November 2000

DECEMBER MEETING PREVIEW

Hope for the Despairing Professional:
The Analytic Practitioner Faces Trauma
Laurel Bass Wagner, Ph.D. and Pat Wood, Ph.D.

In December, Laurel Bass Wagner, Ph.D., president of the Division of Psychoanalysis of APA, and Pat Wood, Ph.D., president of DSPP, will give presentations on functioning as analytically-oriented therapists while experiencing personal trauma. Obviously, real life does not stop, and therapists face losses at times. Those losses inevitably impinge on the therapist's professional life. Drs. Wagner and Wood will talk about transference and counter-transference issues, which inevitably arise in such circumstances.

Recommended Readings

Morrison, Andrew. (1996). Trauma and disruption in the life of the analyst. In B. Gerson, (Ed.), The therapist as a person: Life crisis, life choices, life experiences, and their effects on treatment (pp. 41-54). Hillsdale, NJ: The Analytic Press.

Civin, Michael A. & Lombardi, Karen L. (1996). Chloe by the afternoon: Relational configurations, identificatory processes, and the organization of clinical experiences in unusual circumstances. In B. Gerson, (Ed.), The therapist as a person: Life crisis, life choices, life experiences, and their effects on treatment (pp. 89-100). Hillsdale, NJ: The Analytic Press.

Smith, Betsy, Surrey, Janet L., & Watkins, Mary. (1998). “Real” mothers: Adoptive mothers resisting marginalization and re-creating motherhood. In C G Cull, J. L. Surrey, & K. Weingarten, ( Eds.), Mothering against the odds (pp. 104-214). New York: Guilford Press.

DIVISION 39 MEMBERSHIP INVITATION

As President of the Division of Psychoanalysis it is my pleasure to invite DSPP members to join Division 39. As a local chapter of Division 39, DSPP is my home. I am very proud to be a member of DSPP. My work in Division 39 started when I represented DSPP in the Section of Local Chapters. I went on to be that Section’s Treasurer and President and from there become a Member-at-Large to the Division Board for three years and then President of the Division. I remember feeling lost and out of place at my first Section of Local Chapters Senate meeting. But, as I got to know the representatives from other local chapters I found a group of colleagues who remain valuable to me to this day. The more involved I became in the Division of Psychoanalysis the more I met intelligent, inquisitive colleagues who share a common love of psychoanalysis while encompassing many different theoretical views and traditions. I say all this because I view the collegiality of Division 39 as one of its strongest assets. I have attended every Spring Meeting for the past twelve years and these meetings and the discourse I have encountered have been invaluable to me in my growth as a psychoanalytic therapist.

In 1998 the Division 39 opened membership to those in other disciplines who are interested in psychoanalysis. This decision was based in large part on a wish to include the many valuable non-psychologist members of local chapters. I am proud and honored to be President of the Division of Psychoanalysis and I hope that each of you will consider finding a home in the Division.

Laurel Bass Wagner, Ph.D.

OCTOBER MEETING REVIEW

Hope or Despair for the Analytic Practitioner’s
Professional Future

Malcolm L. Bonnheim, Ph.D.
----------
With Opening Remarks by
Scott Nelson

A Student’s Perspective on Hope for Incorporating
Analytic Work in the Practice of the Future
---------------
Reviewed by Don J. Brix, Ph.D.

Mr. Nelson:

In a pleasantly autobiographical style, Scott Nelson told us of his pilgrimage reaching the decision to become a clinical psychologist. He is now in his fourth year of the training program at The University of Texas Southwestern Medical Center. His early exposure to psychology as an undergraduate student at SMU was a definite turn-off. Compared to the “interesting readings, curious questions from students, …uncertain but thoughtful answers from the professors,” of his History, Religious Studies and Political Science courses his psychology course was dull, being an endless reference to the research base of the field. He thus decided to become a History professor.

But then he took a class, which exposed him to Freud and Jung. With the counsel of several professors as well as DSPP’s own Dr. Dale Godby, a Nelson family friend, Scott discovered that clinical psychology was what he wanted to pursue.

So it was off to graduate school at Loyola Marymount University in Los Angeles. “In a way, what I did was postpone a quest for understanding, in order to take in so-called facts and truly scientific findings.” He ponders, “What took me from the quest to understand stories and history, through the facts and figures and back again? Many things. Time, curiosity and hope, yes, but most importantly YOU.”

His perspective is that while analytic theories are still part of the currency of graduate departments, their place is much diminished. Which leads him to heap enormous credit on DSPP and, by inference, similar groups for keeping alive an interest in the study of an analytic approach to understanding the human situation.

Dr’s. Melissa Black, Malcolm Bonnheim and John Herman were mentioned explicitly as DSPP members by whom he has been beneficially influenced. He concludes, “In summary, it is this community and its continuing efforts that bridge the space between hope and despair for the analytic practice of the future.”

Dr. Bonnheim:

One time I heard Dr. Bonnheim say to a patient, “I don’t think you believe you have an unconscious.” It was during a group therapy session in which he and I were acting as co-therapists. Like any single intervention with a patient, his confrontation probably didn’t of itself, transform the person’s life, but in an unexpected way his words continue to have an effect on me. Said briefly, the remark started me thinking about the likelihood that skepticism about “having an unconscious” is much more widespread than is quickly obvious. Superficial acceptance of the notion of an unconscious within so many cultures probably masks the enormous resistance to really buying into the idea at an individual level. It’s not easy for most of us to come to terms with the reality that our life is being swept along by forces which are, paradoxically within us and yet operating entirely beyond our awareness. During the course of his recent formal presentation, Dr. Bonnheim drew attention to the importance, as therapists of having our own attitudes clear about our ability to help. “If our conviction (about the efficacy of psychoanalytic therapy) is comfortable and well internalized, we have a clarity in our efforts to structure the therapy and educate the patient to the process…”

Malcolm Bonnheim’s thirty years experience coupled with an array of beneficial internalizations and his willingness to stand humbly before his own unconscious were manifest in his competent yet unpretentious presentation on the evening of October 18. He launched into his remarks by reminding us of the popularity of “Freud bashing” as well as the explicit salvos Psychoanalysis has endured from critics including Crew, Grunbaum, Tillis and Steinham. Drastically diminished popularity within training programs for mental health professionals and the near contempt with which managed care organizations view psychoanalytic therapies add to the besieged status of “psychoanalytic prescriptions for treatment.”

“Given the criticisms, disappointments and threats, is the practice of psychoanalytic psychology to be relegated to the quaintness of an historical curiosity…or will it endure?” To Dr. Bonnheim “the only sensible place to begin to explore this and related questions is with our human nature; our instinctual base.” He proceeded to remind us that human beings are meaning makers. “Efforts to unravel meanings have been unrelenting pursuits of humans throughout history…” He emphasized the point by quoting a patient who recently remarked, “I don’t want to just manage my anger, I want to find out what this anger means about me.” Add to this human penchant to seek meanings, the fact that psychoanalysis is concerned with “systematically unraveling drives, motives and meanings and, in Dr. Bonnheim’s mind the pursuit of understanding which is embodied in psychoanalysis is so closely allied with our human instincts as to almost guarantee its survival.

Stay in a helping profession long enough and you will probably find yourself singing a paean to the overarching virtue, in this work we do, of simply listening. Dr. Bonnheim segued to this topic by mentioning having attended a public appearance of Ellie Weisel speaking about the culture of violence in our world. He heard Weisel describe the soothing and transformative effect of being acknowledged and listened to when one is the victim of unspeakable trauma.

The fundamental need we have to be listened to was related to early developmental experiences between parents and infants, experiences in which the infant learns that he or she is of interest to and has value to another. Dr. Bonnheim suggested the child internalizes “a sense and image of who they are” from these experiences. He went on to differentiate this idea a bit more, suggesting that optimally, respectful listening is not a stand-alone behavioral performance but rather grows from the “act, attitude, and emotion of being interested in the other.” He adds that such experiences are “probably at the core of how healthy narcissism is established and the heart of the experience of feeling loved.”

His reasoning evolved into a near-syllogism. “If …our search for meanings, our needs for self-expression and freedom, our needs to be listened to empathically and with interest, and if the core values of psychoanalytic psychology are founded on such pursuits, the match between our basic nature and psychoanalytic psychology is so complimentary that it is inconceivable to me that in the long run we will not repeatedly return to our deepening psychoanalytic science to better (understand ourselves).”

From here, Dr. Bonnheim’s paper moved to a consideration of the political and economic realities, which we face. He mentions a sprinkling of countries where generous coverage for psychotherapy, even psychoanalysis is available. These are countries with much more socialized systems than ours and even if our country eventually moves in this direction it would be many years away. Similarly, to hold our breath awaiting a day the policies of managed care companies become friendlier to the delivery of long-term therapies, Dr. Bonnheim believes to be “not only a serious mistake, but an avoidance of reality.” His counsel is rather to “accept what actually can be.” He draws attention to the time, prior to widespread insurance reimbursement for the cost of psychotherapy, when those seeking treatment were much more prepared to pay out-of-pocket. While giving up reliance on third party support is a more mature and honest arrangement, it requires educating potential patients regarding the merits of making such an investment conveying to the person “the integrity of their treatment and confidentiality … can only be assured in a private pay arrangement.” He acknowledges that therapists may have to reconcile themselves to reduced incomes particularly when our economy eventually weakens.

“…I believe that the future of psychoanalytic psychology includes creatively addressing ourselves to the various opportunities we have for psychoanalytically based treatments, beyond strict psychoanalysis and technically pure psychotherapy.” What this means to Dr. Bonnheim is occasionally conducting what he has come to call psychoanalytic counseling, for example with parents struggling with how to discipline a child. In this situation he serves a psychoeducational function. It means realizing he must at times move to a role of guidance as he has currently done in dealing with a patient, not able to tolerate transference issues which would emerge in more intensive treatment. Citing Robert Wallerstein as his source, Dr. Bonnheim mentioned the increased interest in (non-clinical) psychoanalysis in a variety of academic disciplines. And he added, “psychoanalysis is a growth industry,” in Latin America, Europe, Russia and Asia.

Touching briefly on training, Dr. Bonnheim sees little prospect for renewed enthusiasm in traditional academic programs. He drew attention to possibilities that exist within Division 39 as well as local groups such as the Dallas Group Analytic Practice. His final prescription: resolve our own conflicts, most notably our regressive wish that we be cared for just so by our society, and our oedipal reluctance to give up the fight for power over managed care and the politics of academia, and go our own way…”

Listening to Faith and Doubt

Dale C. Godby, Ph.D.

Margaret Mahler, who helped us understand how we develop an internal sense of security, tells us in her memoirs about her sense of security. “On arriving in England in 1938 and seeing the British Union Jack, she felt a sense of security she had long lost in Vienna. On arriving in the United States six months later and seeing the Stars and Stripes, she felt a greater sense of security. But one evening, years later, when she was driving a car in Manhattan and saw a lit synagogue, she felt the greatest sense of security of all. It is perhaps fitting that in 1985, the year of her death, Margaret Mahler attended Rosh Hashanah services at New York’s Temple Emanu-El. It was the first time…that she had set foot in a synagogue in almost half a century…” Stepansky tells us that Mahler’s lifelong affirmation of her Jewishness coexisted with her nonobservance, (Stepansky, 1988, pp. 158-159).

So how do you listen to this brief vignette from Mahler’s life? What does it say about her faith, her sense of security? And what of her life long practice of religious non-observance? If she were a patient telling you this, where would you start? Would you wonder how the light from the synagogue could bring security? How is it that this symbol of Judaism could bring security after losing her mother in the Holocaust? Or would you wonder with her why she kept her self from a more mindful observance of her faith. What blocked her from an intentional practice of Judaism, which may have led to a deeper, more intimate, and fulfilling sense of her Jewish identity? In short, do you analyze her belief or unbelief? If we answer both, where do we start and why?

Freud placed his focus on the analysis of immature belief. He failed to see belief as a developmental line from the immature to the mature and neglected to analyze his own unbelief or doubt. Why Did Freud Reject God? A Psychodynamic Interpretation, a new book by Rizzuto (1998), reviewed by Halpern (2000), places Freud on the couch to develop a psychoanalytic formulation of his atheism through an unfolding of his deep disillusion and compulsive self-reliance. This book points clearly to the fact that the psychoanalytic community has frequently failed to analyze unbelief. Our task is to understand both faith and doubt.

So when patients present us with narratives of their life of faith and doubt, we should be alert to what we choose to analyze. A therapist with a Buddhist meditation practice listens to his Jewish patient tell about having taken up a Vipassana meditation practice. As he listens to her tell of the joys and sorrows of meditation, should he analyze what has made it possible for her to incorporate some healthy discipline into her life? Or should he wonder what keeps her form mining the depths of her Judaism. Knowing she has recently fallen in love with an orthodox man at the same time she is taking up a Vipassana practice further complicates the psychodynamic understanding of her new religious practice. The complexity of an analysis of her belief and unbelief rapidly becomes apparent. Fortunately, we have more than Freud to make sense of these complexities. James Jones offers an excellent example of the depth that is being offered by psychoanalytic writers in his Contemporary Psychoanalysis and Religion: Transference and Transcendence, (1991).

Therapists frequently feel stymied by their lack of knowledge about a particular patient’s faith. This can be an advantage. A good place to begin when the patient presents belief as an organizing issue is to ask them to explain who in their faith tradition they particularly admire. Who are the heroes of their faith? Try to develop with them a developmental line of faith and practice that ranges from the immature to the mature. One listens to these hero stories with the sense of the ironic that is reflected in Scott Fitzgerald’s, “Show me a hero, and I will write you a tragedy.” There is a fine line between listening with an ironic sense and listening with a skeptical or cynical sense. The believing patient will often notice the difference between therapists who analyze faith with an eye toward maturing their faith versus eliminating it.

The type of belief or unbelief the patient presents can often be placed in a useful context by understanding the practices of their parents or grandparents. Frequently, one discovers a variety of practices and intensities of belief and unbelief. The patient who wants to know what you believe as a therapist can sometimes be helped by looking at the practice of his ancestors. As the patient explores the faith and doubt of his relatives it will usually become clear that his decision about what to believe or practice won’t be solved by getting the therapist’s confession of faith. When parents and grandparents are seen to have a range of faith and doubt the patient is confronted with the need to make an existential choice. As their therapist you can help them look at the psychological meaning of their choice, but you can be of little help in deciding the truth claims of one over the other. In spite of this limit, the therapist can often be useful in helping the patient find an authentic balance between his faith and doubt. The therapist need not practice the patient’s particular faith to do this. Moses led the Israelites to the Promised Land but didn’t enter in himself. If as therapists we are willing to struggle with the dynamics of our own belief and unbelief, we will be in a better position to help our patients with theirs.

References

Godby, D. C. (2000). Spirituality in psychodynamic
group psychotherapy. www.dgapractice.com/papers/SpiritBib.htm  Provides further reading and references on the topic discussed here.)

Halpern, J. (2000). Review of Rizzuto’s Why did Freud reject God? A Psychodynamic interpretation. In Journal of the American Psychoanalytic Association, 48, 1009-1013.

Jones, J. (1991). Contemporary psychoanalysis and religion: Transference and transcendence. New Haven and London: Yale University Press.

Rizzuto, A.M. (1998). Why did Freud reject God? A Psychodynamic interpretation. New Haven and London: Yale University Press.

Stepansky, P.E., (Ed). (1988). The memoirs of Magaret S. Mahler. New York: The Free Press, pp158-159.

Editor’s Note: I’d like to thank Dr. Godby for submitting his thought-provoking article to the DSPP Bulletin. Dr. Godby’s paper is the first of several DSPP member articles and book reviews to be published in the DSPP Bulletin this year. Comments are welcome and encouraged.

ANNOUNCEMENTS

DSPP FILM GROUP PRESENTS

“THE EXECUTION”

Documentary of a Three-Year Interview Series
by
Alan Austin
With Clifford Boggess, Artist and Texas Death-row Inmate who was executed in 1998

Sunday, December 3, 2000
5:00 pm

A DISCUSSION FOCUSED ON PSYCHOANALYTIC ISSUES ARISING FROM THE FILM WILL FOLLOW

Hosted By:
Sandra Pitts, Ph.D.

Open to DSPP Members and Invited Guests

Pot Luck Buffet
Please RSVP Your Attendance to the Host

DSPP SPRING STUDY GROUP

Introduction to Melanie Klein

Study Group Leader: Myrna Little, Ph.D.

Begins January 8th

This study group will focus on the themes that guide Melanie Klein's work - greed, hatred, aggression, the guilt these ugly passions evoke, and the attempt to make reparation for the damage they cause. Using clinical material from Klein, as well as from cases volunteered in the class, the integration of Klein's theory with practice will emphasize object relations and defences, and enactments in the transference and countertransference as the therapist's tools for containing and interpreting.

Experienced clinicians are encouraged to join.

For information contact Myrna Little at 972-233-0647, m.little@airmail.net  or John Herman, Ph.D. at 214-456-7267, remsleep@mindspring.com

Full details and schedule