Psychoanalysis On and Off the Couch

"How do we continue doing this work when the socio-political realities are unimaginable? I've been living in Paris the last few years, and I continue to have a full caseload in Tehran and other cities. There was a time that the internet was cut off for our Iranian patients, so there is reality, and then there is a reality that actually affects the frame -  they couldn't contact their analyst. But in the middle of all of these things, something very interesting came up, which is, some patients, as soon as there was the possibility of contacting me, they would find a way. There were other things that came up in the supervisions I was doing, particularly if the analysts were outside of Iran and the patients were in Iran. For example, one thing that came up in the supervision was that the analyst would write to the patient all the time, saying, "Are you safe? Are you okay?"  That's not something I chose to do. When we discussed this and reflected upon this in the supervisions I felt like the analysts were feeling quite guilty for feeling that they are in a safe place and the patients weren't, or they were at times terrified of the aggression that could be awaiting them in the session. It was in a sense like a little bit of an acting out on the part of the analyst." 
Episode Description: We begin by acknowledging the ongoing war and Gohar's safety in Paris while many of her patients remain in Iran. We explore what this gradient  in danger between analyst and analysand means and evokes for both parties. Gohar notes that many supervisees contact their patients to ask, "Are you OK?" and she invites them to reconsider this response. She also describes working with Russian colleagues, many of whom were abandoned by their Western supervisors after Russia's invasion of Ukraine. This leads to a discussion of analytic work with patients whose political views sharply differ from those of their analysts. Gohar reflects on Jonathan Lear's concept of "radical hope" and shares her perspective on the Woman, Life, Freedom movement. She closes by reminding us that, even with those we regard as 'other,' "our emancipation is inherently intertwined, whether we like it or not."
Linked Episodes:
https://ipaoffthecouch.org/2022/10/15/episode-120-foreignness-the-blues-and-psychoanalysis-in-iran-with-gohar-homayounpour-psyd-tehran/
https://ipaoffthecouch.org/2025/09/21/episode-189-when-we-feel-provoked-by-the-politics-of-our-patients-with-heribert-blass-dr-med-md-dusseldorf-germany/
Our Guest: Gohar Homayounpour PsyD is a psychoanalyst and author. She is a member of the International Psychoanalytic Association, the American Psychoanalytic Association, the Italian Psychoanalytical Society, and the National Association for the Advancement of Psychoanalysis (NAAP). She is a Training and Supervising Analyst of the Freudian Group of Tehran, of which she is  the founder and past president. She is a member of the scientific board of the Freud Museum in Vienna and of the IPA group Geographies of Psychoanalysis. She serves on the editorial board of The Psychoanalytic Quarterly, Vestigia and Psychoanalysis, Culture & Society. She is also the editor-in-chief of the series Psychoanalytic Notebooks, published in Iran by Ghatreh Publishing House.
Her first book, Doing Psychoanalysis in Tehran won the Gradiva Award and has been translated into many languages. Her latest book is Persian Blues: Psychoanalysis and Mourning. 
 
Recommended Readings: 
Homayounpour, G. (2012). Doing Psychoanalysis in Tehran. Cambridge, MA: MIT Press.
 
Homayounpour, G. (2022). Persian Blues: Psychoanalysis and Mourning. London: Routledge.
 
Lear, J. (2006). Radical Hope: Ethics in the Face of Cultural Devastation. Cambridge, MA: Harvard University Press.
 
Busch, F., & Delgado, N. (Eds.). (2024). The Ego and the Id: 100 Years Later. London: Routledge.
 
Lorena Preta (2024). Geographies of Psychoanalysis - Encounters in Tehran. London: Routledge.
 
Bolognini, S., & Nicoli, L. (2024). Freud and the Changing World: Contemporary Psychoanalysis and Its Troubles. Bicester, UK: Phoenix Publishing House.

"We have a trove of treasure. These are the case studies, and we need the case studies - these are the flora and fauna of our field. This is how we work. We work by reading case studies and they enrich us. Not only do they enrich the community, but they also enrich us as therapists who write their case studies, and they get to be involved in deeper layers of the actual case study. When we write a case study we are in a better position to understand the patient, and we are in a better position to convey that knowledge to the psychoanalytic community. But as you said, it's a big challenge. Psychodynamic case studies belong to the genre of creative nonfiction. They are like memoirs, biographies, all are based on truth and imagination. This dual form of truth, what actually happened and imagination, is very important to our genre. But we are different from those who write memoirs or biographies, because we have responsibility to our patients and to our community." 
Episode Description: Aner views case reports as the Rosetta Stones of our field. We discuss the nature of the 'creative non-fiction' that is inherent in writing about the nuanced, intimate and affectively alive experience that is dynamic treatment. He shares his commitment to maintaining "responsible creativity" in writing about this work and always keeps in mind protecting the dignity of the patient. Aner recognizes the vulnerability that the therapist also undergoes in revealing themselves to the reader and alerts us to "clinical narcissism" - the temptation to exhibit oneself in place of sharing the authenticity of the clinical encounter. He presents the different phases of a deepening treatment along with the understanding that they are inherently schematic and removed from the aliveness of the dyad. He shares vignettes that are understood through a Kleinian, Winnicottian and Relational lens and closes noting that "effective clinical writing is as much an art as a science requiring technical proficiency, creative insight and literary skills."
Our Guest: Aner Govrin, PhD, is a psychoanalyst, philosopher, and clinical psychologist. He is the director of a doctoral program, "Psychoanalysis and Hermeneutics," at The Program for Hermeneutics & Cultural Studies, Bar-Ilan University. He is a member of the Tel-Aviv Institute for Contemporary Psychoanalysis (TAICP) and Editor of the Routledge series Introductions to Contemporary Psychoanalysis. He also conducts workshops on psychodynamic case-study writing and on a range of psychoanalytic topics at the Tavistock, as well as in training programs in the United States, England, China and Israel. 
Recommended Readings: 
Amir, D. (2016). Studium and punctum in psychoanalytic writing: Reading case studies through Roland Barthes. Psychoanalytic Review, 103(1), 51–65.
 
Bernstein, S. B. (2024) The Process of Case Writing: A Fourth Pillar of Analytic Training. Journal of the American Psychoanalytic Association 72:267-294
 
Boesky, D., Barros, E. R., & Chabert, C. (2013). What does the presentation of case material tell us about what actually happened in an analysis and how does it do this? International Journal of Psychoanalysis, 94, 1129–1134.
 
Gabbard, G. O. (2000). Disguise or consent: Problems and recommendations concerning the publication and presentation of clinical material. International Journal of Psychoanalysis, 81(6), 1071–1086.
 
Govrin, A. (2025) Responsible Creativity: Combining Clinical Report and Literary Writing in the Psychodynamic Case Study. Psychoanalytic Psychotherapy 39:20-39
 
Govrin, A. (2026). The Craft of the Psychodynamic Case Study: A Practical Guide, Routledge.
 
Ogden, T. H. (2021). Analytic writing as a form of fiction. Journal of the American Psychoanalytic Association, 69(2), 221–223.
 
Piccioli, E., Rossi, P. L., & Semi, A. A. (Eds.). (1996). Writing in psychoanalysis. Karnac Books.

"I have always been fascinated by the world of animals. What fascinated me about them is that when you pay attention to animals, this is a world beyond words. Words are not part of their world, so you start paying attention to movement, to breath, to reaction, to the pause, all these things, and I found it fascinating…Certainly, in veterinary medicine, as any type of clinical medical practice, if a patient comes to you, there's always things that you can do. You can take a blood sample, you can do a radiograph, you can give oxygen, you can give certain treatments. There's always a solution that you can give, a fix. Psychoanalysis is very, very different. I haven't successfully overcome the urge to fix, but I have come to realize that solutions that are given too early are oftentimes not usable. So, as a clinical veterinarian, most of my solutions were usable. That's not what happens in psychoanalysis." 
Episode Description: Michele begins with sharing her life-long fascination with animals. As a veterinarian she learned to attend to the nonverbal and to the triadic aspects of veterinary medicine - clinician, animal and owner. She noted that owners often communicate their own distress through their animal's behavior. She learned that "animals don't require you to be brilliant but to pay attention" - certainly relevant to psychoanalysis. In addition to describing her ongoing practice of Zen meditation, she shared with us the challenges of changing mindsets from medical intervening to analytic listening, "This shift - from resolving not knowing to working within it - has been a central aspect of my development." We discuss the role of suffering and mourning, which relates to her Catholic background, and the importance of the body both in her veterinary and psychoanalytic work. She closes with an example of an analysand crying out for help with her acutely ill pet and recognizing that "you can help me."
Our Guest: Michele Gaspar is an advanced candidate at the Chicago Center for Psychoanalysis (CCP). She currently has a private psychoanalytic psychotherapy practice in Chicago, provides feline internal medicine consultations to clinical veterinarians through the Veterinary Information Network (VIN) and works with veterinarians and veterinary students who have professional and personal challenges. Michele lectures at national veterinary conferences on psychological issues impacting veterinarians and also teaches Introduction to Psychoanalytic Theory and Introduction to Object Relations in CCP's two-year Adult Psychoanalytic Psychotherapy Certificate Program.
Recommended Readings: 
The Other Family Doctor Karen Fine, DVM
A thoughtful exploration of veterinary medicine as relationship-centered work. Fine illustrates how veterinarians routinely encounter attachment, grief, caregiving, guilt, and love through their work with animals and the people who care for them.
 
Animals in Translation Temple Grandin, PhD
Grandin explores how animals perceive and experience the world, challenging readers to understand minds that communicate differently from our own. The book offers insights into observation, empathy, nonverbal communication, and the challenge of understanding another subjective experience.
 
How Animals Grieve Barbara J. King, PhD
Drawing on scientific observations and research, King examines evidence of grief and mourning across species. The book raises important questions about attachment, loss, emotional bonds, and the continuity between human and animal experiences of bereavement.
 
All Creatures Great and Small James Herriot
A beloved memoir of rural veterinary practice that captures the joys, frustrations, humor, and heartbreak of caring for animals and their owners. Herriot's stories reveal veterinary medicine as a deeply human profession grounded in relationships, responsibility, and compassion.
 
The Wisdom of Insecurity Alan Watts
A classic introduction to Zen-influenced thinking about uncertainty, impermanence, and the limits of control. Watts offers a compelling perspective on living with ambiguity and cultivating a deeper comfort with not knowing.
 
When Elephants Weep: The Emotional Lives of Animals Jeffrey Moussaieff Masson, PhD and Susan McCarthy
An influential exploration of animal emotional life, including grief, joy, attachment, fear, and affection. The book invites readers to consider the emotional complexity of animals and what their experiences may teach us about our own.
 
The Loss of a Pet Wallace Sife, PhD
A foundational work on companion animal bereavement. Sife examines the profound attachment people form with their animals and the often-underappreciated grief that accompanies their illness and death.

"As analysts, we have our own development - as humans, we have our own development. My view is that the work of analysis, if the developmental piece is present, requires some relatively sophisticated developmental capacity on the part of the analyst. The work is intimate, and the patient is going to know something of our inner lives, despite the fact that we work hard not to let our own selves interfere with the work. I think to truly trust the analyst, the patient has to believe that the analyst can tolerate knowing all of him or her. If you think about it, how many times have you heard patients say that nobody in the world quite knows him the way the analyst does? There's going to be something in that connection that doesn't happen anywhere else."
Episode Description: We begin by outlining the distinctions between serving as a transference vs. a developmental object for a patient. Carla writes about "affective honesty," which concerns the analyst's willingness to have their heart be experienced by a patient as malevolent or compassionate based on the patient's needs. We consider similarities between child and adult work, the differences between the 'corrective emotional experience' and being a developmental object, and her sense that a patient's "intimate experience can bring structural change." She presents a clinical example where her own authentic sadness helpfully enabled the patient to recognize her own - "we take on what the patient can't bear." We close with Carla sharing her personal analytic journey and stating, "I expect I will keep searching, as that is what analysts do."
 
Our Guest: Carla Neely, PhD, adult and child psychoanalyst, guest faculty, Cincinnati Psychoanalytic Institute.  Past President, Association for Child Psychoanalysis. Past faculty member at the Denver Institute for Psychoanalysis and the Washington, Baltimore Psychoanalytic Institute. Topics of her publications - sublimation, creativity,  developmental object, working through, and therapeutic action.
Recommended Readings: 
Hurry, Anne, ed., 1998. Psychoanalysis and Developmental Therapy. London: Karnac Books
 
Elliott-Neely, C. 1996. The analytic resolution of a developmental imbalance. Psychoanalytic Study of the Child. Vol. 51
 
Miller, J. 2013. Developmental psychoanalysis and developmental objects. Psychoanalytic Inquiry. Vol. 33
 
Tahka, V. 1993. Mind and its treatment. Madison, CT: IUP

"Humanism has been the dominant Western belief system of the last century. It's based on the worship of human wisdom, human creation, human experience, human mind, and psychoanalysis has very much emerged from this humanist tradition. We believe in psychoanalysis, that delving into our feelings, our thoughts, and our shared wisdom will allow us to access truth and meaning and find proper direction for navigating life. AI is changing all of that. Instead of trusting our feelings and our thoughts, people are turning to algorithms to make meaning of our experiences and to offer us direction. We're plugging in our data and allowing the algorithms, or Chat GPT or Claude, to do the thinking and the decision making for us."
Episode Description: We begin with Freud in 1930: "Humanity would proceed to create unimaginably great advances in technology so as to increase our likeness to God." Amy outlines the challenge that AI poses to our humanistic tradition and values within which psychoanalysis makes its home. She starts with the 'cult grooming' aspects of smartphones, which introduces our exchanging "human dependence for AI companionship." The question of the subjectivity of AI is a central focus, with some analysts emphasizing its "simulation of human intimacy" and others considering that "is it not also possible for AIs to at the same time be intersubjectively engaged with us?" Regarding using AIs as a therapist, we discuss the clinical implications of "without there being two bodies in a room, the contact is shallow and lacking an essential human component." Amy describes "a desire for transgression" involving AIs as well as the associated search for immortality that they represent. She writes about Bach's prescient 2008 term of "digital consciousness" as contrasted with the "analog watch where one can see the hour from which the hand has come and the hour to which it is going." Amy shares that it was fear that motivated her personal interest in the AI world we are facing, and she closes with, "And how do we address what we are losing from within psychoanalysis?"
 
Our Guest: Amy Levy, PhD, is a clinical psychologist and psychoanalyst. She chairs the American Psychoanalytic Association President's Commission on Artificial Intelligence, serves on the subcommittee "Artificial Intelligence" for the International Psychoanalytical Association, serves on the editorial board of The Psychoanalytic Quarterly, and is Editor of the Substack series, "AI in My Mind," for The Psychoanalytic Quarterly. Along with her fellow CAI chair, Todd Essig, she is producing a documentary film for APsA which examines AI from a psychoanalytic perspective for the general public, entitled: Uncharted Territory: Humans and the Rise of AI. Dr. Levy is in private practice in Chapel Hill, North Carolina. She is the author of the 2026 book, The New Other: Alien Intelligence and the Innovation Drive.
Recommended Readings: 
Harari, Y. N. (2017). Homo Deus: A Brief History of Tomorrow. New York: HarperCollins.
 
Knafo, D. (2024). Artificial intelligence on the couch: Staying human post-AI. American Journal of Psychoanalysis, 84: 155–180. 
 
Lemma, A. (2024). Mourning, melancholia, and machines: An applied psychoanalytic investigation of mourning in the age of griefbots. International Journal of Psychoanalysis, 105(4): 542–563.
 
Shelley, M. (2003). Frankenstein. Penguin Classics.
 
Solms, M. (2021a). The Hidden Spring: A Journey to the Source of Consciousness. New York: W. W. Norton.
 
Suleyman, M. (2023). The Coming Wave: Technology, Power, and the 21st Century's Greatest Dilemma. New York: Crown.