Trainees in the Yale Department of Psychiatry have long had a valuable mentor and friend in Sidney H. Phillips, MD.
Once a month, on a Thursday evening, Phillips hosts a convivial gathering at his home for residents, fellows, and medical students who want to explore psychoanalysis with actual case studies that involve adults and children.
Phillips, a board-certified adult psychiatrist in full time private practice of general psychiatry, psychotherapy, and psychoanalysis, invites fellow analysts from the Western New England Institute for Psychoanalysis, where he is on faculty, to speak about their interactions with patients, and any challenges they may have faced during therapy.
“It’s really illuminating for the residents because they don’t get to do this type of psychodynamic work,” said Phillips, a voluntary clinical faculty member in the Yale Department of Psychiatry. “They get to hear how an analyst thinks and works with someone, and can ask questions.”
The Psychodynamic Psychotherapy Group is open to anyone in training, including all adult psychiatry residents, psychology fellows, Yale Child Study Center fellows, integrated fellows, and medical students. “The only requirement is that there be some clinical orientation so that people appreciate the importance of confidentiality,” Phillips said.
The evening begins with casual conversation over dinner and drinks, and then people settle in to hear the adult or child analyst present their case.
Phillips, who has hosted the group for 13 or 14 years, describes the conversation as a learning experience for everyone, including himself.
“I haven’t heard these cases before,” he said. “I’m having to think through the case like (the trainees) are. I’m a little ahead of them in the work, but I don’t know what’s going to come up.”
“As the case unfolds in my living room, I try to push (the trainees) to do a dynamic formulation of the case," Phillips said. "Instinctual development, ego traits, object relations. I push them to formulate the case along those lines such that they will have a deeper understanding of the case being presented, but this is something they can take with them and they can use.”
With the patient’s consent, Phillips once presented a case that involved a Vietnam-era combat veteran with classic symptoms of posttraumatic stress disorder and unrelenting headaches that had no medically discernible etiology.
While talking about fighting in intense combat situations, the man came to learn that his headaches were the result of his killing North Vietnamese soldiers his age.
“He was kind of guiltily punishing himself for having killed young soldiers,” Phillips said. “This was a case where I could really show the relation between adult trauma and precursors of those in childhood, and the relationship between the two.”
Attendance at the monthly meetings fluctuates, from six to as many as 20 people. Confidentiality is the bedrock of the group’s work. “It can’t go forward without that,” Phillips said.
He said there are advantages to both smaller and larger group meetings. “People get to participate more when it’s a small group. No one is raising their hand. They feel free to speak up,” he said. “But with a larger group, you really hear a wide range of thoughts and ideas.”