I n Italy, everybody is Catholic, even the Protestants. Jay Greenberg, one of the founders of Rel... more I n Italy, everybody is Catholic, even the Protestants. Jay Greenberg, one of the founders of Relational psychoanalysis, uses this quip to evoke the climate of American psychoanalysis in the 1970s and early '80 s. The Mother Church was Ego Psychology; its knights were the vast majority of American psychoanalysts, trained in classical technique, loyal to its magic, hostile to heresy (Greenberg & Aron, 2018) and quick to identify as "not psychoanalysis" anything that didn't center on drives, adaptation and intrapsychic conflict. In 1983, Greenberg and Stephen Mitchell published Relational Concepts in Psychoanalysis, which presented an alternative to Ego Psychology-one that didn't do away with the unconscious, but that organized the story around human beings: Where drives had been now there were people, out in the world and inside the patient's mind. And where classical technique (reticent, authoritative, theorydriven) had been, now there was an analyst skeptical of his own authority and striving not for interpretive accuracy but for authenticity and emotional connection between analyst and patient. Outside Greenberg and Mitchell's community at NYU PostDoc, the book was greeted with brickbats. At the Freudian institutes uptown,
Psychoanalysts in North America have mostly rejected the theory that homosexuality in men is "cau... more Psychoanalysts in North America have mostly rejected the theory that homosexuality in men is "caused" by developmental arrest. Most have also rejected the belief that the Oedipus Complex is the main determinant of adult sexuality (a belief that used to be the very foundation of psychoanalytic thinking). Today's "gay-friendly" psychoanalysts deplore the mid-20th-century analysts who, in the name of bedrock Freudian principles, pathologized homosexuality and believed they could "cure" it. However, the author argues, this wholesale expulsion of a giant body of mainstream theory has two downsides: It pressures us to fudge our clinical perception when we encounter that rare patient who actually does fit the profile of the "sick" homosexual of the past. And it lets us elide the likelihood that fashionable moralism and self-interest may still be distorting our clinical judgment today. I begin with a story about keeping a secret from a supervisee: Several years ago I supervised the first year of treatment of a young man whose presenting complaint was "a problem with incompletes." Eric, the patient, had been referred for therapy to avoid expulsion from college; in two years he had finished fewer than one-third of his courses. "I've always been this way," he told his therapist. "I know I have the talent to do really well but I have zero motivation to work at anything. I start every semester with enthusiasm-like, THIS is going to be the semester I really shine! But then somewhere around week 4 I get bored, or frustrated, and something sets in where I just stop going to class." Something similar happened in his close relationships: He would lose interest in friends, and his one important romantic relationship-a girlfriend he was together with for two years-was "sort of in a twilight state at this point. I know I don't want to break up with her, but it hasn't really felt like a romance since the first few weeks." The therapist treating him at the college clinic was perplexed. "I can't figure out what makes Eric tick," she said a few times. We set about trying to figure out what Eric DID care about: He had reported being treated in high school for "major reactive depression" triggered when a foreign student whom he had become close friends with moved back to Ecuador. "Boy or girl?" I asked the therapist. "Boy." And what classes has he passed? "Dramatic arts," she said. "It's his minor." "Could Eric be gay?" I asked the therapist. "I've brought up the possibility," the therapist said. "He denies it. He says he's uncomfortable around gay people-he was in a gay bar once and he panicked. He felt that all the men around him would want him to 'be the girl.'" In addition, there was no reason to believe that Eric would keep it a secret: He had a gay brother, 15 years older, who had been out "forever" and who was accepted and beloved by both parents. About a year into the treatment the patient mentioned that he was in the habit of carrying a knife-every day at school and almost any time he left the house. The therapist asked why, and the patient launched into a complex matrix of evasions that boiled down to paranoia and preoccupation with
This essay is an individual reflection on an aspect of the analyst’s personal history of loss and... more This essay is an individual reflection on an aspect of the analyst’s personal history of loss and developmental trauma, as well as part of a theoretical exploration of the unconscious forces always at play in analytic work. Reflecting on loss and disappointment in the father–son dyad of the past leads to a greater sense of freedom and appreciation for the present.
Abstract Many workers in HIV-prevention and mental health have feared that publicity surrounding ... more Abstract Many workers in HIV-prevention and mental health have feared that publicity surrounding new drugs for treating HIV would cause HIV-negative gay men to lapse from safer sex. However, a recent informal survey of health workers and therapists in New York City suggests that although information about the new drugs has shifted the thinking of many negative men, it hasn't changed their behavior a great deal as yet. Anecdotal evidence of minor behavior change is described, along with medical data concerning how dangerous unsafe sex with an infected person undergoing combination drug therapy may be.
I n Italy, everybody is Catholic, even the Protestants. Jay Greenberg, one of the founders of Rel... more I n Italy, everybody is Catholic, even the Protestants. Jay Greenberg, one of the founders of Relational psychoanalysis, uses this quip to evoke the climate of American psychoanalysis in the 1970s and early '80 s. The Mother Church was Ego Psychology; its knights were the vast majority of American psychoanalysts, trained in classical technique, loyal to its magic, hostile to heresy (Greenberg & Aron, 2018) and quick to identify as "not psychoanalysis" anything that didn't center on drives, adaptation and intrapsychic conflict. In 1983, Greenberg and Stephen Mitchell published Relational Concepts in Psychoanalysis, which presented an alternative to Ego Psychology-one that didn't do away with the unconscious, but that organized the story around human beings: Where drives had been now there were people, out in the world and inside the patient's mind. And where classical technique (reticent, authoritative, theorydriven) had been, now there was an analyst skeptical of his own authority and striving not for interpretive accuracy but for authenticity and emotional connection between analyst and patient. Outside Greenberg and Mitchell's community at NYU PostDoc, the book was greeted with brickbats. At the Freudian institutes uptown,
Psychoanalysts in North America have mostly rejected the theory that homosexuality in men is "cau... more Psychoanalysts in North America have mostly rejected the theory that homosexuality in men is "caused" by developmental arrest. Most have also rejected the belief that the Oedipus Complex is the main determinant of adult sexuality (a belief that used to be the very foundation of psychoanalytic thinking). Today's "gay-friendly" psychoanalysts deplore the mid-20th-century analysts who, in the name of bedrock Freudian principles, pathologized homosexuality and believed they could "cure" it. However, the author argues, this wholesale expulsion of a giant body of mainstream theory has two downsides: It pressures us to fudge our clinical perception when we encounter that rare patient who actually does fit the profile of the "sick" homosexual of the past. And it lets us elide the likelihood that fashionable moralism and self-interest may still be distorting our clinical judgment today. I begin with a story about keeping a secret from a supervisee: Several years ago I supervised the first year of treatment of a young man whose presenting complaint was "a problem with incompletes." Eric, the patient, had been referred for therapy to avoid expulsion from college; in two years he had finished fewer than one-third of his courses. "I've always been this way," he told his therapist. "I know I have the talent to do really well but I have zero motivation to work at anything. I start every semester with enthusiasm-like, THIS is going to be the semester I really shine! But then somewhere around week 4 I get bored, or frustrated, and something sets in where I just stop going to class." Something similar happened in his close relationships: He would lose interest in friends, and his one important romantic relationship-a girlfriend he was together with for two years-was "sort of in a twilight state at this point. I know I don't want to break up with her, but it hasn't really felt like a romance since the first few weeks." The therapist treating him at the college clinic was perplexed. "I can't figure out what makes Eric tick," she said a few times. We set about trying to figure out what Eric DID care about: He had reported being treated in high school for "major reactive depression" triggered when a foreign student whom he had become close friends with moved back to Ecuador. "Boy or girl?" I asked the therapist. "Boy." And what classes has he passed? "Dramatic arts," she said. "It's his minor." "Could Eric be gay?" I asked the therapist. "I've brought up the possibility," the therapist said. "He denies it. He says he's uncomfortable around gay people-he was in a gay bar once and he panicked. He felt that all the men around him would want him to 'be the girl.'" In addition, there was no reason to believe that Eric would keep it a secret: He had a gay brother, 15 years older, who had been out "forever" and who was accepted and beloved by both parents. About a year into the treatment the patient mentioned that he was in the habit of carrying a knife-every day at school and almost any time he left the house. The therapist asked why, and the patient launched into a complex matrix of evasions that boiled down to paranoia and preoccupation with
This essay is an individual reflection on an aspect of the analyst’s personal history of loss and... more This essay is an individual reflection on an aspect of the analyst’s personal history of loss and developmental trauma, as well as part of a theoretical exploration of the unconscious forces always at play in analytic work. Reflecting on loss and disappointment in the father–son dyad of the past leads to a greater sense of freedom and appreciation for the present.
Abstract Many workers in HIV-prevention and mental health have feared that publicity surrounding ... more Abstract Many workers in HIV-prevention and mental health have feared that publicity surrounding new drugs for treating HIV would cause HIV-negative gay men to lapse from safer sex. However, a recent informal survey of health workers and therapists in New York City suggests that although information about the new drugs has shifted the thinking of many negative men, it hasn't changed their behavior a great deal as yet. Anecdotal evidence of minor behavior change is described, along with medical data concerning how dangerous unsafe sex with an infected person undergoing combination drug therapy may be.
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