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103 Classics of Formulation – 10 seminars

Seminar Leaders: L. Barton, E. Hubbard, S. Leibow, C. Melchiorre, S. Moore, M.K. O’Neil and A. Taheri

Course Description

This course, in ten seminars, explores Freud’s discovery of the psychic unconscious and psychoanalysis as a theory of human nature as it reveals itself in the case studies which serve as the foundation for all later formulations of the clinical conditions and diagnoses for which psychoanalysis has proven to be the essential treatment modality.

These include hysterical and obsessional symptoms and conditions, paranoid states and childhood phobias, anxiety neurosis, and depression and mourning and melancholia.

The course will provide clinical grounding for candidates in the ongoing importance in clinical work of the seduction theory; the subsequent development of the importance of typical unconscious fantasies, defenses and treatment difficulties and challenges in the treatment of these conditions. Of central importance will be the understanding of these key unconscious dynamics and more particularly how they influence the treatment relationship with emphasis on the role of transference. The course will trace the development of this concept and its application in Freud’s clinical work and its ongoing essential value and role in the psychotherapeutic effort with these patients.

Course Objectives

The Candidates will learn to:

  1. (1.1) understand how the readings illuminate the ways in which Freud used his experience with the case studies to create a theory of human development related to psychosexual stages that helped account for the various psychopathologies at various stages.
  2. (1.1) see how the case studies provide an ideal format for the study of the respective roles of and subtle interplay of biological, social/cultural, and familial roles in the development of hysteria, obsessive compulsive and other psychological states and disorders.
  3. (1.2) integrate how the cases show the therapist in action bringing to life the therapeutic effects and role of ‘talk’ therapy. Supportive, clarifying and insight generating activity are studied and their role in forging an alliance and bringing unconscious factors to light are highlighted. The emerging and growing importance for the theory of psychoanalytic therapeutic effect of transference are studied in a format that brings the concept vividly to life for the student.
  4. (1.2) understand the impact of childhood trauma on psychological function is an important factor that is traced in detail through the study for example of the role of the primal scene and sexual seduction in the “Wolf Man” and Dora cases. Key theoretical articles study the role of the environment and trauma in subsequent psychological disturbances and symptoms, including in phobias, anxiety neurosis, obsessional symptoms and paranoia
  5. (1.3) apply the case material as it provides a portrait or picture of fundamental psychological syndromes and a clear explication of the fundamental underlying psychodynamics and how they were arrived at.
  6. (1.3) understand the basic psychodynamics of obsessive and hysterical symptoms, obsessive compulsive disorder, phobias and anxiety neurosis, and paranoia and to integrate detailed accounts of how to manage and intervene therapeutically in their treatment.
  7. (4.5) formulate their cases based on diagnoses and their typical dynamics, with an understanding of basic traumas, unconscious wishes and fantasies, typical defenses and forms of therapeutic difficulties encountered in each syndrome, as taught with actual case material and dialogue.
  8. (4.5) better understand the typical therapeutic requirements and challenges in order to better individualize goals and objectives for each patient and to better formulate a direction for therapy.

Seminar 1

Hysteria I

In the Dora paper Freud introduces a new theory of the aetiology of neurosis that made fantasy and repression central. This seminar will take up the universality of unconscious fantasy in neurosis, normal development and character. It will also take up family dynamics, social factors including the role of women and developmental considerations.

Required Readings

Freud, S. (1905a). Fragment of an analysis of a case of hysteria. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 7, 3-122.

Ahbel-Rappe, K. (2009). After a long pause: How to read Dora as history. Journal of the American Psychoanalytic Association, 57, 595-629.

Seminar 2

Hysteria 2

The underlying wishes, conflicts and defenses that predominate in hysteria are considered. The nature of conversion and hysteric character are also considered and related to current issues in the treatment of borderline personality disorder.

Required Readings

Reich, Willhelm. (1972 [1945]). The hysterical character. In Character Analysis (pp. 204-209). New York, NY: Touchstone, Simon and Schuster.

Easser, Barbara Ruth & Lesser, Stanley. (1965). Hysterical personality: a re-evaluation. Psychoanalytic Quarterly, 34, 390-405.

Halberstadt-Freud, Henrika C. (1996). Studies on hysteria one hundred years on: A century of psychoanalysis. International Journal of Psychoanalysis, 77, 983-996.

Seminar 3

Phobia

These seminars look at the nature of a phobia in a childhood. The role of ambivalence and death wishes, infantile sexuality and anxiety are understood in the genesis of the horse-complex.

Required Readings

Freud, S. (1909). Little Hans: Analysis of a phobia in a five-year old boy. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol.10, 3-149.

Blum, H.P. (2007). Little Hans: A contemporary overview. Psychoanalytic Study of the Child, 62, 44-60.

Seminar 4

Phobia 2 (continued from seminar 1)

Seminar 5

Paranoia

The candidates will develop an understanding of paranoia and paranoid illnesses. They will learn about the development of paranoid illnesses, the developmental fixation that occurs and the role of the environment in these conditions.

Required Readings

Freud, S. (1911). The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 12, 1-85.

Quinidoz, Jean-Michel. (2004). Reading Freud (pp. 101-107). London: Routledge.

Seminar 6

Obsessions 1

This seminar explores the developmental and psychodynamic factors in the development of an obsessional neurosis with emphasis on the initial presentation and treatment challenges posed to the therapist.

Required Readings

Freud, S. (1909). Notes on a case of obsessional neurosis. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 10, 153-220.

Osman, Marvin, (2009). Freud’s Rat Man from the perspective of an early-life variant of the Oedipus complex. Psychoanalytic Quarterly, 78, 765-790.

Auchincloss, E. & Samberg, E. (2012). Ambivalence. In Psychoanalytic Terms and Concepts. New Haven, CT: Yale University Press.

Seminar 7

Obsessions 2

This seminar will look at the understanding of obsessive symptoms theoretically, including how religion and the study of other social and cultural factors interact with constitutional factors in the development of obsessive symptoms. A developmental perspective focusing on early childhood and the role of parenting and sibling factors will be considered with the diagnostic and therapeutic distinctions related to hysterical symptoms considered in some detail.

Required Readings

Freud, S. (1907). Obsessive actions and religious practices. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 9, 115-128.

Freud, S. (1913). The disposition to obsessional neurosis. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 12, 311-326.

Freud, S. (1913). Totem and taboo. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 13, 1-162.

Auchincloss, E. & Samberg, E. (2012). Anality. In Psychoanalytic Terms and Concepts. New Haven, CT: Yale University Press.

Seminar 8

Obsessions 3 (continued from seminar 2)

Seminar 9

Infantile Neurosis

This seminar will look at a neurosis in childhood through the psychoanalytic treatment of an adult in order to understand the typical connections between the structure of the adult and childhood conditions and symptoms in anxiety neurosis and borderline conditions. The roles of traumatic memories, childhood illness, familial dysfunction and the witnessing of parental intercourse in a young child in the aetiology of the childhood and subsequently adult conditions will be explored.

Required Readings

Freud, S. (1918). From the history of an infantile neurosis. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 17, 7-122.

Auchincloss, E. & Samberg, E. (2012). Infantile neurosis. In Psychoanalytic Terms and Concepts. New Haven, CT: Yale University Press.            

Seminar 10

The “Wolf Man” continued

In this seminar the psychosexual theory of development will be elaborated including the importance of anal erotism and oral organization of the libido. Their relevance for the current diagnosis and treatment of anxiety and borderline conditions will be explored.

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