By Ron Nasim (Israel)

When Irit Kleiner-Paz, my fellow presenter and dear colleague, asked if we should send a presentation proposal to the IARPP Toronto conference, I agreed without hesitation. We had been working together on one of my cases, a couple, and our meetings had sparked many rich conversations that I thought would be great to write about and share at the conference. For several years now I have been working with couples in LOTEM, a clinic in Tel Aviv for childhood sexual abuse survivors (Nasim & Nadan, 2013). This couple in particular had shown noticeable involvement and progress in their treatment, and I was interested in exploring how combining concepts from the narrative (e.g. White, 2007) and relational (e.g. Ringstrom, 2014) approaches might have facilitated this process.

Irit has been long interested in applying relational psychoanalytic ideas to couples therapy. In her PhD dissertation she identified “the couple’s stream of conversation” in the relationship, highlighting the fact that much of any relationship is created through discourse, with words gaining their meaning in the context of a couple’s stream of conversation. In our conversations Irit and I started playing with how my couple’s stream of conversation conveyed different language-games (Wittgenstein, 1953) in the context of the diverse aspects and events in the couple’s life. Through Irit’s philosophical prism, we considered the implications of an integrative approach to couples therapy, determining that relational theory offers a model of thinking that is not available within the narrative frame. As I started integrating these ideas into my own theoretical and clinical perspectives, the shift in my thinking enabled the couple and me to formulate heretofore unformulated experiences.

After going back and forth between the clinical material and the theoretical ideas, Irit and I decided that I would present the case and Irit would follow with a discussion. We called our presentation Shifting Perspectives in Long-Term Relationships: Integrating Relational and Narrative Thought in Couples Therapy. In this couple’s case I tried to demonstrate the importance of telling one’s story and of hearing it retold by the witnessing partner in what becomes a significant act of mutual recognition. For the couple I was working with, this resulted in a shift in the way each partner experienced the other in their relationship.

In Irit’s presentation she stressed that this shift in perspective in the couple could not have been achieved if I, the therapist, had not changed my own perspective as well. In this way the therapeutic process experiences changes that enable both therapist and patients to expand the multiplicity of narratives available to them, in so doing getting in touch with even more self states.

Of course we were very pleased to be accepted by the conference committee to present our papers, and then went straight into the process of editing and chopping our presentations to fit the (very early!) submission deadline and time frame. When I learned that we would be presenting together with two other presenters, I must say I was worried that this could become a very crowded and maybe even flooding panel. After reading, and very much liking, the two other presentations, I settled down. Limor Kaufman’s beautiful paper, Belonging, Not belonging, and Longing to Belong, had a strong Israeli resonance, and Stacy Malin’s moving paper, A Romantic Home, impressed me by conveying things that are essential for any therapist dealing with relational material.

With the help of our very sensitive moderator, Catherine Martin, we felt that the four presentations worked together smoothly and enriched each other. The audience resonated both from a personal and a professional stance. We could feel the same movement of ideas and feelings that I had felt when working with Irit on our paper back in Israel, right there again in the Haliburton room at the Toronto Intercontinental Hotel.

What struck me the most was the strong echo Limor’s paper brought up for all of us. She shared her analytic work with a patient with whom she closely identified. Both Limor and her patient felt like dislocated foreigners in their new homes and both longed for their original homes. I suspect that what contributed to this strong resonance was the fact that our conference was held in Toronto, a city of more than 50% immigrants. Furthermore, as Jody Davies commented in her plenary talk, being part of the relational movement places us all as “immigrants” from different schools of thought, with common questions connecting us together. Thinking about myself as a couples therapist, I always have this kind of immigrant’s feeling when I enter a particular couple’s “stream of conversations,” with its unique language, landscape, and stories. All in all, I believe our panel exemplified this “immigrant” position in various ways but also offered different ways of finding a common language and reflective space in our relationships with our patients and our colleagues.

Note: My thanks to Catherine Martin for allowing me to use her moderator’s summary notes and Irit Kleiner-Paz for proofreading.

References:
– Nasim, R., & Nadan, Y. (2013). Couples therapy with childhood sexual abuse survivors (CSA) and their partners: Establishing a context for witnessing. Family Process, 52(3), 368-377.‏
– Ringstrom, P. A. (2014). A Relational Psychoanalytic Approach to Couples Therapy. New York: Routledge.
– White, M. (2007). Maps of Narrative Practice. New York / London: W. W. Norton.
– Wittgenstein, L. (2009[1953]). In G. Anscombe, P. Hacker, & J. Schute, (Eds.) Philosophical Investigations, Revised Fourth Edition (2009 ed.). MA, USA and Oxford, UK: Wiley Blackwell.

Ron Nasim, MA
Clinical Psychologist & Family Therapist
5 Shtriker St.
Tel Aviv 62006
Israel
Email Ron Nasim
website: ronnasim.co.il

Irit Kleiner-Paz, MA
34 Elyahu Miferara St.
Tel Aviv 69865
Israel
Email Irit Kleiner-Paz

Limor Kaufman, PhD
740 West End Ave., #44
New York NY 10025
USA
Email Limor Kaufman

Stacy Malin, PhD
One West 64th Street, Suite 1C
New York, NY 10024
USA
email: stacy.malin@gmail.com

Catherine A. Martin, MSW
225 Riverside Drive
Toronto ON M6S4A8
Canada
Email Catherine Martin

By Neil Altman (USA)

During the recent IARPP conference in Toronto, a panel comprised of Elizabeth Hegeman (USA), Neil Altman (USA), and Cleonie White (USA) addressed the question of why psychoanalysis—and psychoanalysts—pay so little attention to the experience of nannies, the nannies’ own children and families, and the children and families for whom they work.   There were three papers and a discussion provided by Melanie Suchet (USA).

The first paper, written by Elizabeth Hegeman, PhD, from the William Alanson White Institute in New York City, was entitled What Should I Do When They Call Me Mom? Hegeman emphasized the following points:

1. Normative unconscious processes replicate the power relationships in society, including splits around dominance and submission, which get played out in childcare with important consequences for development.

2. Family attachment patterns, rather than being one-to-one or maternal-infant as the theory assumes, are actually more multiple and fluid, with tremendous individual variation in how porous or exclusive a particular family system is.

3. Caregiving systems are loaded with unconscious meaning to which we need to attend more closely. For example, the commodification of the caregiver relationship may itself be a parental defense against the parental reaction to the helplessness of infants and children. Parents may have the illusion that they can control the nanny and thus feel they have more control.

The second paper was presented by Neil Altman, Ph.D., also from the William Alanson White Institute. His paper was entitled The Invisible Nanny. Altman emphasized the anxiety-laden feelings circulating among nannies, parents, and children, and the larger societal power relations that organize these relationships.   He pointed out that many psychoanalysts employ nannies to care for their children. Personally, many analysts feel they are at the epicenter of the love, hate, and guilt involved when nannies care for one’s children. The invisibility of nannies is evident in a pervasive inattention, on the part of analysts, to the emotional experience of nannies, particularly concerning their own left-behind children and families. This inattention is also seen in the neglect of nannies’ basic needs, reflected in poor pay and lack of health insurance.   Analysts as a group pay exquisite attention to the experiences of young children, yet largely ignore the emotionally crucial impact of nanny-child-family relationships. Inattention to the larger social context further predisposes analysts to neglect the impact of the power imbalance between nannies and the people for whom they work, with profound consequences for emotional interactions.

The third paper was written by Cleonie White, PhD, from the William Alanson White Institute. Her paper was entitled Barrels of Goods to Make Me Smile: But, Mommy, Who Tended My Wounds? White emphasized both the experience of nannies as immigrants who have left their own children behind and the experience of those children. The title of the paper captures vividly the way nannies try to provide something for the children they have left behind, in the form of barrels of toys. In a very powerful clinical example White conveyed the anger, shame, and guilt that can erupt when women who leave their own children to care for the children of other, more economically privileged, people, are reunited with their own children.

The discussion was provided by Melanie Suchet, PhD, from the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis. In her discussion Suchet brought out the paradox in which nannies, occupying a socially subordinate position, coexist with their emotional centrality for the children they care for. She spoke movingly of her feelings about her own childhood nanny.

Neil Altman, PhD
275 Central Park West #13E
New York, NY 10024
USA
Email Neil Altman

Elizabeth Hegeman, PhD
100 Riverside Drive, #10C
New York, NY 10024
USA
Email Elizabeth Hegeman

Cleonie White, PhD
6771 Yellowstone Blvd.
Forest Hills, NY 11375
USA
Email Cleonie White

Melanie Suchet, PhD
124 West 79th Street, Suite 1C
New York, NY 10024
USA
Email Melanie Suchet