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From Reacting to Reflecting: "How Psychoanalysis Made Us Better Surgeons" with Mauro Vasella, MD and Flavio Vasella, MD, PhD (Zurich)

Psychoanalysis On and Off the Couch

Release Date: 07/27/2025

On Transience and the Cycle of Time: Freud and Ecclesiastes with Paul Marcus, PhD (Great Neck, New York)

Psychoanalysis On and Off the Couch

“The similarity between Freud and Kohelet [Ecclesiastes] is that both of them believe that there's no overarching totalistic system that integrates all the disparate experiences that one has. You have that, Freud says, in psychotics, and you have that in philosophers, and you have that in devout people - they look for systematicity. They try to cram everything into a framework of meaning. Both Freud and Kohelet reject that. They don't have a worldview in that way. However, in order to flourish, you do need a meaning-giving, affect-integrating and action-guiding set of...

A Memoir of Transformation: a patient examines two analyses at two stages of life with Joan Peters, PhD (Ojai, California)

Psychoanalysis On and Off the Couch

“With Kristi [second analyst], it was much, much deeper. This whole dependent and infantile part of me was coming out. This is psychoanalytic language - I was moving into a regression that was terrifying, because I had been trained by my mother, and it was my nature, and it was what had worked for me to really approach things as an ‘independent person’ ie I don't need anybody; I don't need anything; I can function whatever happens. While I explored a little bit of that with Lane [first analyst], it was only very slight, and we never talked about it. With Kristi, she would actually make...

Psychotherapeutic Aphorisms: Reflections from a Lifetime of Listening with David Joseph, MD (Washington DC)

Psychoanalysis On and Off the Couch

“Some time ago, I realized that there was such a thing for me as experiencing my patients as being friends, but they were psychoanalytic friends. It was a psychoanalytic friendship that was quite unique and unlike any other friendship. I think that's what people are talking about when they write about psychoanalytic love. It's not love like any other kind of relationship, because the psychoanalytic relationship is so unique. And I feel the same way about psychoanalytic parenting. It's like it's close to mentoring, but it's different because the structure of the relationship is different than...

An Analyst's Reflections on Her Treatments and Her Life with Beverly Kolsky, MSW (Tupper Lake, New York)

Psychoanalysis On and Off the Couch

“This really is the full motivation for my having written the memoir. I want people to know what the process is like; not only what the process is like but what the feelings are that don't really make you think of psychoanalysis as a way of changing your life. We're just living and hoping that things will change without really taking account of the fact that we could be living better lives and in a better way. I began to think of the ways of the world and the wickedness in it. There's so many things that we do to keep us going - me and my aphrodisiacs, and I think other people doing other...

When We Feel Provoked by the Politics of Our Patients with Heribert Blass, Dr. Med. (MD) (Dusseldorf, Germany)

Psychoanalysis On and Off the Couch

“I think that the comparison [between political and erotic passions] is related to the danger of transgressing boundaries from the side of the analyst. It's not totally the same, but it's because of the emotions and the danger of being too much involved as an analyst, if you don't pay attention to what is happening in ourselves with our own emotions, then it can be similar. I think both are important for the psychoanalytic process, to see it as a real relationship - there is this setting where two people in the room meet. They are real persons, but at the same time, a kind of dramatic...

Analysts' Reflections on Their Parenting with Andy Cohen (Johannesburg)

Psychoanalysis On and Off the Couch

"I was quite protective of the parent reader while I was editing this. I feel that so many of the books out there on the shelf have a real kind of finger wagging quality to parents. They kind of tell parents what to do, what not to do, mostly what they're doing wrong. I felt like I wanted to create a resource that empathized with the parents' position, and that protected them, because this is literally the hardest thing in the world. So the protectiveness felt important to me, and it was one of the things that was really quite important that we always held the parent in mind, which is...

From Reacting to Reflecting: "How Psychoanalysis Made Us Better Surgeons" with Mauro Vasella, MD and Flavio Vasella, MD, PhD (Zurich)

Psychoanalysis On and Off the Couch

"I have had quite some reactions to the article [on their psychoanalyses]. I was also telling Mauro and my colleagues that out of quite a number of articles I've published on maybe more pressing issues in the field of cancer research, for example, brain tumor research that I've spent quite some time with, I think it's actually the article [on psychoanalysis] that probably prompted the most reactions, at least in my personal surroundings, and the reactions have been overwhelmingly positive. So colleagues are very interested. They often ask questions about psychoanalysis, quite specifically, how...

'Why is This Happening in My Body'?: the meeting of/between patients' imaginings and analysts' theories with Sharone Bergner, PhD (New York)

Psychoanalysis On and Off the Couch

“I really think that the purpose is to make space for the unknown, uncertainty, and for our kind of humility in the face of the complexity of our belonging to the physical world. So it's our animality, our physicality, all of that is so complicated and difficult to grapple with. The unknown is uncontrollable and is a huge abyss, as we know, for everybody. I do think that I'm trying to pivot here a little bit towards meeting the patient's attempts to grapple with that unknown.” Episode description: We begin by examining the assumptions of causality that we humans commonly invoke when...

Affairs: Exploring the Dynamic Mind with non-Clinical Readers with Juliet Rosenfeld(London)

Psychoanalysis On and Off the Couch

“The subject of affairs, I think it's of interest to everybody. We have all had an Oedipal experience - we've all been babies who have at some point realized that we are not the only person. We're not perfectly fused with our mother, and she has other things to do, and there may be a father. We've all known what rejection feels like, and probably betrayal, and I think that affairs are in our unconscious. I think that's sort of evident in the way that most great novels, most great films, or at least many, have an affair at their heart. From Anna Karenina to Madame Bovary to Fatal Attraction,...

Affects, Curiosity, and Corporal Punishment with Paul Holinger, MD, MPH (Chicago)

Psychoanalysis On and Off the Couch

“Now's the time to tell that wonderful story of the little boy. He was about two or three years old, and he went in the icebox to get some milk, and he managed to get this big carton and spill it all over the floor. Now, needless to say, there'd be a lot of parents that would react very negatively and frustrated - this mother happened to be a scientist. So she came in, she saw the bottle of milk, and what had happened. She went and got some paper towels, put them on the milk, and said, ‘Look at this. Look how the milk starts creeping up these fibers of the towel. Isn't that cool?’ And...

More Episodes

"How can we reach surgeons? How can we make this interesting and attractive for them to even consider? I think most surgeons will be very performance-driven people, and I think that it goes hand in hand that that type of person will seek ways to improve themselves, but probably more in a technical way. Let's say they want to get faster in their operations. They want to get more skillful. They want to do more complicated surgeries. So there's a lot about self improvement in that you exercise until you master something. And I think that analogy with sports was our way of saying, hey, you know, this is actually pretty cool. You can compare yourself to professional athletes, in terms of self improvement, and this is actually one way you can get there, how you can improve. At the same time, it was also important for us to acknowledge that it's not for everyone so we also mentioned alternatives, of course." - MV

Episode Description: Mauro and Flavio begin by describing the encouragement they received from their father to pursue personal analysis "to explore our unconscious minds for a lighter life and less emotional baggage." They share their psychoanalytic journeys and give examples of how their greater capacity to reflect instead of react has led to improved surgical patient outcomes. They also describe collegial tensions that were more clearly addressed through their ability to authentically know how they felt. They recommend that like elite athletes who have sports psychologists to address obstacles to their performances, so might surgeons appreciate the utility of psychoanalysis and other measures to improve their clinical attunement. Mauro concludes "Everyone has their baggage - don't be afraid to look at it and to understand what's going on. It's worth it."

Our Guests:

Flavio Vasella, MD PhD, is a junior attending neurosurgeon at the University Hospital Zurich, with a clinical and research focus on neurosurgical oncology. He earned his PhD in Molecular Life Sciences at the University of Zurich, where his research explored genome editing strategies in primary brain tumors. His primary academic interests include translational and clinical neuro-oncology as well as surgical education.

Mauro Vasella, MD, is a board-certified plastic surgeon with multiple years of clinical experience specializing in reconstructive surgery. He is affiliated with the University Hospital Zurich in Switzerland and the Royal Melbourne Hospital in Australia and has held positions as a fellow and attending surgeon. His practice and research field focuses on regenerative-reconstructive surgery and burn injuries.

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