This video recording is from a conference that addressed the problems that confront patients with neuropsychological impairments, such as ADHD, dyslexia, executive function disorder, and other brain-based disorders. Some can often feel intense shame and humiliation. At times, the impact of these self-deficits can be traumatic and lead to dissociative responses. The presenters explored the defenses that they developed that often lead to dysfunctional feelings, thoughts and behaviors. For therapists, the challenge is to find ways of responding to such patients and to help them deal with their issues at the level of multiple domains of self-experience.
While the U.S. is presently experiencing a surge in media focus on both state and individual violence perpetrated upon Black and Brown bodies, this condition is anything but new. Despite what may have been the intentions of its early theorists, psychoanalysis has historically relegated racialized subjective experience to that of otherness, compounding this injury with a theoretical bias which persists in its over-pathologizing of aggression and resistance.
In its utility in helping people gain access to unconscious bias, the psychoanalytic perspective contains a potential for transformation that is revolutionary. However, without a critical examination of power dynamics existing within both the therapeutic dyad as well as our theoretical foundations, we are destined to enact those same dynamics that exist within the world at large, leaving this potential as yet to be fully realized. In challenging the analytic ideal of therapist-as-blank-slate, the Relational turn has brought us part-way in inviting a critical discourse.
Great Conversations in Psychoanalysis: Deconstructing Confusion in Clinical Practice
Psychoanalysis can be thought of as a long conversation. Since its beginnings, practitioners and theoreticians have responded to each other based on clinical practice, new findings, expansions of theory, and even external events. We continue this tradition today.
One of the great conversations in psychoanalysis was between Freud and his protégé Sandor Ferenczi. A complex relationship, as Ferenczi was Freud’s patient, friend and colleague, Ferenczi’s ideas were controversial even as many considered him one of the most gifted of pioneering analysts. Yet, for a long time, Ferenczi was written out of the history of psychoanalysis. Now his work is being rediscovered as foundational for theory and clinical practice.
In recent years, controversy has arisen as to whether the findings of the neuroscience should be integrated into psychoanalytic theory. In this presentation, I propose that such an integration is critical to our understanding of our patients. I offer a neuropsychodynamic model based on scientific realism and dynamic systems theory as an approach to such an integration and illustrate the application of the model through a clinical vignette.