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Psychoanalysis On and Off the Couch

Jun 30, 2019

“Both analyst and patient will have to share a bitter taste of abandonment, of boredom, of antagonism  and they have to remain together, because together they will be able to construct something to get out of it.” 


Description: Harvey Schwartz welcomes Dr. Jose Zusman who is a psychiatrist and a psychoanalyst in Rio de Janeiro. He is a training analyst and a professor at the Psychoanalytic Society of Rio de Janeiro and he is a professor and supervisor in psychoanalytic oriented psychotherapy for the Psychiatry Residents at the Federal University in Rio de Janeiro, where he holds a Master in Psychiatry and also a PhD in Psychoanalysis. As you will hear in today’s interview, Dr. Zusman shares with us a sensitive understanding of the trauma and lack of resonances that one can find in the early lives of patients who later become addicted. He also describes how one, as a depth psychotherapist and analyst, can listen and ameliorate some of the pain in the patient’s inner lives that lead them to turn to addictive substances. 


Key takeaways

[3:19] What is vital about a psychoanalytic approach in working with addicted patients? 

[5:01] Addiction is a symptom. 

[5:58] The environment is fundamental. 

[6:40] Object seeking. 

[7:13] Distortion of the reality. 

[8:09] The addicted patient can't find what they need. 

[8:44] Human beings are a dependent species. 

[11:44] How do you treat a patient who has not been recognized? 

[12:39] The addicted clings to any element that makes them feel alive. 

[13:18] Patients turn to sensations instead of affects. 

[14:27] A clinical case. 

[22:57] “I am seeing you” 

[23:20] How do you apply a psychoanalytic intervention with patients that are financially impaired? 

[24:05] Do not forget the patient. 

[25:50] Current situation in Brazil regarding psychoanalytic assistance. 

[27:30] We don’t treat symptoms, we deal with the origins. 


Mentioned in this episode

IPA Off the Couch  


Recommended Readings


Balint, M. (1968/1979).The Basic Fault. Tavistock Publication. London. 


Dodes, L (2003). The Heart of Addiction. HarperCollins Publishers. New York. 


Fairbairn, W: (2014). Then and Now Routledge Publishers. New York. 


Khantzian, E.J. (1997). Treating Addiction as a Human Process 

Jason Aronson. New York 


McDougall, J (1995). The Many Faces of Eros. W.W. Norton Company, Inc.  New York.