For the holidays, return to the home within

Article on holiday stress written by local psychologist Jacque Roller, Psy.D. in the Sarasota Herald (title links to online article). Dr. Roller is in private practice in Sarasota, FL.

Dr. Edward Kissi and Clinicians on Black Survivors of the Holocaust

Black Survivors of the Holocaust also titled Hitler's Forgotten Victims Afro-Wisdom Productions is a documentary about the offspring of African soldiers who stationed in Germany’s Rhineland, intermarried with German women and reared their Afro-German children as Black Germans. When Hitler came to power, many of these children were involuntarily sterilized as teenagers. The shame and humiliation haunted them throughout their lives. In addition,the documentary tells the story of Blacks who were actually interned in the camps, as well as Black prisoners of war.

Dr. Edward Kissi looked at the experiences of the Holocaust’s hidden victims; thus, widening the scope about the Holocaust is usually seen as an exclusively Jewish experience. The idea that Blacks died or were a witness to Jewish deaths often meets with disbelieving reactions. People quizzically wonder, "If there were Blacks affected by the Holocaust, why are we just hearing about them now?" Dr. Kissi noted that Jews and Blacks were two groups that were most implicated in the Nazi’s racial consciousness about their ability to “contaminate” so-called Aryan purity.

Dr. Kissi explained the difficulty of conducting research in this area.. While the Nazi’s were meticulous record keepers, since they could not conceive of a Black German, they did not record the disappearance and experimentation on Black victims. The Nazi’s slated Jews and Blacks for different fates; Jews were to be exterminated and Blacks were to be sterilized.

Dr. Jessica Rausch-Medina cautioned against painting people with a broad brush. Just as race is a constructed and artificial category, Jewish people are not all the same and differ depending on where they come from. When applied to the interracial people featured in the film, it is literally impossible to tell who is Black. Her second point was that history is remembered by individuals and societies whether through conscious effort or not and is evoked and mobilized during periods of natural crisis. She provided the example of the way Jews were treated during Argentina’s “dirty war” in the late 1970s in which Jews were treated as concentration camp victims had been treated in Auschwitz and then the Jewish citizens were “disappeared.”

Sheldon Wykell shared Dr. Rausch Medina’s view that race is and ethnicity are constructs that are used by regimes to manipulate reality to appear to resemble how they want it to seem. Mr. Wykell was moved by the similarities in suffering of the Black survivors and other survivors of the Holocaust who believed because they were Germans first that nothing adverse would happen to them. Both Mr. Wykell and Dr. Rausch Medina called for the need for reparations for the Black survivors.

From watching the film, Kim Vaz was struck by the fact of there are no ‘simple’ questions. For the Afro Germans who were sterilized in their youth, the seemingly simple question of “do you have children” is loaded with human rights violations. For this simple question contains personal, family, community, state and international implications of a child’s fundamental right to control her or his own body. The violation of the body that prevents a child from reproducing not simply a new physical life is at issue but more importantly is, the distortions done to the ability of individuals to give birth and rebirth to their own subjective experience over the course of an entire life. For Dr. Vaz, perhaps no one captured this idea better than Imre Kertesz, the Hungarian Noble Prize winner for literature in his autobiographical novel of his experience in the concentration camp he called Kaddish for an Unborn Child.

Presenters Biographies:

Edward Kissi is a historian who studies Ethiopia and the Horn of Africa and also genocide, from a global and comparative perspective. He is the author of Revolution and Genocide in Ethiopia and Cambodia, published by Lexington Books, in 2006. Edward has been teaching courses on African history and the history and theory of genocide in the Department of Africana Studies since Fall 2003. He was granted tenure and promotion to Associate Professor this past Summer. As a genocide scholar, Edward has always been interested in the Holocaust. In recent years, he has been looking at “Blacks in the Holocaust” as well as “Blacks and the Holocaust.” He is currently working on a second book which examines what people on the African continent, especially Ethiopian Jews, knew and thought about the annihilation of European Jews in the course of World War II. He, therefore, has knowledge about our theme today.

Kim Vaz, Ph.D., LMHC coordinated the Film Series: Fears of Difference, Diversity of Holocaust Experiences.

Jessica G. Rausch-Medina, M.D. Child, Adolescent Adult Psychiatrist, in private practice in Tampa since 1984, was at U.S.F. until 1992, completed all her training in Philadelphia, at Hahnemann Medical College. Went to Medical School in Argentina at the National University of Buenos Aires. Has very lose ties to the Holocaust, this has been an integral part of who she is.

Sheldon Wykell, MSW, LCSW graduated from the Jane Addams School of Social Work at the University of Illinois Chicago. He has 35 years in the field of clinical social work and social services administration. He is the former Executive Director of Jewish Family Service of Sarasota-Manatee. While at the Jewish Family Service in Chicago he directed Chicago office of HIAS, the immigrant resettlement program that historically has sponsored and managed the resettlement of Jews in America for over 100 years including before, during and after the Holocaust. Clinical practice includes work with a wide range of clients in individual and group therapy including couples, families, children, elderly, and chronically mentally ill. Currently in private practice in downtown St. Petersburg. Sheldon is a major film fanatic. He sees everything and feels the only thing missing from life in the St. Pete-Tampa area is an independent film house to see films like this.

Working with Patients who have Survived Childhood Sexual Abuse

Today, in Winter Park, FL, I had the pleasure of discussing with the Florida Organization for Relational Studies (FORS), an affiliate of The American Psychological Association’s Psychoanalytic Division (Division 39) the Davies and Frawley (1994) text Treating Adult Survivors of Childhood Sexual Abuse. After laying the biological groundwork for dissociation:
Hormones triggered by stress impair hippocampal functioning, while neurotransmitter (NE) stimulates the amygdala. Generally speaking, the amygdala is responsible for procedural (behavior you can do without thinking, like riding a bike) memory, perceptional-sensory/body memories (like when the hair on the back of your neck stands up when you sense danger, even before you have a conscious recognition of danger), and emotional memory. The hippocampus is responsible for episodic (event) memory, for explicit, semantic (symbolically encoding, giving words to) memories, and for contextualizing events with their emotional significance.

When implicit, perceptual, affective memory is enhanced, but not linked to the event (such as childhood abuse), we have fragmented affective states without a link to their causes. And we have episodic memory of a moment (e.g. a flash of the abuser’s face) without link to its emotional significance or meaning. That these memories are not linguistically encoded has a huge impact on therapy which has traditionally relied on words and narrative. As a result, trauma in childhood impairs organization of memories.

Abuse is also an attack on subjectivity. Consequently, Intersubjectivity as a developmental achievement (the capacity to recognize the subjectivity of the other as well as the self) [subjectivity defined as the sense of self as a subject with an independent agency and desire] is impaired. Because therapy is an invitation to consider meaning from one’s own point of view, inviting a patient to hold forth her own reality can produce anxiety and panic. When the abuse was denied or invalidated by caretakers, the child’s sense of reality (reality testing) is also impaired.
To survive, a child must preserve the needed ties to caregivers and so takes upon herself (introjects) the sense of badness of the abuser, leading to decreased Self esteem and sense of self. The child maintains an illusion of control (‘if I caused it, then if I change it; if I can change the situation, then I am not helpless).
Without sound reality testing and the ability to trust her perceptions, adult survivors cannot adequately obtain gratification nor avoid danger. They tend to subjugate their reality to that of an Other, including complying with therapists’ interpretations. Not being recognized, comforted and protected, the isolation is profound. The world is seen as unsafe, and others, as betrayers.
There is also an impaired capacity to self regulate, such that any arousal is experience as hyperarousal. Therapy, inviting feeling, and intimacy, can lead to hyperarousal. To self soothe a survivor may engage in dangerous or self-abusive behavior to feel the subsequent calm (facilitated by the release of endogenous opioids) and to feel in control (turning passive into active), as well as attacking the abuser-introject, serving, at the same time, to attack the treatment and the therapist’s ability to contain and help.
The therapist can imagine out loud (symbolize in words) what the behaviors might be telling us.

“Behaviors have meaning. They tell us things that have yet to be put in words. When you miss sessions or come late or come high I think about how this unpredictability and instability is what you experienced when your parents could lash out for no reason or when they could not get up to get you to school. Since I am left confused, disappointed, and resentful about the interruption of our work here together, I can only imagine that you too might likely have felt these things (and more) at the hands of your parents. Maybe your lateness and missing sessions is your hope to help me see what it was like for you as a child.” [Note: in this way you highlight the behaviors without blaming. In fact, part of you is grateful to be getting the message. You also let the pt know that one can have negative feelings and still be invested in the relationship and the work. This kind of disclosure does not reveal personal content like where you went over the weekend or how many children you have. It reveals personal feeling states and thoughts about what is going on between the two of you, revelations that model the naming of feelings, their connection to events, and that having feelings does not self or other or the relationship.]

Or the therapist can make empathy-filled interpretations:

“It makes sense that, with the unpredictability of childhood events, you want to be the one who says when the pain starts or stops.”

Before traumatic experiences can be remembered, they must be reenacted. Through projective identification various roles in relational paradigms will be reenacted in complementary, simultaneous, ever-shifting, and overlapping fashion, like hot potatoes passing freely between patient and therapist. Davies and Frawley explicate many permutations of the Neglecting Adult -Neglected child; Abusing Adult -Abused child; idealized and omnipotent Rescuer-Entitled/needy child; and the Seducing Adult-Seduced child, all eight roles, representations of the patient’s child and adult selves, and of her object representations.
Sometimes the pt, unconsciously identified with the uninvolved parent, is the cold, rejecting, unavailable one, silent and withholding, disdainful, preoccupied, bored, hostile. The therapist, as the complementary neglected child, may feel compelled to try harder to reach the patient. When the therapist is reenacting the indifferent adult, her neutral ‘blank screen” may parallel the indifference and denial of the non-protecting parent.
When the patient is reenacting identification with her abuser, she may attack the therapist, the therapeutic frame, or engage in self-abuse. Privileging the love (attachment to the abuser), pain and terror around which the abusive behavior is organized may be easier for pt to engage.

“We all prefer to feel in control, even powerful, rather than feel so painfully vulnerable and helpless. Because I sometimes feel helpless to meet your demands, I wonder if these demands aren’t the additional communication to me that you really want me to know what it felt like to have your father make such controlling, angry demands on you. Also, all children wish to be loved by their parents, even abusing, out of control parents. Maybe if you can be like him sometimes, that allows you to feel a connection to him, and then it is not so sad to feel you never were close to your father.”

Or about the self abuse:

“I understand that this way you feel you are the one in control of the pain-- when it starts, when it stops-- just as your father had been when you were a child.”

As therapists, we are already drawn to the role of rescuer. The pressure to heroically save the abused plaintive child must be made explicit. To attempt re-parenting can interfere with mourning the lost childhood and the loss of the idealized parent. Instead the pt’s adult-self must be allowed to mourn. The therapist must accept that there will be constant tension between symbolic gratifications, frustrations, and interpretations.

“It may seem to you that the only way I can be with you is to be in the same geographic place, that it is not enough that I hold you in my mind or that you hold me in your mind. As much as we both might want to have dinner… together, to do so would have me feeling like your intrusive and inappropriate (father) and then you would begin to doubt the safety we are beginning to forge here.“

Thx needs to recognize pt as sexual subject, without the threat of action.

“Sometimes children learn that the only way anyone seems to pay attention to them is when something flirtatious or teasing is going on.”

“It is only natural that describing sexual activities is, however unwelcome, arousing. I am concerned on the one hand that you may feel rejected if I do not respond in kind to your overtures, but, on the other, am concerned that you may feel responsible for my arousal, the way you did about your father’s, and that would cause you to worry even more that you are dangerously seductive.”

Davies and Frawley use a Treatment Model of: Containment (of hyperarousal); Recovery, Disclosure, Elaboration (of trauma experiences); Symbolization and Encoding (putting into words, making explicxit); Integration (Contextualization); and Internalizing New Object Relationships. Taking for granted first co-creating a safe place, I like mnemonic devices, so I call it the four I’s: Identification (Recovery); Interpretation (putting into words); Integration; and healing as Internalization (of new relational paradigms).
In creating a safe space, the therapist must be comfortable with protracted chaotic reenactments and must maintain the frame, including the stopping and starting on time, and the patient respecting the therapist’s privacy, sleep, vacation. To foster safety, effects on both the therapist and pt of the daunting and protracted reenactments, must be discussed along with how to better negotiate tenacity for the therapeutic work and relationship. This includes inviting the patient to tell the therapist what the therapist does, or does not do, which leads to the therapist or the therapy being [inadvertently] experienced as re-traumatizing. Reality testing can be strengthened by asking what aspects of therapist’s behavior led pt to arrive at her conclusion. Treatment must be a MUTUAL process. The working alliance includes awareness of therapist’s contributions to the relationship. Two-person psychology means the therapist’s behavior is under scrutiny. If not part of the negotiation, then the one-sidedness parallels the abuser’s abrogation of responsibility. It is in negotiation, about the difference in how therapist and patient experience their relationship and each other, that the absence in childhood of toleration of difference is highlighted.
The therapist must ask herself: Can I tolerate the demands, survive the psychological assaults, complaints and invectives, participate in reenactments, work with the dissociated child-selves? Do I get angry when pt brings up… ? Am I reluctant to fully experience myself as a bad object? Am I un-comfortable with my own aggression and helplessness?

Discrepancies in therapist’s and patient’s experience create the potential for managing contradiction and the opportunity for strengthening the pt’s reality testing. To explore these discrepancies requires collaborative inquiry. It is the process, including validating (considering patient’s reality as something to be considered), not the content that is useful. The experience to agree, or disagree, without concomitant loss of integrity on either’s part, leads to mutual recognition, and to an increased subjectivity. It’s a paradox: one needs subjectivity to negotiate well, and negotiation develops/enhances subjectivity.
Empathic immersion and affective attunement foster capacity for self regulation; and diminish self doubt, and affective instability. Containment paves the way for recovery, disclosure and elaboration. As reality testing is strengthened and confidence in her memory increases, memories will emerge.
When you contain, listen and accept (believe), you change the original traumatic experience of isolation and despair and bring about a new object relations configuration, a change in internal structure. These MUST be repeatedly enacted.
Being curious about the meaning of the behavior helps the patient be curious about its meaning.

“This behavior is trying to tell us something, give us clues to something. You are telling us so emphatically through action, over and over again, it is as if you’ve had the experience of no one hearing or believing you.”

“You must have been very distressed, fearing being abandoned by me if you let us both know how angry you were at me. The cutting, by stimulating release of your body’s natural painkillers (opioids), temporarily relieves your fear and helps you feel in control.” [This type of empathic comment makes explicit the meaning of the behavior without passing judgment.]

In Tx: Ask questions and make interpretations to help make CS the roles being enacted.

“I have a theory about this recent cutting behavior, would you like to hear it? When I would not accommodate a change in appointment time I was the abuser who did not care about you, but cared only about herself. This understandably would make anyone angry. We have already discussed that you are uncomfortable with being angry at anyone, and prefer to be angry at yourself, take anger out on yourself. Could that be what was happening here, when after our last session you cut yourself? “

But the dangerous concreteness of self abuse can lead to the therapist’s dilemma which needs to be actively stated:

“I am concerned that should I under react and not step in to hospitalize you, then you could seriously, even fatally endanger yourself, but, on the other hand, I am concerned that if I over react and arrange to Baker act you, I become like your mother who never heard the meaning behind your crying and who got angrier at you and sent you away when you needed her help the most. So you and I together have to figure out what kind of danger you are in right now and what needs to be done about it.”

Replacing a the sadomasochistic struggle with collaborative effort may take years of active interpretation and repetition, containment and self soothing.

All the self states need to participate in treatment. “Neutrality” now comes to stand for the therapist’s capacity to keep fluid these ever changing re-enactments. Here neutrality means equidistance from all the multiple selves that are patient and therapist. Working through, for patients with dissociation, means integrating episodic memories with their dissociated emotional and cognitive significance, as well as integrating dissociated self and object representations.
It is from mis-attunement and correction, rupture and repair, from failing but surviving, that recognition and mutual respect arise. The child-self, previously existing only in the context of the abusive internalized object relationship, now can be integrated into the whole personality and child-like creativity and spontaneity are there to be expressed without fear of fragmentation of the self or without fear that disappointment will devastate. Integration of self and object representations is an aspect of healing, and it is heralded by mourning. Both the child and adult selves have struggled to come to terms with the horrific, deadening realities: That the abuse occurred; that childhood was destroyed and is never to be reclaimed. The pateint has come to terms with the finality and irreversibility of loss.
Treatment is a negotiation between two people each of whom requires a mutual recognition of difference, and allowing for each person to impact and influence the other. New object relationships accept both loving and hating identifications. Acceptance changes intrapsychic and interpersonal reality. Patient has seen that her own hate does not destroy the other and that the therapist’s anger is not accompanied by the attempt to destroy the pt. The experience in treatment to agree, or disagree, without loss of integrity on either’s part, leads to mutual recognition, and an increased subjectivity.
Healthy, mature self-organization is an amalgam of widely varying self- and object representations, each unique in its affect and ideational content, some even contradictory but no longer mutually exclusive. Internalization of new object relationships now allow for different self-states to have mutual understanding, respect, and affection (adult/child) for each other. There is increased tolerance and empathy. Now the child-self confers on the adult survivor increased vitality, passion-without-shame, play, fantasy, creativity, imagination, and ambition. The increased capacity to tolerate contradiction, love and anger, in self and others, and intersubjective experience, leads to an increased capacity for intimacy (exploring interiority of another and allowing an Other in) (both sexual and non-sexual).
Healing, like treatment, is an ongoing process, an ongoing dialogue between self states. It is not a finished product. Because treatment is co-created, no two therapists will have traveled the same path with a given patient. The acceptance of defeat without dissolution, failure, but survival, exists. Now there is a philosophical expansion of a profound appreciation for life, and for connection with an Other.

Recommended book: Identical Strangers

Identical Strangers by Elyse Schein and Paula Bernstein.

I was intrigued and fascinated by this book written by identical twins who had been separately adopted at birth for a "twin study": Their website is http://www.identicalstrangersbook.com/about.html It presents a balanced perspective on nature-nurture contributions on behavior.

Recommended by John Lambert, LCSW

NPR talks about Carl Jung's Secret Book

Click to read more and hear NPR's 'On Point' with Tom Ashbrook

Carl Jung's Secret Book

"Jung said his 'red book,' in which he recorded his visions, was the basis of everything else he did. But it was locked away in a Swiss vault. Now it's out."

Book Review: Literature and the Brain

In Literature and the Brain (©2009 The PsyArt Foundation, Gainesville, FL) Norman N. Holland combines his love of ideas, questions, and answers with his love for literature. Like Malcolm Gladwell's Blink or The Tipping Point, Holland’s is the perfect vacation or bedtime reading for the learned person interested in human behaviors, in this case, in thinking about literature. This is not a book that analyzes particular pieces of literature, as many of his other books do, but one that asks questions such as “Why do we feel real emotions at things we know are fictional” and what allows us to suspend disbelief, as well as explores “how the brain both enables and limits us in creating and responding to literature.”

To answer and explore some of these, Holland elucidates workings of the brain and looks at our relation to reality in general. Apparently, when our brain is cognizant that it cannot (or needs not) act or change the outcome of a situation, for example, on a work of art as when viewing a movie in a theater, then the motor cortex 'relaxes' allowing the limbic system its freer emotional expression.
He describes four changes in the brain when we are transported by reading a book or watching a play: our perception changes in relation to the body, to the environment, in reality testing, and in our emotions.

Holland provides biological and evolutionary reasons why we can lose awareness of our bodies and the world, and why we can cease to judge reality, allowing us to react emotionally toward fictional characters as if they were real. He explores why literary works engender such strong emotions by explaining the functioning of the brain, its cortical and subcortical workings. Holland says that the sole purpose of the brain is to move the body as in the four F’s learned by all medical students: feeding, fighting, fleeing, and sexual reproduction [the latter ‘F’ an example of the joy of surprise, as in a joke or well-turned phrase. ]


In explaining how the retina and the occipital brain perceive electrical physiological processes as something “out there,” he begins:

“Sensing objects as ‘out-there’ in a not-me world is useful, even essential, for survival. I have to know that somewhere beyond my skin is a mountain lion, a banana split, or Marilyn Monroe, depending on which basic need I am trying to satisfy at the moment.”


In Literature and the Brain Holland makes complex ideas accessible to the lay person. It is a rich book of neurological and psychoanalytic ideas about emotion and motivation, combined with thoughts from philosophers and poets, and peppered with humor. His avuncular writing style leads the reader into comfortable conversation with the author. Sometimes there are lovely metaphors: “A poem lies inert, like Sleeping Beauty, until we love it into life.” [Loving both poems and fairy tales, and with its allusion to sexual awakening, this one delighted me, despite the unconscious misogyny intimating that women find life from men.] Sometimes there is frank science: "...the brain stores information: not in the cells, but in the patterns of linkage between cells." But, throughout, there is the desire to read and understand more.

For the psychoanalyst, there are both ideas to fortify traditional views (about free association; the structural theory of id, ego, and superego; repression; and sublimation) and contemporary ones (cultural construction of our worlds; subjectivity; and negotiation of agreement about understanding) as well as those to support both (implicit learning and varying memory systems; how our brains are interconnected, porous to another’s person’s feelings). And when Holland writes about our enjoyment of tragedies (such as Hamlet) “…we fit them into our schemas for understanding the world. By making sense of them, we tame them.,” we think not only of Piaget, or Stolorow, or even Maurice Sendak, but we also resonate with what goes on, in part, in treatment with our patients. Later, privileging the left brain and insight, Holland notes how “Symbolization makes meaning possible,” however idiosyncratic and personal that meaning may be. But he also notes the importance of implicit connection, what Benjamin may write about as the joy of two subjects sharing a moment of like-mindedness, when he quotes the student Ellen “…this book [referring to the cartoons of Kliban] proves that someone else sees what I see.”


SEEKING behaviors and CONSUMMATORY behaviors, essential to the survival of the species, shed light on why we make meaning from and sense of literary works. Authors create a problem and we hunger for its resolution. We seek to learn the meaning of things. We seek to be reassured. Seeking satisfactions and getting them both bring us pleasure. I took pleasure in reading Literature and the Brain. In it we “discover this mysterious, magical treasure,[the] Mind.”

review by Lycia Alexander-Guerra, M.D.

Upcoming National Convention on Trauma: American Psychoanalytic Association, Division 39 (Psychoanalytic Division)

2010 August APA Convention - Division 39 Program


CREATIVITY IN THE TREATMENT OF TRAUMA
Thinking Outside the Box

A major challenge to contemporary psychoanalysts is the treatment of patients who have suffered severe early trauma. Contributions from differing schools of psychoanalytic thought, and from other fields such as cognitive science and infant research, have expanded our therapeutic armamentarium and made psychoanalysis available to previously inaccessible cases. Psychoanalysis has matured to the point where we can now have meaningful discussions -- not duels -- about differing ways of working with more challenging situations.

Because early experiences of pain may be before the time of speech, feelings may not be available for discussion and interpretation. Ways in which therapists creatively connect with and help transform early experiences will be the theme of this conference.

Information for submissions is available on the APA web site, http://www.apa.org/convention/2010/
Chairs: Sandy Shapiro, MD , shapiro@ucsd.edu and Holly McMillan, hollism@san.rr.com

“The Shared Labor of Relational Mourning:” Watching and Witnessing the Trauma Imposed by Germany’s Paragraph 175

Paragraph 175 is a documentary film researched and tenderly presented by Klaus Müller and directed by Rob Epstein and Jeffrey Friedman. It chronicles the experiences of the 100,000 men as well as the women who were persecuted under this criminal code. This was the third film in the Fears of Difference: Diversity of the Holocaust Experience Film Series.

Tamara Zwick, Ph.D. an Assistant Professor of European History at the University of South Florida provided the historical context in which to view the film. Paragraph 175 was the anti-sodomy ordinance with origins dating back to 1871, the year of German unification. In Berlin, the ordinance was not enforced as the liberal climate was welcoming of gays and lesbians. Berlin was considered the Gay Eden.

As political and economic instability increased in the Republic, the enforcement of heterosexual norms increased through enforcement of the code and through the protonatalist movement women's behavior was tightly regulated. Women would find it harder to have abortions and contraception and would be given prizes for procreating.

Mental Health Counselor, William Spell’s comments are below.

Audience questions and comments included the following:

One audience member was curious about the reception Dr. Zwick’s students give to the film when she screens it in class. She uses it to introduce failures in humane treatment in historical periods and some students are hostile and don’t see the importance of using such a film in an instructional context. Mr. Spell added that the film allows viewers to join with the tellers in finding solace in community.

Another audience member brought up the recent documentary Outrage illustrating the viciousness of closeted homosexuals. Mr. Spell noted that 13 states continue to have Sodomy laws. And Florida is the only state that does not allow gays to adopt. More and more states are outlawing gay marriage and the continuation of hate crimes such as the one committed against Ryan Skipper in Winter Haven, FL constitute negative trends in becoming a more inclusive nation. Yet, other audience members noted that there is a balance. With young people’s attitudes reflecting more acceptance of sexual difference and the increase in anti-discrimination laws, progress is happening.

One audience member asked about the meaning of the film for the gay movement. The audience discussed this question in regard to how education helps change attitudes. One response is to keep Foucault’s explanation in mind that educational institutions defined and made certain sexualities normative in order to pathologize some. Education should teach us to open our minds and hearts to the multiplicity within ourselves.

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Tamara Zwick, Ph.D. is an Assistant Professor of European History at the University of South Florida where she offers courses in European and German social and cultural history, gender history, and Holocaust historiography. Her major research focuses largely on the intersections of kinship, gender, and class in northern Germany. She is currently at work on a manuscript titled Writing Between the Lines: Women, Kinship, and Bürgertum in Early Nineteenth-Century Hamburg. She has previously published articles on memory at the concentration camp Auschwitz-Birkenau and on bourgeois culture as a written practice.

William Spell received his B.A. in Sociology and Religion from the University of Florida. He received his Masters of Arts in Mental Health Counseling, (M.A.) from Rollins College and currently is a Licensed Mental Health Counselor in Private Practice in Winter Park, FL. From 1992-2004 William worked as a School-Based Family Counselor for the Citizen's Commission for Children, Orange County, FL. He considers his recent and ongoing study of psychoanalytic theory and practice to be an opportunity for enhancing personal and professional growth. Currently he is a member of the International Association of Relational Psychoanalysis and Psychotherapy, a Member of Florida Organization for Relational Studies (FORS), and a Corresponding Member of Tampa Bay Psychoanalytic Society. He is an Allied Professional Member of the American Psychological Association's Division of Psychoanalysis (39) and serves on the Committee on Sexualities and Gender Identities which sponsors program development at Division meetings.

Picture: Heinz Dörmer, 1928, age 18. Dörmer was 10 when he joined the German Youth Movement in 1922. He eventually became a group leader before his troop was forced by the Nazis to join the Hitler Youth.
Photo courtesy of Schwules Museum, Berlin

Trust, Contextualization, and Trauma: Documenting Holocaust Experiences of Homosexuals

Film: Paragraph 175

By William Spell
presented November 8, 2009 at the Film Series: Fear of Difference: The Diversity of Holocaust Experiences, Tampa, FL

Our presence here together unites us for a living tribute to the courageous Holocaust survivors of the documentary Paragraph 175 as well as all survivors of genocidal trauma. The seven remarkably articulate elders emerge from these interviews with a seemingly impossible grace and eloquence, putting words to unbearable experience.

I am also in awe of this achievement by the director-producers, Rob Epstein and Jeffrey Friedman, their partner in production, Michael Ehrenzweig and their many talented collaborators, who with the inspiring guidance of Klaus Muller, have set a sensitive stage and created a trusting rapport with each survivor.….for their voices to be heard and their beautiful faces to be seen with a clarifying light.

Dr. Doris Brothers, in her paper, Trust, Uncertainty and Therapeutic Alliance in Trauma-Centered Treatment suggests that “trauma does not reside in a specific event alone, but rather in the meanings of that event for the individual involved.” And she places “the focus of treatment on the trustworthiness of the relational engagement of analyst and patient.”

We see from the beginning of this project, a resistance and ongoing crisis of trust when Klaus telephones to confirm a meeting, Karl Gorath answers, “Not today” and later in person, Karl agrees to the session.

.....Pierre Seele, arriving at the train station feeling sick, not wanting to proceed, feeling hostile toward Klaus and offended by his black leather jacket, not wanting to shake hands with a German and paranoid about Klaus’ intentions.

Heinz F. speaks for the first time with another person about his 8 ¼ years in the concentration camps of Dachau, Mauthausen and Buchenwald, confined for being a homosexual. He fears using his surname for the film and initially requests that his face be seen in an anonymous silhouette of dark shadow.

From listening to the director’s added commentary on the DVD, I learned that Heinz F. upon viewing the monitor and seeing how dark his image appeared, decided that he wanted his face to be seen, since at age 93 he felt that he hadn’t much time left for the rest of his life.

There was a survivor living in Poland who ultimately declined being interviewed on film because he was battling with the fear of being publicly exposed as a homosexual.

Another German man who was castrated by the Nazis, had given consent to participate when, on the day of his filming, someone helping with the production told his landlady that he was going to be interviewed. When he found out that she knew this, he became very upset and refused to continue and Klaus spent a lot of time calming and comforting him.

The directors discuss their experience of a troubling ambivalence as they respectfully engaged Albrecht Becker, arrested for his homosexuality by the Nazis. Albrecht explains the alarming indifference and passivity of many German citizens to their widespread, word-of-mouth knowledge of the death camps.

Michael Ehrenzweig affirms that without Klaus having established relationships of safety and trust with the film’s subjects over a period of years, this ground breaking documentary would not have been possible.

Dr. Lycia Alexander-Guerra, in her presentation for the Tampa Bay Institute for Psychoanalytic Studies’ Trauma Workshop Series, discussed how, physiologically, traumatic memories are dissociated, de-contextualized from each other, and unlinked to words. In referencing the work of Dr. Jody Messler Davies and Dr. Gail Frawley, she discussed how re-enactments of experiences which lack words can become an opportunity for the therapist to lend words and help construct meanings with the survivor of previously unspeakable traumas.

Klaus encourages Heinz Dormer’s painstaking, verbal descriptions of “the singing forest”. There are haunting silences between Heinz Dormer’s words, the palpable “goosebumps” and his powerful gaze, contained by Klaus.

After approaching the abyss again, I was relieved to hear Heinz find his open-ended meanings, in his words: “inhuman” “beyond human comprehension” “inexplicable” “and much remains untold”.

Heinz F. and Klaus offered words freely and tenderly to one another. Heinz F., often tearfully sobbing, spoke of his shame. “It’s all about patiently carrying one’s burden”. When asked if there was anyone he could have spoken with, he insisted, “Never!” “Nobody wanted to hear about it” “If you would just mention one of those words…..Leave me alone with this stuff---it’s over now and done with”.

Dr. Sam Gerson's paper, When the Third is Dead: Memory, Mourning, and Witnessing in the Aftermath of the Holocaust is in press: International Journal of Psychoanalysis, 2010.

Paragraph 175 remained a law until 1968 in East Germany and 1969 in West Germany. Homosexuals continued to be classified as criminals. Heinz Dormer was re-arrested during the 1950s and 1960s.

Dr. Bruce Reis emphasizes that in the treatment of massive trauma the language of narration cannot translate away the raw pain of traumatic exposure. He recommends the work of Dr. Sue Grand in being a witness to trauma, illuminating silence and rendering it audible.

Dr. Ghislaine Boulanger represents therapeutic recognition as "when clinicians resonate to situations in their patient’s lives with which they can identify only too well; locating parallel experiences and feeling states in themselves. This often unacknowledged resonance between the patient’s and analyst’s experience signals a level of acceptance and understanding that can be transformative and promote analytic reflection.
However, when resonating to a familiar affect state is not possible, clinicians must be prepared to serve as containers and witnesses to terrifying and alienating experiences without losing their connection to the survivor. Inevitably, that connection is sometimes lost as the clinician struggles against his or her own tendency to dissociate in the face of horror."

Our hearts today contain these passages of love, hope, faith and devastating loss.

Annette Eick recounts the story of the miraculous “love letter” that saved her life, surviving only with her brother as her entire family perished in the camps.

Gad Beck remembering trying desperately to rescue and flee with his young lover, Manfred Lewin, who felt compelled to stay with and take care of his sick family, soon to go to their deaths in a camp. As Gad describes the moments of agony when he and Manfred were separated for the last time, he says, “I couldn’t think but I knew something was forever broken.”

Pierre Seele frantically beseeching Klaus, “Do you think I can talk about that?” “This is too much for my nerves, Klaus! I can’t do this anymore! I am ashamed for humanity.”

In the director’s commentary, Michael Ehrenzweig shares a story of the transformative power of Paragraph 175, the documentary.

Immediately following the film’s premiere showing in Berlin, Michael quickly joined Gad Beck and Pierre Seele in the audience and walked them slowly down the aisle to the stage, both men on each of his arms, as the fully packed theater gave them a standing ovation with thunderous applause.

Later that night Gad and Pierre sat at a café table nearby, holding hands and receiving the loving recognition and warm attention of many who had just seen their film. As a result, both men were inspired to subsequently travel extensively, speaking publicly and seeking official acknowledgement for their case and advocating support for other survivors. This reminds me of Dr. Adrienne Harris’ description of analytic process as “the shared labor of relational mourning.”

I feel this humbling work of art is an archive for all of humanity with the potential to inspire honesty and compassion for the understanding of massive traumatic experience and a caring acceptance of women desiring women and men desiring men.

-- Will Spell

References:

Alexander-Guerra, M.D., Lycia (2009). http://tbips.blogspot.com/2009/02/healing-through-witnessing.html

Boulanger, Ph.D., Ghislaine (2008). "Witnesses to Reality: Working Psychodynamically with Survivors of Terror." Psychoanalytic Dialogues, 18:638-657.

Brothers, Ph.D., Doris (2008). http://blogs.confer.uk.com/0809trauma/the-lead-paper.html

Gerson, Ph.D., Samuel (2010). "When The Third is Dead: Memory, Mourning, and Witnessing in the Aftermath of the Holocaust." IN PRESS: International Journal of Psychoanalysis.

Harris, Ph.D., Adrienne (2005). "Gender as Soft Assembly." Hillsdale, NJ: The Analytic Press.

Reis, Ph.D., Bruce E. (2000). "A Review of the Reproduction of Evil: A Clinical and Cultural Perspective: Sue Grand. Hillsdale, NJ: The Analytic Press, 2000. xvi + 167 pp." Contemporary Psychoanalysis, 36:730-734.

Narcissism Negates Subjectivity

In an early morning conversation with Daniel Shaw, LCSW, from the National Institute for the Psychotherapies (NIP), NYC, as the prelude to his presentation to the Tampa Bay Psychoanalytic Society, Inc (TBPS) on November 7, 2009 of his paper Enter Ghosts: The Loss of Intersubjectivity in Clinical Work with Adult Children of Pathological Narcissists, Shaw disclosed how he was inspired, in part, by the NY production of Eugene O’Neill’s Long Day’s Journey into Night to write about Alice and the cumulative relational trauma she suffered at the hands of her narcissistic parents. Shaw’s early training had led him to Heinz Kohut’s How Does Analysis Cure and Alice Miller’s The Drama of the Gifted Child, but he credits Alice with teaching him to ‘hang in there with’ challenging patients, and for helping him to grow as an analyst and a person. Allowing for the possibility that nobody is always right allows for growth (even in such hegemonic ideologies as classical psychoanalytic theory).

The breakdown of intersubjectivity is complementarity. Shaw expands Fairbairn’s concept of “the moral defense” to include the complementary part parents play in this relational dynamic. Recall that the moral defense, put simply, states that in order to maintain the attachment to the parents, a child of bad parents chooses to feel s/he is bad rather than acknowledge that the parents are bad. Complementary to the child, narcissistic parents see themselves as all good, perfect, and infallible, the complement to the child’s taking on the badness. As the parent disavows her/his own badness, the child is coerced into accepting the projection. The child is continually objectified, not subjectified.

Narcissism negates subjectivity. When a child is continually objectified by narcissistic parents who do not recognize the child as her/his own center of agency, the child suffers cumulative relational stress, or cumulative developmental trauma. The child grows up in a double bind, not allowed independent desire which risks abandonment and rejection, but disdained for her/his dependence, a dependence associated with shame and humiliation.

Kim Vaz, in her introduction of Shaw to TBPS, revealed his struggles with, and his compassion for, his challenging patients when she took this excerpt from another of Shaw’s papers, which received the 2001 Educator's Award for an Outstanding Scholarly Paper from NIP ( Shaw, D. (2003). On the Therapeutic Action of Analytic Love. Contemporary Psychoanalysis, 39:251-278.):

“Ari was a patient who was not easy to love, at least not at first and not for me. Ari was forty when he began to see me. His marriage was falling apart and he had been miserable for years. He felt close to becoming violent with his wife. He was burned out, always angry and always anxious, at home and at work . . . . Ari spent most of a year splenetically venting, about his wife, his son, his partners, his employees, and so forth. Feeling shut out, I often found myself shuttling between resentment, detachment, and feeling intimidated. Eventually, I understood that I was withdrawing, withholding a necessary confrontation, in retaliation for the narcissistic injury I felt about my perceived lack of effect on him. This understanding helped me to reorganize and mobilize the assertiveness I needed in order to reach Ari. One day, I finally raised my voice and said, quite loudly, ‘You know, I would like to say some things to you, but I'm afraid if you don't like what you hear, you will bite my head off, possibly literally.’
Ari looked up at me with his sharp, penetrating eyes, and I was scared. I was quite surprised and touched, though, to see Ari's eyes go moist, his face reddening. He said sadly, ‘I'm just like my father. Yes, this is what I do to everyone, my wife, my son, everyone, just like my father did.’
I said, ‘It must be awfully lonely, with everyone afraid of you like that.’ He looked up at me, silently. I added, ‘You know that song “Desperado?”’
‘Yes, I know it,’ he said, still looking intently at me.
‘You remind me of those lines, “you better let somebody love you, before it's too late.”’
Ari looked down and began to weep. I was quite moved. Right then, my very mixed feelings about Ari melted into an unexpected warmth, respect, and tenderness, and I heard myself say to myself, ‘I really love this guy.’ ”