Psychoanalysis On and Off the Couch

“The theme that I found with IPSO [International Psychoanalytical Studies Organization] was that there was a common theme [in psychoanalytic training].  There was an initial phase full of terror and excitement, and then a middle phase of maybe some lethargy or apathy or disillusionment. In that middle phase, many candidates found IPSO, or IPSO found them, where they found refuge. They found solace. They found community, not just at their local institutes, but at this kind of world market. Many of the candidates talk about what a timely and wonderful experience it was to be seen, to be validated by fellow candidates in a way that only fellow candidates can do. At least a couple of the authors have written about how they were delighted to see that more than anything else we are similar as human beings, no matter where we're from.”  Episode Description:  We begin with recognizing the deep attachment that many analytic candidates have about their training experiences, which includes affections and resentments. Himanshu outlines the process of reaching out to candidates globally, inviting them to share their reflections on their journeys. We read from a sampling of their essays that eloquently describe their idealizations and de-idealizations, their delights and their burdens, their profound regard for the mysteries of the mind and the appreciation of the power of psychoanalysis to engage with it. We discuss the importance of IPSO, the difficulties associated with Covid and the relevance of our field's traumatic origins. Himanshu closes with sharing his story of encountering an insightful analytic supervisor during his residency and declaring "I want to be like him." Linked Episode:Episode 89: Wisdom and Enthusiasm for Today’s Candidates with Fred Busch, PhD   Our Guest: Himanshu Agrawal, MD is an adult and child psychiatrist and recently completed psychoanalytic training through the Minnesota Psychoanalytic Institute. He is an associate professor of psychiatry and behavioral medicine at the Medical College of Wisconsin in Milwaukee where he sees patients, conducts research, and teaches. He recently completed his term as the president of the candidates’ council of the American Psychoanalytic Association Recommended Readings: Busch F (Ed), Dear candidate. Routledge, 2020   Agrawal H,  Trials and Tribulations of being a candidate. The American Psychoanalyst, winter 2022   Kernberg O, Thirty methods to destroy the creativity of psychoanalytic candidates. International Journal of psychoanalysis, 77, 1031- 1040

Stefano Bolognini, a prominent psychiatrist and former IPA president, shares insights on the evolving landscape of psychoanalysis. He discusses the shift from internal conflicts to contemporary issues of self-perception driven by societal pressures. Bolognini emphasizes the importance of long-term therapeutic relationships, highlighting how transformation in a patient can emerge from deep engagement with their internal world. The conversation touches on the impact of modern family dynamics and the need for personalized care in navigating the complexities of identity.

“The original papers that were written about the analyst’s unconscious being attuned to the patient's unconscious  by Hyman and Racker, in both cases they talk about this phenomenon. But both of them utter a caution, which is that one always has to take into account one's own ‘mishegas’.  Essentially, what they're saying is, the unconscious is pretty individualistic and we have our own things, and we have to consider that possibly it's our own difficulties, our own unconscious, that is playing a bigger role in our countertransference reaction to the patient's unconscious.” Episode Description: We begin by discussing the meaning of the many italics throughout the book and my sense of their being an expression of Fred's wish to be carefully understood. This is part of our conversation where we examine how internal reactions are used to comprehend another person's mind. There are a number of themes to this work, and to Fred's contributions over the years, which focus on helping individuals understand the way their mind works, as distinct from the particular contents of their mind. One of the gifts of psychoanalysis is to facilitate patient's discovery of the freedom to think which allows for a post-termination capacity for self-analysis. We discuss how self-criticism can serve as an unconscious lifeline, the importance of attending to the need for silence as distinct from what is not being said and the seductiveness of gossip, to name but a few of the topics in the book that we cover. Fred closes by describing "The wonderful thing about being a psychoanalyst is there are always things to learn and ways to grow."   Our Guest: Fred Busch, Ph.D. is a Training and Supervising Analyst at the Boston Psychoanalytic Society and Institute. He has published eight books, and over 80 articles on psychoanalytic technique, along with many book reviews and chapters in books.  His work has been translated into many languages, and he has been invited to present over 180 papers and clinical workshops nationally and internationally. His last six books are: Creating a Psychoanalytic Mind (2014); The Analyst’s Reveries: Explorations in Bion’s Enigmatic Concept (2019); Dear Candidate: Analyst From Around the World Offer Personal Reflections on Psychoanalytic Training, Education, and the Profession (2020); A Fresh Look at Psychoanalytic Technique (2021), Psychoanalysis at the Crossroads: An International Perspective (2023).The Ego and Id: 100 years later (2023), How Does Analysis Cure? (2024).   Recommended Readings: Busch, F. (2014). Creating a Psychoanalytic Mind: A Psychoanalytic Method and Theory. London: Routledge.   Busch, F. (2019). The Analyst’s Reveries: Explorations in Bion’s Enigmatic Concept. London: Routledge.   Busch, F. (2021). A Fresh Look at Psychoanalytic Technique: Selected papers on Psychoanalysis. Routledge: London.   Busch, F. (2023) The Significance of the Ego in “The Ego and the Id” and its Unfulfilled Promise. International Journal of Psychoanalysis 104:1077-1090.   Busch, F. (2000). What is a deep interpretation? J. Amer. Psychoanal.Assn., 48:238-254.   Busch, F. (2005). Conflict Theory/Trauma Theory. Psychoanal.Q., 74: 27-46.   Busch, F. (2006). A shadow concept. Int.J.Psychoanal.,87: 1471-1485. Also appearing as Un oncerto ombra, Psycoanalisi, 11:5-26.   Busch, F. (2015). Our Vital Profession*. Int. J. Psycho-Anal., 96(3):553-568. Reprinted in Busch, F. (2015). La nostra professione vitale. Rivista Psicoanal., 61(2):435-456; Busch, F. (2015). Nuestra profesión vital*. Int. J. Psycho-Anal. Es., 1(3):605-627; Busch, F. (2015). Nuestra profesión vital1. Rev. Psicoanál. Asoc. Psico. Madrid, 75:131-153.  

David Black, a retired fellow of the British Psychoanalytical Society, dives into the intersection of psychoanalysis and religion. He discusses Freud's perspective of religion as a protective illusion against life's uncertainties. Black highlights Levinas's call for ethical recognition of the 'other,' emphasizing our interconnectedness. The conversation shifts to the dangers of dogmatism in religion versus the poetic depth of allegory, drawing parallels with Dante's works. Ultimately, he reflects on how personal trauma shapes identity and ethical responsibility.

“There are very specific fears that people have that are specifically related to their own childhood, and I'd like to give an example. A mom with twins had a kidnapping fear. She was afraid every time she saw a car drive by her house that her twins would be kidnapped. Now this mother was herself adopted when she was a newborn, but her adoption did not become final until she was one year old. Her twins were approaching one year. I was struck by the anniversary of her fear of kidnapping, and when I asked her who she thought was driving the car that drove by her house, she blurted out, 'my biological mother - adoption was never an issue for me, I have the best parents,' she said, but her fears about her babies being kidnapped were rooted in her own guilty feelings. She said, 'I get to keep my biological babies and my biological mother did not. I can have biological babies and my adoptive mother could not.' Carrie’s fantasy that her biological mother was threatening to kidnap her babies represented both her fears of retaliation for her aggressive victories over both her biological mother and her adoptive mother, and the repair of her disavowed feeling of loss by a reunion with her biological mother. This meaning of the memory, this understanding of the memory, resolved her kidnapping fear. It dissolved.” Episode Description: We begin with an overview of the importance of mothers' childhood memories in their experience of their own children. These memories are of the conscious sort and also the not-so conscious. They are of the loving as well as the misattuned versions. "The challenge for mothers is to understand the complexity of their own childhood memories and to help their babies and toddlers adapt to the everyday ups and downs of life, as well as to the exceptional ones." We discuss typical fears, sleep problems, 'mutually-regulated patterns', naming body parts, nakedness, weaning and screen time. Ilene ran mother-baby-toddler groups for 35 years and shares with us her relentless curiosity for what we all bring to the parenting experience.   Our Guest: In 1982, Ilene Lefcourt established the Sackler Lefcourt Center for Child Development - programs for parents and their children from birth to three years. She was the Director, led the Mother-Baby-Toddler Groups, and provided Developmental Consultation to parents for over 35 years. She saw over 1,000 families and taught Child Psychiatry Residents and Parent-Infant Psychotherapy Trainees about her work. She has been a faculty member at the Columbia Psychoanalytic Center since 1995. Ms. Lefcourt is currently in private practice in New York City. She is the author of When Mothers Talk, Parenting and Childhood Memories, and Mother-Baby-Toddler Group Guide. Her forthcoming book is, Mothers and Daughters: The First Three Years. Visit Ilene’s website: http://ilenelefcourt.com/.      Recommended Readings: 1975, Fraiberg S. Adelson E., Shapiro V., Ghosts in the Nursery,  Journal of the American Academy of Child Psychiatry, 14, 387-421   1975, Mahler, M., F. and Bergman, A. The Psychological Birth of the Human Infant, Basic Books   1985, Main, M. Kaplan, N. Cassidy, J. Security in Infancy, Childhood, and Adulthood: A move to the Level of Representation. Monographs of the Society for Research in Child Development   1991, Fonagy, P., Steele, M., Steele,H., Moran, G. S . The Capacity for Understanding Mental States. Infant Mental Health Journal, 12(3) 201-218   1992, Bretherton, I. The Origins of Attachment Theory. Developmental Psychology, 28(5) 759-775   1993, Lieberman, A ., The Emotional Life of the Toddler, Simon and Schuster    1995, Stern, D. The Motherhood Constellation, Basic Books   1998, Stern, D., Brushwweiler-Stern, N. The Birth of a Mother. Basic Books   2005, Lieberman, A., Angels in The Nursery, Infant Mental Health Journal. Vol. 26(6)   

Ashis Roy, a psychoanalyst from Kolkata, specializes in Hindu-Muslim relationships and discusses his book, Intimacy in Alienation. He explores the guilt and alienation felt by those in interfaith love, delving into the harmful concept of 'malignant othering.' Roy emphasizes the need for supportive familial structures and the impact of historical trauma on identity formation in interfaith families. He argues that transcending binaries is essential for a renewed understanding of communal identities, advocating for deeper connections that foster healing.

“I belong to the race that in the Middle Ages was blamed for all the plagues and such experiences have a sobering effect, and they do not arouse the tendency to believe in illusions. Much of my life has been devoted to trying to shed illusions. But if there is an illusion worth believing in, at least partially, this is the illusion: that we learn how to divert the impulse of destruction from our own kind, how to stop hating each other because of trivial differences, and stop killing each other for profits. That we stop taking advantage of the achievements of progress to control the forces of nature in a way that will lead to our destruction. Without this illusion, what future awaits us?”  Sigmund Freud, Letter to Romain Rolland, 1923 “I found [this letter] in the collection that Eran Rolnik translated into Hebrew. I met it in the Hebrew version, and when I got back to the German, something else happened. In the Hebrew translation it was talking about the ‘hope’. But then the people in Vienna told me in German this is not ‘hope’, this is ‘illusion’. I thought it is even more powerful that he speaks about the power of illusion, the needed illusion. It also brought me back to the beginning of my journey when a friend said the main purpose of the film is to have Freud telling us something like the ‘big father’, how should we live today? A tip and insight from Freud. So this is an insight from Freud, a message from Freud over time to us now. I'm not sure it's prophetic. I think there's no prophecies, but it speaks to us now. It speaks to us now.”  Episode Description: We begin with an opening quote from Freud that characterized his sense of being an 'outsider'. Yair then shares with us his own personal journey of discovering Freud as distinct from his father. Having some analytic exposure awakened in him the capacity to, like Freud, ignite his creativity and discover Freud anew. Unique among the many Freud documentaries, Yair utilizes 3D animation techniques as well as dreamlike imagery, newly uncovered archival film and evocative music to invite the viewer to regressively experience the possibilities of the unconscious. We go through four periods of Freud's life which include his struggles with Viennese antisemitism, his discovery of the role of childhood sexuality, his illness and the deaths of his father, daughter, granddaughter and mother and his exile to London. We conclude with his 1923 letter to Romain Rolland where he pleads "that we stop taking advantage of the achievements of progress to control the forces of nature in a way that will lead to our destruction.”    Our Guest: Yair Qedar is an Israeli documentary filmmaker, social activist and former journalist. In his project "the Hebrews", he had been chronicling the lives of Jewish and Israeli figures of the modern Hebrew literary canon. Qedar's 19 feature length documentaries have all premiered at film festivals and have won the director over 30 prizes. Also, Qedar is a leading LGBTQ activist and created the first Israeli LGBTQ newspaper.   To View the Film: This documentary was first shown at the Sigmund Freud Museum in Vienna on January 9th, 2025. It is currently being screened at film festivals worldwide. To arrange a viewing, please contact Yair Qedar at quedary@gmail.com    Website and Trailer: https://ivrim.co.il/en/films/outsider-freud/     Recommended Readings: Adam Phillips (2014): Becoming Freud: The Making of a Psychoanalyst. Yale University Press. Ernest Jones (1953): The Life and Work of Sigmund Freud. Basic Books. Sigmund Freud (1926): The Ego and the Id. Standard Edition, Vol. XIX, Hogarth Press. Sigmund Freud (1937): Letter from Sigmund Freud to Marie Bonaparte  Sigmund Freud (1929): Letter to Romain Rolland 

“I've had the experience of having some wonderful supervisees, many of whom have done quite fine work and where it has not been an issue of any kind of great concerns. And allowing the candidate to see what's written and also discussing it with them, obviously makes it quite easy for them to get both positive input, but also at times, input that will help them evolve and deepen their work even more.”  Episode Description: We begin by exploring the critical role of case writing in psychoanalytic training, discussing Stephen’s concept of "a fourth pillar of analytic training." Stephen introduces the dynamic interplay between writing and self-reflection, arguing that the act of writing illuminates resistances, countertransference, and areas of growth that might elude the analyst in supervision or personal analysis. He shares his innovative "three-minute chess match" technique for identifying the heart of a case narrative and reflects on his journey—from his mother’s poetry to his current work mentoring candidates in the art of case writing. We explore Stephen’s insights on the 're-immersion anxiety' that can inhibit case writing, and how addressing these resistances transforms the writing process and deepens clinical work. We conclude with a discussion of how the process of writing fosters an enduring capacity for self-supervision and analytic insight.   Our Guest: Dr. Stephen Bernstein, MD is a Training and Supervising Analyst at the Boston Psychoanalytic Society and Institute and has chaired a discussion group on writing about analytic cases for over 30 years. He is a prolific author, including his recent paper, The Process of Case Writing: A Fourth Pillar of Analytic Training, published in the Journal of the American Psychoanalytic Association. Dr. Bernstein’s work highlights the centrality of case writing as an essential tool for self-reflection and professional development. Beyond his focus on writing, he has contributed to the field with early research demonstrating the compatibility of preparatory psychotherapy with psychoanalysis and continues to mentor candidates, fostering their growth as analysts and writers.   Recommended Readings: Bernstein, S. (2023). The Process of Case Writing: A Fourth Pillar of Analytic Training. Journal of the American Psychoanalytic Association. Gabbard, G. O. (2000). Disguise or Consent? Problems and Recommendations Concerning the Publication and Presentation of Clinical Material. International Journal of Psychoanalysis, 81, 1071-1086. Kantrowitz, J. L. (2004). Writing About Patients: I. Ways of Protecting Confidentiality and Analysts' Conflicts Over Choice of Method. Journal of the American Psychoanalytic Association, 52, 69-99. Stimmel, B. (2013). The Conundrum of Confidentiality. Canadian Journal of Psychoanalysis, 21(1), 84-106. Stein, M. H. (1988). Writing About Psychoanalysis: II. Analysts Who Write, Patients Who Read. Journal of the American Psychoanalytic Association, 36, 393-408.  

Joyce Slochower, Professor Emerita of Psychology at Hunter College and author of "Psychoanalysis and the Unspoken," discusses the profound impact of collective mourning rituals on personal and communal healing. She explores how early psychoanalysis often overlooked the value of attachment and shared experiences in grief. Joyce reflects on the evolution of therapeutic practices, the complexities of post-treatment relationships, and the ethical challenges analysts face as they balance personal needs with patient care while navigating their own aging process.

"What Freud may have missed here is that the investment in the lost object is a much more reconstructive and integrative process. It’s one where we remember all the stories that we have heard from the lost object - the repetitive stories about the childhood of the person or how they met significant others and all these stories are within us and revived, and we have questions. We think: ‘Too bad I never asked about this or that’ and in activating these memories we also experience joy and we have a slow process of integration which is not necessarily about loss but about how continuous this person lives in our mind and that is a little bit the focus of this novel. It's in that sense a portrait of the mind and the process of mourning."    Episode Description: We begin with recognizing Cordelia's contributions to clinical and theoretical psychoanalysis in addition to her fiction writing. Her latest novel, Memento, has been described as "a journey through the labyrinth of the dream world" and invites the reader into the experiences of ambiguity, timelessness, and the absurd. On a theoretical level, Cordelia introduces the usefulness of the term lethe - the river in the underworld of Hades that causes people to forget their past when they drink from it. We discuss the distinction between libido and lethe and how they manifest themselves in the analytic setting. She emphasizes the importance of understanding aggression not as a stand-alone but as a container of further meaning. We close with her sharing her childhood story of wanting to please her father with her detailed knowledge - a sublimation that she continues to gain pleasure from to this day.   Our Guest: Cordelia Schmidt-Hellerau, Ph.D.,  is a Training and Supervising Analyst and on the Faculty of the Boston Psychoanalytic Society and Institute as well as of the Swiss Psychoanalytic Society. Her area of expertise is metapsychology, in particular drive theory and its clinical applications. An updated version of her monograph of Freud's metapsychology, Life Drive & Death Drive, Libido & Lethe, is just being published by International Psychoanalytic Books. Her psychoanalytic books and articles have been published in many languages. She has also published three novels and edited a Freud Reader, an Essay Book, and three collections of Short Stories. She is the Chair of the IPA in Culture Committee and works in private practice in Brookline, Massachusetts.   Recommended Readings: Freud, S (1917) Morning and Melancholia. In Freud, S. Standard Edition, Vol IVX,     239 258   Schmidt-Hellerau, C. (2018) Driven to Survive. Selected Papers Psychoanalysis.      New York: International, Psychoanalytic Books.   Schmidt-Hellerau, C. (2020) Memory’s Eyes. A New-York Oedipus Novel. Queens, NY: International Psychoanalytic Books.   Schmidt-Hellerau, C. (2023) Memento. A Novel in Dreams, Thoughts, and Images. New York: International Psychoanalytic Books.   Schmidt-Hellerau, C. (2024) Life Drive & Death Drive, Libido & Lethe. A clear road through Freud's metapsychology leading to helpful findings and new concepts. New York: International Psychoanalytic Books.