Thu, Feb 14, 2019 to Thu, Mar 21, 2019
7:30 - 9:00 pm

St. Clement's Episcopal Church

2837 Claremont Boulevard
Berkeley, CA 94705
Reyna Cowan, Psy.D.
CE Credits: 
Participant Limit: 

$315 General Public
$225 Full Members
$198 CMH Members
$180 Associate Members
$135 Student Members
$135 Scholarship (prior approval required to register at this fee)

Tuition listed above is for early registration ($40 discount off full fee, $15 discount for NCSPP Student Members). For registrations received after the deadline, full tuition will be applied to all registrations.

Tuition does not include the cost of readers.

Early Registration Deadline: 
January 31, 2019
All major credit cards, as well as checking account debit payments, are accepted.


The Inability to Learn from Experience

Course Overview: 

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.

Course Objectives: 

At the conclusion of this course participants will be able to:

  1. Analyze and describe a way to think about the way that emotional growth can be hindered through the use of various unconscious defensive strategies.
  2. List the differences between autistic defenses, dissociative defenses and feelings of deadness.
  3. 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.
  4. Discuss and use Andre Green’s concept of the work of the negative in the therapeutic setting.
  5. Assess and compare the three different variations of the claustrum.
Empirical Reference: 

Berghout, C. C. and J. Zevalkink (2009). Clinical significance of long-term psychoanalytic treatment. Bulletin of the Menninger Clinic73(1), 7–33. doi: 10.1521/bumc.2009.73.1.7.

Cohen, E, S. Chazan, M. Lerner, et al. (2010). Posttraumatic play in young children exposed to terrorism: An empirical study. Infant Mental Health Journal31(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 Psychiatry165(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, Training46(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, Training47(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.

Target Audience & Level: 

This course is for clinicians with moderate to extensive experience in clinical work with some background in the principles of psychoanalytic approaches.

Cancellation & Refund Policies: 

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.

Contact Information: 

For program related questions contact Anna Zozulinsky at 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.

Education Committee

The Education Committee is responsible for the development of a variety of courses and workshops given throughout the year in San Francisco and the East Bay.

Asya Grigorieva, Ph.D., Chair
Clara Brandt, Psy.D.
June Lin-Arlow
Cameron Murphey, MFTi
Jonathan Willett, MA
Anna Zozulinsky, Ph.D.