SUFFERING AS A RESPONSE TO GRATIFICATION
As therapists and as patients, we naturally look for what has gone wrong in our lives to explain our anxiety or depression. Yet, as Freud discovered and as can be inferred repeatedly from news reports, people struggling with symptoms of depression and anxiety or engaging in self-defeating behaviors often have lives that are going unexpectedly well. For therapists and patients alike, this phenomenon can be difficult to recognize because patients naturally present what is going (or has gone) badly in their lives e.g. frustrations, disappointments, and failures.
The aim of this case conference will be to sensitize therapists to the possibility that when patients present with self-criticism, feelings of hopelessness, or self-defeating behaviors, their suffering may reflect an escape from intense anxiety triggered by heightened success. We will read three papers and follow a few clinical cases in order to familiarize participants with this phenomenon. We will also demonstrate ways to help patients recognize and deepen their understanding of it, so that they can better manage ongoing gratifications in their lives.
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.
The course will consider the question as to how the phenomenon being studied is impacted by race and culture, taking into consideration the effect of systemic racism on experiences of success. We will discuss whether and in what ways this phenomenon is universal across all cultures, and how it presents in specific ways in dominant and oppressed cultures. Since many of the papers in the literature on this topic center on case illustrations of individuals who are either White American or White European, we must consider how the culture of whiteness permeates our understanding of success and gratification, as well as the anxieties stimulated by those experiences.
Harris, A. (2012). The House of Difference, or White Silence. Studies in Gender and Sexuality, 13(3):197-216.
Tummala-Narra, P. (2013). Psychoanalytic Applications in a Diverse Society. Psychoanal. Psychol., 30(3):471-487.
At the end of this course participants will be able to:
- Recognize and identify instances, in your child and adult patients, in which anxiety or depressive symptoms are preceded by experience(s) of heightened success in school, work or relationships.
- Recognize and identify the defensive function of pain/suffering and self-defeating behaviors in the face of experiences of gratification.
- Demonstrate ways in which the therapist/analyst can help patients recognize self-defeating behaviors and depressive affects as responses to experiences of success.
- Demonstrate ways in which the therapist/analyst can help patients develop or strengthen more adaptive ways of coping with success.
- Demonstrate ways to help patients grasp some of the reasons why success triggers anxiety.
- Demonstrate ways that anxiety triggered by success manifests itself within the therapy relationship.
- Discuss how this phenomenon is impacted by race and culture, taking into consideration the impact of systemic racism on experiences of success.
- Bartels, A. and S. Zeki (2004). The neural correlates of maternal and romantic love. NeuroImage, 21(3), 1155–1166. doi: 10.1016/j.neuroimage.2003.11.003.
- de Maat S, de Jonghe F, de Kraker R, et al. The current state of the empirical evidence for psychoanalysis: a meta-analytic approach. Harv Rev Psychiatry. 2013;21(3):107-137. doi:10.1097/HRP.0b013e318294f5fd
- Gilbert, P. , McEwan, K. , Catarino, F. , Baião, R. and Palmeira, L. (2014), Fears of happiness and compassion in relationship with depression, alexithymia, and attachment security in a depressed sample. Br J Clin Psychol, 53: 228-244. doi:10.1111/bjc.12037
- Høglend, P, A. G. Hersoug, K. Bøgwald, et al. (2011). Effects of transference work in the context of therapeutic alliance and quality of object relations. Journal of Consulting and Clinical Psychology, 79(5), 697–706. doi: 10.1037/a0024863.
- Leichsenring F, Leweke F, Klein S, Steinert C. The empirical status of psychodynamic psychotherapy - an update: Bambi's alive and kicking. Psychother Psychosom. 2015;84(3):129-148. doi:10.1159/000376584
Diane Donnelly, Ph.D., is a psychologist and psychoanalyst on the SFCP Faculty. She practices in San Francisco and Marin, where she sees adults and children. In 2012, she received JAPA’s New Author Prize for her paper “The Function of Suffering as Portrayed in The Scarlet Letter and Reflected in Clinical Work.”
This course is intended for licensed mental health professionals at all stages in their career who have a foundation in basic principles of psychoanalytic theory and technique and are familiar with concepts such as repression, drives, defense, and transference/countertransference.
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.