שיחה עם דונה אורנג'- לשמוע מטופלים - איפה אנחנו נכשלים ואיך ניתן לתקן ?

Introduction Welcome and Event Overview

• Host welcomes attendees from Tel Aviv for a conversation series on psychotherapy.

• Introduction of philosopher and psychoanalyst Donna Orange as the guest speaker.

• Upcoming events include discussions with Jane Abram, Bob Hinchelwood, Leslie Greenberg, and Ophra Eshel.

Focus on Plurality Embracing Diverse Voices in Psychotherapy

• The institute values diverse perspectives in psychotherapy beyond specific schools of thought.

• Encouragement for audience participation through chat comments during the event.

• Anar Vreen introduces himself and his research focus on psychoanalytic knowledge evolution.

Discussion on Silencing Exploring the Concept of Silencing

• The conversation will center around the theme of silencing in various contexts.

• Reference to Donna's book discussing experiences of silencing within individuals and organizations.

• Psychoanalysis historically has a legacy of silencing despite promoting open dialogue.

Critique of Psychoanalytic Legacy Freud's Influence on Silence

• Freud's silence towards patients' clinical material that conflicted with his theories is noted.

• Loyalty among analysts led to compliance with Freud’s ideas, contributing to a culture of silence.

Donna Orange's Perspective Broader Implications of Silence

• Donna Orange critiques psychological trends related to self-states and moral integrity.

• Concerns about indecisiveness stemming from multiple self-concepts affecting responses to suffering.

Spiritual Psychoanalysis Critique Threat to Humanism

• Criticism of spiritual psychologies that undermine humanistic voices in psychology.

Introducing Donna Orange Background and Contributions

• Donna Orange is introduced as a psychoanalyst and philosopher based in California.

• Overview of her recent works including topics like ethics, suffering, and climate crisis.

Introduction The Importance of Listening and Hearing

• The speaker expresses gratitude for the invitation to discuss contemporary psychoanalysis.

• Discussion begins on the impact of sudden deafness in one ear, leading to reflections on silence.

• The speaker shares insights from their new book, highlighting a photograph that symbolizes beauty.

Experiencing Deafness Challenges of Hearing Loss

• The speaker recounts losing the ability to locate sounds, creating humorous yet challenging situations.

• Describes the difficulties faced while navigating daily life without proper hearing.

• Emphasizes how masks exacerbate communication issues for those with hearing impairments.

Isolation and Communication Effects of Invisible Disabilities

• Discusses the emotional toll of living with single-sided deafness and feeling isolated in conversations.

• Highlights how this condition can lead to a sense of loneliness akin to victims of normalized violence.

• After cochlear implant surgery, learning to hear again becomes a significant challenge.

Learning to Hear Again Metaphors and Ethical Implications

• The integration of electronic input from the implant signifies a journey towards improved hearing.

• Learning to hear is framed as a metaphor for understanding voices and ethical responsibilities.

• Reflecting on privilege associated with cochlear implants raises questions about ethical listening.

Ethical Listening vs. Hearing Distinctions in Psychoanalytic Context

• Explores the difference between listening (trained skill in therapy programs) and genuine hearing.

• Questions whether ethical capacity can be lost or regained through experiences like hearing loss.

Understanding Emotional Availability

• Discussion on how hearing loss influenced understanding of patients and human suffering.

• Question raised about whether therapists must experience suffering to understand others' suffering.

• Introduction of the concept of emotional availability as crucial for therapy.

Impact of Parental Emotional Availability

• Research indicates parental emotional availability significantly affects child development.

• Therapists must strive to be emotionally available to understand patients' struggles.

• Deafness heightened awareness of emotional availability in therapeutic settings.

The Role of Personal Suffering in Therapy

• Life experiences, including personal suffering, contribute to clinical wisdom and maturity.

• Emphasis on becoming more emotionally available through personal experiences.

• Understanding patients through one's own trauma differs from classical psychoanalysis.

Evolution of Psychoanalytic Understanding

• Freud's approach aimed for a universally applicable theory but lacked personal experience integration.

• Recognition that analysts' life experiences enhance their psychoanalytic capacity is growing.

• Acknowledgment that learning from Freud's evolution as a therapist is important.

Self-Awareness in Therapy Practice

• Reflection on past judgments about Freud and recognizing his growth over time.

• Importance of acknowledging ways therapists may silence patients during sessions.

Challenges in Patient Communication

• Awareness of biases and prejudices is essential for effective therapy practice.

• Example shared about a patient’s experience with racial profiling and therapist's limitations in understanding it.

Understanding the Balance Between Theory and Patient Care

The Challenge of Theoretical Frameworks

• Focusing too much on specific theories can hinder understanding patients' concerns outside those frameworks.

• Rigid adherence to theories may prevent genuine connection with patients, emphasizing the need to hold theories lightly.

• Supervisors should also remain open to understanding struggles without imposing their theoretical beliefs.

Navigating Personal Biases

• Awareness of personal biases is crucial for effective patient engagement while maintaining emotional availability.

• Being sensitive to one's own history enhances receptivity to patients' needs and suffering.

• Ethical practice involves integrating personal experiences into service for others rather than disregarding them.

Embracing Complexity in Clinical Choices

• Acknowledging personal history enriches the therapeutic process and fosters a deeper connection with patients.

• Balancing personal insights with patient care requires embracing the messiness of individual histories.

• Learning from diverse histories increases capacity to empathize and support others effectively.

Reflecting on Clinical Decisions

• Every theoretical choice made during therapy silences other potential options, highlighting the importance of inclusivity in practice.

• Engaging in supervision helps clinicians navigate complex clinical choices and learn from past experiences.

• Reflection on clinical decisions reveals how previous ideas influence choices made during sessions.

The Nature of Choice in Therapy

• Clinical choices are often influenced by underlying theories or experiences, making them feel predetermined at times.

• Reflective practice allows therapists to assess whether decisions were conscious or automatic responses.

Silencing in Psychoanalysis

• Reflective and self-critical capacity is crucial for analysts' development.

• Dana shares experiences of being silenced in religious communities and during analytic training.

• A notable experience involved a prominent analyst dismissing questions about Freud, leading to silence in class.

Teaching Methods and Their Impact

• Teaching psychoanalysis can convey messages that certain thoughts are unacceptable, silencing students.

• Imposing viewpoints on students leads to learned behaviors of silence and conformity.

• Supervisors' treatment of candidates influences how they will treat their future patients.

The Challenge of Silence

• Theoretical biases from supervisors can be passed down to patients unless candidates leave the supervision.

• Quoting Levin, the importance of recognizing vulnerable silence is emphasized as a challenge in psychoanalysis.

Navigating Client Dynamics

• Discusses listening to clients with contrasting values, such as wealthy individuals versus those from marginalized backgrounds.

• The speaker reflects on personal biases when working with affluent clients who may not recognize their privilege.

Personal Background Influences

• Experiences with diverse patient backgrounds highlight challenges faced when dealing with wealthy clients.

• The speaker's upbringing influences perceptions of wealth and social justice issues in therapy sessions.

Ethical Considerations in Therapy

• Awareness of personal prejudices is essential for effective therapy, focusing on client suffering rather than wealth origins.

Understanding Patient Vulnerabilities

• Focus on specific troubles or fears that patients present, showing rather than telling ethical behavior.

• Avoid direct challenges to wealth or entitlement; instead, demonstrate humane behavior through actions.

• Wealth often comes with a sense of entitlement; explore what individuals feel entitled to regarding their suffering.

The Role of Shame in Therapy

• Aim to show humane behavior without verbal instruction; some patients may engage in humanitarian efforts as a result.

• Directly challenging narcissism is often unhelpful; understanding underlying shame can be more effective in therapy.

• Making patients socially engaged is not the primary goal but can be a beneficial side effect of therapy.

Shifts in Clinical Reality

• Patients are increasingly discussing social issues like racism and climate change during sessions.

• The pandemic has created shared vulnerabilities, altering the clinical landscape for both therapists and patients.

• The aim is to increase patient consciousness rather than impose any specific agenda.

Navigating Personal Biases in Therapy

• Therapists may have internal criticisms about clients' wealth but must focus on understanding their perspectives.

• Responses to clients’ material concerns communicate values; it's essential to express genuine interest in their motivations.

• Bracketing personal prejudices allows therapists to serve the needs of the client effectively while addressing relevant social issues.

Engagement Beyond Traditional Roles

Radical Hearing and Patient Connection

Understanding Radical Hearing

• Radical hearing is a developed sensitivity to the suffering of others, allowing one to prioritize their needs over personal suffering.

• The importance of being fully present with patients, regardless of personal experiences or assumptions.

• A case study illustrates the deep connection formed through shared rituals and support during a patient's illness.

Acceptance and Human Connection

• The patient expressed gratitude for helping her accept her illness, highlighting the significance of simply being present.

• Emphasizes that psychoanalytic training can complicate humane interactions; it's essential to focus on the patient's needs.

• Questions posed during supervision help clarify whether actions are for the patient’s benefit or the therapist's.

Philosophical Influences on Listening

• The speaker acknowledges influences from humanistic psychology figures like Carl Rogers while maintaining a psychoanalytic perspective.

• Psychoanalysis enriches understanding by exploring unconscious elements that affect interpersonal dynamics.

• Philosophers like Socrates emphasize self-awareness as crucial in understanding oneself and others.

Western Philosophy's Role

• Western philosophy traditionally values knowledge, with Socratic wisdom emphasizing knowing one's ignorance as key to understanding.

Understanding Dialogic Thinking

• Heidegger and Gadamer's influence on dialogic thinking emphasized the importance of bracketing assumptions in understanding experiences.

• Focus shifts from seeking absolute truth to understanding the patient's experience and sensitivity to their feelings.

• The approach changes from identifying what's wrong with a patient to exploring how to help them based on their perceptions.

Philosophical Influence on Clinical Work

• Emphasis on understanding the structures of a patient's experience rather than labeling their pathology.

• A shift in perspective encourages curiosity about patients' narratives instead of dismissing their beliefs as irrational.

• Engaging with patients' experiences, like George Atwood's approach, fosters deeper clinical insights.

The Role of Interpretation in Therapy

• Analysts must be sensitive and receptive to others' suffering rather than assuming they know what is wrong.

• Interpretation should acknowledge shared experiences without claiming absolute knowledge about a patient's issues.

• Recognizing moments of connection or disconnection between analyst and patient enhances therapeutic dialogue.

Expanding Interpretive Practices

• Advocating for an inclusive interpretation that considers both verbal and non-verbal cues in therapy sessions.

• Understanding unconscious elements through gentle questioning can reveal deeper layers of experience.

Hermeneutics: Trust vs. Suspicion

• Discussion on hermeneutics distinguishes between suspicion (doubtful interpretation) and faith (trusting interpretation).

Understanding the Hermeneutics of Suspicion

• The hermeneutics of suspicion suggests looking beyond surface meanings to uncover hidden motives, as taught by Nietzsche, Marx, and Freud.

• Gadamer's hermeneutics contrasts with suspicion by emphasizing that every statement is an answer to a question, focusing on understanding the underlying inquiry.

• The discussion includes the philosophical influences on phenomenology and how they relate to concepts of sameness and difference.

Comparing Buber and Levinas

• Both Buber and Levinas have overlapping ideas; both are valued for their contributions to radical ethics.

• Buber introduced the "I-Thou" relationship, emphasizing dialogue and equality in interpersonal connections.

• Levinas critiques Buber's view by asserting that ethical relationships are asymmetrical, prioritizing the needs of others over oneself.

Ethical Priorities in Relationships

• Levinas argues that ethical situations always place the other at a higher moral level than oneself.

• He emphasizes non-indifference towards others' precarious lives, advocating for small acts of kindness as ethical responsibilities.

• Developing a habit of prioritizing others prepares individuals for larger ethical demands when necessary.

Holiness and Ethical Actions

• Levinas describes moments of holiness as actions taken for others in need without clear justification or personal gain.

• In contrast to Buber’s focus on dialogue, Levinas highlights spontaneous acts of care as significant ethical expressions.

• Both philosophers critique modern life’s tendency to objectify individuals rather than recognizing their inherent value.

The Impact of Ethical Orientation

• Adopting an ethical orientation shifts focus from self-needs to addressing the needs of others effectively.

Understanding Acceptance in Psychoanalysis

The Role of Acceptance

• Discusses the importance of helping patients accept their conditions, emphasizing actions over words.

• Highlights a patient's struggle with self-perception and the impact of being treated as a valued individual.

Challenges in Psychoanalytic Service

• Questions why it's difficult to serve others in pain, suggesting cultural influences on individualism.

• Notes that psychoanalytic training often discourages simply being present for patients.

Shifts in Psychoanalytic Attitudes

• Describes a significant change in perspective towards patient care, moving from authority to companionship.

• Compares this shift to a religious conversion, altering how therapists view their roles.

Ethics and Decency During Crisis

Ethical Responsibilities

• References literature illustrating ethical behavior during crises, such as caring for dying patients.

• Discusses the relevance of ethics observed during the COVID pandemic and its implications for therapy.

Personal Reflections on Pandemic Impact

• Shares personal feelings about lockdown and reflections on American culture's selfishness.

• States that while not directly involved clinically anymore, philosophical views remain unchanged by the pandemic.

Communication Barriers in Therapy

Challenges with Non-Verbal Communication

• Introduces an example involving a deaf young man using sign language during therapy sessions.

Understanding the Role of Senses in Therapy

• We rely on hearing more than we realize; sensory deprivation complicates therapy.

• The ethical commitment to understanding a patient's suffering is crucial for therapists.

• Therapists face personal needs and conflicts, such as payment and self-care, impacting their practice.

Navigating Ethical Dilemmas in Therapy

• Balancing financial needs with patient care can be challenging for therapists.

• Therapists may adopt varied fee structures to accommodate different patients' financial situations.

• Open communication about boundaries is essential for developing a child's capacity for concern.

Relational Theory and Therapist Needs

• Some relational theorists emphasize the need for mutual recognition between therapist and patient.

• Maintaining respect is vital; mistreatment can hinder therapeutic work.

• Self-care must coexist with serving the patient, requiring careful management of both aspects.

The Importance of Mutual Recognition

• Recognizing each other as meaningful others enhances therapeutic relationships.

• Addressing feelings of insult or humiliation is necessary to maintain effective collaboration.

• The goal should be to facilitate working together while ensuring mutual respect.

Final Thoughts on Objective Identification

Relationship to Brahmberg's Work

• The speaker discusses their essay on relational psychoanalysis and Brahmberg's positive feedback.

• Brahmberg invited the speaker for dinner, expressing appreciation despite some disagreements.

Critique of Projective Identification

• The speaker critiques projective identification as an authoritarian concept in psychoanalysis.

• They argue it simplifies complex emotional processes into a formulaic idea.

Personal Experience with Projective Identification

• The speaker acknowledges clinical experiences that use the term but finds it reductive.

• They prefer describing personal experiences rather than relying on the term itself.

Conclusion and Gratitude

• The speaker thanks participants for a meaningful conversation and expresses a desire to connect more personally.

Community Reflection

• Acknowledges the global community of participants, emphasizing its significance.

Poetic Reflection: Sounds of Silence