So much came to mind when I started to think about hope. Hope seems loaded right now and possibly in short supply, but when I retreat to my psychoanalytic frame of thought, I understand that opposing poles hold each other down. Kind of like on a camping tent. You cannot have a move toward the positive without an opposing move toward the negative, and when things seem at their worst, is exactly when the potential for great hope is more open and available than ever. We simply wouldn’t be able to see hope existing on the horizon, without acknowledging despair. Analytic greats like Winnicott and later Stephen Mitchell regarded hope as being essential to the analytic relationship and in an object relations way, critical to our survival. We must have hope that our caretaker will understand us. We must have hope for a good object. We must have hope for repair. Mitchell’s book Hope and Dread in Psychoanalysis is a great read - if you consider analytic study a great read. Check the episode notes. 

Musing on hope for a few days led me to an early conversation I had in my training with my mentor Dr. David Gard. We were talking about change. I was having a difficult day of cases and was wondering if change was really possible. Could my patients change? Was it really possible? David looked at me with intent and said, “well if you didn't inherently believe in change, you'd never do what you are doing. Of course they can. And of course you do.” It was one of the few times in my training that my wondering was met with an empathic answer and not a trail of breadcrumbs to look more within. Change, my belief in it, and my patient’s ability to experience, when placed together, was a fact. Thanks, David. What I came to understand about psychoanalysis and psychotherapy for that matter, is that it is a science based on hope. A way of thinking together with another person that relies on the analyst’s ability to see the positive. A hope that no matter how the person is presenting, what they have done, who they have hurt and how they have hurt themselves, there is a goodness in them that we can see and allow them to see too. It is a practice built upon hope. Hope of connection and hope of repair. David was right. If I didn’t think change was possible, if I didn't believe in hope, I wouldn’t have ended up devoting hours of my life to the work of hope. I think perhaps we all engage in this work of hope when we allow ourselves to connect.

Outside of psychoanalytic musings, hope itself is indeed real. Scientists have been able to locate it in the brain. Turns out hope lives in the bilateral medial orbitofrontal cortex, the region of the brain involved in motivation, problem solving and goal-oriented behavior. A 2017 study in China found not only that hope exists in the orbitofrontal cortex - located just above the eyes, but that hope was hard at work in this region of the brain acting as a mediator between medial orbitofrontal cortex activity and anxiety. Earlier studies have shown that there is a direct correlation between hope and anxiety. Those who experience hope, generally experience less anxiety. What the most recent findings from China suggest is that hope actually influences brain chemistry and acts as a kind of negotiator in this part of the brain. Scientists are hopeful - pun intended - that their research will provide insight into more effective methodologies for treating anxiety and depression. So hope in and of itself is hopeful! 

For more on HOPE listen to JOY IS NOW Episode 12 with Melissa McArdle. 

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