Browse Health
Psychiatrist
43 years of experience

Education ?

Medical School
(1967)

Awards & Distinctions ?

Associations
American Board of Psychiatry and Neurology
American Psychoanalytic Association

Publications & Research

Dr. Chused has contributed to 13 publications.
Title Little Hans "analyzed" in the Twenty-first Century.
Date October 2007
Journal Journal of the American Psychoanalytic Association
Excerpt

Freud's monograph on the analysis of Little Hans is examined from a perspective aimed at highlighting elements of current thinking that would be considered mutative from those originally emphasized at the time it was written, and with a specific focus on the relative importance of verbal versus nonverbal interventions.

Title Obsessional Manifestations in Children.
Date May 2000
Journal The Psychoanalytic Study of the Child
Excerpt

Material is presented from the analyses of three children who developed obsessional behavior during the course of their analytic work. The author's intent is to use a careful examination of the emergence of these children's obsessions to try to understand the unconscious determinants that lead to the development of obsessive-compulsive behavior as a way to deal with psychic distress.

Title Male Gender Identity and Sexual Behaviour.
Date March 2000
Journal The International Journal of Psycho-analysis
Excerpt

One consequence of a heightened interest in intersubjectivity in the current psychoanalytic literature has been a relative neglect of the examination of unconscious fantasies. Presenting material from the analysis of three males, each of whom, in childhood and/or adolescence, hid his penis between his legs and looked at himself in a mirror naked, the author demonstrates the importance of attending to both unconscious fantasies and their manifestations within the interactive field of analysis. The first patient is a young child with a gender identity disorder, whose wish to be like his mother was a response to the emotional loss of her during early childhood. The second patient is an adolescent, whose behaviour in front of a mirror was a manifestation of his desire to possess his mother and be her, to humiliate and sadistically control her, and at the same time, to experience the masochistic sexual gratification of being a seemingly helpless victim. The third patient, a 48-year-old male, came to analysis filled with suicidal impulses and self-hatred related to homosexual impulses. His repeated examination of himself in a mirror, with penis hidden, reflected severe castration anxiety, related to an ambivalent relationship with an angry mother and a longing for attention from an unavailable father. The article closes with a description of the similarities and differences in the dynamics of these three males as well as a discussion of the meaning of similar behaviour in other males seen in consultation.

Title The Therapeutic Action of Psychoanalysis: Abstinence and Informative Experiences.
Date March 1997
Journal Journal of the American Psychoanalytic Association
Excerpt

In recent years a number of analytic concepts have been subject to scrutiny, with the value of interpretations, the usefulness of abstinence, the possibility of neutrality, all questioned. One reason for the skepticism about interpretations, in particular, is that before a patient can use an interpretation for psychic change, his perceptual frame must change, a process that is rarely initiated by the verbal content of an interpretation alone. Instead, alterations in perception usually require experiences which are discordant with expectations. In this paper the author demonstrates how the nonverbal elements of an intervention, the action communications, provide informative experiences, creating the dissonance between expectation and eventuality which makes psychic change possible. Case vignettes are presented to illustrate this point as well as to support the idea that when nonverbal experiences contribute to lasting change within a patient, the therapeutic benefit does not accrue primarily from the gratification provided by the experience, but from how the experience informs the patient about his mode of thinking, perceiving, and reacting.

Title The Patient's Perception of the Analyst: the Hidden Transference.
Date June 1992
Journal The Psychoanalytic Quarterly
Excerpt

Just as the person of the analyst becomes a nidus for the manifestations of transference, so does the analyst's technique. When the patient misperceives person and technique, identifying the transference is not difficult. More complicated are those situations in which the patient's perception of the analyst and of his or her technique is congruent with the analyst's self-representation, or when the patient uses reality aspects of the analysis and the analyst as a resistance. Clinical material from the analysis of three patients is used to illustrate this.

Title The Analyst's Mistakes.
Date June 1992
Journal Journal of the American Psychoanalytic Association
Excerpt

The analyst's mistakes are an inevitable aspect of his conduct of psychoanalysis. They result from the inherent uncertainties and ambiguities of the analytic process itself, and from the continuing effect upon analytic technique of the analyst's unresolved conflicts, as manifested in countertransference attitudes and enactments. Variables of clinical experience, skill, and the vicissitudes of the analyst's life also contribute to the susceptibility to error. When the analyst's mistakes result from his active engagement in the psychoanalytic process, they yield important clues for understanding clinical material as well as present potential obstacles to analytic progress.

Title The Evocative Power of Enactments.
Date December 1991
Journal Journal of the American Psychoanalytic Association
Excerpt

The inevitability of analytic enactments, defined as symbolic interactions between patient and analyst, is discussed. Clinical material from the psychoanalysis of a latency-age child is presented to illustrate the role of enactments and to demonstrate their usefulness in furthering the analytic work.

Title Neutrality in the Analysis of Action-prone Adolescents.
Date December 1990
Journal Journal of the American Psychoanalytic Association
Excerpt

An adolescent patient's action during analysis reflects both neurotic conflicts and the developmentally determined task of establishing an integrated self-representation. Concern for the consequences of the action often provokes the analyst to respond, covertly, with interventions intended to change the action through influence rather than understanding. This can lead to a distortion of the analytic process which, in itself, may be an enactment of the developmental conflict. Examination of such interventions reveals a lack of analytic neutrality and an unconscious participation in the patient's neurotic and developmental conflicts. Clinical material from the analyses of two fourteen-year-old girls and a sixteen-year-old boy is presented to illustrate and support this hypothesis.

Title The Transference Neurosis in Child Analysis.
Date March 1989
Journal The Psychoanalytic Study of the Child
Title Transference Across Gender Lines.
Date June 1988
Journal Journal of the American Psychoanalytic Association
Excerpt

Four clinical examples of oedipal-based transference across gender lines are presented with the aim of illustrating (1) its existence, (2) the defenses against its emergence, and (3) the use of the analyst's gender as both an organizer of and resistance to certain transference manifestations. Factors that contribute to the availability for analysis of cross-gender transference are discussed, as are the resistances and other obstacles to its actualization.

Title Idealization of the Analyst by the Young Adult.
Date February 1988
Journal Journal of the American Psychoanalytic Association
Excerpt

Idealization is an intrapsychic process that serves many functions. In addition to its use defensively and for gratification of libidinal and aggressive drive derivatives, it can contribute to developmental progression, particularly during late adolescence and young adulthood. During an analysis, it is important to recognize all the determinants of idealization, including those related to the reworking of developmental conflicts. If an analyst understands idealization solely as a manifestation of pathology, he may interfere with his patient's use of it for the development of autonomous functioning.

Title Consequences of Paternal Nurturing.
Date March 1987
Journal The Psychoanalytic Study of the Child
Title The Role of Analytic Neutrality in the Use of the Child Analyst As a New Object.
Date March 1985
Journal Journal of the American Psychoanalytic Association
Excerpt

The analyses of two children and one adolescent were presented to illustrate the concept that the neutrality of the analyst can be used not only to (a) establish a working, analyzing, and observing alliance, (b) permit the development, recognition, and working through of the transference neurosis, but also to (c) develop a sense of autonomy and self-esteem which had been contaminated by the neediness and lack of true empathy of the primary objects during the practicing and rapprochement phases of separation-individuation. For the patients discussed above, many ego functions which should have had a degree of secondary autonomy were either inhibited, enmeshed in conflict, or experienced as nongenuine, part of a "false self." It was as if the experience with the neutral analyst permitted an "autonomous practicing" that had not been possible during the period of separation-individuation.

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