Fourth Year Adult Psychoanalytic Training (APT)
2020-21, 1st Trimester — Fridays, 12:00-1:30pm
Píyale Cömert, PhD
Table of Contents
Hello and welcome. It is my pleasure to welcome you to the first trimester of your first year at SPSI and to your first class meeting.
The Psychoanalytic Listening course is a preparation for the mixed Continuous Case Conference classes you will be attending every trimester over the next four years of didactics and continue attending till your graduation, after you complete the course work. Starting the Winter trimester of this year, you will be in a Case Conference every term comprised of some clinical associates from your own cohort and some from the cohorts ahead of you. In those classes, one clinical associate will present throughout the trimester and the rest of the classmates will discuss the case in order to learn to listen-to-learn, discuss what they hear, formulate what may be going on with the patient presented and within the analysis, and learn from each other. This course is structured slightly differently.
One aspect of this course is the review of some concepts that are useful in listening to clinical material and in formulating a case. Analytic listening differs from ordinary listening in a variety of ways and takes place on multiple levels. It is the cornerstone of what we do in our interaction with patients and it is an essential part of the analytic stance. Towards that end, at the beginning of each class meeting, I will review some analytic concepts we can keep in mind as we hear one of you present your work with a patient of your choice.
Unlike case conferences in the future where one clinical associate will present throughout the trimester, during this class each person will present for only one or two weeks. We will set up the presentation schedule during our first meeting. Because there are more of you than weeks in the trimester, only some of you will be able to present. Even though we will only have time for one of you, all of you please give some thought to presenting during part of our first meeting on 9/11/20.
The majority of our class time during the trimester will be spent hearing one of you present your work with a patient while the rest of us listen. Our group discussion of the case may include transference, countertransference, developmental themes, motivations, affective themes, conflicts and defenses, attachment styles, enactments, verbalized and nonverbal cues that give us clues about the analytic process, and how we envision responding to the patient.
A case conference is not a forum to be competitive, critical of each other’s work, or demonstrate how clinically astute we are. Neither is it meant to be supervision of the presenter’s work. Case conference is the opportunity to hear each other’s thoughts about a case, about the unfolding process, to think about alternative ways of understanding the interaction between the patient and the analyst, and to contemplate a variety of ways one could respond analytically. It is an opportunity to think out loud clinically. Our job as a group is to attend, notice, get confused, ask questions, wonder, share, formulate, think flexibly, be humble, and be open to differing views. We have to remember that the presenter and the patient are doing us all a big favor by generously sharing their process with us to benefit our learning.
We will go over the ground rules together during the first class meeting such as strict confidentiality, not discussing the clinical material outside the classroom, etc.
Another goal of the course is to start developing your individual identity as an analyst and your identity as a cohort by getting to know and trust each other. Your support for and collaboration with each other as you go through your training is the main ingredient in determining how well you learn, what your educational experience will be like, and how you form your analytic identity as a clinical associate and a graduate analyst. How we listen, hear, and respond to each other in this course will take you closer to that goal.
An implicit aspect of your years at SPSI as clinical associates and later as faculty is that you all come to this endeavor with a wealth of professional and life experiences. You have a lot to offer as well as to learn. Respecting and utilizing each other’s varied backgrounds, experiences, expertise, and viewpoint will make this course richer for all of us.
The fact that we are not in a room together in person adds, by now, a rather familiar challenge to our interaction. To help us all participate and engage in the process, I may call on specific people to hear their views on what we are discussing. This is an invitation rather than pressure for you to speak. Please feel free to decline and speak at a time of your choice.
I like to start each class I teach by reading a poem. Sometimes I am fortunate enough to locate a poem that has direct relevance to what we discuss and sometimes I am not. Regardless, hearing a poem read out loud and giving it some thought as a group is likely to put us all in a more receptive and reflective mode.
I have consulted the following materials in preparing for this class.
- Abbasi, Aisha. (2012). A very dangerous conversation: The patient's internal conflicts elaborated through the use of ethnic and religious differences between analyst and patient. International Journal of Psychoanaysis, 93(3): 515-534.
- Akhtar, Salman (Ed.). Listening to others. Lanham: Jason Aronson (2007).
- Akhtar, Salman. Psychoanalytic listening. London and New York: Routledge (2013).
- Arnold, Kyle. (2006). Reik’s theory of psychoanalytic listening. Psychoanalytic Psychology, 23(4): 754-765.
- Atlas, Galit, Aron, Lewis. Dramatic dialogue. Routledge, London and New York. (2018). (Chapter 3: Dramatic Dialogues. Chapter 7: At-one-ment, mutual vulnerability, and co-suffering).
- Cooper, Steven H. (2017). The Analyst’s “use” of theory or theories: The play of theory. Journal of the American Psychoanalytic Association (JAPA), 65(5): 859-882.
- Egit, Esin. (2020). ”I’ve never been that traditional domestic Turkish woman”: Self, culture, and the dissociative mind. Contemporary Psychoanalysis, 56:1, 57-86.
- Ehrlich, Lena Theodorou. (2004). The analyst’s reluctance to begin a new analysis. JAPA, 52(4): 1075-1093.
Ehrlich, Lena Theodorou. (2013). Analysis begins in the analyst’s mind: Conceptual and technical considerations on recommending analysis. JAPA, 61(6): 1077-1107.
- Felman, Shoshana. (1982). Psychoanalysis and education: Teaching terminable and interminable. Yale French Studies, (63), 21-44.
- Fosshage, James L. (2011). The use and impact of the analyst’s subjectivity with empathic and other listening/experiencing perspectives. Psychoanalytic Quarterly, 80(1): 139-160.
- Fosshage, James L. (2011). How do we “know” what we “know”? And change what we “know”. Psychoanalytic Dialogues,21 (1): 55-74.
- Freud, Sigmund. (1958). Recommendations to physicians practicing psycho-analysis. In: J. Strachey (Ed. and Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 12, pp. 111-120). London: Hogarth Press. (Original work published 1912).
- Grossmark, Robert. (2018). The Unobtrusive relational analyst and psychoanalytic companioning. In De-idealizing relational theory. London and NewYork: Routledge. (2018). (Read with Maroda, 2020),
- Hanoch, Esther. (2006). The loudness of the unspoken: Candidates’ anxiety in supervision. Psychoanalytic Perspectives, 3(2): 127-146.
- Harris, Adrienne. (2007). The house of difference: Enactment, a play in three scenes. In Relational Psychoanalysis (Vol. 3 New Voices. 81-95)
- Heimann, Paula. (1950). On counter-transference. International Journal of Psychoanalysis, 31:81-84.
- Hoffman, Irwin Z. (1996). The intimate and ironic authority of the psychoanalyst’s presence. The Psychoanalytic Quarterly, 65:102-136.
- Holmgren, Bengt. (2005). Reports and brief communications: Two ways of listening to the patient. Scandinavian Psychoanalytic Review, 28(2): 110-114.
- Ivey, Gavin. (2000) A listening-formulating model for psychoanalytic psychotherapy. Psychotherapy, 37 No 1, 22-35.
- Kaufman, Judith. (2006). Candidates’ anxiety in supervision: A discussion. Psychoanalytic Perspectives, 3(2): 147-157.
- Kitsen, Jane. (2008) Listening to people who do not speak: attachment, communication, and meaning in working with disabled adults and children. Attachment: New directions on psychotherapy and relational psychoanalysis. Vol 2, March 2008, 56-61.
- Langs, Robert. (1978). The listening process. New York: Jason Aronson.
- Lister, Elena; Kravis, Nathan; Sandberg, Larry; Halpern, Jeffrey K.; Cabaniss, Deborah L., and Singer, Meriamne B. (2008). “I write to know what I think”: A four-year writing curriculum. JAPA, 56(4); 1231-1247.
- Luiz, Claudia. (2018). The making of a psychoanalyst. London and New York: Routledge.
- Makari, George, and Shapiro, Theodore. (1993). On psychoanalytic listening: Language and unconscious communication.JAPA, 41:991-1020.
- McLaughlin, James T. (1991). Clinical and theoretical aspects of enactment. JAPA, 39:595-614.
- McWilliams, Nancy. Core competency two: Therapeutic stance/Attitude. In Roy E. Barness (Ed.), Core competencies in relational psychoanalysis. Routledge: London and New York. 2018.
- Maroda, Karen J. (2020). Deconstructing enactment. Psychoanalytic Psychology, 37(1); 8-17. (read with Grossmark, 2018)
- Pizer, Stuart. Core competency three: Deep listening/Affective attunement. In Roy E. Barsness (Ed.), Core competencies of relational psychoanalysis. Routledge: London and New York. 2018.
- Safran, Jeremy (2011). Theodor Reik’s “listening with the third ear” and the role of self-analysis in contemporary psychoanalytic thinking. Psychoanalytic Review, 98(2), April 2011.
- Sandler, Anne-Marie. (1988). Comments on therapeutic and counter-therapeutic factors in psychoanalytic technique. Bulletin of the Anna Freud Centre, 11:3-13.
- Schwaber, Evelyne Albrecht. (1996). The conceptualization and communication of clinical facts in psychoanalysis: A discussion. International Journal of Psychoanalysis, 77:235-253.
- Schwaber, Evelyne Albrecht. (2005). The struggle to listen: Continuing reflections, lingering paradoxes, and some thoughts on recovery of memory. JAPA, 53(3): 789-810.
- Tummala-Narra, Pratyusha. Considering culture from a psychoanalytic perspective. In Roy E. Barsness (Ed.), Core Competencies in Relational psychoanalysis. Routledge: London and New York. 2018.
- Winnicott, Clare. (1964). Development towards self-awareness. Unpublished lecture included in: Kanter, Joel. (2004). Face-to-face with children: The life and work of Clare Winnicott. London: Karnac.
By the end of this course, the students will be able to:
- Identify psychoanalytic themes when listening to case presentations (such as varieties of unconscious communication, intrapsychic levels, and areas of affective meaning) for the purpose of discussing cases with peers and colleagues.
- Describe the subjective experience of clinical encounters to peers and instructors, in order to elicit exploration of psychoanalytic process.
- Identify and verbalize empathic responses, identifications, countertransference reactions, and affective responses when hearing clinical material with the goal of making substantial contributions to discussions.
- Improve their presentation and listening/discussing skills, more accurately formulate psychoanalytic cases, contributing to meaningful diagnostic assessments, determination of most effective evaluation and treatment approaches early in treatment.
September 11, 2020 — Listening to ourselves and each other
We will begin to know each other. We will review ground rules for the course, getting oriented to SPSI and training, and scheduling your presentations. We will begin to think about conditions in which we listen to our patients. What does it mean to listen analytically? How do we create the space for our patients to speak?
September 18, 2020 — Developing a psychoanalytic stance
We listen to get acquainted with our patients’ worlds. What do we pay attention to as we listen? How do we organize and prioritize the information we hear?
September 25, 2020 — Unconscious Communication
[Class ends at 12:45pm due to the CAAO meeting.]
Patients communicate with more than words. We will consider nonverbal communication, levels of communication, and manifest and latent content. Why do we pay attention to the unconscious?
Brown, L. (2012). "Countertransference", in Textbook of Psychoanalysis, Gabbard, G. O., Litowitz, B. E., & Williams, P. (Eds), Washington, DC: American Psychiatric Pub., pp79-92
October 2, 2020 — Unconscious Communication (cont.)
The concepts of dream-work and primary process offer us ways to think more about intrapsychic activity and unconscious communication. What purposes are served by these operations? How do we organize the subtext of what we hear?
October 9, 2020 — Countertransference Dynamics
*The mid-term class evaluation will be conducted during this session. Please use these questions to facilitate your discussion: Midterm Evaluation 2019-02-13
Countertransference, once thought of as a problematic, incidental intrusion, is now considered a central feature of psychoanalysis. We will review several concepts of countertransference. What is the role of the analyst’s life experience?
October 16, 2020 — Traditional Concepts of Listening, Current Notions
The psychoanalytic canon presents ideals of neutrality, abstinence, and optimal distance. Do these ideals still influence us? Do we hold onto certain ideals for our own reasons? What is the current thinking about how we listen?
October 23, 2020 — Representations of Self and Others
As we refine and organize our listening, we begin to pay attention to how patients describe their object relations – who is doing what to whom.
October 30, 2020 — Across Cultural Boundaries
[Class ends at 12:45pm due to the CAAO meeting.]
When we are working with someone from a different culture than our own, how do we listen? What is the role of our need to know? Can we tolerate ambiguity and not-knowing, yet maintain our commitment to be present with our patients?
November 6, 2020 — Attachment styles and fragmented presentation
(Class ends at 12:45pm due to the CAAO meeting.)
The quality of coherence and integration in a patient’s presentation is an important source of information. How do we notice and assess this quality? How do we respond to the implications of what we hear?
Winnicott, D.W. (1949). Hate in the Counter-Transference. Int. J. Psycho-Anal., 30:69-74.
Epstein, L. (1977). The Therapeutic Function of Hate in the Countertransference. Contemp. Psychoanal., 13:442-460.
Coen, S.J. (2003). The Thrall of the Negative and How to Analyze it. J. Amer. Psychoanal. Assn., 51(2):465-489.
Davies, J.M. (2004). Whose Bad Objects Are We Anyway? Repetition and Our Elusive Love Affair with Evil. Psychoanal. Dial., 14(6):711-732.
Fosshage, J.L. (2005). Moments of Therapeutic Impasse: Commentary on Jody Messler Davies's “Whose Bad Objects Are We Anyway? Repetition and Our Elusive Love Affair with Evil”. Psychoanal. Dial., 15(5):759-769.
I am following up with some articles about feelings of “hate” in the analyst with the hope that you may find some helpful ideas in them to develop your own perspective, whenever you choose to read them.
November 13, 2020 — Listening through our own filters and theories
Our own selves—our own lives and identities—constitute our “listening instrument”. How do we account for the influence that we ourselves have on what we hear and how we hear? As we finish this course, how are we thinking about analytic process?
November 20, 2020 — CAAO Symposium
No class due to the CAAO Symposium from 12:00 – 1:30 pm.