Foundations of Child Psychoanalysis

Fourth Year Child Psychoanalytic Training (CPT)
2020-21, 1st Trimester — Fridays, 10:15-11:45am
Julie Wood, MA
Ellika McGuire, MD
Ann De Lancey, PhD
Donald Schimmel, PhD
Denise C.K. Fort, PhD
Flaviane Ferreira, MD LMHC

---

Introduction

Welcome!

Child analysis is fun and enhances your work with adults. We look forward to learning together. This course is the first course of the first year in a four year rotation of child psychoanalysis didactics. A new cohort typically begins every other year with the result that some clinical associates might be joining a cohort “out of order”. This entire year will be focused on the theme of “An Introduction to Psychoanalysis” or rather, answering the questions: What makes child psychotherapy psychoanalytic? What is child psychoanalysis? Each of the next three years are focused on a developmental stage:

• Year 1 (2020) – Foundations for Child Psychoanalysis
• Year 2 (2021) – Treatment of children in pre-latency (about age birth to 5)
• Year 3 (2022) – Treatment of latency age children (about ages 6 – 12 or preadolescent)
• Year 4 (2023) – Treatment of adolescence and emerging adulthood (about ages 12 -24)

Each year of child psychoanalytic training follows a rhythm:

• Fall trimester is a didactic, theoretically focused course.
• Winter trimester is a focus on clinical application of concepts learned in the fall with all associates presenting their case material of child analysis or psychotherapy or family work. Reading are more process oriented and focused on specific disorders of that developmental phase.
• Spring trimester is a continuous case conference in which one or two associates present the clinical transcripts, the back and forth process between child and analyst, as material for the entire class to work with and learn from.

Learning Objectives

Clinical associates will:

1. learn the historical roots of child psychoanalysis and the subsequent multi-theoretical approaches to treatment of children.
2. identify the key features of child analytic treatment: healing as restoration of development, establishing a working alliance and treatment frame with parents or caregivers, transference and counter transference experiences unique to child work, play as the language of children, setting up a child practice, including essential play materials.
3. identify initial interventions with parents, child, and adolescent patients.

September 11, 2020 — Cohort formation and context

Presenters: Julie Wood, MA, Ellika McGuire, MD

[25 pages]

Please come prepared to discuss your desires, worries, intrigues, and gratification of working with children and families. We’ll talk together about our own motivations and skills and wishes for your training. We aim to work collaboratively as a learning and treatment community who helps children and teens and to that end we wish for your interests and curiosity to guide your training, in addition to learning the fundamentals of the practice. We’ll begin a look at the historical roots and the various multidisciplinary professions that influence contemporary child psychoanalytic treatment, including the place of child analysis in the larger analytic world. We’ll consider how adult and child analysis inform each other and deepen the work with both.

Freud, A. (1972). Child-Analysis as a Sub-Speciality of Psychoanalysis. Int. J. Psycho-Anal., 53:151-156

Mahon, E. (2000). A “Good Hour” in Child Analysis and Adult Analysis. Psychoanal. St. Child, 55:124-142

Optional Reading

Feigelson, C.I. (1977). On the Essential Characteristics of Child Analysis. Psychoanal. St. Child, 32:353-361.

Edgcumbe, R. (1983). Anna Freud—Child Analyst. Int. J. Psycho-Anal., 64:427-433

Solnit, A.J. (2001). Introduction and Historical Perspective. Psychoanal. St. Child, 56:3-8.

Mahon, E.J. (2001). Anna Freud and the Evolution of Psychoanalytic Technique. Psychoanal. St. Child, 56:76-95.

Kris, A.O. (2001). Discussion of “Anna Freud and the Evolution of Psychoanalytic Technique”. Psychoanal. St. Child, 56:96-100.

(Additional readings are for both weeks 1 and 2.)

 

September 18, 2020 — History of Child Psychoanalysis: Anna Freud

Presenter: Julie Wood, MA

[30 pages]

This week we’ll look at the historical foundations of child psychoanalysis. Anna Freud began her studies with her father in Vienna, from her perspective as an analysand (of her father’s) and a preschool teacher. In London, she established the Hampstead Nursery and applied her developmental knowledge of psychoanalysis to children. Meanwhile, Melanie Klein, had already been working in London and had a following of people working with children. Please come prepared to discuss the Miller article.

Miller, J.M. (1996). Anna Freud. Psychoanal. St. Child, 51:142-171.

Optional Reading

Feigelson, C.I. (1977). On the Essential Characteristics of Child Analysis. Psychoanal. St. Child, 32:353-361.

Edgcumbe, R. (1983). Anna Freud—Child Analyst. Int. J. Psycho-Anal., 64:427-433

Solnit, A.J. (2001). Introduction and Historical Perspective. Psychoanal. St. Child, 56:3-8.

Mahon, E.J. (2001). Anna Freud and the Evolution of Psychoanalytic Technique. Psychoanal. St. Child, 56:76-95.

Kris, A.O. (2001). Discussion of “Anna Freud and the Evolution of Psychoanalytic Technique”. Psychoanal. St. Child, 56:96-100.

(Additional readings are for both weeks 1 and 2.)

September 25, 2020 — History: Klein, Mahler, Bowlby, Winnicott

Presenter: Ann De Lancey, PhD

[47 pages]

As this seminar is both an introduction to child analysis and a quick dive into the opening phase of analysis, we will focus on Winnicott’s concept of regression to dependence, only giving a brief nod to his predecessors  and focusing forward to current reformulations of his theory and toward and including an understanding of racialized trauma.

A note about the reading. I am well aware that when you in the child as well as the core program, there is an enormous amount of reading. Please focus on the first article listed. If you don’t have time to read the full second article, maybe just read the introduction and conclusion of the secondary article. The optional articles are just that. For your reference!

As you read you may want to keep the following questions/issues in mind:

• Three modes of functioning. Regression to
  • Fixation
  • Good fixation
  • Thoroughgoing regression or regression to dependence
• The difference between a more flattened view of stages and a fluid, free-flowing functioning and symbolization with co-existence and interlocking matrices
• How is trauma racialized

Overall Learning Objectives­

1. To enable clinical associates to articulate a more fluid way of considering Winnicott’s three modes of functioning
2. To be able to describe the relationship between trauma and après coup
3. To be able to understand to what extend we use countertransference
4. To cite the advantages and disadvantages of physical contact
5. To be able to articulate what it means when we say that white-body supremacy and our adaptations to it are in our blood
6. To cite the difference between clean pain and dirty pain

Clinical Impact of the Knowledge or Skills Gained

1. Clinical associates will have a greater ability to name, tolerate, and put into perspective their patients, and their own, defenses against and feelings about their own racism.
2. Clinical associates will open themselves to the satisfactions and joys of working with the regression to dependence and racialized trauma and do so more often
3. Clinical associates will enact more creative responses to regression and trauma

Quagelli, L. (2020). Reading Winnicott: Return to the concept of regression to dependence. The International Journal of Psychoanalysis, 101, 456-478.

Menakem, R. (2017). “Your body and blood.”, in My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies. Las Vegas: Central Recovery Press, pp3-26.

Please read 3-16 & 25-26 in the Menakem reading.

Optional Reading

BBC Recordings of Winnicott to the British people.

 

October 2, 2020 — Establishing a working alliance with parents

Presenter: Ellika McGuire, MD

[48 pages]

Beginning work with a child or teen requires significant work with parents or caregivers. The Novicks are a contemporary voice in the child analysis world. They build upon a rich tradition, starting with Anna Freud, of considering the “child in context”, across developmental domains, and always within the family relational world.

Novick, J. Novick, K.K. (2000). Parent Work in Analysis: Children, Adolescents, and Adults: Part One: The Evaluation Phase. J. Infant Child Adolesc. Psychother., 1(4):55-77.

Rosenbaum, A.L. (1994). The Assessment of Parental Functioning: A Critical Process in the Evaluation of Children for Psychoanalysis. Psychoanal Q., 63:466-490.

Optional Reading

Novick, K.K. Novick, J. (2002). Parent Work in Analysis II—Children, Adolescents, and Adults: Recommendation, Beginning, and Middle Phases of Treatment. J. Infant Child Adolesc. Psychother., 2(1):1-27.

October 9, 2020 — Play as Language

Presenter: Donald Schimmel, PhD

[15 pages]

*The mid-term class evaluation will be conducted during this session. Please use these questions to facilitate your discussion: Midterm Evaluation 2019-02-13

Solnit, A.J. (1987). A Psychoanalytic View of Play. Psychoanal. St. Child, 42:205-219.

October 16, 2020 — Play

Presenter: Donald Schimmel, PhD

[61 pages]

Gilmore, K. (2005). “Play in the Psychoanalytic Setting.” Psychoan. St. Child, 60:213-238

Mahon, E.J. (2004). “Playing and Working Through.” Psychoanal. Qrtly, 73(2): 379-413

October 23, 2020 — The Primary Triangle: Evolution

Presenter: Denise C.K. Fort, PhD

Fivaz-Depeursing and Corboz-Warner. (1999). The Primary Triangle: A Developmental Systems View of Mothers, Fathers, and Infants. New York: Basic Books. pp. xi-31.

October 30, 2020 — The Primary Triangle: Dissolution

Presenter: Denise C.K. Fort, PhD

[56 pages]

Hoffman, L. (2007). Do Children Get Better when we Interpret their Defenses against Painful Feelings?. Psychoanal. St. Child, 62:291-313.

Novick, K.K.; Novick, J.; Barrett, D.; Barrett, T. (2020). Parent Work Casebook. New York: International Psychoanalytic Books. pp1-11.

Novick, K.K.; Novick, J.; Barrett, D.; Barrett, T. (2020). Parent Work Casebook. New York: International Psychoanalytic Books. pp115-136.

November 6, 2020 — Transference and Countertransference

Presenter: Flaviane Ferreira, MD LMHC

[25 pages]

There is no longer any doubt that children are capable of transference.

In fact, the child analyst’s main difficulty is not the absence of transference but the opposite: seeing the development of a transference of unusual intensity, with archaic components that are sometimes so massive and so violent that they become difficult for the analyst to tolerate. The management and understanding of the analyst’s countertransference as a part of the child’s communication requires closely attention to what the child’s projections induces in the analyst and what in turn is reactivated in the child by the analyst’s countertransference.

It is my hope that these articles will aid our discussion and enable us:

1. Recognize a common instinct among adults to protect and nurture the young and how it can resonate with rescues phantasies in the child.
2. Identify possible difficulties in the treatment when the child analyst focuses on being a “good” object, thus becoming the protector of the child from the “bad” object.
3. Distinguish transference/countertransference of normal erotic nature from child sexual and seductive behavior.

Bonovitz, C. (2009). Countertransference in Child Psychoanalytic Psychotherapy: The Emergence of the Analyst’s Childhood. Psychoanalytic Psychology, 26(3):235-245.

Alvarez, A. (2010). Types of sexual transference and countertransference in psychotherapeutic work with children and adolescents. J. of Child Psychotherapy, 36(3):211-224.

Optional Reading

Marcus, I.M. (1980). Countertransference and the Psychoanalytic Process in Children and Adolescents. Psychoanal. St. Child, 35:285-298.

November 13, 2020 — Relational Strengths: Agency, Resilience, and Mentalization

Presenters: Ann De Lancey, PhD, Carla Hershman, MSW LICSW

[38 pages]

Perhaps one of the overlooked areas in our work is the value of a focus on strengths, resilience, self-agency. In this seminar we will focus on these in the context of trauma and higher levels of functioning.

Same note as Week 3 about the reading:  I am well aware that when you in the child as well as the core program, there is an enormous amount of reading. Please focus on the first article listed. If you don’t have time to read the full second article, maybe just read the introduction and conclusion of the secondary article. The optional articles are just that. For your reference!

Questions/issues to keep in mind as you do the reading.

• What are the advantages and disadvantages of focusing on:
  • Trauma
  • Internal conflict
• What are the components of self-agency?
• How has racialized socialization affected and thwarted mentalization?

Overall Learning Objectives­

1. To enable clinical associates to be able to name three ways that prioritizing self-reflection into how their patients are thinking/feeling increases the sense of self as agent
2. To be able to name ways that emphasizing trauma can lead to increased anxiety and stuckness
3. To be able to name ways that mentalization impairs or interferes with therapeutic progress
4. Name one way mentalization and internalization can increase levels of self-agency and capacity to use affects as signals

Clinical Impact of the Knowledge or Skills Gained

1. Clinical associates will have a greater ability to name, tolerate, and put into perspective their patients, and their own, defenses against and feelings about their own racism.
2. Clinical associates will be able to sense in their bodies when trauma and/or racialized trauma is present and requires an approach that more resembles a regression to dependence.
3. Clinical associates will be able to effect greater consolidation of a sense of self-agency where mentalization of defenses and internal conflict is possible

Sugarman, A. (2018) The importance of a promoting a sense of self-agency in child analysis. Psychoanalytic Study of the Child 71:108-122.

Stoute, B.J. (2019). Racial socialization and thwarted mentalization: Psychoanalytic reflections from the lived experience of James Baldwin’s America. American Imago. 76: 335-357. 

Optional Reading

Why We’re All Suffering from Racial Trauma (Even White People) and How to Handle It — Resmaa Menakem

The following article is only for your interest and reference, but relevant.

Stob, V.; Slade, A.; Adnopoz, J. (2020). The family cycle: Breaking the intergenerational transmission of trauma through mentalizing. Journal of Infant, Child, and Adolescent Psychotherapy. 19: 255-270.

November 20, 2020 — Wrapping up didactics and preparing for clinical applications

Presenter: Julie Wood, MA

[39 pages]

We will summarize our work together this trimester. Additionally, we would like to hear more from you about your wishes for ongoing didactic study in the winter trimester as we look at clinical applications. In winter, we will work together with associate and faculty case material. Each associate will present material at least twice.

Ritvo, S. (1996). Observations on the Long-term Effects of Child Analysis: Implications for Technique. Psychoanal. St. Child, 51:365-385

Furman, E. (1992). On Feeling and Being Felt with. Psychoanal. St. Child, 47:67-84.

Optional Reading

Fonagy, P.; Target, M. (1998). Mentalization and the Changing Aims of Child Psychoanalysis. Psychoanal. Dial., 8(1):87-114.