DIRECTORS' COLUMN

By Seth Warren, PhD

As we approach the end of our academic year I would like to give the membership a brief report on some of the recent activities of the CPPNJ Board of Directors. Last month the entire Board met for a full day retreat, kindly hosted at the home of Rose Oosting, for an opportunity to address some larger strategic issues, plan for the future of our institute, and to creatively think about ways to expand our activities while maintaining a focus on our core mandate to provide excellent training in psychotherapy, psychoanalysis, and couples therapy.

We affirmed our commitment to a diverse and flexible approach in our programming, recognizing a "continuum of involvement" with CPPNJ, from casual conference attendees to full participation in the training program and administration. This model, of concentric levels of participation, acknowledges the importance of a strong central core program dedicated to psychoanalytic principles, knowledge, and training, graduated or tiered training, while recognizing the importance of contributions to wider circles of participants through programs, workshops, newsletter, etc. It was recognized that this model is likely to be successful in the current cultural and historical environment, with much greater pressures on everyone in terms of time, commitments, mobility, and reliance on technologies that have arisen in this context.

One of the topics that received special attention was the development of a new information technology initiative, and the idea of creating a new Technology and Media Committee. Discussion focused on new ways of presenting information to current and potential members, making use of available educational technology, social media, and the greater use of the Internet for administrative functions such as meetings. Rose Oosting, our Director of PR is spearheading some efforts to update our website, and making use of our website for outreach, "pay-per-view" video-conferencing, and investigating the use of distance education for some parts of our training programs. Members of the Board recognize the need to balance these new ways of reaching members and others interested in our institute with the value we place on real, personal, and human contact, and recognized that at the heart of our work is a kind of intimate engagement that is becoming more and more a thing of the past in our fast-evolving world of new technologies. We very much need individuals who can support the activities of this new committee. We will need all the human resources we can get, including the important contributions of family members who may have expertise in these areas we, as psychoanalysts, tend to lack. Please do not be shy about volunteering your own time and skills, or those of a willing spouse or child who would like to offer their expertise.

The Board also unanimously voted to proceed with the next step in moving toward the national accreditation of CPPNJ. We discussed the existing options for accrediting bodies, and strong support was expressed for investigating the process of accreditation by the Accreditation Council for Psychoanalytic Education (ACPE). I want to emphasize that the formal decision to seek accreditation was NOT made, nor will be made without ample opportunity for input from all members of our community. This is a decision that requires thought and consideration and dialogue, as it would represent a significant commitment of time, money and energy. At this stage, we have formed a committee to learn more about the process, the costs and benefits, and to understand better what the process would entail. However, we believe - regardless of the final outcome - that this process represents an excellent opportunity for self-study along with free consultation from sympathetic and knowledgeable experts in the organizational management of psychoanalytic institutes, and the result can only be a stronger CPPNJ. Anyone interested in contributing in any way to this historically important process should be in touch with me.

Another topic of importance was the Board's recognition that we want to make certain that the Institute supports and gives back to the faculty who are so vital the training process. We hope to initiate annual faculty meetings, to provide an opportunity for faculty to offer feedback, suggestions, and to express concerns. We also want to explore ways of supporting the professional development and activities of our faculty, including advertising supervision groups, non-CPPNJ training opportunities (that do not directly compete with our own programs), and to foster networking opportunities that seem essential to maintaining clinical practices in these rather challenging times.

We are continuing to work on maintaining contact with all our members across the state, both by scheduling CPPNJ events in different locations and by creating Regional Interest Groups for three geographical areas: North (Bergen County etc), North-central (Essex, Hudson, Morris, Union), and South-central (Middlesex, Monmouth, Mercer, Ocean, etc). I am in the process of appointing Regional Coordinators for each of these regions to help organize local social events, faculty workshops, and local recruiting and outreach efforts. These three coordinators will meet with the Board regularly to facilitate communication and coordinate activities. Those interested in working on regional initiatives should be in touch with me.

We discussed the ongoing topic of a "Board of Trustees" or "Advisory Board." It was affirmed that we do not wish to give up the autonomy and administrative flexibility necessary for the potential security of a traditional Board of Trustees (that would have administrative and fiduciary authority). We recognized the need for help, support, fund-raising, and organizational management that might be provided by an Advisory Board. We also noted that many of our consulting needs might also be met in an Ad Hoc way, hiring fee-for-service consultants without the structure of an advisory board. However, we agreed to pursue the creation of an Advisory Board, composed of individuals with particular interest in CPPNJ and skills in the above noted areas. We will reconvene a committee to create a procedure for screening and vetting potential candidates.

As always, I would like to end my column with a plea to all members for your involvement and participation. Our success and survival as an institute depends entirely on the energy, commitment, dedication and time of our members. While acknowledging the incredible contributions to CPPNJ made by so many in our community, it is clear that we will need new energy, perspectives, and the time and effort of volunteers to make these current projects realities. If you would like to become involved, and are not sure how, please feel free to reach out to me to discuss your interests and our organizational needs.    

Happy spring! Hope to see everyone at graduation.

On Sunday, June 2nd, as we gather to celebrate our graduates and mark the close of another academic year, we will also pause to honor Dr. Stanley Moldawsky:  an analyst whose tireless efforts on behalf of our field have touched the professional lives of so many.  Stan describes himself first and foremost as an activist who was always willing to organize and fight for what he felt was most important.  He started right from the beginning, gathering together fellow graduate students at the University of Iowa, where he earned his Ph.D., to press for a course on psychoanalysis in an otherwise decidedly non-analytic department.  An early encounter with reading Freud on a whim had convinced him that psychoanalysis was the most exciting and intriguing field of thought available; the fact that nobody was teaching it was all the more reason to gather his peers and create a brand new course to fill this gap. 

Stan describes himself as "dumbfounded by the notion of such a thing as the unconscious," and he was clearly inspired by Freud's vision that we are all much more complicated than we naively assume.  As soon as he entered the profession, a newly minted psychologist working for the Mental Hygiene Unit at the VA in Omaha, Nebraska, Stan began his analysis.  An opportunity to take a first step into the world of private practice soon presented itself.  At that time, the private practice of psychotherapy was the nearly exclusive venue of MD's, a grip they were not particularly willing to loosen.  Stan's analyst gave him 'the Interpretation':  your father is a physician, so your wish to go into private practice is an acting out of Oedipal issues.  Stan's activist nature prevailed, however.  He took the private practice opportunity and organized colleagues to form the first-ever Nebraska Psychological Association, which then went on to lobby for licensure to practice for psychologists.  Perhaps the seeds of a later, quieter activism were also sown at that time:  Stan's shift from the more authoritarian, often critical stance of the classical Freudian analyst (a description he remembers feeling defensive about:  "Moldawsky is an Oedipal analyst") to a more relational stance emphasizing connectedness, the importance of early experience and the patient's feelings about attachments.  In the Nebraska years, however, what he knew was that if you do what you are trained to do, then it's within a scope of practice worth fighting for.  "Once I was committed," Stan says, "I was committed all the way."

Back in New Jersey, Stan continued both his activism and his dedication to psychoanalysis.  He completed his analytic training in 1962 at the National Psychological Association for Psychoanalysis, and earned formal recognition as both a Training and a Supervisory Analyst by the International Psychoanalytic Association.  He became an active voice for psychology and psychoanalysis at both state and national levels.  Stan was president of the New Jersey Psychological Association in 1975, and was elected to the American Psychological Association Council of Representatives multiple times and by multiple groups from 1974-2004 (New Jersey, APA Division 12-Clinical Psychology, Division 29-Psychotherapy and Division 42-Psychologists in Independent Practice).  On the APA Council of Representatives, he was the lone voice for psychoanalysis for many years, advocating for psychoanalytic ways of thinking and practicing and facing down the empirical and cognitive-behavioral critics.  In multi-year terms, Stan served nationally as Chair of the APA Board of Professional Affairs, was elected to the APA Board of Directors, served on the APA Accreditation Committee and as president of APA Division 42.  To honor all this service and more, Governor Jon Corzine proclaimed that May 7,  2006 was "Dr. Stanley Moldawsky Day in New Jersey!"  Throughout, Stan's energies have been directed at bringing the message of psychoanalytic and psychological perspectives to the public (e.g., through APA's large-scale Public Education Campaign) and advocating for - and, in the recent New Jersey campaign for a license to practice psychoanalysis, against - licensure to practice that which we have been fully and competently trained to do.

Stan has often said that his proudest accomplishment, however, was to help create a school of professional psychology at Rutgers - the Graduate School of Applied and Professional Psychology.  "It started in my living room," he recalls, where twenty psychologists gathered together to discuss building a psychological services center, and ended up concluding that they should create a Psy.D. program instead.  Meeting twice a month for five years, they plotted, planned and raised $100,000, and in 1974 opened the doors to a new clinical psychology graduate program where Stan continued to teach in the psychoanalytic track for 14 years.  Teaching, mentoring, advocating and ambassadorship - this has been the stuff of Stan's professional passion throughout his career.

Moreover, it is still what moves him.  In thinking about the meaning of being an analyst, Stan is reminded of what one of his Rutgers graduate students once told him:  "I asked you what I should do, and you said, 'you don't do anything.  You just be.'  All I have to do now is define what that means!"   Stan attributes his shift toward a more relational stance to a number of influences.  His wife, Pat, a family therapist, urged him over the years to pay more attention to actual family relationships.  The attachment literature had a powerful impact on him:  "...how that [first relationship] goes affects the rest of your life ... It's so valuable, so important."  Above all, though, Stan observes that "I slowly became more open to it as I grew inside."

Beyond the worlds of psychology and psychoanalysis, Stan's passions have included music and sailing.  His talents as a jazz pianist, both solo and with his band, have brought music to many a psychoanalytic venue over the years.  When he says, "I've been an activist all of my life," he speaks to the vitality and optimism he has brought to work, love and play across the board.  To fight for causes and projects worth fighting for, and to open to ways of listening to patients that harness the power of understanding:  for Stan, this has always been the value of finding ways to "just be."

I want to share this recent, amazing moment in class.  Two students in particular, Gerti Schoen, LCSW and Debbie Frank, LCSW showed how creative analogies helped clarify a very complex clinical process.  Let me explain.

During the first year clinical course in the couples program, called Elements of Clinical Practice, we cover how projective identification can promote emotional gridlock in the couple.  As a teacher, I can dread these classes because I wonder if I'll be able to make this critical concept accessible to students and applicable to couple dynamics in particular.   Since it's an unconscious process of communication between two partners, students (and I at times as well) find it mystifying to explain how is it actually possible to transfer a part of one partner so that it now resides in the other.   Moreover, some experienced clinicians dismiss projective identification outright since its definition and psychic mechanisms are constantly being reworked and even devalued.

Complicating it further is that projective identification contains a kind of ruthlessness in its complexity.  If it could speak, the unconscious might say: "I want you, my partner, to take on what I don't want to experience. You won't even know I'm putting this aspect of me into you, and you won't even realize that you're willing to identify and take in my bad part that I'm projecting into you, and then here's the real kicker... I can now blame you for it!"   Maybe this is a form of the old schoolyard game "Tag-you're it," but on an unconscious level our psyche works in marvelous ways to protect us from reliving pain.  From another perspective, a partner may even use projective identification as a form of communication, in that it allows the other to actually experience what it feels like to live in the partner's subjectivity (a more interpersonal understanding of the utility of projective identification, i.e. a search for empathic connection).

So during class, I tried to provide real-life pictures of what projective identification might look like.  As an example, a wife disowns a part of herself (e.g., sexual anxieties) and projects it into her husband who unwittingly identifies with this unwanted part of his wife, introjecting his partner's sexual anxiety since there's a part of him that also is anxious about aspects of his own sexuality.  Perhaps, he now feels the angst about sexuality in the relationship and defensively, becomes an overly eager sexual pursuer.  Now that the projection has indeed taken hold inside the husband, his wife grows critical of how more sexually "urgent" he has become (e.g., "As soon as we hug, I can tell that his mind immediately goes to sex like he's anxious to move it forward all the time and that just turns me off").  So, couples develop a kind of projective gridlock over time.  Of course, things are even more complicated when these part-objects or joint unconscious fears get projected into the therapist, who all of sudden starts identifying with the couples' fear of conflict, perhaps by acting out the unconscious projective identification by challenging the couple in a more intrusive way than is typical for the therapist.

So, returning to that day in class.  I finished my clinical examples, hoping that maybe projective identification had become clear to the students and could now be a useful psychoanalytic concept in doing couples therapy. I looked at the class and there was a moment of silence.  I wondered if I had lost them.  But, then Gerti and Debbie added their gems.  Gerti said, "Oh, I get it. It's sort of like outsourcing."  Everyone took a moment to take in the analogy, and then a wave of understanding and energy spread over the class.  Outsourcing.  And of course the country where we outsource has to have sufficient resources to take on the job.  That spark of creativity was followed by Debbie's attempt to make an incredibly thoughtful connection to the family therapy concept of the "identified patient."  She thought that maybe an identified patient, even one who might somaticize the family's anxiety, might be explained by the process of projective identification.  The family was "putting" something into the child who carried the family's conflict as the identified patient.  This was a terrific integration with material taught earlier in the course. Now, the class was popping with energy and the concepts came alive. 

It was a great moment in the course this semester.  Two students helping to simplify an elusive concept.  Thanks, Gerti and Debbie.

Front: Daniel Goldberg, Debbie Frank, Elise Aronov and Gerti Schoen. Rear: Kevin Fried, Toby Reifman, Lauren Meyer, Elizabeth Buonomo, Nathan Hilton, Arlene Kappraff and Joe Armentano.

Christine Girard, Alan Kintzer and Barry Cohen.

A thought provoking and informative workshop on practice wills was hosted by CPPNJ on April 7^th.  Barry Cohen chaired the event, and introduced the theme of the workshop with a Woody Allen clip in which Allen talked about the denial of death.  Other workshop members shared experiences which had led them to encourage fellow therapists to put their professional affairs in order with a practice will. Issues such as conflict of interest, confidentiality, and personal problems that interfere with performance of professional duties, as well as competence to practice, needed to be recognized, assessed and considered.  As well, patients' wishes regarding their records must be respected. HIPAA requirements must also determine how these professional concerns are handled.

Karen Gordon shared her own reaction when her supervisor at NYU, Ruth Stein, died quite suddenly and unexpectedly, leaving behind many stunned and bereaved patients. Following this experience, Karen developed a passionate interest in crafting a workshop which would provide a comprehensive template reflecting the NYU community's interests and values.  Similarly, Alan Kintzer shared his reaction to learning, in 1994, that his 52 year old supervisor, Dr. Duffy, had lapsed quite suddenly into a coma from which she never emerged. Her family, patients and supervisees needed to be informed and their feelings handled as appropriate, by her devastated NYU colleagues.

Lisa Lyons, whose special interest and expertise at the NYU Postdoctoral program is in ethics, treated a person who had been in analysis for 12 years, whose analyst was dying. Lisa described a strong belief that some kind of protocol needed to be set up to deal with such situations. Tom Johnson spoke about his recent emergency surgery.  He became aware that he had made no provision for the disposition of his patient load should he not survive. He noted that in discussions of Freud's cases, there was no mention of Freud's thirteen surgeries and the impact it must have had on his treating his patients and handling the ensuing issues arising from his declining health.  Tom suggested attendees read Aimee Morrison's account of how she handled her metastatic cancer in her treatment of the patients she was seeing.

The last speaker was Christine Girard.  She focused on the emotional challenges of a therapist being disabled and/or terminally ill.  She felt enriched in her understanding of this by her own study of Zendo, a Zen-inspired system of meditation from a Buddhist perspective. It was recommended that attendees read the Steven Levy book, One Year to Live, which concentrates on the precariousness of life and the need for attention to life-affirming interventions with patients.

After the main proceedings, the attendees were divided into 3 smaller groups to discuss the presentations and consider the ramifications of the Practice Will and what it does and doesn't include.  Attendees left the program with a clear understanding of the need for a practice will, and the means to create one for themselves.

All Programs are Co-Sponsored with the New Jersey Society for Clinical Social Workers 

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Thank you for joining us. Look for our next newsletter in June 2013.