I was so moved by our ACAP graduation on October 18 and therefore I doubly rejoiced in the recent New York Times articles on the work we are so proud of doing. (http://opinionator.blogs.nytimes.com/author/christopher-bollas/ and
Working with schizophrenics and borderline patients, along with all the other vulnerable populations we respect and serve, is the heart of modern psychoanalytic training and the foundation of students’ progress toward graduation.. What characterizes the experience of modern psychoanalysis? I believe modern analytic training is characterized by gentleness, fierceness, and liveliness.
There is a gentleness in the work as we protect the defenses of the patient and student. Therapists are taught to provide no sharp edges to the patient but to allow the patient to experience the therapist as a mirror or as part of the self or even as not there and as if alone in the room. This gentleness can also be a quiet period as the therapist learns to follow the contact function (which involves following the lead of the patient, not directing, but consulting the patient).
What is the fierceness we see? This occurs when the therapist is taught to intervene and to enjoy the aggression of the patient as well as their own energy and aggression. To echo the importance of expressing feelings often turned against the self, the faculty encourage the student’s perceptions and join them in an accepting and curious way. If the patient sees himself as inadequate or hopeless, the therapist is encouraged to accept this view and become curious about this stance. In parallel fashion, if criticized by the student, teachers are curious about how they had a bad effect and failed the student.
There is a fierceness in allowing the patient and student to experience negative feelings about the self and toward others. While reading the fascinating article by Bollas, I wondered if the positive comments he made about the patient’s functioning did not set off her regression. Fiercely allowing the patient’s negative perceptions while building ego strength requires a brave commitment to uncomfortable feelings in oneself and others. By the way, these feelings can be grandiosely positive as well as negative. Students learn to fiercely welcome all emotions no matter how uncomfortable or outrageous.
And now for liveliness. I think what helps prevent burnout in the work we do is that there is fun and a lightness about the most serious of topics. One can discuss aggressive fantasies or wishes for murderous activities with a humorous shape and tone. Walk past ACAP/BGSP-NJ classes in Livingston, New Jersey, and hear laughter and fun. The ability to turn discomfort into acceptance of one’s difficult feelings and thoughts creates a liveliness in our endeavor.
We like to think of the ripple effect of our educational experience. If we teachers and supervisors are doing our jobs properly, not only is the student maturing and developing better ways to work with patients, they are learning to help their students or bosses, even teenagers and spouses.
As teachers at ACAP, we have spent decades treating and training clinicians to help our more seriously mentally ill patients and their families. That the ACAP community celebration of our graduates occurred while the New York Times presented accounts in recognition of the commitment to treat and even “cure” the severely mentally ill seems a fitting reward for our commitment to our mission and a way to honor our students.
I am delighted and moved by our graduates’ achievement and by how the media conspired to celebrate their creative learning by showing that the more seriously disturbed patients could be helped to develop productive coping styles and can benefit from the gentleness, fierceness and liveliness of a well-trained modern psychoanalyst.