Countertransference revisited

A female patient of mine recounts her week. I listen with interest, waiting for her to arrive at particular conclusions. She has suffered a great deal and still does, but prefers not to dwell on it. My interest turns into patience as she continues to talk but circumvents her discontent. She is adroit at avoidance, but easily offended when I point such things out. "I'd better wait" I think. I grow more aware that I must encourage her digressions. I feel frustrated. Getting further and further away, she skirts the issue with supple grace, then strays off into tangentiality. I forget her point and lose my focus, then get down on myself. The opportunity is soon gone. I glance at the clock as her monologue drones on into banality. I grow more uninterested and distant. There is a subtle irritation to her voice; a whiney indecisive ring begins to pervade my consciousness. I home in on her mouth with aversion, watching apprehensively as this disgusting hole flaps tirelessly but says nothing. It looks carnivorous, voracious. Now she is unattractive, something I have noticed before. I forget who my next patient is. I think about the meal I will prepare for my wife this evening, then glance at the time once more. Then I am struck: Why am I looking at the clock? So soon? The session has just begun. I catch myself. What is going on in me, between us? I am detached, but why? Is she too feeling unattuned, disconnected? I am failing my patient. What is her experience of me? I lamentingly confess that I do not feel I have been listening to her, and wonder what has gone wrong between us. I ask her if she has noticed. We talk about our feelings, our impact on one another, why we had lost our sense of connection, what it means to us. I instantly feel more involved, rejuvenated, and she continues, this time with me present. Her mouth is no longer odious, but sincere and articulate. She is attractive and tender; I suddenly feel empathy and warmth toward her. We are now very close. I am moved. Time flies, the session is soon over; we do not want it to end.     

Encounters with raven

I have been visited by Eurydice. She first came to me, unbidden, unexpected, in the way things usually first come to me–in a poem. But there was something different about how this poem happened. On one of my Fridays devoted to writing, I was suddenly hijacked by Eurydice's point of view, her voice, her demand that I speak for her. She was shrill. She was insistent. She gave me no choice but to work on the poem till I had gotten it how she wanted it. She feels she has been much neglected and misunderstood, and she let me know a poem was not enough. It was just the beginning. She wants prose. She wants essays. She wants public presentations. She wants me to tell her version of the story.     

Memoirs of a Mentor: Using Creativity for Counselors in Coping With the Loss of a Mentor

This article was inspired by my (S.S.) own personal loss. My mentor passed away during spring break of my 2nd year postgraduate school after a short battle with systemic lupus. I remember the deep sadness that I felt when it became apparent that she was coming home from the hospital for the last time. No words can describe the emotions; she had helped me through the toughest times in my academic life. How would I ever get the type of mentorship she provided again? She was there when I almost quit as a young student, back when my anger still got the best of me. She talked me down from the edge so many times; I never expected to be on this journey without her.

I dedicate this article to her and mentors like her. Equally, I dedicate this article to mentees who have lost their mentors. I offer my story (in italicized font) in the hopes that it will help others who are dealing with a similar loss. In this article, we attempt to illuminate the true power of mentorship, honor the significance of the relationship between mentor and mentee, and provide a tool useful to anyone who has lost their guide. I share my story in gratitude for my own mentor; I am so thankful that she was a part of my journey and that I can pass on to others the patience she had with me.     

Dreaming of spiders: Abuse,economics, and theological insecurity in pastoral counseling

... This hope in no hope is clearly demonstrated in the following dream of a young adult woman who had been severely hurt emotionally in her relationships in her family of origin and again in her failing marriage. In this dream, which was presented in a group and dealt with mainly by my co-therapist, the woman placed herself in a glass room like a shower, with the handle to the room's only door on the outside. There was a crack in the glass of one of the room's corners, and through this crack came some spiders. She was lying on the floor and the spiders began to crawl over her. Though she screamed for help, no one would come to open the door. As one approach (among many) to the interpretation of this dream my colleague utilized the manipulation of the dream symbols to ask her to imagine that the spiders had changed into kittens. She resisted this suggestion intensely, saying that she could not allow such an imaginary change. Besides, the spiders weren't too bad to endure, for if she changed the spiders into kittens and the kittens turned out to be evil, then she would be at her rope's end. She preferred to live with her perspective that the world is hostile rather than risk the possibility of another hope being shattered. (Jordan, 1986, pp. 98–99)     

Living in with Normal Families

Connie Hansen participated in my project, “Methodology for Studying Family Interaction,” in the mid 1960s. One of the purposes of that project was to compare several groups of families, including “normals.” Connie suggested that it might provide a rich source of data if she were to “live in” with a few of the “normal” families and observe them day to day on their own territory. (A year or so before, Dr. Jules Henry had given a talk to the MRI staff about living-in with “schizogenic” families, and I believe that Connie had discussed her idea with him.) Connie was an experienced family therapist — she was one of Virginia Satir's first students — and a most perceptive observer. She lived with three “normal” families for a week each during 1966–67; she was excited by the wealth of material and exhausted by the experience. She tried to develop a group of central themes from her data and gave me a preliminary draft of a paper in 1969. It clearly contained a number of important observations about the complexities and subtleties of family systems and some beginning attempts at conceptualization. She struggled for years to clarify and elaborate on her material. Several times she sent me portions and fragments of new drafts, each with additional insights, but she was never satisfied with her efforts. It seems a fitting tribute to Connie — she died early in 1979 — to attempt to put together her various drafts. We wanted to publish this very important material in a readable form and yet still preserve the immediateness, enthusiasm, and vividness of her observations. I hope, that if she were to read it, she would not be overly critical of this final draft. JULES RISKIN, M.D. It is a special privilege for me to participate in this posthumous publication of Connie Hansen's unique contribution to the further knowledge of family interaction. She died before the material could be published. I feel particular gratitude to the young woman who entered my first training program in 1961 at the Mental Research Institute. This was a time when such training seemed “far out” and was regarded as “probably only a fad.” She was willing to face the risks inherent to her professional standing by choosing to do this training. It was this same courage together with her imagination and curiosity and her willingness to document her experience without judging it that resulted in the article now being published. Farewell, Connie, and thank you for your presence in my life. VIRGINIA M.SATIR     

Submission, inhibition and sexuality: Masochistic character and psychic change in Austen's Mansfi eld Park

Mansfield Park is Austen's most controversial novel. 'Squarely taking on such issues as class, gender, sexuality, religion, education, theatricality, and colonialism, Mansfield Park now appears to occupy a more critical place in Austen's canon and in literary and cultural history generally than that perennial favorite, Pride and prejudice' (Johnson, 1998, p. xiii). Austen's heroine, Fanny Price has generated heated controversy because of the provocative contradictions in her character, which this paper argues tally with the psychoanalytic understanding of moral masochism within the masochistic character. As a child neglected at home and then sent to a frightening new environment, in which she was lowest and last, Fanny Price needed the love and protection even of those who mistreated her. She needed to control and influence them with submission and the inhibition of her aggressive impulses and through a vigilant scrupulousness. Austen created a plot in which she also dramatized the seeds of change that lie within the submissive character, within the repressed and inhibited psychosexual desire linked to the father which can drive the reemergence of wishes for love and satisfaction in situations of relative safety.     

A physically handicapped teenager is helped to own her body

In this paper I am presenting my work with a 15-year-old girl, Nina, who was born premature with congenital feet deformities. Her twin had died at birth, and Nina spent eight weeks in a Special Care Baby unit. She had also suffered from bronchial asthma, which was under control during the months she was in therapy with me.

An attempt to overdose, and a letter she had written to a teacher, brought Nina to our services and to individual psychotherapy. The weekly sessions gave Nina the opportunity to elaborate her mourning for the dead twin and to face her physical problems more realistically. She had coped with these by idealising a beautiful body and giving it, in her phantasy, to her dead sister for whose death she felt responsible. Her identification with characters from horror stories, of which she was an avid reader, was a key to understanding how she felt trapped in her deformed body, to which she would refer in the phrase ‘It doesn't bother me.’ The working through of her feelings of guilt, anger, and envy enabled her to lessen the split and to own her body.     

Did You Say He Has a Hitler Mustache?: Analytic Vulnerability and Destabilization in the Face of Trauma

This paper looks at analytic vulnerability and destabilization through a detailed clinical example. There are different ways in which we may be vulnerable with our patients. In this paper I describe the raw and sudden vulnerability of allowing ourselves to be in a place of not knowing when both patient and analyst are unable “to see.” I describe an experience in which I lose my ability “to see,” both literally and metaphorically, while in session with a patient who is unable “to see” because she has dissociated her experience of loss and her experience of a sense of danger when in the presence of her stepfather. I link this clinical experience to the patient’s dissociated feelings and to my history of intergenerational trauma as well to current cultural violence and hate.     

Norine G. Johnson (1935-2011)

On November 19, 2011, Norine G. Johnson, the ninth woman to serve as president of the American Psychological Association (APA), lost a valiant battle with cancer. Norine's curiosity about her grandmother's strength led to much of her later work on the development of strength and resiliency in adolescent girls and in women. She received her doctorate in 1972, with a minor in child development, and she became one of the first to be considered a pediatric psychologist, a newly emerging specialty. Norine became involved in organized psychology as her children got older. When she learned there had not been a woman president of the Massachusetts Psychological Association (MPA) for almost 50 years, she was appalled. An ardent feminist, who had served on MPA's Board of Directors, she could not let the situation remain that way. She ran for president and won, serving from 1981 to 1983, and then mentored many women colleagues into the role. MPA sent her to the Council of the APA as one of their representatives, and she immediately ran for a seat on the Finance Committee, later serving as chair of the committee. During her tenure on the Finance Committee, she helped create financial policy that changed APA from an organization whose assets were threatened and shrinking to a financially solid association. Norine considered Division 35 (Psychology of Women) to be her home in APA, a place filled with warmth, collegiality, and shared values. She and Judith Worell spearheaded the extremely important and successful 1993 National Conference on Education and Training in Feminist Practice. Norine was elected to the APA Board of Directors in 1997, where she served with distinction, continuing to focus on the financial well-being of the Association. Not surprisingly, she went from that role to being elected APA president. Her focus as president was on the changes in the health care delivery system in the United States. She was a staunch champion of the biopsychosocial model of health. Under her presidential leadership, the APA Mission Statement was amended to add the word "health," confirming the importance of health to the psychological community. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Psyche and Cinema: “Go Ask Alice (or Neo); I Think They'll Know”

The Walt Disney version of Alice in Wonderland is a musical animation beginning in a semi-pastoral setting with butterflies, birds, and daisies. Alice is bored with the textual reading of classical history being given by her uptight Victorian sister. Instead, she wants images, pictures in a book. She sees image as world. “In my world, books will have nothing but pictures,” she declares. This thought takes her further into her imagination and the deconstructive realm it creates. “Everything will be what it isn't and not be what it is.” Finally, she looks into a pond and the reflection of a white rabbit dressed in a frock coat passes by. The mirror of the water surface has released an image of the “other,” an animal, difficult to catch and associated with luck, fertility, and the underground. Alice follows the rabbit into a hole and takes a fall, a radical descent into the underworld. She speculates about descending through the earth to the other side and walking around upside down. She finally lands in front of a door with a punning knob that takes three linguistic “turns.” For Alice, it is impassible but not impossible. Stuck and distraught, she finally gets caught up in the flow of her tears, and rides through the door on her stream of consciousness.     

All Things Possible

Noa Bar-Haim’s thoughtful and impressively comprehensive paper deftly focuses on the complicated relationship between psychotherapy and psychopharmacologic treatments, and the dyadic and triadic dynamics inherent to the relationships that exist between psychotherapists, psychiatrists, and patients in the context of shared clinical work. I applaud Dr. Bar-Haim for bringing these important issues to bear. These are prodigious topics about which much can be said, and for which historically, in my estimation, not enough has been said. I am appreciative that this journal is open to including them in its scope by welcoming her thoughts and this discussion to its highly esteemed and well-respected pages. Given the vast range of topics that Dr. Bar-Haim admirably presents in her paper, and the extensive nature of what these issues encompass, this discussion addresses a selection of the many concepts she raises. It is my hope that my thoughts will serve to amplify some of hers, provide some additional and related perspectives, and mostly, have a generative effect that will promote further awareness of these issues and a continuing discussion about them within our field.     

A Book to Think With: Margaret Miles’ Augustine and the Fundamentalist’s Daughter

Margaret Miles’ work with Augustine’s Confessions offers a model for a “philosophical life,” a term used in an earlier century for a life focused on seeking wisdom. As Miles reviews her life, she traces how she has come to see in all the particularity of her experience “what really exists.” She shares many scenes from her life, but most striking is her frank exploration of sexual experience in its complexities as a doorway to the kind of knowing that leads us to gratitude. She found Plotinus’ understanding of what really exists as the “surround-love of the All” most useful. This review describes how her autobiography permits fresh thinking and talking about God among those of us with a modern worldview.     

“Pleasure and Joy in the Work”: Using Simone Weil in the Classroom

Richard Rorty once wrote that inspired teaching “is the result of an encounter with an author, character, plot, stanza, line or archaic torso which has made a difference to the [teacher’s] conception of who she is, what she is good for, what she wants to do with herself: an encounter which has rearranged her priorities and purposes.” In a teaching career more than three decades long, no author has influenced me more profoundly as a teacher and as a human being than Simone Weil. She has changed how I think about myself, my relationships, the world around me and ultimately about what transcends me. And this could not help but change how I am in the classroom. This essay is a reflection on how Simone Weil has changed my life, both in and out of the classroom.     

The Body Doesn't Lie: Five Tales of Superobesity as Somatic Language

The bodies of the five patients described here seemed to signal their ongoing dilemma: they could not fully grow up and therefore resorted to a somatic language that fairly shouted to be recognized. The author presents the case histories from an unusual point of view: She reaches her patients by working with the incomplete body images in both verbal and nonverbal modes. While the patients are on the couch, she uses verbal interpretations. When pre- and nonverbal phenomena raise their heads, she uses dance therapeutic interventions. She describes how and what she does with her patients from the point of view that motility is another way to reach the unconscious. Some of her patients were able to use movement improvisation like free association. Her highly sophisticated conceptualizations about the why and how of superobesity shine a new light on the etiology of this particular syndrome     

Visual imagery: A case study

This paper describes the performance of a subject who, when presented with a word or a sentence, is abnormally proficient at spelling this material in reverse order. She reports that she does this by visualizing this material and reading off from this visual image. Her tachistoscopic performance is also abnormally good. It is suggested that her superiority in these two tasks is achieved principally because her internal visual representations are extremely resistant to disruption by other mental activities.     

The pearl of great price

“The Pearl of Great Price” is a short story that explores the ways faith can go wrong. The central character, Janet, a single mom in a dead end job, is drawn into a multi-level marketing scheme, Benevite, by an unscrupulous salesman. She is encouraged to believe in herself and her dream and to give everything she has to it. She is fed the standard clichés to the effect that you can achieve whatever you want if you try hard enough. In the end her faith in her dream leads to the loss of her relationship with her child and other losses. Her pursuit exhibits many of the standard features of faith, belief, desire, resilience, tenacity, passion, and yet she does not save herself. The story is not meant as an indictment of faith in general, but as an acknowledgement of the fact that faith can be a vice and an exploration of when this might be so.     

Risk, Rights, and Restitution

In “Imposing Risks,” Judith Thomson gives a case in which, by turning on her stove, she accidentally causes her neighbor’s death. She claims that both the following are true: (1) she ought not to have caused her neighbor’s death; (2) it was permissible for her to turn her stove on. In this paper it is argued that it cannot be that both (1) and (2) are true, that (2) is true, and that therefore (1) is false. How this is so is explained, and the implications of this position regarding the relation between rights and duties is explored.     

Gray Matters: A Deployed Physician’s Perspective on Combat Medicine in Iraq

A female physician who was serving as a first-year medicine resident in Manhattan in September 2001 writes this paper. It details her experience of signing up for military service as a result of the September 11th attack on the United States. She lays out the surroundings, atmosphere, and reactions of those around her during the attack and details her own personal motivations for joining the military, her need to take control and help those in need heal while also trying to heal herself. Grateful, yet haunted by her experience, she provides an intimate glimpse into her time serving as a combat physician at a trauma hospital in Balad, Iraq during the 2007 military surge. A trained geriatrician and palliative care physician she recounts the stories of several patients that have forever shaped her life and explores the contradictions and ethical challenges she faced while caring for them ultimately struggling with the uncertainty of whether what she was truly doing was good for those she served or herself.