“How Do We Know What We Didn't Know?
Recognizing Secrets in the Body"
Kathryn Zerbe, MD, FIPA
The impact of secrets on body and mind has received relatively little attention in psychoanalysis, despite their ubiquity in clinical practice. Growing evidence suggests that secrets are often sensed in the bodies of both clinician and patient. In this presentation, Kathryn Zerbe explores how secrets can be and often have been “hidden, but in plain sight” for decades, such that they may be “known and yet not known” by both patient and clinician. This information can exert subtle, unconscious effects on the treatment process and may manifest through somatic countertransference responses. Zerbe examines how secrets can be effectively recognized and addressed in the treatment, particularly when they are manifested within the body. By linking psychodynamic principles with evolving knowledge from neuroscience and cognitive science, she shows how clinicians can more effectively attune to these secrets within the dyad and take preventive steps to maintain their own wellbeing.
Learning Objectives:
After attending this scientific meeting, participants will be able to:
1. Recognize the unanticipated impact that a warded off secret (e.g., "what we know but may not know") has on the patient's and therapist's body.
2. Demonstrate and use somatic/embodied countertransference as an additional source of recognition of warded off secrets.
3. Use three concepts emerging from contemporary psychoanalysis, cognitive science, and neuroscience research that can assist the well-being of both patient and clinician.
About the Presenter
Kathryn J. Zerbe, MD, FIPA is currently a Training and Supervising Analyst of the Oregon Psychoanalytic Institute and Clinical Professor of Psychiatry, Oregon Health & Science University. Before moving to Portland in 2001, she served in numerous clinical and administrative roles at the Menninger Clinic and was a Training and Supervising Analyst at the Topeka Institute for Psychoanalysis. Dr. Zerbe has published over 100 chapters, papers and reviews and 5 books, including her most recent book: Secrets in Psychotherapy: Stories that Inform Clinical Work (2025, Routledge). She speaks nationally and internationally on topics such as the mind/body relationship, eating disorders and addictive economies, and the impact of secrets on the body and mind of clinician and patient. Dr. Zerbe received the Lifetime Achievement Award from the National Eating Disorders Association in 2011 and in 2022 gave the G. Phillip Wilson Lecture for contributions to mind/body medicine. She practices in Portland.
About the Moderator
Nancy C. Winters, MD, FIPA practices in Portland, Oregon. She is a Training and Supervising Analyst on the faculty of the Oregon Psychoanalytic Institute and the Northwestern Psychoanalytic Society and Institute, and a Clinical Professor of Psychiatry at the Oregon Health & Science University. Recent publications and presentations include: Co-editor and chapter author of Body as Psychoanalytic Object: Clinical Applications from Winnicott to Bion and Beyond (2022, Routledge); “Autoimmunity and its Expression in the Analytic Situation: Contemporary Reflections on Our Inherent Self-Destructiveness” (2022); “A Home to the Lie: The Contemporary (Per)Version of Truth” (2023); “Transformations in O Online: Group Process in the Virtual Realm” (2024); and recent presentations: “The Liar and the Truth-Teller: An Analytic Dialogue” (Lisbon, 2025), and “Freud’s ‘Open Wound’ of Melancholia: Psychic Inflammation and Self-Healing” (Seattle, 2026).
