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410 Psychoanalytic Process: Initiating, Deepening the Analytic Process, Termination – 7 seminars

Seminar Leaders: C. Lunney, MD and D. Traub-Werner, MD, R. Ruskin, MD

Course Description

This course focuses on initiating, deepening and the termination of the psychoanalytic process. It builds upon earlier courses in assessment for analyzability and consultation with a Supervisor on suitability of a control case.

Part I Initiating Psychoanalysis

Initiating an analysis is complex and multi-layered. Papers and discussion in these two seminars explore the questions: how does a psychoanalysis begin? What goes on when the analyst and prospective analysand meet for the first time? What processes are activated to make the project for an analysis possible? Does the indication for analysis lie as much in the analyst as in the patient?

Part II Mid-phase Analytic Process: Therapeutic Action, Deepening the Analytic Process

In the mid-phase section, the papers and discussion will explore the major questions: What is it that happens in the course of psychoanalysis? How and why do changes occur? What is the nature of the psychoanalytic process? Review papers will outline the range of positions on the core factors at work in the analytic process and in therapeutic action. The seminar will also examine the analyst’s ambivalence about maintaining and deepening the analytic engagement and the analyst’s conflicts around maintaining the analytic frame.

Part III Termination

Three seminars on termination will discuss the major papers on this subject: Freud’s 1937 work on “Analysis Terminable and Interminable”.  Balint, Buxbaum, Klein and Reich articles from the 1950s are considered in the light of the development of Freud’s ideas about termination. Issues which arise at termination are explored: Who decides readiness? Analyst, analysand or both?; ambivalence of analyst and analysand; completeness of the analysis; saying good-bye, loss, grief and mourning; and how the analysand approaches ending in the light of the person’s history and character.

Course Objectives

Candidates will:

  1. Review and consolidate ideas on initiating the psychoanalytic process, including the effective use of the self (1.2 a, 1.2.c, 4.5b)
  2. Discuss the process of beginning of a psychoanalysis with difficult patients (1.2 f, 1.4.b, 4.2.a, 4.2.e, 4.2.k)
  3. Understand, and integrate into practice the wide range of therapeutic factors that are work in effecting change in the patient through a psychoanalytic process (4.2.a, 4.5.o)
  4. Read major papers, early and recent, on termination of a psychoanalytic process in order to facilitate a therapeutic ending to the process (4.5.s, 4.5.t)

Part I Initiating Psychoanalysis

Seminar 1

Recommending Psychoanalysis and the Working Alliance

Required Readings

Freud, S. (1940) An Outline of Psychoanalysis. SE 23: 139 – 208 (PepWeb)

Winnicott, D. (1962) The Maturational Process and the Facilitating Environment. Chapter 15: The Aims of Psychoanalytic Treatment p.166-170 (PepWeb)

Supplementary Reading

Reith, B. (2011). The specific dynamics of initial interviews: Switching the level or opening a meaningful space. European Federation of Psychoanalysis: Bulletin 64(Suppl.):57-80 (will make available).

Seminar 2

The Analytic Process with difficult patients and the Therapeutic Alliance

Required Readings

Green, A. (2005) Key Ideas for a Contemporary Psychoanalysis: Misrecognition and Recognition of the Unconscious. Chapter 3: Setting – Process – Transference p. 32-42. The new Library of Psychoanalysis. Routledge. ISBN 1-58391-839-6 (We will provide a copy of the chapter)

Reith, B. (2015) The First Interview: Anxieties and Research on Initiating Psychoanalysis. International Journal of Psychoanalysis 96:637-657 (PepWeb)

Supplementary Reading

Rothstein, A. (1998) On Beginning with a Reluctant Patient.  In On Beginning an Analysis Ed. Jacobs T. and Rothstein, A. IUP Press pp. 153-162.

II Mid phase: Analytic Process, Therapeutic Action and Deepening the analytic process

Seminar 3

Analytic Process and Therapeutic Action

Required Readings

Nacht, S. (1962). The Curative Factors in Psycho-Analysis1. Int. J. Psycho-Anal., 43:206-211

Weinshel, E. M. (1984) Some observations on the psychoanalytic process Psychoanal. Q. 53:63-92

Arlow, J.A. and Brenner, C. (1990). The Psychoanalytic Process. Psychoanal. Q., 59:678-692

Seminar 4

Deepening the analytic process

Required Readings

Killingmo, B. (1989). Conflict and Deficit: Implications for Technique. Int. J. Psycho-Anal., 70:65-79

Ehrlich, L.T. (2010). The analyst’s ambivalence about continuing and deepening an analysis. Journ. Amer. Psychoanal., 58:515-532

III Termination

Seminar 5

Termination major papers

Required Readings

Freud, S. (1937). Analysis terminable and interminable. In The Standard Edition of the Complete Psychological Works of Sigmund Freud, 23 (pp. 210-253).

Balint, M. (1950). On the termination of analysis. International Journal of Psychoanalysis, 31, 196-199.

Buxbaum, E. (1950). Technique of terminating analysis. International Journal of Psychoanalysis, 31,184-190.

Klein, M. (1950). On the Criteria for the Termination of an Analysis. International Journal of Psychoanalysis, 31, 78-80; 204.

Reich, A. (1950). On the Termination of Analysis. International Journal of Psychoanalysis, 31, 179-183.

Seminar 6

Contemporary Concepts of Termination

Required Readings

Ticho, E. (1972). Termination in psychoanalysis: treatment goals, life goals. Psychoanalytic Quarterly, 41, 315-333.

Gabbard, G. (2009). What is “good enough” termination? Journal of American Psychoanalytic Association, 57, 575-594.

Seminar 7

Post-termination Contact

Required Readings

Schachter, J. et al. (1997). Clinical experience with psychoanalytic post-termination meetings. International Journal of Psychoanalysis, 78, 1183-1198.

Kantrowitz, J. (2002).   Follow-up of psychoanalysis five to ten years after termination (Part II): development of the self-analytic function. Journal of American Psychoanalytic Association, 38, 637-678.

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