Hidden in Plain Sight: Thoughts on Imagination and the Lived Unconscious

Teleanalysis Does Not Have to be "Muted": On the Crucial Role of the Analyst's Internal Frame in any Setting

Given that practicing teleanalytically is relatively new and more widespread than ever, questions about how to practice and teach it effectively have increased and are more pressing than ever. To contribute answers to these questions, this paper addresses long-standing and persisting negative views of teleanalysis as an inherently muted, remote, and pale experience with reduced therapeutic effectiveness. I propose that this view of teleanalysis as inherently inferior to in-office analysis limits or even precludes its therapeutic usefulness because it allows analysts to avoid making analytic use of the disturbing feelings hiding within the experience of practicing teleanalysis. Through case examples, I suggest that when analysts do not take our negative views of teleanalysis at face value but instead consider them as symbolic expressions of our and our patients' anxieties, we can improve our understanding of our analytic functioning within the tele-setting and enhance our capacity to think and engage analytically effectively in any setting. I maintain that these considerations have important implications, not only for how experienced analysts practice, but also for how we treat and teach future analysts.

Psychiatrists' Illustration of Awe in Empathic Listening Assessments: A Pilot Study

Background "Awe" is typically an inspiring emotional response to perceptually vast stimuli signifying the transcendence beyond all cognitive frames of reference when we encounter the unexpected. Physicians' experience of awe in clinical care interactions has not been studied in an empirical, evidence-based way. We aim to present a focused study of awe in a psychiatrist's empathic listening (EL) assessments and propose an evidence-based framework to study it. Methodology This is an exploratory case series of a psychiatrist's EL interactions (mean duration/x̄ of 46.17 minutes) with six patients (two males and four females) aged 32-72 years (x̄ =54.67, σ = 16.64). Using the method of autoethnography, the verbal and nonverbal aspects of the EL assessments were analyzed and open-coded to generate qualitative data. Results The study revealed that the data in all the case studies could be classed into two thematic groups, namely, mindfulness and transpersonal mindfulness. The emotions of "awe" and "non-agency" were ubiquitous in all six case studies both for the psychiatrist and patients. Conclusions Recognizing the awe and non-agency in EL interaction is essential in conceptualizing the "mindfulness-to-transcendence" framework and the first step toward the evidence-based study of transcendence/metaphysics in phenomenological psychiatry.