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An Interview with Nancy McWilliams, PhD

McWilliams Nancy McWilliams, PhD, whose book trilogy, Psychoanalytic Diagnosis, Psychoanalytic Case Formulation, and Psychoanalytic Psychotherapy, is appreciated by therapists around the world, served as Visiting Faculty at GSAPP for almost thirty years. She has shared her wisdom as a compassionate practitioner in clinical supervision, inspired cordial debate with her openness in the classroom, and encouraged students by example and advising to become their best professional selves.
On December 6th, 2010, I had the blessing of sitting down with Nancy McWilliams on the eve of her semi-retirement from GSAPP. Although she will not be doing any classroom teaching, she will continue her popular group supervision class. We wanted to interview Nancy on her experience at GSAPP, and commemorate her almost thirty-years of service to our community.

Daniel: Thank you for this opportunity, Nancy. We wanted to do an interview with you about your journey to GSAPP, and how things developed for you. We want to do this as a way of commemorating you, your work, and your place in our community. I’d like to start by hearing a little bit about how you came to be a part of us here at GSAPP.

Nancy: Well, back in 1969 my husband got a really good job offer to teach at Livingston College, serving people who were usually the first in their families to go to college. My husband was a political scientist, and this was the community he was most interested in serving. He was already a tenured professor at Brooklyn College, and I followed him to Rutgers, knowing at that point that I wanted to be a clinical psychologist. I applied to the PhD program in psychology here, but I decided to focus on personality rather than clinical psychology because the people who were interested in the kinds of things I was interested in, such as personality structure and subjective experience, were in the personality and social psychology department. That group included Sylvan Tomkins, Dan Ogilvie, and others. Then the second year I was here as a graduate student, George Atwood joined the faculty, and the following year Bob Stolorow joined, and they began their productive conversation. It was a good for me to be there. In the 70s, it was easier in New Jersey to become a licensed psychologist without an APA-approved internship. I cobbled together an internship by working at what was then the Rutgers Community Mental Health Center and is now UMDNJ. I was there at a particularly fertile time. I was supervised by psychologists, psychiatrists, and social workers, including Iradj Siassi, who was a talented diagnostician, and Monica McGoldrick, who is well known as a family therapist, and several other impressive people. They were not all psychoanalytic; it was a diverse experience.
GSAPP didn’t start as an institution until the year I graduated from the PhD program. I got interested in teaching at GSAPP in the late 70s. Al Shire was teaching a course and taking a semester off, so I was asked if I wanted to teach a semester. I was thrilled, thought I’d get a foot in the door and stay. But I had two very young children at the time, so I didn’t do it then. But two years later another opportunity appeared; someone was taking a break and I was hired for a semester. I was hired over the objection of the chair at the time, who later became a friend of mine, Peter Nathan. He had on principle an objection to people who had become clinical psychologists through what he saw as the “back door.” But he was appreciative of someone that the students felt they were learning from, so when I got good reviews on my teaching he got behind me.

Daniel: What kind of courses were you teaching at that time?
Nancy: Foundations, originally in 1981…

Daniel: Foundations of Psychodynamic Theory?
Nancy: [Laughs] Yes! I’ve taught that for thirty years now. And that suits me, because I like psychoanalytic history, it’s almost like teaching a course in the history of therapy in general, not just psychoanalysis. And originally I also taught the psychodynamic interview course. In fact, the idea for my book came out of teaching that course. My students got tired of hearing me gripe that there should be a book like the one I ended up writing. I started to say, “Alright, alright I’ll do it.” Then Stan Messer started nagging me to actually do what I said I was going to do. That’s when my career took off. It’s a direct result of my teaching at GSAPP.

Daniel: So it was through the probing of students and faculty at GSAPP that you wrote THE BOOK, appropriately titled Psychoanalytic Diagnosis.
Nancy: Yeah, it’s kind of an improbable book. The advice I was given at the time was “Don’t call it ‘psychoanalytic,’ if you have to label it in that tradition, call it ‘psychodynamic,’  - it’s so old-fashioned to call it psychoanalytic!” But I wanted to call it what it was! I got tired of trying to figure out a sexier name, and I tried for about a year. I even bribed some of my supervision groups that if they could come up with a good name I’d give them a free session.

Daniel: [Laughs] A free therapy session?
Nancy: No, A free supervision session! I was having them brainstorm…

Daniel:
You should have offered a free psychoanalysis! [Laughs]
Nancy: [Laughs] My editor says that it’s the only book he knows of that sells in spite of the title! He’s still not happy about the title, but I’m happy now because it says what it is.

Daniel: How did your presence here at GSAPP relate to your presence in the psychoanalytic world?
Nancy: I went through an institute at the same time I was doing my graduate education in personality. They were very synergistic experiences. I was in analysis, going to an institute, and getting a doctorate at the same time. I found it enormously enriching in all those arenas. When I began teaching at GSAPP, a lot of people were interested in becoming analysts. Students came to GSAPP hoping to get analytic training after getting their doctorates. We had several analysts on the faculty who were very good teachers, such as Stan Moldawsky, Al Shire, Morrie Goodman, and Micky Fox. I was following in their footsteps. I think one of the ways my being an analyst influenced my work here is that I feel strongly that if you are going to be doing psychoanalytic therapy you should have gone through an analysis or good psychoanalytic therapy yourself. So very early I was one of the people who connected students to therapists in the community, for their own personal therapy. I must have connected well over 100 people to therapists. That probably is a much bigger influence than many of the other things I’ve done at GSAPP.
  "I think one of the ways my being an analyst influenced my work here is that I feel strongly that if you are going to be doing psychoanalytic therapy you should have gone through an analysis or good psychoanalytic therapy yourself."


Daniel: As a very happy customer of your services, I have to say that even though it’s not something that’s enforced in any way for students, I definitely found that very useful, not only in terms of getting services myself, but I also found it to have an almost pedagogical function. I’m seeing someone doing with me what I would prospectively be doing with patients.
Nancy: It’s very valuable to be able to internalize what works - and what doesn’t work, for that matter! I don’t think we should require such a thing, though. I would in fact resist requiring it. Going into therapy has to be an individual choice. But I’m happy that we encourage it, and I get a lot of feedback from people who have been appreciative of it. I know that all of my confidence about the value of psychoanalytic therapy comes from how much it helped me. My life would have been very different without it. My marriage wouldn’t have worked; I don’t think I would have had kids. I had a really good analysis.

Daniel: What was your experience with students and faculty over the course of your time here?
Nancy: I find myself identifying more with my students, who want to be what I am, a practitioner. Most of them, anyway. They are not as interested in doing research or teaching at the university level. I feel the passion students have about helping people is different from wanting to do research and raise questions and critique existing ideas, which is a sensibility central to the motivation to be a scholar in this field. Having said that, I would say that I greatly enjoy being on the faculty and have experienced almost nothing but collegiality. I think that is in part due to leadership like that of Don Peterson, Sandy Harris, and Stan Messer, who have insisted on being respectful toward people despite significant differences of orientation. I know the students don’t experience it that way, and I know the students at times don’t experience it as quite as collegial - like when it comes to hiring decisions, all the fault lines open up! But I have always felt the faculty meetings are - well, as far as academic meetings go, which isn’t that far – quite collaborative.  I have a lot of positive things to say about my colleagues and students, and also about the staff, who are utterly central to our effectiveness as an educational organization.

Daniel: What would you say are the values in the GSAPP community that stand out the most to you?
Nancy: Well that’s hard… certainly scholarship. There’s a strong faculty feeling that becoming a practicing psychologist involves more than learning a bunch of skills, it involves asking questions, critiquing assumptions, and reading literature across various points of view. Second to that I would say meeting unmet needs in the community. We try to admit students who are interested in working with people who are disenfranchised or oppressed or poor, or marginal in some way. How well we do that is a separate question from the value that is behind that. Our heart is in the right place. I think we have the blinders of middle-class intellectuals sometimes about issues of diversity. I remember in the 80s when gay and lesbian students were coming out of the closet, they confronted me about readings I assigned at the time that were heterosexist. That had been invisible to me! Makes me wonder what other things are invisible when you are in the majority. I would say the second value is a service value, especially to the underserved, whether you define that in terms of ethnicity, sexuality, religion, or in terms of clinical populations, such as people with mental disabilities. A lot of us on the faculty - and this shifts as we get as old as we are - a lot of us came of age in the 60s and early 70s, and were politically on the left. We are grateful that GSAPP helps us live out the values that spoke to us in those years.

Daniel: I guess there is a certain value in psychoanalysis, about making the invisible visible, or becoming aware of the things that are in our blind spot, or in our shadow in the Jungian sense. It makes me wonder what the relationship had been in your teaching or supervision between those psychoanalytic values, and the values you just described.
Nancy: Hmm… it’s interesting, I would say one of my main concerns as a teacher is to try to set a tone that makes it easier for people to criticize their education, and to be honest in other ways, on a level that is not social niceties. For example, in classes in therapy, for students to say what they really did with the client, not just what the professor wants to hear. It’s kind of the old psychoanalytic idea of getting people to say everything, including politically incorrect or shameful things. It’s a big part of my general style of operating, and goes back in me before psychoanalysis. I was attracted to psychoanalysis because it tried to talk about things that are unspeakable. But even before that my mother used to tell me that you can say practically anything as long as you say it in a tactful way. I think that was a good lesson for a prospective therapist, because part of what we do as therapists is to say things people don’t want to hear. So we need to find a way of saying things to people so that they will hear.

Daniel: I think that quality in your work as a teacher comes across in a very meaningful way. A lot of people across the years really value your style and approach in the classroom.
Nancy: Well, I’m glad to hear that because that’s important to me. And that in my mind is another psychoanalytic principle. The thing that was most helpful to me in my analysis was that my analyst could tolerate my negative feelings. It’s basic psychoanalytic theory that if you can get people to talk about the negative experiences of relationship, whether that’s a teaching relationship, therapy relationship, or any kind of relationship, the better they will do. So if people feel I’m open to their critiquing, or bringing up a different way to think about it, they’re finding their own voice. They’re going to be out there being independent practitioners; if you can’t have real psychological independence, you can’t speak truth to power.

Daniel: In general, but especially with supervision, being able to say things to a supervisor is a kind of parallel process. The patient expresses negative feelings toward the student-therapist, and then the latter isn’t very happy about their supervisor and has to say something! I think it’s important that if we’re going to be asking people to be honest with us, then we need to be able to turn around and be honest with supervisors, with teachers, and advisors at a general level. And I think there is a special way in which you distill that value to people in the process of your teaching, as opposed to simply the content of what you are overtly teaching people.
Nancy: Thank you. I think that process is critical. Content changes, but the process of being curious and saying what you’re curious about, and being critical and saying what you’re critical about, is part of being a competent adult and professional.

Daniel: In terms of your involvement at GSAPP, apart from the Psychodynamic Foundations course you’ve also taught a course on Basic Principles of Psychoanalytic Therapy. Could you talk a little about that?
Nancy: Yes, I inherited that from Stan Moldawsky, who taught it as a 2-semester course. Then numerous changes happened in the curriculum and it was cut down to a one-semester course. I enjoy that course very much. I like treating it as a kind of laboratory where colleagues present their work and try to help each other out, and address the issues that arise with the patient based on the psychoanalytic literature. I like that mentoring aspect of the work a lot. Every patient is different, every therapist-patient dyad is different, and I like to tease out the particularity of any therapeutic process.


Daniel: Given that the foundations course is a kind of history course, what would be the goals of the Principles of Psychoanalytic Therapy course?
Nancy: I like people to get a sense of the evolution of classical analysis as Freud conceptualized it, through ego psychology, object relations, self psychology, the American interpersonalists, to the contemporary relational movement, and also the more research-based approaches such as those arising from attachment research and from the work of people like Weiss, Sampson, and George Silberschatz. I want them to get the big picture, because I think that different patients make those different ideas good or bad based on their particular psychologies. Everyone who has contributed to the psychoanalytic world has been very good at describing some aspects of the unconscious but not others. The more that students get a sense of the different angles of vision in contemporary psychoanalysis, the more ready they will be to respond to a wide variety of patients.
  "The more that students get a sense of the different angles of vision in contemporary psychoanalysis, the more ready they will be to respond to a wide variety of patients."


Daniel: You also have a psychoanalytic supervision group that you run, would you mind telling us how that started?
Nancy: When I was hired as a visiting person, the deal was that I would give a full day to GSAPP and teach one course. The rest of it was up to me. I could chair dissertations, do supervision, attend faculty meetings, participate on committees, and so on. And I asked Peter Nathan, “Where do you think I would best put my time?” He wanted me to make myself available to the students as a mentor and advisor. So I put up a sign inviting students to discuss difficult cases. And a handful of people showed up and started talking about their clients. The group met weekly in an informal way for several years before Ruth Schulman, who was then the Associate Dean, found out we were meeting regularly and insisted that students should get credit for taking this, I should get credit for teaching it, and GSAPP should get credit for offering it. At that point they made it a one-credit elective course, which I’m still somewhat ambivalent about. I liked the environment of a free, informal group. Now I have to follow procedures that make certain that anyone who wants to be in the group will get in, in a timely way. But what I tried to keep, when it shifted from an informal voluntary group to a course, was some sense of safety where people could say anything about their patients, the group process, their reactions to each other, their reactions to me, their reactions to their supervisors, their reactions to GSAPP. And if they feel there is a dynamic going on at GSAPP, they can address it safely. So I very much enjoy the group. I feel useful in my role as facilitator. I’m not as didactic in that role, though when people present a case I know something about—say a paranoid case, as I’ve gotten very interested in paranoia—then I may teach a little bit. But there isn’t a schedule as such.

Daniel: I’ve certainly had the impression that you have a back-logged waiting list.
Nancy: Once it was a course, I had to make it open to everybody, but there were more people who wanted to be in the group than it could reasonably contain, so I created a waiting list. It waxes and wanes in terms of how long the list is. But once you’re in the group, you can stay as long as you like. It’s a place where you learn how much you’ve grown; there’s a nice dynamic where more advanced students help supervise their professionally younger peers in the group.

Daniel: Sounds like a very special group. I understand that as you scale back your responsibilities at GSAPP it will continue to meet?
Nancy: Yes, I couldn’t quite give up all my connections to GSAPP.

Daniel: Is this like an official retirement from GSAPP or are you just scaling back your responsibilities here?
Nancy: Well, I’ve been scaling back for a while, so it’s pretty much a retirement, but I still want to be involved here. I would like to spend more time writing, freer from the academic calendar in order to travel to some of the places where I have the opportunity to teach and consult now. And I’m 65 years old; I’d like to spend time with my new granddaughter. And now that my husband has been gone for five years, I want to look around and see if I’d like to date somebody. I’d like to have a life, and not just work 24/7!

Daniel: Wow! Makes me wonder if psychoanalytic institutes around the world won’t have their own list going on… a list of possible suitors!
Nancy: Not that I know of! But if they’re out there, and they read this interview, they’re welcome to call me.

Daniel: And that’s how the Nancy McWilliams dating site was set up, as a GSAPP collaborative effort.
Nancy: [Laughs]

Daniel: Good for you Nancy! Those are all wonderful things.
Nancy: I’m very happy with the shape of my life, and I’m very curious what the next chapter will look like. I want to write a book on the concept of mental health beyond symptom relief, about what we’re trying to help people toward, that goes way beyond positive psychology, going into other areas that the psychoanalytic tradition has had a valuable record of confronting and conceptualizing.

Daniel: What would you say about your experiences being on students’ dissertation committees?
Nancy: I’ve loved that, I’ve learned so much! The kind of research I’m most interested in is qualitative research, when students are interested in a specific area, such as gay black men, or Haitian teenagers, or what it’s like to be a breast cancer survivor or a person with loss of hearing. I’ve learned a great deal via students’ dissertations through reading their literature reviews. I’m very interested in hypothesis-generating research. Although I’ve also sat in on some hypothesis-testing research dissertations, I don’t enjoy them as much. I would say, except for the occasional student who writes really badly - in which case I spend an inordinate amount of time trying to help them with style and… grammar - I am incapable of letting grammatical errors go by - aside from, that I have found it a really nice part of the job.

Daniel: As we commemorate your work and your time with us, what would you like to leave behind for your students, and for future generations of GSAPP students? Especially if people come to GSAPP and complain, why isn’t this person here!
Nancy: I guess I leave my books behind. I complained to my husband one time that if I hadn’t followed him to Rutgers, I might have trained at Yale or Berkeley with really famous psychoanalytic mentors, and would have had a leg up pursuing my career. And he told me “It’s not your teachers who make your reputation, it’s your students.” That’s been absolutely true for me. And I think it’s because I have figured out, in my role at GSAPP, ways of being helpful to therapists in training. My books are my best efforts at concretizing what I’ve learned. In terms of resources, I’d certainly like for there to be some financial support for ongoing psychoanalytic education at GSAPP, and I think Stan Messer has some concern for that as well. If such a fund were established I’d probably contribute to it.

Daniel: Do you have any final thoughts or hopes about GSAPP as an institution?
Nancy: I hope GSAPP continues to do what it does well, which is to give our students a lot of intellectual preparation, a wide range of clinical opportunities, and a lot of support. I think there are probably many ways we fail students that are somewhat invisible to us well-intentioned people teaching here, but in general we provide them with a lot of supervision and a lot of practice, so that they will be helpful to people. I would hate to see GSAPP become a single-orientation program, whether that would be psychoanalytic or cognitive or behavioral or something else.. I would love to have more colleagues from the humanistic-Rogerian and family systems traditions; I would also like to see a greater focus on dissociation and trauma, but those are more specific things. I don’t have many complaints about GSAPP. Well, the pay hasn’t been great, but the teaching experience has been wonderful, and there is no question that my career is a result of my having been here. It’s been a wonderful career.

Daniel: It’s really exciting to hear not only how you’ve influenced GSAPP, but also how GSAPP has influenced you in your career. I mean, what you were saying before about not being able to go to Yale or Berkeley and have these renowned psychoanalytic mentors, I’m thinking, well why get one when you can be one? You became one of those renowned psychoanalytic mentors here at GSAPP.
Nancy:  [Laughs] One of the unintended positive consequences of my not being mentored by some particular school of psychoanalysis is that I was able to synthesize from all of them. I wasn’t anyone’s protégé. It was ultimately a richer intellectual experience.

Daniel: Well Nancy, thank you for taking the time to speak with me  about your life at GSAPP, even as it comes for us to a melancholy close.
Nancy: It’s been a pleasure. I’m not disappearing, but I am going to enjoy having some more time for myself.


Interview by Daniel Gaztambide