Thursday Clinical Training 2021/22

AUTUMN TERM

Philip Hill

October 14th, 2021
Freud and Lacan clinical teaching

Affect, insight, reality and psychosis.What clinical value do ‘affect’, ‘insight’ and ‘reality’ have, and what is their relation to the ego? What is diagnostically distinctive in Freud, Lacan and other schools? How should we work with psychosis, and distinguish it from neurosis and perversion? We will use Freud’s case of President Schreber.
Reading:Essential: Freud, The Case of Schreber:
https://www.sas.upenn.edu/~cavitch/pdf-library/Freud_PsychoanalyticNotes_Schreber.pdf
Desirable: Using Lacanian Clinical Technique, an introduction. This is available online without cost from:
https://www.researchgate.net/publication/ 343988905_Using_Lacanian_Clinical_Technique_an_introduction
Pages 89-122
Schacter and Singer, Cognitive, Social and Physiological Determinants of Emotional State, Psychological Review, 69, 379-399, 1962.You can find this on: https://web.mit.edu/curhan/www/docs/Articles/15341_Readings/Affect/required_reading/ 1Schacter_SInger_1962_Cognitive_social_and_physiological_determinants_of_emotional_state.pdf

October 21, 2021

Hysteria: demand and desire, love and freedom

Reading:Essential: Using Lacanian Clinical Technique, an introduction. Pages 131-137 Desirable:. Does the Woman Exist? Paul Verhaeghe, Rebus Press, 1996.

October 28, 2021

The impossible loves of Freud’s Ratman:Obsessional Neurosis asan infinite series of incomplete proofs
Reading:Essential:
The Ratman, Freud, A Case of Obsessional Neurosis:
http://www.mhweb.org/freud/ratman1.pdf
Desirable:Using Lacanian Clinical Technique, an introduction. Pages 138-163

November 4th, 2021

Two opposing theories of Interpretation and Truth:Plato-Jung-Klein vsAristotle-Freud-Lacan.
Reading:Essential:
The Last Days of Socrates, Plato: https://www.gutenberg.org/files/13726/13726-h/13726-h.htm Desirable:THE STATE OF THE SUBJECT AND THE SUBJECT OF THE STATE IN PLATO AND KLEIN
https://www.academia.edu/33965228/ THE_STATE_OF_THE_SUBJECT_AND_THE_SUBJECT_OF_THE_STATE_IN_PLATO_AND_KLEIN_doc
Plato, The Republic, trans Cornford, Oxford, 1941.Plato, The Last Days of Socrates, Penguin, trans Tredennick, 1965Using Lacanian Clinical Technique, an introduction. Pages 212-34

November 11th, 2021

Risk and Ethics.What is the difference between a traffic warden and a psychoanalyst? What risks exist in the clinic? What should a clinician do and when? Towards answering this we will distinguish ‘tactics, strategy and policy’ with reference to ‘need, demand and desire’, and hopefully damage the distinction between technique and ethics.Reading:Essential:
Using Lacanian Clinical Technique, an introduction. Pages 46-87, 346-366 Desirable:
Lacan J, The Ethics of Psychoanalysis, The Seminar of Jacques Lacan, ed Miller, trans Porter, 1992.
What can we trust? Who do we turn to? Five seminars examine contemporary anxieties around the practice of psychoanalysis.
Clinicals Barbara Cawdron

November 18 Peter Nevins
Safeguarding

How can a psychoanalytic association discharge its responsibilities around demands for safeguarding? What resources can an analyst in private practice draw on when issues arise that cannot be contained within the frame? Is safeguarding an appropriate or even safe procedure when faced with the fears and dangers of borderline and psychotic phenomena?

November 25 Keith Armitage
Care

In this seminar, we will look at what happens when psychotherapeutic care and responsibility goes adrift and the complexity of factors and motivations that might be involved. As our texts, we will discuss the published decisions in a number of recent hearings brought against psychoanalytic psychotherapists through the UKCP’s Complaints and Conduct Process under the Code of Ethics. I will share these documents ahead of the seminar.

December 2 Barbara Cawdron
The Frame

Working with people who present with risky behaviours such as self-harming, suicidal ideation, severe eating disorders and violence to others can be very disturbing and difficult to respond to. They often occur where there is a history of complex early trauma and abuse. In this seminar we will consider the way that the traditional psychoanalytic frame of the work may need to berethought in these circumstances. Responses may be to extend the frame, having contact outside of the therapeutic hour, or to stick tightly to it, as a ‘container’ for unbearable thoughts and anxiety. When, and how, would you break the frame? Oakley gives a vivd account of her work with a patient that extends the boundary of the room, and Winnicott writes about the form and function of the frame and how it can act as an invitation to regression. I shall bring clinical examples from my NHS work.Haya Oakley (1989) Touching and Being Touched, The Negotiated boundaries and the ‘extended’ consulting room, in Thresholds between philosophy and psychoanalysis: Papers from the Philadelphia Association
Winnicott (1955 ) Metapsychological and Clinical Aspects of Regression Within the Psycho- Analytic Set-Up, International Journal of Psycho-Analysis 36:16-26 (available on PEP Web)

December 9 Eric Harper
Suicide

In this seminar we will consider different ‘reasons’ and meanings attached to thoughts of wanting to end one’s life. We will discuss the differences between ‘dark thoughts’, impulsivity and immediate risk. We will explore potential risk indicators and risk management. Lastly, we will discuss the importance of a support network when working with clients deemed to be high risk.

December 16

Plenary

The practice of psychoanalysis and a training in psychoanalysis brings upheaval and risk to all parties: patients, trainees, institutions. In this plenary session, we want to explore together our varied experiences of that upheaval and to reflect and learn from it and to think about our obligations of care for each other.

SPRING TERM 2022

Jan 13 20 27, Feb 3 10

Peter Nevins

The aim of these five seminars is to explore how to bring a different sensibility to pour psychoanalytic work. We will do this by exploring the of phenomenology and pragmatism. Tracing the practical consequences of the issues that our patients bring to us is the heart of the matter, and what they want to do about it seems to me to be the conversation that takes place much of the time.

Allowing ourselves and our patients to be open to a variety of possibilities without being bound by own or our patients’ habits. The habits that make up our identity as psychoanalysts can be questioned and are not set in stone.

This pragmatism will be conjoined with Merleau-Ponty’s ‘The Phenomenology of Perception’ for inspiration when considering the perceptual practices involved in our understanding of our patients that can hidden from view and thus inaccessible to critical reflection.

Reading list Week one

Merleau-Ponty M. Phenomenology of Perception, Introduction: Traditional Prejudices and the return to Phenomena pg 3 – 66. Routledge and Kegan Paul (1962) translator Colin French. ISBN 0415-04556-8

Week two

Rorty R. Consequences of Pragmatism, Chapter 9 Pragmatism, Relativism, and Irrationalism. University of Minnesota press, (982) ISBN 0-8166-1064-9

Week three

Ahmed S. Queer Phenomenology, Chapter 2 Sexual Orientation. Duke University Press (2006) ISBN 978-0-8223-3914-4

Freud S. The Psychogenesis of a Case of Homosexuality in a Woman, The Standard Edition of the Complete Psychological Works of Sigmund Freud, (1920) also on pep-web

Week four

Merleau-Ponty M. Phenomenology of Perception, Part Two, Other Selves and the Human World pg 346 – 369. Routledge and Kegan Paul (1962) translator Colin French. ISBN 0415-04556-8

Week five

Rorty R. The Rorty Reader, Part 3 Chapter 14 Freud and Moral Reflection: Wiley Blackwell 2010 ISBN 978-1-4051-9832-5

All will be made available in PDF form via a dropbox link

Feb 24, March 3 10 17 24 Stephen Gee

Countertransference and it’s controversies

From the early 1950s a proliferation of theorisations elaborated ‘the Countertransference’ as a key to the analyst’s sense of the patient’s state of mind in the session. With this came an orientation to the ‘hic et nunc’ of the session over and above a tracing back of the symptom in the patient’s history. Lacan started a rearguard battle

against this trend as part of his insistent return to Freud. The current situation is complex. Positions that were once calls to arms defending theoretical and clinical turf are no longer held with such conviction. This can make finding one’s own way as an analyst more challenging and possibly more interesting. As the title of these seminars indicates, clinical advances in psychoanalysis are overdetermined but one element is trauma, particular with regard to the subjectivity of the analyst in her/his own historical time and place.

Alongside specific clinical developments throughout the 20th century there were expansive critiques of psychoanalysis which had a bearing on clinicians lives and approaches to work particularly with respect to the transference. Not least of these critiques were what might be described as feminist returns to Freud. Particularly illuminating are authors Jane Gallop in ‘Feminism and Psychoanalysis’ and Juliet Mitchell in ‘Psychoanalysis and Feminism’ .

Starting with Bion’s attempt to create a basis for the transformations particular to the psychoanalytic situation we will consider what might be implied in a treatment without desire or memory. We will go back to Freud and consider the case of Dora and the subsequent critiques. We will also study a case presented by Meira Likierman and discussed by Jessica Benjamin, Malcolm Slavin and Stephen Seligman. It vividly describes a creative tension between post kleinian and relational psychoanalytic practice.

Really good background is Adrienne Harris’s video on pep-web in which she makes interesting links between analytic impasses and the melancholia of the analyst.

Marilynne Robinson’s chapter ‘The Freudian Self’ in her name book of essays ‘Absence of Mind’ provokes further questions about psychoanalysis, and what psychosexual theory might be trying to do for its author in fin de siècle anti-semitic Vienna.

Reading Week 1

Attention and Interpretation, Chapter 4 ‘Opacity of Memory and Desire’, Bion W R

On Counter-Transference, Heimann P 1950 Playing and Reality,

Chapter 5 (section: Clinical Data), Winnicott D W

Weeks 2 and 3

Fragment of an Analysis of a Case of Hysteria, Freud S 1905 Feminism and Psychoanalysis, Chapter 9 ‘Keys to Dora’ Gallop J 1982

Weeks 4 and 5

Psychoanalytic Dialogues 2006 Issue 4

Unconscious Experience: Relational Perspectives Likierman M Followed by commentaries by Benjamin, Slavin, Seligman and Likierman’s reply to commentaries.

Background

Video ( pep-web) Adrienne Harris on ‘You Must Remember This’ Psychoanalytic Dialogues 2009

Absence of Mind, Chapter 3 ‘The Freudian Self’ Robinson M 2010

TRAINING WEEKEND April 23/24

Anastasios Gaitanidis

“It is not a matter of fact; it is the fact that matters” Empirical Research and Psychoanalysis

Most of the empirical research carried out in the field of psychotherapy and psychoanalysis today is influenced to a greater or lesser degree by the 20th Century ‘positivistic’ paradigm as it is believed to be the only one which can confer to them the status of ‘science’. Thus, the goal of most current empirical therapeutic research is to construct an objective and systematic foundation for therapeutic knowledge based on ‘facts’. These facts are given directly, or indirectly, in sensory observation and experimental investigation and are the only objects of knowledge.

The world of ‘facts’ appears to be the ultimate arbiter of what constitutes valid therapeutic ‘knowledge’. This creates a structure of knowledge and a type of therapeutic ‘reality’ which is as fixed, rigid, and dogmatic as the religious views and superstitions that Hume’s sceptical empiricism tried to combat. Any form of ‘unverifiable’ knowledge (i.e., the notion of ‘the unconscious’) or imaginative speculation which is not based on ‘facts’ – or cannot be manualised and/or operationalised – is discarded as irrelevant or superfluous. This produces a form of thought censorship and intellectual constipation which is counter-productive to a therapeutic environment which promotes creativity and imagination.

Under the pretext of examining the empirical relevance of the suitability of multiple therapeutic truths and approaches for different patients, a hidden agenda is promoted which privileges one type of (hegemonic) truth/discourse over and above any single therapeutic truth – the truth of empirically verifiable ‘facts’. What is forgotten in this quest for empirical ‘facts’, is that facts cannot be seen in isolation but only as aspects of a total personal and social context caught up in the process of historical change.

Thus, the current emphasis on evidence-based practice cannot be perceived only as a ‘neutral’, ‘objective’ process which independently validates the appropriateness and effectiveness of certain types of therapy. It also needs to be seen as a moment/ aspect of the general neo-liberal tendency to privilege certain practices – the ones that better serve its ideological objectives – and exclude others which seem to function against these objectives. In this respect, one needs to be suspicious of therapeutic approaches which are proven to be ‘too effective’.

References

Gellner, E. (1992). ‘Psychoanalysis, Social Role and Testability’, in W. Dryden and C. Feltham ( eds.), Psychotherapy and its Discontents. Milton Keynes: Open University Press.
Steiner, R. (1995). ‘Hermeneutics or Hermes-mess?’International Journal of Psycho-Analysis, 76.
Flax, J. (1981). ‘Psychoanalysis and the philosophy of science’, Journal of Philosophy, 78.
Flax, J. (1990) Thinking Fragments. Berkeley: University of California Press.

SUMMER TERM

Oedipus complex

May 5, 12,19, 26 (Francesca Joseph and Suzanne Adebari)

9 June (Stephen Gee and Suzanne Adebari)

Rosebud? Maybe it’s something he couldn’t get or something he lost”

Orson Welles (Citizen Kane 1941)

We will be reading Analysis of a Phobia in a Five-Year-Old Boy alongside references from Literature and Cinema together with clinical material as a means of exploring the Oedipus complex and the abundance of fascinating questions and controversies it has generated throughout the history of psychoanalysis.

We will ask you to watch some films nearer the time. We will be sending you supplementary reading material in the New Year. In the first instance please read Analysis of a Phobia in a Five-Year-Old Boy Volume X. (1909)

You may also find any of the following papers by Freud useful:

Three Essays on Sexuality. SE volume VII (1901-1905)
The Dissolution of the Oedipus Complex SE volume XlX (1924)
Some Psychical Consequences of the Anatomical Differences Between the Sexes. SE volume XIX (1925)

June 16 23 30 James O’Neill

Clinical: Stephen Gee

James O’ Neill will explore with us the intensely emotional themes and issues raised for us as contemporary psychoanalysts in his book ‘Undressing’. Please order a copy (link attached). We will all read it in class and bring to life the clinical journey James O’Neill shared with his patient over a period of twelve years.

Undressing

https://www.amazon.co.uk/dp/1780723946/ ref=cm_sw_r_awdo_5FKVC65QQBEFBYFZX7G8

July 7 14

Peter Nevins and Geraldine Ryan

The Free Clinic

In these two seminars Geraldine Ryan and I will be presenting the histories of our own charities provision of free psychotherapy to Irish Immigrants, people with mental health problems and LGBTQ+ refugee and Asylum seekers. We will also be looking at the following texts:

Week 1: 7th July

Freud’s free clinic: Columbia University Press; Illustrated edition (31 May 2007)

ISBN-978-0231131810: Introduction and Chapter 1: Treatment will be free

Week 2 : 14th July