Christina McKelvy: 0:13

Welcome to Hopology stories of hope, healing and resilience. I'm your host, christina McKelvey. Today we're going to be speaking with Dr Kuzovitsky. He's a psychoanalyst and he's researched different ways that hope can bring meaning to people. How are you?

Max Kusovitky : 0:29

I'm okay. I'm excited to be here.

Christina McKelvy: 0:33

Excited too. Why don't you introduce yourself for us?

Max Kusovitky : 0:37

Sure, so I'm Dr Kuzovitsky, but obviously Max is fine. I'm a psychoanalyst practicing in New York, new Jersey tri-state area, and I guess what brought me here involved, as we previously discussed, is the relationship to hope and how it plays out in the frame of psychodynamic therapy or psychoanalytic therapy or just meaningful therapy, or whatever people prefer to call it. And I felt particularly motivated to speak to and attend to how complicated it is, and especially when hope as a virtue is not the same thing as hope as it's played out in the therapeutic dynamic or the therapeutic frame, and it deserves to be understood in a much more meaningful way. It's complicated, it certainly can be a danger and it certainly can be a wonderful, wonderful thing that fuels something like resilience in a person.

Christina McKelvy: 1:36

It can be a danger. I want to focus on that in a minute but before we do, can you lay out the framework a little bit on psychodynamic, psychoanalyst framework, because I know some of our listeners might be like oh, I'm familiar with CBT or EMDR, all these different types of therapy. It's super saturated.

Max Kusovitky : 1:56

So if you want to explain a little bit, yes, the alphabet soup of contemporary therapy, right, it's super saturated. So, if you want to explain a little bit, yes, the alphabet soup of contemporary Right. So so much. So I I'm standing on the shoulders of giants who have said this better than I can, but essentially, what depth therapy is? Psychodynamic therapy is bringing awareness where it hasn't been before, bringing consciousness where it hasn't been before, saying the quiet parts aloud, essentially introspecting in a robust sense, that is to say, an appreciation of the unconscious landscape, which certainly exists. And by getting to know ourselves much more fully, by experiencing things that we might avoid experiencing through the nature of ego defenses, as it's called, or just keeping them out of awareness, we can facilitate a real and actual healing resolution, as we would call it in the sense of inner conflict that might not be felt prior to entering into a treatment like that. So a symptom, to speak even more simply, is not separate from the self. A symptom is part of the anatomy of one's own psychology.

Max Kusovitky : 3:06

The metaphor often used is the fever. The fever can be caused by a multitude of pathologies and you could take Tylenol to get rid of the fever, but that doesn't address, maybe, the infection. Or you can take Tylenol to get rid of the fever, but that doesn't address, maybe, the infection. Or you can take another medication that is analgesic and neutralizes the pain, but the pain returns and the inflammation returns, maybe sometimes with a vengeance therapy or in-depth therapy in service of understanding themselves, which is eventually what can give rise to not only hope. Uh pun maybe not pun intended, but intended to say uh what gives rise to the opportunity to heal that they might not have had otherwise or prior okay, it sounds like the root, getting to the root of the issue, as opposed to putting a band-aid on into that?

Max Kusovitky : 3:57

yes, that is, that is commonly used my anxiety my anxiety, sometimes, as people, you know, I want to stay as diplomatic as possible. I don't want to offend other forms of therapy, but yes, we, we, I. I tend to agree with that in that the genesis or origination of so many of what we experience as symptoms in today's world, or what the DSM organizes as symptoms, but without causality or etiology, it's really important. Right, the symptoms exist anxiety, depression, what happens, somatic issues and so on but if we don't dignify the reality of our own psychology and saying that this is something that can actually generate suffering or a point of suffering, we do our own humanity a really huge disservice, and I don't think any of that is an exaggeration.

Christina McKelvy: 4:52

Yeah, it's like the point of suffering. This is like the point of suffering, this is like the like, like the foundation almost, and it's more than because when people hear psycho, analytic, analytic theory, I am having a hard time speaking today. Probably shouldn't have had that whole big cup of coffee before. But you know, people hear about like they think traditional therapy, freud, young things like that. Yes, the common what we say.

Max Kusovitky : 5:18

Again, you're teeing me up for some wonderful classical refrains we use. They argue against the straw man from the horse and buggy era. So they say psychoanalysis is the same thing that you know. Hysteria is a good example of the wandering womb, or something.

Max Kusovitky : 5:35

And as if, in my training starting in the 2010s, as if that's what I was taught, even though that was something said, obviously, in 18, I don't remember 80s or 90s, and yet it's true. People argue as if nothing's changed in 110 years. But if the example we use as contrast or to confront, that is, people aren't bloodletting anymore, we don't argue against that. People aren't talking about the four humors anymore, you don't argue against that. People aren't talking about the four humors anymore. People aren't arguing, arguing against that. But when it comes to psychology and you say you're a psychoanalyst, people think, yes, that you're lying down on a couch and you know, seven times a week and giving away your, your child's college tuition to pay me so I could build my pool, and it's just to pay me so I could build my pool, and a lot of it is incredibly untrue and unfair. But it goes with the territory of doing the real work, as you were saying, of what gives rise to hope and meaning in somebody's life. It's a very serious responsibility.

Christina McKelvy: 6:31

Mm-hmm, mm-hmm yeah yeah, and I think there's a lot of. I don't know if animosity is the right word. That's not the right word, but you know, maybe I'll wall up with it just because of Freud.

Max Kusovitky : 6:43

It's the right word, okay.

Christina McKelvy: 6:45

It's the right word, but you know I'm a therapist and a lot of the adults I work with I always go back to birth to five. You know we're going to do some birth to five work, early childhood work. We're going to look at what happened to you in the womb, we're going to look at you know um, the generational patterns with your parents and we're going to look at maybe some of these core beliefs is cbt, but I feel like you can't get away from doing psychodynamic work, even if you are aligned with other theoretical orientations. So I think it's, it's a foundation, is my belief yeah, we.

Max Kusovitky : 7:16

We would say that the reinvention of the wheel has been tried over and over the last 140, 130 years, and human psychology has not changed since the species began about 200,000 years ago. It's still the same, the drives, what motivates us, animates us, mobilizes us, the hierarchy of systems in the brain, if you want to bring in the neuroscience stuff, it hasn't changed. And so to say that affect isn't fueling thought in this topography of the brain to me, someone like me, is to sort of fit, is to sort of lie. And so we have to appreciate that these systems work in an emergent way, in a systematic way, in that psychoanalysis or just call it meaningful, whatever meaningful therapy, depth therapy appreciates the reality of how the brain and mind are super deemed or mapped onto each other. Or just say how the heart, soul, spirit, mind and brain are mapped onto each other. Again we. Or just say how the heart, soul, spirit, mind and brain are mapped onto each other. Again, we're trying to be as inclusive as possible. It ought not be a civil war.

Christina McKelvy: 8:27

Civil war within the fields. But yes, you know, the heart, soul, brain, mind all, like you said, are mapped onto each other. So I think that leads us to something you said at the beginning that hope can be dangerous, and so my podcast is called Hopeology. I love hearing stories about hope, healing and resilience, but I think I'm guessing where you're going to go with it. So I'm actually really excited to hear your perspective on what you mean by how hope can be dangerous. So let's delve more into that.

Max Kusovitky : 9:01

Sure, so to provide, I guess, some background and context. Essentially what? Although it's a nice soundbite, it's very pithy.

Christina McKelvy: 9:14

I know I was just thinking not to laugh.

Max Kusovitky : 9:18

It's true, it's a good soundbite, We'll get some clicks. Hope can be dangerous insofar as who's harboring the hope, who's generating the hope, who's ferrying the hope back and forth in the therapeutic relationship or frame. And, of course, what hope means? Let's get back to the individual, what hope means to the patient or the person. And hope throughout our lives plays different roles.

Max Kusovitky : 9:46

You know the inability to construct hope I think Raoul May said this, I could be wrong is the genesis of depression.

Max Kusovitky : 9:51

I mean, you can't construct a future plan.

Max Kusovitky : 9:53

You know the absence of hope in people's lives, and hopelessness and its symmetry to despair has been talked about by Mitchell, and other say that if it's utilized defensively which is maybe a controversial statement, but it can be utilized as a preventative, prophylactic, a membrane of sorts, it can get in the way of somebody's actual strivings towards potential.

Max Kusovitky : 10:33

And so what that means is that speak kind of more, more plainly is that hope can be something someone holds onto, but it can be based, founded upon fantasy that is incongruent with reality. So the hope can be generated or originated within the mind, spirit, the heart as we were talking about, but it might not be congruent or mapped onto a potential reality for that individual. So if my hope let's speak very simply if my hope was to be the king of England and then I found out that I was born in the United States, or I denied a defense that I was born in the United States, that could be quite painful and that also can produce real symptomatology. I might get very depressed, I might lose my spark or vitality or resilience in life, and so hope is very different as a verb or as a an actionable concept than it is as a virtue no-transcript.

Christina McKelvy: 11:39

So to summarize it sound what you're talking about is when someone has this false sense of hope, unrealistic expectations and realistic hope, like you mentioned. If it's my hope to be the king of england, but I was born in america and not even from you know the royal family, then that's gonna which I'm not, by the way yes, disclaimer everybody I am not speaking to the royal family, but that would be cool if you know of anyone will be be cool.

Christina McKelvy: 12:02

What brings you guys is hope. No, yeah, so it's like setting up like that could be dangerous if we go back to that Right.

Max Kusovitky : 12:13

And even the phrase, you know, can be quite controversial.

Max Kusovitky : 12:16

Again, I'm sticking with diplomacy as best I can, as best I can.

Max Kusovitky : 12:24

Realistic versus unrealistic can be a controversial because, depending on the person's personality, organization or structure or realm of where they're organized to speak to dynamic principles and neurotic and a borderland or psychotic, the realistic hope might be that they become King of England, president of the United States, oscar winner, pulitzer Prize winner of england, president, united states oscar winner, a poltergeist winner, you name it, and it could.

Max Kusovitky : 12:44

It can be incredibly intoxicated and incredibly seductive at the same time, and this is the hard part, because the unconscious could have lots of paradoxes, it can be very defensive. So, again, the king of england example is so powerful where that person might need to believe that they have the capacity or potential, or maybe they've been wronged or slighted by the royal family a funny topic today and they really should be the king of England, you know. And so people have these belief systems, which is, again, belief and hope go hand in hand, and so they can very strongly believe in a hope that might not be congruent, we would say, with who they actually are. There's a big difference between authenticity and a sort of fabricated sense of self or a false self or, you know, an image. People might say as well.

Christina McKelvy: 13:38

Okay. So where do you draw the line between okay, this false sense of hope is needed for this individual at this moment, to maybe we need to kind of delve into this more and help this individual know. Well, this is not really realistic. Where do you draw that line?

Max Kusovitky : 14:02

you know this is not really realistic, like where do you draw that line? So it's a really it's a really really good question. But the classic answer is not a cop out, and I will elaborate is is it's?

Max Kusovitky : 14:11

case by case, because you, I think, by asking, already recognize what you're asking, insofar as that hope or fantasy of hope might be gluing them together. And if I were to rob them of that, if I were to surgically excise it and remove it from the anatomy of their own psychology, they could genuinely fracture. That's not any hyperbole, that's not an exaggeration. So the word we use is tact, which is to say there is an art and science, a tact to knowing when this person is amenable or available to appraising their relationship to that fantasy of hope.

Max Kusovitky : 14:51

And let's say it's. In this case, let's say it's false. So it's not congruent with their way of being or where they live, and whatever it might be, or their age, or you name it, and the work of addressing it takes a certain arc of understanding. Let's use a lotto as a classic example. I'm going to bet all my money and just win lotto eventually, so I don't have to worry about anything. That can be a fantasy of hope, that can drive somebody. And if I said first meeting hi, I'm Dr Kuzovitsky, let's get rid of it. You came here, you were referred by your husband or wife or spouse or parent because you're addicted to the lotto. I'd probably say it that way, but we have to get rid of it now.

Christina McKelvy: 15:35

The person would run out of the office, they'd laugh at me, they'd scoff.

Max Kusovitky : 15:39

And so the work of establishing trust first, and understanding and empathizing with the hope again, and treating the hope as an actionable, you know, serviceable fuel, almost like a gas station you bring to mind in this conversation, be appreciated as a systemic part of what's fueling their vitality.

Max Kusovitky : 16:05

And again, if I were to tell them, oh, that's all wrong, there'd be no work to be had. They would never trust me, they would never trust their relationship to their own perception or they would never have the wherewithal to see the forest for the trees, let's say, and start to investigate what gives rise to that need for that fantasy of hope, and that's the danger it has to be treated with. I would use the word respect, even if it seems outlandish, which is a whole other conversation about treating somebody who might be more. Can I use the word psychotic? I don't know anymore. We would use the word psychotic, but what I mean is very alienated from reality, like the king of england fantasy. My job would not be to convince them that the hope of becoming the king of eng is bad or pathological. My work, in speaking to understanding the hope and liberating resilience, would be to help them understand where that comes from.

Christina McKelvy: 17:16

Help them gain that insight. So it's going to Rogerian theory. It's unconditional positive regard, meeting them where they're at yes, it gets tricky.

Max Kusovitky : 17:29

Unconditional gets very that's. I don't know how many hours you have today, but that that's a tricky concept throwing things at you.

Max Kusovitky : 17:36

I don't mean to no no, I'm, I'm, I'm, I would. I would love to talk about it. I'll'll talk in Blue Streak about it. But there is certainly, yes, positivity, affection, but it's couched within the frame and in my point of view and take it with a bowl of salt there's plenty of people who disagree with me it is absolutely conditional and it's conditional in the sense that it has to be within the frame.

Max Kusovitky : 18:02

Now someone could say I'm misconceptualizing unconditional positive art and I'm no expert in Roger's work. But in my understanding that positivity is more. I would just translate it and say the affection and respect and dignification if that's a word of the patient's psychology is where my investment goes. My emotional investment goes in the work, including all the stuff about hope and resilience. But it is conditional, meaning if they never came back that's a condition. They have to attend therapy, that's a real one. They have to pay a fee, in whatever variety, that's a real one. I have to be licensed in that state. So again, I don't mean to play, you know semantics, but it is conditional in my understanding yes, no, that definitely makes sense.

Christina McKelvy: 18:52

Um, so it does make sense to like go back to the term respect. You know, respecting the patient, respecting the individual and, like you said, it's a case-by case basis. Where, as far as like, where do you draw that line?

Max Kusovitky : 19:04

You know, like it makes sense, why it would be dependent on individual all the intermissing, you know, mutually destructive warfare in the field of mental health right now that I get very up in arms about that motivated me to join this podcast, because it ought not be there. You know, I'm not trying to say one is better than the other. I'm merely trying to respect the reality of how these things emerge. You know, what gives them life and human condition is incredibly complicated, and that's what you know. What gives them life and and human condition is incredibly complicated and it's what you know. Your podcast am I allowed to compliment the host? But it's admirable because hope is so much more complicated. I really, really it means a lot to me personally, professionally, because it's it's in my experience.

Max Kusovitky : 20:00

It's treated again. It's different than being a virtue. You know it's like saying everyone should be nice or the golden rule. You know, biblically there's a difference between the virtue of being nice versus actually putting effort in understanding somebody, or the effort in helping somebody, or even an apology. It's a great classic and intuitive example. You could say you're sorry and do the same behavior over and over again. That's the virtue of contrition is not the same thing as, or the performance of contrition is not the same thing as, actual contrition if you don't feel it, and so if you don't experience hope in the dyad between the patient and the analyst or therapist, it can become a real danger. I'm not just saying that so that we get a lot of clicks.

Christina McKelvy: 20:49

No, yeah, I know it can be, and because I was reading an article I think it was in Psychology Today just a couple days ago and it was perfect, because I was like, oh, I'm going to have, you know, this podcast interview about how you know hope can instilling false hope, false expectations in someone can be detrimental and it could hinder that resilience and so again, it goes with that, that hope and resilience.

Max Kusovitky : 21:15

It's actually that's, it's that's well, that's a very valuable point. I didn't consider consciously that's a very valuable point. I didn't consider consciously. Um, and what I mean is that the the virtue of hope, or false hope, or it being ingratiating, or being super complimentary or being a you know, a good mother to speak classically to the patient it's a very good point can rob them of their own resilience. Because if you're not respecting the key word maybe today, besides hope, if you're not respecting their own capacity, their own right to self-determination, their own autonomy or the points of arrest that preclude autonomy, in the topography of their own mind, they might never reach a place of what I would call endogenous, self-generated or internally generated hope. And if that's absent and I'm the one fueling it and you depend on me to give it to you we would call that an enactment and that means you need better supervision or better training. I don't know if that should stay. You might need to edit that out.

Max Kusovitky : 22:22

I'll research that, and if otherwise, then you're robbing the person of their vitality. It's sort of the irony of again this conversation to me again means so much and I think what you're doing is so powerful in the sense that it is that respect for the person's humanity that seems to have been lost in this alphabet soup of therapy or in the focus on symptomatology. Eradicating symptoms is not in and of itself the goal, right, the goal if there is a goal we wouldn't necessarily use that word if I could speak for the whole field, which is silly, I can't Is resilience and hope that's internally generated, or authenticity, striving towards one's own capacity, utmost capacity, karen Horei would say it's a moral obligation, a moral duty for the person to be able to become themselves. Moral obligation, a moral duty for the person to be able to become themselves.

Max Kusovitky : 23:25

Many analysts, or many, not just analysts, have said that philosophers and others, and hope again, can be one of those engines, truly that facilitates development. But if it's again treated as in and of itself a panacea of sorts, a false cure, you know, without the respect it deserves and instead kind of almost forced down somebody's throat in service of alleviating maybe my anxiety or my worries of being about ineffective and ineffective therapist. I'm absolutely failing the therapy and the person is not going to reach what that point in what I would call is genuine hope. Yeah, they become dependent on the therapist. Again, I agree with you, but I'm very afraid to speak to that. In terms of being respectful for other forms of therapy, I will say that I'll interrupt you there.

Christina McKelvy: 24:21

I don't think being dependent on the therapist. I think that is something a lot of different discipline um theoretical orientation more and against yes, that's true, yes and analysts are very guilty, please.

Max Kusovitky : 24:34

This is not unique, like like, analysts are immune. It's just, I think, that analysts can be so obsessive about trying to understand things that they that, if they're modest enough and if they've been in enough supervision and enough personal therapy, they're not going to allow that enactment to unfold. So, yes, dependence on the therapist is universal, you're absolutely correct, but it's about interpreting it so as not to let it become acted out without realization, without awareness. That's the big problem. And so if dependence to use that example becomes part of the frame of the work, then maybe the argument I would make in service of the conversation today is that hope can't be had by the person, because I'm harboring the hope that they themselves need to harbor.

Max Kusovitky : 25:21

And when we spoke for the first time prior to this recording, that metaphor meant a lot to me. It was something you and I came up with together. In the sense of ferrying hope is incredibly, incredibly powerful, and if you again force feed it and ferry that hope into the patient's harbor too early, they could run right, because that hope can be their hopelessness, can be a defense against all sorts of potential growth. Similarly, if I hold on to it myself and I'm harboring the hope, all of it. On one hand, I could be the auxiliary source of hope, which is certainly constructive or can be, but it also can be very defensive on my side. I don't want to give it to you, I don't think you're ready for it. Maybe I'm not realizing that. I'm like a mother or father who never provided it. Who knows? But that is another avenue or another ocean to cross. That very much plays a role in how hope is. I use the phrase before a verb. I currently I can't think of a better phrase. It's actionable, it's a verb, it's alive, it's dynamic.

Christina McKelvy: 26:33

Maybe it's a better word yeah, it's dynamic, it's ever-changing and it's needed and and I apologize to you I have background noise. I'm going to try and edit that out, but I apologize if it's distracting to any of my listeners, but there's construction going on across the street I can't, I can't, I can't hear it oh, yay, yay, um, you know hope and resilience.

Christina McKelvy: 26:59

As you were speaking, I was I thinking like what would come first? What would be needed? Resilience to instill the hope or hope to facilitate resilience, and how, as a practitioner, can you encourage that?

Max Kusovitky : 27:16

That's, you're blowing my mind. I've never thought of the order of operations or the permutation or combination of hope versus resilience Is there. Can I take a moment to think?

Christina McKelvy: 27:28

Yes, you can.

Max Kusovitky : 27:30

Can I phone a friend?

Christina McKelvy: 27:32

Sure go ahead, I think resilience comes from hope.

Max Kusovitky : 27:38

I don't know if there is. Don't know if there is, I have to think more clearly about it. But my knee-jerk reaction or my off-the-cuff would just be to say they go hand in hand. Resilience is distinct from hope, in my understanding, in that it's a capacity to manage and tolerate and survive what let's call negative experience, failure, pain, oppression, you know, of any kind. I think of depression, suppression, repression, oppression, compression. These forces maybe top down more than bottom up, although inhibition bottom up can be a big part of that. That, to me, is more in the vein of resilience being again actionable and a hedging against it or a fight against it.

Max Kusovitky : 28:31

Hope, it's a really good question. I have not thought of it. Hope, to me, is more a pursuit forward-facing. I see hope as more within the realm of fantasy of an inner working model that provides somebody animation of their life, motivation in their life, mobilization of their forces. Resilience to me seems more at bottom, if that makes sense in the way that I can conceptualize it. You need resilience and hope, and resilience is maybe what keeps you standing up in the face of what's the word? The face of opposition, or the face of the combatant, or the face of failure and hope is what allows you to put one foot in front of the other in pursuit of your own goals, dreams, development and authenticity.

Christina McKelvy: 29:39

Hope are the shoes and resilience is like the arm, like the shield or something.

Max Kusovitky : 30:04

Yeah, yeah, resilience is the internal capacity to face, manage, tolerate Again a lot of words come to mind Forces that go against the self. Maybe, and hope is the thing that keeps you going to hope is that you need resilience to maybe. So maybe there is an answer, maybe resilience is what is what undergirds hope, if you can, if I see it vertically in the brain or in the mind, and hope is what you know helps you pursue. But without, without resilience, it seems like hope would flounder, it would fall, and resilience without hope would allow you to survive but not live.

Christina McKelvy: 30:31

Like you said, they're interconnected.

Max Kusovitky : 30:34

Yeah, they seem very mutually dependent in a constructive way. Yes, way?

Christina McKelvy: 30:47

yes, and how can a practice practitioner um, especially in the work that you do, help someone towards the you know resilience and hope?

Max Kusovitky : 30:52

that's another big question. Um, you have to buy my book. I don't have a book. Um, I was like, really I wish, um, you have to attend my class on the weekends. It's five thousand dollars and they go hand in hand.

Max Kusovitky : 31:10

But I guess, to speak as simply as possible, the nurturing or cultivation of resilience and you're teaching your questions are very apt because you're sort of reteaching me things I haven't thought about as explicitly like back to the king of england, example, because shifting somebody's fantasy in service of a gravitational pull, you know, if there was a planet outside of them that moves them towards a realistic goal, that is, hope, and that that that evolution from a hope that is congruent with who they actually are and authentic and genuine and sort of self-sustaining, is not the same thing as somebody who might lack resilience. Let's say, life really has beat them down. Trauma is a real thing and even though nowadays it seems extremely common, it's used very lightly. The word has a lot of meaning psychodynamically, and so if someone has unfortunately suffered a prolific amount of trauma, there might not be resilience to get them into a position of, let's say, uprightness to even combat their own inner conflicts or their own interpersonal strivings or their own pain and so cultivating. That is a different approach. They go hand in hand. They could be in the same session, as an example, with the same patient, with the same arc in the work, but one to me feels as though they're both having to be self-sustained and self-generated.

Max Kusovitky : 32:45

But resilience might be more, let's say, I think in my experience, anecdotally, or in my cases in the history of my practice, resilience is something almost, like we said, a prerequisite, because if the person is in pursuit of some goal but they don't have the capacity to tolerate rejection very simple example, complicated but simple in in the language they might not ever pursue it, but the reason they can't tolerate rejection can be incredibly complicated. Another example would be that if that goal that involves rejection, they need to be a Hollywood Oscar winning director or something. If that goal itself is false or a defense against an absence of other wishes of accolade, affection and admiration, then that has to be interpreted and understood as well. Do with it seems more to do with depression, uh, more to do with a compression of force against the self and the absence of hope although there can be depressing, of course seems to do with the absence of meaning and purpose. Back to sort of what I do so then how?

Max Kusovitky : 34:10

okay okay, I'm just I'm gonna think about that I hope that I apologize if that was didn't make sense, because I'm improvising no, it did, it did.

Christina McKelvy: 34:21

And some, you know, I was thinking like well, how can you see? I don't know if you change is the right um words, but how can their internal? So, if they have this false hope, this, you know, fabricated self as opposed to their authentic self, how can you? How? What does one shift someone's psyche to go from fabricated self to authentic self? Like you are not going to be the king of England, but maybe you can do this instead.

Max Kusovitky : 34:56

Right, I mean, I mean you, you, you kind of hit the nail on the head it's, it's, it's. It's not that easy. I I again, not to be controversial, I don't think it'd be done in one session. But, uh, what you're doing is you're, you're converting, yes, you're, you're transforming, you're converting, you're transmutating, whatever word you would use, and that process, although held within the frame of the treatment by the therapist or analyst, it has to be done by the individual. So for them to, we would use the word grief. Right, all therapy is grief work, and I stand on that, I would fight on my mountaintop for that.

Max Kusovitky : 35:37

Because you're grieving fantasies all the time, You're grieving old ways of being, you're mourning dynamics that maybe you grew up with or dynamics that meant so much to you to make room for your own authenticity or development, if we don't know ourselves so fully, which is the case for all of us, because we contain many minds and the unconscious is real, and so making that change, like you're saying, is very difficult and very challenging, because to go from A to B, you have to grieve A, you also have to build a bridge to B, you also have to have the courage to go to B. Talk about resilience and then be itself, and it's in its hope that it provides. It also has to be authentic or congruent or have the sort of capacity to map onto what the person's actually capable of. So you were about to say an example with the King of England and that could be an exaggerated fantasy. It could be a sublimation of a wish, a reaction formation, if everybody listeners remember ego defenses.

Max Kusovitky : 36:39

But what matters isn't the jargon. What matters is that maybe that's a pursuit of wanting just to feel powerful and in reality they have this capacity to feel powerful in pursuit of their own let's say, I don't know an academic career and they become a professor and they're well-respected in their field of geology or anthropology. But it has nothing to do with the king. Maybe it would be more akin to history because king of England and the United States, but their king of England fantasy is all about hedging against feelings of inferiority or feelings of castration, classically speaking, feelings of just being ineffective, to speak plainly, and getting them into a position where they can tolerate a reality. That not only is the fantasy meaningful and not only are we respecting it and not only did it provide you hope, but we're going to use all those variables in terms of helping you to see what's really going on in the totality or in the tapestry of your whole mind, which includes the parts that you don't know yet, and people get very anxious.

Christina McKelvy: 37:45

The parts you do not know yet.

Max Kusovitky : 37:49

We don't know. I mean, this has been substantiated in in the neuroscience, which is a fancy way to support my biases, but it is true nonetheless that the brain is organized in a way. You know, if you study theories of what gives rise to consciousness or why the lights are on at all in the first place.

Max Kusovitky : 38:06

Consciousness is not the totality of you know, our experience right right which is just to say, depending on what theory you want to look at, it's like a lighthouse, and the way the light is focused is what we're paying attention to, but there could be a million things going on in the background, and who's in charge of where the light is pointing on the ocean and on which ship, and also the aperture of the light, when it's opening and closing, and how focused is it. So the classic examples of learning and unlearning and autonomic nervous system stuff, and I could keep going, but the point being is you don't think about your heart beating, you don't think about your diaphragm expanding and contracting, you don't think about putting one foot in front of the other. That's an unconscious process, but to a 10-month-old or 13-month-old it's very conscious.

Christina McKelvy: 38:58

Right.

Max Kusovitky : 38:59

Once it's learned this is again all these principles in the neuropsychoanalytic stuff it becomes integrated and so it no longer is available to awareness. A lot of the work we do is I wouldn't use the word unlearning because it sounds kind of yucky but it is bringing things into awareness that haven't been for some time. So the King of England fantasy is a good one, where maybe that's all they think about. But the thing that's fueling it, or the many variables I should say that are fueling it and fueling their hope, might be something they haven't felt, just like the heartbeat the lungs are walking in in a lifetime, not since they were a kid or not, since they were a teenager or not since their first job or first kiss. It's this, is that's what has to be appreciated. You know, memory is not always conscious, but when you wake up all your memory comes back.

Christina McKelvy: 40:06

Every morning, hopefully yes, yes, hopefully there. So it's yeah, it's bringing that to the that to the forefront, making it conscious and even just like kind of unpacking and bringing up, like, well, maybe this individual that wanted to be the king of england or wants to be the king of england also wasn't heard, didn't feel heard, didn't feel seen when they're a child, like whatever it could be. Yeah, like again, I just picture it's like a tree, like it's the root, you know, and yeah, I mean, there's the.

Max Kusovitky : 40:38

You know young, I attended a freudian institute I'm young and no but but young would say that I, I adore, I truly love, uh, and passionate about that young's quote about for the tree to reach to the heavens it has to root itself in hell. And what he's speaking to is the reality of not only what he called the shadow, but the reality that to get to know the self fully is to get to know the parts that we don't want to. So the fantasy back to hope, hope, hope can be prophylactic. I am just. All I am is hope. I'm a hopeful person and I'm optimistic, and I'm even maybe mawkish, or I'm cloyingly nice to people. Hope, hope, hope. And I don't think you have to be a psychoanalyst to know where there's the sun, there's the moon, and that person might be defending against a prolific amount of anger, rage, rejection, sadism, pain and suffering, and I have the utmost compassion and sympathy for that personality. But nonetheless it would benefit to integrate those things and appreciate that that person is much more complicated than their eternal optimism or hope leads on yeah, so this is how hope can be dangerous or, to soften it, unhelpful yeah, it could be, uh, it could be an obstacle, an obstacle

Max Kusovitky : 42:09

yeah, sure, yeah, absolutely it can be. I've experienced it professionally. Uh, we spoke to flight into health in the first, in our first interview and, uh, the flight into health is a fairly common I don't know statistically how common, but it's the. I found somebody, a therapist, who understands me, I feel seen, I feel I feel heard. These are constructive things. We want that in the frame, but by those variables alone I feel better. And then that person then says that it's session eight or session 15 and they leave because they have flown into this position of health, which you could call it a flight into hope. Maybe you should, and that would be why this episode goes viral. But it's the same difference in that it's an idealization of the process and a devaluation of what the work, the heavy lifting truly actually entails. And so somebody might fly into that position really quickly, in a sort of simulation of hope and resilience. I feel so much better, I feel so strong. This person understands me. You've helped me so much, dr Max. You know, see you later. And that happens sometimes.

Christina McKelvy: 43:25

Mm-hmm, mm-hmm. Yeah, yeah, flight into health. Yeah, flight into health.

Max Kusovitky : 43:41

And that's that false hope or that sense of hope that may not be based in any depth right.

Christina McKelvy: 43:45

It might not be grounded grounded themselves.

Max Kusovitky : 43:46

yes, yeah, and. And the falseness gets tricky because so much of our perception involves falsehoods. You know, you see the world, like Gandhi said right you see the world not as it is, but as you are, and so a lot of our percepts, our frames of reference and perspectives can be false-ish. So, you know, false hope also gets controversial if you were to be really nitty gritty about it or real stickler. Because sometimes a false hope yes, it's not grounded in the person's actual capacities and authenticities is providing them a buttress of sorts to keep them upright, and that dynamic can be invaluable to somebody, let's say, who's lacked resilience or has been through a lot of struggle in life.

Christina McKelvy: 44:43

Again, it goes back to it's very resilient and hope is very interconnected and that leads to healing. Well, max, I feel like we can keep talking for another hour and I remember, like when we first met, I kept I was like, oh my goodness, I'm learning so much and there's just so much to unpack. So I really appreciate that you came on to you know the podcast to give a different perspective about hope and, with that being said, I'd like to end my podcast with the same question for everybody what brings you hope?

Max Kusovitky : 45:16

What brings me hope Just in general, you're asking. But what brings me hope is fighting this fight. I don't want to sound so cliche but it's true. What brings me hope is the good fight for meaningful therapy. You know, you could have people in my personal life know that, hopefully professionally too. And it brings me hope to see people in the field that are really fighting, not against each other but fighting for.

Max Kusovitky : 45:52

You know the sort of helping profession, of what it is to be a psychotherapist, irrespective of modality, but to robustly, actually and long-lastingly help a person. It matters so much more than I think people realize in our world right now. People speak to the virtue right To bring that example again, bring it back to that where, yeah, mental health, mental health, mental health, mental health is mental health. That word has become meaningless and people are not appreciative of the effort, the boots on the ground effort it takes for the everyday therapist to do this work, especially if they lack the resources or don't know things that they don't know. And what brings me hope is the people I admire in the field that are prolific with this and lecture and teach and so on and talk about how to make therapy as effective and meaningful and powerful and hopeful as it, as it ought to be. The science of subjectivity, the science of psychology is real, it's rigorous yeah, and it's needed, especially nowadays it's needed more than ever.

Max Kusovitky : 47:07

I mean, you don't need to bring in this the really saddening statistics about. I don't want to say all the metrics that they use, but we all know what I'm implying when it comes to different versions of suffering, individual family, country, you name it. It's bad, it's a bad situation.

Christina McKelvy: 47:28

Yeah, yeah, yeah, yeah.

Max Kusovitky : 47:30

And so thank you, you know, for the work you're doing, the work all of our peers are doing, and instilling that hope teaching resilience so that people can heal, so and I would say, teaching respecting the reality that a person, an individual, has the capacity to heal and has authentic elements to their own vitality. Yeah, it's like that, it's almost that simple. Each person this isn't, like you know, sesame Street talking about your special. That's not what I mean. It's not a virtue, it's a reality that people have this capacity. It's just hard work to get there.

Christina McKelvy: 48:13

Mm-hmm, mm-hmm. Yeah, hard, deep, meaningful work so well. Thank you for being on here and definitely happy back.

Max Kusovitky : 48:23

Thank you for having me. Of course it means a lot. Am I allowed to say this was my first podcast?

Christina McKelvy: 48:28

If you want to.

Max Kusovitky : 48:30

I do, I do. This is my first time being interviewed formally. I really appreciate you gambling on me. It means a lot. It really does.

Christina McKelvy: 48:38

Oh no, it was amazing, it was fun and, like I said, you can come back for your second podcast interview.

Max Kusovitky : 48:45

Awesome.

Christina McKelvy: 48:45

Or maybe it'll be your 100th when I have you back on who knows? Yeah, and I'll have information in the show notes if for whatever you want to share. But thank you again for being here and I hope everyone has a wonderful day.