Psychoanalysis On and Off the Couch

“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.

"A number of art schools in the early 60s said: “Clearly, it is the relationship of the painter to the medium that is the essence of painting - the painter must be emotionally present, and this is what we should instill in our students.” So they started to take away traditional training in art schools of representational drawing, of color theory, of figurative drawing, and what they ended up with was a generation of artists who were passionately throwing paint at canvases but unable to make art. The relationship between the fundamentals and intuition is very complicated. Nobody seemed to make the point that the great abstract expressionists  were all trained for decades in traditional art schools. That’s what they came out of, and we see this in our analytic colleagues. Many of them are writing wonderfully at the moment, but they were trained as Kleinians or trained as ego psychologists, and they have that in their bone marrow. The kind of representational work with Apple [painting of his dog] that I am talking about when I say: I draw and I draw and I draw until I can put that aside, in analytic work I go to something basic in my training. For me it happens to be something that's close to Paul Gray, it's not where I'm going to stop, but I can use Paul Gray because that's what I was trained in - I will look for transference, I'll look for defense, I'll look for resistance and I'll go back and look for the derivatives of certain affects that are enacted in the relationship. I go over it and over it until I can relinquish it like I did with the painting of Apple, and then the intuitive comes in, but the intuitive is the reward at the end of decades of hard work."   Episode Description: We begin with Jon's mother's encouragement to paint by finding the bird's vitality through "becoming the bird." This leads us to consider the relationship between intuitive seeing and the "images which I might desire to produce." We discuss his notion of the aesthetic matrix which applies both to the analytic encounter as it does to the painter's relationship to his creative process. Jon shares with us his conviction that basic technique, whether artistic or analytic, must first become part of one's inner make-up before intuition can enlighten an obscure moment. He walks us through his creative process in the face of a blank canvas on the wall in front of him. He discusses the different uses of watercolor and oil paint and how their unique properties parallel his spontaneous engagement at various periods of an analysis. He presents a clinical encounter and how he was able to unpack a countertransference impasse through working on a painting. He closes with sharing an experience he had in his native South Africa which leads him to feel that "it's a blessing to be able to work in America."   Linked Paper and Websites: The Aesthetic Matrix: A Conversation Between a Painter and a Psychoanalyst  

"The Holocaust seems to me to be the paradigmatic case of the acting out of unconscious fears, fantasies and projections onto another group that has ever occurred. It is the place therefore for psychoanalytic concepts in understanding anti-Semitism and racism more generally. Particularly in this context and thinking about Nazism and Nazi perpetrators is crucial, especially given what for me is so interesting about this is not just thinking as a historian and how can I borrow psychoanalytic ideas to enrich the thing I am interested in explaining. Also, because the history of psychoanalysis is bound up with this history. It’s why I cited Fenichel and Loewenstein - the idea of psychoanalysis as this ‘Jewish science’, of the emigrates all persecuted by Nazism and how they restarted their lives in the US or elsewhere, the grappling with the German psychoanalysts after the war, the conflicts in the International Psychoanalytic Association after the war - these are all part of the history of the Holocaust. For me, this combination of the history of psychoanalysis as an endeavor, plus the usefulness of psychoanalytic concepts in trying  to explain this phenomenon in the first place is a hugely enriching conversation.”     Episode Description: We begin with outlining the tension within the 'complemental series' where external events and intrapsychic registration of those events are both contributors to psychic difficulties. This applies to early as well as later life traumas. Dan's book invites us to additionally consider the conflicting psychoanalytic contributions to the question of what enables survival. All research points to the essential dimension of luck in enabling survival in concentration camps. As a historian he fleshes out the contrasting viewpoints of analysts Eddy de Wind and Viktor Frankl as they each describe what they felt were the essential psychological qualities that contributed to survival. De Wind and others point to a state of stupor, also characterized as estrangement or dissociation, as an essential state of mind to facilitate surviving in overwhelming circumstances. He shares with us why he as a historian feels that an analytic way of thinking is essential as "history without psychoanalysis cannot access aspects of the human experience that elude rational thought - and there are sadly many."   Our Guest: Dan Stone, PhD, is Professor of Modern History and director of the Holocaust Research Institute at Royal Holloway, University of London, where he has taught since 1999. He is the author of numerous articles and books, including, most recently: The Holocaust: An Unfinished History; Fate Unknown: Tracing the Missing after World War II and the Holocaust; and Psychoanalysis, Historiography and the Nazi Camps: Accounting for Survival. He is also the co-editor, with Mark Roseman, of volume I of the Cambridge History of the Holocaust. Dan chaired the academic advisory committee for the Imperial War Museum London’s redesigned Holocaust Galleries (opened in 2021) and is a member of the UK’s Advisory Group on Spoliation Matters.   Recommended Readings:   Martin S. Bergmann and Milton E. Jucovy (eds.), Generations of the Holocaust (New York: Columbia University Press, 1982)   Werner Bohleber, Destructiveness, Intersubjectivity, and Trauma: The Identity Crisis of Modern Psychoanalysis (London: Routledge, 2018)   Matt Ffytche and Daniel Pick (eds.), Psychoanalysis in the Age of Totalitarianism (London: Routledge, 2016)   Dagmar Herzog, Cold War Freud: Psychoanalysis in an Age of Catastrophes (Cambridge: Cambridge University Press, 2017)   Emily A. Kuriloff, Contemporary Psychoanalysis and the Legacy of the Third Reich: History, Memory, Tradition (New York: Routledge, 2014)   Dori Laub and Andreas Hamburger (eds.), Psychoanalysis and Holocaust Testimony: Unwanted Memories of Social Trauma (London: Routledge, 2017)   Steven A. Luel and Paul Marcus (eds.), Psychoanalytic Reflections on the Holocaust: Selected Essays (New York: Ktav, 1984)   Dan Stone, Psychologists in Auschwitz: Accounting for Survival (lecture at the German Historical Institute,( London, 11 July 2024):   

Mark Solms, a neuropsychologist and author, discusses his journey to reconcile his family's vineyard with its troubling history linked to apartheid in South Africa. He emphasizes the importance of oral histories shared by black farm workers, revealing their struggles and resilience. Solms explores themes of historical trauma, counter-transference in psychotherapy, and the complexities of trust between owners and workers. Through community engagement and healing, he advocates for transforming painful legacies into collaborative futures and renewed cultural pride.

Gabriela Goldstein, Ph.D., a key figure in psychoanalysis and former president of APA, delves into the chaos of modern society and its impact on individual subjectivity. She discusses the decline of traditional authority and its implications for creativity and freedom. Goldstein highlights the importance of love over revenge in therapeutic settings and the significance of non-verbal communication. She also connects philosophical insights from Shakespeare's Hamlet to contemporary mental health challenges, emphasizing the evolving role of art and dialogue in psychoanalysis.

Roberta Satow, PhD, is a practicing psychoanalyst and former sociologist whose writing blends personal and professional reflections. In a captivating discussion, she delves into the evolution of unspoken thoughts in therapy, drawing parallels to her memoir/novel, 'Our Time is Up.' Satow also shares insights from her historical fiction inspired by Trotsky's life, revealing how culture shapes therapeutic experiences. They explore the emotional intertwining of patient and therapist, spotlighting the profound connections that deepen through shared vulnerabilities.

Jhuma Basak, PhD, an analyst from Calcutta, reveals her poignant journey through a sudden cancer diagnosis. She candidly discusses the emotional upheaval of balancing her illness with patient care, emphasizing the significance of 'honest submission' in therapy. Jhuma explores cultural beliefs about mortality in Indian society, the complexities of vulnerability in the therapeutic relationship, and how personal experiences can enhance connections with patients. Her story is a testament to the healing power of shared struggles.

Marianne Leuzinger-Bohleber, a professor specializing in the transformation of dreams in psychoanalysis, shares her personal and professional insights. She recounts her journey through grief and how her dreams evolved from nightmares to positive, problem-solving narratives during therapy. The discussion highlights the significance of dream analysis in tracking therapeutic progress, the interplay between psychoanalysis and empirical research, and the broader implications of dreams for emotional healing. Leuzinger-Bohleber emphasizes the importance of individualized approaches to therapy.