Monday, August 29, 2016

Poem: Human Family by Maya Angelou

What better describes our need for sameness and difference, and for belonging, than this beautiful poem offered as an elaboration of yesterday’s post on Twinship.  

Poem: Human Family by Maya Angelou

I note the obvious differences
in the human family.
Some of us are serious,
some thrive on comedy.

Some declare their lives are lived
as true profundity,
and others claim they really live
the real reality.

The variety of our skin tones
can confuse, bemuse, delight,
brown and pink and beige and purple,
tan and blue and white.

I’ve sailed upon the seven seas
and stopped in every land,
I’ve seen the wonders of the world
not yet one common man.

I know ten thousand women
called Jane and Mary Jane,
but I’ve not seen any two
who really were the same.

Mirror twins are different
although their features jibe,
and lovers think quite different thoughts
while lying side by side.

We love and lose in China,
we weep on England's moors,
we laugh and moan in Guinea,
and thrive on Spanish shores.

We seek success in Finland,
are born and die in Maine.
In minor ways we differ,
in major ways the same.

I note the obvious differences
between each sort and type.
But we are more alike, my friends,
than we are unalike.

We are more alike, my friends,
than we are unalike.

We are more alike, my friends,
than we are unalike.

Sunday, August 28, 2016


Most psychoanalysts are familiar with Kohut’s mirroring and idealizing transferences. Togashi and Kottler (2012) write about the twinship transference and note Kohut’s “transformation from the psychology of the self to the psychology of being human” and from “the disorder of the self to… trauma-centered psychoanalysis.” They enumerate the many faces of twinship:

(1)    between merger and mirroring. Kohut originally conceived of the mirror transference in three forms: merger, twinship, and the narrowed mirror transference, their differences “based on the degree to which an individual” sees others as an extension of themselves or as a separate person.
(2)    as a process of mutual finding. This does not mean “recognizing…the other’s subjectivity” but rather that “two participants…regulate a sense of sameness and difference in their effort to match…their subjectivity” such as when the analyst finds aspects of herself and not-herself in her patient and the patient, likewise, can find aspects of himself and not-himself in his analyst, this mutual finding process, essential to the twinship experience.
(3)    as a sense of belonging. Later (1984), Kohut distinguished twinship from mirroring to a sense of belonging. Here twinship speaks to [authors quoting White and Weiner] ‘a similarity in interests and talents, along with the sense of being understood by someone like yourself” and [quoting Basch] ‘the need to belong and feel accepted by one’s cohort.’ [BTW, in this same volume, VanDerHyde writes a lovely paper on the importance of twinship, stating the need to belong precedes the need for mirroring or idealizing]
(4)    passing talents and skills to the next generation. Togashi and Kottler write: “For Kohut, an individual’s efforts to educate others is often based on her yearning for a person who[m] she can experience as essentially alike, or for a person in whom she can find herself.” The parent sees herself in the child and, reciprocally, the child sees himself in the parent. The child sees himself as the welcomed “successor” as the parent is “creating and finding oneself in the next generation.”
(5)    as silent communication. Twinship allows each “to share the feeling of connection without verbal communication –as with mother and infant; lovers; or analyst and patient—and to share in a “regulatory process to match (and not-match) one another.”
(6)    feeling human among other human beings. Kohut noted the necessity to feel human among other human beings. Narcissistic parents can treat the child as an extension of themselves or as a non-human thing, the latter causing the child to experience himself as non-human among non-humans.
(7)    in trauma. The authors cite Stolorow: “a need for twinship is a reaction to psychological trauma” [IMO, the authors decline to temper this statement by adding that we are hard-wired for a social network (a tribe), as well as that we can find joy in being understood and this not simply as secondary to trauma] and Brothers, noting that trauma destroys certainty and meaning. [and that we need relationship to restore the latter.]

Please see the next post for a poem by Angelou which beautifully illustrates humans’ need for a human family, same and different, but belonging.

Monday, August 22, 2016


Cultural relics have been targeted by ISIS in northern Africa and the Middle East in alarming numbers. The first successful prosecution by the International Criminal Court for only the destruction of cultural heritage took place today at The Hague. Ahmad Al-Fagi Al-Mahdi took part in the destruction by Islamic militants of the 14th century Holy Tombs of Timbuktu in his native Mali in 2012 and today he admitted and apologized, calling for an end to these acts.

The phrase destruction of cultural heritage got me thinking about our individual specific and pointed cultural heritage, that of each of our families, and how psychoanalysts navigate the change in perspective of our unique stories. Some people come to us hoping we will undo what they have had to endure, or hoping that the painful experiences of childhood will be eradicated. But our history is part of who we are, for better or worse, forever embedded in our neuro-circuitry [unless damage occurs, such as by a stroke or traumatic brain injury] and I encourage patients to respect what has transpired, give it its due, its voice, and give it a place beside all that has made them the courageous and resourceful enough person now before me who seeks psychotherapeutic treatment.

Some patients worry, as we empathize with the relational trauma of chronic misrecognition and misattunement or with the Trauma of physical and sexual abuse of their childhoods, that their newly welcomed and understandable anger will be insurmountable to finding their way back to loving and forgiving their families of origin. It does seem remarkable that, if we persevere with recognizing, naming, and accepting anger, we will find it can be more easily lived, lived alongside the more palatable emotions and memories that are human experience.  I don’t know how forgiveness for heinous acts comes about, but it seems partially linked to learning to forgive ourselves. I know I am grateful life-long for those who have forgiven me.

Friday, August 19, 2016

"the pleasures and perils" of technology

Tonight on the PBS NewsHour was aired an interview with German filmmaker Werner Herzog (Grizzly Man; The Cave of Forgotten Dreams) whose latest film, the documentary Lo and Behold: Reveries of the Connected World was released today. He asks “What makes us human? How do we communicate?” Herzog, like myself, does not have a cell phone as a matter of culture. Like me, he wants to be involved with the person across the table with whom he shares a meal and not be available to everyone else all the time.

It is a danger if we teach our children, for example: when preoccupied with our cell phones, that they are uninteresting and unimportant. A parent, chronically disinterested in the experiences of a child, may seriously impede the development of that child’s ‘voice.’ Many years ago, when my younger daughter was in preschool, I observed a sad scene.

Another parent and I drove into the parking lot at the same time. She was on her cell phone. We parked alongside one another. We walked the sidewalk together, into the building together, down the hall, and out the door to the playground area. She was still on her cell phone. I dropped to my knees when I saw my daughter and opened my arms. My daughter ran into them. The other parent did not say ‘hi’ to the little boy she had come for, but took his hand and the four of us retraced our steps. My daughter is telling me of her morning experiences as I buckle her into her car seat. The woman next to me is still on her phone. Her son is silent.

What or who is it that is so compelling on the other end of a cell phone that is worth making the person right beside us feel second best?

One of the salubrious pleasures of the quiet consulting room is the intense attention paid to one another as we struggle to navigate intimacy in the here and now.

Sunday, November 8, 2015


Actor George Takei, best known for his character Sulu in the original Star Trek,  makes his Broadway debut at the Longacre Theater in Allegiance, which opens tonight. Allegiance is a musical about the internment of Japanese Americans during World War II and is partly based on Takei's own experience. When Takei was five years old his family was sent to an internment camp for almost four years. His childhood imprisonment taught him about gaman which means “to carry on.” Takei says of resilience that it includes “the ability to find joy — even under those harsh circumstances— and love.”

Takei recalls having chastised his own father with “you led us like sheep to slaughter.” His father agreed. Takei felt so guilty that he never apologized to his father. But now he says he can apologize nightly through his participation in this musical, the humanization of those injured by this protracted injustice in America’s history.

Sunday, October 4, 2015

Rudnytsky and Milton’s “Paradise Lost”

The Tampa Bay Psychoanalytic Society, Inc hosted an unusual speaker last weekend at its monthly speaker program meeting. Peter Rudnytsky, UF professor, Shakespeare and Freud scholar, long time honorary American Psychoanalytic Association member, and long time, former editor of American Imago, explicated in his paper “Freud as Milton’s God…” the long running critical debate over an inherent contradiction in Milton’s Paradise Lost. The contradiction concerns whether humankind had free will to choose to disobey God or whether the Fall was predetermined, even put into motion by God’s actions, God in Milton’s poem failing intersubjectively to take responsibility for situating himself*  in the outcome. Quoting Rumrich’s take on the epic poem – “negotiations between narcissistic longings for perfect recognition and the recalcitrance of an unresponsive reality” – Rudnytsky adds that God is portrayed as a controlling and narcissistic parent, demanding obedience, which if not freely given will be exacted through punishment.

We now know that it is failure to provide sufficient response to longings for recognition which sets up narcissistic longings for perfection. The narcissistic parent has been unable to accept the imperfect child as good enough, and the child, humiliatingly aware of its deficiencies, grows up seeking to overcome or to hide what its parents made glaringly shameful, often requiring, as Milton’s God seems to, “an insatiable need for praise.” [But what if the injured God was also seeking healing or, naively, reconciliation?]

Rudnytsky notes that Freud, too, exacted loyalty, or else followers were extruded from his inner circle.Freud, in anointing Jung the ‘crown prince’ both elevated Jung above all his other followers and, at the same time, made Jung subordinate to himself. In subordinating another, rebellion is engendered, as is the Oedipal struggle and sibling rivalry.  God, too, in Milton’s poem, by anointing Christ, created Satan from a passed over Lucifer.

*While for Milton, and for many, God is the Father, an interesting discussion ensued about womb envy and the need for men to erect a male Creator in compensation for the fact that it is from women’s bodies that we come into this world; An interesting reversal of this fact is Eve springing from Adam’s rib; or Athena from Zeus’ head.

Sunday, September 27, 2015

Film: Away From Her

The Tampa Bay Institute for Psychoanalytic Studies, Inc and the Tampa Bay Psychoanalytic Society, Inc kicked off their co-sponsored 2015-16 Film Series “On Aging” with writer/director Sarah Polley’s 2006 Away From Her based on a short story (The Bear Came Over the Mountain) by Alice Monro. Film critic Roger Ebert described it as “the story of a marriage that drifts out of the memory of the wife [Fiona Anderson played by Julie Christie], and of the husband’s [Gordon Pinsent as Grant] efforts to deal with that fact.”  Of Polley he wrote that she, unlike Bergman’s merciless ‘winter light,’ “bathes the film in the mercy of simple truth.”

Discussant USF Film Professor Scott Ferguson, PhD called Away From Her a tour de force by Polley who made this beautiful film more “capacious, ambiguous, and interesting” then its contemporary Still Alice (which is based on a true story and which more narrowly focuses on the disease process of Alzheimer’s and how to combat its loss of identity). Away From Her is about being and time and difference, and about the “deliciousness of oblivion” in all its “passions, horrors, surprises, melancholy, and potential.”

The clinical discussant Kathryn Lamson, LMHC reminded us that “as we age, we move toward resolution, separating the essential from the non essential.” Grant suffer the inescapable loss of his wife and of her as co-witness to their shared lives.

Erickson (1950) extended Freud’s developmental stages beyond young adulthood to include love, care (generativity v. stagnation), and, over 65, wisdom (ego integration v. despair). Hildebrand (1987) noted “the creative power of continually changing relationships.” Aging can bring increased acceptance of the self (Wild Strawberries on Nov 22nd), new discoveries, time for latent talents and for luxuriating in new found pleasures and for creative, social and spiritual endeavors (Quartet on May 17th, 2016). Enthusiasm and curiosity can keep us young (Cherry Blossoms on Feb 28th). The risk for despair comes, too, with age.  Loss of family (Amour on Mar 27th, and, of course, Away  From Her) and friends (through death and empty nest), decline in sexual function, possible physical and mental infirmity (as in Away  From Her), isolation, childhood fears of abandonment, and proximity to our own death. Economic security may improve for some, but decline for others (Grey Gardens on Jan 24th, 2016). It takes courage, and adaptability to face losses (Trip to Bountiful on Oct 18th) and accept changes in function and the narcissistic injuries that ensue. Hopefully, we will be in good company as we age.

The sensitive and moving topic of aging will be discussed next on October 18th at 2:00pm in Trip to Bountiful (written by Horton Foote) by USF Professor Adriana Novoa, PhD and clinician Linda Berkowitz, LMHC. Hope you join in.

Saturday, September 5, 2015

Who is responsible?

A precocious ten year old asked me yesterday what I plan to do to help the Syrian refugee children. An only child, she wishes to “adopt” at least one child. Her question shook me deeply. As Hungary struggles with an overwhelming influx of refugees fleeing the war in Syria-- many who will never reach the Euro Zone but instead die at the hands of ruthless traffickers by suffocation in vans, or drowning, as 3 year old Ilan Kurdi did, as they attempt to make their way from Turkey to Greece-- one German reporter characterized Hungary’s change of heart to bus refugees to the Austrian border as “not finding a clear line” and ”a confused policy” to explain the doubt of frightened refugees for Hungarian authorities’ intentions. Volunteers along the lengthy march through Hungary to Austria hand out food and water and offer a place to sleep.

Pundits are asked “Who is responsible?” and I am reminded that ‘Few are guilty, all are responsible’ [Heschel]. Yes, the world-- not solely the USA, who did create a power vacuum for so called ISIS in Iraq-- has insufficiently turned its attention to the tragedy that is destroying Syria.  My ten year old patient said to me hopefully, “When I adopt a child, you can talk to her like you talk to me.” 

Monday, August 10, 2015

FIlm "Inside Out"

Today I went to see a movie "Inside Out," a Disney animation on emotion, and how emotions interact. 
I think Disney depicted the emotions pretty well, still keeping the information understandable.  I would recommend that anyone interested in affect and neuroscience  see this movie.  The movie gives a brief but accurate account of how emotions interact to cause our behavior.  The movie also goes into long and short term memory and lost or forgotten memories and images.  

One thing that the movie depicts is that we are not completely in charge of all our emotions but that emotions are based on circumstances as well as on past memories and experiences.  The movie also pointed out that emotions are also based on future expectations, which in turn involve past and current experiences.  

The characters of happiness and sadness  are initially working separately, each thinking their  ideas are the only important thoughts, and then unite to  create a thought process that is more beneficial. The unity of the characters of happiness and sadness united the other emotions, joy, disgust, fear, anger which  also  evolved.  Disney depicted  the presence of happiness as the most important emotion but the other emotions, once united, as a very necessary contributor to a person's well being.

Sometimes I think that there are those who feel that we have control of our behavior by just understanding what is going on and what may be the correct way of doing things.  In this schema it is hard to  accept that our behavior and actions are controlled by electrical and chemical interactions that form an action potential to initiate stimulation and our actions, which is based on storage of past experiences and other past stimulation.  [But] there is the expression "that which fires together wires together."

by Richard Nikla, LMHC

Thursday, July 23, 2015

Making Meaning Dyadically

Edward Tronick in his talk “The Dyadic Expansion of Consciousness Model of Psychoanalytic Change” noted that there are many “something more”(s) going on between two people in a dyad and that the state between the two contains more information than either has for one’s self. This information can be apprehended by either and used to make meaning. Tronick further noted that one needs to feel secure [At the body level this refers to wholeness, safety,  boundedness] if one is to be flexible, creative, and able to engage in relationship with others.  Conversely, insecurity impairs meaning making, self regulation, and can lead to rigidity, dissociation, defensiveness, etc. as the patient holds on to the organizing patterns he already has.

Information may come at the bodily level, for example, through synchrony of respiratory sinus rhythms by parasympathetic regulation, particularly when each has protracted experience of the other, through ‘matching’ of tone, prosody, etc, as well as emotional matching and shared meaning at the symbolic (linguistic) level. Meaning making occurs bodily, emotionally, and symbolically and one system can bring to light (and help regulate)another.

His comments reminded me of a patient who complained that his “true self” was being “crushed” by the phoniness displayed by friends and family members and induced in him a likewise inauthenticity. I inquired where he felt this sensation of ‘being crushed’ in his body for as he reiterated his complaint I had the image of a baby’s face smashed into its mother’s breast while nursing. He replied that it was his face, like a mask smothering him. When I shared my image aloud, he though it “weird” but was willing, when invited, to consider (or play) with the image I introduced. He came up with a heretofore unrecalled memory of his father musing aloud when the patient cried that “Indians” blew into the face of their crying infants to get them to stop crying, by way of “suffocating” them. [The patient had oft complained of not being able to breathe, not catch his breath fully, since childhood, and of having no one, not even the family doctor, understand his complaint.]

This vignette came to mind as Tronick spoke because it illustrated to me to one particular moment where my patient and I had access to information between us that neither of us might have had access to alone. It was in exploration of the bodily component that the memory was activated and put into words.