Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Thursday, January 16, 2014

Tales from the Waldorf

This week is the annual winter meeting of the American Psychoanalytic Association (APSaA), which always takes place at The Waldorf in NYC. I'll be attending a number of the sessions, and I'll report back on what I learn.

The first time I attended the meeting, I was a PGY-3, because my supervisor, a truly hard-core analyst, encouraged me to go. I was a bit skeptical, so instead of putting in for conference time, which I probably wouldn't have gotten anyway, I scheduled my call so I would be post-call on the first full day of the meeting (I could leave the hospital by 11, and I was off the rest of the day). Of course, I hadn't slept at all, and by the time I got there, I was psychotically tired. I'd never been to The Waldorf before, and I had no idea where I was going, but I spotted a man wearing a tweed jacket and a cashmere vest, and I figured he must be an analyst, so I followed him.
Worked like a charm.
In retrospect, I'd have to say that attending the meeting that first time was a nodal point in my decision to pursue analytic training. It was a bit intimidating-try sitting in a room with 50 analysts talking about masturbatory fantasies (not their own)- but people were warm and encouraging. They had a very reduced fee for residents, something like $25-, and they had special sessions intended just for residents and students.
The important part, though, was the experience of listening to case presentations. I was a PGY-3 then, so I'd written and listened to my share of intakes and H&P's. I had never heard a case presented in this way. I had never walked away from a case conference in residency or medical school with such a full, deep understanding of who the patient was-what his early life was like, how it influenced his way of being in the world, how he relatedness  to others, what his wishes and fears were, his sense of values, his conflicts, fantasies, imagination, sexuality, anxieties.
And even better were the questions people asked. The first group I attended was about Psychoanalysis and Technology. I went in thinking (granted, I hadn't slept) it would be about what technologies were useful, what new and cool gadgets were on the horizon. No. It was more like, How does one handle silence in a phone session? Has the patient put the phone down? Did the call get cut off? Is there more tension because there's nothing to look at? In a long distance analysis, where does one position the video camera? Should it be pointed at the analyst, or the ceiling above the couch? Where does the patient place her camera? What is the meaning of the camera to the patient? Does it become an object that represents attachment to the analyst, the way medication can? Does it contribute to voyeuristic fantasies?
Again, different from and so much more than I was accustomed to.

There are hundreds of discussion groups, workshops, symposia, etc. There are sometimes fun talks on Saturday afternoons. One year they had Lorraine Bracco talking about her role as the psychiatrist on The Sopranos. They had Andrew Jarecki showing extra clips from Capturing the Friedmans. They had Daniel Menaker speaking about his book, The Treatment, a novel about a man in analysis, and at the same talk, Oren Radovsky, who directed the movie based on the book.

Here's a smattering of some of the groups:

*The Analysis of Masturbatory Fantasies: Theory and Technique (I believe that's technique of analysis)
*The Integration of Psychoanalysis and Couples Therapy
*Schizoid Modes in Narcissistic and Borderline States
*Freud as a Letter Writer
*Pharmacotherapy and Psychoanalysis
*Conversations for Analysts: the Embodied Experience of Analytic Listening
*The Analyst's Pregnancy
*Effects of the Holocaust on Survivors and Family Members
*Emerging Perspectives on Gender and Sexuality: Online Relations
*Psychoanalysis of Twins
*Edward Albee's "Who's Afraid of Virginia Woolf?" Are You?
*Love, Sex, and the American Psyche: Political Sexual Scandal
*Psychoanalytic Aspects of Assisted Reproductive Technology
*Trauma and Mastery Through Art: The Life and Work of Frida Kahlo
*Research on the Relation of Psychoanalysis and Neuroscience
*"Facing Death" Psychoanalysis and Psychoanalytic Psychotherapy of Patients with Cancer
*Privacy: A Quaint and Anachronistic Concept? (for residents, trainees, and students)
*Happy Endings in Real Life and in the Cinema

I'll get to the details of the groups I've attended in the next post. So far, four, on supervision, psychotherapy training, psychosis, and loss/death.

Til Then...


  1. I am very glad to see that somebody is talking about fantasies. A single minded focus on DSM technology and anything that might be "subjective" as opposed "objective" has left many psychiatrists out in right field when it comes to human consciousness. If it isn't an excess or deficiency state - we don't know what to do about it. I have always thought that this was the greatest strength of psychoanalysis. If I was at the meeting I would be attending everything that had to do with fantasies.

    1. Be great if you're there next year. It's really interesting, and you don't need to be an analyst.