American Psychoanalytic Association

This paper argues that, despite being highly educated, psychoanalytic candidates need a particular orientation to become students of the strange and offensive unconscious, to help them learn to work together in the pursuit of the repressed. In this paper, the author describes an 8-week introductory course she has cotaught for the past 5 years at the Boston Psychoanalytic Society and Institute. As a kind of "Freud aperitivo course," it gives candidates something to nibble on to stimulate the appetite for depth and to stomach difficulties that arise. The rationale for such a course is based on Freud's ability and process in discovering psychoanalysis and the unconscious. Candidates can witness Freud's persistence in his highly stirring discoveries, finding clues within himself to guide him in discovering the unconscious and the universal. As candidates embark on their own stirring, anxiety-provoking processes of analytic discovery, they are invited to identify with Freud's pleasure in uncovering, to enable them to become a group capable of psychoanalytic learning. Next, the author walks the reader through what this course has to offer.

ABSTRACT Writing Attacks on Linking, it is as if Bion had listened to his former analyst. In a lecture on technique given the year before, Klein expressed the wish that someone would write “a book about linking [...] one of the essential points in analysis”. Later taken up and commented on in Second Thoughts, Attacks on Linking, has become perhaps Bion's most famous paper and, Freud aside, the fourth most cited article in the whole of psychoanalytic literature. In the short and scintillating essay Bion presents the enigmatic and fascinating concept of invisible-visual hallucinations, which subsequently seems never to have been taken up and discussed as such by other scholars. The author's proposal is therefore to reread Bion's text starting from this concept. To try to give a definition that is as clear and distinct as possible, a comparison is made with those of negative hallucination (Freud), dream screen (Lewin), and primitive agony (Winnicott). Finally, the hypothesis is formulated that IVH could give us the model of what stays at the origin of any representation; i.e. a micro-traumatic inscription of the trace of stimuli (but which may come to be actually traumatic) in the psychic fabric.

ABSTRACT When re-read today, “On arrogance”, a very brief paper Bion wrote in 1958, reveals its extraordinary topicality. We can think of it both as a commentary on Sophocles’ Oedipus Rex and as an essay on the “disease” of psychoanalysis. In both cases, lying at its centre is the triad of curiosity–stupidity–arrogance that drives us to know the truth “at any cost”. In this paper Bion redefines the crime of Oedipus (and therefore of psychoanalysis) around epistemic instinct and no longer around sexuality; he unveils the objectifying attitude of the analyst he revolutionizes the understanding of negative therapeutic reactions. The analyst’s “psychosis” (or that of psychoanalysis) finds expression in the phenomena of wanting to become a psychoanalyst, of aspiring to be “scientific” (as opposed to gaining a hermeneutical understanding), of wanting to tell the patient what he believes to be the truth, and finally of looking “down upon” his patients and colleagues. Anticipating the themes of Transformations and A Memory of the Future, “On arrogance” lays the groundwork for a cogent criticism of the ideology of psychoanalysis and an effective ethical re-foundation of the discipline.

Leonard Shengold, a highly esteemed psychoanalyst, died on 16 January 2020 at the age of 94. He was born to Jewish parents who had come to the United States from Minsk and Vilnius. He recalled, fro...

To examine internal medicine residency program directors' (PDs') screening practices and perceptions about current recruitment challenges. In March-May 2017, the Association of Program Directors in Internal Medicine Survey Committee sent a survey to 373 Alliance for Academic Internal Medicine member residency programs. PDs rated the importance of 23 inclusion and 11 exclusion criteria for interview invitation decision making, provided United States Medical Licensing Examination (USMLE) cutoff scores for U.S. medical school and international medical graduates, and indicated changes in recruitment practices due to application inflation, including their ability to conduct holistic review and interest in potential solutions to address application inflation. Exploratory factor analysis was used to identify and confirm factors that were most important to interview invitation decision making. The response rate for eligible programs was 64% (233/363). USMLE Step 2 Clinical Knowledge scores were the criteria most frequently reported to be "very important" (131/233, 57%). Among respondents who reported any criteria as "very important," 155/222 (70%) identified a single most important (SMI) criterion. Non-USMLE criteria were frequently reported as an SMI criterion (68%). Concerning exclusion criteria, 157/231 (68%) reported they "absolutely would not invite" applicants with hints of unprofessional behavior. Of the 214/232 (92%) who reported an increase in applications, 138 (64%) adjusted recruitment practices. Respondents were most interested in limiting the number of applications per applicant (163/231, 71%), allowing applicants to indicate high interest in a subset of programs (151/229, 66%), and creating a national database of qualities of matched applicants for each program (121/228, 53%). PDs rely heavily on USMLE scores when making interview invitation decisions. However, collectively, non-USMLE criteria were more frequently reported as an SMI criterion. Most programs adjusted recruitment practices to respond to application volume. Several potential solutions to address application inflation garnered wide support.

The concept of Bion of O is both essential and elusive like few others. By its ambiguous nature it gives rise to the most disconcerting interpretations and many misunderstandings. Among these is the idea of inaugurating a “mystical” psychoanalysis. To refute this thesis, the author proposes a path of reading that is certainly personal and at times even impervious, but that aims to insert this notion within a theoretical framework that is as clear, logical and coherent as possible. The meaning of the concept of O is only delineated in the relationship with other key concepts (mainly: transformation, invariant and at-one-ment). It therefore escapes us if we do not take into account the dialectical tension that arises from this fruitful trade and if we do not pay attention to the always different discursive contexts in which it is found. But above all it is important to realize that the concept of O is peculiar also in comparison to other more clearly specified and circumscribed concepts of Bion. In fact, it itself consists of a constellation of concepts, as many names or partial definitions.

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Karl is a tall, attractive man, a designer, who was in his early fifties when we met. He was in a state of turmoil. His wife and he had been in a roiling crisis for at least a year. Now, she was ab...