Thursday, November 8, 2001 * 1:00 pm- 4:15 pm

3.0 Hours

Peter J. Radestock, LLB, PhD, PsyD

Shelley R. Doctors PhD

Gianni Nebbiosi, PhD

William J. Coburn, PhD, PsyD

Jeffrey J. Mermelstein, PhD

The Intersubjective perspective, a powerful lens that illuminates the clinical "field", now has a secure place among psychoanalytic theories. But is it truly understood? Many clinicians have never had an opportunity to systematically study its seminal papers and therefore unable to appreciate the excitement of its enthusiastic adherents. This year we invite seasoned practitioners and newer therapists alike to a careful study of Affects and Selfobjects¹, a contribution that links selfobject experience to the integration of affect into the self organization. Registration will receive and read the paper prior to the conference. The workshop will focus on understanding how the inner patterning of affective experience is shaped and reshaped in specific intersubjective contexts. We will touch on the related issues of development, trauma, and therapeutic action. Case material will them be presented and discussed by participants and workshop leaders.

¹We will study the paper as published in Psychoanalytic Treatment: An Intersubjective Approach (Stolorow, Brandchaft & Atwood, 1987). It is an up-dated version of the original article co-authored by Daphne Socarides Stolorow and Robert D. Stolorow (Annual of Psychoanalysis, 1984/85).

Thursday, November 8, 2001 * 1:00 pm- 4:15 pm

3.0 Hours

George Hagman, CSW, LCSW

Carl T. Rotenberg, MD

This workshop will focus on the self psychological understanding of aesthetics, art and creativity. The afternoon will start with an overview of basic issues accompanied by group discussions. Brief papers on Aesthetic Experience and The Creative Self will be presented. The goal will be for participants to enhance their enjoyment and understanding of art using a self psychological perspective, and to have an opportunity to use this knowledge while viewing photos of artwork by various artists.

Thursday, November 8, 2001 * 1:00 pm- 4:15 pm

3.0 Hours

James L. Fosshage, PhD

Malcolm Owen Slavin, PhD

Stephen A. Mitchell was one of the most creative and prolific writers in contemporary psychoanalysis. While often critical of classical self psychology, his relationship to those ideas and to contemporary self psychology was complex. In memory of Steve and his love of ideas, this workshop will focus on illuminating the differences and similarities between his perspective and that of classical and contemporary self psychology. We will examine some of Steve’s published clinical material as well as several of his illuminating commentaries on cases presented by therapists with a self psychological orientation. The clinical material will serve as a springboard for a wilde-ranging discussion of the relationship between these two contemporary sensibilities–relational and self psychological–and their differences from classical analytic traditions.

Thursday, November 8, 2001 * 1:00 pm- 4:15 pm

3.0 Hours

Beatrice Beebe, PhD

Specific patterns of interactive regulation documented by microanalytic methods of infant research can be applied to clinical interventions with mothers and infants. A brief treatment model is described that includes face-to-face split-screen videotaping (one camera on each partner) and therapeutic observation of the videotape with the parent. The intervention uses "video feedback" informed by a psychoanalytic approach, including positive reinforcement, modeling, and information giving, as well as interpretation, while watching the videotape. Specific interactions in the areas of attention, arousal, affect, and timing regulation are evaluated. The psychoanalytic intervention links the "story" of the presenting complaints, the "story" seen in the videotape, and the "story" of the parent’s own upbringing. An attempt is made to identify specific representations of the baby that may interfere with the parents’s ability to observe and process the nonverbal interaction. The mother’s powerful experience of watching herself and her baby interact, and our joint attempts to translate the action-sequences into words, facilitates the mother’s ability to "see" and to "remember", stimulating a rapid integration of the mother’s procedural and declarative modes of information-processing. Three treatment cases are presented to illustrate the approach. By applying the specificity of interactive regulation identified by microanalysis of videotape into the psychodynamic treatment of mother_infant pairs, basic research can be translated into clinical practice. Videotapes will be used to illustrate various interaction patterns.

Thursday, November 8, 2001 * 1:00 pm- 4:15 pm

3.0 Hours

R. Dennis Shelby, PhD

Sharone A. Abramowitz, MD

Karena Franses, MSW, LCSW

Amanda E. Kottler, MA, Clin Psych

The idea of a workshop on homosexuality and current thinking came from the conversations of Gay and Lesbian clinicians at the Chicago Conference. As you may recall, a similar series of papers was given the last time the conference was in San Francisco. Anticipating the return of the conference to that city, we felt it was time for us to step back and reflect on the current directions and trends of depth psychological work with Gay and Lesbian people. We propose a pre-conference workshop consisting of four papers, responses and discussion The papers will address current topics and either formulations or re-formulations of previous thinking. The proposed papers cover internalized homophobia, sexualization, adult development and clinical encounters when orientations are the same or differ.

1) The Missing Link: Internalized Homophobia and Narcissistic Rage –R. Dennis Shelby ,PhD.

Thursday, November 8, 2001 * 1:00 pm- 4:15 pm

3.0 Hours

Amy H. Eldridge, PhD

Joseph Palombo, MA, LCSW

Eva Rass, MA

Learning disabilities are neurologically-based conditions in which a discrepancy may exist between a person’s competence and performance in specific areas of academic functioning. This discrepancy reflects a deficit in specific areas of neuropsychological functioning such as motor, perceptual, attentional, memory, executive functioning, and verbal and nonverbal language as measured by standardized tests. The relationship between learning disorders and psychological disturbances is complex. Some children are unaffected by their learning disorders. Those who are affected may display academic underachievement, dysfunctional behaviors, or emotional problems. The dysfunctional behaviors may range from the absence of motivation to perform academically to disruptive behaviors at home and in the classroom. The children’s emotional problems may range from low self-esteem or depression to a disorder of the self. In this pre-conference workshop a conceptual framework will be presented that explores the effects of neuropsychological deficits or weaknesses on a child’s development, the factors that give rise to a disorder of the self when a child has such deficits or weaknesses, and the modifications of the treatment process when a child has a learning disorder. Case material will be given to illustrate some of these issues.

Thursday, November 8, 2001 * 7:00 pm - 9:00 pm

2.0 Hours

Friday, November 9, 2001 * 9:00 am - 11:15 am

2.5 Hours

Gary M. Rodin, MD

Samuel O. Izenberg, MD

Jane C. Jordan, LCSW

This course will provide an in depth overview of basic concepts and how relational, intersubjective and motivational systems theory extend, elaborate and alter self psychology. Part I will provide a theoretical overview and Part II will focus on its application to the clinical process, through the examination of therapist-patient interactions and intersubjective experience. The course is suitable for psychoanalysts and psychotherapists interested in a review of concepts, controversies and new developments in self psychology.

Thursday, November 8, 2001 * 7:00 pm - 9:00 pm

2.0 Hours

Frank M. Lachmann, PhD

David M. Terman, MD

Anna Ornstein, MD

This course is based on Frank M. Lachmann’s recent book, Transforming Aggression: Psychotherapy with the Difficult-to-Treat Patient. Lachmann examines and expands Kohut’s contributions to the clinical theory that informs treatment of a range of manifestations of aggression, from reactive to eruptive aggression, from mild annoyance to cold-blooded serial killing. The contributions from motivational systems theory, self- and interactive regulation, and dyadic systems theory are elaborated to develop an expanded view of transference, a critique of countertransference, and to illustrate the therapeutic value of framing interpretations with respect to their leading edge or the trailing edge. In listening to clinical material, recognition of the dialectic between "repetition" and "transformation" is proposed to be of particular value in work with the "difficult-to-treat" patients, specifically with respect to the development of various forms of aversiveness, withdrawal and antagonism, as manifested through rage, contempt or provocativeness.

PRE-CONFERENCE PROGRAM

Friday, November 9, 2001 * 9:00 am - 11:45 am

2.5 Hours (each class)

This course is led by a senior self psychologist. An hour's worth of prepared material, to include some developmental history of the patient, a brief description of what brought that patient into treatment and an outline of how the treatment has progressed will be presented. The majority of the material will be in the form of process notes. The presentation will provide sufficient data to allow for a rich and interesting exchange of ideas between the leader and the participants. The meeting itself will be kept informal and guided by the interests of the participants.

Master Class Leaders: Clinical Case Presenters:

Alan Kindler, MBBS/Shelley Doctors, PhD Amy Joelson, MSW

Marian Tolpin, MD Mitchell D. Liberman, PhD

Joseph D. Lichtenberg, MD Judy Supkoff-Stern, PhD

Anna Ornstein Stan Dudley, PhD

Ruth Gruenthal, MSW/Hazel R. Ipp, PhD Jill Gentile, PhD

Ermest Wolf, MD Robert Lundquist, MS, LMFT

Philip Ringstrom PhD, PsyD/Naomi Malin, DSW Elena Bonn, PsyD

George Atwood, PhD David Klugman, MSW

Sanford Shapiro, MD Hollis McMillan, PhD

Howard Bacal, MD/Estelle Shane, PhD Nancy VanDerHeide, PsyD

Thursday, November 8, 2001 * 7:00 pm - 9:00 pm

2.0 Hours

Friday, November 9, 2001 * 9:00 am - 11:45 am

2.5 Hours

Carla M. Leone, PhD

David Shaddock, MA, MFT

This course will demonstrate approaches to therapy with couples that are informed by self psychology, intersubjectivity, and intersubjective systems theory. The course will provide a basic overview of the fluctuating selfobject needs of adult partners and present a dynamic systems view of relationships that enables clinicians to understand the figure/ground relationship between present day problems and genetic material. Specific topics discussed will include creating a more optimal selfobject milieu, the empathic listening stance, dealing with trauma and applying infant research to couples. The course will make extensive use of videotaped case material and will include small group discussions of participants’ cases.

Thursday, November 8, 2001 * 7:00 pm - 9:00 pm

2.0 Hours

Friday, November 9, 2001 * 9:00 am - 11:15 am

2.5 Hours

Rosemary A. Segalla, PhD

Damon L. Silvers, PhD

Bruce S. Wine, PhD

This pre-conference course will teach participants about the application of self psychological principles to group psychotherapy. The underpinnings for the workshop are based on the theoretical advances developed by Drs. Segalla, Silvers, and Wine which emerged from twenty years of experience in co-conducting group therapy from a self psychological perspective.

The program is designed to teach and apply Kohutian, intersubjectivity, and motivational systems theory to group psychotherapy. Further advances also to be taught include the application of infant research to group therapy models, the multiple selfobject model, and groupobject theory (Segalla, 1997). In addition to the theoretical presentations, there will be a demonstration group designed to highlight a co-therapy model of treatment and the range of intervention strategies from a self psychology perspective. A combined treatment approach utilizing both individual and group therapies will be explicated as a model which proves optimally responsive environments. Ample clinical case material will be presented, including case material from the presenters and supervision/consultation with the presenters.

Friday, November 9, 2001 * 1:15 pm - 3:45 pm

2.5 Hours

Sheldon J. Meyers, MD

Judith C. Pickles, PhD

Jeremy Nahum, MD

Howard A. Bacal, MD

Frank M. Lachmann, PhD,

Panel I concerns the issue of enhancing the therapeutic exchange. A case is presented and then discussed from the Boston Research on Change Perspective and the Specificity Theory Perspective. These perspectives on therapeutic process are them compared and contrasted with one another.

Friday, November 9, 2001 * 4:15 pm - 5:15 pm

1.0 hour (each session)

This conference session is designed to allow small groups to discuss the material presented in Panel I with an experienced self psychologist. The Post Panel Discussion Groups will allow the participants to ask questions and to clarify their understanding of the material presented in the panel and to make comments about their thoughts regarding the panel.

Henry Friedman, MD Franco Paparo, MD

Mark Gehrie, MD Jeffrey Seitelman, MD

Andrew Morrison, MD Bruce Herzog, MD

Samual Izenberg, MD Lester Lenoff, MSW

Donna Orange, PhD, PsyD Wolfgang Milch, MD

Robert Leider, MD Philip Ringstrom, PhD, PsyD

David Solomon, MD Sandra Hershberg, MD

Salee Jenkins, PhD Richard Rosenstein, MD

John Lindon, MD Sandra Palef, PhD

Midge Breslin, MEd Gary Taerk, MD

David Terman, MD Taras Babiak, MD

Estelle Shane, PhD Amy Eldridge, PhD

Saturday, November 10, 2001 * 8:30 am - 10:30 am

2.0 Hours

Hans-Peter Hartmann, MD

Margaret Black, CSW

Marian D. Tolpin, MD

Gianni Nebbiosi, PhD

Panel II further elaborates the issue of enhancing the therapeutic exchange. The same case presented in Panel I is discussed from the Relational Perspective of Stephen Mitchell and the Self Psychology Forward Edge Perspective. These perspectives are then compared and contrasted with one another.

Saturday, November 10, 2001 * 11:00 am - 12:00 pm

1.0 hour (each session)

These conference sessions are designed to allow small groups to discuss the material presented in Panel I with an experienced self psychologist. The Post Panel Discussion Groups will allow the participants to ask questions and to clarify their understanding of the material presented in the panels and to make comments about their thoughts regarding the panels.

James Fisch, MD Katie Breckenridge, PhD

Paula Fuqua, MD James Scott, MD, PhD

Rukhsana Bukhari, MBBS Joan Lang, MD

Jule Miller, MD Sandra Keirsky, PhD

Brenda Solomon, MD Joseph Jones, MD

Jill Gardner, PhD Susan Kushner Scott, MSW

Allen Siegel, MD Sally Howard, PhD

Bernard Brickman, MD Amanda Kottler, MA

Sanford Shapiro, MD Judith Levene, PhD

Maxwell Sucharov, MD Tessa Phillips, MA

Ronald Bodansky, PhD Craig Powell, MB BS

Leonard Gilman, MD Jane Jordan, LCSW

Saturday, November 10, 2001 * 1:00 Pm - 2:00 pm

1.0 hour

Arthur Malin, MD

In this presentation, I will review developments in psychoanalytic theory and practice over the past fifty years. I will present these changes in terms of my own perspective, and based upon my own experience, demonstrating my personal involvement with American Psychoanalysis as it evolved, beginning with ego psychology, into popular interest in Melanie Klein, Object Relations Theory, both British and American, Self Psychology, Intersubjective Theory and Relational Theories. My focus in particular will be on the special significance of Self Psychology in the theoretical evolution I experienced, and I will offer some ideas about the angry character of the debates that surrounded these developments. The role of the psychoanalytic organizations in the Southern California area will be highlighted as exemplifying nationwide trends in the field.

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

Donna M. Orange, PhD, PsyD

Bernard Brickman, MD

Within the relational envisioning of psychoanalysis, important questions have emerged concerning the compatibility or incompatibility of the empathic understand so treasured by self psychology and the authentic participation championed by relational analysts more indebted to the interpersonalist and Kleinian traditions. Does remaining close to the patient’s emotional perspective require the analyst to become dishonest or inauthentic? Or conversely, does authentic participation require an emotional distance incompatible with empathic understanding? Here I will argue for a clinical sensibility and theoretical/philosophical orientation that renders authenticity and empathy not only compatible but necessary to each other. This solution proceeds not by an appeal to dialectic, paradox, or shifting listening perspectives, but rather by questioning the assumptions that create the apparent opposition.

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

Lester Lenoff, MSW

Mark J. Gehrie, PhD

This paper will focus on elaborating Kohut’s first section - An Examination of the Relationship Between Mode of Observation and Theory (pp. 205-212). This section embodies: (1) Kohut’s crucial assertion, that "we designate phenomena as ... psychological if our mode of observations includes ...[vicarious introspection] as an essential constituent. (P.209, emphasis original); and (2) his operational description of "vicarious introspection" the means by which we come to understand and an explanation of the patient’s introspective reports and external behavior. The implications of Kohut’s operational framework for practice, some of which I will illustrate, remain, in ways that bear restatement and elaboration, both distinctively self psychological and instructive for all psychoanalysts.

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

Richard M. Childs, MD

Judith Rustin, MSW

In 1948 Heinz Kohut gave a classical psychoanalytic interpretation to Thomas Mann’s 1911 novella Death in Venice. A re-examination of this celebrated story from a selfobject perspective provides a more useful insight into the central character and into its author’s lifelong attraction to other men. The concept of homolimerent selfobject experience is introduced as a distinct entity that merits attention.

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

Henry J. Friedman, MD

Stuart D. Perlman, PhD

The ability to utilize the relationship between patient and psychoanalyst as the source of therapeutic action is dependent upon both changes in technique and theory. Conflict theory with its accompanying technical rules of neutrality, anonymity and abstinence explicitly forbids the development of a real relationship between analyst and patient. In order for a relationship to be considered real, the analyst has to participate authentically; this implies access to his or her feeling states and their honest inclusion in the process of analysis. Classical psychoanalysis imposes distinct restrictions on the analyst’s verbal participation in the process while self psychology insists that the patient’s subjectivity be considered supraordinate to the analyst’s subjectivity. As such, the resultant relationship is drained of the needed presence of the analyst’s self with its subjectivity and experience disclosed in the course of the analysis. This paper attempts to demonstrate the way in which the elimination of the analyst’s uniqueness deprives patients of essential relational experience which is, in itself, primary and necessary for achieving therapeutic change.

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

Jerome S. Biegler, MD

Maxwell S. Sucharov, MD

Clinical examples of intuition, empathy, subliminal perception and non-conscious communication are used to narrate the author’s development of skill in recognizing his visual and affect countertransference responses, thereby fostering merger transferences that are clinically effective. On the premise that psychoanalysis is currently secure enough to tolerate an intellectual evaluation of the "uncanny" as another type of non-conscious communication, the extra-sensory experiences of the author, colleagues and Freud are reviewed.

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

James L. Fosshage, PhD

Carol A. Munschauer, PhD

Ronald A. Bodansky, PhD

Patients of extreme nihilism and aversiveness are most difficult for all analysts, for they relentlessly devalue and denigrate the analyst and analysis. Not only do these treatment situations require an analyst’s survival (Winnicott, 1949, 1958), but they also require an analyst to find a way to engage the patient to reflect on, understand, and, when combined with co-creating new relational experience, gradually transcend the nihilism and aversiveness. The treatment to follow (CAM was the analyst and JLF was the consultant) concerns a man of deeply intractable nihilism and aversiveness (Lichtenberg, 1989; Lichtenberg, Lachmann and Fosshage, 1992, 1996) and serves as an example of a person for whom, without new understanding and reformulation and expansion of traditional analytic technique, psychoanalytic treatment would not have been possible. Often in these most difficult treatment cases a consultant is required to steady the analyst in the face of intense devaluation and inevitable discouragement. In this case, we understood the patient’s nihilism to reflect a profound hopelessness and despair about obtaining the necessary relational nutrients of life, based on a history of extreme emotional deprivation. We also understood that the patient’s extensive nihilism and aversiveness provided an impenetrable protection against hope, relational engagement, and expected painful failure in others’ responsiveness. Finally, we understood that the patient had developed a characteristic aversive style that enabled him to disavow feelings of relational need and associated feelings of weakness and to bolster as well a sense of self-sufficiency and strength. In an attempt to delineate the facilitating analytic interaction (Bacal, 1998; Fosshage, 1997), we focus specifically on the shifting needs of the patient as expressed in different forms of relatedness. We describe the analyst’s listening/experiencing perspectives and the variable requisite disclosure of the analyst’s own experience. We also briefly discuss the term "enactment".

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

Bruce Herzog, MD, FRCP(C)

Estelle Shane, PhD

Using three case examples I have attempted to demonstrate the importance to therapists of observing two distinct levels of interaction: the procedural level, a dimension of action, and the symbolic level, mediated by language. It is in the predominately non-verbal, procedural realm where we learn about relationships in our early years, and it continues to be an important arena of interaction throughout our lives. The ability to translate our experiences into symbolic form develops later on, when we learn to convert what is known at the procedural level into representative words. When the therapist conveys understanding of the patient at a procedural level, he is engaging in what I call a procedural interpretation, which can provide the patient with procedural insight - that is, an experience of understanding within a realm that does not require the use of language. Procedural insight is a necessary adjunct to the symbolic insight conveyed by traditional interpreting, and is likely the focus of much of what is mutative in psychoanalysis. Thus, symbolic interpretation gains validity by a procedural interpretation being communicated either concurrently of preceding it. In addition, because spoken language carries many non-verbal components which communicate information to the patient, I suggest that all symbolic communications carry an implicit procedural message. Further, symbolic interpretations are most effective when the patient has a selfobject need to have meaning given to their procedural experiences - referred to as an "explaining" selfobject experience.

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

David W. Krueger, MD

Alan R. Kindler, MD

A patient’s selfobject functions and relationship with a symptom are discussed. Using action symptoms involving substances and activities, the defensive, symbolic, and restitutive aspects of actions symptoms are illustrated with case material. Developmental disruptions of body self and psychological self intergration manifest in defensive and compensatory use of action symptoms, and present with unique challenges in the clinical exchange.

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

Meryle H. Gellman, PhD

Arthur A. Gray, PhD

The following paper describes a successful case history of a teenage girl who manifested symptoms of anorexia nervosa during the initial phase of treatment. I describe the treatment strategies and interventions that spontaneously evolved while mediating multiple relationships including the parents, physicians and nutritionist. I then elaborate on the clinical details and theoretical nuances (including aspects of self psychology, specificity theory and linear open systems theory) which played a decisive role in an outcome of this case, ending with a discussion and conclusion of a reiteration of my role and development of a model utilizing multiple sources of input for change.

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

Joseph D. Lichtenberg, MD

William J. Coburn, PhD, PsyD

A dynamic process view of transference as unconscious and conscious expectations is presented as the basis for understanding the communicative value of transference configurations during analysis. Then using a clinical observation, the mode of transference communication that some patient’s present through bodily experience rather than words is discussed. Lastly, the question "why talk" is considered given the significance of non-verbal, pre-symbolic, implicit forms of communication.

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

Part I of II

Paul H. Ornstein, MD

Axel Joneck, MA

In this highly autobiographical novel Dostoevsky describes the severe traumata of his incarceration in a penal colony in Siberia. His highly introspective observations and his acute in-depth observations of his fellow-inmates provide us a unique entry into the lives of those who suffered untold physical and emotional degradations as well as the ability of some, to survive reasonably unscathed.

Saturday, November 10, 2001 * 2:15 pm - 3:45 pm

1.5 Hours

Charles B. Strozier, PhD

Tessa Philips, BSc, MA

This session will explore the intriguing ways the life of Heinz Kohut merged with his theories of psychology. Charles B. Strozier, author of the recently published biography, Heinz Kohut; The Making of a Psychoanalyst (Farrar, Straus & Giroux, 2001) will discuss themes from the life and work of Kohut. Tessa Philips, a self psychologist from Australia will make some observations on the book and raise questions for Strozier and the audience. There will be plenty of time and space for participants ro raise their own questions and engage in a lively dialogue about the ideas and life of the creator of self psychology.

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

Daniel Shaw, CSW

Jane C. Jordan, LCSW

The psychoanalytic profession universally condemns intimate involvement with analysands at the level of sexual enactment, yet other forms of intimacy – in particular, love– are less easy to classify and codify in terms of their place in our theory and practice. This may be why few psychoanalytic writers take love in the analyst/analysand relationship as their central theme. I suggest that psychoanalytic theories that see love as primary and as crucial to development call for clinical theories that makes use of the analyst’s emotional responsiveness to the analysand, and that the analyst‘s capacity to love authentically, in ways that are mutually self-enhancing, is of particular relevance in this context. I review the theme of analytic love in the work of Ferenczi, Suttie, Balint and Fairbairn; and follow with an assessment of the impact of the work of Loewald and Kohut, and several contemporary theorists, on the place of analytic love in our theory and practice today.

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

Julia M. Schwartz, MD

Robert D. Stolorow, PhD

Amy H. Eldridge, PhD

We conceptualize a primal sense of sensorimotor integrity–a pre-symbolic sense of one’s physical being as inviolable–taking form in early in infancy. We present a clinical case demonstrating the lastingly traumatic impact of early shattering of sensorimotor integrity.

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

THE DISCOVERER OF EMPATHY:

William Ulwelling, MD, MPH

Sandra G. Hershberg, MD

Edith Stein was one of the most highly praised students of Edmund Husserl, whose work in the early 20^th century began the phonemenologist school of philosophy. Doctor Stein’s summa cum laude doctoral dissertation was On the Problem of Empathy. This phenomenological study foreshadowed many current developments in self psychology and intersubjective theory. Defended in 1916, her dissertation was so ahead of its time in the study of empathy that I have dubbed her "The Discoverer of Empathy." Doctor Stein’s work provides philosophical underpinning for the importance of empathy, not merely as an important quality of a successful self psychologist, but rather as a fundamental human phenomenon, we are also saying that she brought new awareness to absence of empathy. The Holocaust – and the vignette of Dr. Josef Mengele’s execution of Edith Stein at Auschwitz – offers insight into the fundamental role of suppression of empathy in the "problem of evil."

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

Peter Buirski, PhD

Pamela E. Haglund, PsyD

Sandra M. Kiersky, PhD

In this paper we apply the theory of intersubjectivity, as articulated by Stolorow, Atwood, Brandchaft and Orange, to the process of supervision. In doing so, we illuminate the mutually influencing subjectivities of the supervisor, supervisee and patient. As a reflection of an intersubjective understanding of the contextual nature of subjective experience, we address the developing professional identity and self-organization of the supervisee. In addition, we explore the mutual regulation of affect that underlies the intersubjective field. We discuss the potential for supervision to transform organizations of experience for supervisor, supervisee and patient alike. We also highlight how the supervisor’s theory, her experience of the patient and the supervisee, and her sense of responsibility to train and to evaluate the supervisee influence the process of supervision. The paper includes numerous vignettes from supervision and treatment to illustrate the continual and unremitting mutual influence of subjectivities operating in the intersubjective field of supervision.

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

Doris Brothers, PhD

Sheldon J. Meyers, MD

This paper represents an attempt to make sense of our preoccupation with and denial of death from the standpoint of "intersubjective uncertainty regulation," a concept that draws on self psychology as well as intersubjective theory. Using this perspective, Kohut’s profound insight that "it is not death we fear, but the withdrawal of selfobject support in the last phase of our lives" is expanded beyond unidirectional connotations. An alternative to Freud’s understanding of the uncanny and his jaundiced view of those who believe in ghosts and spirits is proposed. The role played by movies in helping viewers come to terms with death is examined and the movie, Ghost, is considered in detail. An illustrative clinical example involves a patient who experiences great difficulty in accepting the death of her mother. Her fascination with the movie, Ghost, provides a means for understanding how the intersubjective regulation of uncertainty in the face of death shaped her self-experience.

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

Dorienne Sorter, PhD

Joseph M. Jones, MD

Attachment theory has as a central premise that infants require a secure base to which they can return in times of danger. Attachment researchers have categorized different attachment patterns in children, including an avoidant pattern that seems to have organizational stability over time. The person with an avoidant pattern has learned that the parent needed to provide a secure base is not available when needed or is a source of fear. The expectation that the analyst will re-traumatize the patient, causes difficulty in early stages of an analytic treatment. This paper provides a case example of an adult patient with an avoidant attachment pattern. Relevant research from infant, cognitive, and attachment research is cited. The discussion demonstrates the usefulness of utilizing the diagnostic category from attachment research, and combining infant research, cognitive science and self psychology in treatment of a patient with an avoidant, dismissive attachment pattern.

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

Anna Ornstein, MD

Paul H. Ornstein, MD

Martha M. Slagerman, PhD

Critiques of empathy, as a mode of listening, consider empathy as limiting the range of what the analyst can encompass of her own associations to the patient’s material, making reflective awareness difficult or impossible. A further limiting factor is considered to be the fact that in order to establish and maintain an empathic listening perspective, the analyst has to make an effort to de-center from her own subjectivity; such effort, the critiques maintain, can only interfere with the analyst’s authenticity and genuine engagement in the treatment process. Other obstacles to empathy may be the analyst’s expectable countertransference reactions. The questions is: Do these facilitate or retard the analyst’s capacity to grasp the patient’s psychic reality? We shall attempt to answer the question: How can we claim the need for prolonged empathic immersion in the patient’s inner world and, at the same time, not impose artificial limits to our own subjectivity which could jeopardize the authenticity of what ought to be an intimate human encounter?

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

Stan T. Dudley, PhD

Todd F. Walker, PsyD

Gianni Nebbiosi, PhD

Psychoanalysis has evolved beyond Freud’s concept of the selfless analyst, who on the theoretical grounds, had to remain neutral. Current theory and clinical practice emphasizes the paramount importance of the analyst’s human presence and participation in the treatment. However, there is a glaring lack of consensus regarding authenticity and the role it has in the treatment process. This paper will critically examine the current emphasis on authentic therapist self-expression as the primary way of providing missing selfobject experiences and transformative moments, which seems to devalue the importance of working in the interpretive mode. A case presentation will illustrate how therapist subjectivity can be transformed into interpretive responses that promote an empathic and experience-near therapeutic encounter.

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

Howard A. Bacal, MD, FRCP(C)_

Steven Stern, PsyD

While phantasy has traditionally been linked with the mental representation of the instincts and addressed in psychoanalytic treatment as a defensive function, it is by no means limited to these activities. This paper describes how phantastic - in effect, creative - aspects of what Kohut identifies as selfobject experience can centrally contribute to an idealization of the analyst that may not only enable the patient to forestall self-fragmentation but can also provide the basis for a relationship that promotes essential analytic work. The author draws particularly upon Winnicott’s formulations of illusion and transitional phenomena in the elaboration of this idea.

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

Maxwell S. Sucharov, MD

Judith Blackstone, MA

This paper articulates a balanced and general approach to the inclusion of spiritual issues in our analytic work. A framework for a spiritual phenomenology is developed that is process oriented, embraces a qualified contextualism, and reflects the complementary poles of transcendence and immanence. A dialogic integration with the intersubjective perspective yields an integrated spiritual/psychological model that embraces a view of the analytic encounter as a dialogic process where optimal emotional growth occurs in the context of a deeply evolving spiritual awareness. The specification of invariance as a variable parameter of restraint on the dialogic process introduces a qualification to intersubjectivity theory’s relentless contextualism. This qualification specifies limiting conditions to contextual restraint and the invariant organizing principles that inform a given context. A case discussion will illuminate the clinical application of the proposed spiritual/psychological model.

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

Mardi J. Horowitz,MD

Christine C. Kieffer, PhD

A clinically based theory of self organization, relational organization, and character development will be presented. Persons schemas theory will be the basis for a discussion of character integrity, and character formulation. Also, control of emotional states by regulation of role relationship models will be reviewed, in relation to conscious and unconscious mental processes. The pertinence to clinical technique will be presented in case vignettes.

Saturday, November 10, 2001 * 4:15 pm - 5:45 pm

1.5 Hours

Steven H. Knoblauch, PhD

Malcolm O. Slavin, PhD

This workshop will be a freewheeling discussion of the contents of Dr. Steven Knoblauch’s new book, The Musical Edge of Therapeutic Dialogue published by The Analytic Press. The musical edge is a focus of attention that shifts from the semantic meanings of an utterance to the acoustic dimensions that are characterized more particularly in terms of rhythm, tone and turn-taking. This focus includes the contributions of both analyst and analysand. Attention to music of dialogue makes available for observation, the later verbal recognition, a continuous emergent process of forming into. In this process, meanings and affects are not yet discrete forms or structures. The performance of jazz is a metaphor capturing the improvisatory and interactive dimension of this perspective.

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Gary Grenell, PhD

James L. Fosshage, PhD

It is the author’s position that the decision of when to terminate analysis has long been underpinned by a theory-driven criterion model, which may steer the analytic dialogue away from its customary activities of free association, empathic listening and interpretation. As a remedy to this situation, the author proposes that by paying careful attention to less consciously crafted patient communications, such as the dream, the analytic dyad gains a perspective from which to observe the state of readiness to set a termination date that is context-sensitive and less encumbered by a set of preordained criteria. Tracing the dreams of one analysand from the vantage point of contemporary dream theory, the author demonstrates how through careful attention to the dream, the patient’s readiness to terminate and her complex feelings about the termination process can be more clearly elucidated. Finally, the author challenges the notion that the termination phase is of greater evaluative than therapeutic importance, and provides the clinical material presented in the present paper as evidence that this is not the case.

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Susanne M. Weil, LCSW

Rosalind Chaplin Kindler, MFA

This presentation will discuss extramarital affairs as attempts to achieve wholeness, integration and the resumption of detailed development. I will make the case for viewing these relationships from the subjectivity of the patient rather than from an experience-distant stance that pathologizes the patient. In my presentation, affairs are presented as attempts to heal early traumatic experiences and can require both the lover and the therapist in the process. I will review some of the literature on adultery and present case material of Claire, a patient engaging in an extramarital relationship.

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Loretta Baylay, BA

Ronald R. Lee, PhD

Nancy S. Wolf, MD

As a number of our female private patients described interactions with envious mothers, we explored mother-daughter envy from a self psychological point of view. This exploration led to our belief that excessive envy develops in a non-attuned mother-daughter intersubjective context, and when the daughter’s loosening of the bond with the mother triggers the mother’s envious behavior and increases the mother’s need to distress and humiliate her daughter. Treatment seeks to empathically understand the mother’s imposed twinship experiences of distress, shame, disgust and dissmell on the daughter, and to facilitate a patient’s twinship experiences of interest and joy.

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Hideki Wada, MD, PhD

Wolfgang E. Milch, MD

Through the use of two case examples, this paper illustrates how two key contributions made by Heinz Kohut--identification of twinship selfobject needs and emphasis on empathy as a mode of observation--have particular relevance to psychotherapy for the elderly. Elderly patients often view themselves as very different from their therapists, especially when their therapists are far younger and healthier than they are. In such situations, which can set the stage for therapeutic impasses, the establishment of a twinship tie can be a very powerful therapeutic agent, and empathy as a mode of observation can be an important tool for investigating and understanding the elderly patient’s subjective world. The paper concludes with a discussion of the differences between self psychology and traditional psychoanalytic theory in terms of their advantages in providing psychotherapy for the elderly. Attention is given to the relevance of Kohut’s ideas on dependency needs to psychotherapy for the elderly.

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Scott M. Davis, MD

Jack H. Kohl, MD, FRCP(C), ABPN

Despite its roots in the study of the expression of psychic distress in bodily symptoms, psychoanalysis has been of limited benefit in the treatment of psychosomatic conditions. Factors that have influenced and hindered the psychoanalytic approach to somatization and psychosomatic conditions are reviewed. Self psychology has viewed psychosomatic states as reflecting developmental arrests due to traumatic failures in affect attunement; such states are commonly seen in treatment with the disruption of and restoration of a selfobject transference. But how can we approach the patient whose only subjective distress is physical and who does not express any emotional discomfort except for physical pain and disruptive havoc caused by the psychosomatic symptom itself? A developmental systems self psychological approach, with emphasis on the clinical implications from the fields of developmental neurobiology and dynamic systems are explicated. A case of a patient with intractable migraine headaches is presented which illustrates how and why this approach can access and reorganize a sub-symbolic mode of organization of experience locked in an enduring somatosensory state of mind.

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Mark D. Smaller, PhD

Joseph Palombo, MA, LCSW

This clinical presentation focuses upon an aspect of the self psychological perspective on adolescent development as contrasted with the classical perspective. The central but not only concern of the adolescent is working through severe and mild inevitable disappointment and disillusionment with admired others and one’s self. This working through allows the integration of ambitions and ideals creating a strong and cohesive self. Three clinical examples describe the transformation of this theoretical perspective to specific technique.

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Jill Gentile, PhD

Sanford Shapiro, MD

This presentation describes a transitional intersubjective space, defined as the location where me-not me and you-not you experience meet in dialectical interplay. After considering Winnicott"s conceptions of transitional experience (and Ogden’s interpretation of Winnicott"s conceptions towards an understanding of the intersubjective subject), contemporary conceptions of intersubjectivity and thirdness are discussed. It is proposed that the shift towards a dialectical or transitional I-ness involves a transformation of the nature of both subjectivity and of reality, and that here, in place of the transitional object, the transitional subject comes into being. Clinical illustrations are provided and discussed with reference to the transformation of semiotic capacity, phenomenology, and reality. Possible developmental precursors are discussed. Specific reference is made to the transformation of the location of the real and the dialectic between private and public.

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Masayo Isono, PsyD

Ruth Gruenthal, MSW

Otto Rank’s name has been more or less absent from the psychoanalytic world for a long time. This paper reconsiders his theories from the point of view of self psychology. Rank’s theory of self and its development, his theory of object relations an the human emotions that are the motivating force behind human relationships are discussed. His position on treatment technique is also examined. Finally, to illustrate his ideas and concepts, Anais Nin’s journal entries about her analysis with Rank are explored.

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Part II of II

Paul H. Ornstein, MD

Axel Joneck, MA

In this highly autobiographical novel Dostoevsky describes the severe traumata of his incarceration in a penal colony in Siberia. His highly introspective observations and his acute in-depth observations of his fellow-inmates provide us a unique entry into the lives of those who suffered untold physical and emotional degradations as well as the ability of some, to survive reasonably unscathed.

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Edward McCrorie, PhD

Jane C. Jordan, LCSW

Estelle Shane, PhD

It is universally acknowledged that the fabric of psychoanalytically oriented psychotherapy is woven of many threads consisting primarily of ghosts of the patient’s past. From an intersubjective standpoint the analyst’s own personal ghosts pervade the analytic hour, figures who hover on the edge of the therapeutic dyad and who have played - or continue to play - a role in the professional life of either the patient or the analyst. Such figures include the analyst’s supervisor, whose invisible presence often occupies considerable space in the treatment room. While self psychology has addressed the issue of the supervisor/consultant (Fuqua et al.), the impact of other ghosts remains relatively unrecognized. The referral source, for example, may constitute an omnipresent figure in the treatment, potentially adding an extra burden on the analytic dyad. Likewise, the subject of the previous therapist as ghost has not been accorded sufficient attention in the self psychological literature. The significance of concurrent other therapists –e.g. group and couple (Dasteel), body workers and alternative healers, clergy and spiritual leaders –also merits inclusion in this investigation. Be they from past or present, these figures can haunt the mid of the analyst, the patient, or both, thereby complicating the transference-countertransference mix. For each member of the dyad, the ghostly presence may range from idealized helper to competing or retraumatizing other. This workshop proposes to explore these issues and to assess their impact on the treatment situation.

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Susanna Federici Nebbiosi, PhD

James T. Scott, MD

This paper illustrates the impact of Infant Research on the developmental view of self psychology as well as on a number of different psychoanalytic theories. According to the author, classical concepts like primary narcissism, symbiosis and authistic phase are becoming obsolete under the impact of infant/mother interactions studies – these studies show how the infant is very competent and extremely active in promoting interactions with the mother and very different from the authistic infant ipothesysised by a number of classical theories (Freud, Kline, Mahler and even Winnicott). A particular attention is given in the paper to the Kohutian concept of "merger" showing how the selfobject can be better understood as "the other as a REGULATOR of the self" instead of "the other as a PART of the self". Some theoretical and clinical proposals are done for a new self psychological understanding of the "symbiotic" phenomenology (both healthy and pathological).

Sunday, November 11, 2001 * 8:30 am - 10:00 am

1.5 Hours

Russell A. Meares, MD

Joseph D. Lichtenberg, MD

This session touches upon aspects of my book Intimacy and Alienation in which self is conceived as a particular form of consciousness which is analogous to an "inner conversation". The role of "the double" in the creation of this form of consciousness, appearing first at about four years of age, is briefly described. Traumatic disruption of this state are understood, in terms of Hughlings Jackson’s hierarchial model of mind. These states of consciousness involve an interpersonal "alienation" and systems of memory which are early in an evolutionary sense. Therapy is based, in part, on the idea that "there is no such thing as a state of consciousness" since this state always arises in the context of a particular form of relatedness.

Sunday, November 11, 2001 * 10:30 am - 12:30 pm

2.0 Hours

Bernard Brickman, MD

Harold Sampson, PhD

Jeffrey L. Trop, MD

William J. Coburn, PhD, PsyD

Panel II concludes the elaboration of enhancing the therapeutic exchange. The same case presented in Panel I is discussed from the Control Mastery Perspective and from Nonlinear Dynamic Systems Perspective. These perspectives are them compared and contrasted with one another. Finally, all six perspectives introduced in the three panels are compared and contrasted.
   

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