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Psychoanalysis On and Off the Couch

Psychoanalysis On and Off the Couch

By: Harvey Schwartz MD
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 Psychoanalysis applied outside the office. Alternative & Complementary Medicine Hygiene & Healthy Living Psychology Psychology & Mental Health
Episodes
  • Care of a Former Analysand with Dementia with Maxine Anderson, MD (Seattle, Washington)

    Care of a Former Analysand with Dementia with Maxine Anderson, MD (Seattle, Washington)
    May 18 2025
    “I think that my analytic awareness of denial and projection and the concreteness of psychic reality when executive function wanes, that I could help the other caretakers to understand some of what was going on - to give them a way to understand that relieves their sense of frustration and uncertainty. I think that the analytic awareness of denial, of projection, that these things are not generally recognized by many caretakers, but it does reorient and make the caretaking function much more tolerable. It expands the understanding of what goes on in the waning personality. I also think that analytic work fosters the capacity to tolerate ambiguity, uncertainty, pain and frustration and in that way may allow us, the analytic mind, to tolerate some of the intense affect - as sort of the phrase I love from an Italian analyst, as “writings waiting to be completed” - by the analytic mind. We can hold and metabolize the difficulty and offer that kind of function rather than unpleasantness just to be rid of. These are some of the things that I felt are useful as a psychoanalyst.” Episode Description: We begin with describing how dementia is a cloud over our field both for individuals and for institutes. Maxine then introduces us to 'Sally' who was her analysand 40 years prior to recontacting her to care for her cognitive decline. Maxine mentions that just hearing her former patient's voice instantly brought alive her past experiences with her. We discuss how she approached the issue of caring for her and her neurological condition. We consider the at times overlap between psychogenic and organic symptoms and she shares with us her countertransference experiences of herself losing her memory. Maxine also shares her approach to answering Sally’s questions about the possibility of recovering. We close with her describing how she feels that being an analyst aided her care of Sally and what she learned from that experience that she brought to her other patients -"to face the pain of difficult truths." Our Guest: Maxine Anderson, MD, is a training and supervising analyst at the Northwestern Psychoanalytic Society and Institute, the Seattle Psychoanalytic Institute and Society and the Canadian Psychoanalytic Society. Originally trained in psychiatry, she pursued psychoanalytic training in Seattle in the early 1970s and then pursued post-graduate work at the British Psychoanalytical Society for 8 years, returning to Seattle in 1992. Thereafter, she became a Founding Member of the Northwestern Psychoanalytic Society and Institute. Maxine has published several articles, and chapters and 3 books, the most recent being The Hardest Passage: a psychoanalyst accompanies her patient’s journey into dementia (Karnac, 2025). Feeling herself now to be an Elder in life and in her field, Maxine hopes to continue to think and write about this phase of personal and professional life. Recommended Readings: Balfour, A. (2007). Facts, phenomenology, and psychoanalytic contributions to dementia care. In: R. Davenhill (Ed.) Looking into Later Life: a psychoanalytic approach to depression and dementia in Old Age. (pp. 222–247). London: Routledge, 2007. Davenhill, R. (Ed.) (2007) Looking into Later Life. A Psychoanalytic approach to Depression and Dementia in Old Age. London: Karnac. Davenhill, R. (2007). No truce with the furies: issues of containment in the provision of care for people with dementia and those who care for them. In: R. Davenhill ( Ed.), Looking into later life: a psychoanalytic approach to dementia and depression in old age. (pp. 201-221). London: Routledge. Evans, S. (2008). “Beyond forgetfulness”: How psychoanalytic ideas can help us to understand the experience of patients with dementia”. Psychoanalytic Psychotherapy, 22(3):155–176. Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Milton Keynes: Open University Press. Malloy, L (2009). Thinking about dementia – a psychodynamic understanding of links between early infantile experience and dementia. Psychoanalytic Psychotherapy, 23(2): 109–120. Plotkin, D. (2014). Older adults and psychoanalytic treatment: It’s about time. Psychodynamic Psychiatry, 42(1): 23–60. Sherwood, J. (2019). Dementia: childhood and loss. In White, K. Cotter, A. & Leventhal, H. (Eds.), Dementia: An Attachment Approach. London: Routledge.
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    56 mins
  • Before 'Ghosts' become 'Ancestors' with Shalini Masih, PhD (Worcestershire, UK)

    Before 'Ghosts' become 'Ancestors' with Shalini Masih, PhD (Worcestershire, UK)
    May 4 2025

    “All of this together shaped how I began to think about mind, not as something to be mastered, but as a landscape of the unspoken whether it was ghosts or griefs or desires that were hard to relinquish. I saw that the ghost was not always an ‘other’. It was often intimate, tied to lost ones, sometimes to unmet desires, to unbearable longings, but in some ways possession was an attempt to keep close what was slipping away. The ghost doesn't just haunt, it feels as if it wants something, and we just have to learn to develop ears to listen to what it wants.”

    Episode Description: We acknowledge Loewald's concept of 'ghosts becoming ancestors' and consider the similarities and differences with those who hold 'ghosts' to be literal. Shalini shares with us her journey to open herself to the uncertainty and ambiguity of these externalized entities while appreciating both their cultural and intrapsychic sources. We learn of her family's involvement with exorcisms, especially her grandmother's "fearless warmth" and "empathy that saw beyond the terror of the ghosts." She considers the many facets of mind that are represented by 'ghosts' and the essential value of approaching them as guides to the "landscape of the unspoken." Shalini describes a long term engagement that she had with an individual who "taught me to receive the inchoate and horrific...to contain the brokenness and not interpret it away.. and to appreciate the glimpses of beauty in the most grotesque parts of self."

    Our Guest: Shalini Masih, a psychoanalytic psychotherapist and writer, grew up in India amidst priests and healers, witnessing spirit possession and exorcism. Now based in Worcestershire, UK, she holds a Master’s degree in Psychoanalytic Studies from Tavistock & Portman, London, and a PhD from the University of Delhi. Mentored by psychoanalysts Michael Eigen and Sudhir Kakar, she’s an award-winning scholar of the American Psychological Association. She has taught and supervised psychoanalytic psychotherapists in Ambedkar University, Delhi and in Birkbeck, University of London. Her acclaimed paper, 'Devil! Sing me the Blues', was nominated for Gradiva Awards in 2020. Her debut book is Psychoanalytic Conversations with States of Spirit Possession: Beauty in Brokenness.

    Recommended Readings:

    Kakar, Sudhir. Shamans, mystics, and doctors: A psychological inquiry into India and its healing traditions. Chicago, IL: University of Chicago Press, 1991.

    Kakar, Sudhir. Mad and Divine. India: Penguin Books India, 2008.

    Eigen, Michael. “On Demonized Aspects of the Self” In The Electrified Tightrope. Routledge. 2018.

    Kumar, Mansi, Dhar Anup & Mishra, Anurag. Psychoanalysis from the Indian Terroir: Emerging Themes in Culture, Family, and Childhood. New York:Lexington Books, 2018.

    Meltzer, Donald, and Williams, Meg H. The apprehension of beauty: The role of aesthetic conflict in development, art and violence. Karnac, London: The Harris Meltzer Trust, 2008.

    Obeyesekere, Gananath. Medusa’s Hair: An Essay on Personal Symbols and Religious Experience. Chicago, IL: University of Chicago Press, 1981.

    Ogden, Thomas. This Art of Psychoanalysis—Dreaming Undreamt Dreams and Interrupted Cries. East Sussex: Routledge, 2005

    Botella, Cesar, and Botella, Sara. The Work of Psychic Figurability: Mental States without Representation. Brunner-Routledge. Taylor and Francis Group: Hove and New York. 2005.

    Winnicott. Donald W. “Transitional objects and transitional phenomena.” International Journal of Psycho-Analysis, 34, (1953): 89–97
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    59 mins
  • Candidates' Reflections on their Psychoanalytic Training with Himanshu Agrawal, MD (Milwaukee, Wisconsin)

    Candidates' Reflections on their Psychoanalytic Training with Himanshu Agrawal, MD (Milwaukee, Wisconsin)
    Apr 20 2025

    “The theme that I found with IPSO [International Psychoanalytical Studies Organization] was that there was a common theme [in psychoanalytic training]. There was an initial phase full of terror and excitement, and then a middle phase of maybe some lethargy or apathy or disillusionment. In that middle phase, many candidates found IPSO, or IPSO found them, where they found refuge. They found solace. They found community, not just at their local institutes, but at this kind of world market. Many of the candidates talk about what a timely and wonderful experience it was to be seen, to be validated by fellow candidates in a way that only fellow candidates can do. At least a couple of the authors have written about how they were delighted to see that more than anything else we are similar as human beings, no matter where we're from.”

    Episode Description: We begin with recognizing the deep attachment that many analytic candidates have about their training experiences, which includes affections and resentments. Himanshu outlines the process of reaching out to candidates globally, inviting them to share their reflections on their journeys. We read from a sampling of their essays that eloquently describe their idealizations and de-idealizations, their delights and their burdens, their profound regard for the mysteries of the mind and the appreciation of the power of psychoanalysis to engage with it. We discuss the importance of IPSO, the difficulties associated with Covid and the relevance of our field's traumatic origins. Himanshu closes with sharing his story of encountering an insightful analytic supervisor during his residency and declaring "I want to be like him."

    Linked Episode:Episode 89: Wisdom and Enthusiasm for Today’s Candidates with Fred Busch, PhD

    Our Guest: Himanshu Agrawal, MD is an adult and child psychiatrist and recently completed psychoanalytic training through the Minnesota Psychoanalytic Institute. He is an associate professor of psychiatry and behavioral medicine at the Medical College of Wisconsin in Milwaukee where he sees patients, conducts research, and teaches. He recently completed his term as the president of the candidates’ council of the American Psychoanalytic Association

    Recommended Readings:

    Busch F (Ed), Dear candidate. Routledge, 2020

    Agrawal H, Trials and Tribulations of being a candidate. The American Psychoanalyst, winter 2022

    Kernberg O, Thirty methods to destroy the creativity of psychoanalytic candidates. International Journal of psychoanalysis, 77, 1031- 1040
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    49 mins

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