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Psychoanalysis On and Off the Couch

Oct 2, 2022

"I started with an analyst right as I was ending residency and starting the fellowship in Behavioral Neurology and Movement Disorders. It was right in this transition time, and over time it transitioned into a psychoanalysis, and I think it served a number of functions. There was something about the way of exploring what was going on, trying to get to the bottom of it, trying to understand it, trying to understand oneself with another person, that I think was closer to what I was trying to get to originally. There was also something about him, my analyst, that seem so…calm… but it’s not quite calm, something related to satisfied that I thought I was missing. What I was doing was good, and we can all work hard and do a lot of things, and there are a lot of things you could do. But somehow the fit wasn’t right - I was forcing a fit of some kind or trying to turn something into something that would be a better fit and working pretty hard at that. There was something about his way that made me feel like ‘maybe I could feel like that in my career.’" — RG 

"I went to therapy because I thought I needed help. It was with a psychoanalyst, and we met two sessions a week, so it wasn’t psychoanalysis yet. The thing that I found most exciting with him was that it was a different kind of thinking. I remember sitting in a session and realized that he was thinking totally different from me, and it was so exciting, so overwhelming, a little frightening but something that I actually found an inclination to think like that. I remember that in one of the sessions I had the image of memory as bits on a line, and I understood that he didn’t think like that. For him, memory fragments are a conglomerate of these bits together, like grapes together, it was not linear. I was really amazed and excited by this. During the years when I really started the analysis, I found out that this kind of thinking can really be influential and make a change in my life as a patient and in my life as a therapist." — IB 


Episode Description: Iftah and Rachel share their pre-medicine life stories and describe those factors that contributed to their pursuing medicine and neurology. They both trained in Behavioral Neurology in an effort to reach more deeply into the personal experiences of their patients. Informed by their own analytic treatments they concluded that they were seeking something deeper than neurology could offer them. Training in psychoanalysis allowed them to integrate their studies of the mind with their prior work with the brain - an integration that had its limitations as well as insights. We discuss the challenges of having differing perspectives on how to encounter clinical phenomena. We close with their sharing with us how they bring their analytic minds back to neurology in leading Balint-type groups for neurology residents - a lovely application of analysis off the couch. 


Our Guests: Iftah Biran, MD, a psychiatrist, and a neurologist with a subspecialty in Behavioral Neurology. He recently finished his training in psychoanalysis and joined the Israeli Psychoanalytic Association as a member. He works part-time in his private practice where he mainly practices analysis. In the last years, he’s been working in the department of Neurology at Tel Aviv Medical Center, a tertiary hospital, as a liaison psychiatrist – neuropsychiatrist, and behavioral neurologist. There Dr. Biran mostly takes care of patients with conversion disorders. He’s the co-editor of the journal Neuropsychoanalysis. Dr. Biran is now completing a bachelor's degree in philosophy and literature at the Open University of Israel. 


Rachel Gross, MD. Prior to becoming a psychoanalyst, Dr. Gross began her career as a neurologist. As a member of the neurology faculty at the University of Pennsylvania, she specialized in the care of patients with Parkinson’s disease, dementia, and other neurodegenerative conditions. She also served as co-director of the Penn neurology residency training program. Dr. Gross has a private practice in Philadelphia where she provides psychotherapy, psychoanalysis, and medication management. She enjoys teaching, mentoring, and supervising trainees in psychoanalysis and psychodynamic psychotherapy. She also facilitates a group to support the emotional well-being and professional development of neurology residents at the University of Pennsylvania.