“I really think that the purpose is to make space for the unknown, uncertainty, and for our kind of humility in the face of the complexity of our belonging to the physical world. So it's our animality, our physicality, all of that is so complicated and difficult to grapple with. The unknown is uncontrollable and is a huge abyss, as we know, for everybody. I do think that I'm trying to pivot here a little bit towards meeting the patient's attempts to grapple with that unknown.”

Episode description: We begin by examining the assumptions of causality that we humans commonly invoke when faced with physical ailments. Childhood imaginings come forward during such times, and, despite being distressing, they offer comfort in the face of frightening uncertainty. Similarly, analytic theorizing has occasionally suggested certainties in the face of the unknown. This may limit the analytic space, thereby making vulnerability, fears, and new awarenesses less accessible. Sharone presents clinical material from patients with testicular cancer and lymphoma, where their psychogenic theories of etiology interfered with their medical care. We consider the distinction between patients with somatic symptoms and psychosomatic patients. We question the ability of the analytic method to uncover the origins of medical illnesses while emphasizing the importance of recognizing the "particular possibilities of our method."

Our Guest: Sharone Bergner Ph.D. is a clinical psychologist and psychoanalyst in full time private practice of psychoanalysis, psychotherapy and clinical supervision in New York City. She is a member and former faculty at the Institute for Psychoanalytic Training and Research and is Adjunct Assistant Clinical Professor and a clinical supervisor at the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis, in the Contemporary Freudian track, where she teaches a course called The Body in Analytic Reverie. She is a member of the International Psychoanalytic Association and the editorial board of The Psychoanalytic Quarterly. She has a special interest in the body/mind in relation to maternal reverie in early development, vitality, embodiment, and medical issues, having worked early in her career in a cancer hospital, with the internal medicine, OBGYN, and dermatology clinics of a large urban teaching hospital, with political refugees and with parent-child pairs.

Recommended Readings:

1. Bergner, S. (2011). Seductive Symbolism: Psychoanalysis in the Context of Oncology. Psychoanalytic Psychology 28:267-292.

2. Gottlieb, R. (2003). Psychosomatic medicine: the divergent legacies of Freud and Janet. Journal of the American Psychoanalytic Association, 51:857-881.

3. Winnicott, D.W. (1966). Psycho-Somatic illness in its positive and negative aspects. International Journal of Psychoanalysis, 47:510-516.

4. Lombardi, R. (2017). Body-Mind Dissociation in Psychoanalysis: Developments After Bion. Routledge.

5. Lemma, A. (2015). Minding the Body: The Body in Psychoanalysis and Beyond. Routledge.

6. Miller, P. (2014). Driving Soma: A Transformational Process in the Analytic Encounter. London: Karnac. Not to be missed: case vignette: Recalling a Challenging Analytic Case, pp. xxvi-xxxviii

5.23 Cixi (2) Reigning in the Regencies