Matthew Bennett

@Underth75515195 Porque no los dos

Oh hey is that your library or are you just happy to see me 🫦

@janresnick @e11_anna Gorgeous.

I cannot improve on Matthew's comprehensive response above, which I wholeheartedly endorse. Especially No 2. and I agree with all of the books in No 5. I would add a personal/professional note. I am learning a great deal about working (analytically?) with autism thanks to a 26-year-old patient diagnosed as such. Without going into huge detail - not all ASD people are the same by a long way. At first, he was extremely broken down, kind of 'dead', disengaged, remote, and beyond 'help'. I doubted if it was worth trying. We had session 20 today. I've done 'nothing fancy', mainly formed a relationship of interest, care and focus on what matters to him. Today, I found him very much alive, engaged, upbeat, direct eye contact (where's the autism? I wondered) and even good-humoured. And that's all I want to say.

I lose patience with cognitive-behavioral theory for the same reasons I lose patience with classical psychoanalysis: both reduce human complexity to empirical analysis of stimulus/response mechanisms (relational and Intersubjective psychoanalysis avoid this trap). As a therapist and as a patient, I need a psychology that is philosophical and ethical.

Thats a complicated question, and I'll just make a few passes at different ways of answering... 1. Autism gets very frequently redefined and recategorized, and everyone seems to have a different idea if what it means. DSM defined it quite narrowly starting in 1980, and it has shifted very widely since then, with categories broadened in 1994 and collapsed again in 2013. Current trends suggest that “autism” is likely a cluster of related neurodevelopmental pathways, not a single syndrome. 2. In any case, consensus has really shifted towards defining autism in the direction of neurodevelopmental genetics and behavioral science, while analytic work relies heavily on clinical phenomenology. In other words, if autism is seen as a collection of discrete behavioral syndromes, then that seems to argue for highly specialized behavioral interventions (and I think this is what usually happens these days). The increasing "disorder-ification" of autism makes it harder to see it as a relationally meaningful phenomenon that can be treated in a primarily relational, phenomenological, or humanistic way. Many therapists will therefore recoil from even trying to help an autistic person in therapy, because they fear not having enough technical expertise...and the way autism keeps getting defined encourages that reaction. In other words, the more autism is seen as a discrete neurogenetic disorder, the less accessible it feels to a psychodynamically trained therapist. 3. Point number 2 above is amplified by a tendency in Psychotherapy I call "Jiffy Lube" Psychology, which suggests that psychologists and therapists are tightly trained specialists (i.e., technicians) who dare not touch something they're not specifically trained for. So-called "evidence based practice" (EBP) has become so extreme that it almost feels criminal to practice outside ones usual patient population. As a result, therapists shy away from (or ignore) personality disorder, self-harm, substance abuse, autism, etc, which are seen as specialty areas, and "I'm not trained in that" becomes an easy answer. 4. Psychodynamic and contemporary psychoanalysis has generally been anti-JiffyLube... as I mentioned in #2, these perspectives tend to focus on relationship, attunement, attachment, and curiosity to the patients internal world while rolling with resistance and defenses, which I personally think would be very powerful for autistic people. But again, The Man says psychoanalysis is not an Evidence Based Practice for autism, so maybe I'm wrong! 5. There is some really bad psychoanalytic history regarding autism (see Bruno Bettelheim's book The Empty Fortress which blames autism on "refrigerator mothers"), and also some really good stuff (see Frances Tustin's work on autistic shapes), also Donald Meltzer (Explorations in Autism) and Anne Alvarez (Live Company).

@drmbennett @janresnick One Q when can see client can’t do CBT is Autism? How does psychoanalytic approach work with autistic people who are often seeking self understanding, validation (eg yes seems like autism) and assistance with approaches.

@jesusrglez In my experience the rigidity varies... I've seen some incredibly uptight training institutes and some that are more freewheeling. Glad to see you had the experience you did. Also...I need to go read some Mahler 😅

@drmbennett with the patient is the most salient point in training and supervision (now me as supervisor). The rigidity ca be present of course in some analysts, but that doesn’t necessarily make a philosophy of ‘the old school’ way of doing things./

@Underth75515195 Thanks. I'm all about Jane Austin!

the imperatives you have chosen, the commitment to think things through for yourself and feel them deeply rather than filtering through academic language or litigating stupid war games is fucking inspiring Matthew Sidebar : the J Austin quote you chose for yr chapter on Complexity Theory is so perfect !!

@proud_penelope archive.nytimes.com/www.nytimes.co…

@drmbennett ❓

Renowned, early psychoanalysts who had sex with patients or married them: Carl Jung, Sandor Ferenczi, Erich Fromm, Harry Stack Sullivan, Karen Horney

I'm not really critiquing the methodologies you listed above...I do those same things and I value them. I'm critiquing something purists of classic psychoanalytic theory have in common with the CBT world: the over-formalization of formal technique over the emphasis of what we already all already know, and which the psychotherapeutic outcome research says over and over: the single best predictors of positive outcome in therapy are relational variables between therapist and client. When analysts rigidly follow technical rules (countertransference as contamination, neutrality, abstinence, interpretive authority) without recognizing their own participation in the analytic field, the process can become impoverished and we lose the most important thing: that psychotherapy is a kind of boundaried, curated, exquisitely observed attachment experience (incidentally, incorporating the relational context and relational complexity and fluidity also helps us to recognize the importance of culture, gender, and other aspects of human difference). This rigidity is amplified, reinforced, and rewarded by the training institutes which treat the work as a matter of technical expertise and ideological purity rather than a profound and disciplined willingness to grab the tail of the therapeutic beast and hang on to it no matter what happens. No matter what assumptions the work ends up challenging... which is what we ask of our clients, after all. I say all this with profound respect for the value and power of the discoveries of Psychoanalysis, including the value of the idea of the drives, and I get frustrated with the intersubjectivists (and Jungians) for throwing babies out with the psychoanalytic bathwater in their zeal to differentiate their perspectives. I'm arguing for a broad, artistic, relational, ethical, integrative, impressionistic, humanistic and existential foundation in which to contextualize psychoanalytic techniques.

@drmbennett When you say classical analysis what exactly do you mean, theory, transference, interpretation, countertransference, free association? Also, house do Relational and Intersubjective avoid a trap? Very interested in your opinion 👍🏻

The honest answer (for me) is that the most interesting literature in philosophical and ethical approaches to psychotherapy comes from original works of philosophy: 1. Immanuel Kant (Dignity, moral law, and the intrinsic worth of persons) 2. Martin Buber (Relational ethics and the I–Thou encounter) 3. Emmanuel Levinas (The face of the Other as the foundation of ethics) 4. Marcus Aurelius (the Stoic ideal as service to the gods and humanity) 5. Gilles Deleuze (the critique of theories of lack, and primacy of desire, and the idea of schizoanalysis) Psychological literature doesn't do enough of this, which is why its hard to find people who write about both philosophy and psychotherapy, and MOST psychotherapist ignore the philosophical implications of the things they do. Exceptions to this: existential and humanistic psychotherapist (like Rollo May), Jung (which his spiritual teleology) and intersubjective theorists like Philip Bromberg, Annie Rogers, and Irwin zhoffman (see Ritual and Spontaneity in the Psychoanalytic Process).

@drmbennett Interesting point of view. What is in your view the most interesting literature in philosophical and ethical approaches of psychotherapy?

@nehabhattherapy I do not disagree, and I say the same thing in my lectures to first year students, although I personally gravitate more towards Zen Buddhism because it's more nontheistic and apophatic.

@drmbennett Hindu philosophy solves this problem

I work humanistically and existentially before any other treatment models, and these represent my guiding lights. Those perspectives provide my philosophy of treatment, and contemporary psychoanalysis provided the methodology and nosological power. I have no quibble with the efficacy of CBT (almost as good as psychodynamic!), I just find it deficient as a world view, and thats a critical flaw in my little worldview.

I recommend phenomenology and existentialism, they work well with the best of psychoanalysis but not so much with the more dogmatic theoretical trends. I have a practice full to overflowing with patients who have not been helped by CBT, or sometimes a little, often all too briefly.

@incalshort Well, CBT practitioners, the American Psychological Association, my graduate programs, and the State of California seem to think it exists!

@drmbennett There is no such thing as CBT. It is just any and every seemingly effective psychological strategy stapled together and walking around in a trench coat.

@yalexos Thats very empathic of you

I appreciate all you people willing to spend time and energy to share interesting thoughts here in spite of how exhausting it might be to do so

All the most powerful motivators of human behavior are archetypal, and fit these characteristics: 1. They are ultimately unconscious 2. They carry a quality of the nuomenal, meaning they transcend our narrow personal realities and seem to connect to a larger, broader unseen world that is beyond us 3. They have a charge which might be experienced as sacred and/or ethical, and seem to suggest some "higher purpose" 4. They function as teleologies 5. They resist empirical analysis or quantification. If you know its important to you, colors the meaning and purpose of your life, and cant really be measured, its likely archetypal. Examples: justice, love, destiny, freedom, dignity.

Jung’s idea of the collective unconscious is a little too weird and grandiose for my feeble mind. HOWEVER it is striking + amazing when you see the same themes of personality, obsessions, delusions, etc. over and over across folks from widely different cultural / ancestral bgs

Nothing about any of this is really a problem, except inasmuch as the therapist is demoralized by it...and if the therapist is demoralized by it, see the first part of this sentence. The therapist has done their job here, which is to try to relate to the client and attempt different ways to attune with them, which is the task. The patient is responding with what Bion calls attacks on Linking. The attacks on the link do not demonstrate that the therapist is doing the wrong thing (which i can see would be demoralizing), in fact they demonstrate the opposite...the therapist is appropriately offering links, which the patient rebuffs because of some blend of (a) difficulty mentalizing...they don't have an internally available category of being loved effectively, so effective love feels disrupting, leading us to (b) important self-states which are central to the clients self-esteem and identity are tied up in assumptions about being forever misunderstood and abandoned (a flavor which has a self-defeating/masochistic flavor to me) which must be preserved in order to maintain said self-esteem and identity. Any patient can ultimately manage to defeat the therapist's attempt to love them skillfully (which i see as the task of psychotherapy). All the therapist can do is try, and persist. Its all going according to Hoyle. Carry on.

To speak bluntly, you’ve had a pt who cannot stand themselves and can’t wait for you to reject them. They show up early to session frothing for it You’ve tried playfulness, lovingness, joining them in anger and none of that has worked You are tempted to show up with gentle curiosity BOTH from a place of sincerity AND as a lame act of self preservation in the face of their desperate aggression You know how alienating this will be for them as it leaves them alone in hatred. You hope that in holding onto empathy without collapsing over the years your work will amount to something for them

@Underth75515195 Yeah, prom did suck.

I should title this, Prom Sucked if it’s ever finissshhhed 🗡️🩸

@Underth75515195 @jesusrglez Andrew P. Morrison (narcissistic function and shame), Leon Wurmser (shame and guilt), Donald Nathanson (popular writer, focuses on defenses), James Gilligan (violent offenders), Terrence Real (shame and depressuon), Gershen Kaufman (shame and male identity)

Ok this isn’t an invite for pervy antics ( there’s a place and a time 🎉) I need resources to learn more about MALE SHAME w early sexual “exploration” • Patrick Carnes PhD has been rccd • And I’m sure there is a trove of Kleinian wisdom (where to start @jesusrglez ?) Anyone ?

@Underth75515195 I would be in traction after trying that

This bish still got it ! actually I tore my jeans and fell on my cat 😌

@smoothiechewer Displaying sunglasses

what could i repurpose this as. any ideas.