Psychoanalysis On and Off the Couch

Available Episodes

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Candidates' Reflections on their Psychoanalytic Training with Himanshu Agrawal, MD (Milwaukee, Wisconsin)
“The theme that I found with IPSO [International Psychoanalytical Studies Organization] was that there was a common theme [in psychoanalytic training]. There was an initial phase full of terror and excitement, and then a middle phase of maybe some lethargy or apathy or disillusionment. In that middle phase, many candidates found IPSO, or IPSO found them, where they found refuge. They found solace. They found community, not just at their local institutes, but at this kind of world market. Many of the candidates talk about what a timely and wonderful experience it was to be seen, to be validated by fellow candidates in a way that only fellow candidates can do. At least a couple of the authors have written about how they were delighted to see that more than anything else we are similar as human beings, no matter where we're from.” Episode Description: We begin with recognizing the deep attachment that many analytic candidates have about their training experiences, which includes affections and resentments. Himanshu outlines the process of reaching out to candidates globally, inviting them to share their reflections on their journeys. We read from a sampling of their essays that eloquently describe their idealizations and de-idealizations, their delights and their burdens, their profound regard for the mysteries of the mind and the appreciation of the power of psychoanalysis to engage with it. We discuss the importance of IPSO, the difficulties associated with Covid and the relevance of our field's traumatic origins. Himanshu closes with sharing his story of encountering an insightful analytic supervisor during his residency and declaring "I want to be like him." Linked Episode:Episode 89: Wisdom and Enthusiasm for Today’s Candidates with Fred Busch, PhD Our Guest: Himanshu Agrawal, MD is an adult and child psychiatrist and recently completed psychoanalytic training through the Minnesota Psychoanalytic Institute. He is an associate professor of psychiatry and behavioral medicine at the Medical College of Wisconsin in Milwaukee where he sees patients, conducts research, and teaches. He recently completed his term as the president of the candidates’ council of the American Psychoanalytic Association Recommended Readings: Busch F (Ed), Dear candidate. Routledge, 2020 Agrawal H, Trials and Tribulations of being a candidate. The American Psychoanalyst, winter 2022 Kernberg O, Thirty methods to destroy the creativity of psychoanalytic candidates. International Journal of psychoanalysis, 77, 1031- 1040
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Reflections on Our Changing Field with Stefano Bolognini, MD (Bologna)
“When we reconstruct [in a patient] a possible lacking object or role or function, we see that if the analyst himself has been able and the patient allowing him to be able to enter to a deep level the objective reality of the internal world of the patient, it can happen that some new function or position can be achieved. This is something that could be rare but it happens. This is one more reason for not blaming the length of some analytic treatments, because time is needed for entering that internal deep area where the analytic relation can create something new. Transformation is also one of the words that in our analytic world became more and more common and utilized because we have achieved the certainty that there can be a transformation. Not only an understanding or a clarification, but also a transformation of the quality of the objective world and of the relation with it.” Episode Description: We begin by describing the differences in psychoanalytic approaches today as compared to past generations. This shift has occurred alongside changes in patients' concerns; currently, individuals are disproportionately preoccupied with how they perceive themselves through others' eyes, rather than grappling with internal conflicts related to guilt. Stefano posits that this increased narcissistic investment stems from alterations in family structures and premature disruptions in "the physiological fusionality" with the early maternal caretaker. We discuss how this sense of distrust in the availability and reliability of caretakers affects the manner in which one introduces a patient into analysis, as well as the broader cultural emphasis on superficial bodily care - what he terms the aperitif experience. We consider the fundamental importance of the depth of object relations in understanding sexual diversities. Stefano concludes by reading the final paragraph from his book, which acknowledges the invaluable lessons learned from his analyst. We reflect on the enduring presence within him of this profoundly personal connection. Linked Episodes: Episode 140: Are Patients Different Today? with Stefano Bolognini, MD (Bologna) https://youtu.be/rjzpA8QZrWk?si=Srf_Tuxt0zTpsKNK Our Guest: Stefano Bolognini, MD, is a psychiatrist and training and supervising analyst of the Italian Psychoanalytic Society (SPI), where he served as president (2009-2013). He also was an IPA Board member (2002-2012) and was IPA president from 2013-2017. He was a member of the European Editorial Board of the International Journal of Psychoanalysis and a founder of the IPA Inter-Regional Encyclopedic Dictionary of Psychoanalysis. He has published over 280 psychoanalytic papers, and his books on empathy and on the inter-psychic dimension have been translated into several languages. Recommended Readings: Bolognini, Stefano - Secret Passages. The Theory and Technique of the Interpsychic Relations. IPA New Library, Routledge, London, 2010 https://www.amazon.com/Vital-Between-Non-Self-Library-Psychoanalysis/dp/1032132973, Routledge, London, 2022 https://pubmed.ncbi.nlm.nih.gov/21387998/ Psychoanal. Quart., vol. LXXX, 1, 33-54, 2012. Enchantments and disenchantments in the formation and use of psychoanalytic theories about psychic reality. The Italian Psychoanalytic Annual, 13, 11-24, July 2019. New forms of psychopathology in a changing world: a challenge for psychoanalysis in the twenty-first century. The Italian Psychoanalytic Annual, 2020. Reflections on the institutional Family of the Analyst and proposing a “fourth Pillar” for Education. Opportunities and problems of transferal dynamics in the training pathway“. In Living and containing Psychoanalysis in Institutions. Psychoanalysts Working Together, edited by Gabriele Junkers, 89-104, Taylor & Francis, 2022. From What to How : A Conversational with Stefano Bolognini on Emotional Attunement by Luca Nicoli & Stefano Bolognini. The Psychoanalytic Quarterly, 91 : 3, 443-477, 2022. The Interpsychic, the Interpersonal, and the Intersubjective: Response to Steven H. Goldberg’s Discussion. The Psychoanalytic Quarterly, 91:3, 489-494, 2022. Hidden unconscious, buried unconscious, implicit unconscious. The Italian Psychoanalytic Annual, 16, 87-102, 2022.
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Discovering the Process of One's Mind with Fred Busch, PhD (Chestnut Hill, Mass.)
“The original papers that were written about the analyst’s unconscious being attuned to the patient's unconscious by Hyman and Racker, in both cases they talk about this phenomenon. But both of them utter a caution, which is that one always has to take into account one's own ‘mishegas’. Essentially, what they're saying is, the unconscious is pretty individualistic and we have our own things, and we have to consider that possibly it's our own difficulties, our own unconscious, that is playing a bigger role in our countertransference reaction to the patient's unconscious.” Episode Description: We begin by discussing the meaning of the many italics throughout the book and my sense of their being an expression of Fred's wish to be carefully understood. This is part of our conversation where we examine how internal reactions are used to comprehend another person's mind. There are a number of themes to this work, and to Fred's contributions over the years, which focus on helping individuals understand the way their mind works, as distinct from the particular contents of their mind. One of the gifts of psychoanalysis is to facilitate patient's discovery of the freedom to think which allows for a post-termination capacity for self-analysis. We discuss how self-criticism can serve as an unconscious lifeline, the importance of attending to the need for silence as distinct from what is not being said and the seductiveness of gossip, to name but a few of the topics in the book that we cover. Fred closes by describing "The wonderful thing about being a psychoanalyst is there are always things to learn and ways to grow." Our Guest: Fred Busch, Ph.D. is a Training and Supervising Analyst at the Boston Psychoanalytic Society and Institute. He has published eight books, and over 80 articles on psychoanalytic technique, along with many book reviews and chapters in books. His work has been translated into many languages, and he has been invited to present over 180 papers and clinical workshops nationally and internationally. His last six books are: Creating a Psychoanalytic Mind (2014); The Analyst’s Reveries: Explorations in Bion’s Enigmatic Concept (2019); Dear Candidate: Analyst From Around the World Offer Personal Reflections on Psychoanalytic Training, Education, and the Profession (2020); A Fresh Look at Psychoanalytic Technique (2021), Psychoanalysis at the Crossroads: An International Perspective (2023).The Ego and Id: 100 years later (2023), How Does Analysis Cure? (2024). Recommended Readings: Busch, F. (2014). Creating a Psychoanalytic Mind: A Psychoanalytic Method and Theory. London: Routledge. Busch, F. (2019). The Analyst’s Reveries: Explorations in Bion’s Enigmatic Concept. London: Routledge. Busch, F. (2021). A Fresh Look at Psychoanalytic Technique: Selected papers on Psychoanalysis. Routledge: London. Busch, F. (2023) The Significance of the Ego in “The Ego and the Id” and its Unfulfilled Promise. International Journal of Psychoanalysis 104:1077-1090. Busch, F. (2000). What is a deep interpretation? J. Amer. Psychoanal.Assn., 48:238-254. Busch, F. (2005). Conflict Theory/Trauma Theory. Psychoanal.Q., 74: 27-46. Busch, F. (2006). A shadow concept. Int.J.Psychoanal.,87: 1471-1485. Also appearing as Un oncerto ombra, Psycoanalisi, 11:5-26. Busch, F. (2015). Our Vital Profession*. Int. J. Psycho-Anal., 96(3):553-568. Reprinted in Busch, F. (2015). La nostra professione vitale. Rivista Psicoanal., 61(2):435-456; Busch, F. (2015). Nuestra profesión vital*. Int. J. Psycho-Anal. Es., 1(3):605-627; Busch, F. (2015). Nuestra profesión vital1. Rev. Psicoanál. Asoc. Psico. Madrid, 75:131-153.
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Religion, 'Allegorical Objects' and Levinas with David Black, PhD (London)
“The idea of analytic neutrality, which was more or less a cliche truth when I was training back in the 1980s, is clearly getting at something very important, which is that we mustn't try to pre-conceive where the patient's development is going to take him or her. But that doesn't mean that the development is not in a direction. Aristotle famously said that the human being is a ‘zoon politikon’, a creature who belongs in a somewhat structured society. Healthy development is in that sort of direction as we become more integrated, as our ‘ghosts become more like ancestors’, to use that famous metaphor. We become more aware of the reality of other people and their real as opposed to their fantasy importance in the ecosystem of which we are all part. And this makes possible the sort of ethical realization that Levinas was talking about. We recognize the reality of the other. We discover that we are interconnected. We are part of something that is hugely greater than ourselves and that goes beyond our knowing. But of course, that doesn't mean that we are not also selfish and unique selves. It's that we are under pressure, so to speak, from both quarters.” Episode Description: We begin with David's description of Freud's view of religion as offering "compellingly attractive" illusions in the face of the helplessness we face by life's and death's unpredictability. Alternatively, David suggests that religions provide 'objects', ie Gods, that are importantly allegorical and offer an ‘ethical seriousness’ over time. We discuss the ability of these allegories to offer possibilities of 'transcendence' in a world that he sees as often limited to the material. He presents Levinas' view of the responsibility we all have when encountering "the face of the other" - a responsibility that is not chosen but "slipped into my consciousness like a thief." We consider the ethical differences between one’s superego and one's conscience. We close with David sharing with us the vicissitudes of his early life that, as for us all, form a context for our later interests. Our Guest: David Black studied philosophy and Eastern religions before training in London, first as a pastoral counsellor and later as a psychoanalyst. He is a Fellow of the British Psychoanalytical Society, now retired, who has written widely on psychoanalysis in relation to matters of ethics and religion. In 2006 he edited Psychoanalysis and Religion in the Twenty-first Century. He has published two collections of his own psychoanalytic papers, most recently Psychoanalysis and Ethics: the Necessity of Perspective. He is also a poet and translator, whose translation of Dante’s Purgatorio was published in 2021 in the New York Review of Books Classics series. (It was later the winner of the annual American National Translation Award in Poetry.) Visit David Black’s website at: https://www.dmblack.net. Recommended Readings: Black, D.M. Psychoanalysis and Ethics: The Necessity of Perspective. (2024: Routledge New Library of Psychoanalysis.) Chetrit-Vatine, V. Primal Seduction, Matricial Space, and Asymmetry in the Psychoanalytic Encounter. (2004: International Journal of Psychoanalysis, 85: 4. Lear, J. Wisdom Won from Illness. (2017: Harvard University Press.) Lemma, A. First Principles: Applied Ethics for Psychoanalytic Practice. (2023: Oxford University Press.) Levinas, E. Ethics as First Philosophy. In The Levinas Reader, ed. Sean Hand. (1989: Blackwell Publishing.) Loewald, H. Papers on Psychoanalysis. (1980: Yale University Press.)
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Childhood Memories: Their Impact on Mothers and Their 0–3-year-old Children with Ilene Lefcourt (New York)
“There are very specific fears that people have that are specifically related to their own childhood, and I'd like to give an example. A mom with twins had a kidnapping fear. She was afraid every time she saw a car drive by her house that her twins would be kidnapped. Now this mother was herself adopted when she was a newborn, but her adoption did not become final until she was one year old. Her twins were approaching one year. I was struck by the anniversary of her fear of kidnapping, and when I asked her who she thought was driving the car that drove by her house, she blurted out, 'my biological mother - adoption was never an issue for me, I have the best parents,' she said, but her fears about her babies being kidnapped were rooted in her own guilty feelings. She said, 'I get to keep my biological babies and my biological mother did not. I can have biological babies and my adoptive mother could not.' Carrie’s fantasy that her biological mother was threatening to kidnap her babies represented both her fears of retaliation for her aggressive victories over both her biological mother and her adoptive mother, and the repair of her disavowed feeling of loss by a reunion with her biological mother. This meaning of the memory, this understanding of the memory, resolved her kidnapping fear. It dissolved.” Episode Description: We begin with an overview of the importance of mothers' childhood memories in their experience of their own children. These memories are of the conscious sort and also the not-so conscious. They are of the loving as well as the misattuned versions. "The challenge for mothers is to understand the complexity of their own childhood memories and to help their babies and toddlers adapt to the everyday ups and downs of life, as well as to the exceptional ones." We discuss typical fears, sleep problems, 'mutually-regulated patterns', naming body parts, nakedness, weaning and screen time. Ilene ran mother-baby-toddler groups for 35 years and shares with us her relentless curiosity for what we all bring to the parenting experience. Our Guest: In 1982, Ilene Lefcourt established the Sackler Lefcourt Center for Child Development - programs for parents and their children from birth to three years. She was the Director, led the Mother-Baby-Toddler Groups, and provided Developmental Consultation to parents for over 35 years. She saw over 1,000 families and taught Child Psychiatry Residents and Parent-Infant Psychotherapy Trainees about her work. She has been a faculty member at the Columbia Psychoanalytic Center since 1995. Ms. Lefcourt is currently in private practice in New York City. She is the author of When Mothers Talk, Parenting and Childhood Memories, and Mother-Baby-Toddler Group Guide. Her forthcoming book is, Mothers and Daughters: The First Three Years. Visit Ilene’s website: http://ilenelefcourt.com/. Recommended Readings: 1975, Fraiberg S. Adelson E., Shapiro V., Ghosts in the Nursery, Journal of the American Academy of Child Psychiatry, 14, 387-421 1975, Mahler, M., F. and Bergman, A. The Psychological Birth of the Human Infant, Basic Books 1985, Main, M. Kaplan, N. Cassidy, J. Security in Infancy, Childhood, and Adulthood: A move to the Level of Representation. Monographs of the Society for Research in Child Development 1991, Fonagy, P., Steele, M., Steele,H., Moran, G. S . The Capacity for Understanding Mental States. Infant Mental Health Journal, 12(3) 201-218 1992, Bretherton, I. The Origins of Attachment Theory. Developmental Psychology, 28(5) 759-775 1993, Lieberman, A ., The Emotional Life of the Toddler, Simon and Schuster 1995, Stern, D. The Motherhood Constellation, Basic Books 1998, Stern, D., Brushwweiler-Stern, N. The Birth of a Mother. Basic Books 2005, Lieberman, A., Angels in The Nursery, Infant Mental Health Journal. Vol. 26(6)
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