CHnical Social Work J o u r n a l Vol. 23, No. 2, Summer 1995

ON BECOMING AND BEING A PSYCHOANALYST OF TI4-E SOCIAL WORK P E R S U A S I O N

Roslyn Goldner, CSW, BCD

In considering my route to becoming a social worker/psychoanalyst, I mus t go back to the fifties for a glance at my formative college years. These were times of peace and prosperi ty tha t fostered a sense of secu- rity. Goals could be set with the expectation of fulfillment of the self. But there had been a major World War and a Korean conflict. Beneath the surface, the air reverberated with the fires from the Holocaust. The residue left a black cloud that would not disintegrate, but j u s t hung in the sky to be seen or felt for those who were willing to remember. It was a cloud made even darker by remnants of nuclear blasts over Hiroshima and Nagasaki. The fifties were fur ther darkened by McCarthyism with all its repressive aspects. Thus, the fifties were a t ime to consider the na ture of man and the psychological and social factors that shaped him. It was a t ime in which cloudy skies overhung a calm surface and formed in me a personal, idealistic commitment to do something to make this a bet ter world in which to live.

The fifties were also times of many rapid changes. We used some of the knowledge fostered by the war to develop the world of antibiotics, polyesters and plastics, to name jus t a few major developments in a world burgeoning with new ideas, perspectives and inventions. It was a world of DDT and the conquering of the mosquito; and, of the dread of malaria. Luckily, Rachael Carson warned us in the nick of t ime that the new chemistry was devastat ing our ecosystem and threatening our exis- tence on the planet, Earth. The fifties were times of change, with an impact too vas t to calculate.

With that setting as the backdrop the fifties, for me, were a t ime to explore a world teeming with new ideas and ideas new to me. It was my introduction to James Joyce's s t ream of consciousness and Salvatore Dali's clocks dripping off a table. It was an introduction to Mar tha Graham's modern dance burst ing with emotion. From an intellectually

2 1 ~ ~ 1995 Human Sdences Press, Inc.

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narrow, sheltered bourgeois existence I was suddenly exposed to new ways of thinking about an inner self, emotions and feelings and a mind's eye view of the world around. I had a course at college with George Klein, on Psychopathology and was taken with his elaborations of Freudian conceptions of how the mind worked. I was drawn to his por- trayal of a successful psychotherapy/psychoanalysis of an alcoholic woman. He used Uspecial" skills to understand her depression and dissi- pate her depressive need to drink. He stimulated me to think and dream of myself doing therapy.

In that college milieu seminal ideas, introduced by Freud a half cen- tury before, were discussed with excitement, hotly argued and much de- bated. At that time, I had become involved in a book by Adorno called The Authoritarian Personality, in an attempt to understand Hitler's rise to power and the Holocaust in psychological terms. That led me to read Freud's insights on Group Psychology and the Analysis of the Ego, which reflected his thinking about World War I and the immorality of group behavior. Reinhold Niebuhr, a Protestant theologian, confirmed Freud's finding in his book Moral Man and Immoral Society.

I was enchanted with the Freudian mode of understanding people rather than the academic curriculum embedded in behaviorism and ex- perimental psychology. It was an intellectual treat when a movie con- cerned with Freud's t reatment of Anna O was shown, and I became in- creasingly involved in reading Freud for myself. I marvelled at Freud's case histories and his revelations of the mysterious ways in which un- conscious thoughts pushed to the surface in disguised form, and how Freud took bits and pieces to form stunning interpretations. His seminal formulations regarding the unconscious, transference, the repetition compulsion, to name just a few, irrevocably challenged our concepts of ourselves as conscious, rational people who made conscious, rational de- cisions. Insights promised personal relief for the neurotic conflict. Be- yond that, by confronting our inner selves, he offered, we could make more rational choices and better shape our destiny.

I longed to be privy to this bold science, psychoanalysis, though probably thought of it as something akin to Pandora's box that offered some marvelous power to anyone who could withstand the noisome pain inflicted on those who would lii~ its cover. But, intrigued as I was, I understood it to be a medical speciality which put such goals off limits for me. Although my parents reluctantly allowed me the frivolous luxury of attending college, my whole family had lurking fears that graduate school would reduce my chances for a successful marriage. After gradua- tion, in compliance with the family plan, I had a brief, unhappy stint as a secretary. Luckily one of my friends, who did not know my suppressed ambition, had been in an analytically oriented therapy with a social worker and considered me to have much in common with her therapist. She persuaded me to explore the field of social work.

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After finding the field of social work held this and many other inter- esting opportunities, I enrolled in New York University's School of So- cial Services where I enjoyed the special status of being in its first class. My co-students were from diverse backgrounds but we shared a common liking of people and a commitment to helping others in different ways. While I had majored in psychology in college I was now learning to deal with people; to listen, to empathize and to guide people towards actively changing their own condition.

My first position was with the Mt. Sinai Hospital in New York City. I had veered into medical social work because of my special fascination with psychosomatic illness. Mr. Sinai was at the forefront of medical social work, with a department dedicated to advanced casework skills and a Depar tment of Psychiatry that was a veritable mecca teeming with psychoanalysts on their staff. Together we looked for the hidden emotional sources that aided and abetted healing, or seemed to compli- cate the process. The gynecology service, where I had been assigned, had weekly, dynamically oriented conferences in psychosomatic factors in ill- ness. Individual consultations were available, upon request, with well known psychoanalysts. Dr. Marcel Heiman, my primary liaison psychi- atrist, often elaborated how a specific patient had somatized her frus- trated libidinal needs.

The cooperative spirit between social worker and analyst flourished, based on somewhat artificially defined roles with the social worker as- signed the task of dealing with a patient by utilizing the patient 's con- scious material to improve social functioning, whereas the psychiatrist/ psychoanalyst dealt with the patient's unconscious conflicts which had led to their symptom formation. The diagnosis and t rea tment of mental illness per se was relegated to the physician only.

My discomfort with this division was brought home to me when a thirty year old woman with whom I had been working around adjust- ment issues related to a gynecological condition seemed preoccupied with a chronic rash of twelve years' duration. Though the rash had been diagnosed as organic in origin, something in this woman provoked my analytic curiosity and I made many inquiries of her regarding the onset of her rash. After many nonchalant responses to my questions she burst into tears and hysterically recalled how her mother had called her a whore for having allowed a handsome young man, with whom she worked on her first job, to drive her home. Still sobbing uncontrollably, she told how the rash had started on the inside of her thighs and spread down her legs and to the upper parts of her body. I met her tearful revelations with intense excitement of having gotten to the hear t of the matter, with worry that I had overstepped the bounds and I was amazed that I was confronted with conversion hysteria. I felt guilty that I wanted to bridge a forbidden gap and realized that my training, to date, had not sufficiently prepared me to deal with this patient. My deter-

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minat ion for further training was solidified though I took time out for marriage and raising children.

Meanwhile, the academic movement in social work was more clearly demonstrat ing the fact that it had integrated analytic theory into the area of casework services. Informed social work clinicians, such as Gor- don Hamilton, argued that Freud's profound formulations regarding personality, had a generic domain and could no longer be dichotomized as belonging to physicians only. Other social work academicians reacted with fear against embracing psychoanalytic concepts as if they threat- ened to delete the social and environmental aspects of traditional social work. Controversies broke out within the field itself as to who had the right to do therapy and about the nature of therapy to be done. Private practice was often regarded as a desertion of commitment to the under- priveleged and for the renegades only.

Upon my resumption of professional obligations I affiliated, on a part-t ime basis, with a private, non-profit mental heal th clinic which, at that t ime, was analytically oriented. In-service training sessions dealt with psychosexual development, ego functioning, including the ubiqui- tous mechanisms of defense and clarifications of mAnlfestations of the transference. Ego building techniques, always a par t of social work training, were re-clarified and refined. I felt comfortable in my role as therapist . Yet a female patient with whom I was worsting presented as overwhelmed by multiple obsessions that were expressions of acute fear and guilt. Her intense need for my he lp - -and the fact tha t the analyst who supervised my work seemed to better unders tand her than I - - h a d reminded me tha t the time had come for me to seek my own further t ra ining if I, too, wanted to get a core understanding of psychoanalytic theory and application. Social work training had prepared me to develop different ego strengths in my patients, but not for the hazards involved in facing a rapidly developing, full-blown transference, where what I did was so exquisitely reacted to by my patient.

Simultaneously, with my functioning at the mental health clinic, I had been in therapy with an analyst who also seemed to possess a deep unders tanding of my anxiety. This added impetus to my wishes for in- tensive psychoanalytic training. Although I had little knowledge of t raining opport, mities open to me, on investigation I learned of many inst i tutes in the Greater New York area offering training for social workers in psychoanalytic theory and in psychoanalysis. I chose IPTAR, The Inst i tute for Psychoanalytic Trainirtg and Research, because it of- fered an integrated theoretical and clinical program and had a reputa- tion of having high standards equal to those of the medical t raining institutes.

In reflection, the program was extraordinarily stimulating, due to the high caliber and commitment of the faculty and members. With it,

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my whole professional development, starting with my social work educa- tion, was now leading to my finding myself in the realm of magical un- derstanding which years back, I had presumed, was the possession only of the medical analyst. My supervisor, May Fine Lipson, who became more of a mentor, was a major influence in the scientific and artful ap- plication of clinical psychoanalysis. I am appreciative that all my super- visors, teachers and analyst were ego ideals in the tradition of Sigmund Freud. Others who had a strong personal influence on me, based on their important contributions to psychoanalytic theory and technique, included Anna Freud, Theodore Reik, Otto Fenichel, Ella Freeman Sharpe, Donald Winnicott, Edith Jacobson, Ralph Greenson, Margaret Mahler, Roy Schaeffer, Jacob Arlow and Harold Blum.

The excitement of becoming a member of "IPTAR," The New York Society for Psychoanalytic Study and Research has been the feeling of camaraderie among colleagues and the opportunity for ongoing profes- sional discourse. The combination provides a sorely needed tonic for the sense of privacy and challenge that pervades our therapeutic work. One such concentrate of study focused on the therapeutic process as viewed through a series of dreams. It resulted in the authorship by three mem- bers of the study group, Alma Bond, Daisy Franco and Arlene Richards, of a book entitled Dream Portrait, which was recently published. I am presently attending another group endeavor regarding the difficulties we encounter in the widening scope of psychoanalysis. A major source of my addiction to such study groups has been intensified by the learning seminars I have attended with Martin Bergman, a most gii~ed teacher, who allows us to establish a topic that is expanded with regard to histor- ical perspectives and confirmatory and contrasting ideas that flow into essences of psychoanalytic understanding.

I was very pleased when I was invited to teach at IPTAR. It was a course on Character Neuroses. I felt it was a gift, as it seemed to me to be the very one I would have chosen to teach, based on my special inter- ests. Subsequently, I have taught courses on dream interpretation, char- acter pathology and the psychoanalytic process. Each one has felt like a gift, perhaps because my students make each session a fresh experience and help to further distill my analytic wisdom.

But the greatest pleasure in doing analysis is "doing analysis," like the thrill of suddenly seeing pieces of a person's inner life fit together like a jugsaw puzzle. Of course, there is the especial satisfaction when there is a successful resolution of a person's conflicts which lead to a more contented life.

For example, a recent case that I am in the midst of terminating, foretells this young man's future in two termination dreams presented in sessions. Initially, this young man came in with complaints of a chronic, low level of energy, an inability to advance in his career, con-

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ceres about feeling attractive to women, and doubts about his mas- culinity.

The first dream followed a weekend, when during a family get to- gether, his father undermined one of his sisters, wherein he heard him put down her attractiveness. He realized these were incessant types of cutesy pellets aimed at him throughout his growing up, which enraged him. After a sleepless night, he decided to confront his father with his feelings and insist on an apology. When, in fact, he had gotten this from his father, he reproached his mother about her years of compliance with his father's derisions. He felt he had shed a lifetime of quiet hostility.

The first dream was of his playing poker with a group of men. His father was one of the players. The patient realizes he has been given extra cards, which he returns to the dealer. He also realizes tha t he is holding a full house and would surely top the other players. Though he believes himself the winner, he does not need to draw them fur ther into the game. He is happy with his winning, ra ther than needing to play it for all it's worth. His associations related to his sense of confidence in finding the lady of his dreams and winning her. He told of upgrading his wardrobe and put t ing his home in better order. He also told of his fan- tasy, as he entered the session, of kissing me on both cheeks. (This is after many years of predominant negative transference and resistance to termination.)

In the second dream, in the manifest content, he is playing football and thrills at scoring a touchdown. Elizabeth Taylor is in the stadium, watching and enjoying the game. The stimulus for the dream was a game the preceding night, played by his favorite team, which had been losing all season, surged to a s tunning victory. In his associations, he compared his beautiful mother of his childhood with Elizabeth Taylor. He thought Elizabeth Taylor's appreciation of his game was very differ- ent from that of his mother 's usual behavior.

He also thought of Taylor as referring to the tailor, to whom he had jus t t aken some of his clothes to have them fit exactly as he wanted. He had also gone to the carwash and had his car washed and it sparkled, both inside and out. He had hung some beautiful objects of art that he had long ago collected and negligently abandoned to a comer of the floor. He felt I was the tailor who helped him alter his life. He also thought of Elizabeth Taylor having had so many husbands, recounting Billy Wilder, Eddie Fisher and Richard Burton, to home just a few. He felt the first talked too much, the second was notably shy, and the third may have been too involved with himself. He thought he had brought all of these different aspects of himself to me, at one t ime or another, and that I had been the tailor who cut away the excess and put him in touch with himself.

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Jus t as my pat ient has found himself a new kind of living through analysis, so have I.

REFERENCES

Adorno, R. 1950. The authoritarian personality. N.Y.: Harper Bros. Bond, A., Franco, D., and Richards, A.K. 1992. Dream portrait. Madison, Conn.: Interna-

tional Universities Press. Carson, R. L. 1951. The sea around us. Boston: Houghton, Mifflin Co. Freud, S. 1921. Group psychology and the analysis of the ego. S. E. 18:65-144. Niebuhr, R. 1932. Moral man and immoral society. N.Y.: Charles Scribaer's Sons.