Psychoanalytic Institute of Northern California

ABSTRACT In my commentary, I discuss the ways Danielle Novack joins the body of analytic writing about people on the continuum of “lostness” and how we adapt the analytic frame to reach them. Novack offers a beautiful clinical example of “analytic fostering” by becoming her patient’s lifeline. However, I take issue with the use of the term fostering as foster children never afford the illusion that their foster homes are “theirs.” In psychoanalysis we strive to offer a sense of a lasting home rather than a temporary refuge. I introduce Milner’s idea of the “framed gap” to conceptualize the analytic framing process and end with some thoughts about the societal meaning of the recurrent presentation of people struggling to feel alive and the ways the framed time and space we offer in analysis becomes sacred – holding the potential for awakening new life.

Behavior arises from the convergence of multiple constraints rather than single causes. The ARCH × Φ model formalizes this process as a computational grammar of behavior, in which Archetype (A), Drive (D), and Culture (C) interact multiplicatively, and expression occurs only when a context-sensitive threshold (Φ) is crossed. This scalar–vector framework specifies behavior as probabilistic and testable, supporting hypotheses that can be evaluated across neurobiological, behavioral, and symbolic domains. We define a provisional taxonomy of ten archetypal systems (Systema Behavorum), such as Agonix (competition), Theromata (caregiving), and Sacrifex (self-sacrifice), which serve as structured inputs to the grammar. ARCH × Φ integrates ethology, affective neuroscience, psychiatry, and cultural psychology, reframing archetypes not as metaphors but as conserved neural scripts subject to scalar amplification and symbolic modulation. The framework supports falsifiable predictions, operational definitions, and clinical applications in decoding motivation, threshold dysregulation, and symbolic distortion. ARCH × Φ thus reframes behavior as an emergent property of convergent constraints across biology, affect, culture, and context.

ABSTRACT This introduction to the special issue on Writing Subaltern Bodies into Psychoanalysis: Autotheory Outside Acceptability presents the editors’ process of generating the idea, presenting on this topic, and being invited to assemble these works to add to psychoanalytic literature on theories of bodily relation. In the face of entrenched psychoanalytic hierarchies set on stabilizing and disciplining the subaltern, the editors find it imperative to continue adding to emerging and prominent literature that erodes the need to preserve these hierarchies and instead offers multiplicity, plurality, and new representations in psychoanalysis of common, yet singular, experiences rarely spoken from the position of the subject. This issue centers autotheory as a way of making theory in the face of limited representation. This introduction ends with an invitation to the reader to make their own theory from lived experience and psychoanalytic reflection in order to recenter curiosity and creativity, which can often be stifled or absented in the service of maintaining normative hierarchies.

ABSTRACT This essay discusses Victor Erice’s film The Spirit of the Beehive in terms of issues relevant to psychoanalysis today: the impact of socio-political trauma on the psyche. Through his cinematic artform, Erice captures the isolation and emotional deadness of village life in the aftermath of the Spanish Civil War which we discuss in terms of the contemporary interest in intergenerational transmission of trauma as well as the expansion of the psychoanalytic paradigm to include socio-historic events impacting unconscious processes. Through a personal narrative of a young girl’s plight, the film captures her mind-numbing surrender to fantasy elaborations – which serves as an allegory for the people of Spain’s mind-numbed surrender to fascist dogma. Throughout the film, a witness is needed, so Erice turns to us, his viewers to take on this role. Beyond being a coded exposé of Franco’s regime, the film serves as a warning with disturbing relevance today.

ABSTRACT Of all current psychologies, psychoanalysis is the most engaged with the complex and chaotic dimensions of human development and suffering – intricate psychic processes, fluxing mental and physical states, unexpected shifts between clarity and confusion, big changes following small inputs, uncertainty about causes and locations – including whose thoughts belong to whom, and more. These crucial elements, however, have not always been taken up explicitly. Nonlinear dynamic systems theory (NLDS) provides an aesthetically pleasing and scientifically current framework for these factors and illuminates established clinical practice and theory. Through clinical examples, conceptual elaboration, and an account of the author’s growing interest in this field, this paper offers a user-friendly invitation to NLDS.

ABSTRACT This paper begins with fragments which came unbidden as I began working with patients during the covid-propelled move to my home office. While my intent in moving to this office was to hold on to my identity as an analyst with so much slipping away and to help my patients hold on to our work through the trauma of covid – not to mention the ongoing political upheavals as well as the horrors of global warming – little did I anticipate that I was moving to a site with a more visible grounding in a social problematic. I hadn’t foreseen the issues which would arise regarding social privilege – issues with which I would fortunately have to reckon working from home in an affluent neighborhood with a dilapidated house next door. Excerpts from my clinical work with 3 patients are presented which reflect efforts to broaden/contextualize my more traditional way of thinking and working.

Abstract Background: Tiragolumab is a fully human IgG1 monoclonal antibody targeting the immune checkpoint TIGIT and is under evaluation in combination with anti-PD-L1 (atezolizumab) therapy. Here we report PK, safety, and preliminary anti-tumor activity from a Phase I open-label study (YP42514, CTR20210219) evaluating tiragolumab + atezolizumab in Chinese patients (pts) with advanced or metastatic solid tumors. Methods: Pts ≥18 years of age with an ECOG performance status of 0 or 1, a life expectancy of ≥12 weeks, adequate hematologic and end organ function who were residents in mainland China were eligible. Pts received tiragolumab 600 mg + atezolizumab 1200 mg IV every 3 weeks. Serial PK sampling was obtained in the first dosing Cycle on Days 1, 2, 8, 15, and 21, followed by sparse peak and trough collection. PK parameters were assessed by noncompartmental analysis and summarized using descriptive statistics. The severity of adverse events (AEs) was assessed using NCI CTCAE v5. Confirmed overall response rate and duration of response (DOR) were determined by investigator. Data cutoff: Feb 10, 2022. To support the dosing approach, findings in the current study were compared with results of a global Phase I study GO30103 (NCT02794571) [Bendell JC, et al. Cancer Res 2020;80:(suppl 16; Abst CT302)] in pts from France, Korea, Spain, the United States, Canada, and Australia receiving the same combination and dosing regimen. Results: Twenty Chinese pts were enrolled and received a median of 5 doses of tiragolumab + atezolizumab. Pts had a median age of 57.5 (range 44-73) years, were mostly male (85%), had a median of ≥2 prior lines of therapy and 30% of pts received prior immunotherapy. Non-small cell lung cancer was the most common tumor type (55%). Exposures in Chinese pts were comparable to the global population, with a geometric mean ratio (GMR) of 1.07 for Cycle 1 tiragolumab area under the concentration-time curve from 0 to 21 days, and a GMR of 0.92 and 0.93 for Cycle 1 peak and trough atezolizumab exposure, respectively. The frequency of treatment-related AEs, all-cause grade 3/4 AEs, grade 3/4 AEs of special interest, and AEs leading to withdrawal from study treatment were generally similar for pts in China (85.0%, 40%, 10%, and 5.0%) and those in the global GO30103 study (71.3%, 41.7%, 5.3%, and 5.6%). Treatment exposure was similar in the YP42514 study vs the respective global GO30103 cohort. Two Chinese pts (10%) had a partial response, their DORs were 3 and 6 months (censored), and seven pts (35%) had stable disease. Conclusions: Tiragolumab + atezolizumab was tolerable with preliminary anti-tumor activity. No meaningful differences in the PK or safety profile of tiragolumab + atezolizumab were seen between Chinese and global populations. Citation Format: Colby Shemesh, Yongsheng Wang, Andrew An, Hao Ding, Phyllis Chan, Qi Liu, Yih-Wen Chen, Benjamin Wu, Qiong Wu, Xian Wang. Chinese race and origin have no clinically meaningful effect on tiragolumab and atezolizumab pharmacokinetics and safety in patients with advanced solid tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr CT266.

ABSTRACT In his beautiful mediation on the sights and sounds that crest in waves of oceanic feeling, Adam Blum challenges a false binary between intuiting the moment and understanding the moment – and, by extension, being in love and knowing love. With attention to how temporality inheres differently during listening and seeing, I describe how psychoanalysts and anthropologists differently locate structure in the manner of being in time that their method posits. Surfers and yoga practitioners span perception immersively – as does Blum – such that listening and seeing, being and knowing, inhere as union, in an Ocean that, when encountered in the simultaneity of possibility and constraint which translates as the love fellow surfers share, joins accomplices in the arc of history at the peak of momentum, as a community vested with the challenge of the next climactic wave.

ABSTRACT As the use of psychedelic agents become a part of mental health treatment, psychoanalysts have the challenge of theorizing how they affect the psyche and the relational field, as well as how they might become part of an analytic process. In this paper, I explore three aspects of psychedelic experience and some ways we might start to understand them in analytic terms. I discuss states of consciousness, transformations to psyche-soma, and the relationally mediated nature of transformational experience. I also describe a case in which I used the psychedelic agent ketamine in the context of a long-term psychoanalysis. This case illustrates ways that psychedelic psychoanalysis can be useful in repairing early attachment wounds, facilitate the healing of transgenerational ancestral trauma, as well as intensify and complicate the transference/countertransference matrix.