Among the horrors of the suppression of protest in Syria comes news that a psychoanalyst has been arrested:
SYRIA: Judge rejects call for release of pyschoanalyst
By Jan Petter Myklebust
21 October 2011
A Syrian judge has rejected international appeals for the release of Dr Rafah Nached (pictured), the founder of the first psychoanalysis school in Damascus, who was arrested last month at Damascus airport and is being held in solitary confinement, according to campaigners.
Twenty-one French intellectuals are supporting an international campaign to free Nached, 66, who was approached by security guards as she was about to board a plane to Paris on 10 September to visit her daughter, who was due to give birth.
Those who signed the petition include philosopher Julie Kristeva, philosopher, writer and director of La Règle du Jeu Bernard-Henri Levy, and former minister of foreign affairs Roland Dumas.
As she was being arrested, Nached managed to telephone her husband, Dr Faisal Abdullah, who is a professor of ancient history at Damascus University. He alerted her colleagues via Facebook, saying he did not know which prison his wife had been taken to.
It has since been revealed that she is being held in solitary confinement in a woman’s prison on the outskirts of Damascus.
Abdullah fears for his wife’s health, since she suffers from hypertension and has recently undergone an operation for cancer.
On 18 October, psychoanalyst Jacques-Alain Miller of the Association Mondiale de Psychanalyse in Paris, which set up the Free Rafah Nached campaign, sent out an email stating that the judge in Damascus had rejected the appeal for her release.
No formal charge has been made by the Syrian authorities, and it appears the only reason for her being held in custody is her profession as a psychoanalyst. She was the first practising psychoanalyst in Syria, having graduated from the University of Paris Diderot, and recently founded the school in Damascus in collaboration with French colleagues.
A statement on the Free Rafah Nashed blog, with an international petition calling for her release, said: “A review of Dr Nashed’s trajectory reveals a woman with a deep commitment to uncovering the secrets of the unconscious, not an insurgent, gangster or Islamist.
“When the revolution broke out in March, she, along with some Jesuit priests, organised support groups open to citizens of all affiliations, with the goal of helping them process the violence around them.”
The appeal asks those who support the release to send an email to this address.
Several hundred people gathered at a protest meeting in Paris organised by ‘Forum des Femmes – Carla, Judith, Isabelle, Julia and Aurelie’ outside the Palais des Congrès on 9 October to call for Nached’s release and hear an appeal by Kristeva, with several videos published on the event on You Tube.
On 2 October Carla Bruni-Sarkozy, the French president’s wife, published an open letter to Abdullah, expressing international understanding of the stress he and his family is exposed to, stating that Nached’s work is of no threat to the state and that she therefore expects that she be released without further delay.
Charles Hanley, president of the International Psychoanalytical Association, sent an e-mail to its members on 6 October requesting them to sign the petition for Rafah’s release, as did the European Psychoanalytical Federation and the Société Psychanalytique de Paris.
Catherine Ashton, high representative of the European Union for foreign affairs and vice-president of the European Commission, last month issued a statement calling for the immediate release of Nached “and all of those arbritrarily detained and arrested”.
The British Psychoanalytic Council has urged supporters to show solidarity by circulating information about Nached’s situation widely, and signing an international petition asking for her immediate release, and for the French Embassy to intervene to obtain information about her condition and the reasons for her detention.
A number of recent research studies have raised questions regarding the efficacy of many commonly prescribed psychotropic medications, including antidepressants. In some studies, these drugs do not perform better than placebo, when the placebo is selected to mimic the side effects that frequently allow participants in “double blind” randomized drug trials to tell whether or not they were given the active drug.
Now a new study adds to concerns by suggesting that antidepressant use may cause harm by significantly raising the likelihood of relapse upon cessation of medication in patients receiving them. In a meta-analysis quantitatively combing data from a number of published studies, Paul Andrews of McMaster University found that antidepressant use increased the risk of relapse from 25% among those not receiving drugs to 42% among those who received antidepressants, as described in a McMaster press release.
They [Andrews and colleagues] analyzed research on subjects who started on medications and were switched to placebos, subjects who were administered placebos throughout their treatment, and subjects who continued to take medication throughout their course of treatment.
Andrews says anti-depressants interfere with the brain’s natural self-regulation of serotonin and other neurotransmitters, and that the brain can overcorrect once medication is suspended, triggering new depression.
Andrews, an evolutionary biologist, uses these results as the basis for speculation about the nature of depression and whether it should be conceptualized as a disease or “disorder”:
“There’s a lot of debate about whether or not depression is truly a disorder, as most clinicians and the majority of the psychiatric establishment believe, or whether it’s an evolved adaptation that does something useful,” he says.
Longitudinal studies cited in the paper show that more than 40 per cent of the population may experience major depression at some point in their lives.
Most depressive episodes are triggered by traumatic events such as the death of a loved one, the end of a relationship or the loss of a job. Andrews says the brain may blunt other functions such as appetite, sex drive, sleep and social connectivity, to focus its effort on coping with the traumatic event.
Just as the body uses fever to fight infection, he believes the brain may also be using depression to fight unusual stress.
If these authors’ view that depression is, in most cases, a natural mechanism to deal with stress, then “treating” it with drugs that short circuit the healing process may be counterproductive in many ways.
As with all new research, we should be cautious about interpreting these results until they are critically examined by other researchers. Like with other research methods, there is often no consensus as to whether a meta-analysis has been properly conducted.
If this study holds up after critical examination, these new results should increase concerns that antidepressants are, at best, radically over-prescribed. Physicians, including primary care physicians who often know little about the subtleties of antidepressant use, often use these medicines as the first, and even only treatment for most depressions. Though knowledge about the danger of relapse when discontinuing these drugs has spread among thoughtful psychiatrists in recent years, this knowledge has often not spread to primary care physicians and others who do most of the prescribing of these medications.
Thus, extant evidence suggests that, these medications should be used carefully. This new study ads to evidence that these drugs should be used sparingly and that, once administered, antidepressants should not be discontinued quickly, but should be gradually tapered over a long time to give the brain’s neurotransmitter systems time to adjust.
Current patterns of antidepressant use may be causing serious harm to public health, this and other studies suggest. Thus, the mental health field should seriously reconsider whether antidepressant use should continue to be the first-line treatment for those suffering from depression. If these drugs increase relapse rates while having uncertain efficacy in many cases, they should be used sparingly and with caution.
Alternatively, first-line use of psychological treatment approaches that aid the body’s natural coping processes may avoid the problems with antidepressant use, including difficulty in withdrawing from the drugs and increased likelihood of relapse. Alas, the power of the pharmaceutical industry makes such reconsideration difficult. When there are billions of dollars at stake, science and public health often count for little.
Patients who use anti-depressants are more likely to suffer relapse, researcher finds
Patients who use anti-depressants are much more likely to suffer relapses of major depression than those who use no medication at all, concludes a McMaster researcher.
In a paper that is likely to ignite new controversy in the hotly debated field of depression and medication, evolutionary psychologist Paul Andrews concludes that patients who have used anti-depressant medications can be nearly twice as susceptible to future episodes of major depression.
Andrews, an assistant professor in the Department of Psychology, Neuroscience & Behaviour, is the lead author of a new paper in the journal Frontiers of Psychology.
The meta-analysis suggests that people who have not been taking any medication are at a 25 per cent risk of relapse, compared to 42 per cent or higher for those who have taken and gone off an anti-depressant.
Andrews and his colleagues studied dozens of previously published studies to compare outcomes for patients who used anti-depressants compared to those who used placebos.
They analyzed research on subjects who started on medications and were switched to placebos, subjects who were administered placebos throughout their treatment, and subjects who continued to take medication throughout their course of treatment.
Andrews says anti-depressants interfere with the brain’s natural self-regulation of serotonin and other neurotransmitters, and that the brain can overcorrect once medication is suspended, triggering new depression.
Though there are several forms of antidepressants, all of them disturb the brain’s natural regulatory mechanisms, which he compares to putting a weight on a spring. The brain, like the spring, pushes back against the weight. Going off antidepressant drugs is like removing the weight from the spring, leaving the person at increased risk of depression when the brain’s regulating mechanism, like the compressed spring, overextends before retracting to its resting state.
“We found that the more these drugs affect serotonin and other neurotransmitters in your brain – and that’s what they’re supposed to do – the greater your risk of relapse once you stop taking them,” Andrews says. “All these drugs do reduce symptoms, probably to some degree, in the short-term. The trick is what happens in the long term. Our results suggest that when you try to go off the drugs, depression will bounce back. This can leave people stuck in a cycle where they need to keep taking anti-depressants to prevent a return of symptoms.”
Andrews believes depression may actually be a natural and beneficial – though painful – state in which the brain is working to cope with stress.
“There’s a lot of debate about whether or not depression is truly a disorder, as most clinicians and the majority of the psychiatric establishment believe, or whether it’s an evolved adaptation that does something useful,” he says.
Longitudinal studies cited in the paper show that more than 40 per cent of the population may experience major depression at some point in their lives.
Most depressive episodes are triggered by traumatic events such as the death of a loved one, the end of a relationship or the loss of a job. Andrews says the brain may blunt other functions such as appetite, sex drive, sleep and social connectivity, to focus its effort on coping with the traumatic event.
Just as the body uses fever to fight infection, he believes the brain may also be using depression to fight unusual stress.
Not every case is the same, and severe cases can reach the point where they are clearly not beneficial, he emphasizes.
Lloyd Sederer, Medical director, New York State Office of Mental Health, described his psychoanalysis in a re3cent Huffington Post article:
Instead of looking for a psychotherapist, I decided to go for the full Monty. I found a traditional Freudian psychoanalyst, a past president of Boston’s major analytic institute. Psychoanalysis, by the time I entered its pool, did not have the eminence it did in the good old 20th Century, having been eclipsed by the promise of neuroscience and an explosion of medications. But analysis was not dead — Woody Allen notwithstanding — nor were its conceptual roots in the power of the unconscious in driving how we feel and act and its methods of free association (‘say whatever comes to mind’) and dream interpretation.
I was on the couch, four times a week. After four years, I was convinced I was done. That led to another year of analysis after which I pronounced to my analyst that now I was surely done. A year later I was. I paid out of pocket for this treatment, which virtually no insurance covered then and I can’t think of one today that does. For me, analysis was exceptionally helpful where Freud said it counted the most, namely in love and work.
I wonder what helped? Was it the traditional technique of couch, dream interpretation, free association and analysis of the transference (how the demons of our past continue to impale us on the spikes of early, troubled relationships)? Or was it the relationship with my wise analyst who knew every psychological evasion in the book (and I had read the book), demanded that I take responsibility for how I felt and lived, and was deeply kind.
…
For me, analysis was a journey into the mind, into the primitive ways we can feel and judge and behave. It helped my ego take the reins of life away from my unconscious and its misguided ways. Psychoanalysis, notably, has evolved in recent decades and is now far more focused on relationships than instinctual sexual and aggressive drives.
The New York Timesreviews a book on the Eitingons, a family that included Max, an early psychoanalyst, and Leonid, a Stalinist assassin who apparently organized Trotsky’s murder.Questions are raised as to whether psychoanalyst Max was himself a Stalinist agent. Very interesting.
Psychoanalysis has provided many tales for cultural consumption. Of these, perhaps none is more titillating than the complex relationships between Carl Jung, Sabina Spielrein, and Sigmund Freud. David Cronenberg is apparently working on a new film on these relationships, with Keira Knightley playing a non-victimized Spielrein. Arifa Akba in the Independent, uses the film as an excuse to discuss the complex relationships of Spielrein-Jung-Freud:
Freud and Jung: A Meeting of Minds
By Arifa Akbar
As David Cronenberg reveals he is to make a film about Sigmund Freud and Carl Jung, Arifa Akbar analyses the relationship between psychiatry’s biggest brains
It is perhaps ironic that when Sigmund Freud – who lived by the psychoanalytic theory that sexual desire was the prime motivator for human beings – found out his young protégé, Carl Jung, was having an extra-marital affair with a pretty patient at a mental hospital, he was damning of it.
It was at the turn of the 20th century when the father of psychoanalysis discovered Jung – a married young doctor – was embroiled in an improper sexual liaison with Sabina Spielrein, a 22-year-old Russian who was first admitted as a patient to the Swiss hospital at which Jung worked, and later became one of his most brilliant students, and committed lover.
The revelation caused a schism in the men’s friendship that would deepen into personal and professional estrangement in years to come when Jung announced a departure from Freudian psychoanalytic thought and launched his own school of analysis based on dream theory, the collective unconscious and spirituality.
Spielrein’s highly charged presence in their lives is now to set the scene for a new film, A Dangerous Method, by the acclaimed director, David Cronenberg, in which Keira Knightley will play the role of Jung’s lover, the unsung heroine of psychoanalysis whose own brilliant theories – in spite of her mental fragility – influenced both Freud’s and Jung’s ground-breaking works.
The director, who is known for his edgy, stylised treatment of stories such as his film adaptation of William S Burroughs’ book Naked Lunch, is preparing for a radical interpretation of the fractious triangular friendship. It is being billed as a “dark tale of sexual and intellectual discovery drawn from true-life events”. Cronenberg, who first had the idea four years ago, said he had “long been drawn to the story of erotic daring between these two good doctors and the woman who both divided and defined them”.
The film will star Michael Fassbender as Jung, and Viggo Mortensen as Freud, who at the time was grappling with many of the neuroses on which he wrote so extensively. A decade earlier, Freud had begun experiencing numerous psychosomatic disorders and exaggerated fears of dying.
The screenplay is to be written by Christopher Hampton, and based on his 2002 stage play, The Talking Cure. Hampton described it as a “true story of the obsessive love affair which played so fateful a role in the pioneering days of psychoanalysis”. Shooting will begin next month in Vienna and Lake Constance, and it is due to be in cinemas from next spring.
Jeremy Thomas, the film’s producer, said while Spielrein may now be largely forgotten internationally, she was still a “much admired and important figure in Russia today”. He said: “In this film, she will be presented as a rather brilliant character, not a victim at all, but a winner. I’m very excited as the film will make psychoanalysis more accessible. It is not usually a topic for popular culture but it is a very important school of thought from the 20th century.”
The drama will offer a 10-year snapshot of their friendship triangle, starting from Spielrein’s entry to the asylum. Born 1885 to a family of a Jewish doctors in Rostov, Spielrein was admitted to the Burghölzli mental hospital near Zürich, in August 1904, where Jung, who had wed two years previously, worked. She remained there for almost a year and established a deep emotional relationship with Jung who was later her medical dissertation advisor.
A fellow psychoanalyst discovered Jung’s breach of professional ethics and he was promptly dismissed from the Burghölzli. Spielrein was later discharged as a patient, wrote a dissertation about schizophrenia, and was elected a member of the Vienna Psychoanalytic Society. She continued to work with Jung until 1912 and met Freud in Vienna, before returning to Soviet Russia to get married.
The intense friendship between Freud and Jung began around the same time as the affair when Jung, then 30, sent his “Studies in Word Association” to Freud, then 50, in Vienna. The first conversation between them is reported to have lasted more than 13 hours.
Six months later in 1905, Freud sent a collection of his latest published essays to Jung in Zürich, which marked the beginning of an intense correspondence and collaboration that lasted six years. But growing intellectual differences saw Jung resign as the chairman of the International Psychoanalytical Association, to which he had been elected with Freud’s support, in May 1910.
The early books of Carl Jung contain theories that chime with Freud’s, but by 1912 he had published a theory about the psychology of the unconscious, from which it became clear that his thoughts were taking a different direction from Freudian psychoanalysis, which he called “analytical psychology”.
While Spielrein is not often given more than a footnote in the history of the development of psychoanalysis, her conception of the sex drive as containing both an instinct of destruction and an instinct of transformation, which she presented to the Society in 1912, anticipated both Freud’s “death wish” and Jung’s views on “transformation”. She may thus, it is believed by some, have inspired both men’s most creative ideas. When Jung had first met Spielrein, he was a fledgling psychiatrist who was very much under the influence of the older, wiser Freud’s pioneering theories of psychoanalysis.
While Freud was said to have been censorious about Jung’s affair, the latter was also meddlesome in his friend’s love life. He is believed to have spread the rumour of a romantic relationship between Freud and his sister-in-law, Minna Bernays, who had moved into Freud’s apartment in 1896. Their names appeared in a Swiss hotel log, dated 13 August 1898. Some Freudian scholars regard this as a factual basis for those rumours.
Costa Rican psychoanalyst Eddie Carrillo has written a piece describing the initial stages of his project teaching brief psychoanalytically-oriented psychotherapy in Cuba. I also asked hi to describe his sense of the island since the transfer of power from Fidel Castro to his brother:
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Psychodynamic Experiences in Cuba
By Eddy Carrillo R.
Asociación de Psicoanálisis Crítico Social
San José, Costa Rica
In March of 2008 I began working on a project training a group of Cuban psychiatrists and psychologists of the Ministry of Public Health in the city of Havana. I would like to share some thoughts, and perhaps, why not, even some feelings, on this ongoing experience. The project, in a nutshell, hopes to provide instruction in short term psychodynamic psychotherapy to a group of 15 mental health professionals (of which 10 are reaching the final stage of training) interested in working clinically from a psychoanalytic perspective. Before getting into any further detail of this project, it is important to understand a bit of the context in which it is taking place, and for that, it is crucial to at least vaguely appreciate where psychoanalysis stands today on the island of Cuba.
A reliable history of psychoanalysis in Cuba is not easy to come by, nor is it my present intention. However, as with everything else regarding Cuba, an historical review is necessary, albeit for now a very brief one, in order to understand whatever current reality one hopes to tackle and analyze. In the case of psychoanalysis, and psychodynamic psychology and psychiatry, one has to rely mostly on verbal accounts of those who were present, or knew those who were present, back in 1959 and the immediate years following the Cuban Revolution. There’s always the internet of course, but who knows how reliable that can be. As difficult a task as it might seem, there is what appears to be a commonly held historical “fact”: with the victory of the Cuban Revolution, psychoanalysis, being perceived as a bourgeois science, fell in disgrace. While there was never, as far as I can tell, a formal governmental prohibition of the field, it was certainly frowned upon. Of an original handful of psychoanalysts (anywhere from 5 to 15, according to different accounts), most fled to the U.S. Those that remained for the most part no longer practiced psychoanalysis, or at least not openly and not what we might consider “psychoanalysis proper”. Some even publicly denounced psychoanalysis. However, a colleague and friend who was exiled in Cuba when escaping during the days of the dictatorship in Argentina, remembers working psychoanalytically at a public hospital. Nonetheless, according to my sources, these cases were few and far between. Adding insult to injury, it also a well known fact that in the early sixties psychoanalytic theory was excluded altogether from the world of academic psychology, and remained so until very recently.
In the mid-eighties this began to change in Cuba. The country took somewhat of a self-critical approach to the history of post-revolution Cuban society, which resulted in a renewed sense of intellectual openness and possibility. This seemed to unlock an underlying interest, dare I say need, for psychoanalysis. This era led directly to one of the first explicitly open contacts of psychoanalysts with post revolution Cuba. This “return of the repressed” so to speak, began in 1986 with the first of seven “Psychoanalysis and Marxist Psychology Encounters”. From this point forward it is possible to speak, if not of psychoanalytic practice proper, at least of a burgeoning psychoanalytic discourse within Cuban academic society. So much so, that the Department of Psychology of the University of La Habana, via it’s clinic, (COAP, or Centro de Orientación y Atencion Psicologica) opened a sub-department of psychoanalysis, which later split into two, as tends to happen in our field, becoming the Department of Psychoanalysis on one hand, and the Department of Lacanian Psychoanalysis on the other. The COAP is also currently offering a Masters program in Psychoanalytic Psychodrama, funded by MediCuba Suisse, an NGO that provides medical aid to Cuba, working to somewhat mitigate the effects of the embargo within the health field.
It is within this context that the current training program began. The main focus lies within the purview of MediCuba which, as I just mentioned, looks to assuage the very detrimental effects of the embargo in the field of health services in Cuba. The Short Term Psychoanalytic Psychotherapy Project (PBOP, for short) hopes to provide clinical tools, both theoretical and technical in nature, to colleagues in the mental health field in Cuba. This objective includes a two-fold approach to psychotherapy in Cuba. First, to provide clinical training that is appropriate to the socio-economic conditions on the island, taking into account that psychotherapy is practiced almost exclusively by mental health professionals in state institutions (outpatient and inpatient) and community health projects. While long-term or open-ended psychotherapy is on occasion accessible, it is by no means the norm. Second, given the recent changes in the attitude towards psychoanalytic thought, I wished to provide a novel, in Cuba that is, yet tangible psychoanalytic approach to colleagues who for the most part have access only to cognitive and systemic perspectives to psychotherapy and are clearly eager to acquire a different, and perhaps more profound approach to clinical work.
This second aspect has indeed been confirmed by my experience so far. The level of motivation, interest and curiosity has been almost overwhelming. Considering that the members of the group in training has nothing to gain in material or economic terms, it is most refreshing to work with psychiatrists and psychologists who wish only to become better at what they do. They are moved solely by the desire to improve their clinical skills, and thereby provide superior help to their patients. Well, that and a great deal of intellectual curiosity. It is interesting to note that among the members of the group is the daughter of one of the most famous psychoanalysts of the original pre-revolutionary group (one of the few that remained in Cuba). While I am not sure what this means exactly, I can say that she is moving slowly back to a field, a way of working clinically, that was previously a practical impossibility. This alone makes the effort worthwhile. In addition, being able to circumvent an embargo that has nefarious consequences in terms of material and intellectual resources is in itself also quite rewarding.
Getting back to the training process, I have been greatly impressed by the willingness of the trainees to conceptualize mental phenomena in terms of unconscious processes, resistance and defense, and most noticeably in terms of transference. For the neophyte, these are not easy concepts to grapple with. Yet it is clear that most of the trainees already had an intuitive grasp of these notions, and an ease of comprehension that at first hand seemed surprising. I believe that one of the reasons for this is that within Cuban academic circles, what is known as the “culturalist-historic” view is quite pervasive. This is the case even if therapists are mostly cognitive or systemic in their original training. As a side note, how the Cubans have managed to combine these approaches is still mystery to me. But what I think is happening is that this almost natural tendency to think historically has allowed the members of the training group to look at psychodynamic therapy and in an almost organic way, see the connections between clinical phenomena and patient history. The link between transference and early object relations (always seen within a social-cultural context), traumas, childhood and adolescence seems to be second nature to them. So while the theoretical concepts and specific techniques might be new to the group, they are by no means foreign. That is to say, while they were never trained to explore the unconscious connections between past and present, between early development and transference, they were quite at home doing so once they felt they understood the technical issues.
Presently, the trainees are exactly at the point where they will in fact apply psychodynamic techniques with two supervised cases. This is of course where the PBOP will be put to the final test. Will the trainees feel at home, both technically and theoretically? Will the patients show significant improvement? Will the trainees themselves find that they can better understand, empathize with and help their patients? These questions will hopefully be answered in August, when the last leg of this two year project finally reaches the end of our joint experience. I keep my fingers crossed.
There is a final issue that deserves some attention. Given the current changes in the Cuban government and its policies, as well as the current changes from the Obama administration and the official U.S. stance towards Cuba, one can’t help but ask oneself what the future holds for Cuba in general, and for psychoanalysis in particular. This may be an impossible question to answer. But I would like to raise a concern that has been on my mind since I last returned from the island.
Perhaps a brief clarification is in order. It is no secret that those of us who take upon ourselves a variety of projects in Cuba are, in greater or lesser degrees, supportive of the Cuban Revolution, and its attempts at staying the advance of western capitalism. In my personal case this does not mean that I disregard the existence of some forms of capitalist mechanisms that do exist in Cuba. There is certainly private ownership of material goods, despite many myths to the contrary. There are also limited modes of individual private ownership of capital (agricultural and animal farms, small private bed and breakfasts, etc.). Furthermore, should one take a rather strict glance through the lens of a classical Marxist perspective one would have to admit that property concentrated in the hands of the State is in fact a monopoly, and therefore a capitalist mode of economic organization. So although the title of the ruling Communist Party might be somewhat of a misnomer, it is nonetheless irrefutable that a clearly defined socialist structure has been instituted for half a century. This model has survived only through the tough perseverance and courage of the Cuban people as well as the government. Ever since I started frequently visiting Cuba back in 2003 there has been talk and speculation about what the power structure might look like once the charismatic figure of Fidel Castro stepped down. Some people would have harsh comments towards the Castro brothers, others would fervently defend them. Despite these differences the sense of direction of the country was never in doubt. Or at least never did I feel that there was any doubt in this respect. It may be that when I began traveling to Cuba Fidel Castro was still head of the party and therefore of the country. Perhaps there has been, in part, some kind of cult of personality that sustained the hopes of the Cuban people, and kept them strongly holding on to socialist ideals. But this sense of security in their subjective revolutionary and socialist identities is no longer as palpable as it once was. By no stretch of the imagination am I implying that in general the Cuban folk I have thus far met are willing to embrace neo-liberal market oriented models, far from it. They are quite aware of the dangers and pitfalls of so-called advanced capitalism. My personal experience, and this is the only thing I can submit at this time, is simply that there is no clear sign as to which direction the newly restructured government is going to take. Some people profess great hope, other great frustration, but none can venture a guess as to where they see Cuba going. This is not only troubling for Cubans, but for the Latin American left as well. We have always looked to Cuba as the last bastion against capitalist imperialism in the region. Be it from a pro or anti Castro perspective, we have always taken Cuba to be a sort of ideological compass. And at a crucial time when Latin America is trying to construct its own alternatives to the neo-liberal model that for decades we have adopted, and I use the term adopted euphemistically, it seems to me this apparent lack of current clarity is reason for concern. It might be the complete opposite of course, that Cuba too will have to find new alternatives, different to its’ enduring but struggling model, and at the same time different than entering the worlds of market driven/private capital economies. If anything the Cuban people have shown to be nothing if not resourceful. Thus, if that is the case, as Latin American countries it would appear we are all in the same boat, so to speak. Thankfully for the time being the boat seems buoyant.
The question that I wrestle with is the following: What might psychoanalysis offer Cuban society in this new era, which by the way might include an embargo-free country? And for that matter, what type of psychoanalysis? For example, would a psychoanalytic perspective that holds fast to the notion of so-called neutrality be applicable in Cuba? Perhaps a skirmish might ensue between orthodox models and a psychoanalytic left, between schools that propose that psychoanalysis is ideologically neutral and those that espouse an ideologically committed psychoanalysis. Perhaps this struggle is already afoot. These questions linger in my mind, not being able to adequately answer them. But then again maybe that’s just me and these questions are no longer relevant to most in these desolate post-ideological times of ours.
Every Christmas I post Christmas in the Trenches, that song that suggests the possibility that the trend toward war can be overcome. This year I’ll give two versions, the first by Danny Quinn. [It is followed by a couple of other songs.]:
And here’s a slide show made with the song sung by its author, John McCutcheon:
The 1914 Christmas Truce and the Possibility of Peace
A new French film, Joyeux Noel , brings the 1914 Christmas truce, that moment when a world of peace could be imagined, to a wider audience.
An article on the truce and the film from the Telegraph has this nugget:
Some viewers might find a certain sentimental excess in the scene in which a Scottish bagpiper spontaneously joins in when German soldiers began singing Stille Nacht (Silent Night). There are records of such an event. “All the acts of fraternisation had one thing in common: music and song,” says Carion. “I loved the idea that these could stop a war for a few hours.”
Perhaps we should learn something from this experience about the importance of music to peace. After all, the 60’s peace movements were infused with song, whereas today’s movements are silent. Music and song can unite, they can inspire, but they also can soothe. Movements for peace need all three.
The Telegraph article continues to point out that the reality of peace is beyond what audiences can believe:
The film also features a foraging ginger cat adopted as a mascot by both the French and the Germans. The cat existed, and, in real life, it was arrested by the French, convicted of espionage and shot in accordance with military regulations. “It was an era of madmen,” says Carion, who filmed this scene – to the great distress of his extras – but decided not to include it in case his audience didn’t believe it.
A Scottish bishop’s sermon, which includes references to a “crusade” and a “holy war”, seems like a thumpingly obvious effort to find parallels with more recent discourses about Iraq. In fact, these words were, Carion says, taken directly from a sermon preached by an Anglican bishop at Westminster Abbey. Here, too, the truth was toned down: Carion excised the real bishop’s references to German soldiers “crucifying babies on Christmas Day” in order to make it credible.
Perhaps the propensity toward war is aided by our unwillingness to imagine the depths to which people can sink when captured by the lure of war, the fantasy of perfect union with the state, that idealized perfect mother, and the ability to extrude all evil onto the enemy, that poisonous cannibalistic bad mother. As Christopher Hedges points out in War Is a Force that Gives Us Meaning, in more normal times we disown this desire for union and extrusion and cannot remember or imagine how destructive it can be.
Perhaps this dynamic also helps explain people’s passivity toward the threats to democracy facing us in the United States today. For those identified with their country, to truly accept the danger puts the evil, the bad, inside the union, where it is especially terrifying.
A resolution for many is the demonization solution, to view George W. Bush and his administration as absolute evil, destroying the country and the world. While tempting, and certainly not without evidence, the problem with this outlook is that it is the mirror image of that attitude which leads us into the nightmare. To those adopting this view, evil resides in Bush, in Cheney, in the Republicans. If only they could be removed, impeached, tried, the world would be saved. The problem with this notion is that it encourages only destruction of the enemy, not construction of something better. History has repeatedly demonstrated that movements guided by hatred do not end up producing a better world.
The Christmas truce, in its magnificence, gives us a tiny glimpse of a true alternative, a world in which we are all simply human, in which that which we have in common is greater than that which divides us. For the brief moment of that truce, lasting days or weeks, the soldiers on all sides embodied the wisdom of peace through union, a union without an all-bad enemy (though the officer class trying so hard to restore their respective killing machines surely could have qualified). A union of fun, of games, and of song. A world dominated by eros.
The challenge, so far unsolved, is how to take such a moment and make it last, or at least not turn into its opposite, a renewed carnage of destruction. This challenge, as pacifists and nonviolent activists have repeatedly discovered, requires us to find a way to accept and tame the capacity for destructiveness in each of us, so as not to need to attribute it to an enemy. At the same time, we need to find a way to continue peace and unity in more normal, less extraordinary times, beyond the moment of fusion. For eventually the excitement fades and we remember all our irritations, our gripes and our fears. To bring peace into daily life is the need upon which the future of the human race may well depend.
The New York Timescovers the controversy around the revision of the American Psychiatric Association’s official diagnostic manual. For the first time, participants were required to sign a nondisclosure agreement. Perhaps the psychiatric association hopes to hide the extent to which their deliberations are driven by the exigencies of the pharmaceutical industry. In the past, studies have shown that the majority of developers of the manuals were paid as consultants to the drug companies. Not surprisingly, critics have complained that the diagnostic categories have been influenced more than they should be the desire of these companies to sell drugs for virtually every human condition.
It is already outrageous that the official diagnostic manual is developed by only one of the mental health professions. and it is a profession in which the average member receives liitle or no training in psychotherapy, no training in research design and methods, and a profession with all too many scandals of top researchers hiding tens or hundreds of thousands of dollars in drug company consulting fees. Thus, the manual is largely designed to promote the idea of biologically-based “illnesses” requiring biological (often pharmacological) treatment, administered by medical doctor psychiatrists. Psychotherapy and other treatments administered largely by social workers, psychologists, psychoanalysts, and counselors are treated largely as ancillary to the “real” pharmacological treatment. This view is a perversion of the research base which is increasingly showing psychotherapy as having good outcomes for many conditions considered “biologically based” by the DSM.
Nondisclosure is yet an additional effort to stifle serious dialog and debate as to the real nature of psychological problems and their appropriate treatment.
Here is the Times article:
Psychiatrists Revising the Book of Human Troubles
By Benedict Carey
The book is at least three years away from publication, but it is already stirring bitter debates over a new set of possible psychiatric disorders.
Is compulsive shopping a mental problem? Do children who continually recoil from sights and sounds suffer from sensory problems — or just need extra attention? Should a fetish be considered a mental disorder, as many now are?
Panels of psychiatrists are hashing out just such questions, and their answers — to be published in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — will have consequences for insurance reimbursement, research and individuals’ psychological identity for years to come.
The process has become such a contentious social and scientific exercise that for the first time the book’s publisher, the American Psychiatric Association, has required its contributors to sign a nondisclosure agreement.
The debate is particularly intense because the manual is both a medical guidebook and a cultural institution. It helps doctors make a diagnosis and provides insurance companies with diagnostic codes without which the insurers will not reimburse patients’ claims for treatment.
The manual — known by its initials and edition number, DSM-V — often organizes symptoms under an evocative name. Labels like obsessive-compulsive disorder have connotations in the wider culture and for an individual’s self-perception.
“This is not cardiology or nephrology, where the basic diseases are well known,” said Edward Shorter, a leading historian of psychiatry whose latest book, “Before Prozac,” is critical of the manual. “In psychiatry no one knows the causes of anything, so classification can be driven by all sorts of factors” — political, social and financial.
“What you have in the end,” Mr. Shorter said, “is this process of sorting the deck of symptoms into syndromes, and the outcome all depends on how the cards fall.”
Psychiatrists involved in preparing the new manual contend that it is too early to say for sure which cards will be added and which dropped.
The current edition of the manual, which was published in 2000, describes 283 disorders — about triple the number in the first edition, published in 1952.
The scientists updating the manual have been meeting in small groups focusing on categories like mood disorders and substance abuse — poring over the latest scientific studies to clarify what qualifies as a disorder and what might distinguish one disorder from another. They have much more work to do, members say, before providing recommendations to a 28-member panel that will gather in closed meetings to make the final editorial changes.
Experts say that some of the most crucial debates are likely to include gender identity, diagnoses of illness involving children, and addictions like shopping and eating.
“Many of these are going to involve huge fights, I expect,” said Dr. Michael First, a professor of psychiatry at Columbia who edited the fourth edition of the manual but is not involved in the fifth.
One example, Dr. First said, is binge eating, now in the manual’s appendix as a tentative category.
“A lot of people want that included in the manual,” Dr. First said, “and there’s some research out there, some evidence that drugs are helpful. But binge eating is also a normal behavior, and you run the risk of labeling up to 30 percent of people with a disorder they don’t really have.”
The debate over gender identity, characterized in the manual as “strong and persistent cross-gender identification,” is already burning hot among transgender people. Soon after the psychiatric association named the group of researchers working on sexual and gender identity, advocates circulated online petitions objecting to two members whose work they considered demeaning.
Transgender people are themselves divided about their place in the manual. Some transgender men and women want nothing to do with psychiatry and demand that the diagnosis be dropped. Others prefer that it remain, in some form, because a doctor’s written diagnosis is needed to obtain insurance coverage for treatment or surgery.
“The language needs to be reformed, at a minimum,” said Mara Keisling, executive director of the National Center for Transgender Equity. “Right now, the manual implies that you cannot be a happy transgender person, that you have to be a social wreck.”
Dr. Jack Drescher, a New York psychoanalyst and member of the sexual disorders work group, said that, in some ways, the gender identity debate echoed efforts to remove homosexuality from the manual in the 1970s.
After protests by gay activists provoked a scientific review, the “homosexuality” diagnosis was dropped in 1973. It was replaced by “sexual orientation disturbance” and then “ego-dystonic homosexuality” before being dropped in 1987.
“You had, in my opinion, what was a social issue, not a medical one; and, in some sense, psychiatry evolved through interaction with the wider culture,” Dr. Drescher said.
The American Psychiatric Association says the contributors’ nondisclosure agreement is meant to allow the revisions to begin without distraction and to prevent authors from making deals to write casebooks or engage in other projects based on the deliberations without working through the association.
In a phone interview, Dr. Darrel A. Regier, the psychiatric association’s research director, who with Dr. David Kupfer of the University of Pittsburgh is co-chairman of the task force, said that experts working on the manual had presented much of their work in scientific conferences.
“But you need to synthesize what you’re doing and make it coherent before having that discussion,” Dr. Regier said. “Nobody wants to put a rough draft or raw data up on the Web.”
Some critics, however, say the secrecy is inappropriate.
“When I first heard about this agreement, I just went bonkers,” said Dr. Robert Spitzer, a psychiatry professor at Columbia and the architect of the third edition of the manual. “Transparency is necessary if the document is to have credibility, and, in time, you’re going to have people complaining all over the place that they didn’t have the opportunity to challenge anything.”
Scientists who accepted the invitation to work on the new manual — a prestigious assignment — agreed to limit their income from drug makers and other sources to $10,000 a year for the duration of the job. “That’s more conservative” than the rules at many agencies and universities, Dr. Regier said.
This being the diagnostic manual, where virtually every sentence is likely to be scrutinized, critics have said that the policy is not strict enough. They have long suspected that pharmaceutical money subtly influences authors’ decisions.
Industry influence was questioned after a surge in diagnoses of bipolar disorder in young children. Once thought to affect only adults and adolescents, the disorder in children was recently promoted by psychiatrists on drug makers’ payrolls.
The team working on childhood disorders is expected to debate the merits of adding pediatric bipolar as a distinct diagnosis, experts say. It is also expected to discuss whether Asperger’s syndrome, a developmental disorder, should be merged with high-functioning autism. The two are virtually identical, but bear different social connotations.
The same team is likely to make a recommendation on so-called sensory processing disorder, a vague label for a poorly understood but disabling childhood behavior. Parent groups and some researchers want recognition in the manual in order to help raise money for research and obtain insurance coverage of expensive treatments.
“I know that some are pushing very hard to get that in,” Dr. First said, “and they believe they have been warmly received. But you just never know for sure, of course, until the thing is published.”
In all, it is a combination of suspense, mystery and prepublication controversy that many publishers would die for. The psychiatric association knows it has a corner on the market and a blockbuster series. The last two editions sold more than 830,000 copies each.
The Washington Post called this afternoon and informed me that John Brennan has removed himself from consideration for a top intelligence post in the Obama administration. [See his resignation letter here. Read Glenn Greenwald's reply here.]
The Post and the Associated Press seem to think that our Open Letter against Brennan’s appointment as CIA Director played a role in the decision. The AP cited our letter in its initial announcement:of Brennan’s withdrawal [of course they get psychologists and]:
A group of about 200 psychoanalysts published an open letter to Obama on Nov. 22 opposing Brennan’s leadership of the CIA. They cited several media interviews in which they deemed Brennan insufficiently opposed to rendition and harsh interrogation to make a clean break with the Bush administration’s policies.
They noted that he told the National Journal in March that he would favor “continuity” in intelligence policies in the early days of the Obama administration.
“I would argue for continuity in those early stages. You don’t want to whipsaw the (intelligence) community,” Brennan said. “I’m hoping there will be a number of professionals coming in who have an understanding of the evolution of the capabilities in the community over the past six years, because there is a method to how things have changed and adapted,” he said.
In a 2005 interview on the News Hour with Jim Lehrer, Brennan defended rendition as “an absolutely vital tool.” In 2007 on CBS News, he said the CIA’s harsh interrogation program, which included waterboarding on at least three prisoners, produced “life saving” intelligence. Waterboarding is a form of simulated drowning.
Of course, we were but a faction of the growing opposition to Brennnan. Scott Horton, Glenn Greenwald and Andrew Sullivan were important others, as was former CIA analyst Melvin Goodman. But, still, our efforts played a part in this victory. Our Letter, together with thee efforts of others, shows what a few committed citizens can sometimes accomplish when they stand together and speak out.
The American Psychoanalytic Association has issued a press release denouncing California’s passage of Proposition 8, making gay marriages unconstitutional:
Psychoanalysts Censure California’s Vote to Ban Same-Sex Marriage
NEW YORK, Nov 06, 2008 / The American Psychoanalytic Association (APsaA) denounces the election results in California that supported Proposition 8, a ballot measure that bans same-sex marriage in the state. In keeping with its overall support of social justice, APsaA issued a position statement earlier this year supporting the legal recognition of same-sex civil marriage while opposing discrimination against same-sex couples. For the full text of the APsaA Marriage Resolution, please visit: http://www.apsa.org/ABOUTAPSAA/POSITIONSTATEMENTS/MARRIAGERESOLUTION/tabid/470/Default.aspx.
APsaA President-elect and Pasadena, CA resident Warren Procci, M.D. remarks: “These ballot propositions such as California’s Proposition 8, deny to gay individuals the rights to freedom of choice of partner in marriage as well as access to equal protection which is granted to all of us by our constitution. These denials are based solely on an individual’s sexual orientation.”
“We want people to think about the broad impact the denial of same-sex marriage has on Americans today,” says psychoanalyst Ethan Grumbach, Ph.D., a Los Angeles resident and chair of APsaA’s Committee on Lesbian, Gay, Bisexual and Transgender Issues. “Families exist in many different ways and it is important for same-sex couples to have legal and societal recognition of their unions for themselves, their children, and their extended families. Research continues to demonstrate the stigmatization and discrimination to which same sex couples and families are subjected is traumatizing and damaging to their health.”
APsaA’s Committee on Lesbian, Gay, Bisexual and Transgender Issues has reviewed extensive research on homosexual relationships and gay and lesbian parents and their children prior to issuing its Same-Sex Marriage Resolution. Some relevant statistics and research results are:
-- The Kaiser Family Foundation Survey of 2001 found that 68 percent of lesbians and gays considered lesbian and gay marriage to be very important and 25 percent considered it to be somewhat important.
-- According to the 2000 U.S. Census, 34 percent of cohabitating female couples and 22 percent of male couples were raising children under the age of 18.
-- In a 2006 paper, Charlotte Patterson, Ph.D., renowned researcher and professor of psychology at the University of Virginia, concluded, "Results of the research (of various population samples of lesbian and gay families) suggest that qualities of family relationships are more tightly linked with child (development) outcomes than is parental sexual orientation."
In addition, APsaA’s Committee on Lesbian, Gay, Bisexual and Transgender Issues is currently developing a proposed position statement on the United States’ military policy of “Don’t Ask, Don’t Tell.”
The American Psychoanalytic Association is a professional organization of psychoanalysts throughout the United States and is comprised of approximately 3,300 members.