Birthday: RFK

Had he lived, Robert Francis Kennedy would be 86 years old today. Perhaps like his brother before him, would also have been a U.S. President and an Elusive Hero. Robert Kennedy, on April 4,1968 in Indianapolis on the campaign trail, upon learning of the assassination of Martin Luther King, Jr, spoke to the crowd gathered before him, and, like a good enough therapist or parent, put himself in the shoes of an other when he said, “For those of you who are black and are tempted to be filled with hatred and distrust at the injustice of such an act, against all white people, I can only say that I feel in my own heart the same kind of feeling.”

As many that night had shown up with intent to avenge the murder of their beloved spokesperson, it was this empathic attunement which, I believe, circumvented in Indianapolis the violence that erupted in other U.S. cities. By acknowledging, understanding, and accepting such a feeling for himself, noting that he, too, had had a family member killed, the crowd knew that it had been heard and so action as attempt to be understood was not necessary. More than mere empathy, Kennedy, offering himself in communion with their sorrow, offered an alternative that might be shared by all “people who love peace all over the world.” That alternative was “love and wisdom, and compassion toward one another, and a feeling of justice toward those who still suffer within our country, whether they be white or they be black,” claiming that “the vast majority of white people and the vast majority of black people in this country want to live together, want to improve the quality of our life, and want justice for all human beings who abide in our land.”

In this same address, Robert Kennedy said,
“My favorite poet was Aeschylus. He wrote:

‘In our sleep, pain which cannot forget falls drop by drop upon the heart until, in our own despair, against our will, comes wisdom through the awful grace of God.’ ”

Sometimes I find the work that we do is also through awful grace.

Shaddock Shares Systems Theory Approach to Couples

The Tampa Bay Institute for Psychoanalytic Studies, Inc (TBIPS) was delighted to have as guest lecturer on October 19, 2011 David Shaddock, author of Contexts and Connections: an interubjective systems approach to couples therapy, apply systems theory to his work with couples. Intersubjective Systems theory recognizes that people are inherently connected. Moment to moment an individual’s psychological life is embedded in relational context. One advantage of a Systems approach is that everything is inherently contextual, everything potentially important. Likewise, the therapist does not have to be the one who knows (everything), as the goal instead is to bring about a shift in the dynamic system. The therapist asks herself in the moment ‘What triggered this shift?’

Shaddock says that a Systems approach, with its tenet that the whole is more than the sum of its parts, is optimistic, for systems can rearrange unpredictably after perturbation. Phase shifts are always possible. Perturb the system and the chance that it will reorganize itself in a new way becomes possible. Systems theory recognizes that the self is organized and reorganized spontaneously, not predictably predetermined. The therapist ‘catches’ these phase shifts. The couples therapist can, by making explicit a shift in the system, empower a couple with the experience that it does not take much to induce change. For example, when an angry couple suddenly softens because of something implicit, Shaddock will, to bring it under conscious control of the couple, point out the shift (e.g. ‘What just happened here? Your face just softened with concern and then your wife became calmer.’)

The therapist may view the couple through the frames of the repetitive selfobject dimension (ala Stolorow ), and the self/interactive regulation of affect dimension (ala infant research). In the former, one member of the couple may, in the therapy situation, have her/his worst fears confirmed. Couples therapist Carla Leone will watch the faces of each member of the couple to discern any hint of this retraumatization. The therapist can then intervene to shift from the repetitive pole to the more hopeful, regulatory one.

Recognizing two important ways to organize the world: defensively, and engaged toward relatedness, the therapist focuses on ‘toward relatedness.’ Couples therapists want both members of the couple to feel understood. (This decreases defensiveness, engenders hope, and increases the chance that each feels safer to state which needs each would like met.) A history, taken in front of the other partner, helps both the therapist to elucidate for herself a partner’s repetitive pole, and invites a new relational dynamic between the couple (by allowing the other partner to witness that it is historical factors, not the witnessing partner, which trigger fearful responses) and this may lead to a reparation of empathy.

In the affect regulatory dimension, each partner sometimes needs attunement from the other (interactive regulation) and sometimes needs time apart or alone for self regulation. Problems arise when there is a mismatch between how much a partner prefers one type of regulation. Because how we regulate and organize ourselves becomes who we are, the mismatch can suddenly shift to a ‘do or die’ level when denial of a preference threatens the self and feels like annihilation. Shaddock will make the shift explicit (e.g. Five seconds ago you were just talking about who does the dishes and now we are talking about divorce. How do we understand such a shift?).

Shaddock’s presentation was so illuminating that we look eagerly forward to his return to TBIPS in January 2012 to lecture again in our Couples Treatment course.

Rimbaud: “Je est un autre” the constructed self

Parents who fear for the future of their rebellious teens might take heart from the life of Arthur Rimbaud who, born in Charleville on this date in 1854, wrote his renowned and iconoclastic poetry before the age of majority and lived, a runaway, his wild, debauched, drugging (to derange his senses) days in Paris, London, and Brussels while still a teen. Rimbaud then put poetry and rebellion behind him to become, for the remainder of his short life (he died in 1891 at the age of thirty-seven), a lucrative coffee and guns trader in colonial East Africa for a French trading company. Not unlike teenagers today, Jean-Nicolas-Arthur Rimbaud, before running off to Paris, scrawled graffiti (“Shit on God”) on town walls, smoked, grew his hair long, and mocked a town priest with an homage to his holy bowel movements (the poem “Squattings”).

Teens have been discovering and held anthem the revolutionary works of precocious, adolescent Rimbaud ever since. Marcel Proust, Jim Morrison, Bob Dylan (who refers in one of his songs to Rimbaud’s tumultuous experiment with homosexuality and Verlaine); singer-songwriter Patti Smith (who wrote Rimbaud’s Illuminations “became the Bible of my life.”) have all, in some way, cited Rimbaud’s influence. Even the film Eddie and the Cruisers (with its nod to the poetic lyrics of Bruce Springsteen) referenced Rimbaud, with Eddie’s lost album entitled Seasons in Hell.

Rimbaud wrote to his friend and former teacher Georges Izambard: “I'm working to turn myself into a seer: … It has to do with making your way toward the unknown by a derangement of all the senses.” And “It's wrong to say I think: one should say I am thought.” and “I is someone else”. Rimbaud was perhaps the most avant garde in this statement “JE est un autre” ( I am an other) intimating, like Hegel before him, that the subjective self, the “I”, is constructed, the other, constitutive. A useful construct, yes, but within it are multiple components, opposing sameness, what today we call multiple selves.

And with nothing merely as its constructed façade, Rimbaud saw the value of writing not only of internal things but also of ordinary things as experienced through the unique subjective self. This required a new way of constructing poetry, including synesthesia (as Baudelaire had done), such that chaos was captured in correct form (Oh, that my keel might rend and give me to the sea!). Soon after, he contacted the Symbolist poet Verlaine.

Mothers of prodigal sons might also appreciate that Rimbaud returned again and again, after many escapes, to the home of his own stern mother, his father having abandoned them when he was five. At fifteen, Rimbaud sought his fortune in Paris, for the Franco-Prussian war had led to closure of his school and he was too young to be allowed to be a soldier. This runaway, homeless in Paris, arrested, destitute, was, most likely, also raped. His suffering and early losses are reflected in his poetry. (See, e.g., The Drunken Boat below.)

In Enid Starkie's biography, she writes that Rimbaud gave up poetry when he realized it would not bring enlightenment. His mother’s influence, when she wrote to encourage the suicidal Verlaine: “..each of us has a wound in his heart, more or less deep...true happiness consists solely in fulfilling of one's duty, however painful it may be. …you'll see that misfortune will grow weary of pursuing you, and you'll become happy once more”, may be evident in Rimbaud’s choice to become an industrious trader of goods. In a twist of fate, his capitalististic endings perhaps mock his earlier work, just as his poems had earlier mocked French conventional verse, liberating it from its 19th century themes and form.

Rimmbaud's suffering is evident in this excerpt from Oliver Bernard’s translation of The Drunken Boat

But, truly, I have wept too much! The Dawns are heartbreaking.
Every moon is atrocious and every sun bitter:
Sharp love has swollen me up with heady langours.
O let my keel split! O let me sink to the bottom!
If there is one water in Europe I want, it is the
Black cold pool where into the scented twilight
A child squatting full of sadness, launches
A boat as fragile as a butterfly in May.

Sunday Morning Musings

This morning I had the unexpected pleasure of hearing a hospital chaplain friend of mine give a sermon at his church. He shared with us his personal story of loss and darkness woven masterfully with the readings of the day from Exodus 33:17 (where God says to Moses “…I know thee by name”) and from Revelations 2:17 (where the those who “overcome”—did my friend know that the Martin Luther King, Jr Memorial was dedicated today?—will be given “a white stone, and in the stone a new name written”) and with the birth and naming of his first son. He thought perhaps the name at time’s end written for him in the white stone might be ‘the carrier of sorrows’ but should one turn over the stone, one might find also the name of joyousness.

After service, my friend reminded me of the psychiatrist (Peter Wilkins, see blog post of 9-9-11) who was asked how he could bear listening all day to the sorrows of others. Then I thought of my answer to the many times I have been asked such a question: I do not bear others’ sorrows as some burden, but rather I embrace them, with joy of communion, and with the recognition of the privilege that is bestowed when others share them with me. Then I thought of a person I see, a Buddhist who lessened her burden, not by bearing her sadness, but by giving it a name, by making it a companion always beside her, recognized and acknowledged, both sides of a coin, or of a stone.

Ethics and Outrage

A few weeks ago at brunch at the home of friends we were expressing our disappointment with the US President. We agreed that Obama seemed to lack outrage, a righteous indignation, at what is happening all around us. It seems Obama has not expressed outrage since the unfortunate arrest of Harvard professor Henry Louis Gates, Jr in Cambridge, MA in July 2009.

So I was very happy to come across the interview with Stephane Hessel two evenings ago on the PBS Newshour. Hessel, a German born Jew raised in Paris, a member of the French Resistance, and a concentration camp survivor, was cogently speaking about his book Time for Outrage--Indignez-Vous! In Time for Outrage, published in October 2010, Hessel asked people to get angry and indignant when their government is not doing what is necessary to preserve the dignity of people.

The subsequent Arab Spring and, later, Occupy Wall Street, hearten him, and he encourages younger people -- now 94 years old, he quips that almost everyone is younger than he—to engage in a cause with outrage, not by violence, but by a determined will. He believes that international law, encouraged by Franklin Roosevelt and the UN charter, the ideals for which WWII was fought, are the values now threatened by failing financial fidelity and corruption around the world. He also sees as unacceptable the treatment of Palestinians by Israel, treatment of the world’s immigrants, that social security does not cover requirements of living, and the organization of lobbyists to oppress our governments.

Just yesterday, in TBIPS’ Practical Analytic Subjectivity course, the class was discussing Claire Allphin’s An Ethical Attitude in the Analytic Relationship (Journal Analytical Psychology, 50:451-468) in which she reminds us that “the source of ethical capacity is the ability to accommodate conflicting needs…” a plea for intersubjectivity if I ever heard one. She cites John Beebe’s obligation of the ethical attitude to protect (the patient’s) self esteem, or, as Hessel might say, each person’s dignity. I was reminded of a 20th century Christian hymn which sang “guard each [one’s] dignity and save each [one’s] pride” as the class, later, discussed interpretation and the exhortation to avoid shaming a patient by the meaning we may bring to their narrative or behavior.

Nobel Laureate

It is hard to be an instructor in psychoanalysis. It is a struggle to hold lightly to our theories while attempting to impart key psychoanalytic concepts, and while simultaneously hoping to co-create an open inquiry in the classroom in order to both model open inquiry and to facilitate the procedural learning of it. The comments this week of Isreali born scientist Dan Schechtman may have helped.

Dan Schechtman, in 1982, described a new chemical structure “quasicrystals” which then defied the expectation that crystals are to be regular and repeating, and for this he lost his place on a US research team. In 1982 his idea was too unorthodox to be credible. Almost thirty years later, quasicrystals are being studied as a way to convert heat into electricity. Schechtman is not only vindicated, but honored when this week he was awarded the Nobel Prize in Chemistry.

Schechtman, now 70 years old, said about his work, “A good scientist is a humble and a listening scientist, and not one who is sure 100% in what he reads in the textbooks; and this is a lesson also to students to be open.”

Self and Relational Psychologies Face-off

Soon after Labor Day each year, The Tampa Bay Institute for Psychoanalytic Studies, Inc (T-BIPS) recommences its two (Self and Relational) Study Groups. On Friday, September 16, the TBIPS Self Psychology Study Group read the 2005 paper by Israeli analyst David G. Kitron The Unacknowledged Knowledge and the Need for a Sanity-Confirming Selfobject. It made for a lively discussion about whether or not an analyst could actually “temporarily” or “partially” “suspend his or her own subjective experience.” Self psychologists and the Stolorow et al Intersubjectivists tend to intimate that we can. Relational Intersubjectivists claim this is not possible.

No doubt that our profession aims at being helpful to our patients, which means being toward a focus, even with our own subjective experience, on the patient’s experience. Kitron aptly commends Ghent’s (1990) surrender over submission. He also reminds us that survivors of childhood trauma have had their reality-testing attacked, what he calls a failure of a sanity confirming self object. I applaud when he writes, “It is the therapist’s duty…to search for any mistake he might have made.” Not to do so would attack again the patient’s reality-testing (gas lighting) and re-traumatize. The analyst’s mistake, if denied by the analyst, becomes part of the “unacknowledged knowledge.”

Where Kitron and Relational thinkers may diverge is when does the therapist deem that “a side-by-side coexistence of two subjectivities is gradually made possible.” Kitron says “the therapist has to ‘step aside’ and suspend his subjectivity temporarily” until the patient has developed the capacity for intersubjectivity [mentalization, Fonagy would contend, is a component of this capacity]. I tend from the very beginning to lean toward the “hold in tension” philosophy. What I mean is that I do not want to obfuscate the part of the patient that is inevitably aware of my subjectivity [as even psychotic patients are] even while, because the patient has had the repeated experience of attack on her/his reality testing, the patient finds any other’s subjectivity unwelcome, even noxious or traumatic. To “suspend” my subjectivity might then be a mere reversal of where one “dominates and paralyzes the other.” I try, then, to hold my subjectivity in tension with the need of the patient to have her/his subjectivity exalted.

Poetry

Reflective, pensive, sad in the week preceding this tenth anniversary, my words seem inadequate. Instead I will post those of Ben Feldman, a colleague, a poet, and a student at TBIPS.


On Compassion

Compassion salvages the heart,
Wounded.
But revenge, vindictive,
Tears and tastes the meat
Like lions.

Practice
If compassion is to create
an antitoxin in the soul
then it must be played and practiced
like a cello in love
under stars with kin in soul
and harmonies woven in heart.

--Ben Feldman

"Super Vision" by Peter Wilkins (Blog)

A provocative account of an imaginary supervision session invites therapists, both novice and seasoned, to examine the rich complexity of our feelings towards our patients.

"Super Vision"

Several people have alluded to the emotional costs of being a therapist. ‘How do you cope,’ they have asked, ‘having to face other people’s distress day after day?’ It is a very pertinent question. How do we, as therapists, manage to survive our own feelings generated by our encounter with the other? (cont.)

Read the rest of the post at http://bit.ly/qrpwyA

Post from "Peter Wilkins Blog"

The Monkey and the Fish

As the Tampa Bay Institute for Psychoanalytic Studies, Inc, a contemporary training program, gears up for classes to begin September 21, 2011, I often muse about how to convey to candidates and students an open attitude toward patients, an attitude which often includes ‘letting go’ of the bastion of [pejorative, accusatory] interpretation in its attempt to rid patients of “defenses” as if we are the authority on what is best for a patient.

My colleague, Horacio Arias, and I have, more than once, discussed the idea, captured beautifully in his pithy statement ‘there is no such thing as pathology,’ that patients have established their ways of being in the world (whether nuanced and called symptoms, defenses, transference, organizing principles, RIGS, relational paradigms, etc) for very good reason, and, as such, we therapists best be respectful of the necessary purposes these serve to maintain the psyche’s functioning, however precarious or constraining that functioning may be (or seem to us). Rushing in to interpret may not be at all fortuitous, and may create a less safe –and inadvertently humiliating-- psychoanalytic space, or even result in bringing down a house of cards.

To bulwark my patience, I remind myself of a little story told on Mt. Gorongosa in central Mozambique about white colonists and modern philanthropists who thought they knew what is best for the local African people. It is the story of The Monkey and the Fish and it goes like this:

A monkey was walking beside a river one day and notices a fish in the water. The monkey thinks to itself, “Oh, no! That poor animal will drown! I must do something.” The monkey scoops up the fish and the fish begins flailing in the monkey’s hands. The monkey says to itself, “Look how happy I have made it. It leaps for joy.” The fish dies, and the monkey thinks, “If only I had gotten here sooner, I might have saved its life.”

I try to remember to not be the monkey in this story when I am tempted to think I know what is best for my patients to do, like when I think they should give up drug use, leave a battering spouse, or stop being so stubborn.