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
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