Psychoanalysis On and Off the Couch

"I'm not suggesting that repression has lost its place as a fundamental defense mechanism. Repression remains central, coherent, and fundamental to the founding of the unconscious. It is what makes certain contents inaccessible to consciousness, and what we access as psychoanalysts through dreams, play, symptoms, and associations. That remains true. What I was observing, and I'm still observing more now, is something different. When I see children and adolescents that are more capable to work on a task while doing homework, and at the same time listening to music, and at the same time texting with somebody - I don't think that they are real. This is my point. I don't think they are real. This multitasking way of living is part of life today… The clinical question for us becomes this - when does this multiplicity become a symptom? When does it interfere with the capacity for depth, for intimacy, for a sustained emotional contact? I think that this is what we need to see, to study and to differentiate in our consulting room." Episode Description: We consider how changes in our culture may impact the individual's intrapsychic space and from that the nature of the psychoanalytic encounter. Virginia comments on the diminishing of the paternal symbolizing function and with that a change in the 'rites of passage' that adolescents traverse - now the rituals are "created by the young people themselves" as contrasted with those passed down by their elders. This, she feels, has resulted in "intimacy becoming spectacle" and for many, the analytic session is where "the construction of intimacy may begin." She shares clinical material with us from 40 years ago and contrasts the nature of her interventions with her contemporary treatments. Now, "I appreciate the mystery in the process and that we create meaning with the patient." Virginia closes with seeing analytic treatment as "an invitation to a process of thinking that, to remain alive, must be rethought." Our Guests: Virginia Ungar M.D., training analyst at the Buenos Aires Psychoanalytic Association (APdeBA). She specializes in child and adolescent analysis, was the Chair of the IPA's Child and Adolescent Psychoanalysis Committee (COCAP) and of the IPA Committee for Integrated Training. She was awarded a Konex of Platinum in 2016. She is the former President of the International Psychoanalytic Association (2017-2021). Recommended Readings: Etchegoyen, H. (1986) The fundamentals of Psychoanalytic Technique, chapters 25 and 26, Karnac, 1991. Meltzer, D. (1968). A note on analytic receptivity. In A. Hahn (Ed.), Sincerity and other works: Collected papers of Donald Meltzer, Karnac Books, 1994. Meltzer, D. (1988). The apprehension of Beauty, chapters 1, 2, and 4, Clunie Press, Perthshire, 1988. Sontag, S. (1966). Against Interpretation, Against Interpretation and Other Essays, Farrar, Straus & Giroux, New York. Ungar, V. (2017) Letter from Argentina, Vol 98, 3, IJP, 2017

Mark Moore, a younger analytic teacher, brings a fresh generational view. Peggy Warren, Boston faculty, shares a life-saving medical crisis and the group's enveloping care. Jonathan Palmer, seasoned analyst, reflects on creativity and emotional authenticity. Stephen Bernstein, longtime organizer, traces the group's shift from writing circle to sustaining monthly collegiality. They discuss mutual support, resilience, intimacy, and creativity.

Ilene Lefcourt, clinician and author on parent-infant psychotherapy, explores mothers’ memories and cultural influences shaping early girlhood. She examines how daughters mirror mothers, the meanings behind nudity and body curiosity, gendered messages like pink/blue, and the tension between sameness and individuation. Short, vivid conversations highlight moments that awaken maternal history and imagination.

Alice Jones, MD, a psychoanalyst, poet, and memoirist, reflects on moving from poetry to meditative prose. She weaves clinical work, family care, and mortality into overlapping narratives. The conversation touches on the musicality of analysis, the porous boundary of body and mind, intimate care during illness, and the tender rhythms of saying goodbye.

Pamela Polizzi, LCSW, an analytic candidate and Manhattan clinician who treats eating disorders and relational trauma. She describes working with patients who are hard to reach and the feeling of having their yearning inside her. She talks about slowing the work, listening to patients’ rhythms, and how intensive analytic training shaped her approach.

Mary Morgan, psychoanalyst and couple psychotherapist, explores the 'couple state of mind' as a therapist stance that couples can internalize. She describes stepping into a third position to understand what partners create together. Short clinical stories show projective systems, countertransference surprises, and how curiosity and containment can shift stuck patterns.

"To come back to this idea of 'groaning' - I really like it because I think it's a good description of the work we do, but particularly because it refers to Antonio Ferro's concept of the absorbency of the frame, which I think is another way of referring to it, that the frame can take a little give and take, that there's something organic about it. It has a structure, but it's absorbent, it can move, it's alive. So that is a very important concept. I think a lot of younger analysts or psychotherapists who want to be inspired by psychoanalysis don't let themselves feel comfortable letting things happen first before they try and immediately intervene and feel that they have to have some kind of magical response to it." Episode Description: We begin by unpacking the meanings contained in the metaphor of the 'groaning' analytic frame. Allannah speaks of flexibility, containment and "the expectation of misunderstanding." She shares the importance of the analyst having a sense of an internal frame which is then introduced to the patient and which contrasts with their assumptions of social relatedness - "Too much comfort in the relationship can lead to a pseudo-analysis." We take up the concept of the 'co-created' frame and touch upon the reflections of Aulagnier, Rothstein and Aisenstein. Allannah shares her thinking on the issue of charging for missed sessions and describes her reconsideration of her personal analytic experience with this. We close with a comment on the analyst's internal frame which enables them to "hear the patient in an out-of-the-ordinary way." Our Guest: Allannah Furlong, Ph.D., a psychologist and psychoanalyst, is a member of the Société psychanalytique de Montréal. After serving on the IPA North American Editorial Committee, she was one of the original members of the IPA Committee on Confidentiality and organizers of the first interdisciplinary Inter-Regional Conference on Confidentiality. These collaborations led to the co-editorship of two books on issues of confidentiality in psychoanalysis. In addition, Dr. Furlong has written on the frame, missed sessions, informed consent in psychoanalysis, and the use of clinical material for teaching or publication. She has also written about the temporality of lovesickness, unconscious choice, and dehumanization as a shield against helpless openness to the other, for which she received the JAPA Prize for excellence in psychoanalytic scholarship. Her current research is on the subject-creating function of baby talk. Recommended Readings: M., Baranger, W., & Mom, J. 1983. Process and Non-Process in Analytic Work. International Journal of Psychoanalysis 64:1–15. Bass, A. 2007a. When the Frame doesn't Fit the Picture. Psychoanalytic Dialogues 17:1–27. Bleger, J. 1967. Psycho-analysis of the psychoanalytic frame. In Symbiosis and ambiguity: a psychoanalytic study, 1–13, trans. S. Rogers and edited by J. Churcher & L. Bleger. London: Routledge, 2013. Caper, R. 1992. Does Psychoanalysis Heal? A Contribution to the Theory of Psychoanalytic Technique. International Journal of Psychoanalysis 73:283–292. Donnet, J.-L. 2001. From the Fundamental Rule to the Analysing Situation. International Journal of Psychoanalysis 82:129–140. Ogden, T. H. 1992. Comments on Transference and Countertransference in the Initial Analytic Meeting. Psychoanalytic Inquiry 12:225–247. Roussillon, R. 2015. An Introduction to the Work on Primary Symbolization. International Journal of Psychoanalysis 96:583–594. Stern, S. 2009. Session Frequency and the Definition of Psychoanalysis. Psychoanalytic Dialogues 19:639–655

"A saturated state is a state in which the conceptual or emotional object has absolute value, it is already stacked or closed to new meanings and therefore cannot undergo any kind of transformation. An unsaturated state, on the other hand, is a state in which the emotional or conceptual object is in an open state in which it is still open to transformation, to new meanings, to all kinds of change. What I think is interesting and important is to understand that one of the most difficult aims of working with traumatic objects is linked to this transformation from saturated to unsaturated states. Traumatic objects become fixed in a saturated state, which does not allow them to undergo any transformation within the psyche or within the therapeutic analytic process. The saturated state of traumatic events or objects is a frozen state in which therapy or analysis is used to preserve rather than intervene. This creates, in quite a few cases, a situation that I call false therapy or false analysis - a process, a therapeutic process in which very detailed materials are ostensibly presented, but in fact they are presented in a way that forces the therapist or to either swallow them as they are, or vomit them up but not digest them because they are presented in a way that does not tolerate any intervention, any other point of view, any creation of movement within the given frozen narrative." Episode Description: We begin with describing the difference between 'saturated' and 'unsaturated' memories - those that are frozen and without the freedom to reflect from those that contain the capacity to create new meaning. Dana emphasizes the importance of not simply collecting the particulars of a trauma, the 'notes', as much as attending to the nature of its delivery, the 'music' - "the way they tell the story." She presents a case involving 'parasitic language' where imitation of the other is at the level of fetishistic attachment lacking a voice of their own. In her countertransference she noted "I search for you - all I find is myself." We consider how this pseudo-relating induces a peculiar sense of closeness that ultimately contributes to a sense of claustrophobia in the analyst. She shares with us her personal story and reflects "Being a psychoanalyst doesn't mean giving up being a musician." Dana concludes with reading her final paragraph on 'forgiveness.' Our Guest: Dana Amir, PhD., is a clinical psychologist, supervising and training analyst at the Israel Psychoanalytic Society, full professor, and head of the interdisciplinary doctoral program in psychoanalysis at the Zramim Postgraduate Psychoanalytic Psychotherapy Program at Haifa University, poetess and literature researcher. She is the author of seven poetry books, four memoirs in prose, and five psychoanalytic books published by Routledge. She was awarded literary as well as academic prizes, including seven international psychoanalytic awards, including the prestigious Sigourney Award (2025). Recommended Readings: Amir, D. (2012). The Inner Witness. The International Journal of Psycho-analysis, 93:879–896. Amir, D. (2013). The Chameleon Language of Perversion. Psychoanalytic Dialogues, 23: 393-407. Amir, D. (2016). The Metaphoric, the Metonymic and the Psychotic aspects of Obsessive-Sympomatology. International Journal of Psychoanalysis, 97, 259–280. Amir, D. (2016). Hermetic Narratives and False Analysis: A Unique Variant of the Mechanism of Identification with the Aggressor. Psychoanalytic Review 103(4):539-54 Amir, D. (2023). "From Turning Away to Turning Toward: Adoption as Radical Hospitality". Psychoanalytic Perspectives, 21: 1–18. Amir, D. (2024). From mind-deadness to mindedness, from collaboration to cooperation. International Journal of Applied Psychoanalytic Studies, 21(4).

"This patient taught me a lot. The context was that I just finished my second training as a psychodynamic psychotherapist and I felt I needed to prove a lot, and I clearly arrived with the wrong agenda. It was that if I was good enough and smart enough, a clever enough just graduated psychodynamic psychotherapist, I would manage to get into why the patient is struggling so much with the realization of his mother's cancer. That is a resistance, he didn't want to touch the topic at all. I thought that if I uncover the underlying reason why the cancer of his mother was so extremely distressing, and be able to explore with him how he's processing this, I would be helping him. I was extremely wrong. The patient was really generous with me. What I meant is he was forgiving. He clearly was tolerating me trying to push for something he really had no appetite for." "Psychoanalysis is not only about clever interpretations. Psychoanalysis can be about the tools to help us feel what we are experiencing. And in those radical settings, you become almost the object you are projected to be and you need a frame of mind to ground you that you are not that and can offer something different. So that is why I thought it was really useful." Episode Description: We begin with a description of the distinction between supportive and exploratory psychotherapy. Rodrigo presents clinical examples of individuals who were in crises and their capacity to be aware of their inner experiences was not available to them, hence supporting their defenses was vital. In addition, "being with them" became a key aspect of the therapeutic benefit they gained. We consider patients who are phobic about intimacy and have backgrounds where trusting others proved to be actually dangerous. He also spoke of therapists who unknowingly privilege their own need to feel like an interpretive healer in the face of their patients' more immediate need to be listened to. Rodrigo alerts us to the risks of colluding with patients' binary view of the world and recommends helping them recognize that "the therapist may not always be on their side or share their perspective" - this is the creative challenge of supportive work. We close with his sharing with us his personal journey and his appreciation that psychoanalysis can be meaningful as well in settings 'off the couch'. Our Guest: Rodrigo Sanchez Escandón Trained as a Clinical Psychologist in Mexico City and completed his Psychoanalytic Psychotherapy training at the Mexican Psychoanalytic Association before moving to London to undertake further psychoanalytic training at the British Psychoanalytic Association (BPA). He is currently the BPA's Director of Curriculum Subcommittee. He is also the Course Lead for Adult Psychotherapies at the Tavistock and Portman NHS Foundation Trust, overseeing programmes in London and the North of England. He previously lectured in the Department of Psychosocial and Psychoanalytic Studies at Essex University, where he continues to supervise PhD students and pursue research. For seven years, Rodrigo worked extensively with individuals experiencing homelessness and complex needs, integrating psychoanalytic approaches into multidisciplinary care. He now maintains a private practice in Leeds, alongside his teaching and leadership roles. Recommended Readings: Winston, A., Rosenthal, R. N., & Roberts, L. W. (2020). Evolution of the concept of supportive psychotherapy. In Learning supportive psychotherapy: An illustrated guide (pp. xx–xx). American Psychiatric Association Publishing. Winston, A., Rosenthal, R. N., & Roberts, L. W. (2020). General framework of supportive psychotherapy. In Learning supportive psychotherapy: An illustrated guide (pp. xx–xx). American Psychiatric Association Publishing. Hellerstein, D. J., Rosenthal, R. N., Pinsker, H., & Klee, S. (1994). Supportive therapy as the treatment model of choice. American Journal of Psychotherapy, 48(1), 80–93. Sanchez Escandon, R. (2025). Introduction to the fundamentals of supportive therapy. In Contemporary developments in supportive therapy: Principles and Practice. Palgrave. Sanchez Escandon, R. (2025). Active and passive use of the transference. Contemporary developments in supportive therapy: Principles and practice. Palgrave.

Jonathan Shedler, clinical professor and psychoanalyst known for work on psychodynamic therapy and the SWAP assessment, speaks about making analytic ideas jargon-free. He explores how childhood templates shape adult relationships. He explains unconscious mental life, protections and disavowal, and how therapy slows processes so patterns can be noticed and changed.