As we enter the third year of the pandemic, better armed with vaccines, masks, and some expertise with teletherapy, I find myself reflecting on both the difficulties and the opportunities that this human tragedy has brought, unasked, to our previously unmasked lives. Before lockdown, I never thought about working remotely in any regular way with my patients or attending online APsaA conferences or delivering presentations online. I never had reason to imagine, other than a few sessions on the phone when someone was out of town, that I would rely so heavily on technology or that I would find it as effective as I have. Teletherapy offered insight, not only in working with patients, but by allowing me to see into their homes, occasionally meet their children, and see their pets whom I knew before only in my imagination when listening from my chair behind the couch or sitting across the room. Patients also see my personal space; my background was viewed from the perspective of my desk and an area behind me with books and some diplomas on the wall. I began to think differently about this long-distance but up-close arrangement that not only sustains treatment but provides the opportunity to think more deeply about what I have thought about for a very long time before the pandemic hovered overhead.
I graduated from the Juilliard School, where I trained to be a concert pianist, with my bachelor's and master's in piano performance in the mid-1960s. Later, I pursued master's degrees in psychology and social work—and then a Ph.D. in both fields—in the 1980s. I then completed analytic training in 2003. Each of these forms of training required thousands of hours of practice, and both continue to shape my professional work. As a psychoanalyst, I have heard my patients burst into song, speaking affectively about celebrations, sad moments, anger, memories, and joy. Music also has come to mind in reaction to what I hear from the couch, often informing my response to patients.
Since I cross boundaries between music and psychoanalysis in my writing and presenting for psychoanalytic and non-psychoanalytic audiences, I advocate reaching out to others in non-traditional venues and promoting connections between music—as well as other disciplines—and psychoanalytic ideas. Psychoanalytic ideas are pertinent to most any other interest the analyst brings to public conversations. Contrary to diluting the age-old tradition about the clinical sanctity of the consulting room, I have found that lay audiences unfamiliar with psychoanalytic ideas or the formal structure of music resonate with discussions that bring together these topics and become affectively involved, often asking questions and making comments that express new curiosity and sensitivity about themselves. Combining psychoanalytic ideas and music often becomes a transformative experience outside our offices.
To be clear, I love practicing clinical psychoanalysis, and I believe deeply in the elegance of psychoanalytic treatment. But one of the personal benefits I gained from my own analysis was the freedom to be creative in sharing psychoanalytic ideas more broadly than what I was taught in the classroom and in clinical practice. I have also found that people who may or may not become patients but could use psychoanalytic ideas to inform their thinking, feelings, and work and personal life can be enriched by interacting outside of formal treatment with the mysterious and empathetic yet often incorrectly portrayed psychoanalyst.
I have had a persistent but creeping fear that psychoanalysis as I was trained to practice it is becoming misunderstood and devalued as times change, as people are mesmerized by Tiktok, Facebook, Instagram, and memes that offer quick answers, and by “evidence-based solutions.” The confusion is reinforced by numerous alternative therapies, while insurance and drug companies resist in-depth treatment. I know that you cannot have a quickie treatment any more than you can perform a Beethoven symphony or Sonata in less than 45 minutes.
I believe an interdisciplinary approach is part of the solution. With data suggesting that some psychoanalytic institutes are contending with lower enrollments and an increased realization of the importance of working sensitively with diverse patients in our multicultural world, psychoanalysts can take up creative leadership in embracing and understanding differences on a global stage as well as in one-to-one treatment. By offering interdisciplinary programs such as the ones I'm describing, I have not remained insular in the comfort, physical confines, and yes, a certain anonymity (probably not as much as we think) of my consulting room.
Music and psychoanalytic ideas, singly or together, can be useful outside the consulting room and the concert hall. How can the royal oral road (words) and royal aural road (music) to the unconscious—as I have called them—intersect and inform
each other? Various colleagues and I have noted that music can influence transference and countertransference in clinical settings. In my non-clinical work, I conceptualize the formal qualities of music that include notation, rhythm, harmony, and melody to provide listeners an aural pathway to affect and unconscious processes. In designing programs for teachers, parents, caregivers, administrators, and students, I have examined—and played recordings of—various musical compositions. This is complementary to psychoanalytic theory and technique that emphasize multiple functions, displacements, and multiple representations which music conveys aurally. Sergei Prokofief's Peter and the Wolf, for example, illustrates nuanced aspects of child development as well as ways composers express in sound political ideas through changing tonalities, rhythms, orchestrations, and melodies.
Despite Freud's disclaimers about music, the auditory sphere long has provided fascination to psychoanalysts interested in the aesthetics of reception, affect, sound, and nonverbal representation in psychic life. In the two-volume anthology Psychoanalytic Explorations in Music (1991 and 1993), co-edited by Stuart Feder, Richard L. Carmel, and George H. Pollock, as well as in my Melodies of the Mind , it is proposed that stylistic features of a musical composition may shed light on mental processes and the structure of the mind in general. In doing so, Feder detailed the concepts shared by music and psychoanalysis, namely, feeling, meaning, affect, and idea. Feder also suggested that the conceptual gap between music and psychoanalysis is bridged with the concept of multiple representation to illustrate complex mental processes. In the theater piece I wrote, “A Conversation Between Freud and Mozart,” the two figures, having returned from Eternity meet in Steinway Hall in New York City, discuss the value of music in mental life. Freud, who supposedly disdained music (Mozart did not believe him!) and Mozart, who said he only could express himself through music, try to convince each other of their convictions. The piece draws upon the composer's great Piano Sonata in A minor K. 310 to help people hear and think about the loss and grief Mozart experienced when his mother died. Since multiple trauma is a topic applicable to people worldwide, musical and psychoanalytic principles can provide understanding and insight toward healing inside and outside the consulting room and concert hall.
Despite Freud's disclaimers about music, the auditory sphere long has provided fascination to psychoanalysts interested in the aesthetics of reception, affect, sound, and nonverbal representation in psychic life.
Comments indicate that people feel understood, they appreciate new ways to think about longstanding issues, and they come to better appreciate their competence instead of self-defeating searches for perfection—or burning out, becoming cynical, feeling misunderstood, and giving up altogether. Sometimes I feel outside my comfort zone with certain groups—for example, when difficult psychoanalytic terminology has to be translated for non-analysts—which allows me to experience viscerally how many patients feel when they are in my office. Fresh perspectives come with every single or group encounter beyond my consulting room.
Clinical psychoanalysts work beyond the public eye, as do performing musicians who practice their instrument hours a day. The pandemic has compelled us to reach out through technology. Many of us have felt the initial frustrations of a quick learning curve on Zoom and Bluejeans and other internet platforms, of sharing the screen to show A/V examples. I have also come to realize that there can be pleasure, intimacy, and insight gained from interacting virtually with patients, and from offering presentations in places (at present on Zoom) that make us stretch our concept of our work and our traditionally shaped identity, leaving our safety zone behind the couch.
If anything good professionally has come from the pandemic for me, working as a psychoanalyst both clinically and through applied/interdisciplinary work has deepened my knowledge and interacting in public places where psychoanalysts previously had not entered the room or the awareness of others. This infinitely creative work has reinforced my conviction that psychoanalysis has a great deal to offer more broadly. I have often referred to the 2009 quote by psychoanalyst Isaac Tylim that “9-11 brought analysis onto the streets and piers.” In his visionary 2005 book, The Artist As Citizen, Joseph Polisi, president emeritus of Juilliard, advocated what the pandemic has crystallized during 2020–2021 and has been clear for many years. To paraphrase, with my own additions in parenthesis, “music (psychoanalytic) education involves more than teaching performers (clinicians) but also nurtures innovators and communicators. A change in music (psychoanalytic) education will require a change in attitudes of the leaders in the profession, particularly music (psychoanalytic) educators and administrators who commit to training educated performers (psychoanalysts) attuned to their role in society.”
Through interactions in our professional communities and beyond them, meaningful opportunities await musicians, other professionals, and psychoanalysts. As we talk about “otherness” it feels inevitable that we can demonstrate our willingness to participate in psychoanalytic endeavors “other” than clinical work.
Now more than ever, music and psychoanalysis rely on our ingenuity, boldness, and resourcefulness to promote their
enduring and endearing value, because an expanded vision to blend music and psychoanalysis can offer a verbal and sonic antibody for our traumatized country and battered psyches while offering multiple creative opportunities for psychic repair. In a redesigned concept of career and expanded educational objectives, my two beloved professions can demonstrate the importance of words and music, respectively, as they contribute healing strategies to discover a heard immunity in the larger community coping with cultural, social, racial, environmental, economic, medical, and mental maladies.
When psychoanalysts strive to be a part of rather than apart from playing an expanded role in society, we introduce controversies and intricacies into our analytic theories, educational training, and practice which can challenge our physical and psychic comfort zones. As we listen to the musical nuances inherent in words and find words to verbalize the untapped music and feelings deep within ourselves and others, we also discover creative possibilities between the royal oral and aural roads to the unconscious. If the pandemic has taught me anything, it is that the time for reaching both inside and outside of our theories, our comfort zones, and our pre-pandemic selves is overdue and is now.
Julie Jaffee Nagel, Ph.D., is on the faculty at the Michigan Psychoanalytic Institute and has a private practice in Ann Arbor, Michigan. She is author of Melodies of the Mind (2013), Managing Stage Fright , and Career Choice in Music (forthcoming).