Change across a completed analysis assessed using a modified Three-Level Model
Jill Savege Scharff & Pat Hedegard
The authors present their design for a clinical teaching exercise to study transformation in psychoanalysis. They chose a completed analysis from which to select the sessions retrospectively so that the clinical review exercise would not influence ongoing analytic process. The co-authors selected three tranches of clinical material, a few years apart, to be presented by the analyst. They studied the material with colleagues in the impressionistic manner of traditional clinical review, and then subjected it to more systematic examination, using a modified application of the Three-Level Model (3-LM) for assessing change. Their prediction was that the use of the 3-LM model could amplify the clinical impressions of the individual analyst and provide a way of being more specific about the changes, if any, that had occurred, and arrive at which theories best explained those changes.
The authors gratefully acknowledge the participation of colleagues who engaged in the exercise, the generosity of Paul Koehler, MSW, Charles Ashbach, PhD, and David Scharff, MD, who shared their responses to the three tranches of case material, and the analysand who gave permission for the use of her clinical material.
The use of a simple writing task to enhance psychoanalytic education
Jill Savege Scharff & Caroline M. Sehon
The authors describe a simple recurrent writing task called the “Two Page Paper Exercise,” designed to enhance candidates’ learning of analytic theory and technique. They set this task in the context of other analytic institutes’ writing programs and show that this exercise is unique. Their educational philosophy is that, as candidates confront multiple perspectives in contemporary psychoanalysis, this writing task develops their ability to conceptualize, reflect on their learning, integrate affect and cognition, and express their ideas to others in written form and in discussion with peers. The candidate group develops cohesion that reduces writing anxiety. As individuals they develop a writing habit that supports the eventual duty to develop the field of psychoanalysis through publishing. The authors present raw data from candidates’ writing for readers to make their own assessment of the usefulness of the task as a measure of candidates’ integration of learning, development of analytic sensibility and synthetic capacity, and communication of experience and ideas to others.
The authors gratefully acknowledge the generous contributions of Flora Barragan, Ryan Garcia, Stefanie Minen, Andi Pilecki, Matthew Rosa, and Karen Sherwood of the International Institute for Psychoanalytic Training.
Yolanda Varela, PhD, President, IPA Panamanian Association of Psychoanalysis (Provisional Society); supervising analyst, IPA; supervising analyst and graduate, APsaA International Institute for Psychoanalytic Training.
Thoughts arising at Town Hall Meeting:
Changes in Frames: COVID-19 and Teleanalysis
With so many countries under lockdown to flatten the curve of the COVID-19 pandemic, the frame of life and work has completely changed. Analysts who always conducted analysis in their private office, now are forbidden from traveling, and must stop practice or continue to see their patients in virtual space, each connecting from their own home. As always, crises bring opportunities for new experiences for us and for our patients. I would like to address my experience under three headings: the use of teleanalysis, the early anxieties that are stirred in the patient, and early anxieties that are stirred in the analyst.
The use of teleanalysis
Unlike some of my colleagues who had never engaged in technology mediated treatment, I had experience to draw on. I had already completed a personal analysis with an ApsaA certified analyst, and much of it was necessarily conducted using the telephone at first, and later using Voice over Internet Protocol with web camera. I had had a full analytic training too — but not one that was approved by ApsaA. Then FEPAL (Psychoanalytic Federation of of Latin America) authorized ILAP (Latin-American Institute of Psychoanalysis) to offer psychoanalytic training in Central America, as a global outreach project of the International Psychoanalytic Association. When ILAP arrived in Panama, one of its requirements was that analytic graduates like me who had already completed a personal analysis would have to do an extra 200 hours of condensed analysis “in-person” that is, traveling to the city where our analysts lived, or meeting in Panama with an IPA authorized analyst newly immigrated to Panama.
In order to meet the new requirement, I would do the extra hours. I decided to travel to the United States to resume with my analyst, but what I chose to do with the extra time in analysis was to focus on what is not represented in me, on my early anxieties. To address these effectively, I decided to continue my required in-person analysis with four-times-a week videoconference technology mediated sessions between trips to the United States. For me, analysis “in-person” continues to be the preferable one, but at no time were transference and countertransference aspects lacking in the technology-mediated portions of the treatment. In fact, it was the change in the frame that evoked the very early anxieties and enabled me to analyze them. This experience gave me confidence in the use of teleanalysis.
Now I am analyzing my own patients in Panama in traditional, in-office analysis. Occasionally I am asked to do teleanalysis. For this, I establish new rules. First, I use the most secure and stable platform (in my case ZOOM) and I don’t let the patient decide the platform. Before each session, the patient receives a link to access the session with a password that only the patient knows. I explain to analysands that they should look for a private place, where they can recline, similar to the office couch, with the camera on one side and behind them, simulating my position inside the office. I greet them with the usual greeting, they recline and lose eye contact with me, but if they turn their head back, they will be able to see me. I think we should stick to rules for technology mediated treatment that are similar to those in use for treatment in the office. Beyond these arrangements to secure the external frame, I also shift my internal frame. It was José Bleger’s article on the psychoanalysis of the frame that helped me to develop my technique in teleanalysis, and so help my patients. Bleger asks us to analyze what lies hidden behind the traditional, well-established frame.
Early anxieties of the patient
During the past three weeks in quarantine because of COVID-19, I have been transitioning my in-office patients to technology mediated psychoanalysis and psychotherapy. Because of social distancing to fight the COVID-19 pandemic, analysands usually treated in the office must now set up a private treatment space of their own choosing. At first, the sessions are dominated by worries about getting sick, the loss of social contact, and being trapped at home with children while trying to work. Behind the emphasis on COVID-19 lies the loss of the analyst’s physical presence and the loss of a safe office, which now seems like a uterus from which the patients were extruded. Having to see the analyst on the screen, and put up with the times that the image freezes as well, the analysand feels as if the analyst is removing affection. These fears of loss of response and loss of love result from early fears related to the dead mother. Fears of viral invasion echo fears of the mother’s death drive, drowning the patient’s desire for life. Feelings of hopelessness, helplessness and lack of trust in agencies that are supposed to protect us (hospitals, government, Ministry of Health) reflect early attachment insecurities, and convey transference to the analyst as an unreliable object. With the change in frame from in-office analysis to teleanalysis, I have been able to observe the expression of very early anxieties in analysands who were previously seen only in the office.
Anxiety of the analyst
Freud’s warnings about the dangers of changing the frame of analysis are echoed by our own psychoanalysts, supervisors and colleagues, especially when confronting any change from the traditional in-office setting to the teleanalytic setting. Teleanalysis is frequently regarded as a transgression. The transgenerationally transmitted superego will have to be somewhat pacified to understand the current situation as a necessary and effective adaptation that brings us the possibility of continuing to work and of countering the guilt of not being able to do more for our patients, a problema that Eizirik pointed out in a recent IPA webinar. Patients come to us with a fear of death and we receive them with our life drive. To support our life drive, we need to pursue our own pleasure and part of that is our work. We will have to continue to be linked to life, taling with colleagues in Town Hall meetings like this, keeping in touch with friends and family, accepting and not denying reality, but without being suffocated by it.
Alice Brand Bartlett was a beloved adjunct faculty in the International Institute of Analytic Training, a sensitive and thoughtful supervisor, a supportive mentor, and a valuable friend to many of us at IPI. She died on July 13, 2019 from ovarian cancer. Those of you who knew Alice can rightly imagine that she was lively until the very end, fighting to survive and to continue in a profession she loved so passionately.
Alice was born on October 27, 1950 in Carrollton, Missouri. She pursued an MS in Library Science and became Chief Librarian of the Menninger Professional Library. At Menninger, she held many prestigious posts, including Associate Dean in the Menninger School of Psychiatry. She went on to pursue training as a psychologist and psychoanalyst, at the Fielding Graduate School and Topeka Psychoanalytic Institute, respectively. The American Psychoanalytic Association affirmed her status as a Training and Supervising Analyst in 1996. We all benefitted from her library science expertise, as she became Board Director for the Psychoanalytic Electronic Publishing database (PEPWEB), awarded the Sigourney Award in 2018. Just before her death, she served as Director of the Greater Kansas City Psychoanalytic Institute.
While all these accomplishments speak to her intelligence, generative contributions, and respected place in the field of psychoanalysis, most of us knew Alice as kind, compassionate, humorous, spunky, and a bit irreverent. She was devoted to her patients and mentees, as is evident in the way she approached the end of her work with them, conveying genuine care and respect and regretting the loss her death would impose. For IIPT, she was one of our most active adjuncts, facilitating clinical case consultation, providing supervision and analysis, and serving on the ethics committee. We miss her already!
Alice leaves behind her husband Tom and many friends and family. A public memorial service will be held on Saturday, August 17th at 11:00am at the Chapel in Mount Hope Cemetery (17th and Fairlawn). In lieu of flowers, please make memorial contributions to The Greater Kansas City Psychoanalytic Foundation, Greater Kansas City-Topeka Psychoanalytic Center, 1000 E. 24th St., 4E-53, Kansas City Missouri or Col. Potter Cairn Terrier Rescue.
The members of the International Working Group on Teleanalysis hosted at the International Psychotherapy Institute were sad to learn that Asbed Aryan, who seemed to be getting better, had suddenly lost his fight with cancer. Asbed was such a kind, generous man, which came through so clearly in his clinical work. He was a devoted training and supervising analyst who pioneered the use of technology in distance analysis with a candidate in Armenia, and the author of books on adolescence such as Clínica de Adolescentes co-written with Carlos Moguillansky. We knew Asbed as a committed participant of our International Working Group in Teleanalysis since its inception many years ago, enthusiastically participating from Buenos Aires with his dear colleague Liliana Manguel in our monthly online meeting, faithfully contributing to our meetings even amid treatments for his illness.
We first met Asbed in Chicago when separate interests in teleanalysis brought us together for an IPA Congress panel on teleanalysis. Our separate proposals were joined, continents were bridged, and the resulting panel was presented with simultaneous translation and chaired by Charles Hanly. Since then we’ve collaborated successfully on shared proposals for IPA precongress workshops held in Mexico, Boston, and Buenos Aires, research panels, and book chapters, the latest of which “Psychoanalytic Process in Cyber-technology” will be published posthumously in Psychoanalysis Online 4: Teleanalytic Practice, Teaching, and Clinical Research, edited by Jill Savege Scharff (Routledge, October 2018).
We will always remember Asbed’s intensely intelligent contributions from his great experience in this field. What good work he did for psychoanalysis, with great sympathy and devotion for those at a distance from major centers: What fun we had talking half in Spanish, half in English with Asbed at Congress banquets! We remember how much he enjoyed coming with us for dinner at the Cosmos Club in Washington DC. We will miss our loyal friend, and will be holding his family and his colleagues in Argentina and Armenia in our minds and in our hearts in the days and months to come.
In sympathy and affection,
Jill Scharff, Founder, and Caroline Sehon Chair, and members of the International Working Group on Teleanalysis hosted at the International Psychotherapy Institute www.theipi.org
Imagine a young African American man raised proudly by his mother, and now the first generation to go to college. Why might he fall victim to depression and academic failure? What effect does the context of poverty, violence and drug abuse have on such a young man? Dissociating himself from the pain, he breaks from his past. As soon as he sees the possibility of success, he feels the shame of separating from his roots and hurting the loved ones from whom he is growing apart. It is hard for a man in that situation to stay true to himself and aggressively develop his potential, and hard for his mother to believe he will be safe in a world that targets and disables aggressive young Black men. The trauma of slavery generations back reaches far into future generations. How do we stop its transmission?
Featured speaker Dr. Janice Gump addressed the destruction of the attachment bond transmitted across generations and the enslavement that squashed healthy ambition and creativity in young African American men as a result of which mothers are therefore highly protective of their sons. Dr. Gump’s writings and presentation, the clinical presentation by Andrew Price, and discussion in the audience in large and small group affective learning processes alerted us to the impact of enslavement on the United States. White, Black, Hispanic and Asian therapists attending the workshop were privileged to learn from one another as we grappled with the issue of how we contribute to the problems of race. This is so important for therapists, because we have shared the position of the African American male client, all of us struggling with the issues of race, and all of us unable to freely address the obvious.
We were grateful for a meaningful experience at IPI in which we could voice our concerns and think together about race relations from an object relations perspective. Several people expressed their appreciation for the group conversation, saying they have been needing opportunities like this and had never experienced anything like it. One person said, “We need to have circles like this all over the world….it’s the only way we’re going to make progress.”
Jeanne Magagna is speaking about working with parents to help their difficult and unhappy children. Of course parents expect the child therapist to be trained in child development and parent effectiveness preparation. But no matter how well trained, the therapist cannot help the child without the parents. She NEEDS the parents to help her treat their child. Together they can build a thinking space where the parents can observe their child more fully, develop a shared narrative of their child and her role in the family, and make links from their experiences as children to their child’s life now. From there, parents at home create a daily routine review of their child’s day, and they can all explore the connections among the child’s experiences and the family history and social setting. In this way the parents build a sturdy emotional cradle in which they hold their child. Feeling secure in this loving, reflective parental cradle, the child grows in self regulation, curiosity and connectedness.
Saturday Feb 3, 2018
We heard from the Scharffs about a brief encounter with a Chinese family. The index patient was a boy who could not make any decision or speak up for his own choices, caught between the unresolved differences of his parents. We heard the therapists describe working with them in an academic setting with a translator and a large audience. They spoke about the boy’s symptom as a distillation of family dynamics and they showed how playing spontaneously with him and his sister could help the boy to find a voice. Then Li Zhen and Mary Morgan discussed the cultural context and the treatment/teaching setting. We usually think of treatment as an intensely private matter but even in this strange setting a therapeutic exchange could occur. Mary Morgan pointed to the importance of the therapists’ internal setting enabling them to relax, engage in word and play, and make a safe, containing therapy space. Li Zhen viewed this family as one that represents not just the parents’ internal conflict but also the generational conflict between grandparents who live by Confucian principles of filial piety and young people who are looking for a way to live in the new China.
Sunday Feb 4, 2018
As the discussion on settings and modalities continues, differences among various approaches are becoming clear. The therapist of an under-5 year old may usefully also do parent counseling or couple therapy with her parents. Others see this as a distortion of the frame. Some of us who begin work with a couple will see only the couple. Others will see whichever part of the couple shows up for the appointment. Those couple therapists with a family orientation may include the children (or even a newborn) for some sessions to explore the couple-as-parents, work on coalitions that replace the vital marital bond, and relive childhood experience that can inform current couple relating. Those with a couple orientation would never break the couple frame like that.
Today Rich Zeitner showed that even though we hold a firm frame for meeting with a couple, we may find ourselves doing individual therapy in the presence of the partner, a difficulty encountered when one partner is identified as mentally ill. It is as though two people are living in one person, said Leora Benioff, and Mariangela Mendes de Almeida advised attending to the theme and the affect that connects them rather than to the projections of internal object relations. Mary Morgan reminded us that a projective identification system like this exists to protect the couple from aspects of themselves that they are frightened of. Mary Morgan reminds us that therapist needs to be patient in allowing the defensive process to continue until it is no longer needed. Damian McCann responded that the modifications in the frame can be an acting out, an acting-in of the transference for subsequent analysis, or a spontaneous or surprising intervention that reflects a shift in the therapist that could release the couple from their entrapment in paranoid-schizoid functioning to depressive concern.
The take away message is that various ways of maintaining and modifying the frame can be helpful or destructive, but the main point is that the therapist needs to examine the impact of any shifts in the frame and use it for therapeutic understanding.
Another way to think about the value and meaning of a change in modality or setting is to consider it in terms of whether the therapist is expressing a defensively caretaking function or a truly adaptive containing function. We might also ask if the change made is an innovative movement forward or a regression to a traditional modality out of guilt.
There are individual, couple and family levels of organization. We can intervene at any level but we need to keep in mind what we are doing and where we are going. We want to keep a multiocular vision on individual, couple and family in any of these treatment settings.
And technical considerations aside, within the secure setting we create we are subject to unexpected external forces, liable to error, but willing to acknowledge mistakes and make reparation. We identify with our preferred settings, work from an internal setting that is firm but flexible when deviations are called for, and feel free to engage as a thinking, feeling human being.
IPI faculty members presented a number of panels, presentations, and precongress workshops at the International Psychoanalytical Congress in Buenos Aires in July 2017. At one of those panels, David Scharff and Lea Setton invited Roberto Losso, Juan Tubert-Oklander and Joaquín Pichon-Rivière, to join them in presenting the ideas and applications of the late Enrique Pichon-Rivière (photo 1 and 2).
Later they gathered to celebrate the launch of their edited book The Linked Self in Psychoanalysis: The Pioneering Work of Enrique Pichon-Rivière edited by Roberto Losso, Lea Setton, and David Scharff, in English for the first time. (London: Karnac 2017) (Photo 3).
Enrique’s ideas are so original, and his early development so fascinating, that I wanted to share them widely, especially with young people who haven’t a clue about what a therapist or psychoanalyst actually does, or how an analytic approach can help. So I got the idea of writing the story of Enrique as a story to read to our children and grandchildren.
Enrique Pichon-Rivière and his theory of the link.
By Jill Savege Scharff
Once upon a time, there was a little French boy called Enrique who lived in Switzerland and France. When he was four years old, his parents took him with them on a long journey. They left their high class life in Europe and went to live during his youth for the next 17 years with the Guaraní tribe in the jungle of northern Argentina. Enrique saw scary pumas, jaguars, alligators, and snakes in that rainforest, but he learned to stay still and not be frightened.
Enrique spoke French with his upper class parents, but he learned the Guaraní language too, so he got along with the local children, played ball with them, and knew their way of life. When he was eight years old he had to leave the jungle, speak Spanish all the time, and go to school in the town. But he always remembered his time in the primitive world of the jungle.
When Enrique grew up he became a doctor and a psychoanalyst. Most of his friends were psychoanalysts, even his wife. A psychoanalyst is a kind and thoughtful person who helps us put our worries and bad memories into words and doesn’t get upset by our strong feelings. After talking with the doctor for a while, we have a new experience of ourselves in this new relationship. We then feel more confident in ourselves and get along better with our friends, our family, and our teacher or boss.
Enrique noticed that psychoanalysts have problems too, and need help with how they think about things. For example, too many psychoanalysts that he met thought about only one patient at a time, and that person was usually just a grown-up. They forgot about the people we all live with, the children and families, and the world we inhabit together. But not Enrique. He saw the total picture.
Enrique thought about everyone. He helped families to be healthy, talked to boys and girls about their worries, taught other therapists, and even helped companies and their workers to be successful. He always remembered his early life in the jungle, and cared about all people, rich and poor, and every level of society.
He saw the world as being like a soccer field where everyone had an important part to play (even the ball) to make a good game. Every family is like a soccer field in which the children and the parents and the grandparents and aunts and uncles all teach the children how to play and run around with them They all take turns to kick the ball, receive a pass, defend the goal, and learn every position to play their part in the team.
Noting that we live in groups and can’t exist without others, Enrique made his theory of the link. He said that a baby is born into el vinculo, a link that is there waiting to welcome the baby to the world and deal with the impact of the new family member on that world. Our family and our community shape who we will become, and equally we shape our family and our culture. Meeting with a psychoanalyst creates a new link, which changes the original link, and lets us recover our balance.
Here is another of Enrique’s ideas about the link. The past, the present and the future are part of the link. They are in our minds all the time, even when we are not thinking about how they affect us. So it is important to remember what happened before we were born, even before our parents were born, and to look outside our own family to our place in school and wider community, if we want to know who we are. When one of us is suffering, he realized, that one is not the only one with a problem. That one is actually the spokesperson for a hidden group problem. With help from a psychoanalyst, that one can lead the way to solving an unrecognized mystery in the family or community.
Enrique was an original thinker. His ideas were ahead of his time. But he had a problem. Although he loved to teach, he didn’t take enough time to write down his ideas. So he didn’t get full credit for being such a pioneer. Although his students loved his ideas and wrote down what they remembered, they did it in Spanish only. Sadly Enrique’s ideas remained unknown to psychoanalysts in Europe and North America.
That is where The International Psychotherapy Institute (IPI) enters the story. Lea Setton, IPI faculty member and IIPT supervising analyst, read all of the Spanish journal articles by and about Enrique and his theory. She consulted Roberto Losso, IIPT adjunct faculty member, and together they chose the best parts and translated them roughly into English. Then their colleague Judith Filc in New York perfected the translation. Added to that, well known psychoanalysts who had known Enrique before he died wrote in English about their memories of him and what they learned about his ideas. David Scharff, IPI Board Chair, faculty member and IIPT supervising analyst helped them put together all these papers and arranged for them to be published as a book The Linked Self in Psychoanalysis: The Pioneering Work of Enrique Pichon-Rivière edited by Roberto Losso, Lea Setton, and David Scharff (London: Karnac 2017). So now psychoanalysts who can’t speak Spanish can read the book in English and appreciate the powerful vision of this clever Argentine psychoanalyst and his theory of the link. That is the story of how Enrique Pichon-Rivière can now be known to people in Europe and North America — thanks to IPI.
Photos courtesy of Caroline M. Sehon
Text by Jill Savege Scharff
Following the success of the International Congress in couple and family psychoanalysis on the frame in Washington DC, USA, the International Psychotherapy Institute (IPI) collaborated with the Family and Couple Psychoanalysis Committee of the International Psychoanalytic Association (IPA), the Madrid Psychoanalytic Association, Sociedad Española de Psicoanálisis (IPA member), the International Association of Couple and Family Psychoanalysis (IACFP) and the Spanish Federation of Psychotherapy Associations (FEAP) and the IPA’s CAPSA program to promote inter-regional analytic dialogue. The 4-day Congress organized by David Scharff and Elizabeth Palacios (Chair and member respectively of the IPA committee on couple and family psychoanalysis) featured case presentations, short papers on the role of interpretation in family and couple psychoanalysis using object relations, link theory and classical Freudian concepts, videos of family therapy, discussant responses, and lots of audience discussion, all with simultaneous Spanish/English translation. IPI faculty Carl Bagnini, Caroline Sehon, Jill and David Scharff and Janine Wanlass and adjuncts Hanni Mann-Shalvi, Elizabeth Palacios, and Karen Proner were joined by other presenters, discussants, and session chairs from Spain, Caracas, Argentina, Brazil, Italy, Greece, London, Beijing, Members of the audience came from 19 countries in North and South America, China, Australia, Israel, and Europe.
Presenters Diana Norsa and Anna Nicolò (Rome), Tim Keogh (Australia), and Lia Cypel (Sao Paulo), gave theoretical papers to kick start the conversation on interpretation in assessment and couple and family psychoanalysis. David and Jill Scharff, and John Zinner (Washington, DC) shared videos of their family therapy with young children and adolescents respectively (subtitled in Spanish) which gave everyone the same clinical experience of the object relations family therapy approach as an object for contemplation and debate. Alicia Monserrat (Madrid) and Elizabeth Palacios (Zaragoza) presented their work with a two-mom family raising two sons whose dissonance they avoided by looking to the boys for mothering. “Oh no,” said one son. “Not MORE mothers!” Mary Morgan (London) presented the complex and creative field of couple interpretation and Karen Proner (New York) addressed the issue of detecting and interpreting underlying pain in the couple relationship, while Pedro Gil and Carmen Monedero (Madrid) and Eric Smadja (Paris) presented couple cases illustrative of couple relationship development, dynamics and interpretation in therapeutic action. Moving through the developmental stages, Antonia Llairó (Barcelona) presented family therapy with a 4-year-old in an emotional mess over the arrival of her newborn brother, Janine Wanlass (Salt Lake City) movingly described helping a family with young children deal with their blocked grief, and Monica Vorcheimer (Buenos Aires) recreated vivid dialogue to illustrate adolescence and family relationships and chaired a clinical exercise using a novel design of spontaneous responses to a-historical fragments.
The whole experience sharpened the lens on global perspectives in the field of couple and family psychoanalysis in which on the one hand there is a structured, empirical approach that follows the expression of object relationships in current experience, gathers them in the transference and understands the historical antecedents, and on the other hand a deconstructed approach that values the creation of the here-and-now moment divorced from the search for causality. We have much to learn from one another as we continue to put our thoughts into mutually enriching dialogue and eventually into print to reach a wider audience and extend the conversation. Contributors to the Committee’s first volume greatly appreciated Valentin Barenblit’s elegant salute to the launch of Family and Couple Psychoanalysis: A Global Perspective (Karnac 2017) edited by David Scharff and Elizabeth Palacios.
The Congress was well received, as shown in many participant comments:
“At a time that our world is in great distress and threat, it is a comfort to be connected to the international community” (USA).
“The organisation was impressively seamless, and the vibrant, friendly atmosphere promoted a very rich, learning experience for us all” (London).
“I certainly took a lot of ‘food for thought’ regarding interpretation through an intersubjectivity and linking point of view” (Greece).
“Fue muy grato e intenso el encuentro en Madrid” (Argentina)
“Diversity and dialogue was central in our activity. I really appreciate that” (Madrid).
“One of the best academic and friendly meetings I attended in many years” (Brazil)
“It was a well-organized, intense learning atmosphere that brought with it a high level of thought and discussion. I think people there benefitted greatly and were encouraged to go back and do the work” (USA).
IPI can now look forward with confidence to continuing the conversation with the IPA committee on couple and family psychoanalysis at the next at the next International Congress in collaboration to be held at the Rockville Hilton at the IPI weekend, February 2018.
The website editor gratefully acknowledges permission from Karnac to adapt Jill Scharff’s Madrid congress report from Couple and Family Psychoanalysis (September 2017).
In 1933, an exchange of letters between Freud and Einstein in which they discussed the nature of human aggression, destruction and the potential for peace, was published under the title, “Why War”. Today, in the after shocks of an election that has the nation and the world reeling, we might ask, “Why Trump? “
As I read Norberto Carlos Marucco’s paper, “Between Memory and Destiny: Repetition” (2007) in preparation for the upcoming IPI conference, I was gratefully reminded of the role psychoanalysis might play in unraveling this most pressing question. Trump is one man, and he could have never reached this position without tapping into and exploiting the reservoirs of a desperate, divisive cultural moment. We might think of him as an unfortunate symbol of the kind of repetition Marucco elucidates, one born out of traumas that have yet to be adequately remembered and worked through. Marucco presented this paper at the IPA Congress in Berlin, and began by drawing a link between the relevance of this location and its history, and the analytic work of “tearing down walls” in order to facilitate the work of transformation. This reference could not be more startlingly resonate, as the United States has just elected a man who placed building another wall at the centerpiece of his campaign rhetoric.
Marucco draws our attention to the influence of the death drive on repetition, saying that this drive, “leaves its trace through the most subtle and destructive effects, namely, the perversity of leadership, the loss of social points of reference, and the degradation of altruistic cultural ideals and identifying bonds, which leads to intense feelings of helplessness and social exclusion” (p. 310). Like many other therapists, in the days following the election I felt like a first responder to a traumatic event. One after another, patients described feeling stunned, heartbroken, depressed, and angry, as they worked their way through these early stages of grief. My holding capacity felt strained and compromised, as I struggled with similar feelings. For so many, suddenly the ‘altruistic cultural ideals and identifying bonds’ that have expanded over these last 8 years crashed down around us, and in one devastating moment, we regressed back to a level of ‘helplessness and social exclusion’ that had seemed only the day before a fading vestige of the past.
Apparently, this was a naïve assumption. We must now ask ourselves: What has not been remembered or worked through? What has yet to be healed, and as a result, now emerges as repetition? We might find clues to these questions in the jubilant support Trump has received from white nationalists and the Ku Klux Klan, groups that suddenly feel they once again have a legitimate place within the mainstream political and social sphere of our country. Of course, this is a moment that can only be understood through an honest analysis of intersecting factors, of which race is one aspect. As a white American, however, I believe we now have a mandate to face and to undermine white supremacy in ways that we have apparently yet to achieve. I would never suggest that every person who voted for the new president-elect is an ardent racist. In fact, I think it is absolutely essential that we resist the temptation to rely on such polarized thinking. I do believe, however, that as a country we have failed to adequately remember, work through, and heal from the legacy of racism that contaminates the deepest roots of the American psyche and its intuitions.
In describing how we might interrupt repetition compulsion, Marucco argues that, “acknowledging trauma and culturally historicizing it plays a key role” (p. 311). He goes on to suggest that contemporary psychoanalysis owes a debt to culture when it comes to facilitating this process. I tend to agree with him. In our consulting rooms, under significant attacks on linking, feeling and thinking, we tenaciously hold space for the work of remembering and working through, for ‘acknowledging trauma’ and helping patients make connections between past and present. We can only hope that such connections enable a more fully awake engagement with a future that is more than mere repetition, one in which our patients continue to develop a capacity for growth. Is this not the same hope that we have for the country, for the world?
I feel galvanized to seize upon this as, what educators call, a “teachable moment”. What does this election have to teach us about repetition and the return of the repressed on a cultural level? What might we as a psychoanalytic community have to offer in terms of a contributing to a long overdue, honest dialogue about race, white supremacy, and the transgenerational trauma of slavery and colonization? What do we have to account for within our own community when it comes to race? I have often wondered why there is such scant discussion of these issues within analytic spaces. Perhaps this absence has something to do with who is at the table, and who is not. Maybe before we can reach out to the world in an attempt to generate such links, we must look within, at what we ourselves may be repressing, and therefore, repeating.
I can say that, as a queer person, I have felt unsettled and alienated by the often heteronormative assumptions underlying so much analytic literature. I am not sure we have fully reckoned with the history of homophobia and heterosexism in our field. Few people in my generation know that there was a time, not too long ago, when training institutes would not permit openly gay trainees to become analysts. Analytic perspectives on homosexuality were not only informed by, but also informed the broader cultural lens. This speaks to the power we had, and I believe still have, when it comes to informing social and cultural narratives, which certainly have a real impact on peoples’ lived experiences.
In the days following the election, stories poured in across the country of black and brown children being bullied by white classmates, of white supremacist vandalism, of LGBTQ people being chased and attacked, and of LGBTQ suicide hotlines reporting a surge in calls. On the other hand, people are reaching out to one another and organizing, inspired by a renewed commitment to justice in the face of bigotry. What is our task as a psychoanalytic community as we reflect upon this moment? What might our unique perspective reveal about restoring a capacity to think and experience empathy in a time where thinking and empathy are under attack? As Marucco reminds us, in the midst of international atrocities, Freud found the ingredients to examine life and our essential nature as human beings. May we continue to carry this torch forward with a renewed faith in the transformative power of psychoanalysis not only on an individual, but also a cultural level, and may we begin with ourselves.
Freud S (1933). Why war? Standard Edition 22, p. 199-215.
Marucco, N.C. (2007). Between Memory and Destiny: Repetition. Int. J. Psycho-
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