Perspective and experience from eight countries in Europe and North and South America informed the International Psychoanalytic Studies Organization (IPSO)-sponsored discussion held at the APsaA's December meetings in New York. Some thirty people participated in a group discussion organized for international candidates that focused on the experience of working as analysts and as analytic candidates under the shadow of terrorism in different parts of the world. Three invited speakers led the discussion.
Michael Grodin, a member and former affiliate scholar of the Boston Psychoanalytic Society and Institute, is a professor at Boston University's School of Public Health and an authority in health law, psychiatry, and human rights. He has written and edited numerous books and articles; with George Annas, he wrote The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation.
Acknowledging that we in America have been lulled into a sense of safety by our friendly borders with Canada and Mexico and the oceans that set us apart from other continents and cultures, Grodin highlighted the complexity of our shared experience. He used as his point of departure a national survey of stress reactions published in the New England Journal of Medicine. He spoke from a public health viewpoint about the effects of the September 11 attacks on the public at large. The survey found that stress was substantial across the whole population of the United States. For example, 90 percent of the national random sample reported some stress symptoms and 44 percent of adults reported one or more substantial symptoms.
In his clinical experience with refugee populations, Grodin works with many different cultural groups including Muslims, Kurds, and Buddhists. Many escaped violence in their own country and came to the United States believing they were now “safe.” The September 11 attacks took away that sense of safety for many.
Photo by Mervin Stewart
Grodin stressed the diversity of reactions among different cultures. Each person brings an individual history and a particular culture to our common experience, and the expression of pain and trauma are both individually and culturally defined. In treating people clinically, we need to respect these multiple contexts, as we need to respect multiple perspectives in our effort to understand perpetrators of “mad,” “bad,” or “evil” acts.
Gabriela Goldstein of Buenos Aires, the second speaker, is a clinical psychologist completing her analytic training at the Argentinean Psychoanalytic Association. She is the vice president of IPSO in South America. A painter and architect as well as an analyst, she brought to the discussion a perspective shaped by her nationality, her sensibility as an artist, and her appreciation of the power of visual experience.
How does one understand and explain terrorism in a country where people disappear as they have in Argentina, leaving a void with no frame of reference for understanding? How does a person contain a uniquely visual trauma like the media-repeated images of the towers falling? How do we protect ourselves from being flooded with so much that can't be worked through?
Goldstein took note of the threat posed by such experience to the basic internal structure by which we seek to make sense of the world. The spoken word, she observed, “involving affects and the other, part of psychoanalysis and culture … can relieve the failure of organized narration that results from the break in continuity that the trauma produces.”
The third invited speaker was Talia Fruehauf, a clinical psychologist in her fourth year of training at the Institute of the Israeli Psychoanalytic Society. She is vice-president-elect of IPSO in Europe. She gave a vivid moment-to-moment account of a day in her life as an analyst in training: meeting with supervisor, analyst, and patients as bombs fall and one episode of violence merges into the next. What is to be shared; what is to be kept personal? Is the reality of relentless violence different from other outer realities dealt with in clinical work?
“There is the danger,” she noted, “of feeling that one's own daily life, with worries and dilemmas, becomes meaningless in the face of so much death and sorrow.” How do we provide a “holding environment” in a state of “everlasting alertness”?
Virginia R. Youngren, Ph.D., is a clinical psychologist in private practice in Cambridge and Belmont, Mass., and an advanced candidate at the Boston Psychoanalytic Society and Institute. She is an assistant attending psychologist and faculty member at McLean Hospital and the Harvard Medical School. She is vice president of IPSO in North America.