A quartet of APsaA stalwarts — Gary Goldsmith, Axel Hoffer, Sheldon Roth, and Leon Wurmser — descended on Mother Russia in late January and February of 1999. Endless snow, ice, subzero weather, and contemporary Russian chaos served only to increase our immersion, identification, and furere didaktikos toward our Moscow and St. Petersburg colleagues.
We moved in strange contrasting realities between ancient, enduring Russian culture — profound, complex, often inscrutable (neither Asian, nor European, but Russian) — and a fledgling profession of new psychoanalytic psychotherapists. At the time of our visit there was not one psychoanalyst in all of Russia. (The IPA has since qualified one Rusian psychiatrist as an analyst.) Despite Russia's vanguard participation in the history of psychoanalysis — the Wolf Man and his analyst-therapist Moshe Wulff, who later developed Israeli psychoanalysis — dark times fell on analysis during the Soviet regime, when it was outlawed and its literature banned. Glasnost brought psychoanalysis out of hiding, and the interest among psychiatric and psychological professionals is intense. The newness of analysis, its freshness, is part of what makes teaching in Russia so especially appealing.
On behalf of the APsaA's Joint Committee on Russian-American Educational Exchanges (co-chairs: Gary Goldsmith and Homer Curtis), ours was the third of seven planned visits for the year to teach psychoanalytic psychotherapy. We met with one “institute” in Moscow and two others in St. Petersburg (Gary and I did brief work with a fourth group in St. Petersburg). In each group (ten to twenty students), we gave individual lectures, followed by open discussion, case seminars jointly chaired by two of us, and the most coveted of instruction — individual supervision (ninety minutes).
Gary is admirably fluent in Russian, but the rest of us were provided with spectacular translators for all activities. Working with a translator requires inordinate concentration, exceedingly careful attention to the creation of digestible comments for total strangers, and reliance on animal intuition guided by ineluctable non-verbal cues. The translator is a complicated bridge between supervisor and supervisee. Such teaching is exhilarating but exhausting.
The students' attitude toward us was marked by openness, trust, deep appreciation for our arduous travels on their behalf, eagerness to learn and, stunningly, a disclosure of countertransferences that were insightful, complicated, and deeply in tune with their patients. In most respects the psychodynamics of the cases presented were familiar: themes of object loss, real or imagined, histories of trauma, and recognizable pre-oedipal and oedipal issues.
The core of the work was individual supervision, with group supervision coming right behind in usefulness. Students valued the exchange they observed when two instructors together led case conferences; they felt that it gave them more room to disagree among themselves gracefully and find their own clinical style. They enjoyed disagreements between Hoffer and me, likening us to Freud and Ferenczi.
Our comraderie carried a special weight with the Moscow students. They felt we were an unusually lively foursome, distinctly openly passionate, and with “heart.” Gary was especially revered by the Moscow group, and they loved seeing him engulfed by the joking and jibing we engaged in quite openly. Axel, Leon, and I frequently marveled at Gary's talent to solve the ever-emerging conundrums of these complicated organizations and their educational needs.
The range of students' skills was wide, but comparable to students of similar experience in' our own country; many are no longer beginners. Dedication to patients is a hallmark of their work, as is professional integrity. All were (or had been) in intensive psychotherapy. Several travel to other countries for varying and repeated periods of personal psychoanalysis. We all felt these people were learning and progressing and would ultimately find professional maturity through experience and continued education.
Let me quote directly from Gary's report to his committee on some of the difficulties in technique noted:
A lack of awareness of phase of treatment and the tasks that should be uppermost in mind during these phases — for
Sheldon Roth, M.D., is a training and supervising psychoanalyst for PINE, an assistant clinical professor of psychiatry at the Harvard Medical School, and a supervisor at the Harvard-Longwood Training Program in Psychiatry. His latest book is Psychotherapy: The Art of Wooing Nature.
example, insufficient attention to alliance formation before interpretation; (2) Inadequate appreciation for working-through with a consequent overvaluation of interpretation and expectation of immediate change [anxiety about “failed” treatment often accompanied this misunderstanding]; (3) A deficient exploration of defense, including attention to the most salient and timely dynamics of dreams, and general issues of “dosage, tact and timing”; (4) An authoritarian tendency in some practitioners; (5) Insufficient organizational skill in presenting cases, which were often hard to follow without a chief complaint, present history, and significant historical data.
The bitter deprivations of current Russian life are ubiquitous: economic strangulation, decaying buildings and streets, crime, open corruption (police at the Hermitage insisted we buy their “cheaper” tickets), and degeneration of public services. For example, guarded by our Russian colleagues, we arrived at the architecturally enormous (notorious for crime) Leningrad station in Moscow to take an overnight train to St. Petersburg at 11:00 p.m. It was pitch black — no lights, no explanation. Our little band of aging, now (of necessity) athletic psychoanalysts trudged perhaps a quarter mile, with luggage, through this mystery to the ultimate safety of our first-class compartments.
Countering this dismaying bleakness was the warmth, energy, and hospitable generosity of our Russian hosts. They never left us alone, shepherding us with detailed attention worthy of Virgil's to Dante. Living in their homes intensified our appreciation and love of specific Russians as well as things Russian. We ate and drank well (Axel is a fanatic for ikra, or black caviar, and vodka — and I am not far behind him). Proud of their cities and culture, they plied us with tours and visits to the Bolshoi Theatre, Moscow Conservatory, the Kremlin, the Hermitage, the Kirov Ballet and Opera, and endless wonders of their staggeringly deep history. It was nice to be in Russia, surrounded by Russians.
Axel, Leon, and I felt our time in this program to be a special experience, professionally and personally, and we are deeply grateful for Gary's magical gift in nurturing psychoanalysis in Russia.