The Secret Life of Secrets: Deleterious Psychosomatic Effects on Patient and Analyst

The Analyst's Self-Care: Further Reflections after the Pandemic on Cultivating Resilience and the Essential Role of the Body-Mind Relationship in Clinical Practice

Sparse attention is paid in the psychoanalytic literature to the management of self-care needs of the analyst. I suggest that pandemic fatigue experienced by psychotherapists during the Covid-19 global crisis has thrown into bold relief the requirement for clinicians to attune to the body, particularly the requirement for rest and creative space. Physical and emotional exhaustion is multidetermined and not unique to this time period; the global crisis appears to have unmasked particular difficulties in sensing and tending to requirements of the body-mind. Changes observed in sleep, dreams, exercise, eating, and somatic states during the pandemic raise additional questions about modifiable risk factors of burnout. Drawing upon contemporary evidence emerging from the fields of cognitive psychology, neuroscience, and psychodynamic practice and theory, suggestions are made to assist the analyst in rendering essential self-care.

Aches, Pains, Rumbles, and Stumbles: Applying Somatic Countertransference and Body Reactivity in Clinical Work and Teaching

Recognizing somatic countertransference reactions is an essential tool for the psychodynamic clinician. Although the analyst's bodily reactivity has been written about throughout the history of our field, contemporary neuroscience, multiple code theory, and nonlinear system dynamics provide scientific buttressing to understand embodied phenomena. Patients often speak with and about their bodies, and the clinician who pays attention to these communications, as well as those emanating from his or her own body, has an additional resource to help the patient. Elvin Semrad's classic but largely unremembered "tour of the body" is one tool that can assist clinicians in how to receive and process body reactions that may be unconsciously split off, consciously withheld, or felt dangerous or beguiling. Three examples are used to illustrate embodiment and somatic countertransference as important clinical guides. An argument is made that these concepts should be taught and integrated into psychodynamic curricula.