Table of Contents > Printer Version
Self Psychology News
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Kati Breckenridge, Ph.D., Psy.D., is the new Editor-in-Chief for the IAPSP newsletter. She is a past president of the Institute of Contemporary Psychoanalysis in Los Angeles where she is a faculty member and a supervising/training analyst. She has a private practice in West Los Angeles. email newsletter@psychologyoftheself.com Holly Levenkron, LICSW, is former co-director of analytic training at ICP in New York City where she was also faculty and a supervising analyst. She is currently teaching in the analytic training program and in the post graduate fellowship program at MIP in Cambridge, MA. She has a private practice in Cambridge, MA. email eastcoast@psychologyoftheself.com Amy Eldridge, Ph.D., is Dean of the Institute for Clinical Social in Chicago. She has a private practice seeing adults, adolescents, and children. She is a member of the governing council of the IAPSP and is on the editorial board of the Clinical Social Work Journal. email midwest@psychologyoftheself.com Nancy VanDerHeide, Psy.D., Ph.D., is President-elect at the Institute of Contemporary Psychoanalysis in Los Angeles where she also teaches and is a training and supervising analyst. She is Associate Editor for the International Journal of Psychoanalytic Self Psychology and Assistant Editor for Psychoanalytic Dialogues. She has a private practice in Beverly Hills, CA. email westcoast@psychologyoftheself.com S. Giac Giacomantonio, MAPS, is a psychologist in private practice in Brisbane, Australia. He teaches and supervises in the post-graduate training programs in the psychiatry and psychology departments at the University of Queensland and at the Queensland University of Technology. He is a founder of the Brisbane Psychoanalytic Self Psychology Group and he is the National Convenor of the Australian Psychological Society's Psychoanalytic Interest Group. email international@psychologyoftheself.com Editor's IntroductionKati Breckenridge | ||||||||||||
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Hi, I'm Kati Breckenridge and this is my first year as the Chief Editor of Self Psyhology News, the IAPSP online newsletter. Let me introduce my area editors: the West coast Editor is Nancy VanDerHeide; the East coast Editor is Holly Levenkron; the Midwest Editor is Amy Eldridge; and the International Editor is Giac Giacomantonio. More information about the editors can be found in the masthead. Christine Kieffer was formerly the Editor-in-Chief and she leaves me with big boots to fill. Having worked on the newsletter for awhile now, I can really appreciate what she did for IAPSP. So... to the contents: There are three op-ed articles about the issue of confidentiality and the Internet as it relates to our clinical case presentations. Sietze VanDerHeide sets out the legal implications and makes some suggestions. Andy Morrison offers a disturbing example of what can happen when a patient's material is published on the Internet and then is recognized by that patient. Amy Eldridge discusses the dilemmas that are integral to internet publishing of clinical cases. There is a feature article by Margy Sperry that argues for the "something more" that results from disruption and repair cycles. And then there are the 2007 self psychology conference summaries. In addition to being summaries, each piece is in and of itself a short article worth reading. Finally, there is a section on recent book publications of members and one for news of members. These are offered pretty much as they were sent in to me, really informal and in no particular order. I look forward to even more postings next year as readers get familiar with these sections. If you want, you can start sending me your information now (newsletter@psychologyoftheself.com) and I'll just keep it for our next edition. So welcome—and welcome too are your comments. Notes from the PresidentEstelle Shane | ||||||||||||
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I'm pleased and proud to be serving my first term as President of the International Association for Psychoanalytic Self Psychology. Having been a member of the organization from its beginning as a small study group, meeting in Arnold Goldberg's living room, with Heinz Kohut himself leading our discussions, to our present membership organization functioning through the operations of a democratically elected International Council, I have been greatly privileged to witness and take part in the expansion of this impressive organization. Our current task must be to strengthen IAPSP as a democratic membership organization and to expand, and even improve, our educational offerings. As therapists, and particularly as therapists influenced by self psychology, we find ourselves in professionally interesting times. If our field is flourishing, despite incredible obstacles such as a bad economy and a bad press, I think it is because it has opened up so enormously. There is increasing evidence that we are unable to isolate a single theory, or even a single set of theories, that can be viewed as encompassing the truth, or as providing the way to practice analysis. The current diversity in psychoanalytic thinking and in ways of being with patients that results from this uncertainty is of critical importance to us all. Faced with, or should I say, blessed with, an increasing heterogeneity in our clinical populations, we are required to avail ourselves of the wide variety of resources on the psychoanalytic scene to insure our ability to match patient needs. There are many ideas, good ideas, available to us, and the contemporary zeitgeist of theoretical freedom of choice enables us to receive and use concepts from a wide range of alternatives, without being constrained to purity of framework. The International Association of Psychoanalytic Self Psychology certainly reflects this trend of valuing theoretical pluralism and of individual expansiveness. We began with the one self psychology created by Heinz Kohut and his early cohorts; we now have the advantage of many self psychologies, including, for example, intersubjective systems, motivational systems, and specificity theory. And from the beginning, adherents of self psychology have been attracted to findings found in related disciplines, such as a systems sensibility, attachment theory, neurobiology, brain science, evolutionary biology, and philosophy, as well as being drawn to related clinical approaches including, especially, relational theory. Our annual conferences over the years have offered this diversity of thought, all the time retaining our basis in Self Psychology as the theory that comes closest to our ideas and ideals, and that provides the best vision of what human beings need, what makes them become ill, and how they can be helped to get better. I look forward to working with all of you to make IAPSP the strongest and best membership organization it can be. Confidentiality and Online PublishingAndrew Morrison | ||||||||||||
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In this technological era it is rather easy to disseminate information through email and listserves that reach thousands of people. Further each person that receives an email can generate many more to groups listed in their own listserves. This is perhaps the first time in psychoanalytic history that information can reach such a large readership. Apart from publishing dilemmas such as subscriptions and copyrights, a serious problem that many organized lecture forums face is confidentiality. There is general agreement that clinical case reporting is the most significant way for psychoanalysts to learn from each other. Most conference formats include several case presentations in their main panel discussions. Psychoanalytic and psychotherapeutic institutions have always been committed to the ethic of confidentiality. In fact, our patients rely on us for that assurance. Although conference planners may be relatively new to technological forms of information dissemination, they now have the potent responsibility to insure confidentiality for those patients discussed in conference case presentation papers. Following is a poignant example of a mishap that disrupted a solid and previously fruitful treatment, rendering pain to both the analyst and a long time, devoted patient. The following story briefly illustrates the need for careful oversight in online publishing, a burgeoning, and mostly beneficial, form of publishing. The story is related by Dr. Andrew Morrison in response to a request from the IAPSP online news editor for examples. He offered the example of a complex supervision he had undertaken with a therapist in training. The therapist is struggling to repair a deep rupture with a patient who felt profoundly betrayed upon discovering an online presentation of his analytic treatment attributed to his therapist. Morrison agreed to share his experience as a supervisor, one who experienced his own surprise and concerns generated by the online publication of his supervisee's paper.
Publishing on the Internet:
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As a clinical psychologist and lawyer applying internet and health law to the issue of the publication of psychoanalytic clinical case material, I find it timely to address the new realities presented by the dissemination through cyberspace of articles previously available only to those with access to psychoanalytic journals. Anna O. on the Internet Patient confidentiality and the internet Informed consent Invasion of privacy Negligence Informed consent The consent must be truly knowledgeable, requiring disclosure of all the facts that a patient might consider relevant in giving the consent. The traditional assurance from the analyst that the patient will remain anonymous is no longer adequate in the age of the Internet. The patient should be informed that the article may well be published on the Internet and that it is conceivable that anyone can, or may in the future, obtain access to the article. The content of the article and the specific details that are going to be published should be disclosed to the patient. Additionally, the analyst must disclose that the publication of the clinical material may further the professional advancement of the analyst. The patient has the right to know that the analyst's interest in the treatment includes a personal benefit. Not only is this a point of law, but it is also a clinical issue that always impacts the course of treatment, whether implicitly or explicitly. The requirements for truly informed consent are high and stringent. Historically, there was less risk of breach of confidentiality, and adherence to these requirements may have been minimized with little risk. The dissemination of information is accelerating exponentially, and whereas it may have taken fifty years or more for the community to learn who Anna O. was, access to the Internet drastically reduces the gap between publication and potential discovery. Participatory collaboration Interest in the relational nature of the therapeutic relationship is at an all-time high, and the new requirements for transparency in presenting clinical case material can be a vehicle for enhancing that exploration. Patients long to apprehend the subjectivity of the analyst, and analysts strive to apprehend the subjective experience of the patient. The analytic community is eager to learn from clinical case material that is lived and visceral. A participatory and collaborative stance to the publication of clinical case material sets the stage for a new transparency in the presentation of clinical case material. One hundred years ago Freud expanded the collective consciousness with the publication of The Interpretation of Dreams, which allowed individuals to reflect upon the inner world of others in order to gain an understanding of their own inner world. Today the transparent presentation of clinical material may afford individuals an opportunity to see relational transactions with a new and deeper appreciation of the way in which relational contexts shapes lived experience.
Writing about Patients for the Internet—What
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Imagine my dismay when hearing from a patient that she read about herself on the Self Psychology website. She said, "I thought that you had another patient like me, and then I realized it was me." A piece that I had written for the online newsletter, under password protection so that only members could read it, was now accessible to anyone. After the decision was made, and long after the article was posted, I was given a general notice that the site was now open to the public. This is not meant to be critical of the decision, but rather to serve as a cautionary tale. I appreciate the opportunity to write about my concerns regarding case material, confidentiality, and the Internet. The above example illustrates the inherent problems in writing about clinical work with patients, and how the problems are amplified by the common use of the Internet. There is no debate about the need to disguise identifying information about patients—we are legally and ethically bound to do so. But what adequate disguise is, and how the disguise process affects the case report, are issues open to debate. The highest level of disguise is to use a composite case, but as a colleague found this week, even that does not ensure that the case won't be recognized. The most common way to disguise is to alter the significant identifying features of the case—changing reported occupation, marital status, age, family composition, even gender. This method generally meets the standard of protecting the patient from being recognized by others, but it does not protect the patient from recognizing his or her own words. The issue of patients knowing about their analyst/therapist writing about them is quite complex. Some analysts/psychotherapists have adapted the policy of asking patients for specific permission to write about them. The patients may be given the opportunity to see the writing ahead and to edit it. Clearly this practice ensures that the patient is completely informed and has "signed off" on the content. Others believe that informing in this way potentially interferes with the therapeutic process and that editing may significantly alter the clinical material. Further, there is the troubling question about what is informed consent. Does a person who is in a therapeutic relationship have the ability to freely give or withhold consent? Some analysts and therapists have adopted the policy of generally informing and seeking permission at the beginning of the treatment. This is done with the belief that, at the beginning, there is less likelihood that the transference and other relational issues will interfere with the patient's ability to decline. By not identifying that the patient is being written about during the course of the therapeutic process, it is believed that it will be less disruptive to the process. This stance is also problematic, as the general nature of permission being sought does not address the specifics of what is being published, where and when. Further, if we believe that the subjectivity of the analyst is involved in the process, the writing is definitely going to influence the process, and in potentially unacknowledged ways. Some who write and present about their patients only write after the treatment process has ended. Obviously, this prevents the process of writing from having an impact on the analysis. It does not, however, prevent the written material from having an impact on the patient, or on future work. Writing on old material also may lack the vibrancy and immediacy of work that is in process. Many therapists refrain from writing about anyone in the field out of concern for confidentiality and exposure. And some do not write at all, as they do not feel that they can protect their patient's process if they do. While not posing answers to the issues identified, I would like to address the specific issues related to clinical material being posted on the Internet. Unlike journal articles, the rules regarding the publication of material on the Internet can change, and affect access to what is written. In other words, there is no assurance that access to the material will be limited in any way. With the advent of Google, writers must assume that the person that is being written about will have access to the writing and may very well find it on the Internet. If a case is presented at a conference, such as ours, and then the components of the conference are summarized for an online newsletter, someone else's writing about the case will also be accessible to the public. This is often done without the permission of the person who presented, and without that person previewing and editing what is posted online. So, people who present clinical material cannot assume that the material won't be referenced in exposing ways online. I do recommend that Internet publishers have clear policies regarding public access to the material, and that if a change in policy is made, that it not be applied to works without gaining the permission of the author. I also recommend that anyone who presents clinical material be asked for specific permission before that material is published electronically (as one would do if it were published in traditional venues) and that the presenter be given the opportunity to edit the piece. Further, I recommend that anyone presenting or publishing give careful thought to the issues related to confidentiality and exposure ahead of time. The therapist should not present or publish unless the idea that the patient could read about his or herself is acceptable. To believe otherwise is naïve in today's electronic age. Finally, I recommend that we continue to address these issues...and keep writing. Endnotes Judy Leopold Kantrowitz's book Writing about Patients: Responsibilities, Risks, and Ramifications, 2006, Other Press, New York is a good reference.
Disruption and Repair:
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New perspectives offer opportunities to refine our understanding of clinical situations and theoretical ideas. The 30th international conference on the Psychology of the Self offered an opportunity to compare self psychological and non-linear dynamic systems (complexity) perspectives on the process of change. In light of those discussions, I wondered how complexity theory might inform our understanding of the role of disruption and repair in the process of change. Who and what is "disrupted?" What does it mean to "repair" a disruption? Who does what to whom? Kohut's delineation of the empathic stance changed our awareness of the relational context in which disruptions and repairs occur. He argued that the analyst's ability to empathically grasp and convey understanding of the patient's inner world facilitates the establishment of a selfobject transference (Kohut, 1971). When this transference is disrupted, the patient's internal dynamics, objects, and conflicts are not the sole focus of investigation; the impact of the analyst's inevitable "empathic failures" must also be considered. Consequently, empathic failure plays a role in ruptures just as empathic attunement facilitates repair. From this perspective, once ruptures are empathically understood and repaired, the selfobject tie is "restored" and the patient's developmental process "resumes." This formulation implies that the repair reinstates the former relationship and selfobject transference. Clinical experience suggests, however, that the nature of the relationship itself may change; the process ushers in new relational possibilities. Describing what emerges as simply the restoration and resumption of the selfobject transference minimizes the significance of this shift. Kohut also recognized that something changes as a result of the disruption and repair process. He argued that optimal frustration promotes the internalization of the analyst's function; that is, if the frustration created by the empathic lapse is "tolerable," then the rupture and repair process supports the acquisition of psychic structure (Kohut, 1984). Although Kohut's conceptualization of transmuting internalization suggests that something changes when ruptures are repaired, his focus on psychic structure does not address the systemic nature of the shift. Infant research further elaborates the dyadic quality of rupture and repair sequences. Beebe and Lachmann (2002) and Stern (1985) demonstrate that ongoing regulations create "expectancies" which organize relational experiences. When the coordination of regulation is disrupted, the dyad tends to return to a coordinated state within a matter of seconds (Beebe & Lachmann, 2002). This research implies that disruptions and repairs are systemically mediated, a point I will revisit. Tronick (1989) suggested that sequences of disjunction, repair, and return to coordinated regulation restore regulation as well as establish repair as a possibility. Ongoing, coordinated regulations and moments of mismatch, disjunction, and repair teach an infant "how to be" with another; thus, both processes serve as a basis for "implicit relational knowing" (Stern et. al., 1998). Stern and his colleagues also propose that "moments of meeting," described as "nodal experiences of authentic person to person connection" (1998, p. 904), alter the intersubjective context, thereby changing the "shared implicit relationship." I submit that the disruption and repair process gives rise to "moments of meeting" which change the "shared implicit relationship" while also facilitating reconnection. Complexity theory also embraces a model of interactive regulation. It further suggests that disruptions are systemic events which affect both members of the dyad and their interactions. Relational expectancies are brought to life and ruptured in a systemic context; the patient's expectancies are not the only ones disturbed—the analyst's are as well. Each influences and "perturbs" (systems language for disruption) the other's relational expectations, affecting the relational patterning and shared implicit relationship. Just as "you can't hold one individual responsible for the sometimes excruciating repetitiveness of relational expectancies and patterns" (Coburn, in press), you can't hold one individual responsible for perturbation. The disruption affects both participants as well as their relationship even though the meaning that it holds will be uniquely contoured by each person's relational history and expectancies. Also, just as the system bears the effects of disruption, so too it bears responsibility for repair. Even when ruptures seem to be easily repaired, the repair requires coordination. The mutually determined ability of patient and analyst to work collaboratively facilitates and supports the repair—neither can realize it alone. From a complexity perspective, the repair is greater than either could create in isolation. This brings us to the role of disruption and repair processes in change. Thelen and Smith (1994) argue that development occurs in a context of "stabilization and destabilization" (p. 61). Stolorow (1997) emphasizes that this conception of change "posits that change requires disorganization of the developing system. It is the loss of stability and coherence that provides the bumps that allow the system to discover its new stable patterns. ..." (p. 342). Systemic repairs require the patient and analyst to "reconfigure themselves in relation to one another in creative and novel ways" (Coburn, 2002). Thus, complexity theory implies that in the wake of a disruption and repair process, the system does not resume its former relational patterning. The joint participation in the repair process, whether explicitly discussed or implicitly experienced, alters the relational expectancies and "shared implicit relationship," thereby allowing the system to discover new ways to be together. I suggest that part of what emerges is novel possibilities for formulating meaning and dialogic relatedness with an other (Sucharov, 2007). Rupture and repair sequences may restore a selfobject tie and facilitate the selfobject transference, as self psychology argues, and create new relational expectancies, as infant research suggests. But neither formulation fully accounts for the clinical perception that something more emerges from the process. Complexity theory emphasizes that the system is changed, and that change is distributed throughout and supported by the entire system. Thus, disruptions destabilize the system, perturbing the understanding each person has of himself, the other, and the way that they interact. The repair process reorganizes the relational experience and expectancies. Taken together, rupture and repair sequences change the system's ability to tolerate, understand, and reorganize in the wake of perturbation, thereby repositioning the system at a new "tipping point" ready for further change to emerge. References Beebe, B. & Lachmann, F. (2002), Infant research and adult treatment: Co-constructing interactions, Hillsdale, NJ: The Analytic Press. Coburn, W. (2002), A world of systems: The role of systemic patterns of experience in the therapeutic process. Psychoanalytic Inquiry, Vol. 22 (5), p. 655-677. Coburn, W. (2007), Psychoanalytic complexity: Pouring new wine directly into one's mouth. New developments in self psychology practice (Buirski & Kottler, Eds.), In press. Kohut, H. (1971), The analysis of the self. Madison, CT: International Universities Press. Kohut, H. (1984), How does analysis cure? (A. Goldberg & P. Stephansky, Eds.) Chicago: University of Chicago Press. Stern, D. (1985), The interpersonal world of the infant. New York: Basic Books. Stern, D., Sander, L., Nahum, J., Harrison, Al, Bruschweiler-Stern, N. & Tronick, E. (1998), Non-interpretative mechanisms in psychoanalytic therapy. International Journal of Psycho-Analysis, 79: 903-921. Stolorow, R.D. (1997), Dynamic, dyadic, intersubjective systems: An evolving paradigm for psychoanalysis. Psychoanalytic Psychology, 14: 337-346. Sucharov, M. (2007), Kafka's window and Kohut's mirror: A dialogic journey to the center of traumatic worlds. New Developments in Self Psychology Ed. Buirski and Kottler, In press. Thelen, E. & Smith, L. (1994), A dynamic systems approach to the development of cognition and action. Cambridge, MA: MIT Press. Tronick, E. (1989), Emotions and emotional communication in infants, American Psychologist, 44: 112-119.
PANEL 1:
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This panel explored Howard Bacal's Specificity Theory and Robert Galatzer-Levy's discussion of the concept of emergence as they relate to therapeutic process and therapeutic efficacy. A rich and detailed case presentation by Leslie Smith offered an opportunity to apply these ideas to unfolding clinical work. Ms. Smith described a patient who presented with anxiety and depression and a tendency to sacrifice herself to meet the needs of important others. Her history was characterized by incest, emotional neglect, and blaming and rejection, particularly in response to choices that differed from those of significant others. As they got to know one another, Ms. Smith was struck by various and numerous points of similarity between herself and her patient, as well as by the patient's exquisite, almost uncanny, attunement to Ms. Smith. In a series of sessions Ms. Smith and the patient talked about their recent negotiation of a reduced fee and number of meeting times per week. As Ms. Smith and her patient explored in detail their separate and mutual perceptions and experiences of the negotiation exchanges between them, a new dyadic experience emerged for both the patient and Ms. Smith, one in which their differences were acknowledged, together with their connectedness. Ms. Smith's close tracking of the patient's experience in this process and her willingness to acknowledge moments in which her assumptions about the patient were inconsistent with the patient's experience promoted an ambience in which the patient was able to more fully articulate her own array of feelings, as well as clarify her own reactions in contradistinction to the assumptions of Ms. Smith. The patient clearly felt relief and exuberance in connection with this newfound experience of acknowledgement of difference which was enhancing rather than destructive of connection. This theme was revisited in a dream much later in treatment, in which the patient was able to remain connected to her own emotional experience, even when Ms. Smith was configuring the situation differently. In addition, the patient, via the dream, was able to call Ms. Smith's attention to the ways Ms. Smith was distracted by her own ideas and not understanding the patient's perspective. Once again, a feeling of shared pleasure arose, as Ms. Smith and the patient noticed the patient's increasing freedom to assert her own emotional experience, while remaining in a connection which was enhanced rather than ruined by the articulation of difference. Dr. Galatzer-Levy presented a paper focused on the concept of "emergence." Emergence, according to Dr. Galatzer-Levy, "is the hallmark of complex dynamical systems, by which novel and unexpected structure, pattern or process arises spontaneously in self-organizing systems." Emergence describes a process in which "complexity at a higher level of description arises from lower levels in a non-linear fashion out of local interactions." In contrast to more reductionist, linear models using cause and effect formulations, with emergence, the outcome cannot be predicted, even with an understanding of the constituent elements and rules of local interaction. Dr. Galatzer-Levy proposed that holding in mind the idea of emergence can reshape the way we listen and understand in our psychoanalytic endeavors. He identified a traditional tendency within psychoanalysis when confronted with novelty to look for underlying continuity. He suggested that this bias toward expectation of continuity can interfere with the recognition of emergent new phenomena and he illustrated his ideas with several case examples. Dr. Galatzer-Levy put forward the idea that emergent phenomena, which are by nature surprising and unpredictable, are not likely to appear in a system which focuses on linear, goal-directed steps toward change, but rather are likely to arise from the novel organizations and configurations that occur within the dyadic system, formed by the "satisfactory coupling" of analyst and analysand. Unfortunately, Dr. Galatzer-Levy did not apply his ideas to the case presented by Ms. Smith. This is regrettable, since the process description presented by Ms. Smith certainly illustrated the concept of emergence in the dyad. Dr. Bacal's paper described his Specificity Theory and applied it in a discussion of Ms. Smith's case presentation. His summation of Specificity Theory is as follows: "Psychotherapeutic efficacy is a function of the specific capacities for reciprocal responsiveness that emerges within the relational process of its particular participants. Consistent with a systems sensibility, Specificity Theory regards therapeutic possibility as an unpredictable spectrum specific to each particular dyad .... That is, therapeutic possibility is specific to the capacities and limitations of any given dyad, and not a function of the expert application of any traditional psychoanalytic theory, (including self psychology) by the analyst." In addressing Ms. Smith's case Dr. Bacal stated that "within Specificity Theory, we are interested in how and why these two people are working together effectively, or not, in their particular therapeutic process." He brought his focus to the complex dynamic in their relationship which concerned the matter of sameness and difference and called attention to the paradoxical nature of this issue. He identified ways the patient's experience of thinking independently was connected with feelings of badness and shame and with not trusting her own mind. He added that this sense of something being wrong with her mind was understandable, since there had been something wrong with her having an independent mind and that experience had led to the loss of connection with centrally important others. He pointed out that only in the experience of sameness with Ms. Smith was the patient able to safely begin to find her own mind and begin to safely experience herself as different. He illustrated the ways the specificity of their process was unique, in that the more traditional idea about giving the patient room to explore in this case was disruptive, rather than helpful. Additionally, he noted that Ms. Smith's disclosure of her own feelings and reactions made significant contributions to the deepening of the work, rather than foreclosing it, as might be expected from a more traditional view. He also proposed that the issues around sameness and difference might have been addressed from the perspective of the twinship selfobject transference as elaborated by self psychology. He pointed out, however, that had Ms. Smith's work been centrally guided by this theoretical structure, she would have been constrained to interpret the patient's need for this selfobject function or the patient's need to defend against it, rather than attending to the unique and complex ways issues of sameness and difference emerged between her and her patient. In summary, Specificity Theory and the concept of emergence offered fresh and stimulating perspectives on therapeutic process and efficacy, and Ms. Smith's case provided an excellent platform for discussion of these ideas.
PANEL 2:
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Finally relegating simple cause-and-effect thinking to a long overdue resting place, William J. Coburn, Ph.D. headlined Panel II of the 2007 conference with his paper, "Complexity Theory Made Easy." Case presentations by Drs. Amy Eldridge and Joye Weisel-Barth offered differing clinical sensibilities highlighting the qualities and perspectives that complexity theory can bring to our psychoanalytic work. Estelle Shane further illuminated the nuances of this approach in her integrative discussion of the panel. To the appreciation of all, Bill augmented his thoughtful review of complexity theory with a creative, compelling, and often amusing, powerpoint presentation depicting the key elements of the theory. A placid group of llamas illustrated an underpinning precept pointing out that although an individual (llama or human being, as the case may be) may be considered a complex system in its own right, in the more contextualist world of relationships, each comprises a reciprocally organizing component of the larger system within which it is embedded. Demonstrating the often powerful short-range effect that interactions can have with an unforgettable snapshot of two babies pointing at one another ensconced in backpacks on their respective parents' backs, followed by the juxtaposition of the delicate flutter of butterfly wings with the gathering force of a tornado halfway across the world, Bill provided us a with a multi-model experience of complexity theory's many concepts. Bill's presentation brought the familiar world of psychoanalytic thinking to bear on terms largely foreign to our field, and, in so doing, added new levels of description to our clinical understandings, expanding on the ways in which we can think and work. Many of those terms are words that hold within them aspects of the crucial attitudes and presuppositions Bill aptly attributes to the theory as informing the therapist's stance toward the patient and the therapeutic relationship itself. Elaborating on the mathematically-derived term "incompressibility," for example, Bill ultimately describes the ways in which each individual's experiential world comprises its own shortest description. In other words, lived, subjective experience can no longer be considered reducible to theoretical concepts, diagnostic categories, or any construct that provides the clinician with an illusion of certainty about the patient or the therapeutic process. As unsettling as this may be, it is also one of the great beauties of a complexity sensibility, as the cases of both Joye and Amy demonstrated. Permission to tolerate the seemingly unending uncertainty that accompanies so many treatments, and the belief that change can emerge in a nonlinear way, are among the great gifts of this perspective. The challenge in reviewing this panel lies in the incompressibility of Bill's presentation, together with the poignant and often heart-wrenching cases included in the panel. Experiencing the poetic imagery of the paper and slide show, and the ways in which each case was illuminated by them, and illuminated each other, enhancing still further Bill's presentation, was its own shortest description. Nonetheless, employing another complexity systems term more familiar to us, I will attempt to frame a number of elements from this panel that struck me as significantly relevant and clinically useful. Expanding on the relatively recent contextualist emphasis on the essential embeddedness of psychological experience in interpenetrating subjective worlds (Stolorow, Atwood and Brandshaft, 1994), the application of systems thinking to psychoanalysis provides us with process language that eliminates linear directionality in construing psychoanalytic action in favor of a sensibility of emergence. The cases of both Dr. Amy Eldridge and Dr. Joye Weisel-Barth depict such an emergence of relatedness and change that could not have been predicted in a linear fashion, though both were working in a manner that emphasized deep empathic immersion in the experiential world of their patient. Amy adhered to a customary self psychological stance with "Lisa", empathically developing understanding, and then explicating that understanding, together with connections between Lisa's feelings of shame and defectiveness and her childhood relational experiences. The treatment may be viewed as fostering the kind of new relationship that can compensate for deficits in Lisa's self structure. But what explanation can self psychology give to the power of Amy's seemingly simple statement that what Lisa needs in order to heal is available only in a relational context? Complexity theory provides the additional sensibility of comfort with not knowing, and not needing to know, where exactly the impetus for change lies within the matrix of each participant's individual history, the history of the therapeutic couple, and the dyad's current mode of relating. All of these factors, and more, contributed elements to the interaction that generated the emergence, in a non-predictable manner, of a seemingly isolated moment encompassing Lisa's spontaneous ability to embrace the hope contained in her relationship with her analyst. Joye's work with "Katherine", an exceedingly traumatized woman struggling to survive an endless series of ongoing traumas, of necessity had to encompass a stance on the analyst's part that relinquished any dependence on traditional theory. In "waving bye-bye to neutrality," Joye opened the treatment to an authentic relational encounter between two people stretched to their emotional limits with one another. This work highlights the struggle in any treatment situation to contend with the location of the dyad along a continuum between fluidity and randomness, on one hand, and stability and order, on the other. Complexity theory posits the potential for change to be contingent on the system's proximity to the "tipping point," that place in which there is enough randomness for perturbations to the system to generate change, and sufficient stability to support that change. Though the story of this 25-year-long experience is far from over, Joye's capacity to hold on to Katherine's humanity throughout the ordeal underlies her ability to maximize the advantage of proximity to tipping points reached at various times in the treatment. In conclusion, I have attempted to highlight, or frame, just a few of the invaluable concepts comprising complexity theory and their relevance to the case material presented and our work as a whole. I was obliged to bypass others, thereby doing less than justice to the panel as a whole, an incompressible entity, as I mentioned above. However, I find much comfort and hope in Bill's summation of this incredibly... well, complex, topic, in which he underscored a key element of this theory, and valuable truth about human nature. To wit: "there is more to the patient, and to us, than what we know thus far: there is more to us than our history, our enactments, and our current, arrived-at conclusions; there is more to us than we can ever know." Thank you Bill, Amy, Joye, and Estelle, for gifting us all with the emergence of this beautiful, seemlessly choreographed, elaboration of a most viable and invaluable new perspective on our unfolding encounters with our patients.
PANEL 3:
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Chair: Sandra G. Hershberg, M.D. In the third panel of the conference, we were treated to a rich and provocative case presentation by Hazel Ipp, and a spontaneous discussion of the case by Drs. Lachmann and Lichtenberg. Each presenter responded to the case from his own systems perspective. Reactions to the clinical material and the application of theory were presented in vivo. The audience was clearly engaged by the way Dr. Ipp brought us so vividly into her experience of the clinical encounter and by the dynamic discussion that ensued—a systems sensibility in action. While the format was familiar, that is, a case followed by discussion by two well renowned theorists, the outcome was a level of audience and panel engagement that was not predictable. Nell: A Bridge to the Amputated Self Dr. Ipp poignantly describes her initial encounter with Nell, recognizing in Nell's first message that she was from her homeland of South Africa and was an Afrikaner who would have found Dr. Ipp's background as an English speaking South African to be that of the enemy in their political struggles. "Suddenly, the thirty years since I had left my homeland collapsed and I felt catapulted back into the world of divisiveness, hatred, pain, suffering, horror; a world of angst and terror." We are thrust, along with Dr. Ipp, as she struggled with her feelings as her "...past comes crashing unannounced into the present...." She came to understand that Nell consulted her regarding her unhappiness at her recent emigration. Having left a homeland ripped apart and at war, the peaceful existence of her new land seemed without life, without meaning. This was a feeling that Dr. Ipp had also struggled with, and she found herself reacting in powerful ways to the recognition that they, who were on opposite sides of the conflict, had common struggles. As Nell began to share her traumatic life in detail, Dr. Ipp was not allowed into her internal world. When Dr. Ipp did comment, she was commenting from her own reactions, her own experience. These were politely dismissed by Nell. Nell seemed devoid of feeling; the feelings were sequestered from her narrative. Dr. Ipp found that focusing on the details of the narrative, instead of the affect, helped Nell develop some curiosity about herself and her life. Nell brought in a dream, ripe with feeling about her mother. This was an entrance into Nell's inner world, inner experience. Together, they came to understand what drove Nell to her dangerous political involvement. Both Dr. Ipp and Nell were freed in this process: Dr. Ipp from her painful feelings about leaving South Africa and Nell from having to engage in dangerous political activities. Dr. Lachmann explained that his perspective involves examining interactions microscopically. When discussing a case, he asks what the patient is saying, how do we understand it, how do we feel about it, and how do we manage it. Turning to the case presentation, Dr. Lachmann noted that Dr. Ipp engaged the audience by taking them into a conflict within herself. Through careful tracking of herself, her reactions, and Nell's, she was able to find a way to emotionally engage Nell. In the context of the tumult created by the intersection of their pasts, they developed a system of mutual regulation which benefited them both. Dr. Lichtenberg began his discussion by referencing the five motivational systems that he and his colleagues have put forth and noting which were engaged with Nell. He noted that the attachment motivation was evident in that the therapeutic connection started with a smile; an implicit level of communication that engaged Dr. Ipp. He emphasized that Nell's theme was that of rescuer vs. rescued. He identified a critical moment, when Nell asks Dr. Ipp a question about traumatized people. Dr. Ipp was able to bring that back to Nell and her own experience—a moment of meeting. The dream revealed a sense that Nell implicitly understood that she needed not to rescue her mother; that it was she who needed rescuing. In Dr. Lichtenberg's understanding of the case, Dr. Ipp rescued Nell.
PANEL 4:
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The last conference panel presented the work of two great thinkers associated with the self psychology community, Malcom Slavin and Robert Stolorow. As the titles of their papers suggested, "The Contextuality and Existentiality of Emotional Trauma" (Stolorow) and "Broadening the Context of Human Intersubjectivity: Making Meaning and Navigating Relational Conflict in Evolutionary, Biological and Clinical Perspectives" (Slavin), Stolorow and Slavin required intellectually athletic participation by conference attendees. Bob Stolorow's paper developed two broad themes, the contextuality and existentiality of trauma, and a synthesis between them. At a lower level of abstraction, the paper shared a deeply personal account of the aftermath of devastating loss, and of healing and reintegration following that loss. At a higher level of discourse, the paper revolved around "being-toward-loss", a concept that Stolorow developed based on Heidegger's "Being-toward-death." Stolorow's more inclusive term, "being-toward-loss" means living with the loss of loved ones as a certain, indefinite, and ever present possibility. Confrontation with being-toward-loss paradoxically makes it possible to live a life that is authentically one's own. Stolorow described three features of the phenomenology of trauma as connected to Heidegger's existential theme: first, the shattering sense of isolation and alienation from others; second, the sense of being exposed to "the inescapable contingency of existence on a universe that is random and unpredictable and in which no safety or continuity of being can be assured"; and third, the collapse of a sense of time, specifically, the sense of being frozen or trapped in the past. Stolorow asserted that these three types of post-traumatic experiences plunges the traumatized person into a form of authentic being-toward-death. Stolorow demonstrated beautifully the way in which philosophical reflection can aid a person toward recovery from trauma. He also disclosed a remarkably personal account of a second path to healing, that of finding a relational home for the experience of trauma. Stolorow concluded his presentation with the case of a patient whose deep and isolating sense of shame, akin to the fundamental aloneness consequential to loss, finds a relational home with her analyst. Malcom Slavin wove together a different text of existential and psychoanalytic concerns. With a multi-media presentation, Slavin asserted that the adaptations over hundreds of thousands of years that led to a distinct human species, are in fact the setting within which existential issues first emerge as human concerns. This evolutionary-biological heritage is part of our existential situation as a given, a deep structure, that continuously shapes, influences, limits, and facilitates our lives with each other. These adaptations also embed us within relational contexts. As Slavin said it, "We literally become ourselves, become an individual with a distinct identity, through the building of subjective meanings that are heavily shaped—non-verbally and verbally—by interactions with the subjectivities of others with whom we are attached." Slavin calls this the relational paradox. The intersubjective context within which we are constituted as individuals leaves us with substantial otherness that we must recognize and come to terms with if we are to live authentic lives. There is an ever present danger of over-accommodation, and pathological shaping of self in accordance with the needs and expectations of others. Slavin then applied this existential and relational dilemma to a clinical vignette. From his perspective, all patients have a general need to experience and evaluate the otherness of the analyst, that is to have "the experience of another person grappling with her own established ways of maintaining hope—wrestling with her illusions—in the face of everything inside the analytic relationship and outside it that erodes them, her particular individual capacity to deal with the background of annihilation anxiety that we all face as a function of being human." In other words, the patients need to experience the analyst's position with regard to the fundamental existential dilemma. The Herculean task of discussing these two papers was given to yet another powerful and agile mind within the Self Psychology community—Peter Schou. His clear and concise outline of each paper, to which this article is indebted, enabled participants to better understand and compare the ideas presented. He made several points of his own worth noting. One was a reference to Kierkegaard's notion of anxiety as a state preceding a leap from one stage of life to another. Anxiety in this sense has a liberating potential, an idea central to both Heidegger and Stolorow. Adding a systems perspective, Schou noted that anxiety can be thought of as a pertubation to the attractor state of everyday immersion. Schou raised the question of the developmental readiness of all patients to engage in existential issues in the manner that Slavin describes as "experiencing and evaluating the otherness of the analyst". How much do patients really want to know about the analyst's struggle with death and ultimate loss? Schou answered the question this way, "Perhaps not so much, after all, or rather, what we want to know is probably specific to our position in the relationship. Perhaps we want to know just enough to allow us the illusion that our analyst is not quite as scared and confused as we are, which in turn would make it safe enough to engage our own fears and uncertainties. And one thing more, perhaps we want to know just enough to believe there is in the analyst something we can learn from as we struggle with these issues, a sense that the analyst has been down a path that can tell us something about where to go. This belief may, of course, ultimately be an illusion on our part and may be too much to hope for. But as Winnicott pointed out, illusions are important, not the least between an analyst and a patient."
Reflections on the Kohut Memorial LectureElizabeth Corpt | ||||||||||||
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At the Kohut Memorial Lecture, attendees of the 30th Annual International Psychology of the Self Conference were treated to a particularly bountiful feast. Following a warm introduction by long time colleague, collaborator, and friend, Dr. Robert Stolorow, Dr. Donna Orange took the podium. In her opening remarks, she graciously thanked her many friends, teachers, supporters, encouragers, and collaborators. To be the first lecturer not to have known Heinz Kohut in a long line of lecturers who knew him personally was quite an honor for her. She set forth to deliver what was to be a most substantive, robust, personal, and deeply thoughtful lecture. In her lecture, entitled "Attitudes, Values, and Intersubjective Vulnerability," she engaged her audience to "ask ourselves what has been the journey of the empathy Kohut so cherished and taught us all to prize, and where its leading edge might be now." She proceeded to offer a solidly intersubjective and expansive view of the contemporary meaning of empathic therapeutic engagement. Those holding this view can claim terra firma far beyond what critics have mistakenly characterized as Self Psychology's flight from aggression and human cruelty via forms of empathic niceness. Donna asserted that empathy is not only what we do to someone, but rather, a way of being with the other. In firm hold of this attitude, Donna said, "we proclaim with Terentius that we are human and that nothing human is alien to us." Donna asserted that empathy entails an intersubjective process whereby psychotherapists and psychoanalysts hold attitudes and values that require them to be intersubjectively vulnerable. She turned to her phenomenological philosophical foundations to ground these ideas; ideas shared by her close collaborators Dr. Robert Stolorow and Dr. George Atwood. Of herself and her cohorts she said, "we philosophical subversives are bringing into psychoanalysis, and specifically into this community, all our phenomenological doubts about the possibility of interpretation-free knowing, as well as a conviction that our being is embodied from the start in experiential worlds. We exist together in lifeworlds." In other words, understanding our patients requires, in Donna's words, "empathic stretch to include in our horizons of understanding that someone whom we find challenging." We are, as Donna quotes from the poet John Donne, "involved in mankind." Drawing from the work of philosopher Hans Georg Gadamer, Donna reminds us, "The person with understanding does not know and judge as one who stands apart and unaffected; but rather as one united by a specific bond with the other, he thinks with the other and undergoes the situation with him" (Gadamer, 1975/1991). Cautioning us against the "temptation to distance by diagnosis, by reductive thinking, by adopting an impartial observer's attitude, by dissociation," Donna encouraged us to accompany our patients. This requires an awareness of the ways in which our particular life worlds, the worlds the phenomenologists say we are thrown into—worlds of class, race, culture, privilege, poverty, emotional trauma or empathic care, etc.—impact our development. These circumstances, and our resultant organizing principles can work to potentially enhance or limit our ability to understand our patients. It was at this point in the lecture that Donna moved into a more personal realm of sharing. She touched on bits and pieces of her own painful family history and the ways in which her experiences have shaped her, including her particular vulnerabilities to shame. These personal disclosures set the stage for us to more deeply understand how the analyst's vulnerabilities are equal factors in the clinical exchange. She held the rapt attention of her audience as she lived out, before us, her deeply felt empathic attitudes, values and ideals; these being made up of "where-I-find-my-self-ness," the unbidden Heideggerian thrownness of experience, and "a kind of personal choice." Embedded here is Donna's notion of empathic stretch. Donna expanded on three attitudes important for us to hold: egalitarianism, a dialogic spirit, and mindful and meditative responsiveness. By egalitarianism, she referred to our needing to respect the "common human dignity and frailty" of both parties in the analytic relationship. Doing so can help us refrain from defensively distancing ourselves through the holding of authoritarian attitudes that mark a retreat into cultural/intellectual privilege, rankism, classism, racism, or sexism. By holding a dialogic spirit, we would approach our work with patients as an "opportunity to learn from a valued other, a chance to engage together in a search for emotional truth." As therapists with a dialogic spirit, we would not retreat into the comfort and predictability of certainties, or theoretical reductionisms, rather remain open to otherness, even if it discomforts or hazards us. "A dialogical spirit keeps us open and tentative all the way down, as the philosophers say." The third attitude, mindful and meditative responsiveness, was presented as an antidote to the frantic, reactive, technique-centered, evidence-based, results-driven foci of many mental health practices today. For Donna, and for many of us, these attitudes are at the very heart of intersubjective vulnerability. Donna related the importance of these attitudes to the values and ideals Kohut believed were so important to a vital selfhood. Curious to understand some of the influences that shaped Kohut's values and ideals, Donna referenced the bravery of Sophie Scholl, a student of the White Rose resistance whose life, firmly held beliefs, and eventual execution in Muenchen in 1943 deeply touched Kohut. Donna reminds us that Kohut's rejection of theories of individualism and innate aggression came from his deep belief in our connectedness and need for one another. But, as Donna points out, establishing and maintaining one's connectedness to others is often difficult and challenging. We each have our particular vulnerabilities, and can feel particularly vulnerable in certain intersubjective contexts. Our patients can feel us failing them in a myriad of ways, and we can experience ourselves as falling short, not measuring up, and needing to stretch further to make contact. Following two illustrative case examples in which Donna modeled both her beliefs and fallibilistic courage, her lecture came to an end. The room burst with applause as attendees rose to give her a standing ovation. She had deeply connected with her audience in her humble but heroic way. We left with a feeling of plentitude.
Summary of the PanelsLucyann Carlton | ||||||||||||
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The Thirtieth Annual International Conference on the Psychoanalytic Psychology of the Self was entitled "Self and Systems in Psychoanalysis." Four panels were held over a span of two days, comprising seven original, complex, and theoretically wide-ranging papers[1], four evocative case presentations, and three discussions of these papers exploring the concepts of Self and Systems. I presented a concluding essay: Making Sense of Self and Systems in Psychoanalysis. Here I present a few highlights of my summation. I noted similarities and distinctions, more than sharp differences, across the presentations that considered psychoanalysis as an open system, and I offered two conceptual paradigms for the reader/listener to utilize to make his/her own sense of these two concepts, Self and Systems, within psychoanalytic theory and practice. Each of the presentations emphasized and developed different aspects of systems theory. Robert Galatzer-Levy emphasized Emergence. Howard Bacal developed Specificity of process in psychoanalytic practice. Bill Coburn offered a cogent summery of the key concepts of systems theory to inform our clinical sensibility. Frank Lachmann presented a dyadic systems view, which places mutually regulated nonverbal exchanges into the foreground and dynamic conceptualizations in the background of clinical practice. Joe Lichtenberg emphasized that systems thinking alters the aim of psychoanalytic treatment to the process itself, requiring the focus of analytic inquiry to shift from content to process. While each of the presentations emphasized different aspects and applications of systems theory, there were noted similarities across the presentations.
Each of the elaborations of systems theory offered different systems-based psychoanalytic theories. However, these theories are not distinct one from the other in the same way that, for example, classical analysis might be distinguished from self psychology. We are challenged to devise new comparative paradigms within which to discern similarities and differences among these new systems-informed theories, their view of therapeutic action and impact upon clinical practice. Conceptual paradigms are needed with which to appraise the relative utility of concepts such as self and systems to organize our clinical thinking. In my summary essay I develop two conceptual paradigms. The first paradigm organizes theory by its purpose, whether its purpose is to (1) describe our subjective felt experience, such as the self as cohesive and vigorous (the experiential level), or whether its purpose is to (2) explain the conditions that give rise to that experience, such as explaining emotional trauma as arising from malattunement from caregivers (the explanatory level). The second paradigm organizes theory by is mode of explanation: whether a given concept is premised upon mind as structure (such as self) or whether a concept is premised upon mind as process (such as systems theories). Self and systems are concepts of a different order of explanation. This is a distinction with a profound consequence for the utility and application of the theory at the explanatory level. Structure concepts and process concepts perform different functions at the explanatory level. If the definitional presentation of these two paradigms intrigues you, you may access their conceptual development in the full text of my Summary Essay, which will be available in a future issue of the International Journal of Psychoanalytic Self Psychology. Endnotes 1. The presentations by Robert Stolorow and Malcolm Slavin considered the existentiality of human trauma, and were not primarily devoted to concepts of self and systems. Thus, given the limited space allotted, these two papers presented during Panel Four are not considered within this brief summary. The reader is referred to the papers themselves and to the full summary essay. [Return to text]
Books by IAPSP Members | ||||||||||||
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TOM GREENSPON, PH.D.: I'm not sure if this is relevant to our group, but I think it might be. Last March my book What to do when good enough isn't good enough: The real deal on perfectionism was published by Free Spirit Publishing. It is a book for 9-13-year-olds and goes with my earlier book for adults and families, entitled Freeing our families from perfectionism. These are of course books for the general public, but they are based on a contextualist, intersubjective understanding of the nature of perfectionism and its treatment (a paper describing this in more detail is awaiting review). Attachment and Sexuality (2007) DIAMOND, SIDNEY BLATT, AND JOSEPH D. LICHTENBERG (Eds.). New York: The Analytic Press and The Psychoanalytic Inquiry Book Series. Sensuality and Sexuality Across the Divide of Shame.(2007) Joseph D. Lichtenberg. New York: The Analytic Press and The Psychoanalytic Inquiry Book Series. BARRY MAGID, Ending the Pursuit of Happiness: A Zen Guide (Wisdom Publications, Boston 2008) "Ending the Pursuit of Happiness is destined to become a classic. Magid has written a guide to Zen practice that is inspired by a deep understanding of the essence of both Zen and psychoanalysis. He systematically exposes and dismantles the subtle fantasies that keep us trapped in our futile attempts to transcend the human condition. Magid speaks with an authentic voice that is wise, sly and subversive. There is not a false note here. In an era dominated by the pursuit of quick fixes and the growing medicalization of the mental health field, this book provides a radical and vitally important challenge to the prevailing cultural ethos." —Review by Jeremy D. Safran, Ph.D., Professor and Director of Clinical Psychology New School for Social Research CHRIS JAENICKE: My book The Risk of Relatedness—Intersubjectivity Theory in Clinical Practice was published by Jason Aronson (Rowman and Littlefield Publishers,Inc.), New York, 2007 in December 2007. The book combines two interrelated subjects: the risk of relatedness for both the patient and the therapist inherent in the therapeutic process and the clinical application of intersubjectivity theory. ANNE PARIS, PH.D., Standing at Water's Edge: Moving Past Fears, Blocks, and Pitfalls to Discover the Power of Creative Immersion published by San Francisco: New World Library, 2008. In describing her book, Dr. Paris says, "Based in the leading edge of contemporary psychoanalytic theory, Standing at Water's Edge helps artists start and sustain their creative process. Filled with examples from psychotherapy sessions, interviews, film clips, and personal reflections, this book is written for a mainstream audience and challenges the notion that we find the courage to create from deep within ourselves. Instead, Dr. Paris argues that our capacity for creativity is generated through connections with others, with the audience, and with the art form. She guides the reader through the internal, secret world of creativity, and offers a new way of understanding what we need in order to immerse into creativity. She conveys an empathic appreciation of the fears, dreads, hopes, and fantasies that artists confront and illuminates the power of selfobject experience in the creative process. Dr. Paris shines a light on a dimension of our inner experience that largely goes unrecognized or is misunderstood—but that has a powerful impact on our moment-to-moment thoughts, feelings, and behaviors. She helps us realize how relationships with mirrors, heroes, and twins can help us to dive into creativity and how to cultivate these types of connections. This is a book to recommend to patients as well as to use as a resource in helping all clients reach their full potentials." DORIS BROTHERS PH.D.: My new book is Toward a Psychology of Uncertainty: Trauma-Centered Psychoanalysis. The publication date is 2008 and it is part of the Psychoanalytic Inquiry Book Series of The Analytic Press. The following paragraph describes the book: By capsizing Freud's positivist paradigm, the relational revolution challenged psychoanalysts to address the profound uncertainties that pervade the analytic situation and human life in general. This book is concerned mainly with uncertainty surrounding the relational bases of selfhood and its experiential transformation within living systems—most notably, the analytic dyad. In optimal development, such transformations occur silently by means of the regulatory processes of everyday life, and through the emergence of "systemically emergent certainties" (SECs) that organize relational experience. Trauma, insofar as it destroys our SECs, generates overwhelming uncertainty about psychological survival and leads to the development of extreme attempts at transformation often in the form of constricting and dualistic relational patterns that dominate treatment. This perspective sheds fresh light on the analytic process and numerous topics of interest to analysts such as gender, faith, and cults. Illustrations are drawn from the clinical situation as well as film and theater. FRANK M. LACHMANN, PH.D., Transforming Narcissism: Reflections on Empathy, Humor, and Expectations, The Analytic Press Using Kohut's seminal paper "Forms and Transformations of Narcissism" as a springboard, Frank Lachmann updates Kohut's proposals for contemporary clinicians. Transforming Narcissism: Reflections on Empathy, Humor, and Expectations draws on a wide range of contributions from empirical infant research, psychoanalytic and psychotherapeutic practice, social psychology, and autobiographies of creative artists to expand and modify Kohut's proposition that archaic narcissism is transformed in the course of development or through treatment into empathy, humor, creativity, an acceptance of transience and wisdom. He asserts that empathy, humor, and creativity are not the goals or end products of transformations, but are an intrinsic part of the ongoing therapist-patient dialogue throughout treatment. For beginning therapists, Transforming Narcissism presents an engaging approach to treatment that incorporates the therapeutic action of these transformations, but also leaves room for therapists to develop styles of their own. For more experienced therapists, it fills a conceptual and clinical gap, provides a scaffold for crucial aspects of treatment that are often unacknowledged (because they are not "analytic", or are dismissed and pejoratively labeled "countertransference.") Most importantly, Lachmann offers a balance between therapeutic spontaneity and professional constraint. Focused and engaging, Transforming Narcissism provides a bridge from self psychology to a rainbow of relational approaches that beginning and seasoned therapists can profitably traverse in either direction. MYRNA ORENSTEIN, PHD: (morenstein@smartbutstuck.com): The second edition of my book Smart but Stuck: How Resilience frees learning disabilities from Imprisoned Intelligence came out last June from Haworth Press. It's about smart people with learning gaps and the self depletion and ensuing resilience that can come with living with undiagnosed learning disabilities. There is a forward by Joe Palombo and a statement from Connie Goldberg endorsing the book. There is a chapter on self psychology and learning disabilities as well as a chapter written by myself and Dr. Fred Levin from a neuroscience perspective entitled: "Fortitude and Flexibility in people with Learning Disabilities." DANIEL SHAW, LCSW, wrote "Narcissistic Authoritarianism in Psychoanalysis," a chapter in a book published by Other Press in 2007, edited by Richard Raubolt, entitled: Power Games: Influence, Persuasaion, and Indoctrination in Psychotherapy Training." BUIRSKI, P. and KOTTLER, A. (Eds.). New Developments in Self Psychology Practice. New York: Jason Aaronson. Published by Jason Aronson Publishers Inc. An imprintof Rowman and Littlefield Publishers Inc. About the book: It has been 35 years since the publication of Heinz Kohut's monumental book The Analysis of the Self in 1971, and in this period self psychology has undergone a vibrant and exciting evolution that has significantly influenced and expanded the range of psychoanalytic thinking. While undergoing this change, self psychology has kept the developmental importance of self-object relatedness and the primacy of subjective experience as central tenets of the theory. But where other theories of mind can tend to stagnate and resist innovations that transcend their founding figure, Kohut's self psychology continues to grow in depth, complexity and richness. Indeed one of the great strengths of the self psychology movement has been the openness of the succeeding generations to push the theoretical envelope—to entertain, examine and integrate new understandings and perspectives. New Developments in Self Psychology Practice gives voice to many of these developments, reflected in its four sections. The first section examines complexity theory, attachment theory and the work of the Boston Change Study Group. The second section is concerned with the treatment of children, while the third section examines various treatment modalities such as family therapy, group therapy, and the supervisory process. The final section looks at diversity, difference, and otherness within both the therapeutic dyad and the therapeutic community and considers how shame, enactments and traumatic experiences influence the therapeutic process. JUDITH BLACKSTONE, PH.D., has two new books this year: The Empathic Ground: Nonduality and Intersubjectivity in the Psychotherapeutic Process, from Suny Press and a revised edition of The Enlightenment Process: A Guide to Embodied Spiritual Awakening, from Paragon House. Both books look at the interface between psychological healing and spiritual development. For more information, visit www.realizationcenter.com. In Trauma and Human Existence, ROBERT STOLOROW, PH.D. , explores the phenomenology, contextuality, and existentiality of emotional trauma as these crystallized in his efforts to grasp his own experience of traumatic loss. News from IAPSP Members | ||||||||||||
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LAWRENCE BALLON, M.D., has succeeded Dorienne Sorter as Editor of the IAPSP Online Reading Seminars. A very successful seminar featuring Joye Weisel-Barth's paper "Thinking and Writing About Complexity Theory in the Clinical Setting" has just been completed. Joye participated in the discussion as the author. Phil Ringstrom and I served as her co-discussants. In addition to our members in the U.S., a number of international members, who have limited opportunity to attend self psychological conferences, participated. It was a very rich and stimulating discussion. Additionally, I am on the faculty of our analytic training program here at ICP&P in Washington, DC, and have just finished teaching a very successful course "Psychoanalytic Writing" for our second-year candidates. I'll be serving as a moderator for one of the paper sessions at the IARPP conference in Baltimore this spring. The paper is "Voice and Cure: The Significance of Voice in Repairing Early Patterns of Disregulation" by Kristin Miscall Brown, LCSW. In personal news, I'm going to become a grandfather for the first time this spring. CHRISTINE C. KIEFFER, PH.D., has been appointed to the editorial boards of Psychoanalytic Inquiry and IJSP. She also was appointed an Editorial Associate of the Journal of the American Psychoanalytic Association. Dr. Kieffer published two new papers in the past year: "Emergence and the Analytic Third: Working at the Edge of Chaos," published by Psychoanalytic Dialogues in Sept./Oct., 2007 and "From Selfobjects to Mutual Recognition" in an issue on "Fathers and Daughters," an issue edited by her, in Psychoanalytic Inquiry, January, 2008. Dr. Kieffer presented a paper in July, 2007 at the International Association for Relational Psychoanalysis in Athens, Greece titled, "Co-Constructing the Analytic Third." ROGER J. SEGALLA, JR., Ph.D., invites you to visit his website. It is a wikipedia site specifically designed to document the growing lexicon of terms, concepts, and theories that represent the field of relational (little "r") psychoanalysis. A wikipedia allows for the collaborative creation of edited definitions just like an encyclopedia. Like the now famous wikipedia.com, the visitors and users are also the writers and editors. With the combined efforts of all of you scholarly and erudite writers, theorists, and consumers of psychoanalytic literature, we will create an invaluable and evolving resource which should support and enrich the development of relational psychoanalytic literature. We need your help to make this website resource work! Once you arrive at the website you will need to enter your email address and use the password "sandor." Here's an important hint: If you want to contribute to the website it is much easier to use the "point and click editor" which you can find in the left hand corner of the page when you go into edit mode. You may need to download and use a different web browser such as FireFox. There are more detailed instructions available when you go to the website. I want your comments and suggestions about the website and I will do everything I can to utilize them as the wiki evolves. Please feel free to contact me at: rsegalla@verizon.net. BRENDA SOLOMON, M.D., presented a case of an analysis of a woman highlighting "the body-self" at one of the discussion groups at the January meetings of the American Psychoanalytic Association. Additionally Dr. Solomon chaired an ongoing group discussion entitled "Special Issues for Women in Analytic Training." ANNA ORNSTEIN, M.D., delivered the plenary address at the American Psychoanalytic Association meeting: "The Missing Tombstone: Reflections on Mourning and Creativity." MARIAN TOLPIN, M.D. , was named The National Woman Psychoanalytic Scholar for the year 2009 by the American Psychoanalytic Association. This award supports her in visiting two distant psychoanalytic communities with special focus on candidate needs. Often the honored scholar also presents a paper to the larger psychotherapeutic community. GEORGE H. NORTHRUP, PH.D., is the new President-elect of the New York State Psychological Association. He is also President of the Fresh Meadows Poets, but (sic transit gloria) is happy to be addressed as George. ALLAN H. GELBER, PH.D., is leading the Self Psychology Study Group in Phoenix, AZ to affiliate status of IAPSP. Any interested people can contact him at 602-954 6700 or AZCMH@AOL.COM. RENEE LEFF-KAPLAN, J.D., MFT, FSCIPP writes: I am a new member. I would like the membership to know that I specialize in high conflict divorce and custody cases. I am approved by the Los Angeles Superior Family Court in high conflict co-parenting education and listed on their website. I have offices in West Los Angeles and in the San Fernando Valley. I lead groups for children, teens and adults. I also help individuals navigate the pitfalls of difficult divorces. Of course, my passion lies with depth psychoanalytic psychotherapy. ROBERT D. STOLOROW, PH.D., completed his Ph.D. in philosophy at the University of California, Riverside, in September 2007. His dissertation was a philosophically refined and expanded version of his recently released book, Trauma and Human Existence: Autobiographical, Psychoanalytic, and Philosophical Reflections (New York: The Analytic Press, 2007). ANNE MARIE PLANE, PH.D., took a short sabbatical from her clinical practice in Santa Barbara, CA so she could spend fall 2007 on a Mellon Fellowship at the Henry E. Huntington Library in San Marino, CA. She was conducting research in the collections there for her book project, forthcoming from University of Pennsylvania Press: 'When I Awaked': Colonialism and the Cultural Meaning of Dreams in Seventeenth-Century New England. She is also close to completing her graduation paper for ICP, Los Angeles, which is entitled "Royal Roads or Blind Alleys?: Culture, Dreams, and Contemporary Clinical Psychoanalysis." She has now returned to her practice, but remains on leave from her position in the history department at University of California, Santa Barbara. ANDREW MORRISON, M.D., was invited to present his paper, "Narcissistic Phenomena and Shame", in Madrid, Spain on February 8 and 9, and in Barcelona on February 16. Discussants included IAPSP members Ramon Riera and Rosa Velasco. HOLLY LEVENKRON, LICSW: Her recent article "Love (and Hate) with the Proper Stranger: Affective Honesty and Enactment," is the lead article in Psychoanalytic Inquiry, V26, No. 3. She also has an article accepted by Contemporary Psychoanalysis entitled, "Engaging the Implicit: Meeting Points between the Boston Change Process Study Group and Relational Psychoanalysis." She has a private practice in Cambridge, MA. |