Ken Levy’s Summary of What Psychodynamic Psychotherapy and Psychoanalysis are all About

Ken Levy is a therapist associated with Penn State. He’s a friend of Dr. Caligor’s. I reproduce an excerpt of Dr. Levy’s brief discussion of Kleinian analysis from the following paper:

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These are Dr. Levy’s comments about Kleinian analysis.

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I wonder if Dr. Levy would view my therapist as doing legitimate Kleinian work.

https://dailstrug.wordpress.com/2019/07/13/things-are-starting-to-add-up/

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Things are Starting to Add Up

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Little things about my therapist are starting to add up. Am I making a mountain out of a molehill or do I have a legitimate reason for concern?

My therapist has a habit of taking my ordinary or non-malign comments or behaviors and using hypercharged, dramatic language to turn my comments into something that they are not.

I offer three examples:

I was talking about my friend Craig D. and she said, “He was evil.” (Evil?) I said, “He wasn’t evil. He had personality issues but he wasn’t evil.”

Last Thursday I was talking about my dentist from childhood, Marvin Sacks, DDS in totally benign terms. I mentioned that my mother used to take my sister and me to the dentist in late June at the end of the school year just before we went to Atlantic City. My therapist responded: “You thought your dentist was a sadist.” Where did she get that? I said, “That’s not true at all. I liked my dentist. I didn’t like dental pain, but I liked my dentist and I didn’t have any unusual fears about seeing him.”  (My dentist was a friendly person who used to engage me in conversion in a soothing way.)  What is striking is that I didn’t describe any negative feelings I had about the dentist or even state that he had ever performed any dental procedures on me.  The notion that I had experienced any pain at the hands of this dentist was the therapist’s confabulation.

And you remember the interaction months ago when I was talking about Dr. P. and she said, “The things you wrote about Dr. P. on the Internet were an act of violence. You committed an act of violence against him.” (Violence?)

My question is whether she is nutty or is this Kleinian approach of hers just a lot of crap?  (My therapist seems to make up interpretations.   When I questioned whether her interpretations were simply her confabulations, she said, “It doesn’t matter.  I am not aiming for factual accuracy.”)

I wonder. It really bothers me the way she distorts things. I don’t view her interpretations (or “interpretations”) as meaningful, useful or clarifying — simply disturbing and confusing.

Additional thoughts about my session on Thursday July 11, 2019.  I talked about the emotional high I was on during the month of June.  I talked about the summer solstice (June 21) and how every year, I experience an elation or euphoria about the month of June.  I talked about the fact that Wagner’s opera Die Meistersinger takes place on June 24 — St. John’s Day and how the opera features a mentoring relationship between the older Hans Sachs, the poet-shoemaker, and the young Walther von Stolzing.  I compared that relationship to my psychological relationship with Dr. P. and how I longed for a mentoring relationship with another male.  I talked about how every year when I was a child I looked forward to going to Atlantic City in early July and how, just before we went to Atlantic City, my mother used to take my sister and me to the dentist.  Then a light went off in my mind: “Hey, you know, I just thought of something.  My dentist’s name was Sacks, Marvin Sacks, and I was just talking about Hans Sachs in Die Meistersinger.”  Then I started talking about my thoughts about possible primal scene material.

https://dailstrug.wordpress.com/2018/11/18/dentists-and-primal-scene-fantasy/

Maybe I did view Dr. Sacks as a sadist — but not in the reality situation.  I might have viewed Dr. Sacks as a sadist in the fantasy situation in which Dr. Sacks was symbolically my father sadistically inflicting pain on my mother during sex.   I remember one year, my mother had to have a root canal and during the procedure my mother started to scream. Dr. Sacks made my mother scream.  That’s a psychoanalytically rich statement that parallels an incident in the Third Act of Wagner’s Die Meistersinger.  Hans Sachs has made a pair of shoes for Eva, a sexually-attractive young woman.  Sachs has Eva try the shoes on.  The shoes are too tight and Eva cries out.  Commentators have pointed out the sexual symbolism of the shoes that are too tight and Eva’s crying out in pain.  But that might be just a coincidence.

[Note how a Kleinian might distort this.  A Kleinian might view the “sadistic dentist” as symbolic of the “bad object” or “bad mother” in a dyadic world made up of mother and infant.  To a Freudian concerned with Oedipal issues the interaction is a three-party situation involving mother — sadistic father — self.   Do you see the disturbing feelings you will arouse in a person with Oedipal conflicts whose conflicts are seen as only two party issues?  There’s something very disturbing to the patient about that distortion.  Stanley Greenspan, M.D. talked about how vital it is that the analyst meet the patient at the patient’s specific stage of development.  That’s precisely what’s not going on here.]

Are free associations really of limited value as my therapist seems to think?   Are these associations really meaningless?  How would another psychoanalyst view this material?

Is the following dream at all relevant?  In the following dream write-up I describe primal scene material in association with thoughts about my childhood pediatrician.  I also write about my perceived need for a mirror-image or alter ego relationship with my primary care doctor (Dr. P.) similar to the relationship between Freud and Fliess.  The associations concern mentoring and a concern for achievement and admiration.   Isn’t there significance in the fact that the cluster of associations in the following dream from September 2015 parallels in important ways my therapy report on July 11, 2019, discussed above.  How can we dismiss clusters of associations in therapy that seem to repeat themselves in different sessions or contexts.    Why are these (repeating) clusters of associations not meaningful to my therapist, a psychoanalyst?

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In the following excerpt from my book Significant Moments we see the co-occurrence of the themes of Die Meistersinger, mentoring, collaboration, and Freud/Fliess (themes symbolic of my obsession with Dr. P.).

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Parallels Between Therapy Session on May 23, 2019 and July 9. 2019

Thoughts About Psychotherapy Session on May 23, 2019

I have formed tentative thoughts about my therapist’s interaction with me at our session on Thursday, May 23, 2019.

General Impression:

The therapist appeared to have a significant level of anxiety that may have been triggered by a dream write-up I had given to her at the conclusion of the previous session on May 21. I speculate that my autonomy (in the form of my thinking, my individuality, and my rationality) sparked persecutory anxiety and envy in the therapist, which, in turn was discharged in her projective identification.   I suspect that my failure to regress, like a majority of patients, in the therapeutic situation — that is, to develop a sense of collaboration with her — is a source of anxiety for her.    The therapist said that she felt “smothered” by my writings, that she perceived me as “high strung,” and that I tried to be my own analyst.

QUESTION: Does the therapist experience my depressive anxiety as a chronic stressor that continually threatens to arouse persecutory anxiety in her?

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SESSION July 2, 2019: I told my therapist that I shipped a copy of my book Psychotherapy Reflections to a senior analyst at a local Psychoanalytic Training Institute. My therapist is acquainted with that senior analyst, and I suggested that to my therapist that she contact the senior analyst to offer her an opportunity to comment on the book.

JULY 4, 2019: No session because of holiday.

JULY 9, 2019: I opened the session by telling the therapist that I no longer wanted to see her twice a week; that I preferred once-a-week sessions. My therapist was strongly displeased. I told her that I thought that she did not allow me to express myself, that the literature said that people like me have to be provided an opportunity for free association, and that I felt engulfed by her. My therapist said to me: “You find our work meaningless.” I said, “Yes.”

My therapist said that I was “expelling” at this session (an apparent reference to what she perceived as my paranoid-schizoid anxiety); that I created “links” then destroyed them; and that my thinking was “ideographic” and not “symbolic.”  She also referred expressly to Bion (and Freud).

I noted something else that struck me as important. At three points in the session, my therapist seemed to emphasize her priority as a psychoanalyst, as if she were emphasizing her authority. I had the sense that, perhaps, at this session the therapist felt that her authority as an analyst had been questioned. Could these feelings have been aroused by some communication with an unknown third party? I have no way of knowing.

a.) At one point the therapist said, “I am the analyst.”

b.) At another point when I said, “I thought you would register my desire to see you once a week as an administrative issue,” she said, “I am a psychoanalyst — nothing is simply administrative to a psychoanalyst.” Note the phrase, “I am a psychoanalyst. . .”

c.) I found the therapist’s use of arcane jargon (ideographic, symbolic thought, links, and attacks on links) as a meretricious display of knowledge — as if she were emphasizing her prerogatives as a psychoanalyst.

Let us revisit the May 23, 2019 session: “3.  It is noteworthy that the therapist reduced my self-analysis or dream analyses to a behavior (or possibly acting out): ‘You try to be your own analyst.'”

DISPLACEMENT:

a.) The statement (July 9, 2019) “You create links then destroy them” can be read as a paranoid displacement. It is possible that the therapist was thinking about my relationship with her, “You created a relationship with me and are now destroying that relationship.” The therapist’s seeming use of paranoid displacement would fit a pattern. In effect, the therapist displaced her anxieties about my abandoning her onto my “destructive acts” against a psychoanalytical construct, namely, “links.”

Let us revisit the session on May 23, 2019, namely my thoughts about the therapist’s seeming paranoid displacement: “2.  The therapist’s statement that I was in fact smothering her and that she subjectively felt smothered by me was clearly persecutory.  At the conclusion of the previous session, I asked: “Can I give you these materials?”  The therapist accepted the materials.  She had free will; she could accept the materials or refuse to accept the materials.  It was patently ridiculous for the therapist to claim that my giving her the materials was my act of smothering her in a situation where it was she herself who consented to accept the materials in the first place.  The therapist’s statements about my smothering her were her persecutory fantasy.  One wonders what it was about my writings that triggered her persecutory feelings.  Why would an analyst apparently feel threatened by a patient’s written thoughts about a dream?    It is noteworthy that at a previous session, the therapist appeared to show persecutory thinking in the session after I had given her one of my dream write-ups.  I later wrote a letter about that session in which the therapist maintained that my primary care doctor had been afraid of me despite persuasive evidence I had given her that the doctor’s statements about his purported fears were false.  I speculated in the letter I wrote about the session that the therapist might have displaced her persecutory fears about me onto my primary care doctor, so that it was no longer she who was afraid of me, it was the doctor who was afraid of me.  I speculated that the therapist was showing a paranoid countertransference.  That possible earlier paranoid countertransference (in the form of displacement) might parallel the therapist’s clearly persecutory statements at the current session that I was smothering her and that she felt smothered by me.  In both cases, the apparent persecutory fears arose in the session after I had given her one of my dream write-ups.”

b.) My therapist is an analyst-in-training. In such a case perhaps we cannot rule out the operation of parallel process. Parallel process is a phenomenon noted between therapist and supervisor, whereby the therapist recreates, or parallels, the client’s problems by way of relating to the supervisor. The client’s transference and the therapist’s countertransference thus re-appear in the mirror of the therapist/supervisor relationship. What about the possibility that the therapist displaces her persecutory anxieties vis-a-vis her training analyst onto me, using me as a container for the anxieties aroused in the therapist/training analyst relationship. This merits attention because what I am suggesting is that I might be a scapegoat for the displaced feelings the therapist has vis-a-vis her training analyst. I have a lifelong history of scapegoating, first in my family and later in the workplace. Is there a mutual “dance” between me and my therapist in which psychologically I need to assume a scapegoat role even as my therapist needs to displace her persecutory anxiety onto me?

THE THERAPIST’S OWN DESTRUCTION OF LINKS:

a.) The therapist emphasized my act of “expelling” (i.e., projecting). She turned my negative reaction to her into an involuntary confession: In her opinion it was I who impaired free association, it was I who fragmented everything, etc.  When I said, “I feel that your work is one step away from bossiness–and I don’t like being bossed around” she replied: “I feel bossed around by you.”  Arguably, the therapist’s interpretation can be seen as an attack on links. By attributing my negative reaction to her to my act of “expelling,” she seemed to deny the transferential meaning of that negative reaction. What about the possibility that I felt that my mother did not allow me to express myself, that I felt engulfed by my mother and bossed around by her. In attributing my negative therapeutic reaction to an act of “expelling,” as opposed to transference, the therapist denied a link between me and my mother or me and some other significant figure from childhood. Is it possible that at this session the therapist was destroying links and expelling (or projecting) that “attack on links” to me?

b.) The therapist appeared to interpret my “attack on links” as an intrapsychically-generated persecutory reaction to her. She seemed to deny the possibility that my tendency to attack links might be a sequel of trauma. It is well to keep in mind that I have a significant trauma history. In fact my MMPI two-point scale is 4/6, an indicator that an individual experienced in childhood a traumatic reaction to frightening displays of parental anger. Other MMPI scales validate abuse and scapegoating in my background.

Prof. C. Fred Alford has offered the following observations about Bion’s work on links: “To characterize these symptoms of trauma as attacks on linking stands in opposition to the way Bion (1967, pp. 101-102) sees attacks on linking: as an act of what Klein calls paranoid-schizoid rage at experience, designed to shatter the experience and perhaps to protect the vulnerable container. From the trauma perspective, attacks on linking are not the result of an internal rage at experience, but an external assault, penetration, or blow—that is, trauma.

This reflects an important way in which the trauma perspective on psychoanalysis changes the way we think about inner and outer. From a strictly psychoanalytic perspective, all the action is within: people create links, people destroy links, and so forth. While there is recognition of the role of another person as container while these links are being formed, a role almost always attributed to mother, there is little acknowledgement of the external forces that can shatter even a securely built container (that is, self), and the links that have been made there. Instead, all the action is internal; external events are secondary.

Freud turned away from the idea that the sexual abuse his women patients remembered was real, and not fantasized (Freud letter to Fliess, quoted in Masson, p. 264). This was not a great moment in psychoanalysis. In a similar way, thinking about attacks on linking as an external attack on the linking medium, the container, caused by trauma, is not what Bion had in mind, but it seems to be the way trauma works. Trauma rips open even the most well sealed container.”

In asserting that my attacks on links are intrapsychically-generated, the therapist is denying the role of traumatic actors in my childhood. Once again, the therapist is denying “links” between me and a negligent mother, an abusive father or other aggressive and traumatogenic persons in my childhood. The denial of a patient’s trauma can in itself be seen as an attack on the links between that patient and traumatogenic persons in the patient’s developmental environment. Again, the therapist’s statement to me “You destroy links” can be seen as her own act of expelling (or projecting) — a symptom of her own persecutory anxiety in reaction to me.

THE THERAPIST’S OWN ACTS OF EXPELLING:

The therapist’s references to certain psychoanalytic jargon (links, ideographic, symbolic thinking) were evidence of a close reading of Bion’s work.  Bion refers to attacks on links in his paper, “Attacks on Linking” (1959) and ideographic thinking in “Differentiation of the Psychotic from the Non-Psychotic Personalities” (1957).

I find it peculiar and noteworthy that a patient could pinpoint specific technical literature a therapist has read simply by listening carefully to the jargon the therapist uses.  I have a remote association.  At autopsy, the presence of apple fragments in a deceased’s stomach is evidence that the deceased consumed an apple in the recent past.  The apple had not yet been digested or “assimilated.”  If the deceased had eaten the apple a day earlier, there would be no trace of the apple in the stomach; the digested or “assimilated” apple would have become a part of the deceased.  Might we say that a person in a training program, such as an analyst-in-training, is engaged in the act of digesting or “assimilating” technical material and that in the trainee there might be a tendency to “expel” jargon as if they were fragments of a recently consumed meal?  Whereas in the experienced analyst, the analyst’s technical knowledge has been metabolized and appears in the analyst’s work only as “molecular traces” that guide the analyst’s interpretations but do not intrude in recognizable chunks.

My point is — is my therapist’s (inappropriate and confusing) use of psychoanalytic jargon evidence that she is struggling with the anxieties of being in a training role, which involves the “digestion” or assimilation of knowledge?

Again, when the therapist states that I am expelling, is she not also expelling (or “vomiting”)  her unassimilated fund of technical knowledge?   Does the therapist’s act of “vomiting” on me point to unconscious feelings of nausea and disgust about working with me?  One wonders.

What is the nature of the countertransference I am attributing to my therapist?

 

WTF?

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I saw my therapist today. Her work is so jargon-laden that I strain to figure what she’s talking about. She told me that at this session I was “creating links then breaking them up.” She also told me that my thinking was more ideographic than symbolic.  Then she started talking about Bion.

I struggle with things in my life. She doesn’t address the things I struggle with; she simply describes my interaction with her using jargon that I don’t understand. What do any of her observations about my “links” and my “ideographic thinking” have to do with my yearnings, my obsessions, my anxieties, and my strivings? I have no idea.

I told my therapist about my association to what she was saying. “You remind me of the Communists. They come into a capitalist country and they use their ideology to label everything. For example, they see a man running his business and he’s no longer just a man running a business, he’s a “capitalist exploiter” — he “exploits labor.” You’re work is so ideological.  You are applying an ideology to me, that’s all. That’s all I see. I didn’t have the feeling Dr. Palombo was a Communist, that he was simply applying an ideology. He was more like an anthropologist. An anthropologist doesn’t have an agenda or ideology, well, maybe the ideology is just investigation and inquiry. That’s their agenda. The anthropologist is not concerned with applying labels from an ideology to a culture. The anthropologist is concerned with understanding another culture from the inside. When a culture has a certain religious ritual, the anthropologist tries to understand that ritual from the perspective of people living in that culture.   “What does it mean to them?”  I thought Dr. Palombo’s work was like that. I see you as a Communist. I saw Dr. Palombo as an anthropologist.”

I seemed to lose her with those comments. I wonder if she was following me and my ideas. Or is this just more of my ideographic thinking?

(Apparently, my therapist has been reading this paper by Bion:   Bion, W.R., “Differentiation of the Psychotic from the Non-Psychotic Personalities.”  (1957). International Journal of Psycho-Analysis, 38:266-275

https://books.google.com/books?id=gPODDwAAQBAJ&lpg=PT1482&ots=lnocOyf4Qu&dq=%22the%20diversity%20of%20such%20objects%20dependent%20as%20it%20is%20on%20the%20sense%22&pg=PT1482#v=onepage&q=ideographic&f=false

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For the Chapter: I Notice You Seem to Work Very Hard

I have a recurring problem with therapists. I read a lot and frequently, in therapy sessions, I will apply what I read to my therapy report. Therapists don’t like that. They call it intellectualization. But as I see it, if I didn’t apply outside knowledge to my therapy reports, therapists would have no idea what I was talking about.  They seem to lack a theoretical framework to apply to my specific personality problems.  I’m not your average therapy patient.

An example happened yesterday. I was reading Dr. Eric A. Fertuck’s paper on differences between anaclitic and introjective patients: “Verbal Representation and Therapeutic Change in Anaclitic and Introjective Inpatients.” He points out the following finding:

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Then, again:

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My mind immediately associated to the September 21, 2018 session I had with my last therapist in which I talked about an experience I had in college at age 17.  In this session, I talked about issues relating to the introjective personality and the coherence of identity — and the therapist had no idea how to respond. She didn’t know the pertinent literature!  I have an interest in personality — and literature relating to personality —  and many of my therapists have no deep interest in personality and are simply not particularly  knowledgeable about issues that relate to my specific personality problems.

It’s clear that in the following report I was talking about “work” — and all that implies about my introjective pathology and my struggles with identity. To my therapist, my report was meaningless.

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At later point in the session I had the following exchange with my therapist:

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Once again, what is “breaking into show business?” It’s a work-related issue!!

So we can see a clear link between the opening of the session (the college writing practice from age 17) and my seemingly unrelated discussion (projected onto the fictional character, Lucy Ricardo) of a desire to break into show business.

Keep in mind also, how the therapist’s intervention “How did you feel when you had to appear in court” did not derail my underlying anxieties about work performance.  This is what I consider one of the more intriguing issues in psychoanalysis: the fact that the unconscious is like a door-to-door salesman.  No matter what you say to the salesman, he has to get his message across to the customer, and he will fit whatever the customer says into his promotion.    In therapy sessions we  see that the unconscious has a mind of its own.  It doesn’t matter what obstacles you place in its way — it is determined to get its message across and it will use whatever symbols are available to communicate that message.

The college writing assignment was the “chlorine” and the “I Love Lucy” material was the “sodium.” In point of fact I was not talking about “sodium” or “chlorine” — I was talking about table salt. Speaking concretely, I was talking about my obsession with work, introjective pathology, and struggles with identity. Even my current therapist (a psychoanalyst!) doesn’t understand these issues.  (Also, note that the comedy team of Laurel and Hardy were collaborators.  Did this fact register in my unconscious as a “secret sharer” relationship?)

email Message to Eric A. Fertuck, Ph.D.

Dr. Fertuck:

I am a psychotherapy patient. I have written summaries of several of my therapy sessions. I put the summaries together into the pdf document that is in the attachment. Perhaps you might be interested in looking at the document. I have severe introjective personality pathology, a topic you have written about.

Gary Freedman
Washington, DC
202 362 7064

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Dr. Fertuck is a co-author of the following paper that found that free association as a treatment technique in the psychotherapy of introjective patients is vital to their therapeutic progress:

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Problem with my Therapist

My therapist says she doesn’t believe in free association in therapy. She says free association leads to intellectualization.

The literature suggests that free association is vital in patients with my personality problems: namely, patients with severe introjective pathology.

Does my therapist know what she is doing?

https://hewittlab.sites.olt.ubc.ca/files/2015/08/BlattShahar2004.pdf

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BUT I AM SEEING A THERAPIST WHO DOESN’T BELIEVE IN FREE ASSOCIATION !!!

Fertuck’s paper:

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