Psychoanalysis On and Off the Couch

"In addition to the easy convenience of bathing two children together, or three children together, there are other motivations of bathing them together. Parents are less aware that there is an excitement in seeing the children naked - although convenience is what's stated first, I think other things do go into it. Through development reactions to the genital difference and nudity will change, and I believe that being aware of those changes is very useful for parents to make decisions about what they want to do in their family, about family nudity, toileting, bathing, running around naked." 
 
Episode Description: Ilene demonstrates the many influences on mothers' engagements with their daughters which include their own remembered and forgotten pasts, cultural influences and their unique imaginations. She mentions the startling messaging in the famous movie "Gigi", "Thank heaven for little girls...so helpless and appealing, without them what would little boys do." We discuss the power of girls wishing to be like their mothers and how that at times conflicts with their wishes to also individuate from their mothers. The book demonstrates differences among new parents around the blue/pink choices for boys and girls, and she also discusses the many feelings parents have associated with family nudity. A special distinction is made between a three-year-old asking 'Do I look pretty?' vs 'Am I pretty' - each having very different meanings to the child and to her parents. We touch upon 'whining', self-stimulation, and what being a 'girly-girl' means to parents. We close with Ilene sharing with us how real her granddaughters found this work to be.
 
Our Guest: Ilene Lefcourt established the Sackler Lefcourt Center for Child Development in 1982. She was the Director, led the Mother-Baby-Toddler Groups, and provided Developmental Consultation to parents for over 35 years. She taught Child Psychiatry Residents and Parent-Infant Psychotherapy Trainees about her work. She has been a faculty member at the Columbia University Center for Psychoanalytic Training and Research since 1995. Ms. Lefcourt is currently in private practice in New York City. She is the author of  Parenting and Childhood Memories: A Psychoanalytic Approach to Reverberating Ghosts and Magic, Mother-Baby-Toddler Group Guide: A Psychodynamic Approach, When Mothers Talk: Magical Moments and Everyday Challenges, and Mothers and Daughters: The First Three Years. Visit Ilene's website: http://ilenelefcourt.com/. 
Recommended Readings:
1975, Fraiberg S. Adelson E., Shapiro V., Ghosts in the Nursery, Journal of the American Academy of Child Psychiatry, 14, 387-421
 
1993, Lieberman, A ., The Emotional Life of the Toddler, Simon and Schuster 
 
2005, Lieberman, A., Angels in The Nursery, Infant Mental Health Journal.
Vol. 26(6)
 
1995, Stern, D. The Motherhood Constellation, Basic Books

"All my writing before this has been poetry, and over the years in my books of poems I found the lines kept getting longer. I think the move towards prose had me working on this journal form, which I've not done. Many people write their journals their entire lives. For me, it's a more dipping in and out of this form of work. I began this segment when my father-in-law was dying, and it began as a small series of prose poems about his decline. What I found myself wanting to do then is weave in stories from work, how they were intersecting with what was going on at home. And the thought that all analysts, all therapists, live in this zone of interwoven stories where we're following multiple narrative threads at once, but we tend to talk to each other in terms of one case story at a time. So it was important to me to have all those levels present, because that's really what a lived life is, is being immersed simultaneously and in all of those."  
 
Episode Description: Alice's 'meditative memoir' invites us into the multiple narratives in analysts' lives both within and outside of their offices. She shares how we inevitably bring our own experiences into each clinical hour which forms part of the musicality of the work. Her attention remains on the inside/outside aspects of the body, the mind and our world views. Mortality is never far from her awareness and is reflected in the work she engages in with her patients. She introduces 'Blake' to us and how after 12 years of vital work together, he dies quite prematurely. We discuss the intimate nature of analytic work and how it becomes part of our own inner life. Alice shares a saying of her at times 'directionally challenged' grandfather, "We are headed in the proper general direction" - a theme applicable to many venues of life and psychoanalysis. We close with her reading a poem of Galway Kinnell which concludes with "The still undanced cadence of vanishing"
 
Our Guest: Alice Jones, MD is a personal and consulting analyst at the San Francisco Center for Psychoanalysis. She is the author of seven collections of poems and Cadence of Vanishing, a memoir. A collection of essays titled Poetry, Depth, and Endings in Psychoanalysis: Distant Music is forthcoming from Routledge in 2026.
 
 
Recommended Readings:
 Alice Jones. (2025) Ever Ending. Psychoanalytic Quarterly. 94:3. 497-517.
 
Alice Jones (2020) Vault. Apogee Press.
 
Alice Jones (2025) Leavings. TAP Magazine. 
 
Thomas Ogden (2025) Inventing Psychoanalysis with Each Patient. International Journal of Psychoanalysis. 106:3, pp 471-488.
 
Ellen Pinsky (2025) Driven to Write: 45 Writers on the Motives and Mysteries of their Craft. Routledge.

"This came from an experience with a patient. It was early in my analytic training, and I was working with a supervisor who I really admired, and worked with her for a number of years. She was post-Kleinian, and was great at interpretation, formulation, and she was really helpful with just starting to guide me towards a lot of this work. I remember describing to her a patient session, and I was going through my process notes, and I said, 'I feel like the patient is inside of me. I feel like they want something that's in me, and I don't know what it is, and I can't quite access my own self, I don't know what to do'. It was through this initial experience where I really felt why analytic training versus other less intense training, we were also right at the time doing infant development, offered so much. It was early in my training and she suggested I think about an infant or even a toddler when they want something from their parents - they want something from their mother. The mother kind of feels this kind of gripping or this yearning from them, the baby wanting something. I started to think of my patients, not as infants or babies, but that what I was feeling was that there was something that the person I was working with needed, and they didn't have words yet to tell me what that was." 
 
Episode Description: We begin by recognizing the unique journeys that lead clinicians to become psychoanalysts. Pam shares with us her initial exposure to dynamic thinking but felt that she was missing some awareness of what was happening in herself and in the patients she was working with - "I was curious...I wanted to go deeper, to know more." This led her to enroll in full-time analytic training. She shares with us her understanding of the 'difficult to reach patients' that she was treating and presents a fictionized case that represents the many countertransference struggles she faced. She noted that "instead of the patient realizing that she wanted something from me, she instead felt attacked by me." Supervision was essential in helping her make sense of her experiences and of learning to 'listen to the music'. We close by noting her open-ended curiosity and interest in learning more - lifelong attributes of analysts who continue to take pleasure in our work.
 
Our Guest: Pamela Polizzi, LCSW maintains a full-time private practice in New York City. She specializes in working with patients struggling with eating disorders, complex personality struggles, anxiety, depression, relational trauma, and life transitions. She earned her Master of Social Work (MSW) in Advanced Standing Clinical Practice from Fordham University at Lincoln Center in 2011. Currently, she is an Advanced Candidate at the Psychoanalytic Training Institute of the Contemporary Freudian Society (CFS) in Manhattan, working toward becoming a psychoanalyst. She completed a 2015 Two-Year Advanced Psychodynamic Psychotherapy Certificate in the Integrated Treatment of Eating Disorders from the Institute of Contemporary Psychotherapy (ICP), Center for the Study of Anorexia and Bulimia (CSAB). She also completed the Contemporary Freudian Society's (CFS) Two-Year Psychoanalytic Psychotherapy Program in 2019. 
Recommended Readings:
Readings for Psychoanalytic Candidates: 
Bach, S. (2011). The How-To Book For Students of Psychoanalysis and Psychotherapy. Karnac.  
Busch, F. (2021). Dear Candidates: Analysts From Around The World Offer Personal Reflections on Psychoanalytic Training, Education, and The Profession. Routledge. 
 
Readings on Clinical Practice with the Patient who is Difficult to Reach:
 
Bollas, C. (1996). Borderline Desire. Int. Forum Psychoanal., (5)(1):5-9.
 
Joseph. B., Feldman, M., & Spillius, M. (1989). Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph. New Lib. of Psycho-Anal., (9):1-222. (on Pep-web). 
Joseph, B. (1975) The patient who is difficult to reach. 

Joseph, B. (1982) Addiction to near-death. 

Joseph, B. (1983) On understanding and not understanding: some technical issues. 

Riesenberg-Malcolm, R. (1999). On Bearing Unbearable States of Mind. Routledge. 
 
Steiner, J. (1993). Psychic Retreats: Pathological Organizations in Psychotic, Neurotic and Psychotic Patients. Routledge. 
 
Winnicott, D.W. (1974). Fear of Breakdown. Int. R. of Psycho-Analysis. 1: 103-107.

"[A couple state of mind] is the capacity to be subjectively involved with both individuals, but then importantly, to be able to step back, find a third position, and try to understand what the couple are creating together. Although it's kind of obvious in a way, because surely, that's what a couple therapist is doing, they're trying to understand the couple relationship. It can have quite a powerful effect on the couple coming for help, because very often they're coming with a different state of mind. They're coming with a state of mind where the other one is felt to be the problem. Quite often, one partner feels brought by the other for treatment, and it's very much a kind of two-person interaction - 'You know, if you weren't this way or if you did this for me, then I would be happy'. What perhaps the couples don't  have is the capacity themselves to step back and observe what they're creating together - that's the couple state of mind. The couple state of mind is initially in the therapist. It's the couple therapist's analytic stance, if you like. But what I'm suggesting is that over time, this gets identified with and internalized by the couple into their relationship." 
 
Episode Description: We begin by describing the nature of the 'couple state of mind' as it exists in the mind of the therapist and as it grows in the couple allowing them to reflect on their 'coupleness'. We consider the similarities and differences between this and the familiar analytic self-reflective capacities that develop in intensive individual treatment. Mary presents clinical examples of her countertransference inclinations that are evoked in working with those who are initially 'likable' or 'unpleasant', i.e., "I can't understand why they're together" and how that evolves into a deeper understanding of the nature of their 'togetherness'. She discusses fixed unconscious fantasies and projective identifications that are both defensive and creative. We also discuss how "curiosity is the opposite of narcissism" and how that vital ability lives in the therapist and in the couple. We close with recognizing that the couple's capacity for their own 'couple state of mind' is an indication of readiness for termination.
 
Our Guest: Mary Morgan, is a Psychoanalyst, Couple Psychoanalytic Psychotherapist, and a writer. She is a Fellow of the British Psychoanalytical Society, Senior Fellow of Tavistock Relationships and Honorary Member of the Polish Society for Psychoanalytic Psychotherapy. She is a consultant member of the International Psychoanalytic Association's Committee on Couple and Family Psychoanalysis, a member of the Editorial board of the International Journal of Psychoanalysis and a member of the International Advisory Board of the journal of Couple and Family Psychoanalysis. She worked for many years at Tavistock Relationships, London, where she was the Reader in Couple Psychoanalysis and Head of the MA and Professional Doctorate in Couple Psychoanalytic Psychotherapy. She currently has a private practice of individuals, couples, supervision, and teaching. Along with Andrew Balfour and Christopher Vincent in 2012, she co-edited How Couple Relationships Shape Our World: Clinical Practice, Research and Policy Perspectives. Her book A Couple State of Mind: Psychoanalysis of Couples – the Tavistock Relationships Model (2019) is available in several languages. Her latest book Couple Relations: A Contemporary Introduction was published in 2025 and is available as an audiobook.
Recommended Readings:
Morgan, M. (2019) A couple state of mind: psychoanalysis of couples and the Tavistock Relationships Model. London & New York: Routledge.
 
Morgan, M. (2025) Couple Relations: A Contemporary Introduction. London: Routledge.
 
Ruszczynski, S. & Fisher, J. V. (Eds.) (1995). Intrusiveness and Intimacy in the Couple. London: Karnac.
 
Fisher, J. (1999). The Uninvited Guest. Emerging from Narcissism towards Marriage. London: Karnac.
 
Grier, F. (Ed.) (2005a). Oedipus and the Couple. London: Karnac.
 
Morgan, M. (2019) Love, Hate, and Otherness in Intimate Relating. Couple and Family Psychoanalysis 9:15-21
 
Clulow, C. (2009) (Ed) Sex, Attachment and Couple Psychotherapy: Psychoanalytic Perspectives (pp. 75–101). London: Karnac.

"To come back to this idea of 'groaning' - I really like it because I think it's a good description of the work we do, but particularly because it refers to Antonio Ferro's concept of the absorbency of the frame, which I think is another way of referring to it, that the frame can take a little give and take, that there's something organic about it. It has a structure, but it's absorbent, it can move, it's alive. So that is a very important concept. I think a lot of younger analysts or psychotherapists who want to be inspired by psychoanalysis don't let themselves feel comfortable letting things happen first before they try and immediately intervene and feel that they have to have some kind of magical response to it." 
 
Episode Description: We begin by unpacking the meanings contained in the metaphor of the 'groaning' analytic frame. Allannah speaks of flexibility, containment and "the expectation of misunderstanding." She shares the importance of the analyst having a sense of an internal frame which is then introduced to the patient and which contrasts with their assumptions of social relatedness - "Too much comfort in the relationship can lead to a pseudo-analysis." We take up the concept of the 'co-created' frame and touch upon the reflections of Aulagnier, Rothstein and Aisenstein. Allannah shares her thinking on the issue of charging for missed sessions and describes her reconsideration of her personal analytic experience with this. We close with a comment on the analyst's internal frame which enables them to "hear the patient in an out-of-the-ordinary way."
 
Our Guest: Allannah Furlong, Ph.D., a psychologist and psychoanalyst, is a member of the Société psychanalytique de Montréal. After serving on the IPA North American Editorial Committee, she was one of the original members of the IPA Committee on Confidentiality and organizers of the first interdisciplinary Inter-Regional Conference on Confidentiality. These collaborations led to the co-editorship of two books on issues of confidentiality in psychoanalysis. In addition, Dr. Furlong has written on the frame, missed sessions, informed consent in psychoanalysis, and the use of clinical material for teaching or publication. She has also written about the temporality of lovesickness, unconscious choice, and dehumanization as a shield against helpless openness to the other, for which she received the JAPA Prize for excellence in psychoanalytic scholarship. Her current research is on the subject-creating function of baby talk.
Recommended Readings:
M., Baranger, W., & Mom, J. 1983. Process and Non-Process in Analytic Work. International Journal of Psychoanalysis 64:1–15.
 
Bass, A. 2007a. When the Frame doesn't Fit the Picture. Psychoanalytic Dialogues 17:1–27.
 
Bleger, J. 1967. Psycho-analysis of the psychoanalytic frame. In Symbiosis and ambiguity: a psychoanalytic study, 1–13, trans. S. Rogers and edited by J. Churcher & L. Bleger. London: Routledge, 2013. 
 
Caper, R. 1992. Does Psychoanalysis Heal? A Contribution to the Theory of Psychoanalytic Technique. International Journal of Psychoanalysis 73:283–292.
 
Donnet, J.-L. 2001. From the Fundamental Rule to the Analysing Situation. International Journal of Psychoanalysis 82:129–140. 
 
Ogden, T. H. 1992. Comments on Transference and Countertransference in the Initial Analytic Meeting. Psychoanalytic Inquiry 12:225–247.
 
Roussillon, R. 2015. An Introduction to the Work on Primary Symbolization. International Journal of Psychoanalysis 96:583–594.
 
Stern, S. 2009. Session Frequency and the Definition of Psychoanalysis. Psychoanalytic Dialogues 19:639–655