coming to know the patient through in-depth experience and creative communication, is analogous to the analyst-artist’s seeing the subject, coming to know it, framing it through his or her medium, and embracing its essence. James and Elyse Blair Among the highlights were Ray Raskin’s lovely gold and silver jewelry, Wendy Wen’s computer generated images which Once again, one of the artistically and intellectually satisfying she brought from Shanghai, Moisy Shopper’s lovingly worked features for both viewers and participants was the discussion by wooden bowls, and Sebastian Zimmerman’s photographs of acclaimed National Geographic photographer James Blair. Blair distinguished analysts. The photography and painting simply devoted many hours to the exhibit, emphasizing the creative get better from year to year. Those who exhibited included process: capturing the moment and conveying its intrinsic Graciela Abelin-Sas, Lauren Katz, Lauri Robertson, Leslie emotion—much as an analyst might work with an analysand. Schweitzer-Miller, Mali Mann, Mervin Stewart, Nathan Szajnberg, He commented on every aspect of the show while inviting Paul Mosher, Peter Mezan, Phyllis Gildston, Susan Radant, Valerie comments from the artist. The addition of a microphone this Laabs-Siemon, William Kenner, and me. There were too many year made Blair’s and the artists’ comments easy to hear excellent pieces, many of professional quality, to single out any throughout the exhibit and gave rise to a lively conversation one of them except to say that some were chosen by viewers among discussant, artist, and audience. to be part of their own collections. There is always a shortage of space at the meetings so that, as in years past, this exhibit lasted for only one day, Friday, January 14, from 9 a.m to 5 p.m.—a sad fact for many members Jon K. Meyer, M.D., is past-president of APsaA, a previous who had hoped to catch it on Saturday. But in the ongoing spirit Erik Erikson Scholar at the Austen Riggs Center, professor of a show that is by and for the analytic community, all sugges- of psychiatry and psychoanalysis emeritus, Medical College of Wisconsin, and a training and supervising analyst at the tions, comments, and feedback are welcome in an ongoing Washington Center for Psychoanalysis. dialogue about the art of and the art in psychoanalysis.

26 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 The Psychoanalyst As Artist

Sebastian Zimmerman “Charles Brenner”

Mervin Stewart “Jewelry by Ray Raskin”

Diana Cuello “Mia”

Jon Meyer “Road to Cortez”

Paul Mosher “Restored Train Station”

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 27 The Psychoanalyst As Artist

Lauri Robertson “Quidnet, Nantucket, Christmas Day”

Mervin Stewart “Braunfels, Germany”

Deborah Genninger “Mary and Betty”

Sebastian Zimmerman “Martin Bergmann”

Nathan Szajnberg “Mind”

28 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 The Psychoanalyst As Artist

Valerie Laabs-Siemon “By the Brook” Wendy Wen “Rescue Me”

William Kenner “Hounds Ready for the Hunt”

Jon Meyer “Ravens and Haystack Rock”

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 29 The Psychoanalyst As Artist

Susan Radant “South Side Chicago Girl”

Leslie Schweitzer-Miller “Shadows”

Elizabeth Danze “Pantheon, Rome”

Mali Mann William Kenner “Man with the Dog, Lisbon” “Fox Hunt Rider After a Spill”

30 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011

those who had once deprived him of his feel- Take ings of self-worth and autonomy. Pilar stayed in the marriage, despite multiple broken My Eyes bones and bruises, because she knew no other way of life. We watch her gradually Barbara Young gaining the courage to leave him, when her The title of efforts to help him change are fruitless. the Spanish film, Shy Pilar is welcomed by her sister’s friends Te Doy Mis Ojos at the museum where she works. In the cama- (I Give You My raderie of the women and their more jaun- Eyes), stresses diced view of men’s behavior, the sparkle the loving aspect begins to return to her eyes, and she with- of the marriage REENACTMENT draws from Antonio. However, he is persistent of Pilar and In our own country, a recent study con- in his pursuit and she is drawn back to him. Antonio. The ducted by the Seattle-based Group Health English title, Take Cooperative’s Center for Health Studies, 44 LEGACY OF MARTYRDOM Barbara Young My Eyes, empha- percent of the women reported having expe- Several interchanges with her mother are sizes the masochistic giving-herself-up-to-be- rienced at least one incident of physical, psy- instructive. Her mother is insensitive to her devoured component of the frightened, chological, or sexual intimate partner violence feelings of despair. Having been victimized victimized wife. during their lifetime. Can women avoid enter- herself, she counsels her daughter to accept How is it that two people who love each ing into such a relationship? The film makes her fate. “No woman is better off alone.” other dearly, who loan each other their bod- clear that the answer is all too often “No,” for, Pilar’s epiphany occurs in the cemetery ies piece by piece in passionate lovemaking, like Pilar, they have been caught in a malignant where her mother is visiting her husband’s can arrive at an irreconcilable, unbearably riptide set in motion by the abuse and victim- grave. The mother says the one thing she painful parting of the ways? We watch Pilar ization that had existed in their childhood feels guilty about is not visiting her brother fighting to save both her body and soul from homes. What does a woman need in order to when he was dying because her husband did Antonio’s violent outbursts, and Antonio’s be able to get out of such a relationship? Take not want her to go. valiant attempts to gain control of himself. My Eyes chronicles one woman’s escape from Pilar confronts her: “Is that all you feel Despite his serious efforts to overcome his servitude into a life of her own. guilty about? What about staying with him all rages, he is incapable of keeping his temper We enter the film at a crisis. Pilar is leaving those years, being a martyr?” under control in order to save his marriage in the middle of the night with her son Juan Mother: “I did it for you girls.” to the woman he both needs and loves. to seek refuge at her sister’s. As she looks Pilar: “You did it for yourself!” However, the best efforts of a group thera- down and sees that she is still wearing her I believe it is at this point that Pilar recog- pist can no more contain Antonio’s jealous bedroom slippers, she collapses in tears on nizes that she, too, is being a martyr like her rage than a silken net can contain an injured her sister’s shoulder, recognizing the depth of mother. bull. His terror at being abandoned brings her despair and the seriousness of her plight. Pilar comes to life in her love of the paint- about the very thing he most fears. How it is that she has sunk to this calami- ings and in her presentations to the tourists Several recent films (e.g., Volver) lead us to tous state? In the love scenes we see the as a beginner docent at the museum. Antonio believe that marital abuse is more accepted as starry-eyed young woman who fell in love finds this intolerable. The woman who once the norm by both men and women in Spain with the handsome Antonio who offered her sparkled for him is now sparkling for others. than in the United States. In a featurette after a way out of her abusive family. Her mouth is His jealousy escalates. When she prepares to the DVD film, director Iciar Bollain tells us that open like a baby bird eager to be fed. In giving go to Madrid to interview for a job, he panics two million Spanish women are victims of all the pieces of herself to him, she is fed. and explodes. He pulls off her clothes and domestic violence and that each week a Antonio not only wants her nose, her ears, shoves her out the window onto the balcony woman dies at the hands of her partner. her mouth, her eyes, he wants all of her; he for all the neighbors to see. He chokes her wants to eat her up, and she is in need of until she slumps to the floor. Barbara Young, M.D., graduated from Johns being eaten. (How reminiscent of Bertram When she finally goes to the police, she Hopkins University School of Medicine in Lewin’s oral triad: the wish to eat, to be eaten, whispers, “The injuries are inside. He has bro- 1945 and from the Baltimore Psychoanalytic and to go to sleep.) ken everything. Everything.” She tells her sis- Society in 1953. At the age of 90, she But there was another side to Antonio: a ter, “I can’t go back to him…. I don’t know practices part-time in Baltimore. Her second jealous insecure self who took out on Pilar who I am.” profession is that of a photographer. what he had obviously wanted to do to Continued on page 32

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 31

Affiliate Council on the Affiliate Council; encourage candi- and help your next president, Hilli Dagony- Continued from page 24 dates in your institute to join APsaA as an Clark, and her newly elected Executive affiliate member, consider joining or start- Committee. • The Affiliate Newsletter was revamped ing an Affiliate Council committee, join Even though I am saying farewell, I want and reformatted as the new Candidate the Practice Network, write for the news- to reassure you that your education, train- Connection Newsletter. letter. Get involved! This is your future, ing, and professional development are all • The Affiliate Council Practice Network, your training, your career, and you have issues of great importance to me, and I will a Web site, where affiliates can com- the opportunity to get as involved as you continue to advocate on your behalf in municate about professional develop- would like. I hope that you will support any capacity I can within APsaA. ment and training issues, was launched. • Support for the new pilot certification program, which allows candi- Editor’s Note: This is an edited reprint of part of an article published in the January 2011 dates to begin the certification edition of the Affiliate Council newsletter, The Candidate Connection. In the full article, process during training or pre-gradu- Pérez discusses the recent bylaw vote which sought to add four councilors to the Executive ation, was strongly endorsed. Committee. She highlighted its flaws with respect to candidate representation, and urged We have accomplished a significant consideration of a different model for expansion of the committee. Prior to TAP’s amount, and there is a lot more we could publication, the bylaw was not passed, and the discussion was removed from this reprint. do. We can use your help. For example, You can read the column in its entirety on the Association Web site at: organize your local candidate group and http://www.apsa.org/Portals/1/docs/publications/ACNews/ACNewsJAN-2011.pdf. make sure that you have a representative

Take My Eyes dynamics that met their parents’ needs. These and his team met with 10 socioeconomically Continued from page 31 little girls were given no support or encour- disadvantaged mothers and their 16 infants agement in the development of their autono- twice a week for seven years, observing the But what effect did their turbulent mar- mous selves. They became competent patterns of aggression and helping the moth- riage have on their son? Already Juan has the women, but women who adapted in a mas- ers deal with the children’s behavior. Out of large apprehensive eyes and solemn facial ochistic way to their husbands. In therapy, this study, he classified four different kinds of expression of his father. Though he is obvi- they gradually learned that they as individuals aggression. The first two, the child’s attempt to ously dearly loved by his mother, Juan is had rights. One woman told me in her last master himself and his environment and the already torn in his loyalty. What defenses will session that what she had gained most from urge to obtain food, are both essential for sur- he build up with which to meet life? Will he her treatment was the sense of being a whole vival and development. But Parens believes the become an abuser too, or will he become the person for the first time in her life. second two, displeasure-related such as tem- victim? Or will he close himself up in a shell My own patients’ accomplishments give per tantrums or rage reactions and pleasure- so that he remains invulnerable to hurt? me hope for our hypothetical Antonio. If he related aggression such as teasing and taunting, could survive the inevitable depression and are not inborn but are activated by emotional CLINICAL UNDERSTANDING avoid suicide after Pilar’s departure, and con- pain. The amount of this hostile aggression that Pilar reminds me of a number of women tinue to build on the relationship he had children display is largely influenced by how who have come to my office for help. They established with the therapeutic group, per- their parents treat them. Physical, sexual, and are strong. As small children, they must have haps he too could overcome his feelings of emotional abuse by parents triggers hostile been loved and helped to establish a funda- helplessness and humiliation, and gain control aggression. Parens says, “It is amazing how mental sense of security, but they were soon of his murderous hands. many parents do not realize that their children caught up in the tension between their abu- Cruelty and sadism have been the focus of have feelings.” The team has followed these sive parents. They searched for a way to sur- psychoanalytic study. The psychoanalyst Henri children ever since. None of them has gotten vive and save themselves from being Parens, survivor of a concentration camp, has into trouble with the law; one has become a destroyed by playing a role in the family done a study of aggression. In 1970, Parens psychologist and one an engineer.

32 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 ME XICO CITY

Come to a Great Congress in Mexico City Steven J. Ellman

On behalf of the Program Committee for Unconscious,” the IPA Congress 2011—the centenary con- has two themes, gress—I invite you to the conference taking one that will place in Mexico City on August 3-6. shape the morn- Some of you may be thinking, “Mexico City, ings and the We have utilized this format to facilitate com- isn’t that a dangerous place?” You may want to other the after- munication among the panelists. After the ask about security but are reluctant to men- noon sessions. In plenary panel the rest of the morning will be Steven J. Ellman tion the topic. You may be interpreting why I the morning ses- utilized for further exploration via group dis- am even bringing up the issue of security. I am sions we will explore three of the core con- cussions. The congress participants will split starting this communication by talking about cepts that have occupied psychoanalysts up into discussion groups, which will each security because it is on the mind of virtually during the last 100 years: the unconscious, have a moderator and a facilitator. The facili- everyone. Here are the facts, as I know them: sexuality, and dreams. The afternoon sessions tator will present a brief summary of the Mexico City is no more dangerous in terms will be devoted to issues that involve disrup- morning panel and then formulate issues and of crime statistics than Chicago or most major tions in the analytic experience. The disrup- questions to stimulate group discussion. The cities of the Americas. However, I realize that tions can be conceived of as occurring intention is that all members will take an this is not reassuring due to the overwhelming intrapsychically, between the analytic couple active part in exploring these core concepts. publicity about the drug cartels in Mexico. (enactments), or in the form of personal To promote discussion each group will stay These incidents have not taken place in Mex- events such as illness and personal loss, natu- together for the duration of the congress. It ico City, and both crime rates and the living ral events, societal events, and so on. The dis- has been the IPA experience that intact conditions in Mexico City have dramatically ruption may stalemate or impair the analytic groups both stimulate discussion and pro- improved under the new internationally process, or may eventually, if survived, further mote collegial relationships. known mayor of Mexico City. But because of the analytic process. We will also feature the the anxiety about security, we are taking a many outreach programs that have helped AFTERNOON DISCUSSIONS number of steps to make the congress be repair various types of disruptions. FOCUS ON DISRUPTIONS secure and also to feel secure. When one The afternoon theme will serve to provide comes off the plane at Mexico City’s major MORNINGS DEVOTED TO some continuity between panels and individ- international airport, there will be an IPA CORE ANALYTIC CONCEPTS ual papers. There will be an attempt to look booth where a representative will direct the In the morning sessions, the exploration of at social as well as individual factors that dis- congress participant to an appropriate bus or the core concepts will take place first in a rupt analytic treatments, including issues in a cab. Official taxis are available, and the IPA plenary panel discussion. Each morning will psychoanalytic society as well as issues in the has also arranged for a shuttle-bus. feature a different panel discussing one of the society at large that affect a psychoanalytic We have excellent pre-congress groups concepts. Members of the panels will be asked treatment. In addition to the submitted and tours arranged particularly with dele- to address four or five key questions that papers, each afternoon will feature the con- gates’ interests in mind. In addition, there will highlight the importance of the concept. These tributions of an analyst whose work has be a post-congress film festival “Disrupted questions will provide the panelists an oppor- strongly influenced psychoanalysis in her or Worlds: The Unconscious in Cinema” with tunity to discuss how or whether the con- his country or larger parts of the psychoana- screenings of Los Olvidados, Babel, and Pan’s cept is important in their clinical formulations. lytic world. There will also be panels that fea- Labyrinth followed by discussions by noted ture work from those of different nationalities analysts and critics. For more details about and theoretical orientations. A variety of The main event—the congress, “Exploring meet-the-authors sessions include those Core Concepts: Sexuality, Dreams, and the the congress, pre-congress who have produced new and important working parties, tours, work such as Peter Fonagy, James Gottstein, Steven J. Ellman, Ph.D., chair of the IPA and the Post-Congress Sheldon Bach, and Arnold Rothstein, who are Program Committee, is professor emeritus of Film Festival go to well known to North American analysts. the City University of New York and training www.ipa.org.uk/congress. There are, of course, authors from around and supervising analyst at IPTAR. the IPA world.

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 33

Freud and Mahler From the Continued from page 25

always been prevented from achiev- Unconscious ing the highest rank through the Sheri Butler Hunt poetry noblest passages, those inspired by the most profound emotions, Gerald Gargiulo is a member of the American Psychoanalytic Association and the because they were spoiled by the International Psychoanalytic Association. He joined APsaA through the Institute for intrusion of some commonplace Psychoanalytic Training and Research (IPTAR). He is located in Stamford, Connecticut, melody. His father, apparently a where he practices psychodynamic psychotherapy, psychoanalysis, and couples therapy. brutal person, treated his wife very His Ph.D. is from Foundation House, Oxford, England, 2003, and he graduated from badly, and when Mahler was a young The Psychoanalytic Training Institute of the National Psychological Association for boy there was a specially painful Psychoanalysis, New York City, in 1970. scene between them. It became quite unbearable to the boy, who rushed away from the house. At that moment, however, a hurdy- on reading Ammons gurdy in the street was grinding out It’s not the leaving the popular Viennese air, “Ach, du that it’s about. lieber Augustin.” In Mahler’s opinion the conjunction of high tragedy and about leaving light amusement was from then on, there is no inextricably fixed in his mind. about.

CLASSICAL MUSIC, PSYCHOANALYSIS, It’s about the silence, AND HOPE like a monotonously sleeping sea, Making classical music accessible is a chal- quiet to the eyes lenge Alsop faces head on. The Baltimore can we leave that way? Symphony has started a program, called OrchKids, which, based on the Venezuela’s That way, non-existence has nationwide El Sistema program, organizes the no argument with us. entire school curriculum in an impoverished we trouble it not neighborhood around the discipline and disturbing with our memories enjoyment of performing classical music. She what cannot be disturbed. made a founding grant of $100,000 from her MacArthur Fellowship to its success, and the No wonder we come again symphony provides administrative assistance. again to learn She herself is on the ground and known to it’s not about the leaving the children. Her “Off the Cuff” series, of but leaving not troubled which the Freud-Mahler work was a part, not troubling the quiet brings in a younger audience. emptiness Making psychoanalysis accessible and rele- which yearns to remember vant is a challenge to the American Psychoan- us alytic Association. Preparing for her interview with no trouble at all. with me, Balle looked at the APsaA homepage. “I expected something fusty,” she said, but was —Gerald Gargiulo delighted by its accessibility and social concerns. Freud leveled the social and economic playing field when it came to human character and emotions. We must regain that if we Sheri Butler Hunt, M.D., is a graduate analyst in the adult and child divisions at the are to continue our enterprise. If we do so, Seattle Psychoanalytic Society and Institute. A published poet and member of TAP’s editorial and Alsop is in the game with us, we will board, she welcomes readers’ comments and suggestions at [email protected]. find others who say, as Balle has Mahler say, “You have given me hope.”

34 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 JUNE MEETING HIGHLIGHTS

particular how it should be taught. Cabaniss APsaA Annual Meeting Highlights envisions a future in which the most valuable insights of psychoanalysis are offered to the June 8–12 in San Francisco widest possible audience. Gina Atkinson PLENARY ADDRESS What’s in store for those attending APsaA’s in addition to a Morris N. Eagle, who has published widely 100th Annual Meeting in San Francisco? clinical practice. in such areas as academic psychology, philos- Aside from the delights of visiting Every- The Sunday ophy, conceptions of the mind, views of psy- body’s Favorite City, here are some of the panel on “The chopathology, and theories of treatment, will program’s highlights. Effect of Unreal- present “Psychoanalysis and the ‘Enlighten- izable Technical ment Vision’: An Overview.” He will highlight PANELS Ideals” will con- some of the significant trends and develop- Gina Atkinson Youngsters take center stage in the subject sider our techni- ments in psychoanalysis during the last 100 matter of two of this meeting’s panels. The cal analytic ideals in light of our evolving years, and specifically the increasing disjunc- first one, “Babies in the Consulting Room: understanding of the mind and then the impli- tion between psychoanalysis and the Enlight- What Happens When Analyst, Mother, and cations for the use of the couch, frequency, enment Vision, as well as the shift in emphasis Infant Meet?”, looks at the unique challenges and free association in the analytic setting. from the interpsychic to the interactional. and opportunities that arise when a patient This session, chaired by Mary Margaret brings her baby to treatment. Panelists Sha- McClure, features panelists Stephen Seligman, MEET THE AUTHOR ron Blum, Jane V. Kite, and Lynne Zeavin, Andrea Celenza, and Maureen Murphy. After Nancy Sherman will discuss her book, The together with chair Jennifer Stuart, will discussion from each panelist, the audience Untold War: Inside the Hearts, Minds, and Souls address the rich and largely unexplored will break into small groups. of Our Soldiers. Sherman advocates listening potential of analytic work in this context. The to soldiers not only as clinicians but also as second, “On Play and Playfulness: Develop- UNIVERSITY FORUM ordinary civilians—as colleagues, neighbors, mental and Clinical Considerations in Child, “Dissecting Unconscious Attachment Pro- fellow students, and teachers—and finds Adolescent, and Adult Psychoanalysis,” cesses: Rapprochement between Social-Per- such listening crucial to understanding the chaired by Christine C. Kieffer, includes clini- sonality Research and Clinical Psychoanalysis,” complex inner battle space of war. Jonathan cal presentations by Monisha C. Akhtar and the University Forum, will be chaired by Anne Lear will be Sherman’s respondent. Philip A. Ringstrom, and discussions by Estelle Erreich. Phillip R. Shaver, a Distinguished Pro- Shane and Alan Sugarman. fessor of Psychology at the University of Cali- SPECIAL ART SYMPOSIUM A new look at the concept of objects is fornia, Davis, will describe research that uses Chaired by Steven H. Goldberg, this sympo- promised by a panel chaired by Irene Cairo, subliminal provocations to reveal systematic sium is presented in conjunction with a special “What Do We Mean by Objects?” Henry J. unconscious processes. Morris N. Eagle will exhibit at the San Francisco Museum of Mod- Friedman, Patrick Miller, and Judith L. Mitrani discuss Shaver’s presentation. ern Art entitled “The Steins Collect: Matisse, will discuss the changing face of this concept Picasso, and the Parisian Avant-Garde.” In her and its clinical applications. The panel, “Ana- PRESIDENTIAL SYMPOSIUM presentation, “The Steins Collect: A Conversa- lytic Listening and the Five Senses,” chaired by Join APsaA president Warren Procci in a tion between Art Curators and Psychoana- Nancy J. Chodorow, targets the contributions session on immigration, which will consist of lysts,” museum curator Janet Bishop will discuss to analytic listening of sensual modalities and three presentations on immigration policy, the the unique collection of paintings, drawings, predilections. Each of the panelists—Peter L. history of immigrants and psychoanalysis, and and sculpture that unites the collections of Goldberg, Forrest M. Hamer, and Jonathan a psychoanalytic perspective on immigration. Gertrude Stein and her brothers Leo and Palmer—as well as the recorder, Susan Yama- Michael Stein and Michael’s wife Sarah. guchi, has a creative vocation or avocation TICHO LECTURE The Gertrude and Ernst Ticho Memorial OTHER OFFERINGS ON THE PROGRAM Gina Atkinson, M.A., is the managing Lecture is given by an early to mid-career A number of other offerings promise to editor of The Psychoanalytic Quarterly analyst who is currently making contributions intrigue meeting attendees. In the area of film and the translator of Stefano Bolognini’s to psychoanalysis and shows promise of mak- and psychoanalysis, there will be workshops latest book, Secret Passages: The Theory ing significant future contributions. In this on The Tempest (Julie Taymor’s 2010 version) and Technique of Interpsychic Relations. year’s lecture, “Teaching Psychodynamics in and Los Olvidados (1950), as well as a discus- She is a community member of the the 21st Century,” Deborah L. Cabaniss will sion group on Frozen River (2008). San Francisco Center for Psychoanalysis. tackle the future of psychoanalysis, and in Continued on page 39

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 35 SAN FRANCISCO

A View from the Golden Gate Gina Atkinson

California’s famous Golden Gate, marking Don’t be surprised if the entrance to one of the world’s largest you find yourself amid natural harbors, is but one of many attrac- an audience watching tions for attendees of APsaA’s 100th Annual one of the many street Meeting in San Francisco in June. The 1.7-mile performers who fre- Golden Gate Bridge is best appreciated by quent the area, includ- walking or cycling the length of it, or even ing musicians, jugglers, sailing under it on a harbor cruise. If you drive comedians, and mimes. over it, be sure to have your camera ready for And don’t miss my vertical shots of the awe-inspiring towers, favorite area of Pier 39: not to mention spectacular views of the bay. the pylons that serve From whichever vantage point you choose to as a gathering place for observe it, San Francisco Bay is a highlight for the bay’s sea lion col- most of the city’s 15 million annual visitors. ony. You’ll often see Which of San Francisco’s well-known dozens of the sleek attractions will you visit in June? If you choose pinnipeds here, snooz- to start out on foot from your conference ing in the sun or sliding hotel, the Palace at Market and New Mont- into the water. If you gomery Streets, an easy stroll of less than five don’t immediately find minutes will take you to the Ferry Building, them, just follow the replete with gourmet food boutiques and sound of their deep, eateries. On Saturdays, one whole side of the hoarse bark. building is given over to local vendors for a colorful farmers’ market. ESCAPE TO ALCATRAZ ISLAND crab cocktails. A stroll along the waterfront Near Pier 39, you can catch a ferryboat where many local fishing boats are moored ON THE WATERFRONT: to Alcatraz Island, now part of the Golden will bring you to the red brick Cannery and STREET PERFORMERS AND SEA LIONS Gate National Recreation Area, where you on to Hyde Street Pier, a maritime park and From the Ferry Building, consider taking a can soak up the history of one of the home of the Balclutha, an 1886 square-rigged walk along the waterfront thoroughfare, the world’s most infamous prisons—including sailing ship that’s now a floating museum. Embarcadero, or hop onto one of the city’s tales of famous escape attempts—via a self- Look across the green to your left for a restored antique streetcars that traverse the guided or ranger-led tour. Stop at the Cell- great view of the multilevel Ghirardelli “F” line. Aboard one of these trams, you may house Museum Store to browse the books Square, once a chocolate and pasta factory. just find yourself reading a “No Smoking” and historic exhibits, and you might be lucky Here you can indulge in one of many deca- notice in Italian since some of the heritage enough, as I was on my last visit, to chat dent ice cream sundae concoctions with streetcars come from Milan, while others with one of the former inmates who visit whimsical names like “The Rock” and “The originally rattled over the tracks in Manches- occasionally, now as free citizens willing to Emperor Norton.” (The latter is named for a ter, England. share their stories and answer questions San Francisco citizen and self-proclaimed However you get there, you’ll find a lot to about life on “The Rock.” Alcatraz tours royal who in 1859 declared himself “Emperor see at Pier 39, located at the junction of usually sell out in advance, so book early at of These United States.” According to Wiki- Embarcadero and Grant Avenue. It’s a shop- www.alcatraztickets.com. pedia, “Though Emperor Norton was consid- pers’ mecca that boasts an aquarium, a carou- ered insane, or at least highly eccentric, the sel depicting San Francisco landmarks, a BALCLUTHA AND GHIRADELLI citizens of San Francisco celebrated his regal sports and game arcade, specialty shops, Continue along the Embarcadero and presence and his proclamations”—evidence and restaurants of all kinds, offering every- you’ll come to world-famous Fisherman’s of the city’s long history of social tolerance thing from gourmet seafood to takeaway Wharf, home of San Francisco’s ubiquitous and enthusiasm for the avant-garde.) clam chowder, hot dogs, and ice cream. sourdough bread and takeaway Dungeness Continued on page 37

36 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 SAN FRANCISCO

DISTINCTIVE MUSEUMS AND and natural history exhibits, as well as some Jerusalem-Tel Aviv Highway in Lod (ancient SPECTACULAR CITY PARK brand-new attractions—among them a four- Lydda), Israel; the Legion of Honor is one of Besides the waterfront, San Francisco has story indoor rainforest adventure. only four museums to display this treasure many other fascinating neighborhoods and These are only three of Golden Gate before it is returned to the archaeological attractions that are easily accessible from Park’s landmarks; the 1,017-acre park (bigger center in Lod. Second, an exhibit entitled the Palace Hotel. A five- to ten-minute walk than New York’s Central Park) holds many “Reading the Floating World: Japanese Ukiyo- will take you to the San Francisco Museum delights and is well worth as much time as e Books from the Collection of Arthur Tress,” of Modern Art (six blocks from the hotel), the visitor can spare. The Conservatory of will portray the flowering of popular culture popular for the striking design of its architec- Flowers in Golden Gate Park will host a sum- during Japan’s Edo period (1600-1868) and ture as well as its impressive, 26,000-piece mer exhibit, “Wicked Plants: Botanical Rogues will include books with woodcut illustrations permanent collection. Those attending Ste- and Assassins,” in which visitors can meet liv- of samurai warriors, courtesans, supernatural ven Goldberg’s Friday symposium, “The ing examples of dozens of infamous plants beings, and natural wonders. Steins Collect,” will especially want to take that have left their mark on history and the private guided tour of the exhibit on Sat- claimed many an unfortunate victim. This FOR A CHANGE OF PACE urday morning, led by museum curator Janet exhibit will show that paralysis, strangulation, Consider visiting A T & T Baseball Park, Bishop. If you can’t make the tour, you can and derangement are just a few of the mis- home of the 2010 World Champion San still enjoy the exhibit during the museum’s deeds of the plant kingdom—who knew? Francisco Giants, located a short taxi ride (or regular hours, and keep in approximately a 30-minute mind that it’s open until 8:45 walk) from the conference p.m. on Thursdays. hotel. A 90-minute tour of the And while you’re in the park includes visits to the mood for art, take a Market press box, batting cage, and Street tram to the extensive dugouts, plus a chance to step Asian Art Museum, or a little out onto the field. The Giants longer bus or cab ride to the will be playing the Cincinnati DeYoung Museum of Fine Reds at A T & T Park on Arts. San Franciscans are justi- Thursday and Friday evenings fiably proud of the DeYoung, during the meeting, and again for which a new building and on Saturday and Sunday after- tower opened in 2005. noons; for tickets and park Located in Golden Gate Park, tours, visit www.sfgiants.com. the museum will feature Numerous other fascinat- “Balenciaga and Spain,” a spe- ing places await you in San cial exhibit exploring Spanish San Francisco Francisco: Union Square and culture, history, and traditions the downtown shopping dis- (including art, regional dress, the bullfight, and San Francisco’s Contemporary Jewish trict, also an easy—and level!—walk from dance) through the work of haute couture Museum, within walking distance of the con- the Palace Hotel; Coit Tower atop Telegraph master Cristóbal Balenciaga. ference hotel, will feature a new media instal- Hill; North Beach (the Italian quarter); the A visit to the DeYoung Museum can be an lation this summer entitled “Are We There Exploratorium, a first-class science and tech- occasion to explore Golden Gate Park, where Yet? 5000 Years of Answering Questions with nology museum, where you should visit the the museum is located. Right next to the Questions.” Sure to be fascinating, it poses Tactile Dome; Lombard Street, known as the museum is the refurbished Japanese Tea Gar- questions from the Torah, pop culture, and crookedest street in the world; the Palace den, so beautifully and authentically designed the public. of Fine Arts, built for the 1915 World’s Fair and maintained that it served as a scene in Don’t forget the stately Palace of the and Pan-Pacific Exposition; Japantown; Twin Japan in the 2005 film Memoirs of a Geisha. Legion of Honor in the western part of the Peaks; Fort Point; and Mission Dolores. For Directly across from the DeYoung Museum city, where you’ll no longer find the portrait more info, see the following Web site: www. is the California Academy of Sciences, com- of Carlotta Valdez that hung there in 1958 for onlyinsanfrancisco.com. And for evening pletely redone for its grand reopening in 2009. Alfred Hitchcock’s Vertigo, but you will see a entertainment ideas see: Those who remember the old Academy will number of other masterpieces. In addition to www.san-francisco-theater.com find many of their favorites in new surround- its permanent collection, this museum will www.sfsymphony.org ings, such as the excellent aquarium, the plan- host two special exhibits in June: first, a large www.sfballet.org etarium, and comprehensive Native American Roman mosaic unearthed in 1996 along the Continued on page 38

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 37 SAN FRANCISCO

The Golden Gate and (6) John’s Grill, down- Continued from page 37 town, which Jeff Miller, CEO at San Francisco Center for Psychoanalysis, says is great for “a taste of old San Fran- cisco—the Maltese Falcon and all that.” And let’s not forget the Garden Court at the conference hotel, where I’m told the crab salad is excellent—and where Green Tip of the Golden Gate Bridge Goddess salad dressing orig- inated in 1923 (invented by MOBILE NATIONAL chef Philip Roemer to honor HISTORIC LANDMARKS an actor in William Archer’s And, naturally, you can’t leave San Fran- play, The Green Goddess). Bay Bridge and Treasure Island cisco without riding a cable car, which you can board near the Palace Hotel at the foot PLAN AHEAD Former Mayor Gavin Newsom has of California Street, or at Powell and Market From a National Meeting that promises a described San Francisco as “47 square miles Streets or Ghirardelli Square. As you trundle range of intellectually stimulating presenta- surrounded by reality.” If you’re already along at 9.5 miles per hour, ask your conduc- tions and discussions, to painting, baseball, familiar with the city, you’ll appreciate that tor if the car you’re on stops at the Cable Car and goddesses, San Francisco has a lot to this description captures something of its Barn, a lesser-known museum where you can offer the visiting psychoanalyst. June is a pop- magical essence and land-of-enchantment see the giant underground cables that actu- ular tourist month, so you may want to plan quality, not to mention its unique worldview. ally move the cars. some of your activities, including restaurant If you’re gearing up for your first visit, I’m meals, in advance. A comprehensive Restau- confident that when you arrive, you’ll SAN FRANCISCO RESTAURANTS rant and Visitor’s Guide will be available on understand why San Francisco is known as Foodies will find plenty of choices to tempt the APsaA Web site in the spring. “Everybody’s Favorite City.” their palates. A small, unofficial poll of randomly selected members of San Francisco Center for Psychoanalysis (n = 10) yielded the following top two San Francisco restau- Venture out from rants: (1) Slanted Door, serving award-win- the Palace Hotel ning Vietnamese food on the waterfront, a short cab ride or about 20 minutes’ walk to visit lots of from the conference hotel (though it may be hard to get reservations there, cautions local exciting attractions analyst Mary Margaret McClure); and (2) Delfina, featuring authentic Italian specialties in San Francisco. in the Mission district. Delfina also operates an excellent pizzeria in Pacific Heights; both You can tour on foot, are a cab ride away. by antique tram, Other favorites that emerged in the poll: (3) Boulevard, on the Embarcadero, also a and ferry boat to short cab ride from the conference hotel; (4) Heirloom, in the outer Mission district (“small, discover, or rediscover, not expensive, excellent bistro-type food,” says local analyst Alan Skolnikoff); (5) Zuni the sites and charms of Café, in the Civic Center area, characterized the City by the Bay. by local analyst Sam Gerson as “a kind of cross between a bistro and hip American”);

38 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011

June Meeting Highlights Continued from page 35 Certified in Psychoanalysis More than 40 discussion groups address By the Board such diverse topics as spirituality, patients who are adoptees, Wagner’s The Ring, assisted On Professional Standards reproductive technology, and Edgar Allan Poe. Two-day clinical workshops will feature dis- January 12, 2011 cussions by Alfred S. Margulies, Patrick Miller, Shelley Orgel, and Robert A. Prosser. Adult A special highlight will be a presentation by Leo Rangell, one of the best-known and well- Nancy Blieden, Ph.D. regarded analysts of our time, at Saturday morn- Michigan Psychoanalytic Institute and Society ing’s “Coffee with a Distinguished Analyst.” As you can see, this program will capture Ian D. Buckingham, M.D. your interest by addressing many topics at New York Psychoanalytic Society and Institute the forefront of psychoanalysis today. Join Joseph Cronin, M.S.W. your colleagues this summer in San Francisco for what promises to be a stimulating and Chicago Institute for Psychoanalysis diversified meeting. Miriam Field, M.S.S., M.L.S.P. Psychoanalytic Center of Philadelphia

William C. Glover, Ph.D. Contacting the San Francisco Center for Psychoanalysis

National Office Tora Hanssen, M.D. San Francisco Center for Psychoanalysis The American Psychoanalytic Association Sheri Butler Hunt, M.D. 309 East 49th Street Seattle Psychoanalytic Society and Institute New York, NY 10017 Wendy W. Katz, Ph.D. Phone: 212-752-0450 Columbia University Center for Psychoanalytic Training and Research Fax: 212-593-0571 E-mail: [email protected] Mojgan Khademi, Psy.D. World Wide Web Site: San Diego Psychoanalytic Society and Institute http://apsa.org/ Robin Maisel, Psy.D. National Office Boston Psychoanalytic Society and Institute Voice Mail Extensions Daniel W. Prezant, Ph.D. Chris Broughton x19 New York Psychoanalytic Society and Institute Brian Canty x17 Sherkima Edwards x15 Kathleen Reicker, M.S.W. Tina Faison x23 Oregon Psychoanalytic Institute Diana Franklin x28 Carolyn Gatto x20 Child and Adolescent James Guimaraes x12 Jake Lynn x29 Daniel W. Prezant, Ph.D. Nerissa Steele-Browne x16 New York Psychoanalytic Society and Institute Dean K. Stein x30 Niki Turner x18 Maida Greenberg, Ed.D. Debbie Steinke Wardell x26 PINE Psychoanalytic Center

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 39 ACTIVE MEMBERS Janet Marie Schwind, Ph.D. Karen C. Liput, L.C.S.W. David J. Ansell, D.O. Randy A. Smith, M.D. Lisa Madsen, M.D. Scott Boles, Ph.D. Suzanne Rensel Thomas, L.M.S.W. Catherine Maihoefer, M.S., L.P.C. Susan Ellis Chance, Ph.D. Susan Turner, M.D. Matthew Markon, M.S.W. Anna Chapman, M.D. Umar Wadood, M.D. Paul V. Marshall, Th.D. Victoria B. Coburn, M.S., L.P.C. Nancy Claire Winters, M.D. Donna M. Mathias, M.D. Mark J. Corsale, M.D. Jed Yalof, Psy.D. Ilana Meller, Psy.D. Richard P. DeBenedetto, Ph.D. Shirley Milstead, L.C.S.W. Maxim J. A. de Sauma, M.D. AFFILIATE MEMBERS Barbara Mosbacher, Ph.D. Lilia Feinberg, M.D. Lou Agosta, Ph.D. Christina Mueller, M.D. Kim Liponis Foehl, M.D. Nuar Alsadir, Ph.D. Jennifer J. Nadeau, M.D. Sylvia Fogel, M.D. Jonathan Amiel, M.D. Patrick Neer, Psy.D. Stacey L. Fry, Psy.D. Johanna Arenaza, Psy.D. Jacqueline A. Neilson, Ph.D. Andrew J. Gerber, M.D., Ph.D. Carla R. Bauer, M.S.W. Deborah Offner, Ph.D. Carole T. Goldberg, Psy.D. Steven Baum, Psy.D. Alphonse Daniel Osinski, M.D. Geoffrey David Goodman, Ph.D. Meiram Bendat, J.D., M.F.T Michael Pauly, M.D. Cynthia Ellis Gray, M.D. Karen Block, M.S.W. Fred Pisoni, Psy.D. Pamela Pomeroy Greenberg, M.S.W. Jane Rowlenson Brandt Daniel Plotkin, M.D., M.P.H. Dorothy Therese Grunes, M.D. Matthew Brooks, M.S.W., L.I.C.S.W. Sabina Preter, M.D., Ph.D. Jane Hanenberg, Ed.D. Susan A. Catto, M.D. Elahe Sagart, M.D. Hilary Hatch, Ph.D. Sharon Chada, Ph.D. Shuli Sandler, Psy.D. John M. Hayes, Ph.D. Beth A. Chambers, M.D. Nadia Sawicki, M.D. Richard G. Hersh, M.D. Vittorio Comelli, Psy.D. Stephanie Schechter, Psy.D. Holly Friedman Housman, L.I.C.S.W. Jorgelina F. Corbatta, Ph.D. Katherine A. Schott, L.C.S.W. Judith P. Kane, M.D. Holly Crisp-Han, M.D. Jennifer Scroggie, A.P.R.N., B.C. Susan Kattlove, M.D. Sylvia R. Delgado, M.S. Mark C. Sexton, Ph.D. Mehmet Sagman Kayatekin, M.D. Susan Depew, L.C.S.W. J. Peter Shaft, M.S.W. Mojgan Khademi, Psy.D. Anand Desai, M.D. Nisha Navayan Shah, M.D. Elizabeth Lennihan, L.C.S.W. Nancy Dolin Dietrich, Ph.D. Kelly Shanks, M.Ed., L.M.H.C. Christian N. Linton, M.D. Eileen M. Dunn, Psy.D. Vanessa Sinclair, Psy.D. Saskia Hostetler Lippy, M.D. Flaviane Ferreira, M.D. Renee Spencer, Ph.D., M.F.T. Esther Lowenstein, Psy.D. Sara K. Gardiner, M.D. Susan Spencer, L.C.S.W. Paul E. Lynch, M.D. Emily Gastelum, M.D. Silvana Starowlansky-Kaufman, M.S.W. Robin Maisel, Psy.D. Scot Gibson, M.D. Alberta Totz, J.D. Stephen Malach, M.D. Lori Goldstein, M.D. Patricia A. Winter, L.C.S.W. Joel F. Martell, Ph.D. Wou Sang Han, M.D. Janet M. Witte, M.D., M.P.H. Ramon A. Mon, Ph.D. Howard Hao, M.D. Christopher Morse, Ph.D. Susan A. Hawkins, J.D., Psy.D. ACADEMIC ASSOCIATE MEMBERS William Olcott, M.D. Tiffany A. Hughes, M.D. Donna L. Bonan, J.D. Felecia R. Powell-Williams, Ed.D., L.P.C. Aerin Hyun, M.D., Ph.D. R. Robert Eskuchen, Jr., M.D. Emanuele Prosepe, Psy.D., Ph.D. Joshua Kane, M.D. Paul P. Roberts, M.D. Sharon E. Krikorian, Ph.D.

40 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 FIND AN ANALYST

“Find an Analyst” Web Site Feature Upgraded Jake Lynn

If you haven’t noticed it yet, there is a major HOW TO CUSTOMIZE YOUR PROFILE from the drop-down list and click the “Add” new upgrade to the APsaA Web site. The Customizing your analyst profile is quite button. These fields allow for multiple values, popular “Find an Analyst” module has been easy. Just log into the APsaA Web site by so you can continue to add all attributes completely overhauled to provide a much selecting “Member Log In” at the top right of that apply. easier search experience for those who are the home page. Enter your membership ID To remove an attribute, click the red “x” on looking for a psychoanalyst in their commu- and password and click “Log In.” the right to delete it. nity. By simply using a zip code and a mile To make changes to your name or contact You can add a photo to your profile at the radius, prospective patients will find results details, contact Brian Canty in the National end of the list of elements. Click the displayed next to a Google Map, on which Office ([email protected]), but you can “Browse” button to find an image file the location of each member’s office is update all other fields on your own. located on your computer. Select the image marked with a pin. and click “Open” to return From the search results that to the edit page. Now click match the zip code and mile the “Upload Picture” button radius, the Web site visitor can to add the image to your view the analyst’s profile. profile. APsaA members can—and When you are finished should—add to their own making changes to your profile details about their profile, scroll down to the practice which will help pro- bottom of the page and spective patients better match click “Save Your Profile.” up their needs with an analyst. Wait for confirmation that This improvement is a ter- “Your Profile Has Been rific new benefit of member- Saved,” which displays next ship as it allows members to to the button. customize their individual pro- It is now safe to navigate files with extensive informa- away from the page. tion on their specialties, Be sure to return often to interests, insurance policies, keep your profile up to date! languages spoken, and many Note—The Find an Ana- more categories. In fact, the lyst function is primarily search function (e.g., analysts designed for the general specializing in child and adoles- public to find an appropriate cent analysis, analysts who analyst. For APsaA members speak Spanish) will only be trying to find other APsaA effective for prospective members, it is suggested patients to the degree that that you use the Member- APsaA members add this ship Roster in the Members information to their profiles. Customizing Once you are logged in, scroll your mouse Section of the Web site at http://www.apsa. your profile also allows you to decide whether over “Find an Analyst” in the main menu and org/Portals/1/docs/Members/roster.pdf. you want certain pieces of information avail- select “Edit Analyst Profile” from the drop- There is an easy search function within the able to the public such as your e-mail address. down menu. Membership Roster. An important reason to Below are simple instructions for custom- Your analyst profile will open and you will use the Membership Roster (as opposed to izing your profile. For a video tutorial on the see the available fields. the Find an Analyst function) is it may include new Find an Analyst module, visit: www. You can use the check boxes along the left information (such as an e-mail address) that apsa.org/CustomizeProfile. side to choose which elements you would will not be displayed in the Find an Analyst like to display on your profile. display. If you would prefer to use the Find an You can reach Jake Lynn at [email protected] You can also add preselected attributes Analyst module, click on the Advanced or (212) 752-0450. on some of the fields. Select an attribute Search tab.

THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 41 BYLAWS

• The bylaws require that the annual meeting Streamlining of APsaA be held in conjunction with the annual meeting of the American Psychiatric APsaA’s Bylaws Association—which has not happened for Norman A. Clemens at least eight years. Our membership now includes many people trained in other pro- Good bedtime reading for insomniacs. Dry, fessions, not just psychiatry, and the timing torturous, legalistic verbiage. No one wants to of our meetings does not coincide. The spend time studying bylaws—until one of our or totally anachronistic. After careful analysis the proposed revision will be consistent with perennial controversies comes along. Then the committee reported its findings to the Execu- the current policy that APsaA chooses its bylaws are the focus of intense scrutiny and tive Council and BOPS in July 2009, and the own venue. impassioned interpretations. Ambiguities feed committee was given the green light to go ahead • Some terms, such as “affiliate” and “center,” the flames, and proposed changes stir acrimo- with a major revision to correct the problems. are used in several senses in APsaA so that nious debate. the result is confusing. In the updated Bylaws are the rules of the road in a demo- INTERNAL CONSISTENCY bylaws, affiliate members will now more cratic organization. They also govern the corpo- AND RELEVANCY accurately be named candidate members ration that functions as a legal entity. Along with The Association contracted with a profes- (a change desired and welcomed by the Robert’s Rules of Order their intent is to ensure sional parliamentarian to work with the com- leaders of the candidate organization). The stability, structure, and clarity while providing for mittee to achieve a product that would meet obsolete term, “approved training centers,” orderly, fair debate, and decision making. They parliamentary standards of organization, clarity, has been removed. need to be relevant, current, straightforward, and effectiveness in facilitating good gover- • Certain procedures for directly, by mail, and unambiguous. In many respects the current nance. The work of A Great Meeting, Inc., has seeking the members’ approval of an bylaws of the American Psychoanalytic Associa- been invaluable in revising the APsaA bylaws. action remain seriously out of compliance tion don’t altogether meet these standards. The first step in achieving this remarkable with New York law. On the recommenda- product was to reformat the bylaws to make tion of the Association’s attorney these COMPLIANCE WITH N.Y. LAW them much clearer and consistent with sound have been brought into the context of a Four years ago, APsaA’s Committee on parliamentary principles and organization, with- vote in person or by proxy in a meeting of Bylaws was given the task of bringing the bylaws out introducing any substantive changes other members, as required. into compliance with New York’s Not-for-Profit than eliminating redundant or confusing ver- Corporation Law. An ad hoc task force of the biage. After this draft was approved by the Upcoming Ballot Executive Council had worked with legal Executive Council and reviewed by BOPS in Members may read the proposed revision in experts on bylaws and identified a number of June, the Council authorized the committee to the Members’ Section of the APsaA Web site instances in which our bylaws were not com- draft substantive changes that were necessary at www.apsa.org/DraftBylaws. The committee plying with the law. The Committee on Bylaws, to eliminate anachronisms, inconsistencies, and welcomes comments and questions, directed which is appointed mutually by the president confusing terminology. to me, as chair, at [email protected]. Other and the chair of the Board on Professional Here are some examples of provisions in the members of the committee are Michael Gun- Standards and reports to both the Council and current bylaws that are anachronistic, confusing, dle, Anton Kris, Paul Mosher, Malkah Notman, BOPS, was charged to redraft numerous sec- and/or totally out of keeping with the way Warren Procci, and Robert Pyles. Sheila Hafter tions of the bylaws to achieve compliance. The APsaA works. None of the changes we recom- Gray, David Miller, Lynne Moritz, and Mary corrected bylaws were approved by the mem- mend are likely to relate to the various contro- Scharold served on this hard-working commit- bers in June 2008. versies with which APsaA members are familiar. tee at earlier stages of this process. But the committee’s work was not done. In • The bylaws describe the office of vice pres- The Executive Council approved the bylaws the course of the revision, it had found many ident: APsaA does not have a V.P. and nei- revision and BOPS voted its support in January items that were confusing, redundant, inconsis- ther will the updated bylaws. 2011. It will now be submitted to the member- tent between different parts of the bylaws, out • The bylaws allow up to five past presidents ship for a vote. If the members agree by a mar- of sync with the way the Association operates, to serve with a vote on the Executive gin of two-thirds of the votes cast in person or Council for a period of five years. The provi- by proxy at the meeting of members which Norman A. Clemens, M.D., is chair of sion was written when the term of a presi- will take place no later than June 10, 2011, the the Committee on Bylaws. He is a training dent was one year. Now that the president’s streamlined bylaws will replace the current and supervising analyst in the Cleveland term is two years, it is more appropriate to bylaws. Due to the need to have another elec- Psychoanalytic Center and a Fellow of the reduce the number of past presidents on tion for treasurer, the exact date of the mailing Board on Professional Standards. the Council to three. is yet to be determined.

42 THE AMERICAN PSYCHOANALYST • Volume 45, No. 1 • Winter/Spring 2011 Training and Supervising Analyst Appointments Announced By the Board on Professional Standards January 12, 2011 Waldorf-Astoria, New York

Training and Supervising Analysts Carmela Perri, Ph.D. Geographic Rule Supervising Analysts New York Psychoanalytic Society Ellen R. Golding, Ph.D. Richard Almond, M.D. and Institute Boston Psychoanalytic Society Oregon Psychoanalytic Center and Institute Barbara Rainwater Redinger, Ph.D. Jan C. Van Schaik, M.D. Denver Institute for Psychoanalysis Catherine Rising Kimble, M.D. Pittsburgh Psychoanalytic Center Boston Psychoanalytic Society Michael Singer, Ph.D. Kathryn J. Zerbe, M.D. and Institute Michigan Psychoanalytic Institute Greater Kansas City Richard G. Michael, Ph.D. Andrew I. Smolar, M.D. Psychoanalytic Institute Houston-Galveston Psychoanalytic Center of Philadelphia Psychoanalytic Institute Geographic Rule Child and Barry M. Miller, M.D. Geographic Rule Training Adolescent Supervising Analysts and Supervising Analyst Michigan Psychoanalytic Institute Lawrence J. Brown, Ph.D. Eric S. Millman, M.D. Rosemary H. Balsam, M.D. New Orleans-Birmingham Western New England Institute Cleveland Psychoanalytic Center Psychoanalytic Center for Psychoanalysis Jack Novick, Ph.D. New Center for Psychoanalysis I n M emoriam

Marvin L. Adland, M.D. Rose Fromm-Kirsten, Facundo P. Lima, M.D. Joseph D. Teicher, M.D. June 3, 2005* M.D., Ph.D. March 2, 2009 August 18, 2000* April 27, 2007* Bernard Brodsky, M.D. Leslie M. Luczy, M.D., Ph.D. Sanford A. Weisblatt, M.D. February 12, 1998* Eleanor Galenson, M.D. August 18, 2005* June 30, 2010 January 15, 2011 Lili R. Bussel, M.D. David R. Metcalf, M.D. Harold Winn, M.D. November 4, 2010 Floyd Bruce Galler, M.D. August 21, 2010 February 25, 2004* June 18, 2010 Helen Davidoff-Hirsch, M.D. John H. Porter III, M.D. Marianne Young, M.D. July 19, 2010 Samuel P. Hunt, M.D. November 14, 2010 January 8, 2011 July 23, 2010 Bernard L. Diamond, M.D. Frederick Shevin, M.D. *APsaA notified in 2010. November 18, 1990* Roberta K. Jaeger, M.D. November 26, 2010 December 8, 2010 Lawrence Deutsch, M.D. Alberta B. Szalita, M.D. January 30, 2011 Eli W. Lane, M.D. November 10, 2010 April 12, 2010

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