“All of us learn soon enough, (…), how pale are even our most elegant and satisfying formulations, next to the mystery that is human nature. Hence, I trust and encourage my readers to outgrow my constructions.” - McWilliams, N. (2020).

Those last-minute things patients mention as they leave, when there’s no time for a thoughtful response, sometimes leave me frozen or wishing for a time machine to undo a thoughtless reply. More often, though, I’m left wondering what they might mean. open.substack.com/pub/chiarast...

“The exit line is stated while leaving precisely because the patient wants to keep it out of the session. More exactly, the patient is ambivalent about communicating this material in his sessions. Hurling it up as a parting shot is a compromise between saying it and not saying it.” - Gabbard (1982)

“Over the past two decades, pressure from managed-care insurance companies to reduce the allotted time for reimbursable mental health treatment has resulted in graduate schools shifting their curricula to short-term treatment models ... 1/

“Feeling stuck in psychotherapy is actually the place of opportunity. Stuck is where our patient has been living before she met us, or else she would not have made her first appointment. The difference is this time she and we are arriving at her place of stuck together.” - Peebles, M.J. (2022).

“Psychotherapy grows a sense of value and contentment that we can generate internally. Our well-being becomes less dependent on external circumstances over which we have lessening control.” - Peebles, M.J. (2022).

Peebles (2022) on how change—in psychotherapy—takes time. “The quandary is that the patient arriving for her first session, the one who is intuitively seeking for her Monday-maps to change, is also likely, given our culture, expecting this change to happen fast.”

“The place where we don’t-know, and feel stuck in the therapeutic process, is often the place that holds the nub of why our patients came to see us.” - Peebles, M.J. (2022).

“Discussions in classrooms could not explain what it would feel like to sit in a room with someone who wanted, and at the same time did not want, to be there with me.” - Peebles, M.J. (2022).

The papers I vowed to read over the summer.

“CBT is not without virtue, and in a sense the problem is not with CBT itself, (…). Problems became apparent when CBT’s ambitions expanded to colonize all forms of psychological suffering.” - Dalal, F. (2018).

“As things stand today, in order for something to count, it must be countable. But further, and more worryingly, in some contexts the number itself becomes more real than the thing it is apparently representing, some much so that in some instances the numbers become the reality.” 1/

“Psychoanalytically, Bion suggests, the royal road to O is through the analyst’s suspension of memory, desire, and understanding. Since memory focuses on a past that is already gone and desire on a future that does not yet exist, one is left only with the present.” - Reiner, A. (2023).

“Bion’s ideas about lies are also among his most useful ideas in understanding mental functioning. We may see patients who function at a high level but whose primary mode of mental functioning is a lie. 1/

“Apropos of Bion’s (1962) early idea that thinking develops ‘as a method or apparatus for dealing with thoughts’, many writers say that they don’t write to express what they think, but rather to find out what they think, as their unthought thoughts are revealed to them.” - Reiner, A. (2023).

“To hear the selected fact requires the intuitive waking dream state of the unknowable O, which starts with our having the faith and courage to face our own ignorance, to stop thinking about what we know so we can focus on learning what we don’t know.” - Reiner, A. (2023).

“Bion adds that if one can suffer pain one can also ‘suffer’ pleasure, so the real issue isn’t pleasure or pain but the capacity for a mind able to tolerate the reality of feeling.” - Reiner, A. (2023).

“How does one address an absent self when the false self knows nothing of the true self or its needs?” - Reiner, A. (2023).

“Silence has an important role in analysis, for one has to take time to feel, and think, and keep observing without preconceived ideas, in order to detect the underlying meaning of a session.” - Reiner, A. (2023).

“Some people may be frightened of Bion’s ideas without recognising that what is actually feared is the uncertainty of a vast, unknowable human mind beyond our control.” - Reiner, A. (2023).

“His [Bion’s] tendency to leave space for people to think for themselves seemed evasive to some, or purposefully confusing, and others wondered if he was psychotic.” - Reiner, A. (2023).

“A rigid allegiance to one or the other type of analytic thinking can narrow the way one listens to the patient. Worse, it can lead to a situation where the analyst does not listen at all because his theory offers him a prepackaged and formulaic understanding.” - Akhtar, S. (2012).

“The relevance of silence to psychoanalysis becomes unmistakably clear when one takes into account that silence between two (or more) human beings can signify a vast range of feelings and psychic configurations.” - Akhtar, S. (2012).

“Analytic listening, for Freud, was not restricted to the patient’s spoken words. It also included paying attention to his silences, and to the non-verbal cues he offered. Attention of such breadth required a relaxed submission to all the input that was coming one’s way.” - Akhtar, S. (2012).

“The analyst’s investment in her own therapeutic powers probably inevitably always functions partly to help the analyst heal herself. 1/

“Being the analyst is never simple; when it seems to be, there is something wrong.” - Mitchell, S.A. (1993).

Freud (1917) on the existence of unconscious mental processes and the importance of drives: “With two of its assertions, psychoanalysis offends the whole world and draws aversion upon itself. One of these assertions offends an intellectual prejudice, the other an aesthetic-moral one.”

“Usually when we introduce a patient to a medical technique which is strange to him we minimize its difficulties and give him confident promises concerning the result of the treatment. When we undertake psychoanalytic treatment with a neurotic patient we proceed differently. 1/

“Feeling your pain is what makes movement possible, while turning away from it ensures you will stay stuck in it. Perhaps this is what the psychoanalyst Bion was exploring when he wrote that good therapy should ‘increase the patient’s capacity for suffering’”. www.theguardian.com/lifeandstyle...

“Ideally, the process of training should educate but not indoctrinate, and encourage freedom of thought within a psychoanalytic framework without espousing any one variety of psychoanalysis.” - Bateman, A.W., Holmes, J., & Allison, E. (2022).

“There is an inherent tension in psychoanalysis between the need for creative uncertainty, and the search for safe footholds in the uncharted terrain of the mind. The former can all too easily degenerate into muddle and mystery, the latter into dogmatism.” - Bateman, Holmes & Allison. (2022).

"[Freud] became more and more convinced that our thinking is influenced by processes of which we are not consciously aware, that we are actively invested in remaining unaware of these processes, and that we will resist efforts to make us aware, (…) 1/

“He [Michael Sussman] notes that if you ask therapists why they chose their profession, you will get generic answers about wanting to help people, doing something to change the world, wanting to solve problems, and making money.” 1/

Greenson (1967) on defenses: “Let us take as an example the patient who reads books and articles on psychoanalysis in an attempt to discover things for himself and thus avoid the surprise of coming upon the material unprepared.”

“I contend that the clinical fear of breakdown is the fear of a breakdown that has already been experienced. It is a fear of the original agony which caused the defence organization which the patient displays as an illness syndrome.” - Winnicott, D.W. (1974).

What is the most inspiring psychoanalytic paper you’ve ever read, and why?

“It [working through] refers in the main to the repetitive, progressive and elaborate explorations of the resistances which prevent an insight from leading to change.” - Greenson, R.R. (1967) in: The Technique and Practice of Psycho-Analysis.

“The object can cast its shadow without a child being able to process this relation through mental representations or language. While we do know something of the character of the object affects us, we may not have thought it yet. 1/

Can we do psych without psychoanalysis? @psychiara.bsky.social offers some thoughts. www.psychologytoday.com/intl/blog/fr...

The ability to read a scientific study does not guarantee the ability to understand a scientific study.

Psychodynamic therapy is valuable because it has been an incubator of psychotherapeutic innovation for almost a century. Most of the contemporary psychotherapies, and many developed and discarded along the way, have emerged from it. - Summers & Barber (2010)

“A successful analysis results in a much more complex experience of oneself than that with which one began. The analysand learns that there is much more to him than he has previously fully known or been able to use.” - Mitchell, S.A. (1993).

“The state of psychoanalytic knowledge is not anchored in enduring truths or proof, but rather in its use value for making sense of a life, deepening relationships with others, and expanding and enriching the texture of experience.” - Mitchell, S.A. (1993).