Henri Rey’s seminal work on borderline and psychotic patients who alternate between claustro- and agoraphobic anxieties led him to identify the claustro-agoraphobic dilemma, where borderline, narcissistic, and schizoid patients experience no place of safety. They are afraid of being trapped while inside their object and terrified of disintegration if they escape to the emptiness of outside space.

Henri Rey worked from 1945 to 1977 at London’s Maudsley Hospital, where he was a loved and inspiring teacher who profoundly influenced generations of psychiatrists, psychoanalysts, and psychotherapists. Recognized for his warmth, generosity, and kindness toward his students and his empathy toward his patients and their suffering, Rey was able to decipher the confusing states of mind of patients presenting with frightening and psychotic features.

Following Freud’s work on mourning and melancholia and Klein’s understanding of the internal world and need for reparation in states of depression, Rey found ways to assist his patients in the internal and creative work required to help them achieve some degree of reparation.  Rey believed that until this level of work was achieved, patients would continue to feel the burden of persecutory guilt and anxiety that would prevent them from living an individuated life of their own.

Rey understood that there is no place of safety, no internal or external figure who might be called upon as a reliable and trusted object. Rey’s classic papers, Universals of Psychoanalysis in the Treatment of Psychotic and Borderline States, edited by Jean Magagna (Routledge 1994), are widely read today.

The conversation between Michael Feldman and John Steiner will emphasize Rey’s concepts and their profound influence: reparation, a spatial model of mind, a marsupial space as an intermediate locus where the “joey” or patient can mature in the mother’s body and attempt some outside excursion, and safeguarding access to the protection of the mother.

Susan Finkelstein and Heinz Weiss will pick up the conversation to consider Michael Feldman’s work on the emotional availability in the clinical encounter, grievance, and doubt (Doubt, Conviction and Analytic Process (Routledge 2009) and John Steiner’s work on psychic retreats and pathological defensive organizations (Psychic Retreats: Pathological Organizations in Psychotic, Neurotic and Borderline Patients [Routledge 1993]).

The papers appearing in The Claustro-Agoraphobic Dilemma in Psychoanalysis: Fear of Madness (S. Finkelstein, H. Weiss, Routledge 2022) reflect the enormous influence of Henri Rey. This book and conference are intended to remind the audience of Rey’s seminal contributions to psychoanalysis and to elevate him to the prominence he deserves.

Presenters:

Michael Feldman is a Distinguished Fellow of the British Psychoanalytical Society, where he is involved in teaching and supervision. He was previously a Consultant Psychotherapist and Chairman of the Psychotherapy Department at the Maudsley Hospital, the major psychiatric teaching hospital in London. He is also an Honorary Member of the Swedish, and the Danish Psychoanalytical Societies, and Visiting Professor, Psychoanalytical Centre of California. He conducts regular clinical seminars for psychoanalysts in London, and in Germany, Switzerland, Spain, Sweden, Portugal and Norway and Japan.  He has had many papers in peer-reviewed journals, and chapters in several books that have been translated into different languages. He co-edited (with Elizabeth Bott Spillius) ‘Psychic Equilibrium and Psychic Change’, selected papers of Betty Joseph, which has been widely translated and quoted. A collection of his own papers was published by Routledge under the title ‘Doubt, Conviction and the Analytic Process.

John Steiner is a training analyst of the British Psychoanalytical Society, and although he has retired from clinical practice he continues to supervise and write.   He is the author of “Psychic Retreats”, (1993) and “Seeing and Being Seen”, (2011), and has also edited and written introductions to several books including The Oedipus Complex Today, (1989), papers by Hanna Segal entitled, Psychoanalysis, Literature and War, (1997) and Essays on Herbert Rosenfeld’s Clinical Influence, entitled Rosenfeld in Retrospect, (2008).  His latest book, “Lectures on Technique by Melanie Klein”, is discussed in a special section of the 2018:99(4) issue of the International Journal of Psychoanalysis.

Heinz Weiss retired Director of the Department of Psychosomatic Medicine of the Robert-Bosch-Krankenhaus, Stuttgart, and one of the Directors of the Sigmund-Freud-Institute, Frankfurt, Germany. He was a visiting scientist at the Adult Department of the Tavistock Clinic, London, and is teaching at the University of Tübingen. In his publications and books he has dealt extensively with the concepts of contemporary Kleinian analysts, especially with pathological organizations of the personality, the concepts of time and space in borderline pathology, projective identification and countertransference and the resulting technical problems.  Chair of Education Section of the International Journal of Psychoanalysis.  Author of “Trauma, Guilt and Reparation” (Routledge 2020).

Susan N Finkelstein is a Fellow at IPTAR and Training and Supervising analyst at the Contemporary Freudian Society. She developed Understanding Primitive Mental States in NYC. She is in private practice in NYC in psychoanalysis, psychotherapy, couple therapy and clinical supervision.  She is an Associate Board member of the International Journal of Psychoanalysis and has co-edited with Heinz Weiss, The Claustro-agoraphobic Dilemma in Psychoanalysis: The Fear of Madness, Routledge (2022).

Program Fee:  $60 General/$50 CFS Members/$30 Candidates & Students

Learning Objectives:

Upon completion of this seminar, participants will be able to:

1) demonstrate an understanding of Henri Rey’s concept of the claustro-agoraphobic dilemma and be able to utilize it in clinical practice

2) identify examples of his concept of “marsupial space” in the context of clinical data

3) identify the features of pathological narcissistic organizations and discern such organizations when they arise in a clinical context

Who Should Attend: The instructional level for this activity is advanced.  Mental Health Professionals (psychiatrists, psychologists, social workers, licensed professional counselors, e.g. LPs, LCATs, and pastoral counselors) and those with an interest in psychodynamic and psychoanalytic thinking and clinical applications.

Continuing Education Credits:

NY Social Workers: The PTI-CFS is recognized by the NYS Education Department’s State Board for Social Work as an approved provider of continuing education for licensed social workers #0087

NY Psychoanalysts: The PTI-CFS is recognized by the NYS Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed psychoanalysts #P-0021.

NY Licensed Psychologists: The PTI-CFS is recognized by the NYS Education Department’s State Board for Psychology as an approved provide of continuing education for Licensed Psychologists #PSY-0017.

Psychologists: The CFS is approved by the American Psychological Association to sponsor continuing education for psychologists.  The CFS maintains responsibility for this program and its content.  (DC, MD and VA Psychologist licensing boards accept CE credits provided by an APA approved Sponsor.  All other psychologists should check with their licensing boards.)

DC, MD and VA Social Workers: The Social Work Boards of the District of Columbia, Maryland and Virginia will grant continuing education credits to social workers attending a program offered by an APA authorized sponsor.

CE credits will only be granted to participants with documented attendance of the entire program and completed online evaluation form. No partial credit will be offered. It is the responsibility of the participants seeking CE credits to comply with these requirements.  Upon completion of this program and online evaluation form, participants will be granted credits.

Important Disclosure Information: None of the planners and presenters of this program have any relevant financial relationships to disclose.

“The theme of this program is explored in more detail in the book, edited by Susan Finkelstein and Heinz Weiss, The Claustro-agoraphobic Dilemma in Psychoanalysis: The Fear of Madness, published in 2022 by Routledge.”