Editorial introduction: Psychoanalytical perspectives on the COVID‐19 pandemic

1. INTRODUCTION

The COVID‐19 pandemic has changed our lives during the last year dramatically and in a totally unexpected way. For months now, we've been constantly confronted with an elusive mortal threat. In some countries, the virus continues to spread at an alarming rate, for example in India, where (at this writing, May 2, 2021) more than 400,000 people are infected every day. In other countries, such as the United States, which has suffered the most deaths so far (over 568,000), thanks to vaccinations, which are now progressing well, the false sense of security that one can return to a prepandemic life is growing, creating new risks. For example, virologists warn vehemently of newly emerging mutations in populations that have not yet been vaccinated, for example in the Third World, which could then spread globally again and also reinfect those who have already been vaccinated. The difficult truth is that every person all over the world is only save to the degree that everyone in the whole globe is safe. Or, as the public health professionals say “until all of us are safe, none of us.”

In countries like Brazil, where more than 320,000 people have now died, the misery has reached such proportions that a psychoanalytic society even decided to publish an Open Letter to the Population in April 2021.

The Brazilian Federation of Psychoanalysis (FEBRAPSI) would like to publicly express its apprehension and perplexity in view of the epidemiological disaster due to the lack of control of COVID‐19. We are all in a situation of risk and helplessness, whether in the sense of catching the disease or becoming psychically ill, as a result of the frightening experience of seeing family, friends, and strangers succumbing to coronavirus infection. In this scenario hunger, poverty, domestic violence, and other ailments that already existed in our country have also been aggravated.

Even in countries with a less dramatic situation as for example, in Germany, the pandemic has a terrible face. In the third wave of the pandemic, incidence rates in children are far higher than in adults with the looming tragedy of putting their parents' lives in danger. Also in less dramatic respects, all the things we take for granted in our everyday lives have been shaken up completely: children can no longer easily go to school, to their sports clubs, to music lessons; adolescents can hardly meet their peers, let alone go to parties and "hang out" in the park, in discos, or in pubs. Even we adults are forced to limit our social contacts, professionally, personally, and in our leisure activities. Social inequality has worsened. The gap between rich and poor, privileged and unprivileged is continuously widening: a family with small children living in a big house and garden obviously copes much better with the restrictions of the long lockdown than a family with a migrant background with several children in a three‐room apartment. Evidence shows that the number of depressive disorders and other psychosomatic and mental illnesses have increased. In the media, there are many reports of domestic violence and sexual assaults, especially on women and children that are increasing in frequency. The abyss of the human psyche has been cruelly brought to the surface.

The societal consequences are enormous and only visible as iceberg peaks: the capacity of intensive care beds and medical units determine the lockdown measures, virologists have become the most powerful experts in the media and politics, jobs are threatened, international supply chains collapse, the social and economic consequences hardly assessable. Moreover, as border trolls are being reintroduced and the European idea seems to rapidly be swept away, predatory capitalism in the United States and the totalistic systems in China and Russia are proving to be clearly superior to the slower, more deliberate democracies in the EU, at least in terms of procuring vaccine doses for their own populations. And yes—the tensions in the societies, the splitting and fragmentation, and susceptibilities to populistic and nationalistic seductions worldwide are unmistakable.

Psychoanalytic practice is affected by the pandemic as well: if up to now for many of our patients the brief bodily exchange, for example, at the welcome greeting or at the farewell, and the safe psychoanalytic setting was absolutely crucial, it is precisely these embodied interactions of ensuring one´s self vis‐à‐vis the other that has become a new, intangible danger. The controversies about remote analysis, which have been going on for years and can be characterized by high ambivalences and argument, had to be abruptly wiped away: the treatment by video or telephone is often the only responsible means for many of the older analysts, who belong to one of the pandemic risk groups, to continue the treatment especially with their particularly vulnerable patients. As in individual and social emergencies, action comes first—reflection comes later.

This has serious consequences for careful psychoanalytic research on the effects of the pandemic on our patients, ourselves, other individuals, and small and large groups. As is well known, in our genuinely psychoanalytic research, we depend on the application of our specific psychoanalytic research instrument in a protected psychoanalytic space, usually within the psychoanalytic setting, with individual patients over several years (see e.g., Leuzinger‐Bohleber, 2015). In this sense, the serious psychoanalytical clinical research of the consequences of the pandemic on conscious as well as on unconscious mental functioning will occupy us for years to come.

Should psychoanalysts therefore hold back with contributions to the pandemic and its consequences? Is there a danger that current psychoanalytic statements in the context of COVID‐19 are unserious "snapshots" and undermine precisely the specific scientific potential of psychoanalysis? Are they reminiscent of "wild interpretations," which are more indicators of the defense of one's own powerlessness and insufficiency in the face of the complexity of the pandemic, than of careful, self‐critical research?

On the other hand, in these gloomy months we often had to think of the famous quote by the German writer Hölderlin: “Wo aber Gefahr ist, wächst das Rettende auch…” ("But where there is danger, the saving also grows"). It is impressive how many initiatives came from psychoanalysts all over the world, who made their clinical knowledge available to the victims of the pandemic, the helpers in clinics, social services, and schools, sometimes in completely new ways. Many also brought their rich conceptual knowledge of individual, group, and collective responses to disasters or other traumatic social events into public, scientific, and interdisciplinary discourses.

In this Special Issue, we report on some of these initiatives. We think that all the authors agree that their thoughts, clinical findings, and theoretical considerations have to be very preliminary at this point. And for all of us, it seems important to keep in mind that such commitments as well as psychoanalytic work on such a current, complex topic, is quite controversial in the psychoanalytic community. There are quite a few psychoanalysts and psychoanalytic institutions who regard such "psychoanalytic activism" as highly suspect.

2. PSYCHOANALYTIC “ACTIVISM” IN TIMES OF ACUTE SOCIETAL CRISES AS THE CURRENT PANDEMIC

The question whether and in which form psychoanalysts should get involved in social, political, and public actions seems to us to be as old as psychoanalysis (see e.g., controversies around the political commitments of Wilhelm Reich). How can political “activism” be reconciled with the professional neutrality of the analyst? Don't public commitments in the media, in the societal space, destroy the white screen on which our patients should project their fantasies and conflicts? Doesn't it cloud the clear "psychoanalytic mirror"? Don't analysts present themselves as so‐called "do‐gooders" (“Gutmenschen”) when they stand up for social justice and thus make the processing and analyzing of aggressive‐destructive impulses in the transference/countertransference more difficult? Do psychoanalysts satisfy their own problematic exhibitionistic or pathological narcissistic needs through their public commitment?

As director of the Sigmund‐Freud‐Institute (SFI) in Frankfurt a.M. from 2001 to 2016 I (MLB) was confronted with all these questions for years. The SFI has a famous history with respect to “psychoanalytic activists” as it is closely connected with the reappraisal of the history of National Socialism. Alexander Mitscherlich, the first director of the SFI which was founded in 1960, was an official observer of the Nuremberg trials investigating the crimes by physicians in the Holocaust. He wrote a famous book, Medicine without humanity (1947) (co‐author: Fred Mielke), in which he described in detail the unimaginable crimes of the doctors in the extermination camps. Because of this, he became persona non grata in the Germany of the 1950s and never received a chair as a full professor at one of the German medical faculties. In 1956, he organized a series of public lectures celebrating Freud´s 100th birthday in which many of the Jewish analysts who had emigrated, came back to Germany for the first time. The then Prime Minister Zinn of the State of Hessen was one of the listeners and realized that psychoanalysis, as a "Jewish science," had been destroyed by the National Socialists and that the German state, therefore, had to offer a gesture of reconsolidation to psychoanalysis. As one of the consequences of this insight, he founded the Sigmund Freud Institute in 1960. Zinn was supported in this, by the Institute of Social Research which included in its Faculty Theodor W. Adorno, Max Horkheimer, and others.

The SFI developed into the largest psychoanalytic training institute in Germany and contributed significantly to bringing psychoanalysis back to Germany. Alexander Mitscherlich and his wife Margarete Mitscherlich‐Nielsen were not only leading (training) analysts, but charismatic public figures. There was no important social debate between the 1960s through the 1970s in which the Mitscherlichs did not become involved. Their books "Die Unfähigkeit zu Trauern" (The Inability to Mourn), "Auf dem Weg zur vaterlosen Gesellschaft" (On the Way to a Fatherless Society), "Die Idee des Friedens und die menschliche Aggressivität" (The Idea of Peace and Human Aggression), all, among others, became best‐sellers and had a great social influence.

But times changed in many areas of the world including in Germany. To summarize this in a shortened and somewhat dramatizing way: psychoanalysis lost its power to interpret the social unconscious (“Definitionsmacht”—the power to define) and was gradually pushed out of the medical and psychological faculties of German universities at the end of the 20th century; And it has been marginalized in many respects.

With regard to the SFI, the Hessian State withdrew from its responsibility for psychoanalytic training at the end of the 1980s: the Frankfurt Psychoanalytic Institute took over responsibility for training, and the SFI became a pure research institute that was to be linked institutionally more with the universities. This institutional process of transformation proved to be extremely difficult, lasting more than 10 years, and was characterized by great insecurities. The well‐known former university professor and psychoanalyst, Horst‐Eberhard Richter, who was active in the peace movement and ATTAC,¹ took over the interim leadership. But his political commitment led to many conflicts, especially with the right‐wing conservative government in Hessen, so that in 2003, 1 year after Rolf Haubl and I (MLB) had taken over the leadership of the SFI, the SFI was to be closed. It was an existential experience for me that the SFI—as a psychoanalytic research institute—due to the powerful and mighty Zeitgeist of empirical research—could now only survive if it earned an international reputation in the world of science, for example in comparative psychotherapy research, and carried out successfully large, externally funded interdisciplinary research projects (see Leuzinger‐Bohleber & Plänkers, 2019).

I am still very grateful that we managed to prevent the closure of this famous institute and were able to take up the unique, socio‐critical tradition of the institution, and to ally it in a new way with empirical research projects, which—according to the dominating contemporary Zeitgeist of evidence‐based medicine in these years—had to be accepted by the academic, nonpsychoanalytic world, thanks to a careful research methodology, which could also be criticized from the outside.

We took up urgent societal topics, such as the challenges of genetic, prenatal diagnostics, chronic depression, individual and collective trauma and its transgenerational transmission, and early prevention. To mention just one example: in large representative projects, we carried psychoanalytic knowledge out of the psychoanalytic ivory tower and tried to make it fruitful for families, often with traumatic flight and migration backgrounds, in the public kindergartens and nurseries. Since the empirical evidence of the effectiveness of psychoanalytic prevention was convincing, the City of Frankfurt, for example, took over the prevention project "STARTHILFE" (help to start), which annually offers weekly psychoanalytic supervision, psychoanalytically oriented prevention work, and child therapies in the institutions themselves to 10 public kindergartens: the City has now been promoting this project for 15 years.

The outcomes of these (empirically evaluated) psychoanalytic prevention projects have often been presented at scientific conferences as well as in the media and in public settings, for example, at our celebration for opening the new building of the SFI in September 2015; that the reader may recall was at the height of the so‐called refugee crisis. Many politicians were absolutely overwhelmed and felt helpless in how to deal with the thousands of refugees, especially with the severely traumatized ones. Thus, in October 2015, the Hessian Ministry of Social Affairs and Family approached me and asked me to design—based on the experiences of our empirically evaluated psychoanalytic prevention projects—a concept for the care of traumatized refugees which became the project STEP‐BY‐STEP.

I am still very grateful that we managed to implement this psychoanalytically based prevention project in the Michaelisdorf initial reception center in Darmstadt from 2015 to 2017. It became a national model project. Since we were able to empirically show its effectiveness, it led to the establishment of three Psychosocial Centers that continue to serve refugees to this day (now under the responsibility of professor Patrick Meurs—for more details, see Leuzinger‐Bohleber & Plänkers, 2019).

The project also was presented in the IPA series Psychoanalysis Off the Couch (2020). As is discussed in Schestag et al.’s paper in this volume, traumatized refugees belong to the particularly vulnerable groups in the current pandemic. Psychoanalysts, based on their profound knowledge of trauma and its transmission to the next generations, have much to offer to refugees and migrant families in order to prevent the danger of retraumatization due to the COVID ‐19 virus, even if their specific knowledge of contemporary crises is not yet completely based on empirical or systematic clinical studies. However, it takes up the large knowledge base of psychoanalysis as a specific science of the unconscious. In this sense preliminary empirically or clinically “proven” knowledge is applied to the new current societal and individual situation in a careful and cautious way knowing that we are in a position of “not knowing” in many respects. As we know: in psychoanalysis, careful clinical and empirical research always continues. This is particularly true if we dare to apply our psychoanalytic knowledge in new settings, as for example, offering help to traumatized refugees or traumatized victims of the pandemic.

To simplify these complex issues here: for me (MLB) it is not easy to make psychoanalytic knowledge based on the intimacy of clinical psychoanalytic research fruitful for individuals and families outside of our psychoanalytic offices. However, it seems possible, as our experiences in the refugee project might illustrate, particularly if there is a reliable institutional frame like a psychoanalytic research institute as the Sigmund Freud Institute which was founded to support psychoanalytical research, on the one hand, but also to bring psychoanalytic knowledge back to the community on the other hand. The 15 years of shared responsibility for this special psychoanalytic institution also taught me that my clinical psychoanalytic work in the Institute as well as in my private office, in other words, my psychoanalyses and psychoanalytic psychotherapies of course have been influenced by my public appearances, my “activism” as a director of the SFI: they have often been the subject of psychoanalytic work and reflections on my couch. The fantasies and conflicts stimulated by them had to be analyzed, like all other topics as well. However, especially the discussions about the intersubjective turn of psychoanalysis have shown in the meantime that the metaphor of the analyst as an “objective,” “neutral,” and affect‐free surgeon described by Freud, or of the analyst as "clear but hard and not flexible mirror" were problematic. Today, we rather have a great respect for the complexity of the analytic relationship, of transference and countertransference, and the common reflection of the complex interaction of inner and outer realities (see e.g., Bohleber & Leuzinger‐Bohleber, 2016).

All the psychoanalysts describing their experiences as clinicians or “activists” during the COVID‐19 pandemic in this Special Issue are directly or indirectly describing these complexities of clinical psychoanalytic practice during such existential crises as the pandemic.

It is interesting to see how international psychoanalytical organizations, as the International Psychoanalytical Association (IPA) and the European Psychoanalytic Federation (EPF) have reacted to the pandemic.

3. PSYCHOANALYTICAL INSTITUTIONS IN THE PANDEMIC

As current president of the European Psychoanalytic Federation, I (HB) want to consider the question of our psychoanalytic approach to the pandemic from four angles: from the perspective of Freud´s oeuvre as a whole, from the perspective of the basic concept of the EPF as an international scientific federation, from the historical development of the EPF, and finally from the perspective of the activities of the IPA.

To start with the first aspect: Freud´s entire clinical and literary work is based on a multidisciplinary understanding of science. If we take as a basis his famous concept of the “complementary series” (“Ergänzungsreihe”) (Freud, 1905) between nature and environment and then look at his writings on cultural theory, it becomes immediately clear that Freud, too, always saw men and their mental movements: affects, emotions and thinking, in interaction with their respective environment. Some brief references to such important articles as “Group Psychology and the Analysis of the Ego” (Freud, 1921), “The Future of an Illusion” (Freud, 1927) or “Civilization and its Discontents” (Freud, 1930) may suffice to show that Freud was always interested in social issues and included them in the scope of psychoanalysis. So, when we deal in this special issue with the impact of the pandemic on our culture and society, we are following a consistent tradition of Freudian thought.

The scientific self‐image of the EPF shows an equally broad spectrum. Of course, the psychoanalytic process and the bi‐personal field associated with it are at the center, but to understand them we also need connections to neighboring disciplines in the natural sciences and social theory. Human beings are bodily constituted and act with their embodied and felt emotions in an interpersonal social field. Against this backdrop, corresponding topics have always played an important role in the scientific life of the EPF since its official foundation in 1969. A look at the history of the EPF, which I have undertaken again on the basis of the annual scientific Bulletins, however, shows that the reference to socially significant topics has increased more and more in recent years. Phenomena of violence among different cultures and political organizations, which include the impact of the horrific Nazi terror on victims, survivors and their descendants, have been explored, as have the traumatic consequences of war and displacement, flight, migration and also xenophobia. With the emergence of the COVID‐19 epidemic starting in Europe in the Spring of 2020, and especially under the terrible impact of skyrocketing deaths first in Italy, with a frightening peak in Bergamo, the dramatic scale became increasingly clear in a short time. When it became evident that the virus was spreading almost everywhere in the world towards a pandemic, and frightening pictures were seen from China as well from the USA and Latin America, and from many countries in Europe, we in the EPF started an exchange among the presidents of the 43 European psychoanalytic societies. The EPF is a federation of societies, which is different from the IPA which is an association of individual members. But the aim of our exchange was to understand psychoanalytically the traumatic impact of the pandemic on individuals and society, and to exchange ideas on psychoanalytic initiatives in the various countries. In several European countries, such as Italy, Serbia and Belgium, analysts offered telephone consultations for people seeking help, and there were also other individual consultations. Some of these projects are presented in this issue (see for instance Leuzinger‐Bohleber and Montigny; Nicolò; Schestag et al.).

Another important exchange, which took place in videoconferences, concerned the discussion of how to work psychoanalytically under the conditions of the pandemic: whether to work still in person in the consulting room without or with a mask, or only online or rather by telephone? The presidents conducted an analogous exchange with their national members and brought resulting suggestions back into the transnational European discussion. In order to enable a supra‐regional participation of individual psychoanalysts, we decided to carry out three scientific online seminars, which addressed topics associated with the pandemic, such as loss, disruption of continuities, historical denials, but also preservation of liveliness and collegial cohesion. The need for psychoanalytic colleagues to exchange ideas on all these topics is high.

A similar need is also felt in relation to the activities on the part of the IPA, as undertaken with great commitment by IPA President Virginia Ungar (Argentina) and Vice President Sergio Nick (Brazil). One initiative was the establishment of a list serve under the direction of Harvey Schwartz (USA), in which psychoanalysts from all over the world could exchange their feelings and experiences about the pandemic. For many colleagues, this was a great emotional and professional help.

Another initiative was to launch a series of virtual seminars on living and working in times of COVID‐19, coordinated by Silvia Wajnbuch (Argentina). These seminars took place in different languages: English, Spanish, French, Portuguese, Italian, German, and many psychoanalysts from all over the world participated in them. Four authors of this volume (Marianne Leuzinger‐Bohleber, Liana Giorgi, Joachim Küchenhoff, Heribert Blass) have participated in a special seminar in German and we can confirm that there was a lot of resonance from our psychoanalytical colleagues. All virtual seminars are still available on the websites of the IPA and the EPF. The same is true for initiatives and webinars in Latin America, which in turn can be seen on the website of the Federation of Latin American Psychoanalytic Societies (FEPAL).

All in all, this short survey shows that international psychoanalytical institutions are very actively addressing the clinical and cultural implications of the pandemic, and this is also a concern for us as guest editors of this special issue on the COVID‐19 pandemic.

4. WHAT HAS PSYCHOANALYSIS TO CONTRIBUTE IN THE CURRENT COVID‐19 PANDEMIC? OVERVIEW OF THE CONTRIBUTIONS IN THIS SPECIAL ISSUE

In this volume, we are publishing 14 papers. As already mentioned, all the authors are very careful with the generalizations of their clinical or social observations. Many of them stick very closely to their observations and connect them carefully with some speculative psychoanalytical explanations.

We have tried to group the different papers.

4.1. Clinical and conceptual papers

“The completely unexpected, elusive, uncontrollable threat to our lives confronts us with death anxiety, powerlessness and helplessness. We have had to come to terms with this situation in many respects since it has lasted for over a year now. Perhaps we hardly realize anymore what enormous psychological strain the Corona crisis in a very basic way means for us….: The pandemic absorbs ‐ consciously and unconsciously ‐ a large part of our psychic energies. This can have a great impact on the empathic dialogue between generations. … Empathy is a demanding mental skill that is acquired late in development. It is very susceptible to disturbances. Each of us knows the phenomenon that empathy with others is the first thing to be lost in times of stress” (Leuzinger‐Bohleber & Montigny, Frankfurt, Germany, this volume). Leuzinger‐Bohleber and Montigny, in their paper The pandemic as a developmental risk, point to the dangers involved, since primitive defense and coping mechanisms, as well as powerful unconscious fantasies, often unrecognized, determine the mental functioning of all of us in such times of existential crisis. This also may have an impact on the important dialog between adults and adolescents. The pandemic puts a particularly heavy burden on the demanding and disturbance‐prone developmental and identity formation processes of adolescents. In addition, there is a danger that adults will not be able to provide them with enough understanding and support for their developmental needs, as they themselves are hindered and limited in their ability to empathize. This makes it more difficult to deal with ambivalences, which always characterize the dialog among generations. Thus, the pandemic increases the likelihood that, especially for those growing up who already felt the downside of life in childhood, their adolescence will now become a "second hazard" rather than a second chance.

A very similar line of reasoning was followed by Siri Gullestad (Oslo, Norway) in her paper Our contempt for weakness. Like Leuzinger‐Bohleber and Montigny, she assumes that the pictures of the intubated, completely helpless people in the intensive care units in Bergamo have gone around the world and have activated unconscious memories of experiences of total dependence in all of us. She describes with the help of clinical examples, as well as public reactions to the pandemic in Norway, how much we all despise feelings of existential dependence due to our lifelong vulnerability as body‐bound beings and fight them in ourselves and in others. Particularly touching is the short personal account of a processing of a traumatic accident, in which the author recently completely unexpectedly experienced a situation of total dependence on a helping other. Siri Gullestad uses this personal experience to illustrate the psychoanalytic knowledge of reactions after trauma: only in a holding empathetic relationship (or a safe, trusting therapeutic experience) can traumatized people regain access to their affects, weep and mourn the loss of their pretraumatic state of mind and body. If such a possibility is missing, there is the danger of encapsulation of the traumatic experiences.

The author draws parallels between such traumatic experiences and the current pandemic. “The intubated patient struggling to breathe, fighting for his life; the anonymous mass grave; the death on Face‐Time – heartbreaking images, now becoming iconic messages about how Covid‐19 has hit us. The pandemic has taught us how dependent we are on each other. It should inspire us to greater tolerance for vulnerability – and less contempt for weakness” (Gullestadt, this volume).

Cultural and clinical aspects are presented by Heribert Blass (Düsseldorf, Germany) in A New Civilization and its Discontents in Times of Covid‐19? The author focuses on both the burdens on individuals and the effects on society. He sees a broad spectrum of possible reactions to the viral threat: from real fear to panic or to a denial of the impending danger. He names three aspects: (a) the reality of death and a corresponding fear of death have reappeared on a broad scale. (b) The basic trust in the inoffensiveness of the other person has been shaken. The virus has destroyed the assurance that the other is not carrying a deadly weapon, human contacts are contaminated by an underlying mood of paranoia. (c) The pandemic sharpens the ambivalence and contradictions between solidarity and hostility in society. Against this background, the author explores the question of to what extent it is possible to speak of a new “Civilization and its discontents” under the conditions of the pandemic. Citing Freud´s description of the conflicts between the search for happiness, the need for security and hostile tendencies against culture (Freud, 1930), the author sees a corresponding antagonism under the conditions of the pandemic. This thesis is illustrated by three clinical examples. The first example refers to anxiety, depression, and the need for security. The second example refers to hostile tendencies against social regulations and connections to the group of "lateral thinkers." The third example comes from a child analysis and illustrates some psychic consequences of remote analysis in lockdown. Finally, the author sees the task of psychoanalysis in explicitly naming the unconscious conflict between striving for pleasure or the search for security, in order to contribute to dealing with the resulting aggression and fear of death in times of the pandemic.

Joachim Küchenhoff (Basel, Switzerland) deals in The pandemic crisis as a crisis of the symbolic order and psychoanalytic work regarding imaginary objects with the “real state of emergency” which for him is a mirror image of the latent state of emergency in the normality of life. It is being called into question in a crisis. He sees the objective state of emergency as mirrored in the subjective state of emergency. Following Lacan’s categories of the symbolic, the imaginary and the real, he argues that the Corona crisis is a crisis as it challenges the symbolic order in many ways. According to him, the viral pandemic amounts to an incursion of the real that threatens the order of the symbolic where the virus becomes an imaginary object that is uncanny. In other words: unconscious phantasies intensify in searching for an orientation in a precarious situation. However, being subjectively distorted substitutes, they cannot mitigate anxieties. Thus, the COVID‐19 virus becomes an uncanny object. Then, the author discusses questions about psychoanalytic work on the uncanny object (how is it dealt with?) and with the uncanny object (how can work be done under the conditions of the uncanny?). Based on impressive clinical examples, he deals with several elements of the psychoanalytic process under the conditions of COVID‐19, amongst others, intercorporeality and masks in therapy, and whether a psychoanalytic therapy under corona conditions is possible at all. He mentions fatal consequences when reality is rejected, danger cannot be thought, and losses cannot be mourned. Nevertheless, he is convinced that in times of COVID‐19, the intimacy of the analytic encounter can be preserved and work can even intensify—under, however, difficult conditions. With respect to society, solidarity is a means, and the symbolic order can become the new order of the "we" through solidarity.

Sixteen Analysands’ and Large Groups’ Reactions to the COVID‐19 Pandemic is the title of the rich paper by Vamik Volkan (Charlottesville, USA). In the first part of the paper, he describes 16 analysands’ reactions to the COVID‐19 pandemic. The data come from the author’s supervision via telephone of 10 younger psychoanalysts who were treating one or two of these cases in Istanbul, Turkey, in the United States, and in Germany. The second part of this paper describes how the initial response to the virus pandemic has increased some of the 16 analysands’ investments in their large‐group identities. Lastly, Vamik Volkan, an expert on large groups, formulates some suggestions in dealing with the impact of the COVID‐19 pandemic on such groups: meanwhile, the virus situation has illuminated once more how important it is for psychoanalysts to pay attention to large‐group psychology in its own right. “Large‐group psychology ‘in its own right’ means making formulations about the conscious and unconscious shared historical/psychological experiences, past and present, that exist within a large group, whether this large group has its beginnings in childhood or adulthood. Such formulations enlarge our understanding of shared human reactions to major traumas and the role they play in present‐day political/societal movements …. This is similar to psychoanalysts making formulations about their patients’ developmental histories associated with various conscious and unconscious fantasies in order to understand what motivates certain behavior patterns, symptoms and habitual interpersonal relationships. Studying and teaching large‐group psychology will make psychoanalysts’ contributions more valuable when they make public statements about collective human responses to the virus pandemic as well as other major shared external events” (Volkan, in this volume).

Ilany Kogan (Rehovot, Israel) discusses in her paper The impact of the Coronavirus pandemic on the analyses of Holocaust survivors' offspring clinical experiences with this very special group of patients coming from extremely traumatized families of Holocaust survivors in Israel. She discusses complex treatment issues related to specific questions of the treatment technique applied during the pandemic. In her discussion, she focuses on the changes of technique that may be needed in the analyses of Holocaust survivors‘ offspring as well on the impact of counter‐transference feelings of the analyst shared in a life‐threatening situation. Very interesting are her comparisons with her clinical experiences during other dangerous societal situations such as during the bombings during the Iraq war. Ilany Kogan illustrates her thoughts with an extensive, detailed case report of Deborah. “In my view, the aim of therapy with these offspring during the pandemic was to help them perceive the reality of what is happening to them at the present time, rather than concentrate on what they imagined had happened to their parents in the past. As illustrated in the above described case, I reacted to my patients' request during the pandemic by agreeing to change the psychoanalytic setting in order to continue therapy. Prior to the lockdown, I often came up against defensive reactions of denial and omnipotence. I didn't tackle these defenses, since, in my view, they had an adaptive function, helping the patients to feel a better sense of control. …. At this stage, I felt that it was important to respect the patients' resistance and support their ego until they felt safe enough to give up their defenses” (see Kogan, in this volume).

Clara Schejtman (Buenos Aires, Argentina), starts her paper Coping with the pandemic. Psychoanalytical Interventions with parents and children, institutional and community approaches in Argentine with defining the Corona crisis as an event, “a social catastrophe based on a natural catastrophe.” She offers a broad overview on psychoanalytic studies on individual and collective trauma. Particularly interesting are her detailed descriptions of her psychoanalytical work with children, adolescents, and their parents during the time of the pandemic discovering in a new way the technical possibilities of remote‐analyses as well as their boundaries. She also summarizes some of the impressive offerings of psychoanalytical and academic institutions in Buenos Aires for supporting victims of the pandemic. She concludes: “This pause, as some have called it, is a pause that we did not choose, that will not leave us equal. Some discovered time, a time without urgency or overlapping demands, they enjoyed it, they discovered their children and partners from another perspective, a fruitful opportunity to invent something new. Colleagues working with very damaged children in vulnerable families were positively surprised about the satisfactory initiatives and coping resources some families produced. While other families closed themselves off more than before, losing fluid contact and leaving the professionals worried about how the children will react to the reconnection with schooling. For others the forced pause implies a catastrophic threat and the fear that upon leaving Noah's Ark, the home that protected us during the flood, we will find interrupted projects difficult to rebuild, the absence of people who are no longer with us, the impoverishment of many institutions. Plasticity, cooperation, solidarity and constructive energy will be necessary for creative reinvention, so that individuals and societies can transform this potential catastrophe into an ‘event’” (see Schejtman, in this volume).

Paula Ellmann (Rockville, USA) in her paper Safe spaces, unsafe spaces and gendered spaces: psychoanalysis during the pandemic explores the multilayered concept of space that has been unveiled during the pandemic. She discusses our experience of space, what is safe and unsafe, and how it has become reconfigured and differently considered. The pandemic opens social fractures with regards to race and gender, and with that in mind the author discusses the concept of space in terms of race and also space that becomes gendered, and those occasions when it is regressively experienced. She considers the ways that the use of space can become perverse, as well as contain creative life‐giving forces in an effort to defy the fear of illness and death. “On the brighter life‐giving side, during this pandemic I have become aware of efforts to open up space for creation in the context of our experience of the constriction of life and fears of illness and death. Do we attempt to defy the forces of death by our efforts at creativity, even the work to create this monograph? I believe that crises have a way of generating openings for creativity, for something new.” Paula Ellman illustrates her considerations with many detailed examples from her psychoanalytical work particularly with traumatized patients and even mentions her own experiences fighting against a serious illness for months.

Schestag, Mehner‐Gentner, Stein, Rossi, Leuzinger‐Bohleber, and Fritzemeyer (Berlin and Frankfurt, Germany) summarize in their paper Ghosts in the Nursery in exile ‐ Supporting parenting in exile during the COVID‐19 pandemic their observations in an early prevention project for refugee families with young children (0–4 years) The project “Strong together!” was implemented at the Kindergesundheitshaus e.V. (children’s house of health) located on the grounds of a large hospital in Berlin‐Neukölln, an area known for a great number of migrants and the risk of the development of parallel societies. The project stands in the long tradition of psychoanalytical understanding of the long shadows of war, persecution and flight. It was developed from the psychoanalytically oriented FIRST STEPS program for migrant families in Frankfurt (Germany) which has also been implemented in Berlin since 2012. The authors present first empirical findings of the outcomes of their project and then reflect on their observations concerning the influence of the pandemic on these traumatized families. They illustrate their thoughts with two case studies. “We are only at the beginning of understanding the effects of the COVID‐19 pandemic. However…it is evident that those severely traumatized are particularly endangered to experience reactivation of their traumatic experience as they have not been integrated sufficiently. The current situation may already be understood as yet another potentially traumatic phase in the sequence of the mothers’ experience of persecution, flight and post‐migration stressors (poor economic living standard, lack of privacy in camps as well as lack of the experience of self‐agency)” (see Schestag et al., in this volume).

4.2. Commitments of psychoanalysts and psychoanalytic institution in the pandemic

Anna Maria Nicolò (Rome, Italy) summarizes in her paper The COVID‐19 Pandemic and individual and collective defences some observations on the specific nature of the trauma caused by the pandemic and subsequent defenses on the social and individual level. She discusses an opportunity for discovering societal commitments of psychoanalysts as well as modifications in psychoanalytic offers and interventions. Her reflections have grown out of 400 Italian analysts’ experience of listening to and supporting persons who asked for help at various stages in the first phase of the pandemic. For her, the social vocation of psychoanalysis in a societal trauma is without doubt. The author differentiates between a first and a second phase of the pandemic. Initially, an experience of solidarity with the other and with the social group against a common enemy prevailed, but later due to the persistence of the trauma a disconnection between Eros and Thanatos, the Death Instinct, came to the forefront. Hence, very primitive defenses were activated. The project of psychoanalytic listening of 400 Italian psychoanalysts was carried out from March to June 2020. Specific elements were time‐limited telephone or video consultations of up to four free sessions, regular meetings of all volunteer counselors in peer supervision groups where a sort of group reverie was produced. Finally, the listening service had received about 1350 requests, giving a total of nearly 3500 sessions. Important findings from these consultations were the impact of the pandemic on the experience of time, causing a clash between linear time and suspended time, the reawakening in the present of a pre‐existing traumatic situation, the intergenerational transmission of the traumatic situation, the sudden confrontation with death, and a process of mourning. The author emphasizes that transformations in psychoanalytic techniques opened up a contact for people who would never have consulted a psychoanalyst.

Khatuna Ivanishvili (Tiflis, Georgia), in her paper, The Contaminated Analyst and the Transgenerational Traumatism in Abkhazia Après‐coup gives a vivid impression of the impact of the pandemic in this Eastern European country. Using two detailed case studies, she illustrates her observation that the situation of powerlessness and helplessness of the pandemic in many people—and patients and psychoanalysts as well—reminds her of the traumatic experiences of the Russian occupation of Abkhazia, in 1992/1993 which were revived. Once again in the sorrowful history of Georgia, many individuals—through no personal fault of their own—are placed in a situation in which they themselves are threatened with death and cannot ensure their survival and that of their relatives, wives and children. In a touching way, the author tells how a severely traumatized patient once again loses everything in his life and has no money left to pay for the analytical sessions. In a sensitive and emotionally touching way, she describes how she, as an analyst, seeks a way to continue the treatment that is essential for the patient's survival, even in this extreme situation.

“I consider it necessary to mention here the events that followed the breakup of the USSR, when destruction of the customary homeostasis happened through splitting, where the conquering object (Russia) was labeled as "bad" and the conquered freedom‐loving countries were proclaimed to be "the good ones" who appeared to become victims of the regime. Now the evil was perceived as an inward phenomenon which exists within one's own boundaries. Aggression justified by a so‐called protection of a good object leads part of the society into destructive behavior in the name of a moral imperative. As a result, part of the ego fights for return of the old homeostasis and ascription of the evil to the parts within the new boundaries. Preventing spread of danger contributed to a new split when 20% of the country has been cut off. The Covid era has echoed with old traumas provoking rekindling of a new spiral of tensions and triggering return of old defenses and new attempts to reunite or isolate” (see Ivanishvili in this volume).

4.3. Observations of political and societal events during the pandemic

Liana Giorgi (Vienna, Austria) begins her paper Not a Political Statement. Psychoanalytic Notes on the Measures to Fight the Pandemic and the Responses to Them by citing Joe Biden as US President Elect: “The mask is not a political statement.” Nevertheless, there were ideological fights about the use of the mask in the United States and in countries on the European continent. The author proposes to critically examine some of the measures installed to fight the pandemic, such as the face mask, and subsequent responses. She wishes to exemplify the unique contribution of psychoanalysis for decoding both the political narrative and its reception thus helping understand and better address societal challenges. She argues that an effective communication needs to allow for the unconscious responses to both the danger itself and to the measures imposed to deal with it. Several unconscious significations of the measures are centered around elements of a harsh primitive superego facing a weakened ego. Thus, the virus stands for the enraged parent that is out to punish its offspring as carriers of aggressive viral load; on a societal level, the state, representing the collective ego, is weakened and begins to function alike by way of reward and punishment. The resulting unconscious sense of guilt is severe. Other unconscious significations relate to restrictions imposed on intimacy, sexuality, and free speech, causing paranoid phantasies. The defense mechanism of fashion and dressing up is weakened, too. The mask renders the individual less pretty or attractive. Therefore, also in the consulting room, it can be experienced as signifying exposure of one’s own aggressiveness, but carrying an implicit sexual meaning, too. Finally, the author mentions a “vaccination anxiety conundrum,” which is connected with underlying emotions of fear and mistrust. Political risk management and communication strategies should take these unconscious significations into account.

Ira Brenner (Bala Cynwyd, USA), in his passionate paper Disinformation, disease, and Donald Trump, develops the concept of the "dual plague" comparing the pandemic with the political “virus” spread by Donald Trump. Ira Brenner discusses many historical parallels to Nero and the fall of the Roman Empire, to Hitler and Mussolini in a convincing and differentiated way. “Donald Trump’s desperate efforts to subvert the rule of law in order to stay in power for the sake of staying in power took precedence over his actually using that power to mitigate the American carnage he swore to end. Record numbers of Americans died every day as hospitals were overwhelmed with dead and dying patients. Out of necessity, many began making “selections” over who to treat and who not to treat. …In short, all Americans suffered excessively from a leader who not suitable for the job, one whose character and perverse relationship with reality fostered a climate of chaos, confusion, mistrust, and fear. At time of historic deadly crisis when people look to their leaders for protection and help, the populace became split over those who believed the propaganda and possibly suffered vs those who saw through the disinformation and possibly suffered for other reasons. It culminated in the Trump orchestrated political violence on January 6, 2020, when the curiously, poorly protected Capitol building was stormed and desecrated by a mob of his armed supporters wielding Confederate flags. …The nature of this attempted coup highlighted the extreme polarization in Congress, in law enforcement, and in the electorate as a whole.” Fortunately, the worst has been prevented for the moment but the long‐term consequences of the “dual plague” will have to be studied in the coming years.