Conversations

As a psychopharmacologist and an aspiring analyst who frequently provides consultation to analysts regarding medication for their patients, this question has become more compelling. Whereas in the late 1950’s when psychotropic medication became first available, the modality was greeted with almost outright rejection, the emerging data over the last 20 years has shown not only greater efficacy of the “combination treatment,” but also an increasing acceptance in the analytic world. Exploring the changing attitudes towards the combination of psychoanalysis and pharmacotherapy over the years can lead to a wider discussion of individual experiences attesting to or contrary to such findings.

This Conversation will address the topic of how our analytic self changes as we age.  We certainly gain wisdom, understanding and confidence as we acquire more experience, but how do we deal with facing our own aging process and how it might affect our work with patients? Do we decide to work until we drop?  Will we recognize when it’s time to close shop?  How do we feel about losing our identity as a therapist when we are often at the height of our clinical skills?  We need to be able to talk with patients about their fear of diminishment and death but what about our own similar concerns?  This talk will provide a forum for mental health professionals to explore these issues.

Join us for a screening of  “One of Us,” a Netflix documentary released on October 20th, 2017. The documentary follows three individuals over the course of two years who are in different stages of transitioning from Ultra-Orthodox Hasidic communities.  Chani Getter, Director of Family Justice at Footsteps, will be joining us for a Q&A and a conversation after the film. Our focus will be on working with individuals who are contemplating leaving or who have left insular communities.

Every person has (develops) biases that stem from personal experiences, family, community and environment, among other exposures.  The therapist is not exempt from having biases which, many times, are unknown to him/her.  Although many of those biases may be expressed and/or processed in the therapist’s analysis or supervision, not all of them can possibly be evident to express at will.  What happens when the therapist’s biases are triggered by a patient in the therapeutic process?  In this conversation we will discuss how the clinician’s cultural competence and personal development may affect the therapeutic relationship as a whole.

Most of a therapist’s professional time is spent engaging with clients and focusing on clinical material that comes to light during sessions. However, there is less examination about what clinically transpires for therapists outside sessions. In the same way that therapists are trained to tune into the gaps and spaces in between their clients’ words, therapists can benefit from being attuned to their own clinical process that occurs in the gaps and spaces beyond their sessions. These periods of time account for a range of conscious as well as unconscious determinations made by therapists that can impact the treatment in sessions. This Conversation will utilize a psychoanalytic perspective to discuss various elements of clinical practice that may be considered before, after and outside of sessions.

June 2, 2019

Mosse Burns, LCSW and Regina Minsky, LCSW

This workshop will provide an opportunity for therapists to learn and discuss issues that arise when working with people of the trans experience. The program will include a presentation by an experienced psychotherapist who works with people going through the transitioning process, a viewing of the Academy Award movie entitled, “A Fantastic Woman” followed by group reactions and a discussion of psychoanalytic concepts as it pertains to our work with patients/clients.

A Colorful Story of Resilience After Leaving a Dark Environment

April 7, 2019

Lorna Goldberg, L.C.S.W., Psy.A. 

On April 7th, for those of us who were privileged to be there, we experienced another sort of renewal. IPS, along with the International Cultic Studies Association and the New Jersey Society of Clinical Social Workers, hosted a panel discussion of a spellbinding book about an abusive cult entitled Whispering in the Daylight. We heard from author Debby Schriver as well as from three young women who had grown up in the Tony Alamo Christian Ministries. They brought this book to life by telling their stories. We felt heartened from hearing about the courage and resilience of these three women after leaving an abusive environment.

January 13, 2019

Anat Joseph, LCSW, PsyA

Most of us have distinct bathroom and toilet habits, which we repeat and from which we rarely deviate. We consider these rituals absolutely private. Why do we avoid talking about them? Freud believed that the erotic and aggressive fantasies aroused by excretory functions during toilet training may be linked to fear, shame and humiliation. Furthermore, coping and suppressing these fantasies may be the cornerstones of many character traits. Who has not joked about someone’s organizational trait as anal? As psychotherapists, we see many patients who struggle with shame. This conversation will explore how the experiences and fantasies revolving around toilet habits have influenced the character structure of our patients.

November 18, 2018

By Margaret Debrot and Rosenna Pemberton

On Sunday, November 18, 2018, members of our institute and other mental health professionals in the community gathered for a ‘Conversation’ led by Margaret Debrot and Rosenna Pemberton. The topic of the ‘Conversation’ was, The Erotic Transference.

Margaret opened the discussion with excerpts from Sigmund Freud’s 1915 classic paper, “Observation’s on Transference-Love.”

For Freud, the phenomenon whereby the patient falls in love with the analyst “signifies a valuable piece of enlightenment and a useful warning against any tendency to counter-transference which may be present in his own mind.” In other words, Freud saw the experience as transference. He further suggested that the erotic transference be kept alive so that its roots in infancy can be uncovered. The offers of love should be set aside, “caught as the analyst is –between gratification and frustration.” The analyst must rely on his/her analytic skills.

Margaret presented a clinical case example whereby the erotic transference was hiding behind the patient’s anger. Freud saw the erotic transference as resistance and further, that sometimes the “erotic transference can manifest itself in other, less tender feelings.”

Rosenna, on the other hand, presented a clinical case example that showed how the analyst may experience erotic counter-transference feelings. Rosenna commented that her contribution to this ‘Conversation’ was based on her own erotic counter-transference to a patient which left her feeling unsettled and concerned about the negative impact that her thoughts and feelings could have on the analytic process if not handled appropriately. Further, she was reminded of the importance of discussing these experiences in supervision to ensure the fact that they don’t interfere with the psychoanalysis.

Participants also shared comments from their own experiences in a lively discussion. Someone commented, “Hats off to you for being aware of these counter-transference feelings. There’s a challenge when there’s a mixture of induced and non-induced counter-transference.” Another commented that sometimes patients are seductive. Further, the participant shared that she discovered her countertransference feelings when she began looking forward to the sessions with her patient. She learned that the underlying experience the patient was beginning to uncover in the safety of the analytic environment was that he felt he was betraying his wife by his erotic feelings for the analyst. Someone also commented that validating the patient’s feelings, along with acknowledging that the feelings are natural in treatment, are an important part of deepening the analytic process.

 Several other comments included the following: that erotic feelings for the analyst are expressed in dreams, that there can be an emergence of homosexual transference feelings expressed in treatment, that the first love-object is the mother, and that premature termination of the treatment is sometimes due to erotic feelings in therapy. The ‘Conversation’ also led to a discussion about the possibility of having another ‘Conversation’ on the topic of Love.

September 16, 2018

Zachary Schwartz LCSW, PsyA

On Sunday, September 16, 2018, IPS hosted a well-attended discussion among clinicians about navigating the various facets of technology (e.g. text, email, online, video communication) related to working with our clients. The Conversation was led by Zachary Schwartz who shared case examples, pros and cons as well as considerations on this increasingly relevant topic which has many more questions than answers. The group brought up many thought-provoking implications, with a common theme being the nature of the client’s capacity to feel connected to their therapist via technology.

Concerns about how to appropriately address the risk level of texts from clients to ensure safety while also preserving a therapeutic relationship were also processed. Additionally, as attendees at the Conversation spanned multiple generations, spirited reactions were shared about how to effectively work with this next generation of tech-savvy clients and where to draw the line with boundaries related to treatment. Insightful points were also made about how today’s use of phones fosters uninhibited expression and free association, thereby making it the “modern day couch.” Legal and ethical issues in this digital age were also explored, but there wasn’t enough time to completely delve into our complex new landscape. For now, it seems that while the foundation of the therapeutic work we do will likely always be the same, the nuances of it created by technology will be continually evolving.

Thomas Grace, PsyD, PsyA

On March 18, 2018, The Institute for Psychoanalytic Studies was host for a lively and thought-provoking conversation about aspects of self-disclosure of countertransference reactions and personal information by the analyst. Through the recollection of personal experiences, we explored how sharing our personal experiences might enhance and impede the therapeutic process.We began the discussion by identifying two aspects of “deliberate” self-disclosure; the analyst expressing induced reactions to a patient, and the analyst sharing personal details. Participants went on to clarify that the therapeutic value, efficacy, and safety of an analyst’s self-disclosure is simultaneously dependent on the clinical needs and wellbeing of patients, as well as the impulses and intentions driving analysts to disclose. The processes of character analysis might be further enhanced, and ruptures healed by follow up exploration of patients’ reactions and fantasies to analysts’ disclosures. The safety of a healthy therapeutic relationship, not a formula, affords rich opportunities to identify the energy and pervasiveness of needs, frustrations, and character traits. As for “unintended” disclosure of personal information, it might not be possible to completely avoid self-disclosure as we leave traces of ourselves in choices we make, how we present ourselves, and the therapeutic environments we create. Nevertheless, there can be boundary-crossing and vulnerability-inducing risks that occur when patients dig through the online activities of an analyst to actively discover personal details without the analyst’s intention or consent for the patient to know.If a goal of analytic treatment is to help patients to identify and disclose previously unknown and vulnerable aspects of themselves (e.g., aggressive and sexual fantasies and impulses) and then more freely choose how or if to use what they learn, then might it be possible that we as analysts can provide an important frame of reference and practice ground for our patients when we afford ourselves the possibility of using self-disclosure as clinically indicated. If we as analysts happen to benefit from that process, maybe that’s a good thing too. Thank you to all participants for your contributions. I believe we all benefited from each other.

Movie Night: LionMargaret Debrot, LCSW, PsyA
On Sunday, February 11, 2018, the Institute sponsored the first of our Movie Nights, as members of our Institute and other mental health professionals viewed and discussed the 2016 film, Lion. The discussion was led by Cathy Lawrence and myself. Lion is based on the true story of a five year old Indian boy named Saroo, who is lost and separated from his family in India. He is eventually adopted by an upper middle class Australian couple. Twenty-five years later, after he spends four years searching for his birth-mother on Google Earth, Saroo is re-united with his birth-mother and biological sister.After watching the film, participants discussed the psychological dynamics of Saroo and his search for his biological family. Among the topics touched upon were the following: Freud’s theories of repression and the return of the repressed; the inborn temperament of infants; the character of the Saroo and how that character helped him to survive; trauma as it related to individuals who grew up in Uganda; ambivalent feelings expressed by Saroo in his relationships, which may have been a projection of inner conflicts and pain; resilience in people.According to the feedback forms, the participants found the discussion to be informative and helpful. We plan to have more Movie Nights and Discussions in the future.

Conversation: #METOOLisa Sokoloff, LCSW, PsyA
On Sunday, January 29, 2018, IPS hosted a packed room full of clinicians who wanted to discuss the #MeToo movement and how it affects our work with patients. The Conversation was led by Lisa Sokoloff. The group discussed our ability to “not know” as well as how dissociation can be used to wipe away a memory too painful to absorb as a way of protecting the self from being overwhelmed. The conversation covered a lot of ground – men feeling guilty about their fears of what they may have done, fantasies that can be confused with reality, how the climate of women speaking out made it possible for clients to open up and even allow themselves to remember past abuse, and how expectations for women’s sexuality were different in the past. There was a lively discussion about how the culture seems to be changing and many points of view were expressed, including the following: Do some women want to be seen as victims? Do others who were abused want to deny their experiences?  What about women predators and males who are victims?  There wasn’t enough time to addressall the aspects of this timely discussion and we agreed that the conversationshould continue.

SYNOPSIS OF IPS CONVERSATION, JUNE 4, 2017Humor 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.

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.