Psychoanalysis On and Off the Couch

Jan Abrams, a psychologist who emphasizes being present and engaged with patients, discusses her understanding of Winnicott and how he broadened Freudian thinking. She explores the importance of listening without preconceived ideas and the link between psychoanalysis and objectivity. Other topics include the significance of in-person sessions in psychoanalysis, deep analysis, the role of the mother, and exploring the fear of woman and its impact on a child's mind.

Karen Dougherty, a filmmaker and psychoanalyst, discusses her journey from documentary filmmaking to psychoanalysis. She explores the intersections between these two fields and emphasizes the importance of reaching a wider audience. They delve into the concept of transference onto the camera lens, the role of documentary filmmakers as activists, and the use of YouTube to create accessible content. The podcast also touches on the evolution of cinema verité and the promotion of psychoanalysis through various platforms, including podcasts and social media.

Nathan Szajnberg, MD discusses the connection between mourning and creativity, influenced by his parents' losses in the Holocaust. He explores the role of religion in psychoanalysis, similarities between Maimonides and Freud, and the importance of hidden meanings in religious practices. The link between mourning and creative expression is also examined.

Exploring the biological basis of conscience versus socially constructed values, emphasizing core ethics of life, truth, love, and kindness. Distinguishing between super ego and conscience in therapy, discussing empathy and sympathy. Speaker's dynamic relationship with God and conscience, challenges in psychoanalysis on unconscious processes vs. social constructivism, contrasting superego and conscience roles in deterring empathy.

Stefano Bolognini, MD, a seasoned psychiatrist and former president of the Italian Psychoanalytic Society, shares insights on contemporary psychoanalysis. He discusses how modern patients exhibit reluctance towards dependence, showcasing trends of narcissism and pseudo-autonomy. Bolognini highlights the evolution in analysts' understanding of countertransference, emphasizing the importance of long training analyses. He also reflects on the shared human experience of seeking help, rooted in personal journeys and familial dynamics.

"Technology is based on the premise that there can be an optimization of things through algorithmic understanding. 'Ones and zeros' data can be manipulated and thus produce an optimal outcome which is a lovely idea for certain kinds of things. It's not necessarily, in my opinion, the best idea for the psyche or for happiness or for developing a life that's meaningful. I think a psychological mindset is slightly different in that our colleagues are really concerned with being with the person, making meanings, suffering sometimes through difficult things, so there isn't just an automatic assumption as there is in the tech mindset that we're trying to optimize for whatever it is that's good. It becomes very philosophical in the end… What is optimized? What is good? Why should we do it? There are all these kinds of questions that one may ask the technology mindset person: Why would we want to hack our nutrition or our mental health in order to become stronger or better? It is a little problematic, I think, as an end goal." Episode Description: Nicolle begins by describing her journey from being a math teacher in the inner city to then becoming a consultant in the early days of the tech revolution. She shares the ethical concerns that led her to shift her interest to the mental health field and her eventually becoming Dean of the School of Professional Psychology and Health at California Institute of Integral Studies. While there she observed that "analysts think differently." This led her to seek to train as an analyst while also utilizing her familiarity with the tech mindset to create bridges with those in each field. We discuss the differences in ways of thinking between technologically immersed individuals and those with a psychological orientation - keeping in mind that each has much to learn from the other. We consider the dangers in the developing technological world, which include matters of privacy, distractedness, and a capacity to sit with suffering. We close with Nicolle sharing her vision for the future, which includes analysts playing a part in developing ethical approaches to the upcoming new developments. Her podcast is titled Technology and the Mind. Our Guest: Nicolle Zapien, Ph.D. is a licensed MFT with 20 years of clinical experience. She is a post-seminar candidate at the Psychoanalytic Institute of Northern California (PINC). She serves on the Ethics committee and the Visiting Scholar committee at PINC and also on APsA's committee for public information. From 2015 to 2019, Dr. Zapien served as Professor and Dean of the School of Professional Psychology and Health at California Institute of Integral Studies, overseeing 6 clinical training degree programs and 5 training clinics. There, she served on the IRB and chaired the research committee. Prior to her clinical work, Dr. Zapien spent a decade as a consultant designing, conducting, and/or overseeing over 200 quantitative and/or qualitative studies for industry clients and non-profits. Some of these studies employed user experience and human factors design methods to optimize the user experiences of technology products and services delivered via smartphones, tablets, websites, or kiosks. She has authored 2 books and several academic articles on themes associated with human decision-making, ethics, and phenomenology. Recommended Readings: Bednar, K., & Spiekermann, S. (2022). Eliciting Values for Technology Design with Moral Philosophy: An Empirical Exploration of Effects and Shortcomings. Science, Technology, & Human Values. Frankel, R. & Krebs, V. (2022). Human Virtuality and Digital Life: Philosophical and Psychoanalytic Investigations. Routledge: New York, NY. Greenfield. A. (2021). Radical Technologies: The Design of Everyday Life. Verso: New York, NY. Marshall, Brandeis Hill (2023). Data Conscience: Algorithmic S1ege on our Humanity.John Wiley & Sons: Hoboken, NJ. Millar, I. (2021). The Psychoanalysis of Artificial Intelligence. Palgrave MacMillian: Cham, Switzerland. Turkle, S. (2022) The Empathy Diaries. Penguin Press: New York, NY.

"In divorce it's fundamental that even though the couple ends, there's not an end to the family. We still owe a debt to the other - that other who offered to love us, who we had the opportunity to love, our debt to the children of that union. We are irrevocably called to ethics and to the continuing sense of responsibility to that other. Even though the marriage doesn't survive, the family needs to. In the high - conflict scenario, not only does the marriage not survive, often the family doesn't as well. In that sense it is profoundly unethical. So when I attempt to work with people in that situation, I always do so from an ethical perspective - ethical in the sense of creating a third, so that you try and enter into that system, but it has to be a profoundly ethical presence which I also find is distinctly psychoanalytic. I think our method is saturated with ethics without even realizing it, we're always thinking in ethical terms, managing transference, powerful forces within analytic relationship - it's a profoundly ethical task that we do. In that sense we also serve as witnesses to what our patients have experienced. The witnessing is also a kind of engagement and we try to do that when we work with people in the high-conflict position." Episode Description: We begin by distinguishing high-conflict divorce from less malignant versions. Arthur has found that high-conflict divorce is characterized by a particular timeless destructiveness that lacks regard for the sense of the family or the history of affection that had existed within and between the individuals. He has noted an experience of overwhelming disillusionment in the histories of those who are unable to mourn and instead remain immersed in vendetta seeking. We discuss the role of ethics, witnessing, and the capacity for the 'third' in these couples. Arthur shares with us his clinical experience with same-sex couples as well as with the unfortunate scenarios of alienated children who attempt to bolster the fragile capacities of one parent by refusing any contact with the other. He concludes by describing that his attention to the inner realities of these individuals is what he uniquely brings as a psychoanalyst to these often behaviorally tumultuous human tragedies. Our Guest: Arthur Leonoff, Ph.D., is a psychologist and Supervising & Training Analyst of the Canadian Psychoanalytic Society. He is a past president and recipient of his Society's Citation of Merit. He is also an Honorary member of the American Psychoanalytic Association. Dr. Leonoff was the first president of the North American Psychoanalytic Confederation. He currently is chair of the IPA Committee International New Groups.Dr. Leonoff has maintained a private psychoanalytic practice for more than four decades. He is an active clinician, teacher, supervisor, and presenter, as well as author. Recently he has contributed to two edited volumes, Dear Candidate and Psychoanalysis at the Crossroads. He has written on diverse subjects of clinical interest, including the kindling of metaphor in recovering from the impact of early complex psychic trauma.In addition to his psychoanalytic practice, Dr. Leonoff has worked extensively as a consultant and expert witness to the Canadian courts on the confluence of psychopathology and high-conflict divorce. He is the author of three books in this field, most recently The Good Divorce (2015) and When Divorces Fail, Disillusionment, Destructivity & High Conflict Divorce (2021), The Good Divorce has been revised and republished as The Ethical Divorce, which is available from Friesen Press. Recommended Readings: Leonoff, A (2021). When Divorces Fail: Disillusionment, Destructivity, and High Conflict Divorce. Rowman & Littlefield. Leonoff, A. (2021) The Ethical Divorce: A Psychoanalyst's Guide to Separation, Divorce, and Childcare. Friesen Press. Fidler, B. and Bala, N. (2020). Conclusions, concepts, controversies, and conundrums of "alienation:" Lessons learned in a decade and reflections on challenges ahead, Family Court Review, 58(2). 576-603. Greenberg, L., Fidler, B. and Saini, M.A. (Eds). (2019). Evidence-Informed Interventions for Court-Involved Families: Promoting Healthy Coping and Development, Oxford University Press. Levinas, E. (1985). Ethics and Infinity: Conversations with Philippe Nemo (R.A. Cohen, Trans.). Duquesne University Press. Wallerstein, J. and Kelly, J. (1980). Surviving the Breakup: How children and Parents cope with Divorce. Basic Books.

"The basic principle in defense analysis is that one approaches what is going on right now - it's an experience-near technique. You don't make conjectures about what would be called experience-distant phenomenon until you have a lot of material, a lot of knowledge about the patient. As the treatment goes on you really stick with what the patient is doing right now." Episode Description: Leon shares with us what he sees as the fundamental method of analytic treatment, which "regardless of the manifest theoretical orientation of the therapist ... are effectively utilizing the technique of interpreting defenses against unwelcome affects." He emphasizes the importance of being interested in the patient's defenses and less so the warded-off content. We consider the term 'protection' in place of 'defense'; how these interventions are an amalgam of clarification and interpretation; and the source of the bad reputation that attaches to the concept of 'defense interpretation'. He shares with us how this approach links with the neurosciences and the concept of implicit emotion regulation. We discuss the work of Berta Bornstein, who introduced the importance of defending against unpleasant affects. He discusses two cases of disruptive children and their use of aggression in an effort to avoid sadness and loneliness. We close with his sharing his view of our field and his conclusion that "analysis will survive - it's too powerful a tool." Our Guest: Leon Hoffman, MD, is a psychiatrist and child and adolescent psychiatrist. He is a Training and Supervising Analyst at the New York Psychoanalytic Society and Institute. He is the Co-Director of the Pacella Research Center of NYSI. Among many publications, he is co-author with Timothy Rice and Tracy Prout of Regulation Focused Psychotherapy for Children (RFP-C): A Psychodynamic Approach and with Timothy Rice Defense Mechanisms and Implicit Emotion Regulation: A Comparison of a Psychodynamic Construct with One from Contemporary Neuroscience. In 2022, he presented the Norbert and Charlotte Rieger Psychodynamic Psychotherapy lecture at the American Academy of Child and Adolescent Psychiatry on "Helping Parents Spare the Rod: Addressing Their Unbearable Emotions" based on a paper he authored with Tracy Prout. He presented the Paulina Kernberg Memorial Lecture at Weill Cornell Medicine Child & Adolescent Psychiatry Grand Rounds. On Regulation Focused Psychotherapy: An evidence-based psychodynamic treatment for children with disruptive behaviors. And The Bruce A. Gibbard Lectureship in Psychiatry, University of Vermont, Department of Psychiatry. Linked Episode: Episode 38: A Psychoanalyst Studies 'Why is it easier to get mad than it is to feel sad?' with Leon Hoffman Recommended Readings: 1. Hoffman, L. (2007) Do Children Get Better When We Interpret Their Defenses Against Painful Feelings? Psychoanalytic Study of the Child 62:291-313. 2. Hoffman, L. (2014). Berta Bornstein's Frankie: The Contemporary Relevance of a Classic to the Treatment of Children with Disruptive Symptoms. The Psychoanalytic Study of the Child 68:152-176 3. Rice, T. R., & Hoffman, L. (2014). Defense mechanisms and implicit emotion regulation: a comparison of a psychodynamic construct with one from contemporary neuroscience. Journal of the American Psychoanalytic Association, 62(4), 693-708. 4. Prout, T. A., Rice, T., Chung, H., Gorokhovsky, Y., Murphy, S., & Hoffman, L. (2021) Randomized controlled trial of Regulation Focused Psychotherapy for Children: A manualized psychodynamic treatment for externalizing behaviors. Psychotherapy Research, 32(5), 555-570. 5. Hoffman, L. (2020). How can I help you? Dimensional versus categorical distinctions in the assessment for child analysis and child psychotherapy. Journal of Infant, Child, and Adolescent Psychotherapy, 19(1), 1-15. 6. Leon Hoffman, Tracy A. Prout, Timothy Rice & Margo Bernstein (2023): Addressing Emotion Regulation with Children: Play, Verbalization of Feelings, and Reappraisal, Journal of Infant, Child, and Adolescent Psychotherapy, DOI: 10.1080/15289168.2023.2165874 7. Prout, T. A., Malone, A., Rice, T., & Hoffman, L. (2019). Resilience, defenses, and implicit emotion regulation in psychodynamic child psychotherapy. Journal of Contemporary Psychotherapy, 49(4). 235-244. 8. Hoffman, L., & Prout, T. A. (2020). Helping parents spare the rod: Addressing their unbearable emotions. Psychoanalytic Study of the Child, 73(1), 46-61.

"He [Bernays] proposed to his uncle that he'd do a translation of this book that had been given to him and Freud, perhaps without thinking too much about it, approved the idea. Bernays went about hiring a translator who was a psychology Ph.D. student that he found at Columbia University and he got Stanley Hall to write an introduction for what was published in 1920 as 'A General Introduction to Psychoanalysis'. Now, shortly after this happened, Freud had second thoughts about authorizing Bernays to translate his lectures, particularly as he had been working with his trusted colleague Ernest Jones on translations. But by the time Freud wired Bernays to try to stop this publication, Bernays said that it was already too late and that the advertisements had already been placed and the publication was proceeding. Bernays assured Freud that it would be all right and he also assured him that he would get fame and glory and also substantial recompense for the publication. Freud was not too happy about this, nor was Ernest Jones, and when they finally received the translation that Bernays had done they were particularly upset." Episode Description: We begin by describing the complicated bloodline between Freud and Edward Bernays - Bernays' mother was Freud's sister, and his father was the brother of Freud's wife. We then consider Bernays' role as the founder of the field of public relations. This has led many to inaccurately see him as a manipulator of the masses through the use of his uncle's theories. In fact, Bernays served as the pro-bono literary agent for Freud's books in the US which contributed to his popularization and to providing vital financial support during the years of Austria's hyperinflation. We also discuss Bernays' role in the American pro-democracy movement, which was designed to counter the influence of Nazi propaganda in the years before WWII. We close with Joseph's describing his interest in this subject and his wish to "set the record straight" about Edward Bernays. Our Guest: Joseph Malherek is a historian who holds a Ph.D. in American Studies from George Washington University in Washington, D.C. He was the Junior Botstiber Fellow at the Institute for Advanced Study at Central European University, and he has been a Fulbright Visiting Professor of Austrian-American Studies at the University of Vienna. He has published widely on the topics of transatlantic migration, twentieth-century intellectual history, and the history of capitalism and consumer culture. His book, Free-Market Socialists: European Émigrés Who Made Capitalist Culture in America, 1918–1968, was recently published by Central European University Press. Linked Paper: https://www.euppublishing.com/doi/abs/10.3366/pah.2023.0452?journalCode=pah Recommended Readings: Freud's American Nephew: Edward Bernays and the Selling of Psychoanalysis. Psychoanalysis and History 25, no. 1 (2023): 59–78. Bernays, Edward L. (1923) Crystallizing Public Opinion. New York: Boni and Liveright. Bernays, Edward L. (1965) Biography of an Idea: Memoirs of Public Relations Counsel Edward L. Bernays. New York: Simon and Schuster. Freud, Sigmund. (1920) A General Introduction to Psychoanalysis. New York: Horace Liveright. Gay, Peter. (1988) Freud: A Life for Our Time. New York: W.W. Norton. Lippmann, Walter. (1922) Public Opinion. New York: Harcourt, Brace and Company. Roudinesco, Élisabeth. (2016) Freud: In His Time and Ours. Translated by Catherine Porter. Cambridge, Mass.: Harvard University Press

"Analytic candidates in training struggle with the fact that you tend to get thrown into the deep water before you really know what you're doing. Then, the anxious candidate will typically struggle to find something to hang on to - and it's much easier to hang on to a theory than it is to hang on to the subtle and irreproducible nuances of clinical work. Candidates tend to latch on to theory and displace their anxiety about what they don't know to the theory, which is at least in principle knowable in order to calm down their anxiety about the actual interpersonal event that is the therapy." Episode Description: We begin with explaining that our title Technique is Character Rationalized recognizes that we refer to colleagues based on our sense of their character not based on their theoretical orientations. We discuss the use and misuse of theory to offer analysts distancing structures when faced with the uncertainty of intensive treatment. Lee distinguishes between neurotic and perverse mental processes and considers the differing clinical challenges faced with each. We take up sado-masochism as object-preserving, the use of aggression to defend against tenderness, and how privileging psychic reality may for some result in confusing fantasy with reality. We close with Lee sharing with us his personal analytic journey and his reflections on our field now that he is retired. Our Guest: Lee Grossman, MD trained at the San Francisco Center for Psychoanalysis where he was a training and supervising analyst for 40 years. He served on the editorial board of The Psychoanalytic Quarterly for fifteen years, and currently serves on the board of JAPA. He is also an exhibiting photographer whose work can be seen at www.leegrossman.net. He and his wife, Jan Baeuerlen, have both just retired from clinical work. They live in Oakland, CA with an English bulldog named Frank. Recommended Readings: Bateson, Gregory (2002) Mind and Nature: A Necessary Unity. Advances in Systems Theory, Complexity, and the Human Sciences. Hampton Press. Erikson, Erik H. (1963). Childhood and Society, 2nd edition. NY: W.W. Norton. Friedman, Lawrence (1988). The Anatomy of Psychotherapy. Hillsdale NJ: The Analytic Press Greenberg, J.R. (1981). Prescription or description: the therapeutic action of psychoanalysis. Contemp. Psychoanal. 17: 235-57. Hoffman, I.Z. (1983). The patient as interpreter of the analyst's experience. Contemp. Psychoanal. 19:389-422. Levenson, E.A. (1988). Real frogs in imaginary gardens. Facts and fantasies in psychoanalysis. Psa. Inquiry 8:552-67. Loewald, H.W. (1952). The problem of defense and the neurotic interpretation of reality. Int. J. Psa 33:444-449. Reed, G. S. (1987) Rules of Clinical Understanding in Classical Psychoanalysis and in Self Psychology: A Comparison. Journal of the American Psychoanalytic Association 35:421-446 Upcoming Episode: Freud's Nephew and the Creation of 'Buzz' for Psychoanalysis with Joseph Malherek, Ph.D. (Raleigh, NC)