211: Intrusions into the Analytic Space

Course Description

Instructors

Lisa Deutscher, MD
Sarah Fox, MD

September 9 – October 7, 2024
Mondays, 8:35 – 10:00 pm

Course Description

In this course, we will take up different forms of unintentional or inevitable self revelation by the analyst. We will start with the example of the pregnant analyst, whose outside life becomes present in the consulting room. We will also discuss patients’ reactions to the analysts body and to other aspects of the analyst as a person which become apparent through situations such as illness and the use of remote sessions. We will consider patients’ reactions to and analysts’ explorations of manifestations of culture, class and race.

Educational Objectives

Upon completion of this course, participants should be able to:

  1. explain several other kinds of inevitable or nonverbal self-disclosure by the analyst, and discuss how the analyst may make use of this material in the treatment.
  2. explain the influence of women’s bodies, including the potential for pregnancy, or actual pregnancy, on what is unique about the psychology of women and on the transference dynamics.

Evaluation Method

Each student’s participation in class discussion and demonstration of understanding of the course objectives, readings and clinical material is assessed in a written evaluation by the instructor(s).

Schedule of Classes & Course Readings

These articles are protected under relevant copyright regulations. They are available in the New York Psychoanalytic Society & Institute Electronic Reserve for your convenience, and for your personal use.

READINGS ARE CONFIRMED.

I. Unintended Self-Revelations

CLASS 1: September 9, 2024

For Burton and Gilmore–
1. Describe some of the elements that went into JKB’s decision not to disclose his sexual orientation, including countertransference issues. Several observations in the article suggest that the patient is aware that the analyst is gay. What elements of the countertransference might have made it difficult for him to realize that she already knew?

2. What might have been different in the treatment if the analyst had answered the patient’s question?

For Smith and Tang–
1. Smith and Tang describe various ways that perceived similarity to or difference from the therapist or analyst can have significance for the patient. Explain how the significance differed in the case of the L family vs. the case of Miss E.
2. If the analyst limits self-disclosure, how might one still explore the patient’s perception or even knowledge about the analyst?

REQUIRED READINGS
Abbasi, A. (2014). Have you heard? Revelations regarding the analyst. In: The Rupture of Serenity: External Intrusions and Psychoanalytic Technique (1st ed.). Routledge.

Burton, J.K. Gilmore, K. (2010). “This Strange Disease”: Adolescent Transference and the Analyst’s Sexual Orientation. Journal of the American Psychoanalytic Association, 58(4):715-734.

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Smith, B.L. Tang, N.M. (2006). Different Differences: Revelation and Disclosure of Social Identity in the Psychoanalytic Situation. Psychoanal Q., 75(1):295-321.

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SUPPLEMENTAL READINGS

Kantrowitz, J. L. (2020). A Psychoanalytic Memoir: The Analyst Enabled and Disabled by What is Personal. Journal of the American Psychoanalytic Association, 68:83-100.

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II. The Pregnant Analyst

CLASS 2: September 16, 2024
  1. What are some of the common dynamics which can be evoked by the analyst’s pregnancy?
  2. What aspects of the two cases you read illustrate examples of common countertransference issues discussed in the Uyehara article?
  3. Another general question: Does anonymity really exist in analysis?
REQUIRED READINGS

Friedman, M. (1993). When the Analyst Becomes Pregnant – Twice. Psychoanal. Inq. 13:226-239.

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Lazar, S.  (1990). Patients’ responses to pregnancy and miscarriage in the analyst. In H.J. Schwartz & A.L. Silver (Eds.),  Illness in the Analyst, (pp. 199-226). International Universities Press, Inc.

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Uyehara, L.A., Austrian, S., Upton, L.G., Warner, R.H., Williamson, R.A. (1995). Telling About The Analyst’s Pregnancy. J. Amer. Psychoanal. Assn., 43:113-135.

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SUPPLEMENTAL READINGS

Denton, T. (2012). The Analyst’s Pregnancy: A Paradise Lost. Mod. Psychoanal., (37)(1): 82-115.

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Rocah, B.S. (2008). The Impact of the Analyst’s Pregnancy on a Vulnerable Child a Case with Discussion by Anna Freud. Ann. Psychoanal., 36:7-30.

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III. Remote Treatment

CLASS 3: September 23, 2024

Guest Instructor: Natalia van Hissenhoven, LCSW

REQUIRED READINGS

Lemma, A. (2017). The digital age on the couch: Psychoanalytic practice and new media. Routledge/Taylor & Francis Group. [Read Ch. 4 & 5, pp. 81-134]

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IV. Patients’ Reactions to the Analyst’s Body

CLASS 4: September 30, 2024
  1. Consider differences in emphasis between Balsam’s and Lemma’s views on patients’ reactions to the analyst’s appearance.
  2. Think about any clinical material from your own work in which a patient compared his or her appearance with yours, commented on your appearance, or compared his or her own appearance with that of parents or others.  In particular, try to bring in any examples of a woman patient comparing her body to that of other women.
  3. As you read the Lemma article, consider: a) What is meant by the “embodied setting?” b) According to Lemma, why do some patients have particular difficulty with changes in the analyst’s body or appearance? c) How do you think these issues might relate to patients’ reactions to the shift from in-person to virtual work?
REQUIRED READINGS

Balsam, R. (2012). Women’s Bodies in Psychoanalysis. Routledge. [Read pp. 49-53]

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Balsam, R. (2012). Women’s Bodies in Psychoanalysis. Routledge. [Read Ch. 4, pp. 55-75]

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SUPPLEMENTAL READINGS

Lemma, A. (2014). The Body of the Analyst and the Analytic Setting: Reflections on the Embodied Setting and the Symbiotic Transference. Int. J. Psycho-Anal., 95(2):225-244.

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V. Illness in the Analyst

CLASS 5: October 7, 2024
REQUIRED READINGS

Dewald, P. A. (1982). Serious Illness in the Analyst: Transference, Countertransference, and Reality Responses. Journal of the American Psychoanalytic Association 30:347-363.

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Dewald, P. A. (1990). Further Reflections. In Schwartz, H. J., & Silver, A.-L. S. (Eds.), Illness in the analyst: Implications for the treatment relationship (pp. 91 – 98). International Universities Press, Inc.

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Kahn, N. E. (2003). Self-Disclosure of Serious Illness: The Impact of Boundary Disruptions for Patient and Analyst*. Contemporary Psychoanalysis, 39:51-74.

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SUPPLEMENTAL READINGS

Abend, S. M. (1982). Serious Illness in the Analyst: Countertransference Considerations. Journal of the American Psychoanalytic Association, 30:365-379.

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