Tuesday, October 18, 2016
Posted by Lycia Alexander-Guerra, M.D. at 10:09 AM
Friday, October 14, 2016
Dylan, who boasts over 60 albums, was awarded the Prize “for having created new poetic expressions within the great American song tradition.” An American has not won the Nobel Prize for Literature since 1993 (Toni Morrison). This honor was added to his induction in the Rock and Roll Hall of Fame in 1988, and his Presidential Medal of Freedom in 2012.
Therapists know the necessity of not relying wholly on the narrative, the explicit, the spoken word. Dylan, too, understood something about words, “Words have their own meanings or they have different meanings. And then all words change their meanings.” (Scorsese, 2005, No Direction Home). He influenced countless musicians, James Taylor, Bruce Springsteen, and U2.
A personal note: A fan of his music since I was 8 years old, perhaps Dylan made us feel revolutionary, for even my civil rights demonstrating mother, more of a Bizet fan, upon hearing Bob Dylan on the stereo record player, said, only somewhat disparagingly, “He lows like a cow.”
Posted by Lycia Alexander-Guerra, M.D. at 8:10 AM
Tuesday, October 11, 2016
Posted by Lycia Alexander-Guerra, M.D. at 3:13 PM
Sunday, October 9, 2016
Posted by Lycia Alexander-Guerra, M.D. at 6:53 AM
Thursday, October 6, 2016
group process at TBIPS has been challenging, for now I must treat many
individual members as a single whole. In part, this means that each member of
the group can be viewed as if a different self-state of the whole. The group therapist, when he or she speaks,
strives to address the group process and not any one individual member of the
group. Still, it is tempting to do sequential individual therapy with varying
individuals, especially if the therapist is more experienced in individual
therapy. Also difficult is to remember that each member’s comments can speak to
what the whole group might be feeling, a feeling of which the group, and each
individual in the group, may be unaware and possibly projecting onto the member
who speaks what others cannot say.
The group therapist is called upon to make her or his comments addressed to the group as a whole instead of having an individual session with one member in front of all the others members. Just as individual therapy includes not only understanding (insight, cognition left brain) but also the building of a relationship between the two members of the dyad, so group therapy includes the building of a group. A sense of belonging to the group can offer the much needed ‘twinship’ experience.
Posted by Lycia Alexander-Guerra, M.D. at 12:29 PM
Friday, September 23, 2016
One of the benefits of membership in the Tampa Bay Psychoanalytic Society is participating in its monthly discussion group. This year the group is reading Philip Bromberg's Awakening the Dreamer. In the Introduction, Bromberg reprises Standing in the Spaces: "Self-states are what the mind comprises. Dissociation is what the mind does. The relationship between self-states and dissociation is what the mind is."
Bromberg sees dissociation as normative in the structure of the mind, but also as a process by which psychological survival is preserved in the face of overwhelming threat to self-continuity. When parents disallow aspects of a child's self, these aspects are dissociated by the child in order to maintain the needed tie to the parent. As the child grows into adulthood, his sense of self includes "'his parents' child'"-- that is, he continues to dissociate these aspects. Unlike repression that disavows content which causes conflict, dissociation disavows parts of the self. Bromberg claims that this disavowal of parts of the self impairs intersubjectivity such that the self is "largely unable to see himself through the eyes of an other."
Psychoanalysis, writes Bromberg, includes an act of recognition (different from understanding) of the patient's disavowed self-states, states accessible within the intersubjective field through enactment. Repeated experience with recognition [and the welcoming in] of these disavowed self-states increases their accessibility. Once accessible, these self-states are available to symbolization and self-reflection, and to conflict [the stuff addressed by traditional psychoanalysis].
In contrast, self-states that are not recognized by the analyst thwart the patient's desire for recognition and acknowledgement, and lead to shame. "..[B]ecause it is not forthcoming, [it] supports the reality of their needs being illegitimate." But "when the therapist is able to relate to each aspect...[t]his linking of self-states increases a person's sense of wholeness..." allowing one to live a fuller life.
Posted by Lycia Alexander-Guerra, M.D. at 6:16 PM
Saturday, September 17, 2016
The great American playwright Edward Albee died yesterday, September 16, 2016 at the age of 88. The theatre seems to me more than any other medium to reveal the human condition pointedly and in condensed fashion. Like so many great playwrights—Miller, Williams, Chekov, of course Shakespeare – before him, these artists show us a mirror of ourselves that we sometimes wish were left unrevealed (as when Albee’s 1962 play Who’s Afraid of Virginia Woolf, which won five Tony awards, was denied the Pulitzer by the advisory board despite being voted to receive it by the jurors.) Freud, however, would have been proud of Albee’s explications of sex, aggression, and death.
In his first play Zoo Story (1958), Albee wrote about loneliness and miscommunication. In Woolf, he exposed the illusion of the prefect American family. [What couples therapist has not seen a George and Martha in the consulting room?] The Goat, Who is Sylvia? pushed the limits of liberal tolerance when Martin falls in love with a goat (bestiality) while being somewhat judgmental of his homosexual son. Albee received the Pulitzer Prize for Drama for A Delicate Balance (1967), Seascape (1975), and Three Tall Women (1994).
Posted by Lycia Alexander-Guerra, M.D. at 9:40 PM
Posted by Lycia Alexander-Guerra, M.D. at 10:46 AM
Monday, September 12, 2016
On Sept 10, 2016 the Tampa Bay Psychoanalytic Society
hosted Donna Bentolila at its monthly, all day seminar where she presented two
riveting cases. A native of Argentina and a Lacanian by self-report, Bentolila,
despite the privileging of left brain (the Symbolic) over right, and despite her
reluctance to locate herself squarely in the co-creation of the experience of
her patients, nonetheless, worked closely and beautifully in the lives of these
two patients and their analytic relationships with her. Due perhaps to the
severity of their illnesses and to complicated issues in both cases,
Bentolila found herself repeatedly having to bend the frame to fit both the
needs of these two very disturbed people and the limits of her capacity to endure
their demands. For confidentiality sake, I will give no details, but wish you
all had been there to become wholly engrossed in the presentation.
Posted by Lycia Alexander-Guerra, M.D. at 2:53 PM
Thursday, September 8, 2016
Brothers and Lewis write: “…the analyst finds ways to
communicate over and over again to a patient: ‘Yes, you can come home again. No
matter what happened between us during your last session, no matter how
different or similar we found one another, I will be here waiting for you when
it is time for us to meet again.’ "
Posted by Lycia Alexander-Guerra, M.D. at 10:23 AM