IPI’s Annual Scharff Award lecture by Otto Kernberg

Friday September 10, 2024, noon-2:00 pm ET on Zoom

Jill Scharff

 

I am sitting at my Zoom screen, along with 341 colleagues each at their own computer stations, waiting for the IPI Director Caroline Sehon to introduce Otto Kernberg speaking to us from his country home.  Behind him are shelves of decoys, beautiful birds, bringing nature and art into relation with psychoanalysis.  Now in his later years, Otto is still vigorous, his extraordinary breadth and depth of knowledge undiminished by age.  A wonderful support to David and me and a friend to IPI and IIPT, Otto stood by during our development in the controversial and lonely space of introducing innovative distance education in analytic thinking for psychotherapists and designing analytic training for candidates far from an analytic training center. With Otto’s help and letter of support, IIPT, viewed for years as unacceptable to both APSA and the IPA, was approved as the 33rd APSA institute, during the presidency of Bill Glover. Acceptance for the comparable effectiveness of teleanalysis and distance education is still a problem for the IPA, but IPI with APSA’s blessing is devoted to continuing work online, in person, and in hybrid environments to build a global distance learning psychoanalytic learning community in real time.  The Scharff Award Lecture will always be online, always free, and inclusive of all clinicians and students of mental health.

Otto Kernberg lectures via Zoom September 2024

Otto is beginning his lecture “Conflict and Controversy in the Field of Psychoanalytic Technique”.  Used to hearing about the dynamic unconscious, we are surprised to hear Otto focus on the everyday functioning of the operational unconscious that is not dynamic.   In the first few years of life, the original conflict is between affects evoked in pre-bonding, bonding, attachment, desire, frustration, and separation.  Avoiding life-threatening alone-ness, the infant is consciously aware of conflict between love and hate, and then dissociates into opposite libidinal and aggressive segments of experience to defend against the underlying conflict has become unconscious.  Surely, Otto is pointing to the drives not as fundamental but as breakdown products of object relations in the early years.

Turning to theories of neural structure, Otto revisits Panksepp’s seven affect systems – Seeking/ Expectancy, Rage/Frustration, Fear/Anxiety, Lust/Sexual Desire, Care/Nurturance, Panic/Grief, and Play – and ties them to the relevant neural organizations and their locations in the brain. The seeking system is intentional, scanning for survival and generating excitement and erotism. When that is thwarted by threat and curtailed freedom, frustration sets in and give rise to rage.  The fear response secures proximity to a secure base and protects against destruction by predators.  Lust is gender specific,  associated with oxytocin release which in men drives assertiveness and sensitivity to visual stimuli and in women favors bonding and values feeling understood in intimate relations.  Panic/Grief responses are stimulated in terror of separation from mother, in situations of social rejection and threats of disaffiliation.  The play of childhood become the social joy of adulthood.  These affect systems in the limbic system irradiate to the prefrontal cortex where they acquire their content and cognitive meaning and are integrated in perception, memory, imagination, introspection, and self-awareness.   Each affect is experienced in relation to the affects of others, and so there develops an image of the self, the other and the affects that connect them in life and are built into psychic structure as internal object relationships.   Where there are heightened contradictory affects and symbolization is weak, lack of cortical control releases a diffuse trauma response.

This takes us to a section on clinical technique, beginning with Freud’s free association, evenly suspended attention, and neutrality (in which feelings of abandonment are not gratified but are analyzed) and Bion’s being without memory and desire.  With these in place, the analyst is in a position of concerned objectivity from which to stay out of (or recover from) conflicts, observe transference displacements into the outer world, and transform countertransference into transference analysis and interpretation of unconscious object relationships, thereby helping the patient move between dyadic and triadic situations. Otto reviews specific foci for analysis – dreams, repetition compulsion, somatization, negative therapeutic reaction based in unconscious guilt and envy, and analysis of the analytic field. He pauses to warn against the use of cognitive, emotional and environmental supportive measures because those interfere with reaching primitive levels of experience, so essential to recovery.  The termination phase takes us back firstly to paranoid-schizoid anxieties then to depressive operations, stimulated by imminent loss of the analytic relationship, and so analysis of the termination is the final effort in analysis of the analytic field.  Moving from psychoanalysis to psychotherapy, Otto mentions his specialty, the treatment of personality disorders, for which he has developed his signature method of Transference Focused Psychotherapy, with attention to transference specific to each type of personality disorder.

We are covering a lot today, and people are lining up in with electronic hands in their Zoom windows to ask another question, but the time is coming to a close. Otto’s exposition so freewheeling, the grasp of his knowledge so wide and the thrust so deep, that there is no way to capture it fully in these few words— you had to be there! Suffice it to say, thank you, Otto, for an amazingly erudite lecture and generous discussion of contemporary conflicts in psychoanalysis.

Howard Levine April 2024

Friday April 12, 2024

Today, IPI is back in its weekend conference location at the Rockville Hilton to study The Unstructured Unconscious and the Repressed Unconscious: A Clinical Paradigm for the 21st Century with Howard Levine as IPI’s distinguished guest. We haven’t been here since the weekend conference with Anne Alvarez in February of 2020.  The place feels so familiar, even the carpets are the same.  Friends I haven’t seen in four years. Students I have met only on Zoom until now.  I am sitting in my usual seat at the back of the conference room with colleagues – faculty and students who haven’t seen one another except online alongside new onsite participants, and other old and new faces on a large screen from various states and countries. It is only the second hybrid conference IPI has designed, and we are all curious and eager to participate in the integratino of our onsite and online learning community.  It’s a work in progress, an experiment in sharing, sensitivity to the needs of others, and experiencing hybrid as an object of study.  “Everyone hates hybrid,” we’ve heard, but our goal at IPI is to develop expertise in creating an effective hybrid learning environment for communicating across cultures.

April 2024 Hybrid Conference

Now Howard Levine is talking.  “Where are we?” he asks.  This is the central question for the analytic dyad in the unique epistemological universe that is psychoanalysis.  Levine, who is highly conversant with the related elements of theories of Bion, Winnicott, Freud, and Klein, warns us that theories tend to be rather final, exhaustive, exclusive of other ideas, and limiting of growth in the individual psyche and in the field of psychoanalysis.  He allows that models highlight characteristic elements which can be useful for making comparisons between various clinical approaches.  However, he reminds us that assumptions made by theories and models for understanding neuroses  (in which the unconscious is structured by representation of repressed unpleasant experience and desires) cannot be made to apply in the psychoanalytic treatment of all cases.  In widening scope cases, the analyst is responding to fragmented or psychosomatically expressed states of mind that are unrepresented because they are non-ideational.   The task here is to reach a wordless experience in the unstructured unconscious.  Here Levine turns to French psychosomatics and the work of Andre Green.  Heady stuff.  Clearly Levine likes to know the boundaries and break free of them.   His parting shot to us before pausing for discussion — “Are you dislocated enough yet?”

Responding to the word ‘dislocated’, my mind returns to his opening question: “Where are we?” I ask why the sense of place is the central question above all others.  He replies that the whole trend in psychoanalysis has been towards knowing and getting it right.  So, now we need to valorize the space for not knowing, for instability, and for acknowledging that the unstructured unconscious is a force without meaning.  Putting it simply, he says, “There is no there yet.” And that is what we have to be able to resonate with.  As for a more complete exploration of my question, Levine responds: “We will have the whole weekend for that!”

And we will be pondering the questions raised for much longer than that.

Jill Scharff

On the Intersectionality of Racism and Sexism

Jill Savege Scharff

 

I am sitting in my home office, in front of my Zoom screen, where I sit often these days.  But today is a special day.  I am attending an IPI virtual conference that is timely and of much importance to therapists and psychoanalysts.  The conference is called “Be Thoughtful and Act: Confronting Systemic Racism Inside and Outside our Minds” from October 9 – 11, 2020.  Kirkland Vaughans, Earl Hopper and Beverly Greene spoke yesterday about the disadvantaged education of Black children, the need to recognize the impact of the socio-political unconscious on self-perception and behavior, and the constant state of alert in which Black people live.  Now it is Saturday morning and I am listening to Dr. Greene again, and then to Dr. Wolfe, on the topic of the Intersectionality of Racism and Sexism. I want to share a few of their comments and personal reflections that meant the most to me.

Dr. Beverly Greene via Zoom

Dr. Beverly Greene, Professor of Psychology at St. John’s University, entered the screen and began with the history of feminism.  Architects of the women’s movement for equality were White women who were successful in getting the right to vote in 1920. But for Black women, suffrage was mainly theoretical until the Voting Act of 1965. In the second wave of feminism, the focus was on the woman’s right to work.  Dr. Greene pointed out that the pioneering White women ignored the history of Black women who had always been viewed as workers, regardless of their sex.  Some Black women have internalized racist sterotypes about themselves.  Many of them feel compelled to fit the image of the tireless, uncomplaining, subordinate worker who has to be strong, silent, and resilient.  In therapy, they may present with difficulty in claiming attention for themselves instead of always putting others’ needs first.  The late psychoanalyst Cheryl Thompson called this moral masochism.  But in human terms, what we see is that these Black women exhaust themselves from caring for others to the point of depletion, thinking that Black women are supposed to be strong and resilient, bringing in income and raising their children, constantly teaching them how to avoid trouble, and how to stay alive when extra-judicial lynchings, brutal brutality, and demoralization are rampant in insane society.

Dr. Greene told a story about herself and her mother. Dr. Greene grew up in Northern New Jersey of parents from the deep South at the time of American apartheid.  Like millions of other Black Americans, her parents became refugees from domestic terrorism and were part of the Great Northern migration of African Americans from the deep South into Northern and Midwestern cities. Beverly Greene and her family visited her mother’s home in Southern Georgia often.  On one trip, the train had a problem, and so they had to stop for repairs in Jacksonville, Florida.  At that time, the station was completely segregated from bathrooms to convenience stores, with signs saying “Niggers will not be served.  Whites only” right next to signs saying “Coke is 10 Cents.”  The 10-year-old Beverly was furious.  She said, “That sign says Coke is a dime and I have a dime, I’m going in there to buy a Coke.”  She got very loud, and her mom gently said, “If you go in there, those people will not serve us. You can’t go in there.”  Her mother agreed that it was not fair, but explained, “We can’t go in to those places, and don’t think of calling the police, because they will hurt us. We are not going to get hurt just to buy a Coke. For the sake of a coke it’s not worth it.”  Beverly knew she was trying to be disruptive.  Her childhood tantrum was not only that of a child who wanted a coke.  Her outrage was about inequity and even more about its acceptance.  She was most angry that everyone was walking around in that station as if it was perfectly normal.  Her mother understood and accepted that Beverly was angry and wanted to do something.  So, she told her child that it was alright to be angry, but taught her not to go up against a stacked deck.

Dr. Harriet Wolfe via Zoom

Dr. Harriet Wolfe, President-elect of the International Psychoanalytical Association, and former President of the American Psychoanalytic Association, came on to speaker view next.   She talked about her own history in order to model the importance of our looking at ourselves and recognizing racism and other forms of prejudice in ourselves before we can effectively guide others, whether socially or clinically. She described her youth as a child going to a private school and a women’s college. Her Whiteness did not strike her as a problem back then.  In those days, she was more aware of sexism as a problem for her.  Growing up in her family, the daughter had to be protected from behavior that her brother was allowed.  Moving from liberal arts education to medical studies, she experienced sexism when she lost the support of her father who did not approve of her choice of career, her politics, or her being outside his control.  As a medical student sexism was reflected in her having to take breaks in the nurses’ lounge not the doctors’ lounge. This meant she did not have access to informal medical teaching which male students gleaned from locker room conversations with their mentors.  Prior to starting medical school, she had worked with and become friendly with a childcare worker who was Black. She had trouble understanding why her friend never invited her to her home though it was possible for her friend to come to her home.  Dr. Wolfe realized that her colleague lived in a Black community where she could not welcome Dr. Wolfe.  It was a painful experience of racial boundaries. She continues to regret that race remained an unexplored problem between them. Her psychoanalytic training, where the teaching was still based on a one-person psychology with a focus on the internal structure of the patient’s mind, did not draw her attention to her Whiteness and what it meant.  Modern psychoanalysts now think of psychoanalysis occurring in a two-person field in which patient and therapist interact in a mutually influencing relationship.  They also think about transgenerational transmission of trauma and the influence of internal objects on behavior, perception of others, and relationships.  Thanks to psychoanalysis, Dr. Wolfe became able to understand her father’s point of view, stemming from his history, as well as the impact of a racist culture on her upbringing.  Now that the entire psychoanalytic community is dealing with the traumatic impact of systemic racism, Dr. Wolfe is viewing her Whiteness quite differently, as an inter-racial and political challenge to be contemplated in dialogue with diverse others.