When Stress Causes Pain (Conference)

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On October 6, 2012 the PPDA, in partnership with the NYU Postdoctoral Program in Psychotherapy And Psychoanalysis, hosted a conference in New York City entitled When Stress Causes Pain: Innovative Treatments for Psychophysiologic Disorders. The objectives for the conference were: To understand the link between psychosocial stress and pain and other physical symptoms; Learn to assess clients with medically unexplained physical illness; and Learn to use psychotherapy to relieve somatic symptoms.

Program

  • Remarks and Introduction: Lewis Aron, PhD, ABPP – Director of NYU Postdoc
  • Solving Medical Mysteries: Hidden Stresses and Unexplained Symptoms: David D. Clarke, MD – Oregon Health & Science University
  • Psychophysiologic Disorders: A Patient’s Perspective: Forest S., MA, MS – Boston U.
  • Emotions Matter: New Research on Psychophysiologic Disorders: Howard Schubiner, MD – Wayne State University
  • Clinical Case: Mother’s Goody Girl, and Thereafter: Early Attachment Bonds and the Development of Somatic Symptoms: Frances Sommer Anderson, PhD, SEP – NYU Postdoc
    • Discussants: Mary-Joan Gerson, PhD, ABPP — NYU Postdoc; Peter Zafirides, MD — PPDA; David D. Clarke, PPDA Medical Consultant
  • Building Affect Tolerance through the Physiology to Reduce Psychosomatic Symptomatology: A Clinical Case Approach: Raja Selvam, PhD (Keynote Speaker)
  • Peer Support for People with Psychophysiologic Disorders: A View from the Trenches: Forest S., MA, MS – Boston U.
  • Into, and Out of, the Rabbit Hole: Cascading Errors in the Diagnosis and Treatment of PPD: Eric Sherman, PsyD – NYU Postdoc
    • Discussants: Evelyn Rappaport, PsyD, SEP — NYU Postdoc; Sharone Bergner, PhD — NYU Postdoc; Alan Gordon, LCSW — PPDA; Howard Schubiner, MD — PPDA Medical Consultant
  • Closing Remarks: Spyros Orfanos, PhD, ABPP — NYU Postdoc Clinic Director

Interview with Frances Sommer Anderson, PhD and Eric Sherman, PsyD on the PPDA Conference

On October 6th, the PPDA, in partnership with the NYU Postdoc on Psychoanalysis will be hosting a conference entitled When Stress Causes Pain: Innovative Treatments for Psychophysiologic Disorders. In the build up of this groundbreaking event, the PPD/TMS Peer Network recently interviewed two of the primary organizers of the conference: Frances Sommer Anderson, PhD and Eric Sherman, PsyD.


PPD/TMS Peer Network (PTPN): Most of the people on this mailing list know about David Clarke, MD; Howard Schubiner, MD; Peter Zafirides, MD; and Alan Gordon, LCSW. Could you tell me about the backgrounds of the other presenters, Lewis Aron PhD, ABPP; Mary-Joan Gerson, PhD, ABPP; Raja Selvam, PhD; Evelyn Rappaport, PsyD; Sharone Bergner, PhD; and Spyros Orfanos, PhD, ABPP? What are their theoretical approaches?

Frances Sommer Anderson: Eric Sherman and I, graduates of the New York Postdoctoral Program in Psychotherapy and Psychoanalysis in 1999, are delighted that our psychoanalytic institute is co-sponsoring this pioneering collaboration among primary care physicians, mental health clinicians and healthcare consumer advocates! After all, Sigmund Freud’s earliest patients presented with physical symptoms that he found to be related to their psychological conflicts—what a fitting contemporary undertaking. We are pleased that the Director of the NYU Postdoc, Lewis Aron, will launch the conference with Opening Remarks, providing the psychoanalytic and cultural context in which the idea for the conference developed. Aron, one of the founders of contemporary Relational Psychoanalysis, has wide-ranging interests, including an interest in the place of the body in modern theorizing. In 1987, Dr. Aron and I co-edited Relational Perspectives on the Body, now a foundational text credited with bringing the body back into contemporary theorizing. My chapter in the book is a detailed case presentation of my work with a woman referred by John E. Sarno, MD with a diagnosis of TMS musculoskeletal back pain.

Dr. Orfanos, also a Relational Psychoanalyst and Director of the Clinic at the NYU Postdoc, will offer Concluding Remarks at the end of the conference day. Known for his capacity to engage large audiences, Orfanos will provide attendees with an overview in an atmosphere of joy and levity.

Our Keynote Speaker, Raja Selvam, PhD is known internationally as a senior Somatic Experiencing® (SE) trainer. He also developed Integral Somatic Psychotherapy (ISP) and Integral Trauma Resolution (ITR), drawing from bodywork systems of Postural Integration and Biodynamic Cranio-Sacral Therapy, body-psychotherapy systems of Bioenergetics and Biodynamic Analysis, Jungian and Archetypal psychologies, psychoanalytic schools of Object Relations and Inter-Subjectivity, Somatic Experiencing (SE), Affective Neuroscience, and Advaita Vedanta, a spiritual tradition from India.

Mary-Joan Gerson, PhD, ABPP, a psychoanalyst and internationally-recognized expert in couple and family therapy, has presented nationally and internationally on the integration of psychoanalytic, family systemic and attachment theory. An interpersonal psychoanalyst, she is also known for her expertise in treating gastrointestinal disorders, including irritable bowel syndrome, collaborating with her husband, Charles Gerson, MD, a board-certified gastroenterologist. Both are on the Faculty of Mt. Sinai Medical Center in NYC.

Sharone Bergner, PhD, is a member of the faculty at both the Institute for Psychoanalytic Training and Research and NYU’s Postdoctoral Program in Psychotherapy and Psychoanalysis. She has written about theory, fantasy and the therapeutic context in times of bodily dysfunction, and has trained and worked in medical settings including those of oncology, primary care, and women’s reproductive health. Her theoretical orientation is Contemporary Freudian.

Evelyn Rappaport, PsyD, is a clinical psychologist, psychoanalyst and a Somatic Experiencing® Practitioner (SEP). Currently she specializes in trauma resolution and is integrating somatic, embodied experiences with relational psychoanalysis. Author of a number of articles currently in press, she travels between New York and Jerusalem to lecture and consult to trauma coalitions and community centers. Dr. Rappaport is also on the board of the International Trauma Institute where she is developing programs in emotional first aid.

PTPN: Both of you are presenting at the conference. What is the title of your presentation and your key objectives for it? How do these objectives relate to the treatment of PPD?

Frances Sommer Anderson: Clinical Case: Mother’s Goody Girl, and Thereafter: Early Attachment Bonds and the Development of Somatic Symptoms. I chose to present aspects of my treatment of one of John E. Sarno’s TMS patients from 1982. The location of her musculoskeletal pain was unusual and puzzling, thereby being useful for teaching principles of diagnosis and treatment of psychophysiologic disorders. A young immigrant from Japan, her emotional stressors illustrate 1) the impact of acculturation on emotional and physical health 2) the complex interaction between cultural constraints and mindbody health 3) the contribution of early childhood attachment disruptions on the development of physical symptoms in adulthood.

Eric Sherman: The title of my presentation is: “Into, and Out of, The Rabbit Hole: Cascading Errors in the Diagnosis and Treatment of PPD”. The key objectives for my presentation are related to identifying and overcoming the collective professional blind spots shared by both physicians and mental health professionals when it comes to recognizing the existence of Mindbody Disorders, or PPD. Typically, PPD is misdiagnosed by both disciplines because PPD hasn’t found its way onto their professional radar screens. And when a condition is misdiagnosed, people suffering from these conditions are deprived of effective treatment which can alleviate their suffering and improve the quality of their lives. Therefore, to the extent that PPD as a Mindbody Disorder finds its way onto the attendees’ radar screens, then the key objectives of my presentation will have been realized.

PTPN: This is the second conference organized by the PPDA. How would you compare it to previous ones in Los Angeles and Ann Arbor?

Eric Sherman: I would first describe this conference as standing on the shoulders of giants, that is, the successes of both the Ann Arbor and Los Angeles Conferences. The PPDA emerged from the ongoing work initiated by the Ann Arbor and Los Angeles Conferences. You could describe the conference as the PPDA’s official debut.

The joint sponsorship of the conference represents a pioneering collaboration between The New York University Postdoctoral Program in Psychoanalysis and Psychotherapy and the Psychophysiologic Disorders Association (PPDA). With the combined resources and perspectives of both the PPDA and a prestigious academic institution, we are able to still offer a comprehensive overview of PPDA while providing a more in-depth approach to the complexities of diagnosing and treating these conditions.

PTPN: Could you tell us about the organzing committee and who else played a role in organizing the conference?

Eric Sherman: Fran was and is the driving force behind this conference. Her vision, persistence, indefatigability, meticulous attention to detail, and commitment to the mission of the PPDA set the stage for this pioneering collaboration between the NYU Postdoc and the PPDA. I myself was a "conference virgin" until Fran asked me to join her as co-chair. Some of our success working as a Conference Planning Committee can be attributed to hard work and experience. Some of it was the result of good fortune. We had access to the experience of PPDA Board Members who previously played critical roles in the planning and execution of the Ann Arbor and L. A. Conferences. Therefore, we didn't have to reinvent the wheel. Alan Gordon, Dave Clarke, and Forest all generously shared their cumulative experience with the past two conferences while giving us the space to respond to the unique challenges of holding a conference in New York City. Several of us recruited respected friends and colleagues to delegate tasks more efficiently. Fortunately for us, they all accepted our invitations to join the Conference Planning Committee. Alan Gordon introduced us to Derek Sapico who quickly integrated himself into the committee as did Neal May, Dana Geva-Grofman, and Jeff Wentzel who were brought on board by Fran and me.

We were very lucky to meet Francine Leinhardt at the New York Academy of Medicine, the site of the conference. Francine is not only a force of nature but she also has encyclopedic knowledge about all aspects of conference planning. Francine and her staff were unbelievably generous with their time and their patience, both of which were frequently put to the test by our unfamiliarity with the minefields of New York City conference planning. And no one on the Conference Planning Committee will debate whether if it was brains or luck involved in selecting Sergio Quiros as our conference planning assistant; we only express gratitutde for having Sergio on our team.

I'm sure once the conference is over, we will all have a clearer idea of how it all fell into place. Certainly what I've just described will be part of that account.

Frances Sommer Anderson: Thank you Eric! I will expand on your incisive summary to thank you, Eric, for being a quick and willing learner. We met in 1983 on Dr. John E. Sarno's pain service at Rusk Institute--NYU Langone Medical Center. Our collaboration has grown steadily since then. Eric fully supported me, allowed me to direct him, while maintaining a stabilizing voice of his own. He has been a palm tree in the inevitable hurricanes that develop during conference planning! I would add that without the support of Lewis Aron, Director of the NYU Postdoctoral Program, and numerous colleagues at the Postdoc, the PPDA would not have been able to launch a conference with such a broad, respected academic co-sponsorship. I am grateful for the fertile learning environment at the Postdoc.

PTPN: What led you to partner with the NYU Postdoc to co-sponsor the event?

Frances Sommer Anderson: The NYU Postdoctoral Program is my psychoanalytic home and the nurturing theoretical environment in which I enhanced my understanding of psychophysiologic disorders and how to treat them. The program’s respect for diversity and Lew Aron’s encouragement to pursue my interest in this area are the foundation for launching this conference.

PTPN: What role will the NYU-Postdoc play in the program?

Eric Sherman: NYU Postdoc is a co-sponsor of the conference. NYU Postdoc embraces intellectual diversity within the psychoanalytic community and strives to promote opportunities for interdisciplinary dialogue with other clinicians, researchers, and academicians of all stripes. In both the development of the agenda and the selection of The Conference Faculty, NYU Postdoc and the PPDA were guided by a spirit of inclusiveness along every step of the way.

PTPN: What will attendees learn about PPD at the conference?

Frances Sommer Anderson: Physicians will provide cutting edge medical research and clinical case material re the diagnosis and medical intervention re psychophyiologic disorders. Mental health clinicians from varying theoretical orientations will discuss treatment approaches. A healthcare consumer advocate, who recovered from a severe psychophysiologic disorder, will offer the perspective of people who suffer with pain and similar disorders.

PTPN: What skills will attendees learn on treating clients with PPD?

Eric Sherman: The first skill attendees will learn is to recognize the existence of PPD as both a medical and a psychological condition. Then there will be opportunities to learn more about diagnosing PPD in the varied clinical presentations and histories that both physicians and mental health professionals routinely encounter in the trenches of everyday practice.

Another important lesson to take away from the conference is how the intolerance of affect, that is, the inability to maintain positive self-esteem while experiencing certain feelings solely on a private, internal, and emotional level plays a crucial role in the development of PPD symptomatology. Attendees will also be able to learn about therapeutic techniques to increase an individual’s tolerance for negative affect.

PTPN: Professionally, how do you expect the audience to be divided? Who will make up the audience?

Frances Sommer Anderson: Our outreach for this conference was directed primarily to mental health clinicians, as the New York metropolitan area has many healthcare professionals who are likely to be open to learning about the latest diagnostic and treatment approaches. Of course, we welcome medical practitioners, allied healthcare professionals, bodyworkers, yoga teachers, and people in pain.

PTPN: There is a small but passionate group of PPD practitioners. Will there be an opportunity for networking during the course of the day?

Eric Sherman: The conference is very compactly scheduled since it’s a one-day event. However, for those arriving early (before the 8:30 AM start of the conference), and for those who opt to have lunch on the premises, there will be opportunities to network with Conference Faculty and other attendees during these times. Also, there will be a Presenters’ Table featuring flyers describing the publications and other works of the Conference Faculty. This table will be available to all attendees throughout the entire conference. The flyers will include contact information for individual presenters. Of course I can’t speak for everyone, but most presenters would welcome the opportunity to cultivate professional relationships with other colleagues and anyone else who is interested in their work.

PTPN: Lastly, what do you hope to achieve with this conference? How will this conference help spread awareness of PPD?

Frances Sommer Anderson: We hope that attendees will leave the conference with information that equips them to recognize, refer, and treat people in pain and other stress-related physical conditions. We have reached more than 23,000 mental health clinicians in our marketing campaign. As the conference date approaches, we will be contacting local, national, and international media via press release about the conference. We aim to make a lasting impression with didactic and clinical case materials presented by a Faculty of physicians and mental health clinicians who have achieved national and international recognition in their professional domains.

Dr. Frances Sommer Anderson, a licensed psychologist, holds a Certificate of Specialization in Psychoanalysis from the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis and is a Somatic Experiencing © Practitioner. She began treating patients who experience chronic pain in 1979 under the tutelage of Dr. John Sarno at the Rusk Institute of Rehabilitation Medicine-NYU Medical Center. She worked as part of the psychology staff at the Rusk Institute until 1987, when she began working in a private practice and also leading psychoanalytic training programs. She has authored several books about TMS and chronic pain, including a case study in the book Relational Perspectives on the Body which she co-edited with Lewis Aron. She also was an editor of the book Bodies in Treatment, The Unspoken Dimension. Her private practice focuses on psychotherapy and psychoanalysis treatments for adults as well as using Somatic Experiencing.

Dr. Eric Sherman, is a licensed psychologist practicing in New York City. He received a certificate of Specialization in Psychoanalysis and Psychotherapy from The New York University Postdoctoral Program in Psychotherapy and Psychoanalysis. He completed his clinical internship at The Rusk Institute of Rehabilitation Medicine of New York University Langone Medical Center and served on the staff of Rusk's Psychophysiological Pain Program. He has expertise in the evaluation and treatment of patients with psychophysiological disorders. Dr. Sherman was an adjunct assistant professor at The Hunter College School of Health Sciences, where he taught graduate physical therapy students about the psychological implications of physical disability. He has provided supervision to graduate students in The Clinical Psychology Doctoral Program, City College, CUNY. While on staff at The Rusk Institute, he trained psychology interns in the evaluation and treatment of psychophysiological pain disorders. He regularly consults with physicians and other health care professionals struggling to understand and manage their own and their patients' psychological reactions to acute and chronic medical conditions, especially cancer and physical disabilities.

Drs. Anderson and Sherman have also co-authored the forthcoming book, Pathways to Pain Relief. In The Divided Mind, both were called two of Dr. Sarno's most trusted psychologists.


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