Process I: Starting a Psychoanalysis; Opening Phase

Third Year Adult Psychoanalytic Training (APT)
2022-23, 1st Trimester — Fridays, 1:45-3:15pm


Introduction

Development Of Psychoanalytic Cases

  • “Analyzability” And Control Cases
  • Engaging The Patient
  • Understanding The Organ System
  • Recognizing Process

When patients are in your office saying whatever comes to their minds about their problems, they are communicating on multiple developmental levels and using multiple modes of expression simultaneously all the time. Influenced by culture and later by training, we tend not to hear all that our patients communicate. Rather, we hear what makes “sense” to us; what fits our preconceived realities and the theories we bring to each patient encounter.

You may think that with their free associations your patients are only describing the external realities of their lives. They are not. Rather, using diverse modes of communication, they are also reacting to the dynamics of their internal world as shaped by their reactions to the developmental crises they experienced.

With their associations and responses to your interventions, patients are informing you about the functional structures within their mind. These are the structures analytic treatment attempts to modify.

Improved object relationships, constructive affect regulation, and creative insight are catalyzed by tuned-in interactions focused on the functional architecture, developmental levels, and current affective and cognitive states of your patient’s mind—not with the facts of your patient’s external reality.

This course is designed to expand your ability to recognize and nurture analytic process. The articles assigned, while focused on analytic concepts and clinical vignettes, are also an entree to sharing your case experiences and the “raw stuff” of clinical interactions, including your understanding and use of clinical intuition. Hopefully, this will be the “meat” of the course: integrating top-down data—what the patient and analyst feel and express—with bottom-up knowledge of how the brain/mind organ system is organized and functions.

Classes

  • Getting to know one another (class 1)
  • Analyzability – a concept in need of updating (classes 2-5)
  • Engaging the patient: the dynamic structure of the brain/mind and analytic process (classes 6-11)

Learning Objectives

Students completing this course will have refined their ability to engage patients in a psychoanalytic process by:

  1. applying knowledge of the impact of multi-modal communications,
  2. assessing the clinical consequences of developmental levels,
  3. considering the clinical impact of subjective space and intuition,
  4. applying the analyst’s capacity for empathy to the brain/mind’s developmental dynamic as expressed in the patient’s communications.

September 9, 2022 — Getting to know one another

What led you to psychoanalytic training?

Why not just psychotherapy training?

What are the goals of psychoanalytic treatment, do they differ from the goals of psychotherapeutic treatment?

Other than goals, what do you think distinguishes psychoanalysis from psychotherapy?

Would you act differently treating a psychoanalytic, as compared to a psychotherapeutic, patient?

What do you make of the changing standards in the psychoanalytic world?

In what direction do you see psychoanalysis evolving over your professional life?

September 16, 2022 — The concept of “analyzabilty”

[31 pages]

Stolorow, R.D. (1990). Converting Psychotherapy to Psychoanalysis: A Critique of the Underlying Assumptions. Psychoanal. Inq., 10(1):119-130.

Rothstein, A. (2006). Reflections on the Concept “Analyzability”;. Psychoanal. Rev., 93(5):827-833.

Busch, F. (2010). Distinguishing Psychoanalysis from Psychotherapy. Int. J. Psycho-Anal., 91(1):23-34.

September 23, 2022 — Creating control cases and immersion

[50 pages]

Levine, H.B. (2010). Creating Analysts, Creating Analytic Patients. Int. J. Psycho-Anal., 91(6):1385-1404.

Ehrlich T.L. (2016) Finding Control Cases and Maintaining Immersion: Challenges and Opportunities. J. Amer. Psychoanal. Assn., 64(5): 983-1012

September 30, 2022 — Trauma and analyzabilty

[46 pages]

Fajardo, B. (1991) Analyzability and Resilience in Development, Annual of Psychoanalysis, 19, 107-126

Coates, S.W. (2016) Can Babies Remember Trauma? Symbolic Forms of Representation in Traumatized Infants. Journal of the American Psychoanalytic Association 64:751-776

October 7, 2022 — Race and analysis: different aspects of transforming a society

[68 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

Leary, K. (2000). Racial Enactments in Dynamic Treatment. Psychoanal. Dial., 10(4):639-653.

Jacobs, L.M. (2014). Learning to Love White Shame and Guilt: Skills for Working as a White Therapist in a Racially Divided Country. Int. J. Psychoanal. Self Psychol., 9(4):297-312.

Gergen, D. (2022) “Becoming the Author of Your Own Life” in Hearts Touched with Fire, Simon and Schuster, pp41-54

Gergen, D. (2022) “ Your Gathering Years” in Hearts Touched with Fire, Simon and Schuster, pp55-77

(The Gergen articles are easy reading.)

October 14, 2022 — The interplay of transferences in the beginning phase

[31 pages]

Bassen, C. (1989). Transference-Countertransference Enactment in the Recommendation to Convert Psychotherapy to Psychoanalysis.  Int. R. Psycho-Anal., 16:79-92

Jacobs, T. (1999). Chapter 2: On Beginnings: The Concept of the Therapeutic Alliance and the Interplay of Transferences in the Opening Phase. The Therapeutic Alliance, 17-33.

October 21, 2022 — Psychoanalytic diagnosis

[49 pages]

McWilliams, N. (2011). Ch2, “Psychoanalytic Character Diagnosis” in Psychoanalytic Diagnosis: Understanding Personality Structure in Clinical Process (2nd Edition), pp21-69.

October 28, 2022 — Objects and psychoanalytic engagement

[33 pages]

Greenspan, S.I. (1977). The Oedipal–Pre-Oedipal Dilemma: A Reformulation According to Object Relations Theory. Int. R. Psycho-Anal., 4:381-391.

Rosenfeld, H. (1983). Primitive Object Relations and Mechanisms. Int. J. Psycho-Anal., 64:261-267.

Ogden, T.H. (1983). The Concept of Internal Object Relations. Int. J. Psycho-Anal., 64:227-241.

November 4, 2022 — Non-linear dynamics and psychoanalytic engagement

[24 pages]

Marks-Tarlow, T. (2015) “The Nonlinear Dynamics of Clinical Intuition”, Chaos and Complexity Letters, 8(2-3):1-24

Levin, R. (2020) “The Global Brain and Psychoanalytic Engagement”, SPSI Scientific Session – May, 2020

November 11, 2022 — Reconsidering psychoanalytic technique

[44 pages]

Singer, J. & Conway, M. (2011) “Reconsidering Therapeutic Action: Loewald, Cognitive Neuroscience, and the Integration of Memory’s Duality”, IJP, 92(5), 1183-1207

Galatzer-Levy, R. (2016) “The Edge of Chaos: A Nonlinear View of Psychoanalytic Technique”, IJP 97:409-427

November 18, 2022 — A revised functional structure of the brain/mind and psychoanalytic process

[59 pages]

Solms, M. (2021) Revision of Drive Theory. Journal of the American Psychoanalytic Association 69:1033-1091

Read from 1055 (middle) to 1064 (middle). (Difficult reading but muddle through.)

Levin, R. (2021) “ Psychoanalysis and the Central Nervous System: The Rules of the Game”, SPSI Scientific Session – May 2021