Friday, May 31, 2013

American Poet Walt Whitman

Walt Whitman, the great American poet and essayist, was born on this date in 1819. He brought free verse to poetry. He also brought a sensuality and sexuality that in his time was considered obscene. His collection of poems Leaves of Grass, including Song of Myself and I Sing the Body Electric, is hailed today as egalitarian and humanistic with its gender diverse experience and its praise of the common citizen. He wrote from everyday experience, including the nursing of wounded soldiers in the Civil War, and, when Lincoln was assassinated, composed the elegy "O Captain! My Captain!".

His poem To You speaks with the love and acceptance coveted by an analytic attitude in which he sees in the other more than the other sees yet in her/himself. He respects. He encourages. I have included a few verses (I added bold) from To You:

Whoever you are, I fear you are walking the walks of dreams,
I fear these supposed realities are to melt from under your feet and hands,
Even now your features, joys, speech, house, trade, manners,
troubles, follies, costume, crimes, dissipate away from you,
Your true soul and body appear before me.
They stand forth out of affairs, out of commerce, shops, work,
farms, clothes, the house, buying, selling, eating, drinking,
suffering, dying.
I … find no imperfection in you,
O I could sing such grandeurs and glories about you!
You have not known what you are--you have slumber'd upon yourself all
your life;
Your eye-lids have been the same as closed most of the time;
What you have done returns already in mockeries;


The mockeries are not you;
Underneath them, and within them, I see you lurk;

I pursue you where none else has pursued you;

Whoever you are! claim your own at any hazard!
These shows of the east and west are tame, compared to you;
These immense meadows--these interminable rivers--you are immense and
interminable as they;
These furies, elements, storms, motions of Nature, throes of apparent
dissolution--you are he or she who is master or mistress over
them,
Master or mistress in your own right over Nature, elements, pain,
passion, dissolution.

The hopples fall from your ankles--you find an unfailing sufficiency;
Old or young, male or female, rude, low, rejected by the rest,
whatever you are promulges itself;
Through birth, life, death, burial, the means are provided, nothing
is scanted;
Through angers, losses, ambition, ignorance, ennui, what you are
picks its way.


Wednesday, May 22, 2013

Education and psychoanalysis.

The school year is coming to an end here. Not only will I move some of the child patients I see to an earlier time in the day but I am reminded of ways education research informs what I do in the consulting room. For example, in 1964, Robert Rosenthal experimented with what would happen if teachers believed that certain students as reflected on their testing were poised to have a dramatic rise in their IQ. Even though these students had been randomly chosen, and no such test actually predicted who would have a rise in IQ, it turned out that teachers treated these supposed identified students so differently, with the expectation that these students were smart, that, lo and behold, IQs for these differently treated students rose! Teachers’ expectations of these kids really did affect their students’ performance. How was this possible?


We psychoanalysts might think of implicit relational knowing. It turns out that the teachers’ moment to moment interactions with these students changed. They gave these students who were expected to succeed more attention with smiles, nods, and touches, and gave them more time (to answer questions), feedback and approval. So how get teachers to change their expectations? Robert Pianta at the Curry School of Education (UVA) found teachers’ beliefs about students and about what is effective teaching were more likely to change if— through coaching and videotaping of their teaching –teachers changed their behavior rather than if teachers took a course on how to change expectations.
All this got me to thinking about how we behave with patients. Do we have the expectation that they can make a richer life for themselves or do we share too much of their hopelessness? Do we implicitly, and sometimes explicitly, communicate our hope, or despair? And, if so, do we reflect on how we implicitly communicate— through gesture, tone, facial expression— our expectations? Pianta’s work does not make me think that CBT is the way for me of working with patients. Instead it confirms the power of experience and procedural learning that we offer when we do long term treatment with patients. Both studies confirm for me the power of right brain experience over left brain cognition or insight. They say to me that living the experience in the deep immersion of a psychoanalytic relationship changes brain networks.

In addition, one of my favorite contributions from education, and elsewhere, is the idea of constructionism. It recognizes that people construct their own understanding and knowledge of the world, and their place in the world, through the very things we utilize in psychoanalysis: experience and reflection upon experience. Through assimilation and/or accommodation (Piaget) we reconfigure or create our own knowledge. Like teachers in the classrooms, therapists encourage patients to reflect on and talk about what they do and about what they understand about their experiences. While the teacher might have the answer, or the therapist an idea, both encourage the student, or patient, respectively, to find their own answers, encouraged sometimes by the way we formulate our questions or musings, particularly in helping to question the self and the self’s strategies to learn or grow. Rather than a passive recipient of knowledge, we encourage students/patients to actively engage in curiosity and in negotiation and co-creation of reality and emotional truth. 

Saturday, May 11, 2013

Register now for Fall 2013 Courses at TBIPS



Program Offerings
2013-2014

About our Program: TBIPS is a professional community which embraces pluralism and a comprehensive contemporary view of psychoanalysis within the context of a mutually respectful and open learning atmosphere.

We invite you to:
·         Deepen and develop  your clinical skills
·         Join  colleagues  to network and share practical issues
·         Enroll in an individual class, or
·         Enroll in a training program
     Two year certificate program in Psychoanalytic psychotherapy
     Four year certificate program in Psychoanalysis

Courses: Classes are open to mental health professionals with an interest in psychoanalytic ideas. The courses may be taken independently, but, in order to optimally elaborate concepts, we suggest that you enroll in the full semester.  Immersion through training (courses, personal treatment, and supervision) allows the richest outcome.

Distance Learning:  Long distance learning options available through use of conference calling or Skype video conferencing.


Fall Semester 2013
First Year Courses

Introduction to Psychoanalytic Concepts I (16 weeks) A foundation of psychoanalytic frame, attitude, relationship will preface the clinically useful contributions from the various schools of thought. We will emphasize an analytic attitude and building/negotiating relationship, and discuss subjectivity, implicit communications, the unconscious, how to listen and respond, as well as major concepts of Freud, Klein, Winnicott, et al. Clinical material, to be provided by all participants, will be used to illustrate concepts.           
Wednesdays  8:30am-9:45am   Sep 18, Sep 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20,  Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014                    
Fee: $250 for a single course; $200 if enrolled in full semester.
                                        
Clinical Case Conference (16weeks) This course is designed to support the clinician’s work and offers opportunity to integrate clinical material with psychoanalytic concepts, including ethics, and ways to deepen the psychoanalytic process, with a focus on the therapist’s self reflection, the clinical relationship, and ways to facilitate what is mutative for the patient. Attendees are encouraged to present case material.    
 Wednesdays 10:00am-11:15am    Sep 18, Sep 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20,  Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014                    
Fee: $250 for a single course; $200 if enrolled in full semester.

Practical Analytic Subjectivity (16 weeks) Designed to develop in the clinician an increased capacity to negotiate the analytic frame, including fees and frequency, as well as increase the capacity for curiosity in the patient for a deeper psychoanalytic experience. Also included will be emphasis on self care of the clinician.   
Wednesdays 11:30-12:45pm    Sep 18, Sep 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20,  Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014                    
Fee: $250 for a single course; $200 if enrolled in full semester.
                          
Registration deadline                         
If you are to receive a subscription to PEP (psychoanalytic electronic publishing), registration deadline for all application material, registration form, and payment is August 12, 2013.   





REGISTRATION FORM: 
Fall Semester 2013
First Year Courses

______ Introduction to Psychoanalytic Concepts I
               Meets 16 Wednesdays 8:30-9:45am  
               (Sep 18, 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20, Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014)                                      
               Fee: $250 for a single course; $200 if enrolled in full semester
              
_______Clinical Case Conference
                Meets 16 Wednesdays 10:00-11:15am
                (Sep 18, 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20, Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014)                  
                Fee: $250 for a single course; $200 if enrolled in full semester
               
_____ Practical Analytic Subjectivity
              Meets 16 Wednesdays 11:30am-12:45pm
              (Sep 18, 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20, Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014)                                       
              Fee: $250 for a single course; $200 if enrolled in full semester
             

______  Requesting Work Study scholarship (up to $300 for work provided, up to six hours)
                (write in amount you need deducted from payment)
                reduction of tuition by (circle one: $50  $100,  if taking one or two courses)
                reduction of tuition by (circle one:  $50  $100 $150  $200  $250  $300, if taking three courses)

_______Total Payment Enclosed (one course: $250; two courses: $500; three courses: $600)             
refund policy (85% 7 days before)

Name________________________________________ Degree____ License #_______State___
Address_____________________________________City_______________State___Zip______
Email address________________________________  Request long distance learning ____(yes)

Must Send Along With (Or After) Application Material (go to tbpsychoanalytic.org)


Mail form with check payable to TBIPS (and CV if first time registrant) to TBIPS, Inc   13919 Carrollwood Village Run, Tampa, FL  33618




Fall Semester 2013
Third Year Courses
Couples Therapy  (16weeks)    This course will examine the ways in which development informs our clinical work with adult  patients.  Life events and developmental transformations throughout the lifespan will be explored in terms of their relevance for adult treatment. Papers will be paired with clinical material. We will address major developmental concepts in this course.   (16 weeks)        Instructors: differ each week and include instructors such as David Shaddock and Carla Leone:  
Wednesdays  2:00pm-3:15pm   Sep 18, 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20,  Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014                    
Fee: $250 for a single course; $200 if enrolled in full semester.
                                         
Clinical Case Conference  (16weeks)    This course is designed to support the clinician’s work and offers opportunity to integrate clinical material with psychoanalytic concepts, including ethics, and ways to deepen the psychoanalytic process, with a focus on the therapist’s self reflection, the clinical relationship, and ways to facilitate what is mutative for the patient. Attendees are encouraged to present case material.     Instructor:  Susan Horky
Wednesdays  3:30pm-4:45pm   Sep 18, 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20,  Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014                    
Fee: $250 for a single course; $200 if enrolled in full semester.

Practical Analytic Subjectivity III (16 weeks)  This is a peer group format which emphasizes analysts' subjectivity and countertransference, positive and negative feelings of the therapist, and ways our subjectivity facilitates or impedes the analystic process.    Instructors: Lorrie Gold and Susan Horky
Wednesdays  5:00-6:15pm        Sep 18, 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20,  Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014                    
Fee: $250 for a single course; $200 if enrolled in full semester.
                          
Registration deadline                           
If you are to receive a subscription to PEP (psychoanalytic electronic publishing), registration deadline is August 12, 2013.   
      




REGISTRATION FORM:
Fall Semester 2013  
Third Year Courses

______ Couples Therapy  Meets 16 Wednesdays 200-315pm  
               (Sep 18, 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20, Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014)                                              
               Fee: $250 for a single course; $200 if enrolled in full semester
               Registration  deadline  August 19, 2013
   
_______Clinical Case Conference  Meets 16 Wednesdays 330-445pm
                 (Sep 18, 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20, Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014)                    
                 Fee: $250 for a single course; $200 if enrolled in full semester
                 Registration  deadline  August 19, 2011   
______ Practical Analytic Subjectivity III   Meets 16 Wednesdays 500-615pm
                (Sep 18, 25, Oct 2, 9, 16, 23, 30, Nov 6, 13, 20, Dec 4, 11, 2013, Jan 8, 15, 22, 29, 2014)                    
                Fee: $250 for a single course; $200 if enrolled in full semester
               Registration  deadline  August 19, 2011

______  requesting scholarship (write in amount you need deducted from payment)
                reduction of tuition by (circle one: $50  $100,  if taking one or two courses)
                reduction of tuition by (circle one:  $50  $100 $150  $200  $250  $300 $350, if taking three)

_______Total Payment Enclosed  (one course: $250; two courses: $500; three courses: $600)  refund policy (85% 7 days before)

Name________________________________________ Degree____ License #_______State___
Address_____________________________________City_______________State___Zip______
Email address________________________________  Request long distance learning ____(yes)

Mail form with check made out to TBIPS (and CV if first time registrant) to TBIPS, Inc    13919 Carrollwood Village Run, Tampa, FL  33618







Monday, May 6, 2013

Happy Birthday, Siggy

One hundred, fifty-seven years ago today, little ‘Siggy’ was born to a young, beautiful mother and an aging father. Sigmund Freud (b. May 6, 1856) would grow up to be the father of psychoanalysis. He would give us both a way of conceiving of the mind, by emphasizing the Unconscious, and a technique for accessing it, free association. It was from his self analysis, especially of his dreams, that he developed the latter, and wrote his magnum opus The Interpretation of Dreams (1900).


A lot in psychoanalysis has changed since fin de si├Ęcle Vienna. While Freud conceived of the mind as monadic, a closed energy system pressing for the discharge of the libidinal and aggressive drives, contemporary psychoanalysts now recognize that the mind develops within, and is continually influenced by, an interpersonal context. Freud in 1923 posited the structural theory of the mind and a dynamic unconscious where the id, ego, and superego were in constant conflict. Today, additional motivations, including intersubjectivity and attachment, are privileged. Dissociation seems as prevalent, or more so, than repression of conflictual material.

In Vienna, Freud advised abstinence, neutrality, and anonymity to avoid the pitfalls of the heightened psychological intimacy engendered in the therapeutic situation. Today we recognize the inevitability and usefulness of intimate (not physical) involvement with patients and how enactments, if reflected upon, aid the psychoanalytic process.  Freud conceived that relational patterns are ‘transferred’ from previous important relationship figures onto the analyst, and today we also make use of the real and unique components in the therapeutic relationship. Perhaps one of my favorite ideas of Freud’s is that patient’s and analyst’s unconscious speak to one another, something now confirmed by neuroscience research and elaborated in ideas about implicit relational knowing.

Freud catapulted us into a great adventure, and thus we are exploring a vast, unknown frontier. Psychoanalysts report high job satisfaction and an unparalleled professional longevity and for these we are grateful. So HAPPY BIRTHDAY, Siggy!

Sunday, May 5, 2013

Attachment Theory And Therapy

As classes at the Tampa Bay Institute for Psychoanalytic Studies, Inc approach the Spring semester’s end next week, I reflect back on the Second Year’s course in Attachment and Affects. Attachment theory, pioneered by John Bowlby, is a relational theory that conceptualizes an innate human motivation to be connected with others. Crying, clinging and proximity are behaviors infants and toddlers have adapted to remain safe and secure. When parents respond in an attuned fashion, children can use the secure base from which to explore the world. Therapists, too, strive to co-create a safe place which allows better for exploration of interiority. Moreover, human beings require management of their affects, and emotional regulation starts out in the caregiver-infant dyad, where mutual regulation, then infant self regulation can develop. Affect regulation is seen as a necessary component to optimal growth and development. Theorists differ: intersubjectivity may allow for attachment within which there is affect regulation; or, conversely, attachment may allow for intersubjectivity within which emotional regulation is achieved.


Humans throughout life struggle to balance our longings for connection with our striving for autonomy. In traditional psychoanalysis, ‘freedom’ usually meant freedom from dependence, and [masculine] autonomy was privileged over [feminine] connectedness. Dependency, as in human infancy, creates conflict and engenders humiliation. The ubiquitous dilemma is the striving to be connected in dialectical tension with the striving for independence, or as Benjamin might describe it, the tension between recognition (contact and connectedness) and negation (the illusion of omnipotence and control). 

Attachment Theory promotes understanding of how affects foster communication and build relationships, positing ways that early attachment, separation, and loss influence subsequent capacities (and behavioral styles) to form bonds with others, including the therapeutic dyad. It recognizes that development is relationship-based and contextualized, and that affective sharing affects self- and mutual regulation. Patterns of attachment are universal, though they may differ in relation to different caretakers, by culture, or even depend on particular self states. Many contemporary psychoanalysts see attachment, with it concomitant object seeking and need for relationship (to have recognition, to share affectivity), as primary to development. The need for attachments exists throughout life and its presence does not necessarily constitute regression.Though therapists may facilitate the recommencement of patient development, we need not conflate patient-hood with infancy. Relational patterns, developed early in life, are carried forward into the therapeutic relationship and therapy may help a patient reevaluate the expectation that everyone is as unreliable, disinterested, or dangerous as the patient’s parents might have been.