Thursday, March 23, 2017
Posted by Lycia Alexander-Guerra, M.D. at 3:59 PM
Tuesday, March 21, 2017
Unfortunately, self-care may be circumvented by the shame felt over needing, neediness, the shame of disappointed or unfulfilled need, as if all are not entitled to self-care.
Harris also talked about “Ghosts and Demons in the 21st Century.” She asked, “How do cultures come to terms with impossible betrayals?” and noted that “ghosts proliferate when there is no witness” to trauma. Ferenczi had also pointed out in Confusion of Tongues that the lack of a witness is as catastrophic as the traumatic event itself. Harris cited Ireland’s great famine. When catastrophe goes unwitnessed, it reveals itself in symptoms (e.g. alcoholism), sometimes generations later. “Melancholia is a hallmark of ghosts.” These “ghosts are lived through enactments, carrying and reproducing historical trauma.”
Another unwitnessed or insufficiently witnessed historical catastrophe is US slavery, its unfaceable and unspeakable horrors more recently coming to light. Stalinism, too, went long unwitnessed, with its subsequent flourishing of “the grotesque,” the admixture of horror and comedy, in art and literature.
Posted by Lycia Alexander-Guerra, M.D. at 10:27 AM
Tuesday, March 14, 2017
The paradox: father, the “absent authority”, is relatively absent in psychoanalytic discourse, yet the “symbolic weight” of the father in psychoanalytic theory overlooks the “exclusive presence of the mother...as the lynchpin of early childhood development.” (Klein first turned our attention to the mother-infant dyad, but its importance was previously overshadowed by the Freudian idea of the Oedipus complex where the child must repress earlier fantasies, developed in the relative absence of the pre-Oedipal father, and “yield...to the moral order represented by the father” which will then give rise to the child’s separate identity and morality. The disembodied father was also emphasized by Lacan: the “real father” distinguished from the “symbolic father” or “the-name-of-the-father.”)
Posted by Lycia Alexander-Guerra, M.D. at 9:33 AM
Thursday, March 9, 2017
In the clinical situation, an area for envy is when the patient envies traits, imagined or real, of the therapist (patience, or equanimity, or friends, or a family life) which the patient does not possess, or vice versa. Sometimes envy, whose neediness is shaming by revealing the imperfect or incomplete self, makes it hard for one to accept something from the other, except perhaps to grab and steal it. The acceptance and containment by the self of envy allows one to feel sadness and loss for what one does not have. Some people feel chronically deprived.They may wonder why others have love or friends or accolades, and ‘Why not me?” They may hold no hope for their future, for getting what they want, except sometimes when they are demanding. When envy is present in patients, they may criticize others and the therapist; they may accuse the therapist of withholding help and care. [Because of the unpleasantness of their chronic criticism, patients may be accurate about the therapist’s withholding.] A patient’s deprivation and envy may leave the therapist feeling guilty,frustrated, incompetent and helpless. Fees are also fraught with envy dynamics, for either party. The patient can have much more income than the therapist, or much less.
Posted by Lycia Alexander-Guerra, M.D. at 6:57 PM
Posted by Lycia Alexander-Guerra, M.D. at 6:53 PM
Sunday, March 5, 2017
Weber.R.L. & Gans, J.S. (2003) The Group Therapist’s Shame: A Much Undiscussed Topic, International Journal of Group Psychotherapy, 53:4, 395-416.
Posted by Lycia Alexander-Guerra, M.D. at 11:40 AM
Saturday, February 4, 2017
Posted by Lycia Alexander-Guerra, M.D. at 6:05 AM
Monday, January 30, 2017
I found Foehl’s philosophical discussion intriguing and felicitous, and applicable to the philosophy of psychoanalysis. But I am neither an academician nor a scholar. I am simply a clinician, and a flawed one at that. As much as I enjoyed phenomenology’s new names which inform and enliven “intellectuals” and as much as I greatly enjoyed the clinical material, it seemed additionally heartening to me that if we pay sufficient attention to moment to moment changes in our patients and ourselves, including our sensory perceptions, and practice some reflection and intersubjectivity, we might arrive at similar reveries without contemplating that we are employing phenomenology.
Posted by Lycia Alexander-Guerra, M.D. at 11:39 AM
Tuesday, November 22, 2016
Fifty-three years ago, the United States' thirty-fifth president was assassinated in Dallas, TX.
Intersubjectivity includes the constant struggle to hold the tension between recognizing the other as a subject and the tendency to see the other as an object. As our country struggles, after a divisive election, to maintain the capacity to see the other as having the equal right to her/his own thoughts and opinions, I am reminded of the college paper of my younger daughter on JFK. She wrote:
In a speech at American University June 10, 1963 Kennedy reached out to the Soviet Union to join with the USA in ceasing to hold the world hostage with nuclear weapons testing.
History teaches us that enmity between nations as between
individuals do[es] not last forever. No government or social
system is so evil that its people must be considered as lacking
in virtue. Among the many traits that the peoples of our two
countries have in common, none is stronger than our mutual
abhorrence of war.
Historian Timothy Naftali said of this commencement speech,
It’s the first time an American president said ‘the Soviets
are like us’. It’s the first he asked the American people to
think beyond stereotypes and the Cold War and think
about the fact that this is a matter of the future of the
Six weeks later, Kennedy reached an agreement with Khrushchev to ban testing on nuclear weapons. Kennedy referred to the negotiation as “a shaft of light cut into the darkness.”
Posted by Lycia Alexander-Guerra, M.D. at 6:06 AM
Friday, November 4, 2016
Posted by Lycia Alexander-Guerra, M.D. at 2:41 PM