The Robert Aberg Trio has just released a new CD called Degrees of Freedom. M.D. reviewed by Myrna Little, Ph.D. Dr. Edward Shapiro, medical director and CEO of the Austen Riggs Center in Massachusetts and director of the Erik Erickson Institute for Education and Research, brought his finely honed integration of psychoanalytic treatment and organizational dynamics to DSPP's Fall Workshop in his presentation, Lost in Familiar Places . Observing that the meeting room was arranged to induce passive rather than active learning, he nevertheless engaged workshop participants in a very lively, interactive discussion of the analytic task in the present cultural context. Today, the analytic dyad inevitably operates in a context significantly impacted by this shift. Treatment paradigms are changing.
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Managed care does not take care of patients by providing refuge and asylum. The treatment paradigm has shifted from classical concerns with neurotic symptoms in patients who present with internal conflicts for which they take responsibility, to the treatment of character disorders marked by ego syntonic psychopathology for which the patient does not take responsibility. Dr. Shapiro then demonstrated from his own case material how these mutual projections function reciprocally in marital couples in their fixed, irrational roles. Focusing on the consequent pathology enacted in the hospitalized, adolescent daughter of such a couple, he presented both the relevant family sessions and the pivotal individual interactions of himself and the identified patient. The audience was asked to decipher what was projected, resisted, and acknowledged.