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DIRECTORS' COLUMN
By Seth Warren, PhD
 This month I would like to draw attention to an extremely important legislative initiative that is currently taking place in the New Jersey State Legislature. A bill has been released by the Senate Commerce Committee that is of great interest to practicing mental health professionals, and in my opinion represents one of the most important developments in the legal context in which all of us will continue to practice for many years to come. The bill will now proceed to the Senate Budget and Appropriations Committee as the next step toward ultimate passage.
I hope that every member of CPPNJ, and all those others reading this newsletter, will find a way to do something to support passage of this bill in the coming months.
In brief, the proposed legislation seeks to re-define the concept of "medical necessity" to place the sole power and responsibility for such determinations to be made by the provider of services, and not a third party payor such as an insurance company.
The following text contains the important provision, from the current version of the bill:
c. Notwithstanding any law or regulation to the contrary, the benefits provided pursuant to this section shall not be subject to utilization management review [and the only prerequisite or authorization necessary for a covered person to obtain those benefits shall be a determination of medical necessity and a prescription for treatment by a physician licensed to practice medicine and surgery, a licensed psychologist, a licensed clinical social worker, a certified advanced practice nurse, or a licensed physician assistant, acting within their lawful scope of practice] or a medical necessity determination other than the medical necessity determination by the health care provider as specified pursuant to subsection a. of this section.
The full text of the current version of the bill can be found at: https://legiscan.com/NJ/text/S2180/id/1117278 
It is hard to overstate the importance of this initiative. We have all seen the use of "utilization management" and managed care to disrupt and reduce the use of necessary mental health services. We have all experienced unnecessary and intrusive violations of patient privacy under the guise of medical necessity determinations. I am guessing that almost every one of us has experienced mortifying and infuriating clinical reviews conducted by managed care personnel with inferior training, experience, and credentials. And we have all seen needed treatments ended or seriously disrupted by arbitrary "medical necessity" determinations made by self-interested third parties whose clinical decision-making is shielded from meaningful external review or legal consequences. The blatant conflicts of interest inherent in such a system have been overlooked for far too long in the interests of the supposed cost-savings of such measures - cost savings which are often more than offset by the increased bureaucratic and administrative requirements of such systems, to say nothing of the profits taken by health insurance companies and managed care companies. And there are significant costs, rarely measured, of treatments that are rendered inadequate or inaccessible by insurance company decisions, in terms of human suffering, loss of productivity, and unnecessary diminishing of quality of life.
I wish to note that this bill has been substantially developed and advanced by the New Jersey Psychological Association and the New Jersey Society for Clinical Social Work, among other interested parties, who helped write parts of the original bill and who have worked to lobby members of the legislature, to mobilize mental health professionals, and to raise public awareness of its importance.
As psychoanalytic psychotherapists and psychoanalysts we understand very well that patient privacy and therapist autonomy are essential ingredients of successful psychotherapy treatments. These have been greatly compromised in recent decades in the interest of expedience, corporate profitability, and "austerity" budgeting, to the great detriment of mental health consumers and clinicians. I hope each of us will find some way to help this historic legislation succeed against the very predictable opposition it will meet.
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CPPNJ Workshop
March 1, 2015 FDU Florham Park
Cultural Forum: Listening to New Voices
Video Presentation: Black Psychoanalysts Speak
Featuring interviews with eleven Black psychoanalysts, the film is intended to raise awareness of the need for greater openness and understanding of cultural and ethnic issues in psychoanalytic training, in transferential and countertransferential interactions, and in the recruitment of people of color into psychoanalytic education.
The film's participants contend that psychoanalysis has a long history as a progressive movement devoted to the common good. Psychoanalysis asks us to examine the processes of self-deception that perpetuate both individual unhappiness and social structures that are inequitable and oppressive. Yet psychoanalytic education has for the most part focused on training and treating the relatively privileged. The psychoanalysts here examine this dilemma and engage in a vibrant and thought-provoking discussion about race, culture, class and the unrealized promise of psychoanalysis.
Richard Reichbart, PhD, Executive Producer
Michael Moskowitz, PhD, Associate Producer
Click HERE to register for this event
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CPPNJ Northern Region Brunch
March 6, 2015 FDU Teaneck
Integrating New Methods into Current Psychoanalytic Practice
Generating Therapeutic Momentum Using Between-Session Assignments and New Body-Based Methods in Relational Psychoanalytic Treatment
Presented by Kenneth A. Frank, PhD
For many therapists, the psychotherapy integration movement has been seen as an increasingly attractive way to view treatment. From a pragmatic point of view, its benefits are difficult to oppose. Yet psychoanalysts, as a group, remain unfortunately loyal to the old ways, and many of our colleagues hesitate to look to new knowledge from valuable outside sources.
In this presentation, two new methodologies will be presented for discussion. One is helping an analytic patient do constructive work between sessions. The other involves experiential new methods that can enhance in-session analytic productivity. I will contextualize these ideas within a relational psychoanalytic framework of therapeutic action, and show how these can be integrated into analytic practice.
 Kenneth A. Frank, PhD is Co-Founder and Director of Training at NIP and Director of its new Psychotherapy Integration Training Program for Psychoanalytic Psychotherapists. He is on the faculties of CPPNJ, NIP, and the Mitchell Center, among others. He has published approximately 60 articles and books. His talk is based on his forthcoming book, Psychoanalytic Participation (Second Edition); Relational Integrative Analytic Psychotherapy. He practices, supervises, and runs Study Groups in Englewood, NJ and NYC.
Click HERE to register for this event
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CPPNJ Spring Conference
April 19, 2015 FDU Florham Park
Mindfulness: Tailoring the Practice to the Person
Presented by Ronald D. Siegel, PsyD
Mindfulness-based psychotherapy is the most popular new treatment approach in the last decade-and for good reason. Mindfulness practices hold great promise not only for our own personal development, but also as remarkably powerful tools to augment virtually every form of psychotherapy. Mindfulness is not, however, a one-size-fits-all remedy. Practices need to be tailored to fit the needs of particular individuals.
In this workshop you'll first learn how to practice mindfulness yourself, inside and outside of the clinical hour. We'll then explore how to creatively adapt practices to meet the needs of diverse people and conditions, including anxiety, depression, stress-related medical disorders, and interpersonal conflicts.
 Ronald D. Siegel, PsyD is an Assistant Clinical Professor of Psychology at Harvard Medical School, where he has taught for over 30 years. He is a long time student of mindfulness meditation and serves on the Board of Directors and faculty of the Institute for Meditation and Psychotherapy. He teaches internationally about the application of mindfulness practice in psychotherapy and other fields, and maintains a private clinical practice in Lincoln, Massachusetts.
Dr. Siegel is coauthor of the self-treatment guide Back Sense: A Revolutionary Approach to Halting the Cycle of Chronic Back Pain, which integrates Western and Eastern approaches for treating chronic back pain; coeditor of the critically acclaimed text, Mindfulness and Psychotherapy, now in its 2nd edition; author of a book for general audiences, The Mindfulness Solution: Everyday Practices for Everyday Problems; coeditor of Wisdom and Compassion in Psychotherapy: Deepening Mindfulness in Clinical Practice, with a foreword by the Dalai Lama; and coauthor of the new volume for clinicians, Sitting Together: Essential Skills for Mindfulness-based Psychotherapy. He is also a regular contributor to other professional publications, and is co-director of the annual Harvard Medical School Conference on Meditation and Psychotherapy.
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SPOTLIGHT ON ... CPPNJ Instructor
Joan Glass Morgan, PsyD
By Debi Roelke, PhD
 Joan Glass Morgan talks about her involvement with IPPNJ, CCAPS and CPPNJ.
After completing psychoanalytic training in 1991 at the NYU Postdoctoral Program, I was welcomed into the IPPNJ and CCAPS communities. Since the successful merger of the institutes I've worked on the Program Committee, and helped to bring some wonderful speakers and teachers to CPPNJ. The challenge of figuring out how to spread the word about the value of psychoanalytic thinking and training continues, and now I'm on the Marketing and Recruitment Committee, which has taken that as its mission.
My personal journey here has focused on teaching. I've had the opportunity to grow and learn from teaching classes on relational theory, interpersonal theory and contemporary topics. When I discovered that good teaching requires skills quite different from those needed to be a good therapist, I realized I'd have to practice it more to become better at it. Fortunately that chance came when I was invited to become a contributing faculty member at the Graduate School of Applied and Professional Psychology at Rutgers, where I've taught comparative psychoanalytic theory and supervised clinical psychology doctoral candidates.
I discovered that the graduate students who studied psychoanalytic theory and CPPNJ candidates have much in common. It seems that people who are interested in psychoanalysis are simply more willing than others to take risks, expose vulnerabilities, endlessly accept the role of "student," and strive to become their best selves in order to help others. Teaching such amazing people is a privilege.
Alongside my private practice in Westfield, I meditate, practice yoga, and study Buddhism. In an effort to integrate some of this, I pursued intensive training to become a Mindfulness-Based Stress Reduction teacher through the program developed by Jon Kabat-Zinn at the University of Massachusetts Medical Center. Inspired by that training, I offered the CPPNJ community a twelve week experiential course in 2009. This course introduced people to mindfulness, meditation, and some of the secular Buddhist ideas that are woven into many western meditation offerings.
Most recently, I've been leading a meditation group for therapists. The group includes candidates and faculty from the institute, but it's open to other therapists from outside of our community as well. (If you'd like to join this group, please email me at joanmorgan@comcast.net.) Together, we talk and study, but our primary purpose is to support one another in a meditation practice. Next year I hope to offer a course which will focus on integrating meditation, mindfulness, and secular Buddhist ideas into psychodynamic treatment. In this respect too, I'm happily discovering a cohort of like-minded people here at CPPNJ.
Dr. Joan Glass Morgan is a clinical psychologist with a private practice in Westfield, New Jersey.
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View from the Shire:
Reflections in The Hobbit and
Lord of the Rings of Our Universal Attachment Dilemma
By Debi Roelke, PhD
 Not long ago, I was leaving the movie theater, having just seen the finale of The Hobbit, Peter Jackson's second movie cycle recreating the world of JRR Tolkien. In the final scenes, Bilbo, like Frodo in The Lord of the Rings cycle before this, has returned home to the Shire after a long journey and unimaginable adventures. Jackson used the same music for both endings - a peaceful, wistful theme that, for me, captures exactly both the longing and the ambivalence of home. I realize that Jackson, and Tolkien before him, in their tales of Middle Earth, have depicted the rhythms and dilemmas of the attachment cycle beautifully. At the beginning of each saga, both Bilbo and Frodo are very reluctant to leave the safe familiarity of home in the Shire. The sameness and predictability are comforting and secure, but also somewhat stifling. They feel this conflict keenly: to stay with what's safe, predictable and known, or to chance the risk and reward of going off to explore. Bowlby himself could not have expressed it any better! The stodgy, disapproving faces of the Hobbit neighbors express the caution, fear and inertia of the 'stay-at-home' side of this fundamental attachment dilemma. On the other hand, Gandalf the wizard entices them with the magic and urgency of the world outside the Shire. The pull to the unknown wins out. But the flip side of Hobbit stodginess is that Bilbo carries home along with him, its inexorable internal pull on the heart providing him with the portable secure base he needs to weather the challenges of adventure and battle. I've read that Tolkien originally wrote The Hobbit for his children when they were young. The Lord of the Rings was later written in series, sent piece by piece to his son who was in the RAF during World War II. Tolkien had been in World War I himself, having resisted enlisting as long as he possibly could, and marrying shortly before he shipped out. It's easy to imagine Tolkien the storyteller weaving concerns about attachment, separation, safety, change and loss into his creations. Jackson's Shire music evokes, for me, the sense of ambivalence in these stories that perfectly captures the lifelong rhythm of our universal attachment strivings: Home is often idealized as sameness and safety; its familiarity can be hard to leave; there are many awesome, magical and terrifying things out in the world that call on you to go exploring; you will long to come back, but a moderated longing has the power to anchor you to keep going. Most importantly, you will be profoundly changed by what you experience, life at home will also have gone on, and all of that will make coming back home a very complicated thing indeed. That's what I hear in the music of the Shire from the closing scenes of both trilogies: the complex ambivalence of leaving and coming back home; desires to explore and desires for sameness and safety; parting and coming back together. It's a rhythm and a dilemma that marks every stage of human life from its very beginning all the way to the end. We long for the familiarity of our secure base of people and places, and at the same time yearn for the excitement and invigoration of exploring new things. The balance between these two is always shifting, and it's a challenge to keep finding a solid internal ground on which to stand. The strains of the Shire music make me feel that complex mix of the joy and relief at returning home, and yet the disappointment, loss and hint of suffocation at the end of the adventure. It struck me what an incredibly difficult mix this is to hold. That brings to mind how many and sometimes severe are the consequences when you can't. Click HERE to read the rest of this article |
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Psychoanalytic Research Forum
Introduction to the Psychoanalytic Research Forum
By Roz Dorlen, PsyD, ABPP, Chair, Recruitment Committee
One of the goals of the Recruitment Committee is to provide our psychoanalytic as well as our skeptical non-psychoanalytic colleagues with empirical data that supports the validity and efficacy of psychoanalytic research and practice. We are all aware that cognitive/behavioral therapies have been publicizing their research for a long time. Clearly, there is great value for all of us to familiarize ourselves with the outcome measures of research that underscores the efficacy and effectiveness of psychodynamic psychotherapy as well as the emerging areas of neuroscience and biology that support the validity of psychoanalytic practice and the therapeutic relationship.
This issue of our Newsletter is the first in a series of articles that we are calling the Psychoanalytic Research Forum. Dr. Nancie Senet has written on the scientific basis of psychoanalytically informed psychotherapy. We are delighted that she has agreed to contribute to this series in forthcoming issues of the CPPNJ Newsletter.
Researchers Abuzz at the Waldorf
By Nancie Senet, PhD
 Fresh back from the winter meeting of the American Psychoanalytic Association, I am bubbling with excitement about psychoanalysis. So much is going on within our community that should not be missed. First and foremost, there is a lovely marriage between neuroscience and psychoanalysis that enlivened the meeting place. This beautifully matched pair danced into many of the workshops and panel presentations. Freud's dream early in his career was to develop a biologically-based psychology. He even made an attempt to lay out its beginnings at a point in time when the neuron had only just been discovered. He begins his Project for a Scientific Psychology (1895) with the following: "The intention is to furnish a psychology that shall be a natural science; that is, to represent psychical processes as quantitatively determinate states of specifiable material particles, thus making those processes perspicuous and free from contradiction." The fulfillment of Freud's dream is tantalizingly close. The intertwinement of neuroscience research, psychoanalytic theory and psychoanalytic clinical practice is creating that psychology. It is yielding a reservoir of firm evidence supporting not only the validity of our work but also the value of psychoanalysis as a true science of the mind. These studies plumb the depths and complexity of brain/mind functioning and human behavior. The evidence produced is not the wooden, contrived sort from so many of the "empirical" therapy outcome studies that are circulating out there and touted as proof of certain "best practice" therapies, especially that of cognitive behavioral therapy, a therapy that easily lends itself to that kind of study. Here is a brief overview of sessions that I attended at the January APsaA meeting in NYC. Mark Solms is a brilliant and charismatic neuropsychoanalytic researcher from South Africa. He was presenter for a Discussion Group titled, Research on the Relation of Psychoanalysis and Neuroscience: What is a Mind? He held rapt those in attendance as he described what neuroscientific esearch is yielding in terms of elaborating how functional brain systems create the mind. It is a pursuit for a comprehensive theory of the mind and brain that so far tends to corroborate some of Freud's early thinking on things such as free versus bound energy, the unconscious mind, and mental dynamics. Another Discussion Group focused on reviewing in-depth the neuroscientific and psychoanalytic research of Shevrin and Snodgrass and their cohort of researchers. They devised a series of studies that have provided proof that unconscious conflict resulted in symptomatology associated with the clinical condition of social phobia. I attended another session cosponsored by the American Psychoanalytic Association and the Psychodynamic Psychoanalytic Research Society titled, Affect or Emotion: Bridging the Divide through Neuroimaging and Object Relations, that also mesmerized those in attendance.Two researchers from the Developmental Neuroscience Unit at University College London/The Anna Freud Centre, described their recent, not yet published, study demonstrating that the quality of object relations significantly affects one's ability to regulate emotions. They discussed the clinical significance implied in their results in that it supports the value of clinical work in which use of an intense therapeutic relationship is central. Over the next few issues I hope to provide you with a more detailed review of some of this research. We have amassed and are continuing to amass an abundance of evidence supporting the validity of psychoanalytic theoretical concepts and the efficacy of psychoanalytic therapy. We need to speak up about it rather than let stand the false characterizations of psychoanalysis as old-fashioned, out of date, not effective, and constructed out of fanciful myth. The supporting research is wide-ranging from therapy outcome studies to the micro-deconstruction of early developmental processes that underlie the functioning mind. |
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Candidates' Organization Update
By Madine DeSantis, PhD
The Executive Committee of the CPPNJ Candidates' Organization held a successful candidate meeting at the Welcome Back Brunch in October, and planned some events for the 2014-2015 year. Lisa Grossi, CO co-chair, hosted a brunch at her home in November which was well attended.
Another social event is being planned. We will view a psychological thriller/drama entitled "Black Swan" and engage in a casual discussion about the film afterward. We are also planning a professional development event for Spring, 2015.
Some candidates may wonder how their annual dues are spent. Over the last couple of years, the Candidates' Organization has made donations to the CPPNJ scholarship fund. We have also held drawings at the last two Welcome Back Brunches, and paid for the winners of the drawings to attend a CPPNJ event of their choice. In addition, dues cover the cost for professional development events sponsored by the CO, which are always open to all candidates at no cost.
Lastly, we have a new addition to the Executive Committee! Welcome Melanie Karger, Secretary.
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A LOOK AT RECENT CPPNJ EVENTS
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Psychotherapeutic Ethis Beyond Oaths or Codes
By Nell Jackson, MA, LPC
On February 1, 2015, Anton Hart, PhD began his presentation encouraging us to interrupt him at any time, because he wanted to hear what we had to say. Dr. Hart's openness for feedback gave us an immediate sense of his approach to ethical relational work. The greatest insurance against having a "negative impact" on our patients is a "radical openness" to what they have to say, or come to express, about us.
Dr. Hart has been teaching ethics for over a decade, and he comes by this honestly: his mother was a psychologist researching moral development. A Fellow, Training, and Supervising Analyst and Faculty member of the William Alanson White Institute, Dr. Hart explores relational means to ethical behavior through the the pursuit of "safety from within the therapeutic relationship."
Dr. Hart noted the anxiety that many of us experience en route to ethics workshops. It is as if we come to anticipate learning about something we are doing "wrong" from an authority to which we must, then, adhere with "obedience". His concern is that we can hide under this authoritative umbrella, versus questioning and grappling with problems as they arise in the analytic situation, a situation that is filled with "ambiguity." He believes that while external professional codes and internal theoretical beliefs are important guideposts that "orient us as to what to keep our eyes on," they are insufficient in and of themselves in their ability to protect our patients from the harm of our negative impact.
Click HERE to read the rest of this article
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Upcoming 2015 Events
March 22, 2015 - CPPNJ Essex/Morris/Union Brunch - Presentation by Eric Sherman, LCSW - From Dead to Alive: Desire, Dissociation and Passion in the Analytic Dyad - Home of Karyn Reader (Randolph) - RSVP to Ellie Muska elliemuska@verizon.net - 11:00am-1:00pm
May 3, 2015 - Northern Region Networking Brunch - Home of Chana Kahn (Teaneck) - 11:00am-1:00pm
June 7, 2015 - CPPNJ Graduation and End of Year Celebration - Wyndham Hamilton Park Hotel, Florham Park - 12:00noon-4:00pm
November 15, 2015 - HOLD THE DATE - Presentation by Stephen B. Levine, MD - Details TBA
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Thank you for joining us. Look for our next newsletter in March 2015.
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No need to print this email - for future reference, all issues are archived. |
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