Meetings of the Psychoanalytic Institute of New England, East

DISCUSSION: Dr. David Reisen asked whether feelings of shame and humiliation are culture-dependent or universal as they enter into the second censorship in childhood. Dr. Sandler responded that losing face is more important in some cultures than in others, citing the Japanese culture as an example. However, he noted that the major cognitive maturation around age five, from preoperational to operational thought, coincides with "don't be silly" concerns and the massive reinforcement of the repression barrier. He suggested that the extent of cultural differences would be an interesting area to investigate. In response to Dr. Laurie Raymond's question about the application of his concepts to dream interpretation, Dr. Sandler noted that dreams essentially reflect current preoccupations and conflicts in the present unconscious. Dr. Sandler disagreed with Dr. Lewis Kirshner who suggested that Dr. Sandler's point of view seems to have changed over the past twenty years—from an emphasis on conditions of safety and vulnerability to a focus on anxiety having more to do with narcissistic concerns with objects. Both Dr. Michael Charney and Dr. Alfred Margulies questioned the postulation of two agencies of the unconscious as opposed to one agency in continuity as development proceeds. Dr. Sandler responded that he uses past and present for schematic purposes "as a framework to emphasize the distinction in the clinical situation between constructions in the present and past reconstructions." His is a developmental view of the unconscious divided for convenience and clinical relevance into that which can be recalled and that which cannot. In response to a query by Dr. Anton Kris, Dr. Sandler discussed the relationship of creativity to a reduction in the second censorship, and he agreed with Dr. Nancy Parsons Harris that his two levels of the unconscious would be applicable to understanding the countertransference.