Introduction to Psychoanalytic Listening

Second Year Adult Psychoanalytic Training (APT)
2022-23, 1st Trimester — Fridays, 12:00-1:30pm
Katherine Weissbourd, PhD


Introduction

Welcome to “Introduction to Psychoanalytic Listening.” This course prepares you for the case conferences in which you will participate during your time as a clinical associate. In this course you will begin to experience psychoanalytic listening by sharing your clinical work in discussions with one another as students and colleagues.

There are two broad goals for this course. The first is to orient you to psychoanalytic listening as a clinical concept. Listening is foundational to psychoanalysis, and to a psychoanalytic stance. Almost all components of analytic work flow in some way from your ability to listen. As Alessandra Lemma says: “Analytic listening, unlike ordinary listening, takes place simultaneously on multiple levels and in reference to multiple contexts.” These contexts include unconscious communications, affective themes, conflicts and defenses, intrapsychic levels, attachment styles, enactments, and more.

In most case conferences you will attend at SPSI, one clinical associate per term presents an ongoing case that is discussed by everyone in the class. The presenter shares process material from the previous week, or from another selected period in the treatment. The task of the listeners in the conference is to reflect on the case, think about what is happening between the patient and the analyst from multiple viewpoints, and identify analytic process. The group discussions may include examining transference and countertransference, developmental themes, motivations, unconscious processes, and theoretical perspectives — all of the areas you will be learning about. These are the basic parameters of a case conference.

In this course, which again is an introduction, each student will present for one session, so that you can experience being both listener and presenter. The intent is to allow you to begin listening to yourselves and one another with a psychoanalytic sensibility. In our first class session, we will get to know each other, go over the format for these presentations, and decide on a schedule.

Psychoanalytic training, like analysis and therapy, is a deeply personal, intimate endeavor. It is not uncommon for students to feel exposed or judged in the classroom. But judgment and competition are not the point of a case conference. Curiosity, an openness to new experience, a sense of collegiality, and an appreciation for the vulnerability of presenters and discussants alike, can result in a rich, rewarding and creative experience.

With this in mind, the second goal of the course is to support you in beginning to establish your own unique identity as a clinical associate, and to support your cohort in developing a sense of cohesion, community and trust. You will be learning a great deal in the next four years about the history, theory and practice of psychoanalysis. You will learn a great deal about yourselves and each other. This journey requires that we listen to each other with the same respect, safety and attention that we give our patients. We can do this best when we know each other well and actively learn together.

Schedule

The majority of each class session will be taken up with your case presentations. At the beginning of each class, we will have a brief discussion about an aspect of analytic listening.

Related readings

Each week includes texts that I will be using as background for our discussions. They are for reference only, there is no required reading for the course. I will introduce them briefly at the beginning of each class.

Learning Objectives

At the end of this course, students will be able to:

  1. identify psychoanalytic themes when listening to case presentations, such as: unconscious communication, intrapsychic thought processes, and areas of affective experience and communication, for the purpose of formulating and discussing a case with peers and colleagues.
  2. describe the subjective experience of a clinical encounter to peers and teachers, in order to elicit exploration of the psychoanalytic process, with a focus on both empathy and interpretation.
  3. identify and formulate affective responses, identifications, and countertransference reactions when hearing clinical material, with the goal of making substantial contributions to discussions.

September 9, 2022 — Listening to ourselves and each other

How can we make the best use of case conferences? One of the skills that psychoanalysts develop is the capacity to tolerate complexity and to be comfortable with the unknown. We learn to listen with curiosity, and to be cautious about drawing conclusions. In case conferences  we encourage our fellow clinical associates to explore new ways of thinking about clinical material. It is important to remember that the clinical associate is the “expert” who has been in the room with the patient, having shared the clinical space and absorbed what the patient brings to treatment. It can be challenging to formulate this experience. As we listen in case conference we encourage the presenter to explore their own subjective understanding. In addition, a presenter can find other perspectives very useful, because they open up new avenues for thinking about clinical material.

Optional Reading

Freud, S. (1912). "Recommendations to Physicians Practising Psycho-Analysis" in The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913): The Case of Schreber, Papers on Technique and Other Works, pp109-120.

Kris, A.O. (2013) Unlearning and Learning Psychoanalysis. American Imago, 70:341-355

September 16, 2022 — Developing a psychoanalytic stance

What do we mean by free association and free-floating attention? The foundations of psychoanalysis are grounded in the analyst’s commitment to listen deeply to the patient’s thoughts, and to encourage the patient to speak freely. Among other things, analysts listen for changes in the direction of thoughts, gaps and silences, the symbolic use of language and images, and the patient’s level of emotional engagement in the work.

Optional Reading

Busch, F. (2016) Methods of Understanding: Revisions to a Freudian Method. Psychoanalytic Inquiry, 36:548-557

Kris, A.O. (1990) The Analyst's Stance and the Method of Free Association. Psychoanalytic Study of the Child, 45:25-41

Makari, G. & Shapiro, T. (1993) On Psychoanalytic Listening: Language and Unconscious Communication. Journal of the American Psychoanalytic Association, 41:991-1020

September 23, 2022 — Across Cultural Boundaries

[Class ends at 12:45pm due to the CAAO meeting.]

How do we stay alert to our biases in our analytic work? How can we encourage our patients to speak up if they experience bias? In this class we will address micro-aggressions, blind spots, and systemic bias.

Optional Reading

Corbett, K. (2001) Faggot = Loser. Studies in Gender and Sexuality, 2:3-28

Tummala-Narran, P. (2014). Cultural Identity in the Context of Trauma and Immigration from a Psychoanalytic Perspective. In Psychoanalytic Psychology, 31(3), pp. 396-409

September 30, 2022 — The role of the unconscious in thought processes

What do psychoanalysts mean when they use the term “the unconscious”? Traditionally, analysts used the unconscious to describe what could not enter consciousness because it was repressed. Analysts now add splitting and dissociation to describe these processes. Because analysts focus on expanding the capacity for self-reflection, we think about how and why experiences remain outside of our awareness. We work to create an atmosphere of openness and acceptance, where the “unthought known” can emerge.

Optional Reading

Stern, D.B. (1987) Unformulated Experience and Transference. Contemporary Psychoanalysis, 23:484-490

White, W.A. (1915) The Unconscious. Psychoanalytic Review, 2:12-28

Blum, H.P. (2016) Interpretation and Contemporary Reinterpretation. Psychoanalytic Inquiry, 36:40-51

October 7, 2022 — Unconscious communication

*The mid-term class evaluation will be conducted during this session. Please use these questions to facilitate your discussion: Midterm Evaluation 2019-02-13

What takes place in the developing relationship between the patient and the analyst? A caring, supportive environment facilitates nonverbal and unconscious communication, creating a “transitional” space between two subjectivities. We think of the psychoanalytic session as a shared environment, where two people communicate nonverbally as well as verbally, with a fluid connection between self and other, based on empathy and reflection.  The “analytic third” describes how the analyst’s thoughts may be a sign of unconscious affective communication, which the analyst makes available to the patient through interpretation, and at times self-disclosure.

Optional Reading

Winnicott, D.W. (1971). Chapter 1: “Transitional Objects and Transitional Phenomena” in Playing and Reality. London: Tavistock Publications, pp1-25

Kohut, H. (1959). Introspection, Empathy, and Psychoanalysis—An Examination of the Relationship Between Mode of Observation and Theory. J. Amer. Psychoanal. Assn., 7:459-483.

Kohut, H. (2010). On Empathy: Heinz Kohut (1981). Int. J. Psychoanal. Self Psychol., 5(2):122-131.

Ogden, T.H. (1994). The Analytic Third: Working with Intersubjective Clinical Facts. Int. J. Psycho-Anal., 75:3-19.

October 14, 2022 — Countertransference

How do we think and talk about the feelings we have about our patients? Psychoanalysts have become more open to acknowledging and reflecting on their emotional responses to clients, using them as important clinical information. At times, these feelings are evoked by unresolved experiences in the analyst’s present or past. At other times, they may be related to nonverbal communications from the patient, and they may lead to new insights and interpretations. Being aware of our own subjectivity, and comfortable reflecting on it, is an important part of analytic training.

Optional Reading

Winnicott, D.W. (1947). Hate in the Countertransference in Through Paediatrics to Psycho-Analysis: Collected Papers.  New York: Brunner-Mazel (1992) pp.194-203.

Abend, S.M. (2018) Countertransference and Psychoanalytic Technique: A Response. Psychoanalytic Quarterly, 87:587-589

October 21, 2022 — Trauma, attachment, and fragmented analytic process

How does trauma impact analytic process? Patients who have difficulty using free association may be impacted by past trauma. Adverse childhood experiences, both environmental and emotional, constrict the capacity to reflect, particularly when there is no one to talk to about traumatic events. A history of trauma is often enacted in analysis, when a past disruption is repeated rather than remembered. Analysts reflect on their own unexpected responses to enactments. This allows them to be attuned to ways that present experience can open up memories of past suffering.

Optional Reading

Varvin, S. (2016) Psychoanalysis with the traumatized patient: Helping to survive extreme experiences and complicated loss. International Forum of Psychoanalysis, 25:73-80

Fonagy, P. & Allison, E. (2016) Psychic Reality and the Nature of Consciousness, International Journal of Psychoanalysis, 97:5-24

October 28, 2022 — The Analyst’s Vulnerability

[Class ends at 12:45pm due to the CAAO meeting.]

What expectations do we have of ourselves as analysts, and what might be frightening about the analytic relationship? We will address the anxieties clinical associates (and also experienced analysts) often have about beginning an analysis.

Optional Reading

Ehrlich, L.T. (2004) The Analyst's Reluctance to Begin a New Analysis. Journal of the American Psychoanalytic Association, 52:1075-1093

Ehrlich, L.T. (2013). Analysis Begins in the Analyst's Mind: Conceptual and Technical Considerations on Recommending Analysis. J. Amer. Psychoanal. Assn., 61(6):1077-1107

November 4, 2022 — The unique value of psychoanalysis for the psychoanalyst

What do you hope to find in your analytic practice? As we talk about the anxieties and challenges analysts face, we should not lose touch with the satisfactions of the work that analysts do. Psychoanalysis offers a unique relationship, we connect in a deep and authentic way with our patients. In the reflective space that analysis provides, both analyst and patient learn to deepen their self-understanding and live more meaningful lives.

Optional Reading

Shulman, M. (2016) “Unavoidable Satisfactions”: The Analyst's Pleasure. Journal of the American Psychoanalytic Association 64:697-727

November 11, 2022 — Listening through our own filters and theories

Starting next term you will be presenting case material in a more detailed format. You will be revisiting the themes we have touched on, but in more depth. The last class will be an opportunity  for us to reflect on what you have learned that has been helpful to you in your clinical work. What would like to learn more about? Do you have any concerns that you would like to address?