Conversations

SYNOPSIS OF IPS CONVERSATION, JUNE 4, 2017

Humor in psychoanalysis is different from joke telling. A joke is a witticism. It’s a one-way
communication; and, although there is a shared recognition on the part of the joke teller and the
hearer, that’s the extent of the shared feeling.

Humor, on the other hand, is a shared experience between the analyst and the patient, but it’s not
directly translatable to other people because it summarizes a unique recognition on the part of
the analyst and the patient that they share an understanding. The analyst’s unconscious and the
patient’s unconscious meet. We know that we’ve been successful in humorous joining with the
patient when there is surprise or relief, and, frequently, when there is laughter.

Humor can’t be planned. It is a spontaneous manifestation of the space between the analyst and
the patient and is only funny to the two of them. Sometimes when people tell about a funny
thing that happened, they say, “You had to be there,” and that’s true. You had to be there, not
just in the sense of being in the room, but in the sense of two people being there with each other.
Freud wrote Jokes and their Relation to the Unconscious right after he wrote The Interpretation
of Dreams, so this suggests a continuation of his thoughts on the unconscious. He recognized
that many of the same processes that occur in dreams occur in jokes, including symbolism,
condensation, and stream of consciousness. A laugh implies a discharge—inhibitions have been
loosened. The cathartic energy used for inhibitions has become superfluous and has been lifted.
Therefore, that energy is discharged in laughter.

Obviously, humor should be used to acknowledge the shared humanity between the analyst and
the patient, never to belittle the patient. Humor should convey the message that we both
recognize the absurdity of life and our shared reaction to that absurdity.

Clients Suffering Physical Pain:

How an Understanding of Character and Underlying Fantasy Life Might Offer Relief

Conversation – February 12, 2017

Clients initially might look to the therapist for concrete strategies such as mindfulness and
guided imagery to cope with or reduce physical pain. Without doubt, these and other strategies
can be useful components of helping clients.

The question before us is what relief, if any, can an analytic treatment possibly offer? This was
not a lecture on how to use character analysis or other methods to treat pain. Rather, our
community of practicing clinicians got together to have a conversation about how we hear and
experience patients’ reports about acute and chronic pain.

Through attentively listening to clients and in depth work, we discussed how therapists might
help clients discover if there are associations between the physical pain from real injuries and
illnesses and deeply rooted unconscious character traits.

We discussed how we might use transference and countertransference reactions to help clients
identify and examine character traits and underlying fantasies, yes even the sexual ones,
associated with the experiences of physical pain, illness, body image, and ageing. Rather than
blaming, minimizing, or invalidating clients’ experiences, participants in this conversation have
found that this gentle joining approach might actually facilitate clients’ development of a greater
sense of control, comfort, and maybe even relief.

On Sunday, December 11, 2016, the Institute for Psychoanalytic Studies held a Conversation on the topic: When the Political Becomes Personal: How a Psychoanalytic Understanding Can Help Our Clients Deal with the Polarized Post-Election Climate.

The Institute decided to offer a free, open forum for therapists to discuss how this election has affected our work since many of our clients have experienced increased post-election anxiety and a variety of other strong reactions. Since therapists are on the front line of working with depression and anxiety and often work alone in private practice, IPS wanted to create a space for clinicians to share thoughts and experiences related to how the current climate was impacting them as well as their clients.

Our facilitator, Lisa Sokoloff, LCSW, led the discussion of how a lack of safety has been experienced by some clients as a result of the election, especially those that have experienced prior trauma in their lives, including women who have a history of sexual abuse, minorities who have faced discrimination or hate crimes and others who are frightened of how the new administration may impose restrictions on civil rights and women’s right to choose.

The idea that a person’s character would be a major factor in how someone reacts to different life events was explained as a basic tenet underlying all psychoanalytic treatment. The concept of the Third was mentioned, where the polarized position of opposites can expand to include a neutral space where differences can be explored in an atmosphere of acceptance and safety.

In addition, therapists shared how their countertransference came into play when working with clients who shared similar political points of view as well as different ones and how each played a part in shaping the transference/countertransference matrix.

The Conversation was well attended by a wide variety of clinicians and everyone participated, with differing views being explored.

Lisa Sokoloff, LCSW

The Institute for Psychoanalytic Studies together with New Jersey Society for Clinical Social Workers provided an open discussion on “The Complexities of Therapy with Clients who are Dealing with the Aging Process and Physical Illness” on November 13, 2016.

Our facilitator, Mosse Burns, L.C.S.W, introduced the program with two clinical cases that illustrated how aging can affect the client as well as the therapist in different ways. Aging can involve complex patterns of loss, including less independence, altered bodily functions, monetary concerns, loneliness and fear of illness and death. Therapists treat not only the older patient but they also treat the younger family members who often are the caretakers. Complexities arise for the therapist because of their own countertransference issues, i.e. how they might be dealing with their own aging process, and how they might be managing their own caretaking concerns.

The discussion was attended by an enthusiastic group of therapists, who discussed a wide spectrum of clinical experiences. The participants discussed many important issues, such as the limited time available for change, diverse cultural expectations, families burnt out by the aging client, characterological differences in idiosyncratic reactions to multiple losses, the experience of narcissistic injury for some women because of the loss of beauty, and the impact of a psychiatric diagnosis on elderly who are institutionalized and no longer able to live at home.

The discussion was animated and well attended.