I attended the annual spring conference of Division 39 (Psychoanalytic Psychology) of the American Psychological Association. The conference, entitled “Hot and Bothered,” included presentations on sexual and erotic issues, although there were a wide range of other presentations. There were a lot of programs and I could only attend some, so here are notes from “my” conference.
Relational Dream Work: The Bridge Between I and Thou
Kendle Hassinger, LPC
This preconference workshop was one of the most enjoyable and personally useful programs in “my” confefence. Hassinger’s approach to dreamwork was as a relational process in therapy. That is, it’s not a matter of the therapist being some sort of dream expert and pronouncing interpretations, but a process of therapist and client moving together into a deeper understanding of the client’s dream. Hassinger sees the relational process itself as mutative, regardless of theoretical orientation. (“Mutative,” in psychoanalytic context, means it facilitates a beneficial change the state or self-organization of the client or analysand.) She sees the therapeutic relationship as involving two I-Thou relationships: one between the analyst and analysand, and the other between, as it were, the client and herself; between the client’s conscious self and her inner process, objects, and private experience. By definition, the process of striving toward health in these I-Thou relationships is never complete, and the therapist’s job is to facilitate them.
Hassinger asked what we thought dreams were for, and I commented about the relationship between dreams and learning in mammals. This sparked a discussion among the participants, during which a Mexican graduate student said that mammals dream “because they have mothers.” I’m still reflecting on that!
Hassinger encouraged us to participate in discussion, and we talked about research into dreams (REM sleep increases during periods of intense learning) and different analytic perspectives. Freud saw dreams as concealing meanings whereas Jung saw dreams as revealing the unconscious rather than disguising it. Her perspective integrated a number of analytic and non-analytic elements, but was more Jungian than Freudian overall. This was one of several presentations that had an inclusive attitude toward methods and concepts in different approaches to psychoanalysis, contrary to the history of divisive conflict between schools that characterizes so much of psychoanalytic culture, both then and now.
For example, Hassinger mentioned Jung’s comment that “The ego is a complex among other complexes,” and described therapeutic exploration as finding and exploring “feeling-toned complexes” (another Jungian term), which is a different way of looking at the inner life than the more dichotomous “I-it” (ego-id) of Freud; yet her discussion integrated both and flowed easily from one to the other as it suited the context.
Jung saw exploring the “feeling-tone” as the way into exploring the dream, and focused on the details of the dream image. For example, if a barn, in a dream, is full of healthy animals and fodder, or neglected and dirty, it will have a different set of meanings associated with it.
We paired off to do brief explorations of one another’s dreams, and I was paired with a graduate student from Mexico. Interestingly, both of our dreams involved animals—hers were birds, and mine a dog—and both yielded deeper meanings upon exploration.
An Evening With Nancy McWilliams
Nancy McWilliams is a distinguished and prominent teacher, leader and writer in psychoanalysis. This pre-conference gathering was mainly an appreciation of her, and a Q. and A. session. Some selections from my notes:
Q: “You don’t belong to any camp, though you speak to every camp.” NM: “I used to walk the halls to find someone to have lunch with. I’m an integrator temperamentally. I approach anyone from (the perspective of, “What can I learn from this guy,” not “I’m better than this guy.” Different patients make different therapists look good, and and different theories evolve to (explain different kinds of patients).”
Responding to a question about the difference between psychoanalytic diagnosis (which she’d written a book on) and the usual DSM-type psychiatric diagnosis: “Psychoanalytic diagnosis is basically about individual differences,” which, she added, helps explain why it is so popular in Eastern Europe and other more collectivist cultures. She recalled a question she’d received when teaching in China: “What do we do about our depressed grannies?”
I had submitted a question (questions were submitted in writing) on the similarities and differences between the terms “psychoanalytic” and “psychodynamic.” She replied: “That difference has never been salient to me. I think it’s a very artificial difference made up by psychologists who are not familiar with psychoanalytic ideas, who tend to define psychoanalysis as a technique, passé, on the couch, three days a week, etc. If you define it as a treatment, then you have to have another word for all the rest of psychoanalytic knowledge that applies to everything else we do that’s not on the couch. I’m an integrator, what Darwin would call a lumper rather than a splitter. I prefer Freud’s definition, he had a lot of definitions, but I prefer the definition as any activity in which you are attending to transference and resistance. It’s psychoanalytic to work with psychotic people, borderline people, and so forth. I see what the distinction is but I think it’s created more heat than light to try to make that distinction.” (I appreciate Dr. McWilliams’ inclusive perspective, which was characteristic of the attitude toward psychoanalysis in this conference, but I respectfully disagree. The conflicts about what is really psychoanalytic and what isn’t goes all the way back to Freud and Jung, is a distinguishing feature of the history of psychoanalytic culture, and has been particularly virulent in the USA. As Dr. McWilliams said, Freud had a lot of definitions, but she didn’t mention his requirement that his associates agree with whatever his definition of the moment was. I prefer the term “psychodynamic,” because it includes all the perspectives from within the various schools of psychoanalysis, bypassing their conflicts and turf wars, and also has room for perspectives of neuroscientifically and spiritually informed views of mind from outside of psychoanalysis per se. Still, I appreciated her personal warmth and professional inclusiveness within the culture of psychoanalysis.)
In response to a question about eating disorders, Dr. McWilliams said that she thinks extreme eating disorders should be considered psychotic, “when someone weighs 80 pounds and believes she’s fat and is starving herself to death. We’ve been criminal in our treatment of psychotic and other persons, we just medicate them, as if they don’t have souls, as if they don’t have lives.”
Asked about the difference between psychoanalysis and cognitive-behavioral therapy, Dr. McWilliams said, “The important differentiation isn’t between psychoanalysis and CBT, they run into the same issues we do, they develop their own language to describe it. The biggest abyss we have is between clinicians and researchers who have increasingly become alienated from what clinical work is really like. It’s not their fault, it’s conditions in academia (where) it’s so hard to get grants (that) it would be professional suicide to have a small practice on the side. (So) researchers have no idea what it’s like to be a clinician, they think it’s like what they do in the lab. I think we should be allying with cognitive-behavioral, humanistic, family therapists, anyone who is in the trenches.” (This is the direction that we have been moving in with CAPP, the Chicago Association for Psychoanalytic Psychology.)
Q: “How do you understand resilience, beyond ego strength? Do you have a dynamic formulation around resilience?” NM: “No, but I’ll hazard a guess. It all has to do with whether you have somebody who can bear your pain. If you have somebody who can be there with you, you can go through pretty bad pain, you go through a mourning process, mourning is the process by which we adapt to the painful aspects of life. If you have the same traumatic experience and you have nobody who can go with you through it and bear your pain and bear witness to what you’re going through, I think you’re much more likely to be dissociated, because it is unbearable to go through crisis without someone who can bear witness. That’s a time-honored goal of psychoanalytic therapy.” (Note: I see dissociation as a normal aspect of brain function and self-formation, and find support for this view in the “neural networks” model of neuroscience and the “multiple selves” model of spiritual psychology. Psychoanalysis has described traumatic dissociation, and specialized in treating it.)
Q: “You’ve talked about a number of different camps. There’s an ideological process of all this, perhaps a tribal component, who’s on the inside, who’s on the outside. In the history of psychoanalysis, and in many respects of CBT, the ideological component has been so important, to define themselves against (other schools), how do we begin to look at these tribes that we form and bridge those divides?” NM: “In this field, where ideas matter so much, I don’t think it’s been so bad, as long as we can come together in the fight against torture, against accreditation that’s depersonalizing” (here she’s referring to issues within the American Psychological Association). “The danger in psychoanalysis is that we get so distracted by these internal differences between us that we’re fighting over deck chairs on the Titanic.”