Psy 545 Psychodynamic Approaches to Intervention. David L Downing, PsyD



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PSY 545 Psychoanalytical Theories and Psychotherapy page 1 Psy 545 Psychodynamic Approaches to Intervention ddowning@uindy.edu 317.788.6162: University Office Telephone 312.266.1665: Private Practice Telephone, Chicago [Thursday-Sunday] 317.634.6063, ext 1: Private Practice Telephone, Indianapolis [Monday-Thursday] Mondays & Wednesdays, 1:00-3:15 PM Course Objectives: COURSE OUTLINE AND READINGS 1. This first in a sequence of psychoanalytical courses will integrate psychoanalytical theories of personality and psychopathology with the study of the technique of psychoanalytically-informed psychotherapy. Attention will be given to actual case material and the role of the psychotherapist in psychoanalytically-oriented treatment. The psychoanalytical perspective on the psychotherapeutic process itself will be explored from a variety of viewpoints including the Freudian, the ego psychological, interpersonal, object-relational, Lacanian, and self-psychological. Students will be introduced to basic psychoanalytic concepts of personality and psychopathology and their implications for psychotherapeutic technique. 2. It is imperative that whatever our theoretical orientation, it is necessary for the ethical and professional practice of psychotherapy that we become sensitized to the necessity for careful and thoughtful review of clinical material in order to appreciate the complexity of psychological processes and psychopathology. This will of course necessitate attention to intrapsychic as well as cultural, societal, political, economical, and other environmental factors. Attunement to the vicissitudes of interfacing with patients from diverse cultures, racial origins, sexual orientations, class backgrounds, and other life structures will also be encouraged. 3. It should also go without stating that students enrolled in this course will be encouraged to observe and to reflect upon their own intrapsychic state for the purpose of establishing and maintaining empathic contact with others. This necessitates being attuned to metaphorical, symbolical, and derivative aspects of communications, along with the application of course perspectives to students own experiences. Subjectively, students are encouraged to develop an appreciation for such modes of analysing narrative structures within their own professional practice, as well as the material to be discussed within the course itself. 4. Special attention will be placed on the development of the capacity to formulate clinical hypotheses about psychopathology in a psychotherapeutic interaction from a variety of psychoanalytical perspectives. This implies a dialectical process, and more specifically, a form of praxis. Course Expectations: 1. It is anticipated that all reading be completed prior to class to permit a seminar-style dialogue. 2. In addition to the readings, on a weekly basis, transcripts of an on-going psychoanalytical psychotherapy will be analysed from the perspective of that week s readings. The particular session should be summarized utilising the framework being discussed, i.e. classical drive theory, self-psychology, etc., with appropriate citations given for the authors. These weekly assignments should be no longer than four to six pages. 3. Students will be evaluated by their performance on the above as follows: a) In-class participation and attendance: 20%; b) case formulation assignments: 80%.

PSY 545 Psychoanalytical Theories and Psychotherapy page 2 The format for these assignments will be discussed in class. 4. It is the responsibility of students with special needs to bring these to the attention of the Instructor at the beginning of the Term. 5. The Instructor is in the office Monday through Thursday. Questions and consultations about the Course are invited. Class 1 Course introduction. Psychoanalysis in an historical-political context. Have you driven a Freud lately?: Classical psychoanalytical theory I: Early applications and constructs of psychoanalysis. Freud, Sigmund (1909). Notes upon a case of obsessional neurosis. In The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume 10. London: The Hogarth Press. Mitchell, S & Black, M (1995). Sigmund Freud & the classical psychoanalytic tradition. In Freud & Beyond: A History of Modern Psychoanalytic Thought. New York: Basic Books. Strachey, James (1934): The nature of the therapeutic action of psychoanalysis. International Journal of Psycho-analysis, 15 117-126. Class 2 Psychoanalytical technique within the relational matrix: Important concepts and applications I: Initial contacts and the establishment of the psychotherapeutic frame. Langs, R (1983). The initial contact with the patient, in The Technique of Psychoanalytic Psychotherapy, Vol I, pp 41-220. New York: Jason Aronson. Class 3 Class 4 Class two material, from Robert Langs, continued. Classical Psychoanalytical Theory II: Early applications and constructs of psychoanalytical theory. Freud, S (1913): Further recommendations on the technique of psycho-analysis: On beginning the treatment. The question of first communications. The dynamics of cure. In Ellman, SJ (1991): Freud s Technique Papers: A Contemporary Perspective, pp. 165-192. (1914): Further recommendations on the technique of psycho-analysis: Recollection, repetition, and working through. Ibid, pp 51-64. (1912): Recommendations for physicians on the psycho-analytic method of treatment. Ibid, 153-164. (1917). Mourning and Melancholia. In General Psychological Theory, pp 164-180. Class 5 Psychoanalytical technique within the relational matrix: Important concepts and applications II: Analysing patient narratives; manifest and latent elements of communication; unconscious communication. Langs, R (1983). Understanding the patient s communications, in The Technique of Psychoanalytic Psychotherapy, Vol I, pp 277-364. New York: Jason Aronson. Class 6 Psychoanalytical technique within the relational matrix: Important concepts and applications III: Transference and countertransference. Bion, W (1967). Notes on Memory & Desire. In Langs, R, Classics in Psychoanalytic Technique. New

Page 3 York: Jason Aronson. Bollas, C (1987). Expressive uses of the counter-transference. In The Shadow of the Object. London: Free Association Press. Freud. S (1912). The Dynamics of the Transference. In Ellman, SJ (1991): Freud s Technique Papers: A Contemporary Perspective, pp. 35-50. Class 7 Psychoanalytical technique within the relational matrix: Important concepts and applications III: Transference and countertransference, continued. Freud. S (1915). Observations on Transference-Love. In Ellman, SJ (1991): Freud s Technique Papers: A Contemporary Perspective, pp. 65-80. Heimann, P (1950). On Counter-transference. International Journal of Psycho-analysis, 31, 81-84. Searles, H (1979). Feelings of guilt in the psychoanalyst. In Counter-transference: Collected Papers. New York: International Universities Press. Class 8 Psychoanalytical technique within the relational matrix. Important concepts and applications IV: Dreams and dream interpretation. Bonime, W (1962). Introduction: A dynamic concept of the dream in the therapeutic situation. In The Clinical Use of Dreams. New York: Basic Books. Giovacchini, Peter (1987). Ch 4: Dreams. In A Narrative Textbook of Psychoanalysis. New York: Jason Aronson. Jackson, Basil (1988). Dreams: A Summary of Freud s Dream Theory. Chicago: The Center for Psychoanalytic Study. Loden, S (2003). The Fate of the Dream in Contemporary Psychoanalysis. Journal of the American Psychoanalytic Association, 51(1): 43-70. Class 9 Ego Psychology: The application of evolving psychoanalytical theory and technique. Mitchell, S & Black, M (1995). Ego Psychology. In Freud & Beyond: A History of Modern Psychoanalytic Thought. New York: Basic Books. St. Clair, M (2004). "Edith Jacobson: An integrated model", in Object Relations and Self- Psychology, pp. 108-123. Class 10 New Trends & Special Topics in Psychoanalytical Theory & Psychotherapy I: Working with difference : Treating patients of a different race or class. Psychoanalysis in an Historico-political Context. Downing, David L (2000). Controversies in Psychoanalytic Education: The Issue of Race & Its Relevance in Psychoanalytic Treatment. The Psychoanalytic Review. 87(3): 355-375. Hamer, FM (2002). Guards at the Gate : Race, Resistance, and Psychic Reality. Journal of the American Psychoanalytic Association, 50 (4): 1219-1237. Javier, RA & Herron, WG (2002). Psychoanalysis and the Disenfranchised : Counter-transference

Page 4 Issues. Psychoanalytic Psychology. 19(1) : 149-166. Class 11 New trends and special topics in psychoanalytical theory and psychotherapy II: The British School of Object-Relations I. St.Clair, M (2004). Ch 3: Melanie Klein: Innovative and transitional theorist, pp 36-51. St Clair, M (2004). Ch 4: W.R.D. Fairbairn: A pure object relations model, in Object Relations and Self-Psychology, pp 52-67. Guntrip, Harry (1975): My experience of analysis with Fairbairn and Winnicott--(How complete a result does psycho-analytic therapy achieve?). International Review of Psycho-analysis, 2: 145-156. Class 12 New Trends & Special Topics in Psychoanalytical Theory & Psychotherapy III : Psychoanalytical explorations regarding gender and sexuality. Diamond, MJ (2004). The Shaping of Masculinity: Revisioning Boys Turning Away From Their Mothers to Construct Male Gender Identity : International Journal of Psycho-analysis, 85: 359-380. Halberstadt-Freud, HA (1998). Electra Versus Oedipus: Femininity Reconsidered. International Review of Psycho-analysis, 79: 41-56. Litowitz, B (2002). Sexuality and Textuality. Journal of the American Psychoanalytic Association, 50(1): 171-198. Phillips, SH (2003). Homosexuality: Coming Out of the Confusion. International Journal of Psychoanalysis, 84: 1431-1450. Class 13 New trends and special topics in psychoanalytical theory and psychotherapy IV: The British School of Object Relations II. St Clair, M (2004). Ch 5: DW Winnicott: Paediatrician with a unique perspective. In Object Relations & Self-Psychology, pp 68-86. Winnicott, DW ( 1951): Transitional objects & transitional phenomena: A Study of the First Not-Me Possession. In Winnicott, D.W. (1975). Collected Papers: Through Paediatrics to Psychoanalysis: New York: Basic Books. (1954): Meta-psychological and clinical aspects of regression within the psychoanalytical set-up. Ibid. Winnicott, DW (1960): Ego distortion in terms of true and false self. In Maturational Processes and the Facilitating Environment. New York: International Universities Press, 1965. Class 14 New trends and special topics in psychoanalytic theory and psychotherapy V: American Object-Relations Perspectives Flarsheim, A (1972). Treatability, in Giovacchini, P (Ed.) Tactics and Techniques in Psychoanalytic Therapy, Vol I, pp. 113-131. New York: Jason Aronson. St. Clair, M (2004). Ch 6: Margaret S. Mahler: The psychological birth of the individual. In Object Relations and Self-Psychology, pp 87-107. St Clair, M (2004). Ch 8: Otto Kernberg: A synthesis. In Object Relations & Self-Psychology, pp 124-144.

Page 5 Class 15 New trends and special topics in psychoanalytical theory & psychotherapy VI: Psychoanalytical Self-Psychology. Bader, M & Philipson, I (1980). Narcissism and family structure-- a social-historical perspective. In Psychoanalysis and Contemporary Thought, 3: 299-328. Kohut, H and Wolf, E (1978). The disorders of the self and their treatment: An outline. International Journal of Psychoanalysis, 59: 413-425. St. Clair, Michael (2004). Heinz Kohut: Self-Psychology and Narcissism. In Object Relations and Self- Psychology, pp 145-168. Class 16 New trends and special topics in psychoanalytical theory & psychotherapy VII: The psychoses, borderline states, and the theories of Jacques Lacan. Buie, DH & Adler, G (1981). Definitive Treatment of the Borderline Personality. In Langs, R (Editor). International Journal of Psychoanalytic Psychotherapy, 51-87. New York: Jason Aronson. Grotstein, JS (1989). A Revised Psychoanalytic Conception of Schizophrenia: An Inter-disciplinary Up- Date. Psychoanalytic Psychology, 6(3), 253-275. Turk, CE (2002a). An Introduction to the Thought of Jacques Lacan. Paper Presentation, International Symposium for the Psychotherapy of Schizophrenia, Chicago, Illinois.. (2002b). A Commentary on the Treatment of a Psychotic Patient: Wading Through Blood to the Signifier Can This Be Psychoanalysis? Paper Presentation, International Society for the Psychotherapy of Schizophrenia and Other Psychoses (ISPS), New York, New York. Class 17 Termination. Ferraro, F & Garella, A (1997). Termination as a Psychoanalytic Event. International Journal of Psycho-Analysis, 78, 27-41. Penn, LS (1990). When the Therapist Must Leave: Forced Termination of Psychodynamic Psychotherapy. Professional Psychology: Research and Practice, 21(5), 379-384. Weiner, IB (1998). Termination. Principles of Psychotherapy. New York: John Wiley and Sons. Class 18 There Is No Class Eighteen. Lorque tout est fini, j'entre l'invisible dans l'arche. -- André Breton ( When all is finished, I enter invisible into the arch.) Required Texts: Ellman, Steven J (1991). Freud s Technique Papers: A Contemporary Perspective. New York: Other Books. Langs, Robert (1983). The Technique of Psychoanalytic Psychotherapy, Vol I. New York: Jason Aronson. St.Clair, Michael (2004). Object Relations and Self-Psychology: An Introduction, Third Edition. Belmont, California: Brooks/Cole. Selected books and required readings are available through the University of Indianapolis Book Store as well as reserve and journal sections of the University of Indianapolis Library. All journal articles and papers not available in the Bookstore will be available in the Library, as well as on-line, through the University of Indianapolis Intranet Blackboard.

Page 6 Recommended Readings: Brown, Margaret Wise (1942). The Runaway Bunny. Harper Trophy. De Saint - Exupery, Antoine (1943). The Little Prince. Harcourt, Brace, Javanovich. Freud, Sigmund (1917/1966). Introductory Lectures. New York: WW Norton. Freud, Sigmund (1900/1965). The Interpretation of Dreams. New York: Avon Books. Giovacchini, Peter (ED). Tactics & Techniques in Psychoanalytic Psychotherapy, Vols I, II, III (Various dates). New York: Jason Aronson. Kohon, Gregorio (1986). The British School of Psychoanalysis: The Independent Tradition. London: Free Association Books. Langs, Robert (1990). Classics in Psychoanalytic Technique. New York: Jason Aronson. Moore, BE & Fine, BD (1990). Psychoanalytic Terms and Concepts. New Haven: The American Psychoanalytic Association and Yale University Press. McWilliams, N (1994). Psychoanalytic Diagnosis. New York: Guilford Press. Seuss, Dr. (1960). Green Eggs and Ham. Random House. Winnicott, D.W. (1965). Maturational Processes & the Facilitating Environment.: New York: International Universities Press. (1975). Through Paediatrics to Psycho-analysis. New York: Basic Books. Please note: At the conclusion of the course, or upon withdrawing from this course, each student will be required to return transcripts and poetry to Dr. Downing. Due to the sensitive clinical nature of this material, making copies for personal or professional use or discussion/dissemination with anyone not enrolled in the class is strictly prohibited as outlined in the APA ethical standards.... Hark ye yet again, -- the little lower layer. All visible objects, man, are but as pasteboard masks. But in each event -- in the living act, the undoubted deed -- there, some unknown but still reasoning thing puts forth the mouldings of its features from behind the unreasoning mask. If man will strike, strike through the mask! How can the prisoner reach outside except by thrusting through the wall? To me, the white whale is that wall, shoved near to me. Sometimes I think there s naught beyond. But tis enough. He tasks me; he heaps me; I see in him outrageous strength, with an inscrutable malice sinewing it. That inscrutable thing is chiefly what I hate; and be the white whale agent, or be the white whale principal, I will wreak that hate upon him. Talk not to me of blasphemy, man; I d strike the sun if it insulted me. For could the sun do that, then could I do the other; since there is ever a sort of fair play therein, jealousy presiding over all creations. But not my master, man, is even that fair play. Who s over me? Truth hath no confines.... Ahab, in Chapter 36, The Quarter-Deck from Moby-Dick or, The Whale by Herman Melville