PAVING PARADISE AND
PUTTING UP A PARKING LOT:
The Inability to Learn from Experience
How can we make contact with a patient who feels unreachable, unavailable, or under attack when any attempt at contact shuts the patient down or moves the patient away instead of towards the therapist?
The unconscious strategies — employed by fragile patients in service of reaching safety — take a huge toll on a patient’s inner world. When emotional contact itself feels dangerous, the patient is left either feeling actively bereft or, at their core, not alive. Ultimately, this internal process challenges the treatment itself.
In this course, we will examine the unconscious defense strategies that patients employ to manage unbearable pain. We will examine the theoretical underpinnings of these strategies looking at autistic and dissociative defenses as well as feelings of deadness, the claustrum, and the work of the negative. Case material will serve as a springboard for thinking about strategies to enliven these patients in our clinical work.
At the conclusion of this course participants will be able to:
- Analyze and describe a way to think about the way that emotional growth can be hindered through the use of various unconscious defensive strategies.
- List the differences between autistic defenses, dissociative defenses and feelings of deadness.
- Explain the key psychoanalytic ideas of Winnicott and link it to moments in their own clinical work when a patient feels unable to make use of the therapist.
- Discuss and use Andre Green’s concept of the work of the negative in the therapeutic setting.
- Assess and compare the three different variations of the claustrum.
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Cohen, E, S. Chazan, M. Lerner, et al. (2010). Posttraumatic play in young children exposed to terrorism: An empirical study. Infant Mental Health Journal, 31(2), 159–181. doi: 10.1002/imhj.20250.
Høglend, P, K. Bøgwald, S. Amlo, et al. (2008). Transference Interpretations in Dynamic Psychotherapy: Do They Really Yield Sustained Effects? American Journal of Psychiatry, 165(6), 763–771. doi: 10.1176/appi.ajp.2008.07061028
Muran, J. C, J. D. Safran, B. S. Gorman, et al. (2009). The relationship of early alliance ruptures and their resolution to process and outcome in three time-limited psychotherapies for personality disorders. Psychotherapy: Theory, Research, Practice, Training, 46(2), 233–248. doi: 10.1037/a0016085
Ryum, T, T. C. Stiles, M. Svartberg, et al. (2010). The role of transference work, the therapeutic alliance, and their interaction in reducing interpersonal problems among psychotherapy patients with Cluster C personality disorders. Psychotherapy: Theory, Research, Practice, Training, 47(4), 442–453. doi: 10.1037/a0021183.
Reyna Cowan, Psy.D., LCSW, is a psychoanalyst, a personal and supervising analyst at PINC, and is on faculty at both PINC and SFCP. She teaches widely throughout the Bay Area and has a private practice in Oakland, where she works with adults, couples, adolescents, and children.
This course is for clinicians with moderate to extensive experience in clinical work with some background in the principles of psychoanalytic approaches.
Enrollees who cancel at least SEVEN DAYS prior to the event date will receive a refund minus a $35 administrative charge. No refunds will be allowed after this time. Transfers of registration are not allowed.
For program related questions contact Anna Zozulinsky at firstname.lastname@example.org or 707-625-0878.
For questions related to enrollment, locations, CE credit, special needs, course availability and other administrative issues contact Michele McGuinness by email or 415-496-9949.