2003 Schedule & Paper Abstracts

Optional Pre-Conference Workshops
Optional Pre-Conference Courses
Main Conference Program
Special Interest Workshop
Original Papers/Workshops - Session A
Original Papers/Workshops - Session B
Original Papers/Workshops - Session C

OPTIONAL PRE-CONFERENCE WORKSHOPS
Thursday, November 6, 2003
1:00 - 4:15 PM
Workshops A, B, C, and D are offered simultaneously before the Pre-Conference Courses.
There will be a 15 minute break at 2:45 PM.

Optional Workshop A
A Scientific Day in Three Parts
Mother-Infant Research and Implications for Mother-Infant Treatment and Adult Treatment
Part I: Mother-Infant Interaction Patterns and the Prediction of Infant Attachment: A Video Lecture
Presenter:
Beatrice Beebe, PhD
Moderator:
Frank M. Lachmann, PhD

This 3-part workshop will review empirical research on mother-infant interaction, the prediction of infant attachment, and the implications for adult as well as mother-infant treatment. Audience participation will be encouraged.
A film will illustrate these interaction patterns.

Optional Workshop B
Art, Creativity and Self Psychology
Co-Leaders:
George A. Hagman, MSW
Carl T. Rotenberg, MD
Discussant:
Carol M. Press, EdD

This innovative workshop will explore the application of self psychology to the understanding of aesthetic experience, artists and the creative process. Participants will see how an analytic perspective can greatly enhance their enjoyment and understanding of art. In addition, an exploration of art's influence can enhance our understanding of clinical experience. Mr Hagman will present an overview of analytic aesthetics. Dr. Rotenberg will discuss how art shapes self structure, and will illustrate this with an in-depth discussion of illustrated paintings of Paul Gauguin and others. An optional field trip will be conducted to the Art Institute of Chicago to see the exhibition "Paul Gauguin and the South Pacific." There will be a small additional fee for the museum visit, which will be conducted from 11 to 1PM on the day of the workshop. Participants will be contacted prior to the conference with details.

Optional Workshop C
Specificity Theory and the Impact of 'Dual Relationships' on Therapeutic Effect - Part I
Co-Leaders:
Howard A. Bacal, MD, FRCP(C)
Nancy P. VanDerHeide, PsyD

This workshop will provide an opportunity to explore experiences of the multiplicity of roles that both analyst and analysand may play with each other during the course of analysis and after termination, and their effect on the therapeutic process. Polarized perspectives on such constructs as "dual relationships" may result in the restriction of emotional and intellectual freedom of thought that can impede the implementation of responsivity that may be therapeutic to the particular patient. The intent of this workshop is to provide a safe space within which to create a dialogue that will focus on the nature of these relationships within specific dyads, for the purpose of considering how they may enhance or diminish therapeutic effectiveness.

Optional Workshop D
We Were All Once Children: How Child Analytic Therapy Informs Adult Treatment
Co-Leaders:
Iris Hilke, MA
Rosalind C. Chaplin Kindler, MFA
Jacqueline J. Gotthold, PsyD
Mark D. Smaller, PhD
This workshop will be continued on Friday morning during Mark Smaller and Iris Hilke's Master Class

This workshop will describe how child treatment can inform the treatment of adults. Through theoretical presentation and discussion from three self psychological perspectives, followed by a detailed clinical example, the workshop will outline both the self psychology of child treatment and its contribution to all clinical and theoretical work.

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OPTIONAL PRE-CONFERENCE COURSES
Thursday evening, November 6, 2003
7:00 - 9:00 PM
Friday morning, November 7, 2003
9:00 - 11:45 AM
Coffee and breakfast rolls will be provided on Friday morning from 8:00 - 9:00 AM.
There will be a 15 minute break at 10:15 AM.

1.   Introduction to Self Psychology
      Part 1:   Thursday Evening
      7:00 - 9:00 PM
      Part 2:   Friday Morning
      9:00 - 11:45 AM
      Leader:
      Robert J. Leider, MD

This course is intended for conference participants who would like and benefit from a comprehensive overview and discussion of basic concepts in self psychology. It will include discussion of the tri-polar self, of normal and pathological development of the self; of the disorders of the self, of the selfobject transferences, and of therapeutic process from the vantage point of self psychology. Those concepts held in common with traditional analytic theory and practice will be highlighted, and those that differ will be delineated.

2.   Advanced Course in Self Psychology
      Part 1:   Thursday Evening Section:
      7:00 - 9:00 PM
      Title:Self Psychology in the Age of Terrorism
      Chair:
      Mark D. Smaller, PhD
      Presenters:
      Marvin Zonis, PhD
      Charles B. Strozier, PhD
      David M. Terman, MD

The central issue confronting the US is the threat of global terrorism. This threat was realized first on the US homeland, in a significant way, on September 11 with the loss both of 3,000 lives and the illusion of America’s security from attack. This Advanced Course will address the question of terrorism from two perspectives, united by a common commitment to Self Psychology. Professor Chuck Strozier will report on his ongoing research with the victims of September 11—the survivors of the attack on the World Trade Center—and the important psychological consequences of the terrorism on US soil. Professor Marvin Zonis will present his thesis on the ways in which the failures of the Arab world have generated the soil, which supports violence and out of which individual terrorists emerge. David Terman, MD will offer a clinical perspective on these issues.

      Part 2:   Friday Morning Section:
      9:00 - 11:45 AM

This course is led by a senior self psychologist. An hour's worth of prepared material, to include some developmental history of the patient, a brief description of what brought that patient into treatment and an outline of how the treatment has progressed will be presented. The majority of the material will be in the form of process notes. The presentation will provide sufficient data to allow for a rich and interesting exchange of ideas between the leader and the participants. The meeting itself will be kept informal and guided by the interests of the participants.

3.   Working with Parents and Families
      Part 1:   Thursday Evening
      7:00 - 9:00 PM
      Part 2:   Friday Morning
      9:00 - 11:45 AM
      Co-Leaders:
      Carla M. Leone, PhD
      Amy H. Eldridge, PhD

This course will provide an overview of the application of self psychology and intersubjectivity theory to work with children, parents and families. A treatment approach will be outlined, involving individual work with the child, parenting-oriented work with parents or caretakers, and conjoint sessions with the entire family or family subgroups, as appropriate to the needs of the particular case. The course will include a focus on working with “difficult” parents and families, such as those in which one or more members are hostile, defensive, blaming or resistant to the treatment. Finally, the course will incorporate a discussion of how the judicious use of more directive or behavioral interventions with children and families can be understood and integrated within a self psychological framework. Case examples will be used throughout the course to illustrate concepts presented, and the last hour will be devoted to small group discussion of participants' case material.

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MAIN CONFERENCE PROGRAM
Friday Afternoon - November 7, 2003

1:00 - 1:10 PM      Welcome
                                James M. Fisch, MD
                                2003 Conference Chair

1:10 - 1:15 PM      Jerome Winter, MD
                                Director, Institute for Psychoanalysis of Chicago

1:15 - 2:45 PM
PANEL I:
Deconstruction of a Clinical Impasse
Chair:
Jill R. Gardner, PhD
Presenter:
Gianni Nebbiosi, PhD
Discussants:
Margaret J. Black, CSW
Alan R. Kindler, MBBS, FRCP(C)

To use a clinical example to explore the range of questions and considerations related to the notion of clinical impasse. What is it? Whose impasse? How might we conceptualize the central issues of transference, countertransference and therapeutic relationship? What interventions are appropriate? How might we conceptualize the success or failure of various types of interventions?

2:45 - 3:15 PM      Coffee Break

3:15 - 4:45 PM      Post Panel Discussion Group I
Registrants will meet in small groups to discuss Panel I. Sessions will be assigned at random.

Saturday, November 8, 2003

SPECIAL INTEREST WORKSHOP
Saturday, November 8, 2003
7:00 AM

Learning Self Psychology Abroad: The Turkish Experience
Chair:
Yavuz Erten, MA
Presenter:
Melis Tanik, PhD
Authors:
Irem Anlý, MA
Sibel Mercan, MD
Alper Sahin, PhD
Ayse Ozalkus Sahin, MA
Allen Siegel, MD
Nilgün (Tanriverdi) Taskintuna, MD
Verda Tuzer, MD

This workshop is designed to address the difficulties encountered by those who wish to obtain training in the theory and practice of Self Psychology, yet are in geographical areas where teachers and supervisors are not easily available. This is a problem that applies to some areas in the United States as well as to many countries abroad.

A group of 50 plus Turkish mental health professionals have engaged this educational problem and offer their 5-year experience, to those who are interested in the issue, as one possible model to solve problem. Several elements of the Turkish experience will be discussed, including the regular seminars conducted by visiting scholars and the incorporation of information technology into the learning environment via teleconferencing, video-conferencing and group email supervision.

All who share an interest in the problems of obtaining self psychological knowledge in areas that lack appropriate teachers are invited to attend this special interest workshop.

7:30 - 8:30 AM      Coffee and Breakfast Rolls

8:30 - 10:00 AM
PANEL II:
Creative Use of the Therapist's Self
Chair:
Philip A. Ringstrom, PhD, PsyD
Presenter:
Bruce Herzog, MD, FRCP(C)
Discussants:
Kati Breckenridge, PhD
Kenneth Newman, MD

To use clinical examples that raise questions of creativity and innovation in the clinical process. Is there a “standard technique” that one deviates from in special cases? Or do we need to rethink the very essence of the therapeutic process and define it more broadly? Questions regarding therapist’s self disclosure as well as when it is appropriate for the therapist to step outside a traditional listening mode into an action mode will be explored.

10:00 - 10:30 AM      Coffee Break

10:30 AM - 12:00 PM
Post Panel Discussion Group II
Registrants will meet in small groups to discuss Panel II. Sessions will be assigned at random.

12:15 - 2:00 PM
Optional Luncheon and Kohut Memorial Lecture

(This is an optional ticketed event at an additional fee; see Registration Form.) Only those attendees purchasing a ticket for the luncheon will receive one continuing education credit for the luncheon lecture. Those who do not elect to eat but wish to attend the lecture after the meal may do so based on space availability.

Kohut Memorial Lecture
Title: The Psychotheology of Everyday Life
Introduction: Arnold I. Goldberg, MD
Presenter: Eric L. Santner, PhD

The goal of this presentation is to suggest a number of ways in which psychoanalytic and religious thought intersect. The interest here is not merely to produce yet another psychoanalytic exegesis, this time focusing on the indebtedness of Freudian concepts and methods to religious traditions (though that is clearly important); rather, we will want to think about how psychoanalysis might today profit from its intimacy with certain aspects of religious thought and experience.

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ORIGINAL PAPERS/WORKSHOPS
2:15 - 3:45 PM      Session A

1.   Workshop:
      Meditation and Group Psychotherapy
      Presenter:
      Rosemary A. Segalla, PhD
      An Interdisciplinary Look at Love, Reason, and the
      Meditative State
      Presenter:
      Rochelle G. Kainer, PhD
      Moderator:
      Margaret N. Baker, PhD

Two papers on meditation and the psychotherapeutic process will be offered. These papers, rather than be full read will form the foundation of a discussion with the audience on the usefulness of meditation for both therapist and patient. One paper, discussed by Dr. Rochelle Kainer, will emphasize the experience of the analyst and her dialogue with a neuroscientist. Her use of the meditative state informed her clinical work as she also formed connections between love and reason, which more closely aligned cognition and affect. Two short clinical vignettes are offered.
The second paper, by Dr. Rosemary Segalla, offers the proposal that meditation done with patients at the beginning of sessions enhances access to affect and quickly deepens the work done among members of a therapy group. She suggests that because of the experience of a shared meditation process, the group becomes cohesive and functions at a level of intimacy, which is unusual for newly forming groups.
The two authors wish to stimulate audience discussion of issues surrounding the importance of the meditation process for psychoanalytic work.

2.   New Perspectives on Psycho Historical Trauma -
      Lessons Learned from Aging Holocaust Survivors
      Presenter:
      Susan E. Charney, MSW
      Discussant:
      Henry Szor, MD

The paper explores aspects of narcissistic vulnerability from wartime trauma that persist into later life. It touches upon my search as an analyst and a survivor for a viable theory for understanding aspects of narcissism in sustaining trauma. Using the theoretical contribution of Kohut and his followers, material from my work with patients, interviews with survivors under the auspices of the Child Development Research Center of the late Judith Kestenberg and from current biological material is explored. In view of recent events, understanding aspects of surviving psycho historical trauma has become a vital part of our work. In addition, the paper offers sources for restoration from a psychodynamic and cultural perspective.

3.   Getting Unstuck from Therapeutic Impasses:
      Using Peer Group Supervision and Audio-Taped
      Sessions to Integrate Procedural and Explicit Experience
      Presenters:
      Stan T. Dudley, PhD
      Todd F. Walker, PsyD
      Discussant:
      Jill R. Gardner, PhD

Psychoanalysis continues to explore ways to use therapist subjectivity to facilitate a mutative verbal and nonverbal engagement and bond with the patient. Nonverbal or procedural interaction and communication between patient and therapist are being understood in a more comprehensive context of cognitive science, attachment and developmental theory, nonlinear-dynamic systems theory and self psychology. Implicit relational knowing, emotional schemas and nonverbal exchanges all contribute to the co-construction of the therapeutic process. In this paper we will review the models that recognize the importance of therapist identification and integration of procedural/schematic and declarative/narrative experiences in treatment that constitute the sine qua non of therapeutic action. We will also outline the factors that facilitate or impede the therapist’s ability to become more aware of the procedural, nonverbal, and felt experiences. Finally, the benefits of utilizing audio-taped sessions and transcripts of dialogue in a microscopic analysis in the context of peer group consultation are discussed.

4.   Homolimerence as a Selfobject Experience:
      Some Implications for Therapy
      Presenter:
      Richard M. Childs, MD
      Discussant:
      Jeffrey Stern, PhD

The concept of homolimerence as a distinct kind of selfobject experience was introduced in the paper "Death in Venice: A Selfobject Perspective on Thomas Mann’s Homolimerence" presented at the 2001 Self Psychology Conference in San Francisco. An expanded version will appear in Volume 19 of Progress in Self Psychology. This paper applied self psychology to an understanding of the life and work of the German author, Thomas Mann. Mann’s diaries and his fiction show the particular kind of fascination for other males that has been defined as homolimerence. The present paper will review the origin of the term homolimerence and show how viewing it as a selfobject experience can be useful in psychotherapy with certain troubled men. The perspective is relevant to the current scandal of abusive priests in the Roman Catholic Church.

5.   On Getting into the Act: A Values Perspective
      in Working with "Action Symptoms" - Ten Years
      Working with Priest Offenders
      Presenter:
      Carol A. Munschauer, PhD
      Discussant:
      Salee A. Jenkins, PhD

An increasing number of patients come to analysts with symptoms that are not solely internal problems, but which directly affect the security of their own lives or the well-being of other people. Such symptoms can be called “action symptoms” or “narcissistic behavior disorders”. This paper was spawned by my experience treating a large population of Roman Catholic priests who have presented with various forms of sexual misconduct. In this paper, I propose a “listening stance” focused specifically on listening for “core values” in patients who act out. I propose this special listening emphasis in a clergy misconduct population, but it is easily generalizable to other narcissistic behavior disorders as well. The focused learning stance proposed here embraces the contributions of Alcoholics Anonymous, as well as other recent contributions from health-related behavioral change models, which concentrate on helping people become less comfortable with behaviors which might be injuring themselves. In emphasizing this approach, I am making a plea, in the analyses of patients who present with “action symptoms” for the re-invocation of aspects of the one-person model, in addition to the relational and contextual approaches we continue to employ.

6.   Workshop:
      Specificity Theory and the Impact of 'Dual Relationships'
      on Therapeutic Effect - Part II
      Presenters:
      Howard A. Bacal, MD, FRCP(C)
      Nancy P. VanDerHeide, PsyD

This workshop will provide an opportunity to explore experiences of the multiplicity of roles that both analyst and analysand may play with each other during the course of analysis and after termination, and their effect on the therapeutic process. Polarized perspectives on such constructs as "dual relationships" may result in the restriction of emotional and intellectual freedom of thought that can impede the implementation of responsivity that may be therapeutic to the particular patient. The intent of this workshop is to provide a safe space within which to create a dialogue that will focus on the nature of these relationships within specific dyads, for the purpose of considering how they may enhance or diminish therapeutic effectiveness.

7.   Workshop:
      A Scientific Day in Three Parts
      Mother-Infant Research and Implications for
      Mother-Infant Treatment and Adult Treatment
      Part II: The Origins of Psychopathology in the First
          Year of Life: Mother-Infant Self and
          Interactive Regulation
      Presenter:
      Beatrice Beebe, PhD
      Moderator:
      Frank M. Lachmann, PhD

This 3-part workshop will review empirical research on mother-infant interaction, the prediction of infant attachment, and the implications for adult as well as mother-infant treatment. Audience participation will be encouraged.
The following forms of distress will be addressed:
Maternal Distressed States of Mind:
1. Maternal depression
2. Maternal anxiety
3. Maternal self criticism
4. Maternal "empty" dependency
5. Maternal low efficacy/helplessness
6. Maternal perception of infant as difficult temperament
7. Paternal perception of infant as difficult temperament
Infant Distressed States:
1. Progressive vocal distress
2. Progressive facial distress
3. Low self comfort
4. Anxious resistant attachment
5. Disorganized attachment

8.   Workshop:
      The Crises of Adolescents with Learning Disabilities:
      An International Perspective
      Part IA: Problems in the Consolidation of the
          Nuclear Self in Adolescence
      Presenter:
      Joseph Palombo, MA
      Part IB: Relationship Problems Between Adolescents with
          Learning Disabilities and their Unaffected Siblings
      Presenter:
      Eva Rass, PhD
      Moderator:
      Amy H. Eldridge

Adolescents and preadolescents with learning disabilities frequently present therapists with problems that challenge their clinical resources. Some are non-communicative, are resistive to engagement, or come high on drugs or intoxicated to their sessions. Often, they are unaware of the existence of their neuropsychological deficits. These attitudes disrupt or, at times, defeat attempts at engaging them in the therapeutic process. This workshop, by an interaction panel, will present the framework for the diagnostic understanding and the clinical treatment of some of the transference / countertransference configurations that emerge in individual and group treatment and of the complex relationships these patients develop with their therapists. These cases will demonstrate how these configurations and relations may be used to develop treatment strategies that optimize the success of the treatment.

9.   Mini-series on Art and the Self
      Part I: Renoir, His Paintings, and the Self
      Presenter:
      Carl T. Rotenberg, MD
      Discussant:
      Howard S. Baker, MD

This article explores the action of the visual self through the discussion of the experience of viewing a single painting. The painting discussed is “The Luncheon of the Boating Party” (1880-81) by Pierre Auguste Renoir, which today hangs in the Phillips Collection in Washington, D.C. The focus of this paper is on the circular relationship between the experiencing self of viewers and the subjective organizing principles of the artist, as he has expresses them through paint and canvas. Discussion of a particular painting is a kind of laboratory through which we can consider the intersubjective relationship of the viewer with the professional self of the artist. The emphasis of this presentation is on the formal aspects of what is seen as opposed to the literary and narrative aspects of the art work. Viewers encounter art seeking a relationship that can have transformational effects. This paper discusses the visual exploration of the painting under three headings, a) Color b) Space and c) relational aspects. The paper potential expansion of the viewer’s self through visual incorporation and subjective recreation of a particular art work, though the principles apply to a wider range of self-experience.

10.  Divorce at Childbirth:
      A Self-Psychological Perspective
      Presenter:
      Hilary E. Hoge, MD
      Discussant:
      Jane C. Jordan, MSW

Divorce and childbirth are words that do not seem to belong together, yet many couples do separate or divorce within a year of having a baby. By interviewing such parents for my study, I became aware of the pivotal role self-psychology plays in illuminating their difficulties. In this paper, I present one of the women I interviewed, Carol, as background for a discussion of relevant self-psychological concepts. The importance of Carol’s self-object bonds and the vulnerability of new parents with deficits in self-structure to narcissistic rage are highlighted. Finally, I question whether a purely deficit psychology adequately explains disorders of the self, and whether a purely dyadic psychology adequately describes the self-object needs of new parents.

11.  Workshop:
      Love and Anger within the Analytic Relationship:
      A Clinical Workshop, Part II
      Presenter:
      James L. Fosshage, PhD

This Clinical Workshop, Part II, will be a continuation of the Clinical Workshop, Part I, presented at The 25th Annual International Conference on the Psychology of the Self, Washington D.C., October 27, 2002.
Analytic relationships generate the entire range of human emotion. This affective range in all of its complexity informs us moment to moment about ongoing experience within the patient, analyst, and dyad. With a clinical emphasis this workshop will focus on the particular affects involved in love and anger and their various forms, intensities, and meanings. What are the possible meanings of these affective experiences in both patient and analyst? How do we understand them? How do our listening/experiencing perspectives and theoretical models shape our understanding? And what do we, as analysts, do with our patient's and our own loving and aversive feelings? With a comparative lens we will delineate what conceptual tools we have for understanding these affects - motivational models, developmental models, models of psychological change, different forms of relatedness within attachment experience, authenticity, and empathic and other-centered listening/experiencing perspectives. The Workshop leader will summarize his response to these questions presented in last year's workshop and will continue to discuss factors to be considered. He will present detailed clinical illustrations to further the discussion and formulation of clinical guidelines for the use and expression of the analyst's various feelings of love and anger to facilitate the psychoanalytic experience.

12.  Healing Narcissistic Wounds: A Winnicottian
      Contribution to Self Psychology
      Presenter:
      Frank L. Summers, PhD, ABPP
      Discussant:
      Mark J. Gehrie, PhD

This paper applies the Winnicottian concept of the analytic process as transitional space to the self psychological treatment of narcissistically vulnerable patients. Research on the development of self-esteem is briefly reviewed to show that positive self-regard is built from a variety of factors, among them competence, trust in affects, and relatedness. It is argued that the former two require a revision of roles in the analytic couple along the lies suggested by Winnicott’s concept of the analytic dyad. According to his view, the analyst is a facilitator of the patient’s creation of new ways of being and relating. This dimension of the process is uniquely fitted to the needs of patients who suffer from narcissistic vulnerability because the formlessness of the transitional space gives maximal opportunity for the patient to create her own meaning from the givens of the setting. It is this creation based on authentically experienced affects that facilitates the patient’s experience of competence and trust in affects, critical features of self-esteem. This Winnicottian addition to the self psychological concept of therapeutic action is illustrated with the treatment of Suzy, a woman of exquisite narcissistic vulnerability.

3:45 - 4:15 PM      Coffee Break

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ORIGINAL PAPERS/WORKSHOPS
4:15 - 5:45 PM      Session B

1.   Weeble Wobbles: Resilience within the
      Psychoanalytic Situation
      Presenter:
      Phyllis E. DiAmbrosio, PhD
      Discussant:
      William J. Coburn, PhD, PsyD

Often, as analysts we treat patients, who despite highly traumatic histories, are able to evidence a resilience and ability to “self-right” that flies in the face of expected developmental outcomes. This paper reviews the resilience literature from developmental and psychoanalytic perspectives. It then examines the various Self Psychological approaches which help to facilitate the capacity for self-righting. A case illustration is provided.

2.   MEET THE AUTHORS
      Worlds of Experience:
      Interweaving Philisophical and Clinical
      Dimensions in Psychoanalysis
      (New York: Basic Books, 2002)
      Presenters:
      Robert D. Stolorow, PhD
      George E. Atwood, PhD
      Donna M. Orange, PhD, PsyD
      Moderator:
      Peter Buirski, PhD

This meet-the-authors session will present an overview of and critical reflections on their book, Worlds of Experience. A central theme will be the crucial clinical consequences of a Cartesian versus and intersubjective-systems view of psychological life.

3.   The Sense of Freedom: A Primary Experience
      of Mid Life Women in the Years After the
      Deaths of Their Parents
      Presenter:
      Leslie A. Westbrook, PhD
      Discussant:
      Linda A. Chernius, MSW

In research conducted to study the experience of mid life women in the years after the deaths of their parents, it was found that upon their parents’ deaths, many of the subjects described experiencing a feeling of internal freedom or a loosening of inhibitions, coupled with an increased curiosity about their internal psychological lives. Part of the loosening of inhibitions included the surfacing of unconscious feelings and memories, which were apparently suppressed or repressed while the parents were alive. This sense of freedom set in motion the internal processes associated with grief and its aftermath.

4.   Workshop:
      The Crises of Adolescents with Learning Disabilities:
      An International Perspective
      Part II: Group Approaches to the Enhancement
          of Self-Regulation in Pre-Adolescents in School Settings
      Presenters:
      Susanna Federici-Nebbiosi, PhD
      Marco Bernabei, PhD
      Moderator:
      Joseph Palombo, MA

Adolescents and preadolescents with learning disabilities frequently present therapists with problems that challenge their clinical resources. Some are non-communicative, are resistive to engagement, or come high on drugs or intoxicated to their sessions. Often, they are unaware of the existence of their neuropsychological deficits. These attitudes disrupt or, at times, defeat attempts at engaging them in the therapeutic process. This workshop, by an interaction panel, will present the framework for the diagnostic understanding and the clinical treatment of some of the transference / countertransference configurations that emerge in individual and group treatment and of the complex relationships these patients develop with their therapists. These cases will demonstrate how these configurations and relations may be used to develop treatment strategies that optimize the success of the treatment.

5.   Mini-series on Art and the Self
      Part II: Ugliness: Aesthetic Trauma of the Self
      Presenter:
      George A. Hagman, MSW
      Discussant:
      Joseph D. Lichtenberg, MD

Ugliness is the provocation and projection of unconscious fantasies that alter the sense of aesthetic experience in such a way that the formal qualities of the experience, the shape, texture, and color become what we experience as the sources of the most disturbing and repulsive feelings. The paper reviews the psychoanalytic writings concerning the problem of ugliness. It offers a psychoanalytic model of ugliness that addresses several key points: ugliness as a failure of sublimation; the collapse of idealization; ugliness and interaction; the affective dimension of ugliness; and ugliness as a symptom in psychopathology. Clinical vignettes are used throughout to illustrate the various points of the argument. The paper closes with a discussion of how for the artist ugliness can be an opportunity - he or she confronts ugliness and through the creative process brings form and perfection to disintegration and disorder. In this way ugliness succumbs to beauty.

6.   Empathy and/or Authenticity as Growth Promoting
      Factors in a Successful Analytic Process
      Presenter:
      Martin Gossmann, MD
      Discussant:
      Gary M. Rodin, MD

In this paper, "Empathy and/or Authenticity as Growth Promoting Factors in a Successful Analytic Process," the author responds to Judith Teicholz’s 2000 conference paper, "The Analyst's Empathy, Subjectivity and Authenticity: Affect as the Common Denominator" and 2003 presentation, "Some Further Thoughts on Empathy and Authenticity: Their Dialectical Tension and Common Ground." In these presentations, Teicholz proposed a relational understanding of the analyst’s expression of ‘otherness’ as a potential growth promoting experience for the patient in contrast to a primarily empathic mode of interaction as it is the center piece of a self psychologically conducted analysis. In this case presentation, the author suggests that the author’s authenticity is a necessary ingredient in any analytic process and need to be embedded in the maintained empathic listening perspective. Rather than viewing development as fostered by the exposure of the analysand to the analyst’s authenticity coming from ‘outside’ her own subjective world, it is suggested that this developmental achievement will best be obtained ‘from within’ the subjective world of the analysand.

7.   A Scientific Day in Three Parts
      Mother-Infant Research and Implications for
      Mother-Infant Treatment and Adult Treatment
      Part III: The Origins of Psychopathology in the First
          Year of Life: Mother-Infant Self and
          Interactive Regulation
      Presenter:
      Beatrice Beebe, PhD
      Moderator:
      Frank M. Lachmann, PhD

This 3-part workshop will review empirical research on mother-infant interaction, the prediction of infant attachment, and the implications for adult as well as mother-infant treatment. Audience participation will be encouraged.
The following forms of distress will be addressed:
Maternal Distressed States of Mind:
1. Maternal depression
2. Maternal anxiety
3. Maternal self criticism
4. Maternal "empty" dependency
5. Maternal low efficacy/helplessness
6. Maternal perception of infant as difficult temperament
7. Paternal perception of infant as difficult temperament
Infant Distressed States:
1. Progressive vocal distress
2. Progressive facial distress
3. Low self comfort
4. Anxious resistant attachment
5. Disorganized attachment

8.   The Yin and Yang of Intersubjectivity:
      Integrating Self Psychology and Relational Thinking
      Presenter:
      Steven Stern, PsyD
      Discussant:
      James L. Fosshage, PhD

This paper begins with a clinical example of a transference–countertransference enactment, and then asks the question: What is the most useful way to understand the interaction described? Relationalists would understand it as a repetition brought about by some form of projective identification. Self psychologists have rejected this understanding on a variety of grounds. The author argues that these two models rest on differing understandings of the unconscious, which he makes explicit. He suggests that rather than being irreconcilable, the two understandings represent a kind of yin and yang of unconscious experience: i.e., two principles of unconscious functioning that can and should be integrated. This integration, in turn, holds implications for the analyst’s listening stance and theory of therapeutic action. The author then returns for a more in-depth examination of the clinical enactment, demonstrating how his integrated perspective helps to illuminate the richness and complexity of both the patient’s subjectivity and the intersubjective, mutual-regulatory co-created by patient and analyst.

9.   Couples Therapy from the Perspective of
      Self Psychology and Intersubjectivity Theory
      Presenter:
      Carla M. Leone, PhD
      Discussant:
      Carlye G. Perlman, LCSW

Central tenets of self psychology and intersubjectivity theory are applied to the understanding and treatment of couples. The concepts of selfobject needs, unconscious organizing principles, the selfobject and repetitive dimensions of experience and learned interactional patters are used to conceptualize common couples’ difficulties. A treatment approach is then outlined, involving:
1) listening from within each partners’ subjective perspective;
2) establishing a therapeutic dialogue with both partners, through which their selfobject needs, ways of organizing experience, and patterns of relating can be gradually illuminated and transformed;
3) attending carefully to narcissistic vulnerability and the repair of empathic ruptures; and 4) facilitating new relational experiences with the interventions with couples is discussed as appropriate when such techniques constitute or facilitate a selfobject experience for the couple. A case example is used throughout the paper to illustrate key points.

10.  Workshop:
      Focusing on the Body-Mind Relationship as a Way
      for Dealing with the Emergence and Resolution of
      Clinical Impasses in Psychoanalysis
      Presenters:
      Raffaela Panzalis, MD
      Paolo P. Stramba-Badiale, PhD
      Moderator:
      Franco S. Paparo, MD, PhD
      This is a Bilingual Workshop - English/Italian.

The mind-body problem implies that the mind and the body are elements of the experience of the self, and to investigate them means to look at the way this experience show it within conscious subjectivity and its unconscious correlate, the nature of which is sees as essentially relational and intersubjective. Using an approach based on self-psychology and intersubjective systems theories, the authors propose that psychosomatic syndromes and hypochondria are resulting from series of breaks or lack of empathic attunement. The defective self cannot experience valid selfobject experiences, so it risks fragmentation and carries with it the burden of being unable to name the traumatic situations as well as terror of a possible retraumatization. Psychosomatic illness, therefore, can be seen as a form of adaptation to the difficulties of life that is made when the availability of mental states connected to symbolic and creative thought are damaged by traumatic experience of poor empathic attunement. The presence of a significant other makes the experience of containment possible, which in turn helps to create those symbolic structures necessary to face separation and loss. The authors present a case story.

11.  The Cult of Certainty: A Self-Psychological
      View of the Quest for "Unembedded Being" in a
      Coercive Training Program
      Presenters:
      Doris Brothers, PhD
      Annette Richard, M Ps
      Discussant:
      Paula B. Fuqua, PhD

At a vulnerable time in her life, one of the authors of this paper entered The Center for Feeling Therapy (CFT), a coercive, cult-like psychotherapy training program. This paper is based on her experiences. The CFT emphasized the docontextualization of experience as part of a brutal process called “going sane.” Building on Kohut’s insights into the “pervasive sense of infallibility” and the “absolute certainty” of charismatic leaders, the authors understand the appeal of the “unembedded being” and other aspects of the CFT approach as extreme efforts at uncertainty regulation. They examine the denial of difference, the denial of sameness, the inflamation of passion, faith-keeping fantasies, and alter-ego relating in an effort to explain what keeps participants from leaving cults despite their realization that they are abusive.

12.  Extraordinary Pressures: Providing Consultation
      for Therapists Working with Severely Dissociative
      Trauma Survivors
      Presenter:
      Susan H. Sands, PhD
      Discussant:
      Sandra M. Kiersky, PhD

I describe some of what I learned from my consultation work with therapists treating the most severely dissociative survivors. I explore why it is that these patients bring such extraordinary pressures to bear on therapists and why therapists respond as they do. Several factors explored: (1) these patients’ use of dissociation, which distorts the self, makes it almost impossible to experience conflict, inevitably leading to (2) projective identification as a means of “experiencing-through-the-other” that which cannot be tolerated in oneself; (3) physiological dysregulation, leading to states of both hypo- and hyperarousal; (4) severe attachment disorder, which mobilizes attachment behaviors in the therapist as well as the patient and helps explain therapists’ breaching of therapeutic boundaries. These patient’s disorganized / disoriented attachment style also helps explain therapists’ disoriented and frightened responses. (5) Concrete Thinking, seen, for example, in these patients’ demands to be treated as actual children and given actual favors and in their preference for action over verbalization. Trauma, by inhibiting carefree play interferes with the development of abstract thinking and the ability to use metaphor.(6) Sadomasochism, manifesting in a kill-or-be-killed stance and in painful, compulsive re-enactment’s which repeat the sadomasochistic dynamics of the original traumatic interactions. The patient’s continuing relentlessness suicidality is particularly taxing for the therapist.

6:15 - 10:30 PM      Conference Reception
A light Dinner Buffet followed by dancing and music. (This is an optional ticketed event at an additional fee; see Registration Form.)

Sunday, November 9, 2003
7:30 - 8:30 AM      Coffee and Breakfast Rolls

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ORIGINAL PAPERS/WORKSHOPS
8:30 - 10:00 AM      Session C

1.   Autobiographical Reflections on the Intersubjective
      History of An Intersubjective Perspective
      in Psychoanalysis
      Presenter:
      Robert D. Stolorow, PhD
      Discussant:
      Shelley R. Doctors, PhD

This paper traces the evolution of the author’s intersubjective perspective by chronicling four decades of formative relationships that contributed to its creation - relationships with teachers, with mentors, and, especially, with treasured collaborators. The process by which intersubjectivity theory is being created is shown to be a metalogue of its basic principle - the claim that all human psychological products crystallize within systems constituted by interacting worlds of experience.

2.   Workshop:
      Moments of Meeting: Process of Change in Ways of Being
      with Another
      Presenter:
      Dorienne Sorter, PhD
      What about the Children?
      Presenter:
      Jacqueline J. Gotthold, PsyD
      Moderator:
      Frank M. Lachmann, PhD

The focus of Paper One is on the work of the Process of Change Study Group and it’s relevance for adult treatment. Infant researchers or, as they have been dubbed, the ‘baby watchers’ have increasingly provided psychoanalysis with a vast array of new perspectives in the understanding of the psychoanalytic treatment process. The infant and her dyadic, mutually regulated, non-linear, developmental relations has been well studied by prominent researchers such as: Tronick, Sander, Lichtenberg, Stern, Beebe, Main and Fonagy to name a few. The application of their findings towards the understanding of the adult psychoanalytic treatment process is reflected in a rich and ever-expanding literature. Expanding on previous group identified key new concepts they term as “now moments”, “moments of meeting” and dyadic expression of consciousness, among others. Several vignettes from adult treatment cases are offered as ways to illustrate how these perspectives can expand our understanding of therapeutic action in adult treatment cases.
The focus of Paper Two is to ask what about the children? “Non-interpretative mechanisms” (Boston Study Group, 1998), recently noted and focused upon in adult treatment, have long been unspoken staples of the child treatment process. Yet, this ‘something more’ within the intersubjectively configured treatment of dyad has never been fully articulated. The new perspectives illuminated by the Boston Study Group enhance our appreciation of the interpretive contribution of the co construction of the analyst and child’s ways of being together (the implicit procedural knowledge). “Now moments” of a long-term child treatment will be presented as a means of exploring these new perspectives. How can these perspectives enhance our understanding of the therapeutic action within the child treatment process?

3.   The Opening of the Field: Thoughts on the
      Poetics of Psychoanalytic Treatment
      Presenter:
      David Shaddock, MA
      Discussant:
      Edward P. McCrorie, PhD
      Moderator:
      Estelle Shane, PhD

This paper compares poetic communication with psychoanalytic communication, especially in terms of the way subjective states are communicated and intersubjective conjunction is achieved. Four areas of poetics are discussed: metaphor, in which objects are charges with subjective meaning; image, which has the narrative quality of presenting acts of perception; sound and rhythm, which communicate affect; and form, which gives the psychoanalytic encounter a collaboratively achieved sense of shape and inevitability. These concepts are elaborated through the case example of a thirty-six year old woman who had an extremely traumatic childhood. After a general case summary, the paper examines “skin hunger,” an important metaphor the patient produced; an image from childhood of her mother’s guilty look; the way the patient’s sound and rhythm helped guide attention to the heart of a dream the patient reported; and an examination of the overall form of the treatment.

4.   Selfobjects, Oedipal Objects, and Mutual Recognition:
      A Self-Psychological Re-Appraisal on the "Oedipal Victor"
      Presenter:
      Christine C. Kieffer, PhD
      Discussant:
      Joan A. Lang, MD

This paper will focus upon the phenomenon of the female “Oedipal Victor”. This concept as formulated in classical psychoanalytic theory has often been received with a mixture of mysticism and ambivalence. Self-psychological revisions of classical theory have posited that oedipal phase of development, while not universal, is nevertheless a period that is fraught with the potential for selfobject failure. This paper describes a particular kind of selfobject failure that befalls the “Oedipal Victor”.

5.   Mini-series on Art and the Self
      Part III: Phases of the Creative Process and the
         Choreographer's Self
      Presenter:
      Carol M. Press, EdD
      Discussant:
      Anna Ornstein, MD

In modern dance, the choreographer’s sense of self guides the transformation of subjective content into a shared aesthetic form - a completed dance. This transformation is navigated through a three-phase creative process. Kohut and Hagman each describe these phases of creative engagement from a self-psychological perspective. Kohut (1976), in his article, “Creativeness, Charisma, Group Psychology: Reflections on the Self-Analysis of Freud,”, tracks the relation of sense to self to one’s narcissistic energies as the artist encounters the artistic process and medium. Hagman (2000) in his article, “The Creative Process,”, emphasizes the artist’s intersubjective interaction with the aesthetic medium and emerging artwork. I highlight the self-experiences of modern dance choreographers as they engage these phases of creativity described by Kohut and Hagman. Creativity carries psychological risk for self-experience. Choreographers navigate through self-fragmentation and anxiety. However, ultimately the creative process transforms the choreographer’s self-experience and greater self-delineation is discovered.

6.   Workshop:
      "...But She Should Respect Me!"
      Working with the Perpetrator of Domestic Violence
      Presenter:
      Valerie G. Giberman, MSW
      Moderator:
      Brenda C. Solomon, MD

Perpetrators of domestic violence can generate not only clinical problems per se, but can also generate a complexity of legal, ethical and highly charged countertransference problems, for psychoanalytic clinicians. This workshop will explore and illustrate how the cornerstone of self psychology theory, the selfobject experience, provides a psychodynamic understanding of why someone might feel the need to maintain violent control over a mate, for fear of psychic disintegration. Working empathetically within this theoretical framework allows the clinician to facilitate the working through of selfobject transferences, making these desperate interactions unnecessary. The workshop will be centered around a particular case, Mr. B., who introduced himself to the clinician by stating “I’m a batterer!” More general theoretical and clinical considerations will follow the case presentation.

7.   Love and Death: A Clinical
      Exploration of Affect Sharing
      Presenter:
      Bruce Herzog, MD, FRCP(C)
      Discussant:
      Steven H. Knoblauch, PhD

The sharing of affect is a necessary part of normal childhood development and can be demonstrated in various stages of adult life (Herzog 1998). Its manifestation as a self-object can be observed when our patterns attempt to be evocative in their nature, and succeed in creating an atmosphere between themselves and the therapist which allows the therapist to share in their affective experience. The therapist’s communication that he or she can understand and feel someone’s affective state, functions to provide credible reassurance that the patient is not alone. Because loneliness can be a frightening and tragic part of the process of dying, we may be sought our by people who are dying because of their wish to have their affective experience shared by another – to help assuage their sense of aloneness. Two clinical cases of terminal cancer patients are presented which demonstrate the necessity of affect sharing in the psychoanalytic treatment of the dying. Both were in there thirties, and felt driven to tell their tragic stories to the therapist. Through their compelling narratives, they were able to evoke feeling states in the therapist that appeared to be similar to what they themselves were experiencing. The acknowledgement by the therapist that he had felt what they had felt had significant therapeutic impact, resulting in both patients feeling considerably less isolated and allowing them to approach their death in peace.

8.   Reflections on Suicidal Children
      Presenter:
      Ronald A. Zirin, PhD
      Discussant:
      Ruth Gruenthal, MSS

This paper deals with self psychological understanding and treatment of suicidal (pre-adolescent) children. It briefly reviews research in epidemiology, and discusses young children’s concepts of death and their own mortality, with the conclusion that children as young as five years of age may be more aware of the finality of death than is usually assumed. Three cases are reviewed. The first is of a five year old girl who was brought to therapy because she kept stating that she wanted to die, and had attempted to run into traffic with the stated objective of killing herself. The second presents a fragment of the intensive therapy of a suicidal adult whose first suicide attempt occurred when she was eight years old. And the third deals with a boy who started treatment at six years of age because (among other symptoms) of pervasive suicidal ideation. Ideas are presented about the developmental origins of suicidal tendencies, and about the way in which children enlist the aid of the therapist to work through suicidal wishes and ideation.

9.   The Analyst's Defensiveness, Recentering, and Renewed
      Empathy: A Dyadic Approach to Therapeutic Impasses
      Presenters:
      Jeffrey J. Mermelstein, PhD
      John C. Pagura, MA, MSW
      Discussant:
      Paul H. Ornstein, MD

In this paper, we apply a dyadic, postmodern sensibility to a number of interconnected constructs within self psychology and intersubjectivity. We focus on dyadic nature of empathy, defensiveness, and therapeutic impasses as these phenomena unfold in our clinical work. Our emphasis on the analyst’s experience leads us to focus on the analyst’s defensiveness and the process by which analytic recentering occurs. Finally, we present clinical material to illustrate the complex interplay of empathy, defensiveness, and recentering during the development and resolution of a therapeutic impasse.

10.  Self or No Self: Psychoanalytic and Buddhist
      Perspectives on Neuroendocrine Events and
      Subjective Experience
      Presenter:
      Robert A. Besner, PsyD
      Discussant:
      Jeffrey Rubin, PhD

This paper presents the self as a unitary phenomenological and biological experience. A synthesis of literature from psychoanalysis, infant research, neuroscience, and Buddhism results in a model of human functioning in which subjective experience is determined not only by cognitive contents by also by the regulation of physiological arousal states, and further, by the reciprocal regulation of these states between individuals. Psychoanalysis is challenged to reconsider the process of construction of the self and to integrate the on-going influence of physiological arousal states with its conventional reliance on narrative contents.

11.  The Neurobiology of Trauma for Self Psychologists:
      An Interdisciplinary Approach
      Presenter:
      Jeffrey Dietz, MD
      Moderator:
      Wolfgang E. Milch, MD

A mixed media presentation will be used to present a neurobiological understanding of the brain structures that are involved in psychological wellness and trauma. The presentation will allow for an integration of self-psychology and neurobiology with special emphasis on the concept of brain organization and evolution within a selfobject matrix.

12.  Workshop:
      Enactments: Contrasting Relational and
      Self Psychological Perspectives
      Presenter:
      Jody Messler Davies, PhD
      Discussants:
      Malcolm O. Slavin, PhD
      James L. Fosshage, PhD

Dr. Jody Messler Davies will present a pivotal moment from a very challenging case approached and conceptualized according to her version of contemporary relational thinking. Drs. Fosshage and Slavin will compare self psychological and relational perspectives to stimulate and guide discussion about how we understand the patient's experience of the analyst's subjectivity, its relationship to the patient's inner world and to the therapeutic process.

10:00 - 10:30 AM      Coffee Break

10:30 AM - 12:00 PM
PANEL III:
The Emergence of the Self from the Clinical Experience
Chair:
Tessa M. Philips, MA
Presenters:
Frank M. Lachmann, PhD
Marian D. Tolpin, MD
Discussant:
Judith Guss Teicholz, EdD

To explore in broad theoretical terms the question of how the self emerges from the clinical process. Kohut’s original concept of “transmuting internalization” will be amended with contemporary developmental theories positing a “leading edge” of healthy self development.

12:00 PM      Final Adjournment