Insider: Galit Atlas and “Emotional Inheritance: A Therapist, Her Patients, and The Legacy of Trauma.”(2022)

Galit Atlas, Ph.D. is a psychoanalyst in New York , who has just published a new book about emotional inheritance. She has brilliantly and elegantly shared stories of various types of intergenerational trauma of her therapy patients mixed with some of her own life experiences, particularly growing up in Israel and being part of the Israeli army. I have written about case studies or case stories as part of my post on “fictive healing”. I have also posted reviews of Irvin Yalom’s work, some of which include “Love’s Executioner”(1989) and “Momma and the Meaning of Life” (1999), and Lori Gottlieb’s “Maybe You Should Talk to Someone” (2019). There are also plenty other collections of case stories by other therapists. What distinguishes Atlas’s book from others is that she has followed the thread of intergenerational trauma throughout her patients’ stories while sharing an intimate glimpse into a psychoanalytic therapeutic process and the relationship between a therapist and her patients. She does this without obvious use of analytic jargon. And she shares her own experiences not to highlight them but to help contextualize how she works to help her patients move through their dilemmas. I had written about Lori Gottlieb’s clear explanation of therapy terms, such as transference and countertransference. Atlas has explained what these terms mean without ever using the terms but telling the story of each therapy session and the dynamics of the therapeutic relationship. Another distinction between Atlas’s book and most others, to include those of Gottlieb and Yalom, is that she keeps the focus on her patient’s stories without displaying the cleverness of her analytic interpretations or interventions. She almost always supports her patients in their interpreting and moving through their own conflicts.

During a time in the U.S. when psychoanalysis has been falling out of favor for several decades (though as I have written elsewhere psychoanalysis is still popular in Argentina, Israel, France, and possibly a few other countries), Atlas has been able to sneak into her stories the depth and effectiveness of a psychoanalytic process without announcing it as psychoanalysis, and any particular school or approach of psychoanalysis. Her own approach is relational psychoanalysis and she mentions this but only briefly. I believe she has done a great service to the psychoanalytic community by featuring the process in an engaging storytelling manner to a general audience. Along the way there are a number of terrific, almost throwaway, comments with profound meaning. Here are some examples:

Summarizing one of her patient’s journeys as an illustration of emotional inheritance, she states “In the end, we come to realize that it is the unexamined lives of others that we ourselves end up living” (p.262).

“Sex and money are two topics that people usually try to avoid, not only in their lives, but in therapy too.” “Any unwelcome feeling can be expressed through sex or money: aggression, hostility, the need for domination and power, as well as fragility, narcissism, and trauma.” (p. 243).

“Unprocessed abuse keeps the intergenerational cycle going”. “Healing – breaking the cycle of abuse- is often filled with resistance to the possibility of change. That possibility intensifies the conflict between the part of the self that strives for future liberation and the part that is connected to the past and to previous generations.” (p. 223).

“Paranoid thoughts are a result of our aggressive feelings, feelings that we couldn’t tolerate and needed to get rid of by attributing them to another person. the more aggression is disowned and projected onto others, the more frightened we become of those people.” (p.215).

“Confusing the therapist with intense feelings, evoking fear, or even presenting intense erotic fantasy can serve as a defense strategy to make sure the therapist is unable to think, and therefore unable to know anything real about the patient.”(p.209)

“Heterosexual culture often overvalues solidness, which is associated with erection, masculinity, independence, and activity, while it devalues fluidness, which is associated with femininity, vulnerability, passivity and even contamination.”(p.164).

“A dynamic communication evolves that includes moments of mismatch and potential misunderstanding, followed by moments of re-attunement and repair.”(p.142)

“When our minds remember, our bodies are free to forget.” (p.119)

Referring to Freud’s writing about melancholia and mourning, Atlas says: “melancholia, according to Freud, is an unconscious process in which, instead of detaching and withdrawing the emotional investment from the lost person, the melancholic preserves and keeps that person alive inside them through identification with the dead. If the person is me and I am them, then there is not loss. Keeping the lost person caged inside denies the loss, but at the same time it holds the melancholic person forever captive to it. As a result she loses parts of her own investment in life and vitality.” (p.75)

All of the above quotes are imbedded within case stories, thus they relate directly to what is going on between the therapist and her patients, yet, as can be gleaned from each quote they convey significant insight into the various conflicts, issues, insights, and possible resolutions of the knotty human behavior conundrums we can all relate to.

For various reasons, trauma and Post Traumatic Stress Disorder (PTSD) as a topic in its many manifestations, has become almost too familiar to a general population. One of the benefits of this is that those who have suffered from PTSD or other related trauma symptoms are more likely to seek help from therapy, since social stigma about this and other psychological illnesses has been somewhat reduced. A possible downside of such broad social references to trauma and PTSD is that there may have become an over interpretation about what trauma is and who has been traumatized by whom. There is ongoing debate among psychologists about what might constitute trauma, PTSD, types of trauma, various treatments for various types of trauma symptoms, etc. Current research indicates that one size (trauma and treatment) may not fit all (types of trauma and types of treatments). As more people who have experienced various types of trauma in their lives share their stories in memoirs, documentary films, fictional representations, and in undergoing serious therapy, such as that of Atlas’s psychoanalysis or other treatment modalities, we will likely be able to parse particular kinds of trauma which will be responsive to particular kinds of therapy. As in some of my other posts, I have indicated that a systems approach will be the most successful in the long run. Allopathic drugs have not been particularly helpful, and certain CBT treatments are not the answer, but MDMA (Ecstasy) has shown some promise and a combination of careful clinical use of MDMA plus various alternative healing modalities, such as yoga, meditation, and so on, plus talk therapy (psychoanalysis) may be the most effective.

Atlas has helped us understand the inner workings of how one’s parents, grandparents, and other relatives who may have experienced some trauma can manifest in each person who continues to experience traumatic symptoms, and how we might be able to seek help from a psychotherapist who can accompany us in navigating the challenging journey of recovery.

The Importance of Erich Fromm: A Review of “The Lives of Erich Fromm” by Lawrence J. Friedman (2013)

On Multiple levels, Erich Fromm’s writings were prescient and as relevant currently (2021) as they were in the 1940s through the 1970s. Fromm was a psychoanalyst, social psychologist, political activist and public intellectual – perhaps the most influential one in the U.S. during the 1950s through the 1970s. Lawrence Friedman’s biography of Erich Fromm is a thoroughly engaging and balanced investigation into the many “lives” or areas of involvement of Fromm.

A key to Fromm’s impact is what Friedman states in his Prologue: “Fromm’s ‘life’ as a social critic and ‘public intellectual’ was facilitated by his remarkable capacity to convey complex thoughts in psychoanalysis, ethics, theology, political theory, social philosophy, cultural creations, and much more in simple, direct prose, that appealed to the latent ideals and fears of his time.” (p.xxi) I will not be commenting on most of Fromm’s books, but just to note here that his “Art of Loving” from 1956 has sold over twenty million copies, and “Escape from Freedom” (1941),according to Friedman, the “deepest and most important of Fromm’s books, which excavated the social psychology of authoritarianism during the age of Stalin and Hitler, has sold more than five million copies.” (p.xxii) And most of Fromm’s more than twenty books have sold in excess of a million copies.

Fromm was the rare social scientist/philosopher who influenced and was influenced by a number of disparate individuals and groups: Margaret Mead and her interdisciplinary circle of anthropologists and psychologists, often referred to as the culture and personality group; the Frankfurt Institute group, including, Theodore Adorno, Max Horkheimer, Herbert Marcuse and others; the sociologist David Reisman ; psychoanalysts Karen Horney and Freida Fromm-Reichmann, each of whom Fromm was married to; his twenty-three years in Mexico (1950-1973), where he established the Mexican Psychoanalytic Institute and prepared numerous Mexicans to become psychoanalysts; D.T. Suzuki, who mentored Fromm in his brand of Zen Buddhism; Martin Buber, who influenced Fromm and Freida Fromm-Reichmann in the 1920s to open a “therapeuticum’ for Jewish patients in Heidelberg; Fromm counted as friends, Adlai Stevenson, William Fulbright, Philip Hart, and Eugene McCarthy, all of whom sought his advice on world affairs.

Fromm remained committed to both Marx’s and Freud’s central ideas throughout his career. While he eventually distanced himself from Freud’s libido drive theory, he incorporated many other psychoanalytic insights into his own social character theory. Freidman states, “Fromm’s theoretical alternative to Freud was a vaguely outlined concept of ‘social character’ where external social structures recast inner impulses and provided a person his orientation in life.” (p. ) Fromm continued to wrestle with how to incorporate or discard Freud’s libido and instinct drive theory as he developed his own theory of social character. Freidman quotes Fromm: “Character can be defined as the form in which human energy is canalized in the process of assimilation and socialization… the character system can be considered the human substitute for the instinctive apparatus of the animal” (p.xxv) And: “Socially produced drives are specifically human and have to be explained as reactions toward a particular fit of social conditions and not as ‘sublimations’ of instincts” (p.xxvi) Freidman claims that Fromm continued to modify his concept of social character for the rest of his life, but when he first developed it, while he was still a connected scholar with the Frankfurt Institute in 1939, Fromm felt it was mandatory to pursue an alternative to the libidinal theory, and this led to his dismissal from the Institute. Freidman states, “Fromm’s colleagues at the Frankfurt Institute, clinging to the literal wording of Freud’s early texts even as Freud departed from them, felt betrayed and called for Fromm’s termination.”(p.xxi).

I have asked myself why I am so drawn to Fromm and his ideas. The conception and construction of this blog about psychotherapy and culture may provide evidence of my attempts to bridge individual psychology and social theory and my own experience as a practicing anthropologist and psychotherapist has led me to appreciate how Fromm spent his life (or lives?) writing about this very notion of the relationship between the individual and social human. I have written about Gregory Bateson being a kind of ‘bricoleur’ as he moved thorough a number of intellectual disciplines. I now regard Erich Fromm as a both an intellectual and activist ‘bricoleur’. He consistently applied theory to practice and he was able to reconceive and reconstruct his theories and practices based on new political and social conditions wherever he was living and working (Europe, Mexico, the U.S.). I am particularly interested in Fromm’s combining Marxian and Freudian concepts and in his formulations about authoritarian personalities and Fascism, though I will comment on of some of his other ideas as I continue posts.

Fromm wrote “Escape From Freedom” in 1940 and his prescience about the rise of fascism and authoritarianism is particularly potent currently as we are experiencing similar patterns throughout the world more than 80 years later. We might question whether Fromm’s interpretation of what causes authoritarianism fits the rise of Hitler and Musolini in the 1930s and 1940s or Bolsanaro, Trump, Putin, and Duterte in the 21st century, but his cultural, psychological character notions deserve close consideration. Fromm argued that since the enlightenment humans had been experiencing enhanced personal freedom, but that this freedom often set up unmanageable anxiety and uncertainty. Freidman says, “it was less burdensome to delegate new found freedoms to authority figures and to embrace the false securities they promised (i.e. simply conform to external social pressures) than to trust one’s own powers of rational decision making.” (p.66). Fromm also proposed that the dynamic of forfeiting one’s freedom to an authority figure or institution likely set up a neurotic strategy of sadomasochism as a way of coping. Large populations under authoritarian leaders and systems may experience powerlessness and may in turn displace their anger and frustration on those who are perceived as “other” (immigrants, women, socially/culturally different). Freidman says, “Freedom required that the individual summon the energy and courage to make spontaneous, productive, reasoned and life-affirming use of his autonomy, Fromm argued. One must not delegate choices to authority figures that offered sadomasochistic appeals and demanded social conformity.” p.83)

While Fromm was still involved with the Frankfurt Institute group, he and they were committed to Freud’s essential drive theory and to Marx’s early writing “Economic and Philosophical Manuscripts” (1844). Fromm later (after he broke with the Frankfurt group and with Freud’s libido theory) wrote “Marx’s Concept of Man”(1961). Friedman says, “Fromm used ‘Marx’s Concept of Man’ to argue that the young Marx of the ‘Economic and Philosophical Manuscripts’ filled Freud’s conceptual gaps by offering a thoroughgoing critique of the capitalist society and values that orthodox Freudians had uncritically accepted. Fromm found Marx deeply sensitive to inner, and often unconscious, psychological motivation. Fromm’s Marx was essentially a socialist humanist and a formulator of what he called ‘productive social character’.” (p.223)

In further explaining Fromm’s embracing humanist ideas of Marx, Friedman states: “In characterizing the 1844 Marx, Fromm was essentially expounding his own prophetically tinged credo for the 1960s. Marx’s essential concept was to transform man from an alienated laborer who detested his routine work and consumed to fill a sense of inner emptiness. Estranged man worked simply to have goods and services, not to be a vibrant, loving, creative, and productive entity. For Marx, ‘true’ socialism represented ‘the emancipation from alienation, the return of man to himself, his self-realization’. Only through humanistic socialism would man cease to be miserable, cease being an estranged cog in the process to enhance productivity and profits for the few; he would transcend the chronic ‘antagonism between man and nature, and between man and man’.” (p. 223)

Fromm presented a paper, “Marx’s Contribution to the Knowledge of Man” in Paris in 1968, and published in his 1970 book, “The Crisis in Psychoanalysis”. In this paper/article, Fromm argues his case for Marx’s dynamic humanist depth psychology. There are hints in the paper/article about Fromm’s later reckoning of Freud’s and Marx’s approaches to psychology. Fromm says, “Marx saw, and in this respect more deeply than Freud, that consciousness is the product of the particular practice of life which characterizes a given society or class. It is ‘from the beginning a social product’, like language, it arises ‘from the need, the necessity for intercourse with other men, While man thinks he is determined and motivated by his own ideas, he is in reality motivated by forces behind his back and of which he is not aware.'” (p.74) Fromm further states, “Marx’s concept of consciousness and ideology led to one of the most essential parts of his theory of revolution. In a letter of September, 1843, he speaks of consciousness as ‘a thing which the world must appropriate, although it does not want to do so… our motto must be then: reform of consciousness not by dogmas but by the analysis of the mythical consciousness unclear to itself, be it religious or political’. The destruction of illusions and the analysis of consciousness – that is to say, awareness of the reality of which man is not conscious, are the conditions for social change.” (p.74)

Fromm followed this with: ” Awareness of reality as a key to change is for Marx one of the conditions for social progress and revolution, as it is for Freud the condition for the therapy for mental illness. Marx, not being interested in problems of individual therapy, did not speak about the awareness as a condition for individual change, but considering his whole psychological system, it is by no means a tour de force to make this connection.” (p.75)

Most of what Fromm draws from Marx’s 1844 paper is not widely known or understood, but Fromm makes a clear case that Marx , while focusing on social dynamics, had preceded Freud in his position regarding illusions and embracing reality. I subscribe to the same world view. Humanity has not changed significantly since either Marx or Freud established their theories. The world in 2021 is awash in illusions, fake news, scams, conspiracy theories, religious fundamentalism, and bold political lies. Alienated man is all around us. Inequality is rampant throughout the world. The confrontation with illusions and embracing of reality that both Marx and Freud argued for has not taken hold to any significant degree. My blog continues to engage individual behavioral issues and social cultural influences. A psychological, cultural, economic, social revolution awaits us.

Reviews: Lauren Slater – Welcome to My Country & Prozac Diary

I have written elsewhere about psychotherapy “insiders”, which refers to therapists and patients/clients who have written memoirs, or case studies/ case stories about their experiences with the therapy process and mental illness. One of the best insiders for providing an appreciation and understanding of the experiences of both a person suffering from mental illness and a therapist working with those who suffer from mental illness, is Lauren Slater, I reviewed her most recent book, “Blue Dreams” earlier. For this post I will refer to her books, “Welcome to My Country” (1997) and “Prozac Diary” (1999).

“Welcome to My Country” is both about Lauren’s own breakdowns and ongoing depression and the various issues and insights about her clients in her psychotherapy practice, while “Prozac Diary” is all about her own history with depression and her “relationship” with Prozac. This is the best account, among many, of an inside view of depression and reactions to psychiatric medicines. I have used Slater’s book, along with Andrew Solomon’s “The Noonday Demon” for my “insiders” material on depression, which also interrogates the relationship between bio-chemical treatments and psychotherapy. “Prozac Diary” and “The Noonday Demon” are best for discussing the “illness-treatment”relationship and identity issues. Also, the issues of creativity, productivity, and self-worth, which may include the illness (depressions) or at least the dynamic of dealing with the “edge” – pain is worth investigating. Once Prozac or other psychotropic drugs may have removed the pain, what happens to the self or an identity which was previously known and which may have required some “pain” for the creative “whole” person? Both Solomon and Slater discuss this. Does Prozac create a different person? When influenced on a regular basis by a psychotropic drug, will it affect the person as a self – the psychology of one who is in the world and relationships with other people?

Slater comments on people who said something like, “Prozac helped me become the person I was meant to be”. But Slater says, “And yet for me it was not that simple. My personality, yes, had always consisted of suppressed energies and curiosities, but also of depressions, echoing intensities, drivenness that tipped into pain, With the exception of the counting and touching obsessions, which I was only too happy to be rid of, I missed these things, or parts of them anyway, for they were familiar to me as dense fog and drizzle, which had its own sort of lonely beauty, as does a desert or the most mournful of music.”(p. 44).

I will post other material on depression later. There are quite a number of excellent accounts from other insiders, to include William Styron’s “Darkness Visible”, Anthony Storr’s “Churchill’s Black Dog”, Kathy Cronkite’s “On the Edge of Darkness”and several books by Kay Redfield Jamison.

In reflecting on both her being with depression and her role as a therapist, Slater, in “Welcome to My Country”, makes an observation which goes to the heart of the psychotherapy “enterprise”:

“What after all, is therapy, if not a story of progress? Such a story could be harmful to people who are bound to feel like failures in a  milieu where the expectation of improvement is so clearly etched. Perhaps the therapist’s job is not to help grow but to help shed, chipping away at the marbled mind until the original nubs and spurs emerge. Instead of thinking in terms of development, maybe we should be thinking in terms of sloughing, making the padded self thinner and thinner, until a true skeleton juts out.”(pgs 140-141)

Blue Dreams – Lauren Slater

I will be reviewing a number of memoirs by psychotherapists and people who have experienced psychotherapy as clients or patients. For a book that I originally conceived as “The Culture of Psychotherapy” one of my chapters is devoted to what I refer to as the “Insiders” – those on both sides of the couch, so to speak. I will share some comments and interpretations of various memoirs in future posts, but I want to begin with reviewing a recent book by my favorite insider memoirist, Lauren Slater. “Blue Dreams: The Science and Story of the Drugs that Changed Our Minds” (2018) is only part memoir. It is primarily about mind drugs and mental illness. Lauren Slater knows both better than most, as she has been both a long time patient both on and off various drugs, as well as a psychotherapist, helping others navigate their challenges with mental illness. Later I will comment on a few of Slater’s previous memoirs, particularly “Welcome to My Country” (1997)    and “Prozac Diary” (1998).

“Blue Dreams” is an engaging and  thorough tracing of the history of using various psychiatric drugs to deal with various mental illnesses. Slater has experienced numerous medications to treat bipolar and obsessive-compulsive disorders. She draws on both her own experiences and the research on the efficacy in trials and with ongoing patients in psychiatric care. Her conclusions are decidedly mixed about long term efficacy of any drugs, to include the once considered “miracle drug” – Prozac. The book’s chapters follow a general chronological path from Thorazine and Lithium through SSRIs to MDMA (Ecstasy) and Deep Brain Stimulation. Slater wants psychiatry to move toward discovering answers to “why” and not just “how”. She says: “I’d rather see psychiatry come up with a few theories that finally pan out, theories that illuminate the pathophysiology or etiology of depression, the structure of schizophrenia, the reason for the retreat that autism so often is.” “What, for instance, causes schizophrenia? How durable is the dopamine hypothesis, and what does it mean that when it comes to schizophrenics, drugs which dampen dopamine seem to diminish hallucinations and drugs that increase dopamine appear to make schizophrenic symptoms worse, even though, when researchers compare dopamine levels in so-called normal subjects with those in schizophrenic subjects, they find no correlation between high dopamine levels and psychiatric problems in the general population? Perhaps more compellingly, the low-serotonin story suffers the same fate. We have been told that depression and OCD are the results of too little serotonin in the brain, and that this is the reason why serotonin boosting drugs such as Prozac work. But some depressed people have a lot of serotonin while some well-adjusted people have less.”

Slater sums up her view of the possible future of psychiatry in her chapter ” Where We’re Headed”: “I think the future of psychiatry is, strangely enough, right here, in tiny tabs of acid and chalices of psychedelics such as ayahuasca, psilocybin, and MDMA. ” She also reviews the newest psychedelic that psychiatry has turned to – ketamine, a drug typically used by anesthesiologists during surgeries, but now being used (ketamine infusion therapy) only for those patients who are treatment resistant.

In a favorite passage of hers which looks back and points forward in psychiatry, Slater says, “Our next golden era of psychopharmacology, I predict, will be with psychedelics, drugs not discovered, but rediscovered. And in some strange way they reunite us with the father of psychoanalysis, Sigmund Freud, who believed that awareness was the vehicle by which we could be cured of our ills. At once brand-new and ancient, psychedelics allow us a radical awareness of our place and purpose in the universe; they actually seem to set us straight, these tie-dye drugs of the long-gone hippiedom.” Whether Slater is right about this or not we may be opening back up to psychedelics and we may approach them quite differently from our hippie past. We may also discover the “why” of some mental illnesses in the process?

 

Labyrinths: Emma Jung

There have been plenty of biographies of Carl Jung and plenty as well of other leading figures in the history of psychotherapy. I will be reviewing a number of them later, but because “Labyrinths: Emma Jung, Her Marriage to Carl, and the Early Years of Psychoanalysis” (2016) by Catrine Clay is the first biography of Emma Jung and her role in Carl’s life and the psychoanalytic movement, I feel it is fitting to feature her now. During this time in 2018 when we are gradually recognizing and giving credit to women who have contributed so much in many different fields, Emma Jung, as the wife of Carl has rarely been mentioned in literature about the psychoanalytic movement. Emma. She was a wealthy heiress and fell in love with Carl when she was just seventeen. Her wealth enabled him to accomplish a number of things he would otherwise not have done. But it was her steadfastness, tolerance and intelligence which withstood his various affairs and long time quasi marriage to Toni Wolff, that helped Carl succeed. She supported him and her children, and acted as Carl’s thinking partner during the early years of his relationship with Freud. She traveled with Carl for some of his trips to Vienna to work with Freud and she had a series of personal letter exchanges with Freud herself. She stood by Carl when he finally broke with Freud. She eventually embraced his relationship with Toni Wolff. She became an analyst herself in her forties and one of her first analysands was Barbara Hannah, who was Carl’s first biographer. Emma’s approach as an analyst was different from most others: one analysand said, “She approached the problem you brought to her quietly, even tentatively, but there was no fumbling. To be “right” did not appear to interest her. She met you where you were at”.

I have read quite a number of works about the various figures in the psychoanalytic movement and the social/political rifts which were part of the early years. Reading about Emma’s role in helping Carl and herself in shaping the movement, regardless of the split with Freud, is essential in contextualizing what we already know. It really wasn’t all Carl.

Reviews

I will be posting occasional reviews of books, articles, films and television programs about psychotherapy. These reviews will be in random order and not in time sequence – in other words, some reviews will be about books from many years ago, while others will be very current. An example of a current review will be of the book by Catherine Clay (2016), “Labyrinths: Emma Jung, Her Marriage to Carl, and the Early Years of Psychoanalysis”.