Hyman Spotnitz

Hyman Spotnitz (September 29, 1908 – April 18, 2008) was an American psychoanalyst and psychiatrist who pioneered an approach to working psychoanalytically with patients with schizophrenia in the 1950s called Modern psychoanalysis. He also was one of many clinicians practicing at the time interested in group therapy.

Background and education Born in Boston to immigrant parents, Spotnitz attended Harvard College and received a degree in medicine from Friedrich Wilhelms University in Berlin in 1934. He continued his medical studies at the College of Physicians and Surgeons, Columbia University, earning a Medical Science degree in neurology in 1939. His initial work on schizophrenia was conducted while a consulting psychiatrist for the Jewish Board of Guardians in New York City.

At the time, most psychoanalysts did not think that schizophrenia was treatable through therapy and group approaches were not popular . His approach was considered controversial. His clinical work was deemed unpassable by the New York Psychoanalytic Institute where he was training and he left to continue to develop his work.

On April 18, 2008 he died in New York City of natural causes.

Theory of technique Spotnitz's treatment approach emphasizes the development of the narcissistic transference in which the patient relates to the therapist as if he were part of his own mind, rather than a separate person. Some have criticized this approach because it contradicts a general aim of psychotherapy, which is to promote self-other boundaries. He theorizes that most neuroses and severe mental illnesses originate in the preoedipal period, before the development of language. The transference that develops with these patients then is largely enacted nonverbally through behavior, symptoms, symbolic communications and, importantly, the transmission of feeling states, otherwise known as induced feelings. Spotnitz feels that the "narcissistic defense" is central to most mental disturbances and is characterized by self-hate rather than self-love. Aggression is directed towards the self in order to protect the object. Treatment then emphasizes helping patients to better metabolize their aggressive drives, by gradually being able to express their aggression in treatment. Spotnitz emphasized initially joining with the patient's resistance, rather than challenging, and using the countertransference feelings of the therapist to help understand the patient. His central focus on the objective, and hence clinically useful nature of the therapist's countertransference was later taken up by self psychology and intersubjective approaches to psychoanalysis. Also foreshadowing later developments in other schools (as did schools in the U.K. that preceded him,) Spotnitz's approach to the analyst's interventions are primarily intended to provide an emotional-maturational communication to the patient, rather than to promote intellectual insight. With this technique he was able to cure many patients previously deemed incurable by the psychoanalytic world.

Group therapy

Spotnitz began developing modern psychoanalysis and psychoanalytic group therapy during the time he served as consulting psychiatrist at the Jewish Board of Guardians in the mid-1940s and 50’s. His closest students and collaborators at the time were Yonata Feldman and Leo Nagelberg.