Fourth Year Adult Psychoanalytic Training (APT)
2021-22, 2nd Trimester — Fridays, 1:45-3:15pm
Ashley Harmon, MD
Table of Contents
Introduction
Welcome to your second course on human development, historically called the “latency period” of childhood development. We will find throughout this course that the word “latency” does not accurately describe middle childhood. My objective is to co-create with you, a safe and dynamic learning environment, and I hope we can enjoy ourselves as we discuss this vibrant topic. We will be exploring the central foundations of human development between the ages of 6-12 years and why it is important to the clinical practice throughout the lifespan.
Psychoanalytic theories will guide us through various areas of development and how the internal life of a child and the external world (family, school, community, treatment) facilitate or alter developmental progression. Through the lens of modern psychoanalytic research, contemporary authors, and case material, we will discuss various symptoms and clinical treatment.
My goal is to offer diverse readings that will stimulate curiosity and class discussion about theory and practice. I prefer to not overload with reading quantity and instead allow us to dive into the topics in the articles we read together. Zoom teaching is new to me, so please offer feedback about readings vs discussion time. The optional readings are truly optional. If there is a particular interest, we can select optional readings if desired. Readings each week includes case illustrations.
Some classes include a children’s book to put us in the mindset of a school-age child and offer examples of using language and metaphor to play. These are optional and intended for fun.
Before each class, I’ll email the cohort some questions intended to facilitate class discussions.
Learning Objectives
At the end of this course, the clinical associates will be able to:
- Understand significant developmental milestones and common themes in middle childhood period across various domains of functioning.
- List the central theoretical concepts of human development between 6-12 years using various psychoanalytic theories. This will provide an important way of understanding and treating patients of all ages.
- Identify common psychodynamic conflicts and symptoms that present during this development period.
- Identify clinical principles and techniques applicable to the treatment of child, adolescent, and adult patients utilizing developmental knowledge, like transference, play, metaphor, and nonlinear conceptualizations of growth.
- Discuss contemporary social issues to facilitate an understanding of how to clinically work with diverse groups of people and contemplate complex systemic issues that promote discrimination of people of diversity through the lens of psychoanalytic thinking.Often in psychoanalysis we think in terms of the individual, and larger applications of psychoanalytic thinking are also needed as we consider larger issues facing our children and our world.
January 7, 2022 — Introduction and Conceptual History of Middle Childhood
[33 pages]The readings will introduce conceptualizations of human development from ages 6-12. Historical and modern contexts are introduced through the lens of a contemporary psychoanalytic researcher. The optional reading reviews 4 key areas of neuroscience that anchor our professional doctrine, relationships change the brain throughout life.
Deak, J. (2010). Your Fantastic Elastic Brain: Stretch It, Shape It. Little Pickle Press, Inc.
Knight, R. (2014). A Hundred Years of Latency: From Freudian Psychosexual Theory to Dynamic Systems Nonlinear Development in Middle Childhood. J. Amer. Psychoanal. Assn., 62(2):203-235.
Optional Reading
Gold, C. (2017) Ch 6, "How Relationships Change the Brain" in The Developmental Science of Early Childhood: Clinical Applications of Infant Mental Health Concepts from Infancy through Adolescence, pp129-157.
January 14, 2022 — Understanding Transference and Countertransference in Middle Childhood and Implications for Adult Treatment
[29 pages]The goal of this class is to discuss common transference patterns in school age children and the similarities and differences in our understanding and use of transference in child and adult treatment. We will use case illustrations in the literature to further our clinical understanding.
Milne, A.A. (1996) “Us Two” in The Complete Tales & Poems of Winnie-the-Pooh: Now We are Six. Anytime Books, New York, pp489.
Furman, E. (1980). Transference and Externalization in Latency. Psychoanal. St. Child, 35:267-284.
Ablon, S.L. (2000) “Where Work is Play for Mortal Takes”: The Good Hour in Child Analysis. Psychoanalytic Study of the Child, 55:113-123.
January 21, 2022 — Developmental Features of Middle Childhood and Implications for Separation and Growth
[37 pages]This class will focus on how the cognitive maturation of the child influences their capacity to have more autonomy, move their focus away from parents and toward the larger community (peers, other adults, school), engage in friend making, become independent learners, endure life’s challenges, and build resilience.
Mid-term evaluations should be conducted in the closing minutes of your classes today. This is a discussion that should be allowed at least 10 minutes, but no more than 30 minutes. No written records are necessary.
Midterm Class Evaluation Discussion Questions
Spires, A. (2014) The Most Magnificent Thing. Kids Can Press.
Gilmore, K. and Meersand, P. (2014). “The Latency Phase: Cognitive Maturation, Autonomy, Social Development and Learning”, in Normal Child and Adolescent Development: A Psychodynamic Primer. Ch6, pp141-177.
January 28, 2022 — The Role of Play in Middle Childhood and Its Implications for Child and Adult Treatment
[21 pages]The goal of this class is to explore the world of play and how play is an essential component for many psychoanalytic treatments. A recent article is added to demonstrate teleanalysis and its capacity to serve as a potential model for treatment delivery.
Early theoretical and clinical contributions from Donald Winnicott, M.D. and “The Middle School” will be recognized as the early precursors for later key advancements in psychoanalytic theory, attachment research, and clinical practice focusing on mutuality, empathy, and resilience.
Williams, M. (1975) The Velveteen Rabbit: Or, How Toys Become Real. Avon Books, New York.
Ablon, S.L. (2001) Continuities of Tongues: A Developmental Perspective on the Role of Play in Child and Adult Psychoanalytic Process. Journal of Clinical Psychoanalysis, 10:345-365
Optional Reading
Ornstein, A. (1984) The Function of Play in the Process of Child Psychotherapy: A Contemporary Perspective. Annual of Psychoanalysis 12:349-366
Sehon, C. (2021) Technology as a Play Object in Teleanalysis with Young Children. Psychoanalytic Study of the Child 74:26-43
Winnicott, D.W. (1971) Therapeutic Consultations in Child Psychiatry. Basic Books, Inc.
This is a compilation of case illustrations of brief clinical consultations. (I added it because of The Squiggle Game illustrations.
This case was scanned for class discussion.
February 4, 2022 — Attachment and Autonomy: Self-reflection, Mentalization, and Emotional Regulation
[35 pages]This class will focus on readings that explore the impact of cumulative trauma and the “working through” process with children as it relates to autonomy, self reflection, mentalization, and emotional regulation. Displacement as a unique defense and technique is reviewed and demonstrated. Since the early process of attachment to caregivers can also traumatically impact this process and children frequently present for treatment during middle childhood, we will also consider how early trauma may disrupt the person’s development of a cohesive and mentalizing self.
There is a self-psychological perspective on resilience in adult treatment with a history of cumulative trauma in childhood. The research of Rona Knight, and her conclusions regarding the “typical” psychological processes of a child separating from their parents in new more delineated ways and how internal conflict unfolds toward psychological growth is also in the optional readings.
Becker, S. (2006) Maxwell’s Mountain. Charlesbridge.
Tavistock Trauma Service, Tavistock and Portman NHS Foundation Trust, London. U.K. (2020) “The Early Response to Covid 19 – a psychoanalytic and trauma perspective”.
Sugarman, A. (2008) The Use of Play to Promote Insightfulness in the Analysis of Children Suffering from Cumulative Trauma. Psychoanalytic Quarterly 77:799-833.
Optional Reading
DiAmbrosio, P.E. (2006) Weeble Wobbles: Resilience within the Psychoanalytic Situation. International Journal of Psychoanalytic Self Psychology 1:263-284
Jemerin, J.M. (2004). Latency and the capacity to reflect on mental states. Psychoanalytic Study of the Child, 59:211-239.
Knight, R. (2005). The Process of Attachment and Autonomy in Latency A Longitudinal Study of Ten Children. PSC, 60:178-210.
February 18, 2022 — Psychoanalytic Perspectives on Gender Development and Gender Diversity
[24 pages]In this class, we will continue to explore the clinical implications of a nonlinear systems model of human development that describes a fragmenting process before psychological growth occurs. Binary genders are frequently called upon to distinguish differences observed in the middle childhood, and gender diversity in middle childhood is readily observed in this age, too. We will begin a discussion about where psychoanalysis is in the recognition and treatment of transgender children.
Trans Student Educational Resources (2017) “The Gender Unicorn”
Kilpatrick, K. (2020) Pop. Genius Cat Books.
Ehrensaft, D. (2021) Psychoanalysis Meets Transgender Children: The Best of Times and the Worst of Times. Psychoanalytic Perspectives 18:68-91
Optional Reading
Barkai, A.R. (2017) Troubling Gender or Engendering Trouble? The Problem with Gender Dysphoria in Psychoanalysis. Psychoanalytic Review 104:1-32.
Ehrensaft, D. (2014). Listening and learning from gender-nonconforming children. PSC, 68:28-56.
Knight, R. (2014). Free to be you and me: normal gender-role fluidity—commentary on Diane Ehrensaft’s "Listening and learning from gender-nonconforming children." PSC, 68:57-70.
Knight, R. (2011). Fragmentation, Fluidity, and Transformation: Nonlinear Development in Middle Childhood. PSC, 65:19-47.
Knight, R. (2021) Reconsidering Development in Psychoanalysis, The Psychoanalytic Study of the Child, DOI: 10.1080/00797308.2021.1996123
February 25, 2022 — Manifestations of Aggression in Middle Childhood and Societal Implications
[20 pages]We will discuss aggression through a self-psychological lens and further our understanding of aggression through implications in racial disparities in mental health diagnosis and treatment. Optional readings include psychoanalytic perspectives on school violence prevention using a systemic understanding vs an individual orientation.
Sendak, M. (1963) Where the Wild Things Are. Harpercollins Publishing.
Ornstein, A. (1997) A Developmental Perspective on the Sense of Power, Self-Esteem, and Destructive Aggression. Annual of Psychoanalysis 25:145-154
Durham, J.I. (2018). Perceptions of microaggressions: Implications for the mental health and treatment of African American yout. In Journal of Infant, Child, and Adolescent Psychotherapy, 17(1), pp. 52-61
Optional Reading
Pivnick, B.A. & Hassinger, J.A. (2021) The Child in the School, the School in the Community, and the Community in the Child: Linking Psychic and Social Domains in School Violence Prevention. International Journal of Applied Psychoanalytic Studies 18:330-341
Kaplan, E.B. (1976). Manifestations of Aggression in Latency and Preadolescent Girls. PSC, 31:63-78.
Herzog, J.M. (2008) Falling Down: A Girl’s Struggle with Her Oedipus Complex and Her Family’s Dilemmas. Annual of Psychoanalysis 36:62-72.
March 4, 2022 — Moving Toward Adolescence
[24 pages]The readings will introduce the physical and emotional changes in the time leading to puberty and adolescence. This time is rich in conflict, both internal and external. Physical changes, cognitive maturation, and increased self-reflection meet the greater external expectations for independence in the world and academic demands. Earlier intrapsychic conflicts are revived, and external conflicts emerge.
Lang, S. (2018) Grumpy Monkey. Random House, New York.
Gilmore, K. and Meersand, P. (2014) “Preadolescence: Bodily Changes, Changing Relationships, and the Transition to the Teen Years”, in Normal Child and Adolescent Development: A Psychodynamic Primer. Ch7, pp179-202.
Optional Reading
Ablon, S.L. (1990) Developmental Aspects of Self-Esteem in the Analysis of an 11-Year-Old Boy. Psychoanalytic Study of the Child 45:337-356
March 11, 2022 — Wrapping Up and Final Evaluations
Class discussions and video presentations to illustrate learned concepts about childhood development.
Link for videos is: https://www.appi.org/gilmore