IN THE REALM OF THE SENSES:
Conceptualizing the Experience of the Body in the Clinical Hour
A therapist notices her stomach burns when a patient talks about her daughter. A patient tells you about the onset of a terrible headache every time they arrive for an appointment. Another notes being able to use the bathroom at your office but nowhere else outside her home.
How do we make sense of our patients’ and of our own bodily experiences, perceptions, and sensations? Are these phenomena an essential part of work with all patients or unique to those less able to verbalize their feelings such as those with histories of trauma or perhaps those with forms of ‘severe psychopathologies’ including narcissistic or perverse structures? Do they represent regressions to earlier “pre-verbal” states of development, signs of unconscious disturbances in the “field,” or counter-transferential communications sourced in the patient’s unconscious? Or do they have an entirely different origin?
This eight-week class engages the psychoanalytic literature to help think through these clinical questions. It begins with a history of the body as both subject and object of psychoanalytic inquiry, looks in depth at some of the field’s foundational concepts such as Winnicott’s psyche- soma, Bick’s second skin, Anzieu’s skin ego, and Fonagy’s embodied mentalization, and aims to move beyond the blind-spots of a Eurocentric bias in the field. It seeks to expand its gaze to include a non-dualistic Buddhist perspective on oneness of self-and-other in the clinical dyad; the potential for reintegration of bodily experience carried through yet erased in the process of immigration; and a raised consciousness of our perceptions of racial difference and skin tone and of the effect of expectations of fixed gender binaries as they organize, constrain or disrupt the clinical frame. Last but not least, it will include time for conceptual integration through clinical discussion and leave room for other related topics of interest to the group.
NCSPP is aware that historically psychoanalysis has either excluded or pathologized groups outside of the dominant population in terms of age, race, ethnicity, nationality, language, gender, religion, sexual orientation, socioeconomic status, disability, and size. As an organization, we are committed to bringing awareness to matters of anti-oppression, inequity, inequality, diversity, and inclusion as they pertain to our educational offerings, our theoretical orientation, our community, and the broader world we all inhabit.
From the faculty—Maria Pilar Bratko, Kristen Fiorella, Eric Glassgold, Molly Merson, and Jyoti Rao:
What is our commitment to equity as a faculty? To answer this question, we note that each of us has a unique history and a unique process of evolution in our way of being human and in our way of being clinicians. We occupy different positions with regard to gender, gender identification, sexual orientation, age, ethnicity, and race and skin color, and we have different kinds of bodies with regard to shape, size and health status. Yet we share a commitment to a project of knowing ourselves better through psychoanalytic exploration and of leading more examined lives. While we share a conviction that psychoanalysis offers deep insights, we note too that psychoanalysis is a European cultural production that has primarily contemplated and engendered its own like-subjects while denying its colonial project of violence to indigenous, immigrant and queer subjectivities. We recognize, therefore, that psychoanalysis is an incomplete process for deepening our awareness of ourselves precisely because it has overlooked fundamental areas of our own experience as well as those of current and potential colleagues and patients who have felt or continue to feel unwelcome in psychoanalytic communities.
Consequently, as a faculty, we are committed to work that will open space for new and emerging voices, similar and different from our own—voices that represent local cultural knowledge, and the experience of people identifying as lesbian, gay, bisexual, trans, non-binary, queer, immigrant, indigenous, Native American, Asian, African, LatinX, Caribbean and of that of other persons of color. This commitment involves work in the intra-psychic and intersubjective realms but also a process of broadening our awareness of the process of psychoanalytic conceptualization to uncover and recover the social and cultural domains of clinical work. We are committed to learning from each other, from our patients and from all who come to study at NCSPP and most of all, to experiencing and creating change in a realm beyond words.
At the end of this course participants will be able to:
- Describe the bodily origin of the drive in classical psycho-analytic theory
- List two differences that contrast the relation of mind (psyche) and body (soma) in Winnicott’s conception of health with the relation of psyche and soma in traumatic “illness”
- Explain the early developmental and adaptive function of the second skin from Esther Bick’s perspective.
- Using Didier Anzieu’s language of the protective function and permeability of the skin in early object relations, list two different adult pathological outcomes arising from premature ruptures of a shared maternal and infant skin surface.
- Name three potential ways meanings assigned to skin tone differences can be unconsciously elaborated or enacted in the clinical pair.
- Name and describe one difference between a phenomenological perspective and an object relations perspective when conceptualizing bodily perceptions and sensations as forms of communication between patient and therapist
- Name two systems of oppression that affect the immigrant individual's relation to their body
- Name two considerations for treatment unique to the immigrant individual's body
- Anzieu, D. (2016) “The Notion of the Skin Ego” in The Skin Ego. London: Karnac, 2016, pp. 39-48
- Anzieu, Didier. (2016) “The Psychogenesis of the Skin Ego” in The Skin Ego. London: Karnac, 2016, pp. 59-72
- Bick, E. (1968) ‘The experience of the skin in early object-relations’, IJPA, 49, 484-486.
- De Micco, Virginia (2019) The Double Body of Adolescent Migrants: Between Traumatic Uprooting and Cultural Background. The Bulletin of the European Federation of Psychoanalysis, May 2019, pp. 1-10
- Fiorella, Kristin (2022) Thinking in a Marrow Bone. JAPA, in press
- Fotopoulou, A. & Tsakiris, M. (2017) Mentalizing homeostasis: The social origins of interoceptive inference. Neuropsychoanalysis, pp. 3-28
- Foehl, John (2014). Rays of the World: Depth and the Reversibility of Time. Rivista di Psicoanalisi, pp. 461-486
- Fonagy, P. & Campbell, C. (2017) What touch can communicate: Commentary on “Mentalizing homeostasis: the social origins of interoceptive inference” by Fotopoulou and Tsakiris. Neuropsychoanalysis 19:39-42
- Hansbury, Griffin (2011). King Kong & Goldilocks: Imagining Transmasculinities Through the Trans–Trans Dyad. Psychoanalytic Dialogues, pp. 210-220
- Langer, S.J. (2016). Trans Bodies and the Failure of Mirrors. Studies in Gender and Sexuality, pp. 306-16
- Novack, D. (2016) To Know Another Inside and Out: Linking Psychic and Somatic Experience in Eating Disorders. Journal of Infant, Child & Adolescent Psychotherapy 15:278-288
- Tummala-Narra, Pratyusha (2007). Skin color and the therapeutic relationship. Psychoanalytic Psychology, pp. 255-270
- Winnicott, DWW. (1975) Mind and Its Relation to the Psyche-Soma  in Through Paediatrics to Psycho-Analysis, London: Routledge, pp.243-254
- Wooldridge, T. (2018) The Entropic Body: Primitive Anxieties and Secondary Skin Formation in Anorexia Nervosa. Psychoanalytic Dialogues 28:189-202
Maria Pilar Bratko, MFT, DSW, is a bilingual (Spanish-English) psychotherapist working with individuals, couples, and adolescents who are bi- and multi-racial, bilingual, and immigrants. She has presented her dissertation research exploring use of native language in bilingual treatment at several international conferences. She has a private practice in Oakland.
Kristin Fiorella, Psy.D., MFT, is a psychoanalyst in private practice in San Francisco. She sees adults, adolescents, and children in psychotherapy and psychoanalysis.
Eric Glassgold, M.D., is a supervising psychoanalyst at SFCP and in private practice in San Francisco. He works with adults and couples.
Molly Merson, LMFT, is in independent practitioner working with adults and adolescents in psychoanalysis and talk therapy. Whether through writing, presentations, blogging, or in her work with patients, Molly interrogates whiteness and other systems of power and aims to incorporate decolonial approaches to healing. https://www.mollymerson.com/
Jyoti M. Rao, LMFT, is associate faculty and a psychoanalytic candidate at SFCP. She is in private practice in San Francisco and virtually.
The target audience for this course is early and mid-career psychotherapists and advanced trainees in clinical mental health fields who have a strong interest in psychoanalytic perspectives.
LCSW/MFTs: Course meets the requirements for 10.5 hours of continuing education credit for LMFTs, LCSWs, LPCCs and/or LEPS, as required by the CA Board of Behavioral Sciences. NCSPP is approved by the California Association of Marriage and Family Therapists (Provider Number 57020), to sponsor continuing education for LMFTs, LCSWs, LPCCS, and/or LEPs. NCSPP maintains responsibility for this program /course and its content.
Psychologists: Division 39 is approved by the American Psychological Association to sponsor continuing education for psychologists. Division 39 maintains responsibility for these programs and their content.
Enrollees who cancel at least SEVEN DAYS prior to the event date will receive a refund minus a $35 administrative charge. No refunds will be allowed after this time. Transfer of registrations are not allowed.