Weekend Conference April 25-27, 2025 will be offered as a hybrid conference with both online and onsite options. Open to any mental health professional or mental health professional-in-training
Program Date(s):
April 25, 2025 – April 27, 2025
Overview
The course will use lecture, large group discussion, small group/GAM group discussion, case presentation and discussion and informal discussion to achieve the course objectives.
General weekend schedule
Start and end times are approximate for your personal planning purposes. Detailed times, reading lists, and educational objectives will be provided to registered participants.
Friday 9:30am – 6:30 pm US ET
Saturday 9:30am – 6:30pm US ET
Sunday 10:00am – 2:00pm US ET
Damian McCann, D.Sys.Psych and Kate Thompson
Damian McCann, D.Sys.Psych
Kate Thompson
IPI FACULTY WEEKEND CO-CHAIRS
Colleen Sandor, PhD
Hybrid Conference
Attend online by zoom, or onsite in Rockville, MD.
HOTEL INFORMATION
Planning to stay and attend this conference onsite? A limited block of rooms is available at the Rockville Hilton between April 23-April 28.
Participants can only earn CE credits for each session they attend in its entirety. No partial credit can be given.
Membership Benefits
Become a member of IPI at any level and you will have the option of adding on a Zoom Pro account as one of your member benefits. Associate and Full Members also receive discounted registration fees for most of IPI’s events, a subscription to PEP Web, the online psychoanalytic library, and other benefits depending on membership level.
HIPAA compliant Zoom video accounts are an optional add on for all IPI memberships. IPI has a HIPAA Business Associate Agreement with Zoom, which provides a HIPAA compliant platform for our accounts. HIPPA compliance is strongly recommended for all internet-mediated clinical work and clinical teaching. The “+ Zoom Pro” add-on to the IPI membership gives the user the ability to host online meetings with multiple people at the same time. [Current members can upgrade to the “+ Zoom Pro” account and only pay the difference in price from your current membership level.]
The International Psychotherapy Institute, IPI, is approved by The American Psychological Association to sponsor continuing education for psychologists. IPI maintains responsibility for the program and its content. The International Psychotherapy Institute has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6017. Programs that do not qualify for NBCC credit are clearly identified. The International Psychotherapy Institute is responsible for all aspects of the programs. The International Psychotherapy Institute is authorized by the Board of Social Work Examiners in Maryland to sponsor social work continuing education learning activities and maintains full responsibility for this program. This training qualifies for Category I continuing education units. The International Psychotherapy Institute is recognized by the New York State Education Department’s State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0299.
Participants are responsible for verifying that IPI CE credit is accepted by the licensing boards in their own states.
Should you have any questions about the program or the application process, please feel free to contact:
Weekend Conference February 21-23, 2025 will be offered Online. Open to any mental health professional or mental health professional-in-training.
Program Date(s):
February 21, 2025 – February 23, 2025
Overview
The course will use lecture, large group discussion, small group/GAM group discussion, case presentation and discussion and informal discussion to achieve the course objectives.
The International Psychotherapy Institute brings mental health professionals and faculty together to study with international contributors at the leading edge of the field. This weekend conference sees Professor Juliet Mitchell revisiting her bestselling book Psychoanalysis and Feminism, fifty years after its original publication to explore how the ideas she developed in 1974 remain central to our understanding of the condition of women today and the current state of feminism, as well as to the value of psychoanalytic thinking in political thought and action.
General weekend schedule
Start and end times are approximate for your personal planning purposes. Detailed times, reading lists, and educational objectives will be provided to registered participants.
Friday 9:30am – 6:30 pm US ET
Saturday 9:30am – 6:30pm US ET
Sunday 10:00am – 2:00pm US ET
Juliet Mitchell, FBA
Juliet Mitchell FBA is an author, psychoanalyst, socialist feminist and emeritus professor whose work has changed the landscape of both feminist thought and psychoanalytic theory, and remained at the heart of critical thinking for over 50 years. In her most recent book, Fratriarcy: the Sibling Trauma and the Law of the Mother, she juxtaposes Fratriarchy with Patriarchy exemplified by Freud’s notion of a female Oedipus complex.
Dr. Mohatt is in private practice in the Boulder, CO area and practices solely via telehealth. Dr. Mohatt’s clinical interests are in providing treatment for depression, anxiety, and trauma. She especially enjoys working with people in service-related professions. Dr. Mohatt provides both psychotherapy and psychoanalysis.
Dr. Mohatt is currently a Teaching and Supervising Analyst, immediate past Chair of the Candidate Progress Committee, and a Member of the IIPT Psychoanalytic Society. She is also Chair of the Infant Observation Seminar. Dr. Mohatt previously served as a Faculty Representative to the Board of Directors of IPI. Dr. Mohatt is a member of the Denver Psychoanalytic Society. She has taught seminars for IIPT, IPI, Boulder Jungian Program, and internationally for the IPI China and Russia programs.
Anne Taylor, LCSW
Anne Taylor, LCSW is a Psychoanalyst with a background in Nursing, Social Work, and Couples Therapy. Anne is trained in Psychoanalysis, Psychoanalytic Psychotherapy, and Imago Couples Therapy. Anne is frequently a guest lecturer on issues related to psychoanalysis, psychotherapy and couples therapy at universities in the Indianapolis area. An IPI faculty member since 2015, she was the chair of the International Psychotherapy Institute in Indianapolis from 2012-2015 and 2020-2021. Anne is currently the chair of the Candidate Progress Committee and a member of the IPI Board of Directors.
Participants can only earn CE credits for each session they attend in its entirety. No partial credit can be given.
Membership Benefits
Become a member of IPI at any level and you will have the option of adding on a Zoom Pro account as one of your member benefits. Associate and Full Members also receive discounted registration fees for most of IPI’s events, a subscription to PEP Web, the online psychoanalytic library, and other benefits depending on membership level.
HIPAA compliant Zoom video accounts are an optional add on for all IPI memberships. IPI has a HIPAA Business Associate Agreement with Zoom, which provides a HIPAA compliant platform for our accounts. HIPPA compliance is strongly recommended for all internet-mediated clinical work and clinical teaching. The “+ Zoom Pro” add-on to the IPI membership gives the user the ability to host online meetings with multiple people at the same time. [Current members can upgrade to the “+ Zoom Pro” account and only pay the difference in price from your current membership level.]
Click for IPI Membership and Zoom Account information
Continuing Education Information
The International Psychotherapy Institute, IPI, is approved by The American Psychological Association to sponsor continuing education for psychologists. IPI maintains responsibility for the program and its content. The International Psychotherapy Institute has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6017. Programs that do not qualify for NBCC credit are clearly identified. The International Psychotherapy Institute is responsible for all aspects of the programs. The International Psychotherapy Institute is authorized by the Board of Social Work Examiners in Maryland to sponsor social work continuing education learning activities and maintains full responsibility for this program. This training qualifies for Category I continuing education units. The International Psychotherapy Institute is recognized by the New York State Education Department’s State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0299.
Participants are responsible for verifying that IPI CE credit is accepted by the licensing boards in their own states.
Should you have any questions about the program or the application process, please feel free to contact:
October 4, 2024
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8:00 am
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October 6, 2024
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2:00 pm
Weekend Conference October 4-6, 2024 will be offered Online. Open to any mental health professional or mental health professional-in-training.
Program Date(s):
October 4, 2024 – October 6, 2024
Evolving Psychoanalytic Technique in the Context of Contemporary Psychoanalytic Psychotherapies
Overview
This immersive conference delves into the groundbreaking contributions of Otto Kernberg, MD, and the faculty at the Personality Disorders Institute (Department of Psychiatry, Cornell University). Dr. Kernberg directed this institute, and their combined work has significantly impacted the field of psychoanalysis and psychoanalytic psychotherapy. Participants will gain unprecedented access to Dr. Kernberg’s profound insights on integrating diverse theoretical perspectives and pioneering innovative techniques for treating even the most challenging patients. His research underscores the need to adapt and evolve psychoanalytic practice in response to the complexities of clinical work, particularly with patients suffering with severe personality disorders.
Through a series of theoretical and clinical case presentations, the conference will explore Kernberg’s seminal contributions to psychoanalytic theory and technique, including the development of Transference-Focused Psychotherapy (TFP); the emphasis on the centrality of the therapeutic relationship; and the focus on the integration of object relations theory, ego psychology and British psychoanalytic approaches. The conference will also examine the ongoing relevance of Kernberg’s work in contemporary psychoanalytic practice, addressing the challenges and opportunities presented by the treatment of severely ill patients and the need for ongoing innovation and refinement of psychoanalytic technique.
This conference will be of particular interest to psychotherapists, psychoanalysts, psychiatrists, psychologists, and other mental health professionals interested in the treatment of severely ill patients and the ongoing development of psychoanalytic theory and technique. Don’t miss this rare opportunity to learn from a true pioneer in psychoanalysis and elevate your practice to new heights.
The course will use lecture, large group discussion, small group/GAM group discussion, case presentation and discussion and informal discussion to achieve the course objectives.
General weekend schedule
Start and end times are approximate for your personal planning purposes. Detailed times, reading lists, and educational objectives will be provided to registered participants.
Friday 9:30am – 6:30 pm US ET
Saturday 9:30am – 6:30pm US ET
Sunday 10:00am – 2:00pm US ET
Otto Kernberg, M.D.
Dr. Kernberg is world renowned for his seminal work on borderline and narcissistic personality disorders, providing a theory of the precursors of these disorders as well as therapeutic methods for treating these patients using applied psychoanalysis. He developed Transference-Focused Psychotherapy, a novel and useful framework for coordinating personality disorders along dimensions of structural organization and severity. In addition, his work has been central in integrating postwar ego psychology with Kleinian and other object relations and perspectives. His integrative writing was central to the development of modern object relations, a theory of mind that is perhaps the theory most widely accepted among modern psychoanalysts. He has written about object relations, character pathology, falling in love, as well as about problems in psychoanalytic education.
Otto F. Kernberg, M.D., F.A.P.A., is past Director and Senior Consultant of the Personality Disorders Institute at The New York Presbyterian Hospital, Westchester Division and Professor Emeritus of Psychiatry at the Weill Medical College of Cornell University. Dr. Kernberg is a Past-President of the International Psychoanalytic Association. He is also Training and Supervising Analyst of the Columbia University Center for Psychoanalytic Training and Research.
In the past, Dr. Kernberg served as Director of the C.F. Menninger Memorial Hospital, Supervising and Training Analyst of the Topeka Institute for Psychoanalysis, and Director of the Psychotherapy Research Project of the Menninger Foundation. Later, he was Director of the General Clinical Service of the New York State Psychiatric Institute, and Professor of Clinical Psychiatry at the College of Physicians and Surgeons of Columbia University. From 1976 to 1995 he was Associate Chairman and Medical Director of The New York HospitalCornell Medical Center, Westchester Division. He was Book Editor of the Journal of the American Psychoanalytic Association from 1977-1993. He is the author of many books.
Dr.Kernberg was awarded the l972 Heinz Hartmann Award of the New York Psychoanalytic Institute and Society, the l975 Edward A. Strecker Award from the Institute of Pennsylvania Hospital, the l98l George E. Daniels Merit Award of the Association for Psychoanalytic Medicine, the l982 William F. Schonfeld Memorial Award of the American Society for Adolescent Psychiatry, the 1986 Van Gieson Award from the New York State Psychiatric Institute, the 1987 and 1996 Teacher of the Year Award from The New York HospitalCornell Medical Center, Westchester Division. He was elected to membership of the Society of Scholars of the Johns Hopkins University in 1992. He received the 1993 I. Arthur Marshall Distinguished Alumnus Award, Menninger Alumni Association, The Menninger Foundation, the 1993 Presidential Award for Leadership in Psychiatry from the National Association of Psychiatric Health Systems, and the Distinguished Service Award from the American Psychiatric Association in 1995. He was elected Doctor Honoris Causa by the University of Buenos Aires, Argentina, in 1998, and received the Austrian Cross of Honor for Science and Art, in 1999. In 2007 he received the Golden Medal of Honor to the City of Vienna, and the Thomas William Salmon Medal from the New York Academy of Medicine, New York, New York.
Conference Co-Chairs
Caroline Sehon, MD, FABP, is director of the International Psychotherapy Institute (IPI) and chair of its Overseas Programs for Jiandanxinli, the My Therapist platform in China. At IPI, she is a supervising child and adult psychoanalyst and past chair of the International Institute for Psychoanalytic Training. At the American Psychoanalytic Association, she serves on its Executive Committee as Secretary. She is a clinical professor of psychiatry at Georgetown University, Washington, DC, USA. Author of articles and book chapters on adult and child psychoanalysis, couple and family therapy, her private practice is in Bethesda, Maryland, USA, where she works with individuals, couples, and families.
Flora Barragan, MA is an Adult Psychoanalyst who graduated from the IIPT program at IPI. She specializes in Psychodynamic Play Therapy for Children and Adolescents. Flora is the Chair of the Faculty Development Program at IPI, where she teaches in different programs and consults for the PPP in China. She has experience leading groups at IPI and has worked for many years with children and parents as a Director and owner of Kinder KIn in Mexico City. Additionally, she has contributed to mental and educational programs within Indigenous communities in Yucatán, México.
Tuition and Fees
Registration options:
Full Conference
$475 up to 21 days in advance; $525 thereafter
*Full members: $359
*Associate members: $410
Full time students: $175
Saturday All Day (morning and afternoon): $175
Saturday Morning only: $100
*Login to the website with your member information to access your discounted registration rate
Continuing Education Credit Hours
Full Weekend Conference:
14.5 CE credits
Saturday All Day:
6 CE credits
Saturday Morning only:
2.5 CE credits
Weekend Conference Attendance Policy
Participants can only earn CE credits for each session they attend in its entirety. No partial credit can be given.
Full Weekend Schedule
14.5 CE credits
Friday October 4th
Contemporary Object Relation Theory and its Applications
Otto Kernberg
GAM Group
Classification and Controversies regarding Personality Disorders
Otto Kernberg
GAM Group
Saturday October 5th
Overview of Present-day Psychoanalytic Technique
Otto Kernberg
GAM Group
Clinical Presentation and Discussion
Presenter: Charles Ashbach, PhD; Discussant: Otto Kernberg, MD
GAM Group
Plenary
Sunday October 6th
Evolving Strategies of Psychoanalytic Psychotherapy
Otto Kernberg
GAM Group
Closing Dialogue
Saturday All Day Schedule
6 CE credits
Saturday October 5th
Overview of Present-day Psychoanalytic Technique
Otto Kernberg
GAM Group
Clinical Presentation and Discussion
Presenter: Charles Ashbach, PhD; Discussant: Otto Kernberg, MD
GAM Group
Plenary
Saturday Morning Schedule
2.5 CE Credits
Saturday October 5th
Overview of Present-day Psychoanalytic Technique
Otto Kernberg
GAM Group
Educational Objectives
Friday morning, October 4
Presentation: Contemporary Object Relation Theory and its Applications
Explain the role of internalized object relations in shaping psychic experience and contributing to both normal and pathological development.
Explain Dr. Kernberg’s proposed revisions to psychoanalytic theory, particularly the shift towards affect systems as primary motivators and the evolving understanding of the dynamic unconscious.
GAM Group
Apply the Group Affective Model to articulate 3 ways that object relationship interactions with significant others are internalized, and how these internalized object relationships influence both defensive and impulsive processes. And how
Utilize the GAM group to discuss complex internalized object relationships, making links with clinical examples, theoretical ideas, and personal associations.
Friday Afternoon, October 4
Presentation: Classification and Controversies Regarding Personality Disorders
Differentiate between levels of personality organization from neurotic to borderline levels of personality organization.
Explain the clinical implications of different levels of personality organization, namely Normal Personality Organization (NPO), High, Middle, and Low Borderline Personality Organization.
GAM Group
In your small affective group, highlight 3 key distinctions in identity consolidation, defensive operations, and reality testing between the different levels of personality organization.
Select 3 clinical vignettes drawn from your practice or readings to apply Dr. Kernberg’s structural approach to classifying personality pathology.
Saturday Morning, October 5
Presentation: Overview of Present-Day Psychoanalytic Technique
Explain the descriptive, structural, and dynamic features of personality functioning within the framework of object relations theory to facilitate accurate diagnosis and treatment planning for individuals with personality disorders.
Describe 2 key principles and technical approach of Transference-Focused Psychotherapy for treating patients with borderline personality disorder.
GAM Group
Explain how transference-focused psychotherapy utilizes transference analysis to address conflicts arising from contradictory internalized object relations.
Identify 2 clinical examples that demonstrate ways psychotherapists analyze the transference and their countertransference to inform their work.
Saturday Afternoon, October 5
Clinical Presentation
Apply the clinical presentation by Dr. Ashbach to explain the features of personality functioning within the framework of object relations theory to facilitate accurate diagnosis and treatment planning for individuals with personality disorders.
Utilize the clinical example provided by Dr. Ashbach to identify the patient’s levels of personality organization from neurotic to borderline levels of personality organization.
GAM Group
Identify 2 examples from your clinical practice that demonstrate ways psychotherapists analyze the transference and their countertransference to inform their work.
Select 2 clinical moments drawn from Dr. Ashbach’s presentation that illustrate Dr. Kernberg’s structural approach to classifying personality pathology.
Saturday Plenary, October 5
Identify two concepts articulated by Dr. Kernberg that are discussed in the plenary
Identify one example of the hidden, buried, or implicit unconscious during the plenary discussion.
Sunday Morning, October 6
Presentation: Evolving Strategies of Psychoanalytic Psychotherapy
Explain two evolving clinical strategies (described by Dr. Kernberg) for use in psychoanalysis and psychoanalytic therapy.
During a psychoanalytic psychotherapy treatment, describe the sequential steps utilized when interpreting object relations activated in the transference.
GAM Group
Utilize the GAM Group to discuss three of Dr. Otto Kernberg’s recommended clinical strategies from the case material presented in the preceding presentation by Dr. Kernberg
Within the GAM Group, explain two evolving clinical strategies by making links between evolving clinical strategies and clinical examples drawn from your clinical practice.
Sunday Closing Dialogue
Name and describe 2 general themes from the conference that will lead to a change in your clinical practice.
Describe two concepts presented during the conference that will enrich your clinical skills.
Membership Benefits
Become a member of IPI at any level and you will have the option of adding on a Zoom Pro account as one of your member benefits. Associate and Full Members also receive discounted registration fees for most of IPI’s events, a subscription to PEP Web, the online psychoanalytic library, and other benefits depending on membership level.
HIPAA compliant Zoom video accounts are an optional add on for all IPI memberships. IPI has a HIPAA Business Associate Agreement with Zoom, which provides a HIPAA compliant platform for our accounts. HIPPA compliance is strongly recommended for all internet-mediated clinical work and clinical teaching. The “+ Zoom Pro” add-on to the IPI membership gives the user the ability to host online meetings with multiple people at the same time. [Current members can upgrade to the “+ Zoom Pro” account and only pay the difference in price from your current membership level.]
Click for IPI Membership and Zoom Account information
Continuing Education Information
The International Psychotherapy Institute, IPI, is approved by The American Psychological Association to sponsor continuing education for psychologists. IPI maintains responsibility for the program and its content. The International Psychotherapy Institute has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6017. Programs that do not qualify for NBCC credit are clearly identified. The International Psychotherapy Institute is responsible for all aspects of the programs. The International Psychotherapy Institute is authorized by the Board of Social Work Examiners in Maryland to sponsor social work continuing education learning activities and maintains full responsibility for this program. This training qualifies for Category I continuing education units. The International Psychotherapy Institute is recognized by the New York State Education Department’s State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0299.
Participants are responsible for verifying that IPI CE credit is accepted by the licensing boards in their own states.
Should you have any questions about the program or the application process, please feel free to contact:
In preparing to write this blog on our recent weekend exploring French Psychoanalytic thought and its contribution to understanding psychotic and borderline states, I found myself worrying about using too many “I” statements in my reflections. This urge to avoid writing “I” too many times in this composition, I think speaks to the theme and tone of this past weekend. Alain Gibeault described Freud’s theory of psychosis as de-cathexis from worldly objects and the psychotic terror of being engulfed or consumed by an object. Additionally, he discussed the concept of “the blank,” a space between matter and nothingness. We then watched a recording of an institutionalized patient, François, describe murdering an elderly woman, Jeanette, whom he had cared deeply for. He described Jeanette and himself being up on separate pillars with “something growing up between us.” I was struck by the terror of this image, being alone on a pillar, surrounded by the blank, with something terrifying growing up between François and Jeanette.
This material along with Dr. Gibeault’s discussion of psychodrama led into our small group discussions. During our group affective learning, fear and safety and their relation to individuals, patients, our group, and IPI were central themes. As the group went on, I felt myself feeling strangely disengaged and detached. Initially, I defended myself as bored. However, upon reflection, like François I was gripped by a psychotic fear of vulnerability, of being engulfed by the group or by IPI. I too, had in a sense de-cathected from the horror of the material and was existing in the blank.
I’d like to say that the psychodrama of our small group facilitated my re-cathexis with the material, but I found myself struggling to stay focused on Saturday as well. On Saturday afternoon, a colleague in the CORE program gave a fascinating presentation on a boy that he had been working with. The presentation was rich with symbolic meaning and beautifully captured the theme of terror of being engulfed that was running throughout the weekend. During one of the sessions presented, the boy was playing with a dollhouse. The presenter described this patient arranging the dollhouse in such a way that there was a “sealed off room, full of drawers” upstairs. For the second time during the weekend, I was struck by the rich imagery described by a patient. During plenary, themes of fear and violence were discussed. The ambivalence concerning feeling for and treating psychotic patients, like François, and recognizing the horror of the acts that they sometimes commit. Jill Savege Scharff brought up confronting gun violence, hate crime, toxic partisan politics, and climate change that are terrifying realities of our daily lives. It was during this dialogue that the image of the “sealed room, full of drawers” popped back into my consciousness.
I wonder if my feelings of detachment and the theme of unease that seeped into the weekend conference acted as a defense against the sealed room, full of drawers inside of all of us. I began to think of these drawers as full of rage, panic, lust, and violence, terrifying emotions/drives that are walled off inside me, but in reality would take little to provoke. In relation to my small group: would these terrifying affects/emotions kill my group? In relation to psychotic or borderline patients: does the fear of violence or panic in myself incline me to split them off as different and distance myself from them? In thinking about the didactic material or engaging with IPI: am I de-cathecting at times and existing in the blank in order not to experience frightening emotions? This weekend spent thinking about French psychoanalysis and psychodrama provided the opportunity to think about borderline and psychotic states and the terrifying moods and affects associated with those states as positions along a continuum on which we are all precariously perched.
Thomas Ringwood Jr., NP – 1st year student in 2-year Object Relations Theory and Practice Program (CORE) December 1, 201
During the November 8th through 10th weekend of 2019, the International Psychotherapy Institute hosted the French psychoanalyst Alain Gibeault. French analytic writing is often criticized by British and American analysts as overly abstract, lacking in clinical detail, and often difficult to follow; nonetheless, Dr. Gibeault’s presentation, particularly the video recordings of his patient Francois – a man who was legally committed to mental health treatment following his murder of an elderly woman during a psychotic break – gave us a first-hand look at how French psychoanalytic thought can be applied in the treatment of people with overwhelming psychotic terror. In Francois’s case, psychodrama was used by Dr. Gibeault and his colleagues to provide a mediator for the patient to begin to make sense of his otherwise unrepresentable mental state. Rather than applying direct interpretation in an analytic dyad, which is the usual clinical approach in most psychoanalyses, Dr. Gibeault and his team allowed Francois to choose characters among the hospital staff to play out, in real time, the dramas that were occurring in his mind. That part of Francois that killed an elderly woman in his psychosis was re-presented to Francois in a session of psychodrama by an ‘actor-therapist’ who improvised a murderous old woman that Francois ran into while riding on a commuter train. In another session, Francois’s brother was depicted as a carefree, somewhat envious character with whom Francois could interact – and at as much distance as the mediation of the psychodrama would allow. In this way Francois could experience aspects of murderous rage and envy, as represented by the actor-therapist, rather than having to own it as a direct aspect of himself. In other words, rather than attempting to understand and interpret to Francois the unconscious derivatives of his intense envy and murderous rage in a two-person analytic relationship – an approach that Dr. Gibeault believed would probably be too overwhelming for Francois given his inherent engulfment and fusion anxieties that lay at the heart of his psychosis – the mediation of the multiple actors in the psychodrama allowed Francois to begin to think about his experience in a way that he could tolerate.
As I reflect on this particular weekend at IPI, I find myself drawn to the idea of the Group Affective Model as a kind of psychodrama. The Group Affective Model – or GAM group – is a unique aspect of training at IPI that brings to life, much like in psychodrama, the often very complex theoretical and clinical material that participants are trying to digest. Though not itself a “therapy group”, participants in small GAM groups of between four and let’s say ten individuals, are nonetheless encouraged to bring in their own affective material, often derived from their personal lives or immediate experiences of the weekend. By interacting in this way the GAM group works to understand, as a group, the different facets of the material under discussion. As such, what is learned at an IPI weekend is never only theoretical. Rather, it comes to life in some form or another as a memorable emotional experience from which any and all of the members of the group can learn – each in their own way. Given that this weekend was on the terror of non-representative states and the defensive use of psychosis as a way of negotiating the horror of experiencing psychic “nothingness”, it is not surprising that groups would get in touch with psychotic aspects of themselves as a group. It was so in my own GAM group as well as in others’ groups that I had heard about. This is not something to be concerned about as much as it is an opportunity to think about, particularly après coup – in the context of the theoretical material being presented over the weekend.
In thinking about the GAM group at IPI, I am also reminded of Dr. Gibeault’s discussion of the necessity of “the director” of a psychodrama (or of a GAM group, or even of an institute as a whole) as a representative of the ‘thirdness’ – or the analytic third – of the group. The director serves as a container and a mediator, a kind of Perseus’ shield between the raw experience of group members and their distance from the material under discussion. With a good enough “director”, the experience of the psychodrama can be mediated in a way that makes it possible to appropriately reflect upon what is occurring in order that it can be learned from as an experience. Obviously, there is nothing quite so good as a “good enough” anything. In that way, we struggle, as indeed we did once again this past weekend, to understand the ideas presented during the weekend in the context of our own unique clinical experience as well as in ourselves in ever new and enriching ways. Taken in its entirety, this was once again my experience of an IPI weekend – and one that will remain as my own experience in the learning group of analytic training at IPI over the last several years.
Matthew H. Rosa, M.D. – 4th Year Analytic Candidate
True to the traditions of French psychoanalysis, IPI’s visiting guest speaker Alain Gibeault, formerly secretary general of the IPA, bases his theory and clinical practice on the metapsychology of Freud. He approaches the first interview with a new patient with four questions in mind.
What kind of meeting is appropriate for this patient — psychoanalytical or something else?
What indications are there that a psychoanalytic approach to treatment could be useful?
How do patient and analyst work together in this interview?
What has triggered the request for help?
Gibeault’s intention is to explore the conscious, pre conscious and unconscious layers of the mind. In keeping with Freud’s topographical approach, he assesses the psychic functioning, faces the emotional storm, and contains the affect that arises as he works to open a psychoanalytic space, giving access to the unconscious and tracing the structural connections between superego, ego and id.
When treating the psychotic patients he sees in a clinic attached to a hospital, Gibeault, inspired by Lebovichi who introduced psychodrama to France, expands his psychoanalytic technique by including a team of seven psychodramatists (a luxury we can hardly imagine in the USA). He also arranges for a psychiatrist to treat the patient as well, keeping medication, follow up, risk assessment, and medical responsibility separate from the psychoanalytic perspective. The point of the profusion of therapists is to spare the patient the threat of engulfment by a single object. Instead, the transference is spread laterally among psychoanalyst and psychodramatists and the task of containment is shared by the team. The introduction of such a third in this way reduces the threat and diminishes the defense of splitting as a defense against engulfment or intrusion by the single therapeutic object.
Neurotic patients can symbolize their distress and keep it internal and so we can treat them in private practice. Psychotic patients cannot do that and so they need a hospital setting and a team approach that includes psychodrama to create for them an external image for contemplation. These patients can address this externally created image more easily than trying to use words to reach insight, while dealing with the stress of looking at a single therapist. The psychodramatists take on the characters assigned to each of them by the patient but they do not wait for role induction. They spontaneously react in ways that do not try to recreate the patient’s experience. Instead they offer something different. This construction of something new in the third reduces the dissociation from which the psychotic patient suffers. Unlike Klein who teaches us to interrupt the negative transference in the first session, Gibeault recommends that we must respect idealization and only later interpret aggression. Only then is it possible to interpret the negative transference — which must be done before termination can be possible.
I am here at the International Psychotherapy Institute weekend conference Technology and Ethics in Treatment and Training: Best Practices. I am sitting in the audience of 60 people at a hotel conference room while the guest speaker talks with us via proZoom. It is now Saturday October 5, 2019. There on a large screen is Alessandra Lemma, Fellow of the British Psychoanalytical Society and Consultant-Clinical Psychologist at the Anna Freud Centre for Childrenand Families, Honorary Professor of Psychological Therapies at the School of Health and Human Sciences at Essex University, and Visiting Professor, Psychoanalysis Unit, University College, London. She is presenting on the impact of Internet pornography on development. We can see and hear Alessandra. She can see us in general and can hear each one in particular who comes to the microphone and web camera to speak to her. When she moves away or looks down we may miss the end of a word, and she may have to ask us to repeat a word, but by and large we can follow her talk. Some of us would rather interact with her in person, but she lives in London and cannot spare the time to travel here for a weekend conference or for one lecture. This way we are deprived of her actual physical presence but not of her humanity. We have the gift of her presentation, and we get to interact with her and her ideas. And we get to know her as a presenter beyond our experience of her as a writer from reading her book The Digital Age on the Couch. Technology isn’t perfect but it gives access to her knowledge. So what am I taking away from her talk?
I learn that Internet pornography, which obviously fundamentally interferes with sexual desire and development in adolescence, is now leading to sexual dysfunction in young people of the digital generation. Why is this happening in this age of enlightenment about sexuality? They spend their life online and pornography is not only regularly available but also jumps out at them. Ready access to pornography stimulates desire and leads to the delivery of instantaneous satisfaction. There is no need of delay. Under normal circumstances desire experiences a delay before there is the delivery of satisfaction. But in internet pornography there is no need of a journey towards gratification all because it is already there. This collapse of time and space incurs a stultification of psychic development. Psychic development requires delay of gratification, which leads to psychic movement across time, the unconscious mind at work developing its representations of desire and its gratifying objects of satisfaction. Furthermore, pornographic images do not only receive existing fantasies but also project other people’s fantasies violently into the viewer’s body and mind where they take over, creating a “not-me” experience and foreshortening the consolidation of sexual identity.
What makes an adolescent vulnerable to exploitation by pornographic images on the Internet? Alessandra suggests that we need to look backwards to the kind of infancy when an endless sensory, erotic experience occurs without the cognitive resources to make sense of it. Then it falls to the mother to reflect the sexuality of the infant and give the infant time to make sense of it. She delays gratification, which gives the body time to organize its response and fulfill its role as the link between desire and satisfaction, self and other. She develops cycles of frustration and satisfaction that shape the infant’s rhythms, which later underpin the expression of desire in later stages of development. When she fails to do this, the child develops an incoherent mental representation of the body.
Then in adolescence there is a desperate search to find a mirror that will reflect the sexual self accurately and confirm the adolescent’s sexual identity. In the pre-Internet era this was provided by peer groups and teen media during the infinitely lengthy waiting period that was adolescent sexual awakening. Now however the adolescent has been bombarded by sexual imagery in childhood and is now driven to look for reflection in the “black mirror” of the handheld device. The upside is that easy availability of such online mirroring brings a benefit of inclusiveness for those whose sexual proclivities place them in minority groups. The downside is that the adolescent looking for this type of reflection and peer affiliation stumbles upon an orgy of intoxicating sexual possibilities that re-create a view of the primal scene, now constantly open for access. Like an infant in an endlessly sensory state of being, the adolescent does not have the ego development to deal with the overstimulation alone. What is needed is the care and responsiveness of a living breathing other person.
Young people who look for instant, impersonal gratification do not know the value of the work of desire. When they are locked in to a habit of getting aroused and gratified online instantly, they feel that they triumph over desire. In fact they are killing desire. They do not recognize its value in creating movement towards the other. They do not know to wait for that. Learning to derive pleasure from waiting requires psychic work towards maturation. As therapists we can offer a reflective mirror and a relationship that will help these adolescents recover desire, experience anticipation, wait for pleasure, and ultimately enjoy a sexual experience with a partner.
And what about us? How is our digital learning experience different from that of the porno-addicted adolescents? Obviously this is not porn. We are watching and looking at an image, but our desire is for the gratification of learning. It is not a solo activity, and it is not hidden. True, Alessandra arrives the click of a mouse but she appears by careful selection and mutual arrangement. But in this case, there actually is delay between desire and delivery. We have been waiting to work with Alessandra Lemma since April two years ago when she was with us for a whole weekend. She could not offer that amount of teaching and travel given other commitments at this point in her life. So we signed up for the conference on technology and ethics at which she would speak by Zoom. We knew to expect a technology-mediated lecture: It does not intrude on us unbidden.
Looking at the screen and listening to Alessandra is not immediately gratifying: In fact it is slightly frustrating as we strive to catch every word. The image on the screen is inviting but not overstimulating. Yes, the content of the presentation is inducing desire for more, but we share the experience with others in a group setting. With technology, we get to “be with” Alessandra again, sharing with colleagues her brilliant ideas, empathy and responsiveness, and outstanding clinical technique.
Congratulations to our IIPT (analytic) graduate Michele Kwintner and our Core (object relations) graduates, and our clinical consultation program graduates.
Suzanne St. John and Karen Fraley announce the names of the Clinical Consultation Program graduates.
At Saturday’s open workshop, Virginia Ungar presented a version of the keynote paper she gave at the IPA Congress in Boston 2015. She set her remarks in the social and cultural context of our age, characterized by the questioning of authority and current knowledge and the declination of the paternal function. Add to that the proliferation of offers of relief for emotional disorder and the preference of young people for constant connectedness and instant response, and the result is a diminution in the value of psychoanalysis. Psychoanalysts, now more sensitive to their surroundings, are moving out of their isolation and adjusting the analytic setting to respond to new modes of communication with reality. Then the analytic setting can continue its essential role as the analytic device that allows the transference to unfold.
photo credit —Lynda Scalf-Mciver
Coming from an analytic tradition infused with the concepts of Klein, Bion and Meltzer, Ungar noted that the assumption of the prevalence of hostility at the beginning of life had the effect of skewing the focus of the analytic intervention towards the interpretation of hostility across the full repertoire of anxieties. This has led to the genesis of closed circuits of a paranoid nature and the loss of receptivity to the various a aggressive and libidinal impulses expressed in the transference.
photo credit —Lynda Scalf-Mciver
Ungar presented her own “aesthetic model” of interpretation, a model, that, depending on observing and describing, not explaining, conveys an attitude of reflection and conjecture. She presented a session from the period of her own training years ago and one from a later treatment. Comparing her technique in each situation, we saw the movement from the traditional Kleinian approach towards her own aesthetic model. In the first, she was interpreting from a position of certainty informed by theory and in the second she was using theory to reflect on her own responses and allow the patient to discover meaning for herself.
We’ve been fascinated this weekend at IPI by Dr. Björn Salomonsson’s account of his psychoanalytic treatment of infants with their parents. To develop an effective theory and technique for helping infants in distress we need to look beyond attachment research and developmental theory to include analytic theory and technique in our approach. It’s easy to believe that the analyst’s words communicate understanding to the parent. But Dr. Salomonsson believes that he can communicate directly with the baby. Many argue that you can’t analyze a baby because analysis is a talking therapy and babies can’t understand words. Others have argued that they do. But here it is important to distinguish between the lexical and the linguistic. True, babies do not understand the words but they respond to the patterns of the language, words, the rhythm of the speech, the affective tone, the authenticity and integrity of the analyst’s interest and reach the baby and give meaning to the experience. The analyst recognizes the baby’s distress, offers calm interest and concern, and conveys hope that the unmanageable distress can be understood and coped with through a process of co-thinking between baby and analyst and between baby and parent. The analyst recognizes the competence and responsibility of the baby to become a partner in the process of recovery.
– Jill Savege Scharff, M.D.
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I learn that Internet pornography, which obviously fundamentally interferes with sexual desire and development in adolescence, is now leading to sexual dysfunction in young people of the digital generation. Why is this happening in this age of enlightenment about sexuality? They spend their life online and pornography is not only regularly available but also jumps out at them. Ready access to pornography stimulates desire and leads to the delivery of instantaneous satisfaction. There is no need of delay. Under normal circumstances desire experiences a delay before there is the delivery of satisfaction. But in internet pornography there is no need of a journey towards gratification all because it is already there. This collapse of time and space incurs a stultification of psychic dev
