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408 Clinical Klein in Contemporary Practice – 5 seminars

Course Leaders: V. Pasieka, PhD and K. Wiederman, PhD

Course Description

This course situates Klein’s work as an extension and an elaboration of Freud’s in the psychoanalytic progression from Freud to Bion. With its origin in Klein’s development of the psychoanalytic play technique with children and its initial close ties to Freudian theory, this course outlines evolving contemporary Kleinian concepts as applied in clinical practice today, including the specific focus on unconscious phantasy, the role of internal objects and object relations, and Klein’s unique understanding and use of the concepts of developmental positions and characteristics modes of anxiety (paranoid-schizoid and depressive) and defence (splitting, projective identification, and the manic defences).

These seminars will elucidate the contribution of Kleinian thought and the application of contemporary Kleinian theory in working with different levels of pathology, including oedipal configurations, narcissistic and borderline pathology, and more primitive mental states. Candidates are encouraged to bring their own clinical material for discussion.

Course Objectives

Candidates will learn:

  1. To integrate Klein’s developmental theory and clinical method as an outgrowth and elaboration of Freudian ideas in clinical applications, with a particular focus on Klein’s understanding of internal object relations (1.1, 1.2).
  2. To trace the developmental progression from paranoid schizoid to depressive level functioning, bearing in mind that this process loops back and forth, not just in development and over the course of analysis, but also within the session (1.2, 4.5).
  3. How to track this progression within the session and over the course of an analysis (1.2,4.4, 4.5).
  4. To observe and work with projective identification as it emerges in the transference and countertransference (1.4, 4.2, 4.3).
  5. How to apply Kleinian concepts across various levels of pathology to facilitate change (1.2, 4.4, 4.5).

Seminar 1

Projective Identification: Clinical Ramifications

Klein (1946) described the process of projective identification, which, while not seen by Klein herself as one of her major concepts, has since been extensively elaborated and developed by contemporary Kleinians. This seminar will focus on its clinical applications.

Required Readings

Joseph, B. (1987). Chapter 5: Projective identification: clinical aspects. In E. Spillius & E. O’Shaughnessy (Eds.), Projective Identification: The Fate of a Concept (pp. 98-111). New York, NY & London: Routledge. [Also in Psychic Equilibrium and Psychic Change].

Bell, D. (2001). Projective identification, In C. Bronstein (Ed.), Kleinian Theory: A Contemporary Perspective (pp. 125-147). London: Whurr,

Ogden, T. (1979). On projective identification. International Journal of Psychoanalysis, 60, 357-373.

Seminar 2

Working with Narcissistic Pathology

This seminar will describe and provide clinical examples of the Kleinian understanding of narcissism as formulated by H. Rosenfeld and further elaborated by R. Britton and J. Steiner. The objective is for candidates to identify the major defenses and their use in narcissistic functioning as described by Rosenfeld and apply these to case material. Differentiation of the anxieties and unconscious phantasies of “thick-skinned” and “thin-skinned” narcissistic structures will be elaborated through clinical examples.

Required Readings

Rosenfeld, H. (1964). On the psychopathology of narcissism. International Journal of Psychoanalysis, 45, 332-337.

Britton, R. (1998). Chapter 4: Subjectivity, objectivity and triangular space. In Belief and Imagination (pp. 41-58). London: Routledge.

Supplementary Reading

Steiner, J. (2011). The anxiety of being seen: narcissistic pride and narcissistic humiliation. In Seeing and Being Seen (pp. 25-41). London: Routledge.

Seminar 3

Psychic Retreats and the Claustro-Agora-Phobic Dilemma

This seminar explores the Kleinian theory of primitive object relations as explicated by Henri Rey, Herbert Rosenfeld and John Steiner. The concepts of marsupial space, psychotic islands, and psychic retreats, as “places” inside the mind and body that patients with narcissistic, schizoid, psychosomatic, and borderline pathology psychically hide in order to avoid the pain of both separateness and togetherness, will be elucidated. The theory of internal object relations and how pathology manifests in primitive personality structures will be explored.

The clinical emphasis on the movement out of the ‘claustrum’ and the psychic retreats of narcissistic and borderline character pathology into movement towards the conflicts of ‘otherness’ and triangular space will be highlighted. The clinical focus on establishing a new psychic space in the analytic dyad through a process of understanding ‘who is who’ as internal object in the consulting room with a view to facilitating reparation rather than impasse will be studied.

Required Readings

Steiner, J. (1993) Chapter 4: Review: narcissistic object relations and pathological organizations of the personality. In Psychic Retreats (pp.40-53). London: Routledge.

O’Shaughnessy, E. (1992). Enclaves and excursions. International Journal of Psychoanalysis, 73, 603-611.

Supplementary Reading

Rey, J. H. (1979). Schizoid phenomena in the borderline. In E. Bott-Spillius (Ed.) Melanie Klein Today: Developments in Theory and Practice (1988, pp.203-229). New York, NY: Routledge.

Seminar 4

Oedipal Configurations and Triangular Space

This seminar explores Klein’s concept of oedipal configurations that emerge developmentally prior to the Freudian Oedipus complex, as elaborated by contemporary Kleinians. The objective of this seminar is to understand the role of triangulation of internal space and to utilize the concept of triangular space of mind with a view to understanding case material and its implications for technique.

Required Readings

Britton, R. (1989). The missing link, parental sexuality in the Oedipus complex. In R. Britton, M. Feldman, & E. O’Shaughnessy (Eds.), The Oedipus Complex Today. London: Karnac.

Steiner, J. (2011). Chapter 5: Transference to the analyst as an excluded observer. In Seeing and Being Seen (pp. 78-96). London: Routledge.

Supplementary Reading

Ogden, T.H. (1994). The analytic third: Working with intersubjective clinical facts. International Journal of Psychoanalysis, 75, 3-19.

Seminar 5

Understanding Primitive Mental States

This seminar explores how ‘unmentalized’ experiences get expressed in enactments and how primitive or “extra ordinary” protections are created to keep at bay an awareness of deeply traumatic experiences, or sometimes reality itself. Implications for clinical practice and understanding the infantile transference/countertransference will be explored.

Required Readings

Mitrani, J. (2001). Chapter 2: Extra-ordinary protections: the evolution of the theory of adhesive identification. In Ordinary People and Extra-Ordinary Protections (pp.19-40). London: Brunner-Routledge.

Perez-Sanchez, A. (2018). Chapter 2: Communication and the psychotic part of the personality. In Psychotic Organization of the Personality (pp. 25-54). London: Routledge.

Bion, W.R. (1959). Attacks on Linking. International Journal of Psychoanalysis, 40, 308-3 15.

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