2007 Paper Workshop Sessions

There will be two separate workshop sessions - A and B - each offering twelve topics from which to chose. Click on a workshop title to learn more.

SESSION A (Friday, October 12, 2:15 - 3:45 PM)

1. Meet the Author - Craft and Spirit: A Guide to the Exploratory Psychotherapies
2. Moving Along: Reflections on the Boston Change Process Study Group
3. A Strange Convergence: Postmodern Theory, Infant Research and Psychoanalysis
4. How Do We "Know" What We "Know?" And How Do We Change What We "Know?"
5. A Tale of Two Minds: Mentalization and Adult Analysis
6. Notes on Treating a Dying Patient: An Intersubjective Systems View
7. Kurt Godel, Dynamic Systems Theory, and Trauma: Incompleteness of a Grand Narrative
8. Radical Hope and Systems of Adequate Trust
9. Is this Patient "Analyzable?" The Candidate's Dilemma
10. Treating Relationship Problems When Hearing Only One Side of the Story: Suggestions from a Sometimes Frustrated Couples Therapist
11. A Dynamic Systems View of the Transformational Process of Mirroring
12. Fantasy Play as the Conduit for Cure in the Treatment of a Six Year-Old Boy with Asperger's Disorder

SESSION B (Saturday, October 28, 4:15 - 5:45 PM)

1. Meet the Author - Trauma and Human Existence: Autobiographical, Psychoanalytic, and Philosophical Reflections
2. Tone as a Measure of the Relationship in Psychotherapy and other Co-Narrative Experiences
3. Turbulent Contextualism: Bearing Complexity Toward Change
4. Empathy, Connectedness, and the Evolution of Boundaries in Self Psychological Treatment
5. A Dream Looking for a Thinker: Dissociation and Symbolization in the Analytic Relationship
6. The Experience of Pain: Multiple Meanings and Multiple Influences of Self and Systems in the Psychology of the Self
7. The Deaf Mother and the Beauty of Indifference: Marcel Duchamp and the Psychological Foundations of Modern Art
8. Finding a Way to Live With It: Twinship, Loss, Death and Mourning
9. Illusion and Fantasy in Analytic Change
10. Meet the Author - Attachment in Psychotherapy
11. Improvisation Provides a Window into Implicit Processes: Thoughts on Philip Ringstrom's work - in Dialogue with Eugene Gendlin
12. The Case of Emily: Analyst Dissociation from a Systems Perspective

A1. Meet the Author - Craft and Spirit: A Guide to the Exploratory Psychotherapies

Meet the Author Session

Author:
Joseph D. Lichtenberg, MD

Discussant:
Alan R. Kindler, MBBS, FRCPC

Abstract:
In Craft and Spirit, Dr. Lichtenberg tries to capture in words something of the creative skill and artistry that mobilizes and sustains a spirit of inquiry. In the 35 years of experience working within the frame of self psychology, analysts have learned a great deal about how to approach a wide range of patients. Craft and Spirit attempts to describe this evolving approach by integrating guidelines derived from self psychology, intersubjectivity, and relational perspectives. Originally presented in The Clinical Exchange with Dr. Frank Lachmanm and Dr. James Fosshage using a single case example, I have now expanded our description using many clinical vignettes. We regard our guidelines as strategies for negotiating the dilemmas inherent in therapy as a dyadic process in which therapists must sense themselves and be sensed by their patients as fully emotionally involved.

Educational objective: to consider in depth guidelines for a therapeutic approach to a wide range of patients.

A2. Moving Along: Reflections on the Boston Change Process Study Group

Paper Workshop Session

Presenters:
Dorienne Sorter, PhD and Jacqueline J. Gotthold, PsyD

Moderator:
Jane Rubin, PhD

Discussant:
James M. Fisch, MD

Abstract:
In this paper the authors examine in both the adult and child treatment process recent developments explicated by the work of the Boston Change Process Study Group. Highlighted is the interweaving of the explicit/declarative domain with the implicit/ procedural domain in all interactions as it gives new meaning and understanding to self psychology's bidirectional, interactively regulated, attuned-responsive treatment dyad.

A question is raised as to whether sufficient emphasis has been placed on (1) the "moving along" process, explicated in earlier papers (1998, 2002, 2005) by the BSG, (2) the interplay of declarative/explicit and non-declarative/procedural dimensions in the treatment process and (3) whether the recent expansion and application of the BSG's work towards the creation of a unified field theory is not premature. Attention is refocused on the importance of "moving along" which the authors feel to be central in the understanding of therapeutic action. They assert further that co-created, interactively regulated interchanges occurring procedurally are transformative in and/of themselves and are, thus, interpretive.

An adult treatment case and a child treatment case are presented in order to demonstrate the universality of the underlying process of interweaving both declarative and procedural dimensions of the clinical process regardless of the specific developmental capacities brought to the consultation room. Emphasis in these cases is on the "moving along" process.

At the conclusion of this session, participants will be able to explain the "moving along process" as explicated by the Boston Change Process Study Group and expanded in this presentation as exemplified in clinical work with adults and children.

A3. A Strange Convergence: Postmodern Theory, Infant Research and Psychoanalysis

Paper Workshop Session

Presenter:
Judith Guss Teicholz, EdD

Moderator:
Judith Rustin, MSW

Discussant:
Judith C. Pickles, PhD, PsyD

Abstract:
In this paper, I describe what I see as a strange convergence between the postmodern project in psychoanalysis and the recent work of infant-caregiver researchers, attachment theorists, and cognitive neuroscientists—whose findings paradoxically seem to support certain postmodern attitudes. The convergence is strange and paradoxical because, from a postmodern viewpoint, there is no scientific truth "out there," beyond what can mutually be agreed upon through intersubjective negotiation. Holding in mind the tensions between these scientific and post-scientific approaches to reality, I examine selected empirical studies and discuss where their findings might fall on a postmodern continuum. I also discuss the implications for Self Psychology and Relational Psychoanalysis and suggest that the research—as well as the Nonlinear Dynamic Systems model of the mind that the findings support—might be bringing the two contemporary theories together, around certain tenets of their respective paradigms until now understood to be in conflict.

At the conclusion of my presentation, the participant will be able to describe selected findings from infant-caregiver, attachment, and cognitive neuroscience that support certain postmodern ideas in psychoanalysis and seem to bring together previously conflicting tenets of Self Psychology and Relational theory.

A4. How Do We "Know" What We "Know?" And How Do We Change What We "Know?"

Paper Workshop Session

Presenter:
James L. Fosshage, PhD

Moderator:
Susanna I. Martinez, MA

Discussant:
William J. Coburn, PhD, PsyD

Abstract:
A theory of psychological development requires an understanding of how we learn, how we encode information to remember, how memory affects ongoing organization of experience, and how learning, memory and psychological organization are transformed. Over the past quarter of a century, psychoanalytic theoreticians have been integrating and further expanding within a psychoanalytic context the extraordinary developments occurring in cognitive science, creating new theories of psychological development, transformation and psychoanalytic change. Perhaps most revolutionary is the finding that perceptual/ cognitive/affective activity occurs simultaneously at a non-conscious or implicit as well as conscious level of awareness throughout the waking cycle. In addition, REM, dream content and neuroscience research have demonstrated that the brain through REM, non-REM and corresponding dream activity continues its complex cognitive/affective processing during sleep.

The perceptual/affective/cognitive model that differentiates between two domains of learning and memory, the implicit/nondeclarative and explicit/declarative systems, has quite recently received considerable focus in psychoanalysis. The focus of this paper is how these memory systems differ in type of information processed, type of encoding, principles of operation, and neurological structures all of which has considerable import for theories of therapeutic action. Two fundamental avenues of analytic change are proposed.

At the conclusion of this session, participants will learn about the implicit and explicit domains of learning and memory; understand how these two domains of learning are parallel or interconnected systems in part based on the understanding of how each system encodes information; and understand how the two fundamental avenues of analytic change that I propose are related to these two systems.

A5. A Tale of Two Minds: Mentalization and Adult Analysis

Paper Workshop Session

Presenter:
Helen Grebow, PhD

Moderator:
Jill R. Gardner, PhD

Discussant:
Salee Jenkins, PhD

Abstract:
In this paper I examine the concept of mentalization, its utility in contemporary psychoanalysis, and the development of a mentalizing capacity as a requisite component of the analytic process with challenging, dysregulated adult patients. Adults who have lacked the experience of attunement in the early infant/caregiver relationship exhibit profound deficits in their capacity for mentalization. They typically have a history of disruptive and traumatizing attachments. I propose that the development of mentalization within the analytic dyad shapes the initial focus and the beginning phase of analysis with these adult patients. The initial analytic process, with a focus on developing a mentalizing capacity, would have a different shape and feel than a process that focuses on interpretive interventions. I use clinical vignettes to illustrate a contemporary analytic process as patient and analyst engage in a relationship which facilitates the patient's experience of being understood and promotes the development of mentalization—an implicit, nonconscious process that facilitates self-reflection and the ability to make use of interpretive understanding.

Participants will acquire an understanding of how a focus on the development of mentalization is a requisite element for the use of interpretative interventions in adult analysis with particularly challenging, dysregulated patients.

A6. Notes on Treating a Dying Patient: An Intersubjective Systems View

Paper Workshop Session

Presenter:
Bernard Brickman, MD, PhD

Moderator:
Allen Siegel, MD

Discussant:
Andrew Morrison, MD

Abstract:
Much of our thinking about grief related to death and dying has been influenced by the well-known writings of Kubler-Ross (1981). This author describes stages of grief (denial, anger, bargaining, depression and acceptance) that a patient experiences when informed of his terminal prognosis. Although I do not challenge the validity of these findings, in this paper I argue against taking them as preconceived organizers of our work with dying patients. Accordingly, I believe that each therapist-patient dyad must organize its own therapeutic approach that is uniquely responsive to the intersubjective system formed by each. I suggest that a systems approach is most suitable to address the complexity of the issues encountered by each therapist-patient couple. I attempt to show the advantage of applying these principles in my work with a 43 year old man who was given the diagnosis of incurable lung cancer. He believed that he was responsible for causing his illness. I offer a detailed clinical description of the unusual path that we took together. It consisted, among other therapeutic actions, of the use of dream analysis and hypnosis to help maintain his hope that he could wage a successful battle against his illness. We were in fact successful in prolonging his life and in improving its quality.

At the conclusion of my presentation the participant will have gained a deeper understanding of the advantages of an intersubjective systems approach to treating dying patients.

A7. Kurt Godel, Dynamic Systems Theory, and Trauma: Incompleteness of a Grand Narrative

Paper Workshop Session

Presenter:
Maxwell Sucharov, MD, FRCPC

Moderator:
Steven Stern, PsyD

Discussant:
Jeffrey Trop, MD

Abstract:
This paper is concerned with the nature of traumatic experiential realms and the intrinsic limitations of our conceptual narratives to contain them. My central thesis is that the domain of lived truth, especially its horrific dimension, will always exceed the explanatory/descriptive capacity of conceptual discourse. A critical examination of non-linear dynamic systems/complexity theory will disclose it to be a psychological product that emerges from our community's emotional imperative for a Grand Narrative that can make sense of the traumatic medium that occupies the analytic space. Integration of Kurt Godel's Incompleteness Theorem with the principles of complex systems will show why this imperative, must, of necessity, always be incomplete. A clinical discussion will consider the clinical challenge of working productively within this fundamental limitation.

At the conclusion of my presentation the participant will be able to appreciate the inaccessibility of horrific traumatic realms to narrative understanding and to work productively within this fundamental limitation.

A8. Radical Hope and Systems of Adequate Trust

Paper Workshop Session

Presenter:
Donna M. Orange, PsyD, PhD

Moderator:
Susanna Federici-Nebbiosi, PhD

Discussant:
Doris Brothers, PhD

Abstract:
Jonathan Lear's Radical Hope: Ethics in the Face of Cultural Devastation introduces us to Plenty Coups, the last great Crow chief who led his people through their loss of the buffalo and their whole traditional way of life—understood as a world—onto the reservation. Plenty Coups exhibited a kind of Aristotelian courage that Lear is calling radical hope which enables a person or a people to go on when everything that had given their life meaning is gone. This paper asks how it is possible, psychologically, for this to happen, and looks to psychoanalytic concepts of intersubjective systems and attachment for clues.

Learning objective: Listeners will be able to describe the devastation of a psychological or cultural world.

A9. Is this Patient "Analyzable?" The Candidate's Dilemma

Paper Workshop Session

Presenter:
Linda L. Marino, PhD

Moderator:
Sanford Shapiro, MD

Discussant:
Margaret J. Sperry, PsyD

Abstract:
The question "Who is analysis for?" lies at the heart of this paper. The population of patients considered "analyzable" has evolved with each change of theory from Freud's time to the present. Historically the question of analyzability was formulated in terms of what patient characteristics make for a successful analysis. My own experience and my review of the literature (Bachrach 1990) has led to the conclusion that objective criteria based on ego functions, developmental criteria, object relations levels etc. predict analyzability only marginally. In this paper I am going to present two inter-related topics: First, the analyst's subjectivity is an extremely important source of information about the patient and plays a significant role in assessing the potential transference connection between patient and analyst. Second, I also address the crosscurrent of conflicting needs and requirements that analytic candidates face when assessing analyzability and selecting a control case. I use clinical material from a control case to examine the issues that arise when attempting to select a "good," i.e. analyzable, case for analysis. The case demonstrates the use my subjectivity as a source of information about my patient and about the patient-analyst connection during the analysis. (A prominent New York ego psychologist, using traditional criteria, said that this patient was not analyzable and I would not be allowed to treat her at his institute.) I emphasize that whether a patient is analyzable is also dependent on the capacities and limitations of the therapist, and patient-therapist "fit" is an important factor in patient selection. And I conclude that the intuitive use of the analyst's subjective self may be the best indicator of therapeutic success that is currently available to us.

At the conclusion of my presentation, the participant will be able to explain how objective criteria do not predict analyzability, and that the analyst's subjectivity is an extremely important source of information about the patient and plays an ongoing role in assessing the transference connection between patient and analyst.

A10. Treating Relationship Problems When Hearing Only One Side of the Story: Suggestions from a Sometimes Frustrated Couples Therapist

Paper Workshop Session

Presenter:
Carla Leone, PhD

Moderator:
Brenda Solomon, PhD

Discussant:
Judith Levene, PhD

Abstract:
This paper highlights a common problematic dynamic in which individual therapists and analysts whose patients report relationship problems begin to form negative opinions or conclusions about the patient's spouse or partner, despite having (usually) never met the person. For a number of reasons, discussed in the paper, clinicians can lose touch with the fact that their conclusions and beliefs about the spouse are constructions based only on their individual patient's subjective experience—and their own experience of their patient's reports. They can then communicate their constructions and formulations of the spouse or the marriage to the patient in ways that may ultimately do a disservice to the patient, the spouse and the couple's relationship.

After a brief review of relevant literature, this paper outlines various influences on the development of these problematic constructions of the unseen spouse. It then summarizes the basic tenets of a self psychological, intersubjective understanding of couples difficulties, and uses this framework to formulate suggestions about how individual therapists can best respond to complaints about a spouse without falling into the pitfalls described.

By the end of this presentation, participants will be able to describe three influences on the development of problematic conceptualizations of the unseen spouse.

By the end of this presentation, participants will be able to summarize the basic tenets of a self psychological, intersubjective understanding of the causes of couples' difficulties.

By the end of this presentation, participants will be able to list several ways to respond to complaints by an individual patient about his or her spouse that avoid the development of such conceptualizations.

A11. A Dynamic Systems View of the Transformational Process of Mirroring

Paper Workshop Session

Presenter:
Nancy P. VanDerHeide, PsyD

Moderator:
Ronald A. Bodansky, PhD

Discussant:
Sandra G. Hershberg, MD

Abstract:
Dynamic systems theories such as complexity and nonlinear dynamic systems theories provide increased flexibility in approaching psychological phenomena with a less rigid, more fluid sensibility. They provide us with process language that moves away from linear directionality in construing psychoanalytic action in favor of a sensibility of emergence. This paper resituates the concept of mirroring within the realms of systems thinking in an effort both to illustrate systems theory concepts and to elucidate more fully the mirroring process.

At the conclusion of my presentation, the participants should be able to explain complex systems concepts including emergence, embeddedness, and recurrence in the context of the process of mirroring.

A12. Fantasy Play as the Conduit for Cure in the Treatment of a Six Year-Old Boy with Asperger's Disorder

Paper Workshop Session

Presenter:
Katharine Gould, MSW, MFA, LCSW

Moderator:
Samuel Izenberg, MD

Discussant:
Marian Tolpin, MD

Abstract:
I will present the treatment summary of David, a six-year-old boy with Asperger's Disorder, whom I saw in once a week sessions for two and a half years. Using notes from my sessions, I will demonstrate the effectiveness of fantasy play in teaching reciprocity and in rekindling the child's use of creativity and invention. Over the course of treatment, this experience enabled David to feel safe and empowered in the external world where formerly he had been a helpless and angry outcast—a child whose behavior had alienated his peers and who was an unmanageable puzzle for his parents and teachers.

To show that it was my gradual introduction of fantasy into the session material presented by David that eventually enabled him to let go of the mechanistic and repetitive rituals so typical of children with Asperger's Disorder. Using a self-psychological approach, I will demonstrate how I was able to uncover the keen longing for attachment that lay underneath David's "unrelated" and misunderstood behaviors.

B1. Meet the Author - Trauma and Human Existence: Autobiographical, Psychoanalytic, and Philosophical Reflections

Meet the Author Session

Presenter:
Robert D. Stolorow, PhD

Discussant:
Estelle Shane, PhD

Abstract:
Trauma and Human Existence interweaves two themes central to emotional trauma: The first pertains to the contextuality of emotional life in general and of the experience of emotional trauma in particular. The second pertains to the recognition that the possibility of emotional trauma is built into the basic constitution of human existence. This volume traces how the two themes interconnect. Whether or not this constitutive possibility will be brought lastingly into the foreground of our experiential world depends on the relational contexts in which we live. Taken as a whole, the book exhibits the unity of the deeply personal, the theoretical, and the philosophical in the understanding of emotional trauma and the place it occupies in human existence.

B2. Tone as a Measure of the Relationship in Psychotherapy and other Co-Narrative Experiences

Paper Workshop Session

Presenter:
David Goldin, MA

Moderator:
Starr Kelton-Locke, PhD

Discussant:
Bruce Herzog, MD, FRCPC

Abstract:
In this paper I examine how the tone of a client's narrative reflects the tenor of the relationship between therapist and client. I consider how autobiographical memory is co-constructed first by child and caregiver and later within other significant telling relationships, such as that between therapist and client. I explore how the implicit, relational aspects of telling emerge in these narratives as tone, and I offer a case history illustrating how changes in the tone of a client's narrative measure interpersonal (and intra-psychic) change.

At the conclusion of the presentation, the participant will describe ways to identify a dimension of transference that permeates the sessions of some client's in the form of tone. Since tone does not stand out from, so much as underlie a narrative, it can be tricky to delineate. Participant will also illustrate how an introspective-empathic approach to listening to a client can produce changes in the tone of a client's narrative, changes that allow for greater insight and access to new material in the treatment.

B3. Turbulent Contextualism: Bearing Complexity Toward Change

Paper Workshop Session

Presenter:
Elena M. Bonn, PsyD

Moderator:
Hans Peter Hartmann, MD, PhD

Discussant:
Michael D. Pariser, PsyD

Abstract:
Recently, psychoanalysis has approbated physical science concepts to explain the momentum of clinical work. This paper continues in that tradition with turbulent contextualism, a theoretical system that describes the necessary yet destabilizing and chaotic elements of change, which occur in the psychoanalytic process. With turbulent contextualism, the emergence of new solutions in the psychoanalytic environment is connected to the capacity of the psychoanalyst and the patient to bear complexity and be able to accept the non-linear nature of change. The paper concludes with an application of turbulent contextualism to two clinical cases. The first case details the use of this model in a long-term psychoanalytic treatment. The second case uses the same ideas to explore my own personal development and self-definition, which were consolidated through the process of writing this paper.

At the conclusion of my presentation, the participant will be able to explain and apply some key concepts from complexity and non-linear dynamic systems theory to the process of change within the psychoanalytic dyad.

B4. Empathy, Connectedness, and the Evolution of Boundaries in Self Psychological Treatment

Paper Workshop Session

Presenter:
Richard A. Geist, EdD

Moderator:
Robert Lundquist, PsyD

Discussant:
Ruth Gruenthal, MSS

Abstract:
This paper discusses the evolution of non-linear boundaries in the therapeutic dyad when we work from a connectedness sensibility. Using verbatim material from a session with a fragmentation prone and at times rageful patient, the paper argues that boundaries should evolve so that they embrace a form and shape whose structure will provide the relationship with a depth and connectedness that is in the service of enhancing the patient's self organization. The paper emphasizes the difference between boundaries and safety in a dyadic system, how boundary challenging behavior is always in the service of health rather than provocativeness and pathology, the importance of heightened affective moments in the evolution of mutual boundaries, and how boundaries, when allowed to emerge from within the system rather than being imposed from the outside, catalyze affective regulatory structures in the patient while concurrently strengthening and reorganizing the therapist/analyst's self organization.

B5. A Dream Looking for a Thinker: Dissociation and Symbolization in the Analytic Relationship

Paper Workshop Session

Presenter:
Susan H. Sands, PhD

Moderator:
David M. Terman, MD

Discussant:
Carol Mayhew, PhD

Abstract:
The paper centers around a recent, dramatic "traumatic analytic experience," in which a patient's reporting of a traumatic dream interacted with a vulnerability in my own psyche, resulting in a traumatic, dissociative disruption of my therapeutic function and struggle to recover, and subsequently, to a symbolization process and significant alteration of the patient's dissociative process. I argue that such discrete "traumatic analytic experiences" are essential to furthering the work with survivors of massive trauma. In such experiences, the analyst is actually, temporarily traumatized—in part, because an actual personal vulnerability of the analyst is engaged. The analyst's vulnerability serves as a kind of internal contact point, which opens up a process of unconscious empathy with the patient.

At the conclusion of my presentation, the participant will have a better understanding of how dissociated material can become symbolized through mutually-created traumatic enactment and mutual regulation within the analytic relationship.

B6. The Experience of Pain: Multiple Meanings and Multiple Influences of Self and Systems in the Psychology of the Self

Paper Workshop Session

Presenter:
Marilyn S. Jacobs, PhD

Moderator:
Arthur Malin, MD

Discussant:
Gary Rodin, MD

Abstract:
The problem of pain figures largely in the inception of psychoanalysis as what began for Sigmund Freud as an inquiry into unexplained states of pain led to the creation of the psychoanalytic model of the mind. This paper will discuss the issues involved in the treatment of patients with persistent pain states using psychoanalytic theory and technique. The discussion will survey classical and contemporary models of psychoanalysis as well as insights from medicine, philosophy, general psychology and history to arrive at a model for understanding pain at the level of the self and at the level of the system. The discussion will be organized around an illustrative case example.

At the conclusion of this presentation, the participant will understand: The complexity of the problem of persistent pain and the range of psychoanalytic explanations for this condition; and, using psychoanalytic theory and technique be able to derive formulations and treatment for patients with these presentations.

B7. The Deaf Mother and the Beauty of Indifference: Marcel Duchamp and the Psychological Foundations of Modern Art

Paper Workshop Session

Presenter:
George A. Hagman, LCSW, CSW

Moderator:
Sandra M. Keirsky, PhD

Discussant:
Gianni Nebbiosi, PhD

Abstract:
This paper examines the aesthetics of Marcel Duchamp, the French-American artist whose early contributions to the Dadaist and Surrealist movements opened the way for much of the innovation of late 20th century art. From the perspective of contemporary psychoanalytic theory, it is argued that much of Duchamp's aesthetics and his approach to the problem of the modern artist were highly influenced by his relationship with his deaf and schizoid mother. Marcel attempted to compensate for these self and relational deficits through artistic activity and the articulation of an aesthetics that both reflected the experience of failure while at the same time embodying beauty and perfection. His philosophy offered an opportunity for a healing process to occur in which early developmental failure and self-deficits could be compensated for through engagement in the creative process and the production of art. It also recapitulated aspects of the mother-child relationship that remained unresolved and highly conflicted for Marcel. This thesis will be elaborated through discussion of some of Duchamp's most important artwork.

Educational Objective: Participants will acquire an understanding of the influence of psychological development on the creativity of a major 20th Century artist.

B8. Finding a Way to Live With It: Twinship, Loss, Death and Mourning

Paper Workshop Session

Presenter:
Staci L. Butler, LCSW

Moderator:
David S. Solomon, MD

Abstract:
Joan M. Rankin, MSW, PsyD

Abstract:
In this paper, the analyst's experience of a co-constructed twinship transference and countertransference is explored in the treatment of a patient grieving for his brother. When the patient suddenly dies during treatment, the analyst struggles to find a way to mourn and grieve for her patient, given the complexities and confidential nature of the therapeutic relationship. She ultimately finds ways to mourn for her patient, and honor their relationship both within the analytic community and the patient's community of friends and family.

At the conclusion of my presentation, the participant will be able to describe the evolution of a bi-directional twinship transference and countertransference, the analyst's experience of the death of a patient and her own mourning process.

B9. Illusion and Fantasy in Analytic Change

Paper Workshop Session

Presenter:
Laura Caghan, PsyD

Moderator:
Lester Lenoff, MSW

Discussant:
Howard A. Bacal, MD, FRCPC

Abstract:
Here is a man who relied upon anger—both to obscure the emptiness within and to construct a pseudo self around it. In this paper I explore positive ways that fantasy and illusion helped the two of us to build reefs in his emptiness. Using Quinn's case as an example, I spell out ways in which illusion and fantasy can be embedded in the process of analytic change. As they contribute to the development of hope and faith, such positive illusions help clients to resolve resistances.

Individuals will gain understanding of the positive ways that clients use illusion and fantasy to foster their own psychoanalytic changes.

B10. Meet the Author - Attachment in Psychotherapy

Meet the Author Session

Presenter:
David Wallin, PhD

Chair/Discussant:
Margaret Allan, LCSW

Abstract:
My book Attachment in Psychotherapy is a translation of attachment theory into clinical practice that situates the development of the self in a specifically relational—i.e., systems—context. Drawing on neurobiology, cognitive science, intersubjectivity theory, trauma studies, and the psychology of mindfulness, as well as attachment research, I advance a model of treatment as transformation through relationship. This model builds on the three key attachment findings that have the most profound and fertile implications for psychotherapy: first, that co-created attachment relationships are the key context within which the self develops; second, that preverbal experience makes up the core of the developing self; and third, that the stance of the self toward experience predicts attachment security better than the facts of development themselves. Accordingly, the book focuses on the use of the patient's new attachment relationship with the therapist as a crucible of development, on the centrality of the nonverbal subtext of the therapeutic conversation, and on the importance of shifting the patient's stance toward experience in a progressively more reflective and mindful direction. Whether in childhood or psychotherapy, the self develops in the setting of a relational system that is, by definition, co-created. Thus, the book's framework fuses the insights of attachment researchers who describe infant-parent relationships as mutually regulated and co-constructed with the conclusions of clinician/researchers who identify "mutual reciprocal influence" as a pervasive feature of the interactions between patient and therapist.

At the conclusion of my presentation, the participant will be able to grasp the implications of attachment theory research for the conduct of psychotherapy.

B11. Improvisation Provides a Window into Implicit Processes: Thoughts on Philip Ringstrom's work - in Dialogue with Eugene Gendlin

Paper Workshop Session

Presenter:
Lynn Preston, MA, MS

Chair/Discussant:
Steven Knoblauch, PhD

Discussant:
Philip Ringstrom, PhD, PsyD

Abstract:
The model of improvisation provides us with new images, metaphors and guidelines for attuned spontaneous clinical engagements. It also offers us a conceptual framework for understanding implicit experience. This presentation starts with Philip Ringstrom's "relational ethic"—his descriptions of and guidelines for working with the immediacy and liveliness of inventive analytic play. It integrates Eugene Gendlin's philosophical underpinnings—his use of improvisation as an experience-near instance of the nature of "the implicit" and the workings of emergence. In bringing these approaches together we expand both our clinical and theoretical possibilities.

Participants will become familiar with the model of improvisation as it provides us with guidelines for spontaneous, creative, clinical interactions and theoretical understanding of the workings of implicit experience.

B12. The Case of Emily: Analyst Dissociation from a Systems Perspective

Paper Workshop Session

Presenter:
Joye E. Weisel-Barth, PhD, PsyD

Moderator:
James M. Fisch, MD

Discussant:
Kati Breckenridge, PhD

Abstract:
In this case the analyst and patient jointly created an analytic space in which the dissociation of affect from thought was a primary feature. This paper describes how the dyad deals with the dissociation and offers an explanation of the process from a dynamic systems or complexity theory perspective.

To illustrate how some ideas from dynamic systems thinking may be very clinically useful.

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