Adult Psychoanalytic Training (APT)
2020-21, 1st Trimester — Fridays, 1:45-3:15pm
Judy K. Eekhoff, PhD
Kelly Lippman, LMHC
Table of Contents
Introduction
Welcome to our course on Child Development (Birth to age 5). This course is the didactic complement to the Year Two Infant Observation course and we expect to refer to last year’s rich array of observations to illustrate and deepen our understanding of the concepts we will explore this trimester.
Sigmund Freud’s curiosity and theorizing about how childhood was linked to suffering and joy in adulthood led to the idea of developmental progression and therapeutic intervention. Early child psychoanalysis, developed by Melanie Klein and Anna Freud, and based in nuanced observation and clinical work, focused attention on the internal dynamics of infants and young children as well as the importance of their relational and social contexts. These foundational theorists set the stage for decades of observational research and psychoanalytic exploration, all of which has led to our contemporary understanding of attachment, developmental progression, affect regulation, object relations, identity formation, projective processes and neurobiology.
During this class, we will examine this topic from a variety of vantage points with the goal of providing a nuanced and multilayered contemporary understanding of child development rooted in a historical psychoanalytic context. Throughout the course, we will apply our learning to the adult clinical situation.
Learning Objectives
This class will offer clinical associates a broad understanding of child development in the first five years of life. At the end of this course, associates will be able to:
- Assess the developmental experiences of their patients from a variety of perspectives and recognize how patterns of early experience dynamically affect the adult clinical situation.
- Apply their knowledge of internal working models of attachment, affect regulation and object relations in order to listen more sensitively and respond and interpret more accurately to patients, which will enhance treatment persistence and outcomes.
- Recognize the effects of early relational trauma, better empathize with unbearable affect and receive and metabolize projective communication more effectively in order to facilitate improvement in patients’ reflective capacity, self-cohesion and affect regulation.
- Develop an understanding of the process of building representations in an internal world in order to better formulate patients’ material and improve treatment efficacy.
- Recognize relationships between projections, objects and introjects in patients’ internal worlds in order to listen and analyze relationships that generate meaning between internal objects and between the internal and external world.
September 11, 2020 — Origins of the Self
[25 pages]In this session, we will begin to explore the question of how we become who we are. We will consider the internal and external conditions that contribute to development of the infant and young child’s mind/body/self experience. The external family is the matrix for the child’s development. The child’s contribution to their development is the manner in which experience of the family is processed.
Winnicott, D.W. (1960). The Theory of the Parent-Infant Relationship. Int. J. Psycho-Anal., 41:585-595.
Stern, D. (1985) Chapter 6, “The Sense of a Subjective Self: I. Overview”, in The Interpersonal World of the Infant, pp124-137
Optional Reading
Klein, M. (1958). On the Development of Mental Functioning. Int. J. Psycho-Anal., 39:84-90.
Winnicott, D.W. (1949) "Mind in its Relation to the Psyche-Soma", in D.W. Winnicott, Through Paediatrics to Psycho-Analysis, pp243-254
Fonagy, P. and Target, M. (2007). The Rooting of the Mind in the Body: New Links between Attachment Theory and Psychoanalytic Thought. J. Amer. Psychoanal. Assn., 55(2):411-456
September 18, 2020 — Ideas about Developmental Progression - Positions
[39 pages]One way to think about development is as a three-dimensional spiral, one that begins small and ends wide. The movement occurs via a dialectical interaction between the three positions as originally conceptualized by Melanie Klein – the autistic-contiguous, paranoid-schizoid and depressive positions. All three remain active throughout life. This session will introduce progression as the interaction between internal and external factors that contribute to the generation of the meaning of experience.
Ogden, T.H. (1989). On the Concept of an Autistic-Contiguous Position. Int. J. Psycho-Anal., 70:127-140.
Klein, M. (1946). Notes on Some Schizoid Mechanisms. Int. J. Psycho-Anal., 27:99-110.
Segal, H. (1979) The Depressive Position. In H. Segal Introduction to the Work of Melanie Klein (pp. 78-90) London: Karnack Books.
Optional Reading
Pick, I.B. (1992). The Emergence of Early Object Relations in the Psychoanalytic Setting. New Library of Psychoanalysis, 14:24-33.
Riviere, J. (1936). On the Genesis of Psychical Conflict in Earliest Infancy. Int. J. Psycho-Anal., 17:395-422.
September 25, 2020 — Ideas about Developmental Progression - Stages
[36 pages]Mahler’s conceptualization of the separation-individuation process, particularly her ideas about rapprochement, development in symbolic representation, rupture and repair, affective attunement and libidinal object constancy are foundational and continue to have relevance today. We will explore Mahler’s four subphases of separation-individuation and contemporary perspectives that integrate Mahler’s concepts with attachment theory.
Mahler, M.S. (1972). Rapprochement Subphase of the Separation-Individuation Process. Psychoanal Q., 41:487-506.
Bergman, A. Harpaz-Rotem, I. (2004). Revisiting Rapprochement in the Light of Contemporary Developmental Theories. J. Amer. Psychoanal. Assn., 52(2):555-570.
Optional Reading
Gergely, G. (2000). Reapproaching Mahler: New Perspectives on Normal Autism, Symbiosis, Splitting and Libidinal Object Constancy from Cognitive Developmental Theory. J. Amer. Psychoanal. Assn., 48(4):1197-1228.
Furman, R.A. Furman, E. (1984). Intermittent Decathexis—A Type of Parental Dysfunction. Int. J. Psycho-Anal., 65:423-433.
Seligman, S. (2016). Disorders of Temporality and The Subjective Experience of Time: Unresponsive Objects and the Vacuity of the Future. Psychoanal. Dial., 26(2):110-128.
October 2, 2020 — Attachment Theory
[52 pages]Attachment theory and research has helped us understand how infants are intrinsically motivated to preserve relationships with their caregivers, how disruption in primary attachment relationships creates vulnerability in cohesion, affective experience and ways of relating and how patterns of attachment create psychological structure. Listening to patients with an ear to attachment patterns and compromises allows an analyst to understand the underlying dynamics of a patient’s psychic structure and how to work with these dynamics in the clinical realm.
Sroufe, L.A. (2017) Ch1, “Attachment Theory: A Humanistic Approach for Research and Practice Across Cultures” in Attachment Across Clinical and Cultural Perspectives: A Relational Psychoanalytic Approach, New York: NY. Routledge. pp1-24.
Slade, A. (2000). The Development and Organization of Attachment: Implications for Psychoanalysis. J. Amer. Psychoanal. Assn., 48(4):1147-1174.
Optional Reading
Tronick, E. (2002). The Increasing Differentiation and Nontransferability of Ways of Being Together. J. Infant Child Adolesc. Psychother., 2(4):47-60.
Fonagy, P. (2001) "Key Findings of Attachment Research", from Attachment Theory and Psychoanalysis, pp19-46
Seligman, S. (2000). Clinical Implications of Current Attachment Theory. J. Amer. Psychoanal. Assn., 48(4):1189-1194.
October 9, 2020 — Affect, Regulation and Sense of Self
[36 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
Understanding affective experience in an attachment context is central to understanding patients’ sense of themselves, their experience of feeling states and their experience of the analytic relationship. Recent interdisciplinary and neurobiological research efforts have emphasized the centrality of affect and patterns of mutual regulation in attachment processes and developing modes of self-regulation (or dysregulation).
Pedersen, S.H. Poulsen, S. Lunn, S. (2014). Affect Regulation: Holding, Containing and Mirroring. Int. J. Psycho-Anal., 95(5):843-864.
Slade, A. (2014). Imagining Fear: Attachment, Threat, and Psychic Experience. Psychoanal. Dial., 24(3):253-266.
Optional Reading
Furman, E. (1992). On Feeling and Being Felt with. Psychoanal. St. Child, 47:67-84.
Fonagy, P. Target, M. (2002). Early Intervention and the Development of Self-Regulation. Psychoanal. Inq., 22(3):307-335.
Schore, J.R. and Schore, A.N. (2008). Modern attachment theory: The central role of affect regulation in development and treatment. Clinical Social Work Journal 36:9-20.
Eekhoff, J.K. (In Press) Affective Bridges Between Body and Mind. In Trauma and Primitive Mental States: An Object Relations Perspective. New York:NY. Routledge.
Stern, D. (1985) The Sense of a Subjective Self: II. Affect Attunement. In The Interpersonal World of the Infant. (Chapter 7, pp. 138-161). New York, NY: Basic Books
October 16, 2020 — Representation, Introjection, Internalization and Identification I
[54 pages]Young children develop the capacity to symbolize through introjection and internal representation of primary objects. Finding the self in the other requires the child to look for something. Young children discover the me and not me through their identifications with their parents and caregivers. This process requires a psychic movement out and a psychic movement in – much like breathing or the digestive process of taking food in, making use of what is good and then eliminating what is not.
This session will examine the concepts of representation, introjection, internalization and identification and the accretion of an internal object world.
Beebe, B. and Lachmann, F. (1994). Representation and Internalization in Infancy: Three Principles of Salience. Psychoanalytic Psychology, 11(2):127-165.
Anzieu-Premmereur, C. (2013). “The process of representation in early childhood” in Unrepresented States and the Construction of Meaning: Clinical and Theoretical Contributions, H. Levine, G. Reed and D. Scarfone (Eds.) pp240-254.
Optional Reading
Sandler, J. Rosenblatt, B. (1962). The Concept of the Representational World. Psychoanal. St. Child, 17:128-145.
Sandler, J. Sandler, A. (1978). On the Development of Object Relationships and Affects. Int. J. Psycho-Anal., 59:285-296.
October 23, 2020 — Representation, Introjection, Internalization and Identification II
[32 pages]In this session we will examine some particularities about internal object relations when there are difficulties in the child’s constitution and/or deficits in the caregiving context.
Alvarez, A. (2018). The Concept of the Internal Object: Some Defining Features. Psychoanal. Dial., 28(1):25-34.
Meltzer, D. (1975). Adhesive Identification. Contemp. Psychoanal., 11:289-310.
Optional Reading
Alvarez, A. (2006). Some questions concerning states of fragmentation: unintegration, under-integration, disintegration, and the nature of early integrations. J. Child Psychother., 32(2):158-180.
October 30, 2020 — Adoption
[39 pages]Adopted individuals are overrepresented in the clinical population and understanding the unique and complex object relations world set in motion by adoption is necessary when working with patients whose adoption experience reverberates throughout the lifespan. In the modern era, the advent of open adoption has allowed for explicit exploration of the multilayered dynamics of loss, idealization, fantasy, psychic splits and identification in adoption.
de Peyer, J. (2013). Sequestered Selves: Discussion of Adoption Roundtable. Psychoanal. Perspect., 10(1):149-168.
Edwards, J. (2000). On being dropped and picked up: Adopted children and their internal objects. Journal of Child Psychotherapy, 26(3):349-367.
Optional Reading
Freedgood, B. (2013). Loss and Resilience form a family: An adoption story from a relational point of view. Psychoanalytic Perspectives, (10)1:20-41
November 6, 2020 — Dimensionality – Triadic Relations
[39 pages]The movement from one person to two person to three person relating is accompanied by an internal capacity to tolerate more than one thought and relationship at a time. We will discuss the contemporary idea of psychic dimensionality and its relationship to the early ideas of the oedipal situation. We will also explore how ideas of sameness and difference contribute to a capacity to think abstractly.
Edgcumbe, R. Burgner, M. (1975). The Phallic-Narcissistic Phase—A Differentiation Between Preoedipal and Oedipal Aspects of Phallic Development. Psychoanal. St. Child, 30:161-180.
Alvarez, A. (1998). Failures to Link: Attacks or Defects? Some Questions Concerning the Thinkability of Oedipal and Pre-Oedipal Thoughts. J. Child Psychother., 24(2):213-231.
Optional Reading
Klein, M. (1928). Early Stages of the Oedipus Conflict. Int. J. Psycho-Anal., 9:167-180.
November 13, 2020 — Identification and Differentiation – Early Gender and Ethnic/Racial Identity Development
[55 pages]The concept of gender identity development has undergone intense evolution in the past thirty years. We will explore the construct of gender as a process of self and body experience, differentiation, identification, disidentification, complementarity and the capacity for living with contradiction. We will also look at the way in which young children begin to notice, form, use and make meaning of sociocultural concepts of ethnic and racial identity – their own and those of others.
Benjamin, J. (1995). Sameness and Difference: Toward an “Overinclusive” Model of Gender Development. Psychoanal. Inq., 15(1):125-142.
Ehrensaft, D. (2018). “What’s your gender?”, In: C. Bonovitz and A. Harlem (Eds.), Developmental Perspectives in Child Psychoanalysis and Psychotherapy, pp241-262
Van Ausdale, D. and Feagin, J. (1996) Using Racial and Ethnic Concepts: The Critical Case of Very Young Children. American Sociological Review, 61(5):779-793.
Optional Reading
Dimen, M. & Goldner, V. (2011). Ch10, "Gender and Sexuality" in Textbook of Psychoanalysis (2nd Edition), pp133-152.
Person, E.S.; Ovesey, L. (1983). Psychoanalytic Theories of Gender Identity. J. Amer. Acad. Psychoanal., 11(2):203-226.
Fast, I. (1990). Aspects of early gender development: Toward a reformulation, Psychoanalytic Psychology, 7:105-117
Harris, A. (2000). Gender as a Soft Assembly: Tomboys' Stories. Studies in Gender and Sexuality, 1(3):223-250.
Saketopoulou, A. (2018). Holding futurity in mind: Therapeutic action in the relational treatment of a transgender girl. In: C. Bonovitz and A. Harlem (Eds.), Developmental Perspectives in Child Psychoanalysis and Psychotherapy, pp263-282
Corbett, K., Dimen, M., Goldner, V. and Harris A. (2014). Talking Sex, Talking Gender—A roundtable. Studies in Gender and Sexuality, 15(4):295-317.
Park, C. (2011). Young children making sense of racial and ethnic differences: A sociocultural approach. American Educational Research Journal, 48(2):387-420.
November 20, 2020 — Superego Development and Shame
[36 pages]As development progresses, differentiation of self and other and the developing child’s need to negotiate between their own wishes, ideals and their ideas and fantasies about the expectations of important others come under the structure of the developing superego. Affective tone and attunement have a significant effect on the superego. We will consider the superego’s function in affect regulation and the neurobiologic and relational aspects of shame.
Schore, A. (2003). Early Superego Development: The Emergence of Shame and Narcissistic Affect Regulation in the Practicing Period, in Affect Regulation and the Repair of the Self, pp151-186
Optional Reading
Tyson, P; Tyson, R. (1990). Development of the Superego. In Psychoanalytic Theories of Development: An Integration, New Haven: Ct. Yale University Press. pp 207-227
Klein, M. (1948). A Contribution to the Theory of Anxiety and Guilt. Int. J. Psycho-Anal., 29:114-123.