DALLAS SOCIETY FOR PSYCHOANALYTIC PSYCHOLOGY
Exploring and promoting the psychoanalytic perspective

Contents

January Meeting Preview
Review of December Meeting
Reflections on Psychotherapy as Action
Book Notice
Announcements
DSPP/FAIRHILL Scholarship Competition

JANUARY MEETING PREVIEW

Little Children, Big Problems: 
Primary Prevention with Damaged Children in Disturbed Families
Presenter:
Dale Lang Roskos, Ph.D.

In January, our presentations will turn to consideration of analytic work with non-traditional populations in novel settings. Increasingly, our members find themselves as a practical matter and of necessity or choice working in such arenas. These populations often deal with real deprivations rather than fantasized or feared ones; the scales tip toward struggles with actual loss rather than toward anxiety about loss. We will look at the ways analytic methods are adapted to such populations.

Dale Roskos, Ph.D., also a past president and founding member of DSPP, will offer our January presentation on hope for damaged children. For several years, Dr. Roskos ran a successful, primary prevention, treatment program for young children seriously at risk as members of disturbed families. Dr. Roskos will discuss the program and implications for primary prevention in today's treatment climate.

Readings

Fraiberg, S., Adelson, E., & Shapiro, V., (1987). Ghosts in the nursery: A psychoanalytic approach to problems of impaired infant-mother relationships. In L. Fraiberg (Ed.), Selected writings of Selma Fraiberg. (pp 387-419). Columbus: Ohio State Univ. Press.

Kramer, S. (1995). Parents’ hatred of their children: An understudied aspect of cross-generational aggression. In S. Akhtar, S.Kramer, & H. Parens, (Eds.) The birth of hatred: Developmental, clinical, and technical aspects of intense aggression. Northvale, NJ:Jason Aronson

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REVIEW OF DECEMBER MEETING

Hope for the Despairing Professional:
The Analytic Practitioner Faces Trauma

Presented by
Laurel Bass Wagner, Ph.D. and Pat Wood, Ph.D.

Reviewed by
Scott Nelson

In December’s meeting, Laurel Bass Wagner, Ph.D., president of the Division of Psychoanalysis of APA, and Pat Wood, Ph.D., president of DSPP, gave presentations on functioning as analytically-oriented therapists while experiencing personal suffering. Little concerning therapists’ experience of their own trauma exists in analytic literature, making these presentations not only deeply meaningful, but also insightful into the unpredictable and often tragic nature of life.

Dr. Wood shared with us her experience as a practicing analytic therapist and simultaneous mother of an ailing adult child. She discussed the terror, fear, and despair associated with the multiple surgeries and 60 hospitalizations of her daughter.

She eloquently described the therapy environment as one that contains not only the patient, but also concurrently the therapist. Psychoanalytic psychotherapy was described as the “best of work for the worst of times.”

Dr. Wood chronicled her own process of growth and understanding of her position as therapist through this family trauma. Initially, she struggled with what to tell patients about her increasing number of unexplained absences. Wanting to be particularly thoughtful in any

disclosure to patients, she decided to give basic information about her situation in a neutral way. She merely explained that a “relative of mine was ill, the illness was not life threatening, but that it might or might not require surgery, that the person would recover, and that I would have to be away to help.”

Most patients reacted appropriately to her disclosure. Patients who wanted to know more about the “ill relative” were told more and the curiosity was understood. As time went on, it became apparent to Dr. Wood that this disclosure was absolutely necessary.

Important case examples were brought into the presentation, particularly those with parallels between patients’ struggles and those of Dr. Wood’s own family. Therapies were progressively impacted by the disclosure of the therapist. Issues arose of absent mothers, deceased mothers and attempts to become mothers. These examples were more real for Dr. Wood, the analytic therapist who was the mother of an ill child.

Hope arises from the initial despair of this experience. Dr. Wood cited several quotes on processes similar to her own. Such experience illuminates the “remarkable resilience of the analytically based treatment situation which does not depend upon a rigid adherence to a set of rules.” The therapeutic potential of “therapist to receive from, as well as give to, one’s patients.” “For patients to recognize their capacity for generativity, concern, and forbearance would seem to hold considerable therapeutic potential.” A new understanding comes out of the “mutual aspects of containment.”

She described an “increased sense of common humanity which unites us with our patients.” In her conclusion, Dr. Wood included a paraphrased reference to Bion: “we’re all in this together, we’re all in this alone.”

Dr. Wagner shared a very personal and difficult episode of her life when she presented, “The Adoptive Journey: Identity Changes in the Analytic Therapist.” She eloquently wove together a private matter, her journey to become a mother, and its meaning within her life and relationships with psychotherapy patients.

She covered the history of women’s identity being equated with motherhood, in addition to the complex choices modern women have, from abortion to adoption. She covered the psychoanalytic discussion of “submissive roles,” and the omissions of phallocentrism within analytic thought. She described women’s newfound freedoms and pointed out that “freedom is seldom free.”

Included in her presentation were the various stages and decisions involved in attempting to facilitate motherhood, resignation to not being a mother, and later the decision to embrace the option of adoption. Further, Dr. Wagner discussed how these decisions and this process impacted and continues to influence the analytic relationships within her practice.

Despair came to Dr. Wagner through the shocking discovery of her inability to “do it all” – excel academically, achieve professionally, marry, and wait to become a biological parent. This realization came after utilizing much of what assistive reproductive technologies offer to those struggling to become parents. Dr. Wagner disclosed her own progression to the developmental task to saying to herself, “enough is enough.”

Throughout this presentation Dr. Wagner made references to the lifelong learning of the analytically oriented therapist, the changing of one’s perceptions of the struggles of patients, and a new respect for the power of biology in impacting the psychological experience of individuals.

Clinically, Dr. Wagner discussed countertransference in several clinical examples, primarily with adolescent female patients and their mothers. She also spoke of her patients’ ideas about her eventual decision to adopt and her method of disclosing to them this decision. Surprisingly, few adult patients revealed responses to her announcement. Her most notable responses came rather from children.

Dr. Wood and Dr. Wagner shared deeply meaningful and memorable stories of their own journeys from despair to hope. Through their disclosures, they open the door for further analytic thought on therapists’ trauma.

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REFLECTIONS ON PSYCHOTHERAPY AS ACTION

By
Robert Aberg, Ph.D.

I arrive at this topic by way of my interests in play therapy, improvised music, and, lately, golf. Also, it seems to me that much of the intensity that characterizes the conflict between the intersubjective and classical positions (oh no, not that again!) reflects our ambivalence that we psychoanalytically oriented therapists actually do things other than think, reflect, and--occasionally--understand.

I’m starting from the position that all of our behaviors—including “passive” behaviors like sitting still and listening—define our participation in co-creating the therapeutic relationship. Thus, “action” refers broadly to behavior in both active and passive modes. While there are perhaps innumerable elements that go into making a relationship therapeutic, I am most concerned with those that allow for moments of shared subjectivity. (Lest this sound too mystical, think of dancing or laughing together.) Behaviors relating to these elements can be thought of as “tuning in” behaviors and they occur in both patient and therapist. I am also assuming that all behavior—whether the patient’s or the therapist’s—is multiply determined by conscious and unconscious factors. In this sense, therapists do not have the ability to behave in a fundamentally different way than patients. Behavior is behavior, after all. In this sense, everything that occurs within the therapy can be viewed as an enactment of some kind. This can get confusing!

For example, as a psychoanalytically oriented play therapist I often find myself in the midst of a kaleidoscopically changing world where the boundary of real and imagined has all the substance of a flame. The pace and focus of the play may become patterned and concentrated (more like a burning coal) but always there’s some hoped for heat, a hoped for access to something vital, something operating on its own terms, always beyond description or knowing. As this experience takes shape, and as my patient and I begin finding ourselves in it, our awareness and—perhaps--understanding of what it is like for this child to be this child grows and develops. That part of my psyche that is trying to cast some sort of theoretical net over what’s going on from a developmental point of view is like the general figuring out how he might best fight the last war, i.e., always left behind. But that effort is also crucial in the sense that—assuming I’ve achieved any insight into the structure and dynamics of the patient—it can afford me paths and landmarks to follow to get up to where the action is. It’s like trying to figure out where to stand along a parade route to have the best chance of getting a glimpse of the patient as they (the “multiple” selves of the patient—not multiple personalities!) go marching by—and maybe run along side them for awhile and get them to notice me and wave back… For me, this running alongside is an active, highly engaged process. As we act out the play together, that’s me in the guise of the ship captain fleeing the Bad Batman team; that’s me crashing the F14 Tomcat into the carpet after being shot down by the invisible and invincible Stealth; that’s me contemplating my financial demise after landing on New York Avenue (with a hotel…) one too many times. But that is also me noticing when they have begun to notice me noticing (and responding to) them. And at those moments (“Did you just see what I just saw?”) our play has the potential to become something more than mere acting out. Interestingly, we don’t halt our play and have a nice chat about what the play is revealing about the structure and dynamics of the child’s psyche. Rather, the play typically moves forward in an invigorated way. One could say that greater integration and awareness of split off experiences develops and a strengthening/healing of the ego takes place. That is, through a play enactment of the split off experience the split off material has a chance to be made less threatening (“detoxified”), more conscious, and to thereby enrich the patient’s conscious attitude--as evident in a more flexible and creative approach to the play themes. Or one could say that we are exploring the patient’s transitional space. Or we could say that we are having some serious fun.

Does all this action or, really, enactment, mean a loss of authority or legitimacy, or that when we act, we are simply contaminating the patient’s pristine psychic space with our multiply-determined and fundamentally subjective take on things? How can we distinguish acting therapeutically from acting-out?

The word “asymmetry” is often used to describe an essential difference between psychotherapy and, for example, a conversation between friends or simply playing with a child. Certainly there is asymmetry with regard to the focus and intention of the therapist. We wish to know, first of all, what is it like for this patient to be this patient; secondly, how is it that the patient may be stuck or severely hampered in some developmental task; thirdly, is there a way of talking about and working through these stuck bits in the therapeutic relationship. In other words, it’s all about the patient. There is also asymmetry in experience and expertise. The therapist knows something about how these explorations of self (or self states) and others go. Therapists have been trained and supervised and, most importantly, have been on their own therapeutic journey. Having picked up a few things from our own training, supervision, and therapy, we are able to offer ourselves as willing to join and help guide the expedition into the patient’s unknown territory, i.e., their subjectivity. Like Lewis and Clark, we start out with our rough ideas about where and how to proceed and what we think we may find; but, also like Lewis and Clark, we must be ready, willing, and able to stand corrected by what we discover. We must be willing to be open to our experience because, after all, we don’t know what we don’t know. So, one thing that distinguishes acting therapeutically from acting out is that, whereas acting out is a defense that functions to obstruct or constrict conscious awareness, acting therapeutically carries the condition that the action (or enactment) will be examined from the standpoint of our previous understanding with an eye towards elaborating or changing our understanding so as to increase our shared awareness of the patient’s experience. Thus, it seems to me that what we are offering is a certain kind of mastery with regard to being able to get at where psychic life is happening.

One similarity between being a psychoanalytically oriented psychotherapist and being a jazz musician is the sense of living on the cutting edge of being an anachronism (as my brother-in-law—a book editor—has described his own job). We live in an extroverted, market-driven culture that tends to view self-expression and subjective pursuits generally as, well…boring. Indeed, our culture seems to view the Self principally from an instrumental perspective. (Do you have a “winner” sort of self or are you still trying to sport around in one of last year’s “loser” models?) There is a kind of cultural splitting between the notions of Self as Object versus Self as Subject. We—as a culture dedicated to a consumerist ideology--seem to be able to run endless laps around the quest to either capture or become the Self as Object of admiration and desire. ($250 million for a baseball player?) Yet, when it comes to the Self as Subject, few of us can be bothered to take much interest--even though it is in this domain that we experience our closest, most intimate connections with each other and with ourselves; even though it is in this domain that meaning and personal development are experienced; even though it is in this domain that learning and decisions to act (or not act) are made; even though it is in this domain that we can seek and sometimes experience the Self (our own and others’) as authentic and true (cf. Winnicott’s notion of the False Self). Why? Speaking for myself, I find that working through the maze of resistance, distractions, temptations, conflicts, and miscues is extremely frustrating. Much of the time it’s just too hard--and/or I’m just too lazy. But this kind of learning (expanding awareness/integration) happens only in patience and humility. It can only be done on its own terms and on its own schedule; it simply will not yield to wishes for grandiosity—no matter how intense. Authenticity is its own reward and there are no short cuts on the road to Truth or Beauty. Nuts!

The culture clash between objective and subjective views of the Self was best put in perspective for me by a now deceased friend, James Clay. James was a wonderful tenor saxophonist. He’d been a rising star in the 60’s jazz scene but had fallen on hard times and dropped out of the national scene. I got to know him because he continued to play locally. In the late 80’s James re-emerged with a nationally distributed recording, which, while not a best seller, was quite favorably reviewed in the New York Times. At about this time we were playing a private party and, during a break, I mentioned how I’d seen the review and how great I thought it was that he was getting some well-deserved recognition. He made it clear that it hadn’t meant that much to him, but then told me about the one “review” he’d really cared about. As a young man he was playing in a local club. At the time he was a relative “unknown” and there was no publicity about his appearance. But one of the club’s regulars happened to be walking by outside during a solo and, recognizing James’s tone and musical style, the man came in to listen. That was the point at which James felt he’d truly begun to establish his own musical voice. While James’s life was anything but free of misfortunes and miscues, he had an uncanny ability to lock onto that open, authentic place from which all jazz musicians want to play. James could open up and swing.

Which brings us to golf. While an objective observer might file my golfing exploits under the heading, “Sisyphus goes for a walk,” my subjective experience of the game is that it is full of beauty, pathos, exhilaration, and frustration, punctuated by hilarity. While I freely admit that it is, objectively speaking, probably the most amazingly silly game ever invented, no other endeavor has so spectacularly revealed to me the futility of grandiosity, the rewards of patience, and the Truth of humility. I find it an ongoing object lesson in the deviousness of my ego, which is always seeking ways to strut about in Thor-like splendor. And the best thing about the “swing-hard-in-case-you-hit-it” approach to golf is that it never works. Like the most disciplined and unshakable therapist, the little white ball is immune to being manipulated, psyched-out, or coerced by tantrums. Instead, it provides instant feedback in the form of psychic and somatic aches and pains as well as objective confirmation of the futility of my grandiose wishes in the form of zinging away left, fading away right, or--perhaps most dramatically--serenely sitting right where it was before I took my mighty swing. So, for me, it’s a psychological game about submitting (or not) to the reality principle in the form of the biomechanics of one’s physical being as it interacts with a golf club (that most absurd of all inventions!) while executing the Golf Swing. I succeed to the extent that I recognize and accept the limits imposed upon me by Reality. And, as for most of us hackers, the reward is simply in having the awareness of where I am and what I’m doing. (I, obviously, find golf courses exceedingly beautiful places to be!)

The idea of awareness is a common thread in all of this. Whether it is doing therapy, playing music, or searching for golf balls, the common goal is to expand awareness. Awareness in this sense is not the same as ability, insight, or understanding. Indeed, our abilities or ideas about things often serve to foreclose or delimit awareness. These are, in other words, always available to be used defensively. Whereas awareness always includes everything we know, it is also open to the idea that everything we know may, at a moment’s notice, be put into some new perspective that provides greater integration and richness to experience. And, we can take heart from the fact that there is no way through this maze by thought alone, that, at some point, we must jump in and act. This is because we know that our mistakes and always-imperfect efforts will, eventually, lead us to some new appreciation of where we are, what we’re doing, and who’s doing it.

Dr. Aberg is a clinical psychologist in private practice. He is a past president of DSPP and has presented at our monthly meetings.

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DSPP Member, Ronald Schenk, Ph.D. has a newly published book available, Dark Light: The Appearance of Death in Everyday Life.

“Dark Light is about seeing the world through imagination and stimulating our imagination about the world. It provides an imaginative account of how our daily lives are lived through us by larger forms and forces. The book reveals how these forms and forces play out in such ordinary experiences as ball games, television, relationships, violence, and race relations. In presenting the psychological and spiritual significance of death, Schenk details how our imaginations can help to reveal the soul, and allow us to live deeper lives. He puts forth three main ideas: (1) our everyday lives are shaped by patterns and images that link ordinary existence with the world of myth and spirit; (2) we can become aware of these patterns in our day-to-day experience by utilizing our imagination; (3) because the mysterious mythic elements usually work against our conscious ambitions and intentions, they may be felt as a sort of “death” while actually deepening our experience. In other words, while our will moves us toward one great, larger, more mysterious influences take us in different directions. Accepting our life experiences imaginatively as psychological events affords us the opportunity to live our lives from a deeper place. “

Dr. Schenk is a local Jungian Analyst and, when he’s not busy fine-tuning his melodic vocal chords with his favorite choir, you’ll find him at our monthly meetings.