Adult Psychoanalytic Training (APT)
2019-20, 1st Trimester — Fridays, 3:30-5:00pm
Donald Schimmel, PhD
Table of Contents
Introduction
In the first part of this course, you will become conversant with key concepts and terminology derived from post-Freudian ego psychology as it was originally elaborated by Heinz Hartmann, Anna Freud and others. For example, you will gain an understanding of what Hartmann referred to as the average expectable environment, autonomous ego functions, secondary autonomy, intersystemic and intrasystemic conflict, and the conflict-free sphere. You will also become versed in the multitude of defense mechanisms (as enumerated by Anna Freud) that the ego utilizes to defend itself from forbidden id-wishes and impulses. Moreover, you will become acquainted with ego psychology’s influence on psychoanalytic technique. For instance, you will learn what Kurt Eissler meant by parameter and what should be done when the analyst deviates from classical technique. Additionally, you will learn Leo Stone’s perspective on why the analyst deviates from classical technique as a developmental necessity for some patients. Moreover, you will learn about Charles Brenner’s perspective on how the ego is in continuous inter and intrasystemic conflict, and how the ego’s conflict can lead to compromise formation.
In the second part of this course, you will become conversant with key concepts taken from American Object Relations Theory. We begin with chapters from Jay Greenberg and Stephen Mitchell’s seminal book, "Object Relations in Psychoanalytic Theory." In these chapters, you will acquire a working knowledge of two deeply divergent models of object relations theory: Freud's drive model, in which object relations with others are determined by the individual's need to satisfy primary instinctual drives, vs. a relational model in which interpersonal needs with real people, including the analyst, are considered as important if not more important than endogenously derived drives. For example, to set the stage, you will read and discuss authors whose theories have drawn heavily from interpersonal psychoanalysis and studies involving infant observation. Also, you will learn how Harry Stack Sullivan significantly influenced the shape and direction of American Object Relations Theory. Specific key concepts that you will learn and become conversant with are self-system,dynamisms, personifications, Prototaxic, Parataxic and Syntactic experience, as well as Sullivan’s theory of anxiety. Additionally, you will become knowledgeable about and conversant with W. Ronald D. Fairbairn’s object relations theory. Fairbairn’s theory is considered to be a radical departure from Freud and ego psychology and is foundational to understanding contemporary relational theory.
In the third part of the course you will acquire an understanding of Joseph Sandler’s contributions to American Object Relations Theory. For example, you will learn to distinguish between such evocative concepts as introjection and identification; representation and image; self-representation and object-representations. You will also become knowledgeable about Sandler’s theory of how the ego constructs a representational worldfrom the original undifferentiated sensorium of the infant. You will learn about Sandler’s theory of the importance of affect, e.g., safety as the central motivational force in the internal world of the infant, hence supplanting instinctual drives as primary indicator of behavior. You will also be introduced to Sandler’s theory of role-responsiveness and how this concept is a precursor to today’s concept of countertransference-enactment.
In the final part of this course, you will become conversant with Hans Loewald’s theory of motivation and therapeutic action. For example, you will learn what Loewald meant when he wrote that the analyst was a newobject for the patient. In addition, you will acquire knowledge of how Otto Kernberg has developed a contemporary psychoanalytic theory of drives, integrating this theory with contemporary affect theory and with psychoanalytic object relations theory. Finally, you will become familiar with the views of Nancy Chodorow, who provides an example of current theorizing founded on some of the historical developments we will have studied this term. For instance, you will learn what she means by intersubjective ego psychology. These final two weeks of the term are intended to bring us to current applications of ego psychological thought and to set the stage for subsequent theory classes in Self and Relational and Intersubjective theories.
Please begin your reading for each week by reading through the corresponding week’s summaries below. This will help orient you to key points in the reading and the flow of the course overall.
Learning Objectives
At the end of this course, Clinical Associates will be able to:
- define key concepts and terminology from seminal papers in American psychoanalysis, laying the foundation for better clinical outcomes through clearer communication during clinical consultation;
- trace the key dimensions along which American psychoanalytic theory developed over the course of the 20th century, improving clinical outcomes by fostering a broader understanding of alternative clinical approaches and the thinking behind them; and,
- consider current applications of ego and object relations theories in American psychoanalysis, place them in historical context, and incorporate them into their developing clinical approaches, thus enhancing clinical acumen and introducing additional clinical options for optimizing outcomes.
September 13, 2019 — Overview of Ego Psychology and Anna Freud
[54 pages]Before beginning the first week’s reading, please read the overview of the course and the learning objectives for the course.
Wallerstein, R.S. (2002). The Growth and Transformation of American Ego Psychology. JAPA, 50(1):135-168.
In this paper, Robert S. Wallerstein presents an historical overview of ego psychology and its transformation from a mostly structural and intrapsychic model to a set of modern theories that incorporate interpersonal and relational dimensions. This is an important article as it outlines much of what we’ll be discussing in the bulk of this course. While many of the names and concepts may be unfamiliar to you, they will be repeated and illustrated throughout the course. Read it broadly as a preview of coming attractions or as a road map for the next several weeks, with a plan to understand it in greater depth as the course proceeds. Begin to acquaint yourself with the development of ego psychological thinking and the streams of emerging psychoanalytic thought that Wallerstein describes as “cracks in the monolith” of ego psychology’s hegemony in America.
Freud, A. (1946). Chapter 1 in The Ego and the Mechanisms of Defense, International Universities Press, New York. pp3-10.
Freud, A. (1946). Chapter 5 in The Ego and the Mechanisms of Defense, International Universities Press, New York. pp54-65.
This is Anna Freud’s first major contribution to psychoanalytic theory. Her book is considered by many to be the cornerstone of Ego Psychology. Building on her father’s late-career work, she laid the foundations for the systematic study of defenses and their development with ego psychology. Drawing on her direct observation of children and her experiences in child analysis, Anna Freud places defense, and the experience of danger, within a developmental context. She sets out a general theory of technique and defense analysis. Attention is focused on recognizing and interpreting the various ways in which the patient’s ego defends itself against forbidden wishes.
Optional Reading
Freud, A. (1981) The Concept of Developmental Lines—Their Diagnostic Significance. Psychoanalytic Study of the Child 36:129-136.
We will not be discussing this article in class, but the term and the concept of Developmental Lines is one you will likely encounter again later in training.
September 20, 2019 — Early Ego Psychology
[49 pages]Hartmann, H. (1950). Comments on the Psychoanalytic Theory of the Ego. PSC, 5:74-96.
Rangell, L. (1965). The Scope of Heinz Hartmann—Some Selected Comments on his Essays on Ego Psychology an Appreciative Survey on the Occasion of his 70th Birthday, IJP, 46:5-30.
Heinz Hartmann was the leading North American Freudian/Ego Psychological theorist of the 1940s and 50s. He produced a series of theoretical and clinical works that provided the framework for American ego psychology from the 40s through the 70s. Hartmann aimed to develop psychoanalysis in to a “general psychology,” one that would account not only for neurotic psychopathology but for “normal” psychology and the healthy ego as well.
In pursuit of this goal, the ego psychologists added considerably to Freud’s model of the mind. New concepts introduced included the self, the conflict-free sphere, and the adaptive functions of the ego. Alongside Freud’s libidinal and aggressive drives Hartmann proposed what he called “primary neutral energy” as a motivational force driving non-conflictual behavior and experience, and he suggested that intrasystemic conflict as well as conflict among the three psychic structures played an important role in the life of the mind.
During this week we will also consider the analytic diaspora from Europe and the impact of ethnic trauma and sociocultural context on the development of American psychoanalytic thought. Emily Kuriloff, who spoke at SPSI last spring, has published a powerful book on this topic, entitled, “Contemporary Psychoanalysis and the Legacy of the Third Reich” (Routledge, 2014).
September 27, 2019 — Early Modifications and Shifts in the Psychoanalytic Stance
[68 pages]Eissler, K.R. (1953). The Effect of the Structure of the Ego on Psychoanalytic Technique. JAPA, 1:104-143.
Stone, L. (1954). The Widening Scope of Indications for Psychoanalysis. JAPA, 2:567-594.
We now look in more detail how “classical” ego psychology was practiced in its American heyday, and how contemporary thinkers from within this model thought about analytic technique and dealt with patients presenting for analysis who appeared to fall outside the (then-believed) ‘scope of analysis.’ In this context, Kurt Eissler inaugurated the concept of “parameters,” his term and technique regarding deviations from the classical analytic approach, while Stone presents a very realistic look at how treatment progressed with “non-ideal” patients and his belief that what Eissler thought of as parameters were often necessary aspects of analytic treatment.
Optional Reading
Eissler Notes
Provided by Don for discussion today.
October 4, 2019 — Modern Conflict Theory/Modern Structural Theory
[37 pages]There are two major strains in modern structural theory, the “heir” of ego psychology: one is Charles Brenner; the other is the close process resistance analysis developed by Paul Gray and Fred Busch (whom you read last year). In this seminar we have chosen to focus on Brenner and provide Gray’s most important article as optional reading.
Brenner, C. (1994). The Mind as Conflict and Compromise Formation. JCP, 3(4):473-488.
Brenner, C. (2002). Conflict, Compromise Formation, and Structural Theory. PAQ, 71(3):397-417.
Charles Brenner offered a radical revision of ego psychology, and was a central figure in modern conflict theory and compromise formation. Brenner was known for his attempts to strip away unnecessary and anachronistic accretions of meanings in our terms and theories. He moved away from Hartmann’s ideas about autonomous ego functions and the conflict-free sphere; as he developed his approach to affects and conflict resolution he came to his conviction that the concept of compromise formation was superior to the structural theory. Brenner ultimately argued that we should abandon the tripartite theory and its concepts of id, ego and superego because these terms erroneously separate and disconnect the components of conflict in the mind. His stance was that all of mental life is based in conflict.
Optional Reading
Gray, P. (1990). The Nature of Therapeutic Action in Psychoanalysis. JAPA, 38:1083-1096.
Paul Gray represents what might be described as a model of classical ego psychology. Since a patient’s resistance provides a map of the ego’s defensive strategies, the analysis of resistance was central to the ego psychological approach. Paul Gray argued that there was a developmental lag in technique that resulted from ignoring Anna Freud’s emphasis on defense analysis, and introduced the powerful development in the technique of ego psychology known as close process monitoring and later close process attention, which prescribes careful attention to the defensive aspects of the transference. Gray recommends staying attuned to the surface of any analytic hour, providing experience-near material and enlarging the focus on consciousness and ego, and the patient’s awareness of how their mind was functioning.
October 11, 2019 — The turn from a drive based theory of relations with Objects to an evolving Interpersonal/Relational based theory
[49 pages]Greenberg, J. and Mitchell, S. (1983). Introduction and Chapters 1 & 2 in Object Relations in Psychoanalytic Theory, Harvard University Press. pp1-49.
Jay Greenberg and Stephen Mitchell have written a scholarly review of Object Relations Theory. They begin by defining Freud’s use of the term Object and how the Object is built into the drive from the outset. From there the authors introduce two models of object relations theory: The drive-structure, and, later in the book, the structure-relation model.
October 18, 2019 — Child Development and the Turn to Object Relations Theory
[45 pages]Contributions from infant research led to a belief in the indissoluble integration of drives and object relations; affects are not simply discharge manifestations of drives but sustained tension states that represent the drive derivatives embedded in the relationship between self and object. A greater focus on early pre-oedipal stages of development influences the beginning of object relation theorizing.
Joseph Sandler is viewed as one of the modernizers of structural theory. He was trained in Anna Freud’s Hampstead Clinic, and brought some core ideas from the Kleinians into contact with ego psychology. He focused on developing clinical theory, and on establishing a closer relationship between theory and clinical practice. He felt the idea of “object cathexis” (conceiving of an object relationship as the energic investment of an object), was inadequate, moving instead towards object relations theory. His reformulation of clinical theory made it easier to join together a variety of psychoanalytic ideas. He also looked at the motivational power of relationships with others, on the one hand, and of affective states, prototypically feelings of safety (and its absence) on the other. He calls for a place for object relations and affects in motivational theory.
Sandler, J. Rosenblatt, B. (1962). The Concept of the Representational World. PSC, 17:128-145.
Sandler, J. (1976). Countertransference and Role-Responsiveness. IRP, 3:43-47.
Sandler, J. (1985). Towards a Reconsideration of the Psychoanalytic Theory of Motivation. BAFC, 8(4):223-244.
Optional Reading
Greenberg, J. and Mitchell, S. (1983). Ch9, "Margaret Mahler" in Object Relations in Psychoanalytic Theory, Harvard University Press, pp270-303.
October 25, 2019 — Object Relations in America
[15 pages]American Object Relations reflect the influence of both Sullivan and Fairbairn, and represent the shift wherein object relations replace Freud’s drives as the major motivational system. Included in this evolution in theory is a shift from the emphasis on intrapsychic aspects of the transference to a heavy emphasis on the mutual influence of transference and countertransference and the reality aspects of the relationship derived from the analyst’s personality.
Ogden, T.H. (1983). The Concept of Internal Object Relations. Int. J. Psycho-Anal., 64:227-241.
Ogden is an American (San Francisco) psychoanalyst who represents an updated approach based on earlier work by Fairbairn and Melanie Klein.
Otto Kernberg (whom we will read later in the trimester) is also an important figure in the American Object Relations tradition.
Optional Reading
Ogden, T.H. (2010). Why read Fairbairn? IJP, 91(1):101-118.
Ronald Fairbairn is one of the members of the British Middle School, along with Donald Winnicott, Michael Balint (Hungarian-born), and others. All three of these authors are credited with moving Object Relations Theory from a traditional drive or one-person-psychology to a relational or two-person-psychology.
November 1, 2019 — American Interpersonalism
[44 pages]Greenberg, J. and Mitchell, S. (1983). Chapter 4, “Interpersonal Psychoanalysis” in Object Relations in Psychoanalytic Theory, Harvard University Press. pp79-105.
Levenson, E.A. (1992). Harry Stack Sullivan: From Interpersonal Psychiatry to Interpersonal Psychoanalysis. CPS, 28:450-466.
Sullivan was the chief proponent of interpersonal psychoanalysis and the founder of the William Alanson White Institute. Interpersonal psychoanalysis takes as its base the belief that all psychological phenomena are interpersonal in origin (essential human needs are needs for satisfaction and needs for security replacing Freud’s drive theory). Sullivan stands unique among early analytic theorists, in that he also considers the sociocultural context (most especially around issues of class AND culture) as a foundational aspect of psychoanalytic understanding. Proponents of modern day object relations in the US claim Sullivan and Sullivan’s cohort as their early roots. Sullivan’s thinking also had a profound influence on relational psychoanalysis. Stephen Mitchell, a leading proponent of object relations and relational theories, questioned whether drive theory and object relations theory are mutually exclusive.
November 8, 2019 — Bridging the gap between ego psychology and object relations theory
[28 pages]Loewald, H.W. (1960). On the Therapeutic Action of Psycho-Analysis. IJP, 41:16-33.
Loewald, though retaining the language of classical ego psychology, significantly moved it in the direction of a two-person psychology. Loewald’s ideas (here outlined in his landmark article) were the major impetus for the gradual movement of many analysts toward object relational ideas. He argued for the idea of the analyst as a new object for the patient, and his ideas are often described as a bridge to incorporating object relations within ego psychology. He is a key figure representing the shift to a postmodern sensibility in psychoanalytic theory.
Chodorow, N.J. (2018). Love, respect, and being centered Upon: Loewald’s image of development in childhood and the consulting room. The Psychoanalytic Study of the Child, 71:224-233.
In this article, Chodorow highlights what she feels are the unique contributions Loewald’s perspective brought to the evolution of psychoanalytic thinking. She points out that Loewald brought a more patient-centered perspective focused on the patient’s individuality, with greater attention paid to preoedipal issues and the oscillation between preoedipal and oedipal configurations. She also comments on the attention Loewald paid to the inclusion of women in analytic thinking, and thus the way in which he laid a path toward psychoanalytic feminism well in advance of its formulation.
Optional Reading
Cooper, A.M. (1988). Our Changing Views of the Therapeutic Action of Psychoanalysis: Comparing Strachey and Loewald. PAQ, 57:15-27.
Cooper’s article places Loewald’s idea in context by comparing the approaches of Strachey and Loewald.
November 15, 2019 — Integrations and Current Thought
[47 pages]Busch, F. (2013). Transforming the Under-Represented: The Unacknowledged Influence of Ego Psychology. CJP, 21(2):292-312.
Chodorow, N.J. (2004). The American Independent Tradition: Loewald, Erikson, and the (Possible) Rise of Intersubjective Ego Psychology. PD, 14(2):207-232.
Chodorow, N.J. (2018). Nancy J. Chodorow on “The American Independent Tradition: Loewald, Erikson, and the (Possible) Rise of Intersubjective Ego Psychology”. PEP/UCL Top Authors Project, 1(1):23. (video)
Optional Reading
November 22, 2019 — Integrations and Current Thought (con’t)
[50 pages]Kernberg, O. (2001) Object Relations, Affects, and Drives: Toward a New Synthesis. Psychoanalytic Inquiry 21:604-619
Otto Kernberg was trained as a Kleinian but has primarily worked in ego psychology and achieved the greatest level of integration between part of the Klein-Bion model, object relations, and the modernizers of structural theory. His developmental sequence borrows from Edith Jacobson and Margaret Mahler. He views the individual’s internal worlds as an amalgam of attachment needs, self and object representations, and the associated affects. He explains behavior as a consequence of the projection onto the external world of aspects of the internalized representational world. His basic assumption is that all internalizations of object relationship with significant others, from the beginning of life on, have different characteristics under the conditions of peak affect interactions and lo affect interactions.
Blum, H.P. (2010). Object Relations in Contemporary Psychoanalysis: Contrasting Views. CPS, 46(1):32-47.
Harold Blum, also an American Object Relations theorist, argues for a psychoanalytic approach which focuses primarily on intrapsychic and transference manifestations over here and now patient-analyst interactions that are deemed to be co-constructed. He asserts that interpretations derived from relationally-oriented object relations theory overemphasizes the here and now relationship of the patient and analyst and neglects the origins of the patient’s psychopathology.
Blum, H.P. (2016). A Psychoanalytic Odyssey. Am. Imago, 73(4):417-434.
Optional Reading