Maggie's Farm

I thought that I had completed my thoughts about the Psychoanalytic meetings, but I have one more thought to briefly put on paper.

In the US, psychoanalysis is mainly a research tool. It is not, and never will be, a widespread treatment for disorders of the soul because most people cannot use it, and because people have become so dependent on their insurance which will never pay for analytic treatments. Thus it will remain an endeavor for the few, available to the few, and practiced by an elite few (mainly in a handful of metropolitan areas) - the high priests of the craft of psychological treatment.

(Incredibly, in Europe government insurances pay for psychoanalysis, but many believe that if paying for it does not hurt, it will not work. Nobody appropriately values "freebies".)

So, in the US, analysis is a benefit for the few - truly an elective procedure -  but a source of data and information and theorizing which can benefit many. We have yet to find a better method than Freud's for investigating the depths of the heart and soul.

Editor's Note: For Dr. Bliss' recent posts, just click here.

I am back home in Boston. A few final thoughts from the analytic meetings:

1. It makes more sense to speak about "engagement" in treatment than to speak about "treatment alliance" or "therapeutic alliance."

2. A capacity for self-analysis is one good indicator for the end of an analysis.

3. Is psychoanalytic theory, especially its meta-theory, little more than an intellectual crutch for the doctor?

4. Not news, but analysts are prone to all of the obnoxious and nutty human traits that everyone else is.

5. Classical psychoanalysis is for people with mainly neurotic conflicts and personality issues in the neurotic zone, but many are treating less-well put-together people with all sorts of non-classical analysis these days. I always find that interesting, but I am not sure it makes sense. Maybe I am old-fashioned, but I have an analytic tool-kit and a psychotherapy tool-kit, and they are different.

6. How come people who live a short train-ride into the city rarely do anything, but out-of-towners come in and catch a bunch of theater, the NYC Ballet (best in the world), some music, a museum or two like the Neue Gallery, etc. - and feed their souls for a year? Suburban sloth.

Finished my strenuous week in NYC with Jacques Brel is alive and living in Paris, an off-Broadway revival of the 60s hit. Some think that Brel was the greatest songwriter in world history.

I don't think that (David's psalms win the contest, for me), but they are damn good. The music and the singing are extraordinary. Plus they have kept the basics of Brel, but added a bit of appropriate stage movement. And the Zipper Theater (in an old zipper factory) is the funkiest place: you sit on old car seats. They have a bar in front, with a sign that says "Please bring your drinks into the theater."

Brel died in 1978, but he is alive and well at the Zipper. The NY Sun's review is here. The 1966 original recording is at Amazon.

Who really needs a psychiatrist? My wife tells me what's wrong with me every day, for free.

Anon.

More items from the American Psychoanalytic meeting in NY this week:

1. Confidence that antidepressants will work improves their effectiveness by around 40%. I don't know what that means, and I tend to doubt it - but that's the data. Interesting. There are still many analysts who feel that antidepressants interfere with treatment. They could be right.

2. Most psychoanalysts practice very little analysis. It's the nature of the modern world. Analysts regret it, but they feel that their rigorous and lengthy training helps them in whatever they do.

3. I always knew this, but analysts tend to be stiff, unapproachable, stern, and unfriendly people. The presentations are humorless, cold, unrelaxed, and always delivered in a wierd - can I say "hypnotic? - monotone. Very strange, given their profession, in which they are very kind and caring. And yet an analytic meeting is the coldest, most unfriendly sort of "convention" you could ever find. Nobody chats, nobody hoists a few beers at the bar - unless they know eachother already. They are totally isolated at the meeting, which is not fun at all. Even when you sit next to them, they don't acknowledge your existence. It's like an Episcopal Church. A bit schizoid. When you smile at someone and say "hi," you feel like you are intruding. I am not like that, at least since my second analysis. Will ask Nathan to try to explain this unpleasant phenomenon.

4. In semi-contradiction to the above, overheard at the Waldorf lobby bar between a somber but cute youngish analyst gal and a gal friend at 2 pm: "I need a drink or two. And then, let's go do some shopping or something. I need a break." Do not ask me what I was doing at the bar.

5. I always find it amusing that Freud never had a psychoanalysis. He said he did self-analysis, which I am certain that he did. Like any explorer, he opened many doors, and was wrong about some small things, but right about a few very big things. A hero, for certain.

6. "Self-psychology" and object relations theorizing: Just say the term "projected self-object" and I am asleep. Same goes for the words "Melanie Klein." I am outta there. This stuff is gobbledy-gook to me, and I ain't dumb. If you can't explain it to me in the King's English, forget it. No sale. Back to Charles Brenner.