Psychoanalysis On and Off the Couch

"We are a group of analysts working in the greater context of the analytic world, but as a group, we have a profound analytic group process that's evolved and in profoundly successful ways - we've become a group that contains one another, and deals with great difficulties. Mel has given a taste of where we go to an emotional authenticity that's very compelling… Somehow, we've gotten to a place where nobody seems to be hungry in the group. You're not hungry for affirmation or support, so that there isn't a sense that people are waiting to say something smart or do something smart or make a brilliant interpretation, and there's enough resources left over that the tendency is so powerful to look to enhance somebody else's sense of aliveness and creativity." J.P.
 
I feel very lucky in this group, because I received a gem of a gift that was unexpected. We were going along as a group in this wonderful way. I would look forward to speaking with everybody every four weeks. We got a lot of work done. We also became part of each other's lives in our own way. However, there was always reality around us that we had to cope with. And suddenly, last year, I had a catastrophic medical event in which I had routine surgery that went extremely well, and when I went to leave the hospital, I had a cardiac arrest, and then basically six weeks of ICU care, and lived because I was in a hospital. But it is this group that then took on even more of a meaning for me, because I felt the presence of everyone near me in this group always, and it did give me the sense that the group had also morphed into its own living, breathing entity that really kind of enveloped me at a very painful time. I realized we could go back and forth as a group, actually quite easily, between clinical work, psychoanalytic thinking, and the harsh realities of time, illness, whatever that would intrude or were surrounding us as a group. To me, this was kind of a miracle of a gift. It's been life-saving, really life-saving." P.W.
 
"Developing a sense of one another in how not only we talk, but who we are. That friends are people I feel I can be fully open with and not have to worry about it, to feel free and even when I say things that I might question or regret or feel self- conscious or embarrassed about with friends -  it's held, and I feel this has happened in this group, that there is a way in which we very tenderly hold one another, and there's something about that space, perhaps it's an analytic space. I feel we do it with our patients, but I feel with our peers. It's a very precious thing indeed." M.M.
 
Episode Description: This episode of the podcast takes a step back from our usual focus on how an analytic mindset can improve the lives of those in our care - either on or off the couch. Today, we consider how we can and do care for ourselves and each other. We are a group of six analysts who have been meeting regularly for 10 years. We evolved from a thirty-year group originally devoted to the study of analytic writing. We now meet to share our lives and our work in what Peggy Warren calls "a living and breathing entity."  We discuss "what we need as analysts to go on with this work", how time and illness has changed us as a group, how we feel we can share ourselves without inhibiting self-consciousness, and how what Mel Bornstein calls a 'love of life' can serve as an organizing spirit for what we do. We take up how the group is embedded into a creative process, individually and together. Jon Palmer closes our meeting by noting "there's a lot of love in this room - a necessary condition for us all to grow."
 
Our Guests: Stephen Bernstein, Jonathan Palmer, and Peggy Warren are on the faculty of the Boston Psychoanalytic Society and Institute. Melvin Bornstein is on the faculty of the Michigan Psychoanalytic Institute. Mark Moore is on the faculty of the Psychoanalytic Center of Philadelphia, where Harvey Schwartz is also on the faculty, and of the Psychoanalytic Association of New York.
Watercolor by Jonathan Palmer

"In addition to the easy convenience of bathing two children together, or three children together, there are other motivations of bathing them together. Parents are less aware that there is an excitement in seeing the children naked - although convenience is what's stated first, I think other things do go into it. Through development reactions to the genital difference and nudity will change, and I believe that being aware of those changes is very useful for parents to make decisions about what they want to do in their family, about family nudity, toileting, bathing, running around naked." 
 
Episode Description: Ilene demonstrates the many influences on mothers' engagements with their daughters which include their own remembered and forgotten pasts, cultural influences and their unique imaginations. She mentions the startling messaging in the famous movie "Gigi", "Thank heaven for little girls...so helpless and appealing, without them what would little boys do." We discuss the power of girls wishing to be like their mothers and how that at times conflicts with their wishes to also individuate from their mothers. The book demonstrates differences among new parents around the blue/pink choices for boys and girls, and she also discusses the many feelings parents have associated with family nudity. A special distinction is made between a three-year-old asking 'Do I look pretty?' vs 'Am I pretty' - each having very different meanings to the child and to her parents. We touch upon 'whining', self-stimulation, and what being a 'girly-girl' means to parents. We close with Ilene sharing with us how real her granddaughters found this work to be.
 
Our Guest: Ilene Lefcourt established the Sackler Lefcourt Center for Child Development in 1982. She was the Director, led the Mother-Baby-Toddler Groups, and provided Developmental Consultation to parents for over 35 years. She taught Child Psychiatry Residents and Parent-Infant Psychotherapy Trainees about her work. She has been a faculty member at the Columbia University Center for Psychoanalytic Training and Research since 1995. Ms. Lefcourt is currently in private practice in New York City. She is the author of  Parenting and Childhood Memories: A Psychoanalytic Approach to Reverberating Ghosts and Magic, Mother-Baby-Toddler Group Guide: A Psychodynamic Approach, When Mothers Talk: Magical Moments and Everyday Challenges, and Mothers and Daughters: The First Three Years. Visit Ilene's website: http://ilenelefcourt.com/. 
Recommended Readings:
1975, Fraiberg S. Adelson E., Shapiro V., Ghosts in the Nursery, Journal of the American Academy of Child Psychiatry, 14, 387-421
 
1993, Lieberman, A ., The Emotional Life of the Toddler, Simon and Schuster 
 
2005, Lieberman, A., Angels in The Nursery, Infant Mental Health Journal.
Vol. 26(6)
 
1995, Stern, D. The Motherhood Constellation, Basic Books

"All my writing before this has been poetry, and over the years in my books of poems I found the lines kept getting longer. I think the move towards prose had me working on this journal form, which I've not done. Many people write their journals their entire lives. For me, it's a more dipping in and out of this form of work. I began this segment when my father-in-law was dying, and it began as a small series of prose poems about his decline. What I found myself wanting to do then is weave in stories from work, how they were intersecting with what was going on at home. And the thought that all analysts, all therapists, live in this zone of interwoven stories where we're following multiple narrative threads at once, but we tend to talk to each other in terms of one case story at a time. So it was important to me to have all those levels present, because that's really what a lived life is, is being immersed simultaneously and in all of those."  
 
Episode Description: Alice's 'meditative memoir' invites us into the multiple narratives in analysts' lives both within and outside of their offices. She shares how we inevitably bring our own experiences into each clinical hour which forms part of the musicality of the work. Her attention remains on the inside/outside aspects of the body, the mind and our world views. Mortality is never far from her awareness and is reflected in the work she engages in with her patients. She introduces 'Blake' to us and how after 12 years of vital work together, he dies quite prematurely. We discuss the intimate nature of analytic work and how it becomes part of our own inner life. Alice shares a saying of her at times 'directionally challenged' grandfather, "We are headed in the proper general direction" - a theme applicable to many venues of life and psychoanalysis. We close with her reading a poem of Galway Kinnell which concludes with "The still undanced cadence of vanishing"
 
Our Guest: Alice Jones, MD is a personal and consulting analyst at the San Francisco Center for Psychoanalysis. She is the author of seven collections of poems and Cadence of Vanishing, a memoir. A collection of essays titled Poetry, Depth, and Endings in Psychoanalysis: Distant Music is forthcoming from Routledge in 2026.
 
 
Recommended Readings:
 Alice Jones. (2025) Ever Ending. Psychoanalytic Quarterly. 94:3. 497-517.
 
Alice Jones (2020) Vault. Apogee Press.
 
Alice Jones (2025) Leavings. TAP Magazine. 
 
Thomas Ogden (2025) Inventing Psychoanalysis with Each Patient. International Journal of Psychoanalysis. 106:3, pp 471-488.
 
Ellen Pinsky (2025) Driven to Write: 45 Writers on the Motives and Mysteries of their Craft. Routledge.

"This came from an experience with a patient. It was early in my analytic training, and I was working with a supervisor who I really admired, and worked with her for a number of years. She was post-Kleinian, and was great at interpretation, formulation, and she was really helpful with just starting to guide me towards a lot of this work. I remember describing to her a patient session, and I was going through my process notes, and I said, 'I feel like the patient is inside of me. I feel like they want something that's in me, and I don't know what it is, and I can't quite access my own self, I don't know what to do'. It was through this initial experience where I really felt why analytic training versus other less intense training, we were also right at the time doing infant development, offered so much. It was early in my training and she suggested I think about an infant or even a toddler when they want something from their parents - they want something from their mother. The mother kind of feels this kind of gripping or this yearning from them, the baby wanting something. I started to think of my patients, not as infants or babies, but that what I was feeling was that there was something that the person I was working with needed, and they didn't have words yet to tell me what that was." 
 
Episode Description: We begin by recognizing the unique journeys that lead clinicians to become psychoanalysts. Pam shares with us her initial exposure to dynamic thinking but felt that she was missing some awareness of what was happening in herself and in the patients she was working with - "I was curious...I wanted to go deeper, to know more." This led her to enroll in full-time analytic training. She shares with us her understanding of the 'difficult to reach patients' that she was treating and presents a fictionized case that represents the many countertransference struggles she faced. She noted that "instead of the patient realizing that she wanted something from me, she instead felt attacked by me." Supervision was essential in helping her make sense of her experiences and of learning to 'listen to the music'. We close by noting her open-ended curiosity and interest in learning more - lifelong attributes of analysts who continue to take pleasure in our work.
 
Our Guest: Pamela Polizzi, LCSW maintains a full-time private practice in New York City. She specializes in working with patients struggling with eating disorders, complex personality struggles, anxiety, depression, relational trauma, and life transitions. She earned her Master of Social Work (MSW) in Advanced Standing Clinical Practice from Fordham University at Lincoln Center in 2011. Currently, she is an Advanced Candidate at the Psychoanalytic Training Institute of the Contemporary Freudian Society (CFS) in Manhattan, working toward becoming a psychoanalyst. She completed a 2015 Two-Year Advanced Psychodynamic Psychotherapy Certificate in the Integrated Treatment of Eating Disorders from the Institute of Contemporary Psychotherapy (ICP), Center for the Study of Anorexia and Bulimia (CSAB). She also completed the Contemporary Freudian Society's (CFS) Two-Year Psychoanalytic Psychotherapy Program in 2019. 
Recommended Readings:
Readings for Psychoanalytic Candidates: 
Bach, S. (2011). The How-To Book For Students of Psychoanalysis and Psychotherapy. Karnac.  
Busch, F. (2021). Dear Candidates: Analysts From Around The World Offer Personal Reflections on Psychoanalytic Training, Education, and The Profession. Routledge. 
 
Readings on Clinical Practice with the Patient who is Difficult to Reach:
 
Bollas, C. (1996). Borderline Desire. Int. Forum Psychoanal., (5)(1):5-9.
 
Joseph. B., Feldman, M., & Spillius, M. (1989). Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph. New Lib. of Psycho-Anal., (9):1-222. (on Pep-web). 
Joseph, B. (1975) The patient who is difficult to reach. 

Joseph, B. (1982) Addiction to near-death. 

Joseph, B. (1983) On understanding and not understanding: some technical issues. 

Riesenberg-Malcolm, R. (1999). On Bearing Unbearable States of Mind. Routledge. 
 
Steiner, J. (1993). Psychic Retreats: Pathological Organizations in Psychotic, Neurotic and Psychotic Patients. Routledge. 
 
Winnicott, D.W. (1974). Fear of Breakdown. Int. R. of Psycho-Analysis. 1: 103-107.

"[A couple state of mind] is the capacity to be subjectively involved with both individuals, but then importantly, to be able to step back, find a third position, and try to understand what the couple are creating together. Although it's kind of obvious in a way, because surely, that's what a couple therapist is doing, they're trying to understand the couple relationship. It can have quite a powerful effect on the couple coming for help, because very often they're coming with a different state of mind. They're coming with a state of mind where the other one is felt to be the problem. Quite often, one partner feels brought by the other for treatment, and it's very much a kind of two-person interaction - 'You know, if you weren't this way or if you did this for me, then I would be happy'. What perhaps the couples don't  have is the capacity themselves to step back and observe what they're creating together - that's the couple state of mind. The couple state of mind is initially in the therapist. It's the couple therapist's analytic stance, if you like. But what I'm suggesting is that over time, this gets identified with and internalized by the couple into their relationship." 
 
Episode Description: We begin by describing the nature of the 'couple state of mind' as it exists in the mind of the therapist and as it grows in the couple allowing them to reflect on their 'coupleness'. We consider the similarities and differences between this and the familiar analytic self-reflective capacities that develop in intensive individual treatment. Mary presents clinical examples of her countertransference inclinations that are evoked in working with those who are initially 'likable' or 'unpleasant', i.e., "I can't understand why they're together" and how that evolves into a deeper understanding of the nature of their 'togetherness'. She discusses fixed unconscious fantasies and projective identifications that are both defensive and creative. We also discuss how "curiosity is the opposite of narcissism" and how that vital ability lives in the therapist and in the couple. We close with recognizing that the couple's capacity for their own 'couple state of mind' is an indication of readiness for termination.
 
Our Guest: Mary Morgan, is a Psychoanalyst, Couple Psychoanalytic Psychotherapist, and a writer. She is a Fellow of the British Psychoanalytical Society, Senior Fellow of Tavistock Relationships and Honorary Member of the Polish Society for Psychoanalytic Psychotherapy. She is a consultant member of the International Psychoanalytic Association's Committee on Couple and Family Psychoanalysis, a member of the Editorial board of the International Journal of Psychoanalysis and a member of the International Advisory Board of the journal of Couple and Family Psychoanalysis. She worked for many years at Tavistock Relationships, London, where she was the Reader in Couple Psychoanalysis and Head of the MA and Professional Doctorate in Couple Psychoanalytic Psychotherapy. She currently has a private practice of individuals, couples, supervision, and teaching. Along with Andrew Balfour and Christopher Vincent in 2012, she co-edited How Couple Relationships Shape Our World: Clinical Practice, Research and Policy Perspectives. Her book A Couple State of Mind: Psychoanalysis of Couples – the Tavistock Relationships Model (2019) is available in several languages. Her latest book Couple Relations: A Contemporary Introduction was published in 2025 and is available as an audiobook.
Recommended Readings:
Morgan, M. (2019) A couple state of mind: psychoanalysis of couples and the Tavistock Relationships Model. London & New York: Routledge.
 
Morgan, M. (2025) Couple Relations: A Contemporary Introduction. London: Routledge.
 
Ruszczynski, S. & Fisher, J. V. (Eds.) (1995). Intrusiveness and Intimacy in the Couple. London: Karnac.
 
Fisher, J. (1999). The Uninvited Guest. Emerging from Narcissism towards Marriage. London: Karnac.
 
Grier, F. (Ed.) (2005a). Oedipus and the Couple. London: Karnac.
 
Morgan, M. (2019) Love, Hate, and Otherness in Intimate Relating. Couple and Family Psychoanalysis 9:15-21
 
Clulow, C. (2009) (Ed) Sex, Attachment and Couple Psychotherapy: Psychoanalytic Perspectives (pp. 75–101). London: Karnac.