Report on the International Congress on Couple and Family Psychoanalysis, “Interpretation in Family and Couple Psychoanalysis” in Madrid, February 23-26, 2017

Posted on March 9, 2017January 18, 2019 by Melonie Bell

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.

Susan and Carl Bagnini, Janine Wanlass, Anastasia Tsamparli, Hanni Mann-Shalvi, Caroline Sehon, Karen Proner at the Faculty Dinner

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).

Reveries on the U.S. Election

Posted on November 18, 2016January 18, 2019 by Melonie Bell

by Andi Pilecki

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.

joining-770559_1920

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.

References

Freud S (1933). Why war? Standard Edition 22, p. 199-215.

Marucco, N.C. (2007). Between Memory and Destiny: Repetition. Int. J. Psycho-

Anal., 88:309-328

A TRIBUTE TO HAROLD F. SEARLES, M.D.

Posted on November 24, 2015 by Melonie Bell

It is sad for me to tell you of the death of a pioneer of American psychoanalysis, Harold F. Searles, M.D. (1918-2015).

Dr. Searles was a Training and Supervising Analyst at the Washington Psychoanalytic Institute and President of its Society (1969-1971) in Washington DC, Clinical Professor of Psychiatry at Georgetown University Department of Psychiatry, and Consultant in Psychiatry for The National Institute of Mental Health. World-wide, mental health professionals know Harold Searles from his collected seminal papers on schizophrenia and borderline conditions and on the use of countertransference as the key to understanding the clinical situation.

Prior to his retirement to California, Harold worked in private practice of psychoanalysis at the Air Rights building in Bethesda, Maryland. In the 1950s and 60s, he had worked at Chestnut Lodge in Rockville, Maryland where his understanding of psychosis was influenced by Frieda Fromm-Reichmann. Incorporating ideas from the interpersonal and British object relations schools, Harold was a crucial force in moving the field of psychoanalysis in the United States beyond ego psychology.

Locally, we knew Harold as an astute clinician and supervisor who took delight in acknowledging feelings that others disavowed. He thought that patient and analyst share immense ambivalence about being together. They try to avoid establishing an oceanic symbiotic relationship, the very thing that Harold regarded as the core phase in the treatment of neurotic and psychotic patients. He found that the analyst who consciously strives to help his patient recover and grow is unconsciously equally devoted to keeping him ill, especially when the patient shows any signs of improvement. In this way the analytic couple can continue in a mutually dependent, consciously frustrating but unconsciously gratifying relationship, thus delaying recovery and the eventual loss of the analytic relationship. Harold urged analysts to take responsibility for these intensely ambivalent feelings, and engage in a process of reflection in which we would welcome our unusual and private emotional responses as relevant data to help us understand the subtle modes of interaction between analyst and patient. As the symbiotic phase gives way to mature relatedness, analyst and patient emerge, each having been healed by the other.

I was assigned to Harold for supervision during my training at the Washington Center for Psychoanalysis. My clinic case paid $20 a session and Harold charged me the same. Rather than making me at ease, he pointed out that I seemed ambivalent about entering supervision. I agreed that I was nervous because his reputation as a clinician of devastating insight in demonstration interviews had preceded him. He smiled slyly at that reply, went into his office closet, and removed a folder from his file cabinet. He wanted to show me the letters of rejection he had received from academic journals, despite his work having been translated into many languages. He then inquired about my situation. I told him that I had left my parents in Scotland to live in London, then moved to Washington to marry my husband, and was now working part-time, while caring for young children. Asked about my other interests, I mentioned theatre and writing, but with young children and analytic training, I had less time for writing or acting. That reminded him of his married daughter, an actor who had made the reverse journey from her parents in the United States to live in London with her husband. Harold was tickled that her husband had played the role of Dr. Who. After all Harold felt that he himself had been playing the part of Dr. Who in every analysis. We shared a chuckle at that, and I began to relax. With that personal basis established, I proceeded to present my case.

Getting through 4 sessions of analysis in one supervision hour meant that I had to summarize some parts of each session. One day I reported material that let me make an interpretation I was pleased with, and then I told Harold that the patient went on about various boring things for a good while. Harold pounced. “A good while? So, you thought it was good that the patient was boring so you wouldn’t make any progress.” This intervention about our shared ambivalence led to a deep understanding of my participation in this patient’s fantasy of fusion, its purpose being to avoid Oedipal guilt.

Harold was so immersed in clinical work and writing that I was stunned when he announced his retirement. “It is something I always promised Sylvia. She has put up with my work all these years, and now it is time for her.” I was used to Harold speaking uncompromisingly about his sadism and hatred, and now I was surprised and touched to hear him as comfortably speaking of loving commitment. Harold and Sylvia retired to California. I mourned Harold’s departure then, and I feel the loss again now. Assigning his articles on supervision as some of the readings for the supervision seminar at the International Institute for Psychoanalytic Training lets me stay close to his ideas and share them with a generation that did not know him. I am pleased that Psychiatry, the journal of the Washington School of Psychiatry, devoted a recent issue (78(3):199-291, Fall 2015) to Harold’s 1955 paper “The Informational Value of the Supervisor’s Emotional Experience.” Discussants include Dick Fritsch, Rick Waugaman, and Bob Winer of the Washington Center for Psychoanalysis. Mike Stadter of the International Psychotherapy Institute contributed his thoughts on the use and overuse of the reflection process.

Although work and psychoanalysis had seemed to be his life, Harold lived on for many years after his retirement, until his death at the age of 97. I am told that Harold is survived by his daughter, two sons, five grandchildren, and eight great grandchildren. The International Psychotherapy Institute joins with other institutions, colleagues, former patients, and trainees in mourning the loss of one of the most remarkable contributors to psychoanalysis and in expressing our sympathy to his family in their bereavement.

Submitted by Jill Savege Scharff, MD

From ” the Child in the Adult” with Virginia Ungar, President-elect of the IPA

Posted on October 19, 2015January 18, 2019 by Melonie Bell

At Saturday’s open workshop, Virginia Ungar presented a version of the keynote paper she gave at the IPA Congress in Boston 2015. She set her remarks in the social and cultural context of our age, characterized by the questioning of authority and current knowledge and the declination of the paternal function. Add to that the proliferation of offers of relief for emotional disorder and the preference of young people for constant connectedness and instant response, and the result is a diminution in the value of psychoanalysis. Psychoanalysts, now more sensitive to their surroundings, are moving out of their isolation and adjusting the analytic setting to respond to new modes of communication with reality. Then the analytic setting can continue its essential role as the analytic device that allows the transference to unfold.

Attachment-1 — photo credit —Lynda Scalf-Mciver

Coming from an analytic tradition infused with the concepts of Klein, Bion and Meltzer, Ungar noted that the assumption of the prevalence of hostility at the beginning of life had the effect of skewing the focus of the analytic intervention towards the interpretation of hostility across the full repertoire of anxieties. This has led to the genesis of closed circuits of a paranoid nature and the loss of receptivity to the various a aggressive and libidinal impulses expressed in the transference.

Ungar presented her own “aesthetic model” of interpretation, a model, that, depending on observing and describing, not explaining, conveys an attitude of reflection and conjecture. She presented a session from the period of her own training years ago and one from a later treatment. Comparing her technique in each situation, we saw the movement from the traditional Kleinian approach towards her own aesthetic model. In the first, she was interpreting from a position of certainty informed by theory and in the second she was using theory to reflect on her own responses and allow the patient to discover meaning for herself.

Child Couple and Family Therapy – Summer Institute

Posted on July 9, 2015January 18, 2019 by Melonie Bell

Anastasia Tsamparli welcomes Greek, American, Australian and South African participants to the IPI summer institute on child, couple and family therapy at the University of the Aegean in Rhodes, as David Scharff with whom she organized the course waits to give the opening lecture

The Infant-Parent Dyad with Björn Salomonsson, MD

Posted on April 18, 2015 by Melonie Bell

We’ve been fascinated this weekend at IPI by Dr. Björn Salomonsson’s account of his psychoanalytic treatment of infants with their parents. To develop an effective theory and technique for helping infants in distress we need to look beyond attachment research and developmental theory to include analytic theory and technique in our approach. It’s easy to believe that the analyst’s words communicate understanding to the parent. But Dr. Salomonsson believes that he can communicate directly with the baby. Many argue that you can’t analyze a baby because analysis is a talking therapy and babies can’t understand words. Others have argued that they do. But here it is important to distinguish between the lexical and the linguistic. True, babies do not understand the words but they respond to the patterns of the language, words, the rhythm of the speech, the affective tone, the authenticity and integrity of the analyst’s interest and reach the baby and give meaning to the experience. The analyst recognizes the baby’s distress, offers calm interest and concern, and conveys hope that the unmanageable distress can be understood and coped with through a process of co-thinking between baby and analyst and between baby and parent. The analyst recognizes the competence and responsibility of the baby to become a partner in the process of recovery.

– Jill Savege Scharff, M.D.

#theipi
@theipi
#PsychodynamicWeekend

Aspects of Trauma

Posted on February 27, 2015 by Melonie Bell

Caroline Garland speaking today at the International Psychotherapy Institute on aspects of trauma described how the traumatized person experiences the present trauma in the light of past trauma. Defenses against anxiety have broken down and led to extreme distress because the good objects have not been strong enough to protect against reality which now feels immensely unsafe. The person loses a sense of a personal future. When family love and supportive action is not enough, the traumatized person who comes to a therapist needs the containment of analytic psychotherapy — not hugs and action. We do not treat the trauma with compensation or solutions to block the pain. We offer a relationship in which we agree to listen and take in and bear the patient’s fear and pain and contain our reactions of helplessness and emotional distress. We need the support of analytic theory and discussion with our colleagues as we work to contain the trauma past and present and help the patient restore a sense of meaning and purpose in life.

—Jill Savege Scharff

Alvarez on Thoughts and Object Relations

Posted on November 17, 2014 by Melonie Bell

Anne Alvarez is interested in how thoughts are in dynamic relation and link together. Thoughts are highly active as people are. In health thinking is not static: it is always moving on; ideas can wait in line and do not disappear. Sometimes, however, our thoughts escape us and we feel frustrated if we can’t catch them. Other times we feel crowded by them. You cannot link thoughts together if the thoughts are not given weight. What gives weight to a baby’s thought is for it to be listened to and appreciated first by the primary objects and then by the baby herself. The curious baby has a thought, implements it, and takes pleasure in the resulting sense of agency. He also becomes aware of his thought having an effect on someone else’s mind. When there is too much disturbance thoughts cannot be thought, much less connected. When there is too much greed and impatience, the child in therapy does not take time to have his thoughts. Then the analyst needs to provide a container in which thoughts are held and can wait their turn to be thought.

‘The Thinking Heart’

Posted on November 17, 2014 by Melonie Bell

Anne Alvarez looked back over her clinical work of years ago and found her technique at that time insufficient for reaching the terror and despair of tormented, vulnerable children. The interpretation of projections into the therapist as defenses against wishes or of transference as resistance might be useful for those who can hold in mind two thoughts and feelings and two people at once but for these children it is better to speak not of wish but of rightful need so that the children know you understand their need for rectification of deficit. For instance, the child who seems indifferent to the analyst might wrongly be thought of as omnipotently defending against need but Anne Alvarez points not to defense against need but to lack of interest because of having had no interesting or interested object to look up to. Once that child knows the therapist is interested in him, he can become interested and eventually find himself interesting.

Anne Alvarez acknowledges aggression ( how could she not when the child has just put her neck out of alignment) but she cautions against interpretive emphasis on the death wish. When a child becomes angry or horrendously anxious about a weekend separation, rather than say to the child “You are showing me that you want me to die” or “You are afraid that I will die” she suggests saying, “It’s hard to believe I will still be here on Monday”. I enjoyed her emphasis on looking for the good, reliable, interested, surviving object. The child can identify with that good object because the analyst relates positively to the child and to the stability of the therapeutic contact, and she welcomes the child’s identification.

IPI November weekend conference

Posted on November 14, 2014 by Melonie Bell

Anne Alvarez is presenting today at IPI at the conference called The Thinking Heart (the same name as the title of her excellent book). Anne described three levels of therapeutic response — 1) explanatory, 2) descriptive, and 3) intensifying and vitalizing — depending on the state of mind of the patient. At the explanatory level the analyst makes an interpretation about what the patient is projecting into the analyst and why he needs to. At the descriptive level she describes what the patient feels and does not address why. Both these approaches involve addressing the patient directly as “you” but in some states of mind the patient experiences a “you” comment as persecutory. At the intensifying and vitalizing level, she simply says to the patient “it” is upsetting, acknowledging and sharing the experience without intrusion and without insisting on “you” and “I”.

Join our Mailing List