East Bay Intensive Study Group: Untying the K(not)
All therapists have a vision of the “good” patient or therapy — cooperative, trusting, mutually beneficial, and productive. Most of us have also had experiences with the “difficult” patient or therapy, which can feel adversarial, guarded, non-mutual and unproductive. Historically, difficulty in therapy relationships has been seen as the “fault” of the patient, who is conceptualized as resistant to change. As the field has come to encompass the co-constructed crucible of both therapist and patient subjectivities, more has been written about the contribution of the therapist’s inadequacies and vulnerabilities to impasse in psychotherapy.
This course will explore the intersection of patient and therapist when the therapy relationship stalls, implodes, or explodes. How do we understand relational “k(nots)” (Pizer, 2003)? The way some aspect of therapy becomes seemingly impenetrable — who said what to whom, and what was meant. These distressing conversations are often at the heart of a treatment but can feel excruciating. When is a diagnosis of a personality disorder an evacuation of blame, and when is it a useful tool? How might the problem be located in the therapist’s lack of skill or confounding countertransference? What unconscious material is being enacted?
Senior clinicians approach this topic from multiple theoretical perspectives, varying definitions of “difficulty,” and years of clinical experience with working through — or not working through — problematic intersections of subjectivity. Join a group of seasoned colleagues in an intensive study of this topic through reading, didactic discussion, and case presentations.
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- Often, when we feel we have had a "difficult" hour, the difficulty we have had is due to a lack of awareness of our countertransference reaction to our patient. Participants will be able to clarify the countertransference that may have been felt, but not worked with or utilized during the hour and then see where the difficulties arose.
- Impasses, negative therapeutic reactions, and singular difficult sessions occur with regularity and fateful inevitability. Participants will be able to shed light on the multiple ways in which patient-therapist enactments can provoke momentary or sometimes permanent collapses in the analytic relationship.
- Participants will be able to consider counter-transference responses, enactments, and impasses that can occur when working with “difficult couples” and how the couple psychotherapist might use these experiences defensively and/or to promote development and growth in the couple.
The Psychoanalytic Institute of Northern California (PINC), an International Psychoanalytical Association, was established in 1989 as a center for comparative psychoanalytic inquiry, research, and training. PINC provides professionals from all mental health disciplines the opportunity to study the full scope of psychoanalytic theory and practice. For information regarding training or referral for analysis, call (415) 288-4050 or visit www.pincsf.org.
The Intensive Study Groups are designed for mid- to advanced-level clinicians with basic knowledge of psychoanalytic concepts. If you have questions regarding the appropriateness of the study group for you, please call for further information.
Students not admitted due to space limitation will receive a full refund of their deposit. Cancellations prior to Monday, August 25, 2014: Full refund of deposit minus $100 administration charge. Cancellations after Monday, August 25, 2014: No refund provided.
ISG participants are eligible for 12 sessions of consultation with a PINC analyst at $60 per session to help integrate the material into clinical practice.
Administration | registration questions: Michele McGuinness, email@example.com or (415) 496-9949
ISG Program questions: Eric Essman, MA: firstname.lastname@example.org or (510) 486-5853