Psychoanalytic Training InstituteYear One
Listening is a centerpiece of the training program and evolves in depth over the four semesters.
Analytic Listening (Each semester during Year One and Two)
The practice of psychoanalysis is based on the analyst’s capacity to listen. Listening will be taught primarily through the study of clinical process. A distinction between listening to the patient and listening to the candidate’s listening to the patient will be made. The candidates are encouraged to follow the patient, as well as one’s own thinking as an effort to encourage self-reflection. In order to facilitate close study the listening process has been separated into three levels.
Level One teaches the candidates to construct a veridical summary of the hour that is to listen and report a detailed narrative of the hour. This narrative includes an observation of the verbal and nonverbal communication, from the first moments of the hour. The candidates gain an increased capacity to hold the hour in mind as it unfolds, to think about the patient’s moment to moment communication and integrate it with material in the present moment. This approach encourages a capacity for receptive listening, in contrast to the inclination to judge, diagnose and theorize. This method is an adaptation of the Infant Observation Model, originally developed by Esther Bick in London, in which the capacity to listen without attributing meaning or attempting intervention is privileged. This then provides the data and “facts” for the next two levels of listening.
The Second Level involves the candidates beginning effort to find meaning in the patient’s material, in contrast to Level One. The candidates learn to associate to what they have heard, imagining and feeling their way into the patient’s material, looking for themes, affective valence, state of mind. The seminar participants work together to develop a picture of the patient’s inner world, what happens and to whom. Psychoanalytic concepts and theories are discussed, i.e., what are the primary defenses and anxieties in play, the transference-countertransference, level of ego functioning and development of the patient. The candidates develop an openness to the unconscious and primary process, in themselves and their patient.
In Level Three the candidates study psychoanalytic intervention. Having formed a narrative or schema of the hour (Level One) which is resonant with meaning (Level Two), the seminar members are in the position to think about the timing and nature of potential interventions. These formulations take into account the patient’s level of development and functioning, the quality of the transference, the pressing anxiety, and conflict or need of the moment, from a perspective of both inner and outer reality. The candidates’ personal analytic theories come into focus at this level, hence the group can discuss interventions that would follow from different theoretical perspectives. We discuss the presenter’s interventions as a way of understanding his/her thinking about the patient. The patient’s response to the therapist’s statements is followed as a way to understand how the patient experienced the intervention.
Key Concepts of Psychoanalysis I
This course looks at the way psychoanalysts approach understanding of psychic organization of the mind. Major concepts of psychic reality, the unconscious, repression, conflict, fantasy, and object representations are covered. Freud’s two basic models of the mind are presented. The topographic model highlights the important discovery of the unconscious mental life including fantasy, beliefs, traumas, and motivations. The structural model presents the basic concepts of ego, id, and superego useful for comprehending how conflicts between drives and defenses lead to compromise formations and can be deciphered. Clinical significance is a focus of the course showing how concepts help understand emotional pain, anxiety, and symptoms that patients bring to treatment. Throughout the course, concepts are anchored in clinical significance and usefulness for understanding emotional pain and symptomatology. Vignettes are presented by the instructor and the candidates. Readings include work by Freud, Klein, Arlow, Loewald, Schaffer, and Steiner.
Psychoanalytic Human Development I: Birth to Eighteen Months
The first course in the development sequence focuses on early factors influencing the infant and toddler’s development of psychic structure, which includes the ego, drive, early defenses, object relations and self. In addition the mother’s self-representation and unconscious identifications, transmitted through nonverbal dialogue and interactive distortions with the infant, are studied. Readings also include a discussion of the importance of affect feedback systems which help consolidate the beginning development of the infant’s separate mind and capacity for self-regulating, i.e, separation and individuation. The beginning development of sado-masochistic object ties, fragile self-esteem and confusing self-states can be observed very early – these are linked to the adult psychoanalytic transference- countertransference situation. Clinical illustration of current adult analyses facilitates the candidates’ integration of the course material. Readings include a wide range of current and historic material: Freud, Abraham, Ferenczi, Spitz, Bowlby, Winnicott, Mahler, Bergman, Fraiberg, Furman, Fonagy, Daws, Harris, Alvarez, Stern, Schore, Tronick, Hobson, and Trevarthan.
Key Concepts of Psychoanalysis II
This course opens the topic of how to think about the beginning of psychoanalytic treatment as well as deepening further understanding of psychic reality. It is important to convey an analytic attitude to the analysand through establishment of an analytic frame, empathy, neutrality, and analytic boundaries. The topics of ‘analyzability’ and the ‘widening scope’ help reveal ways to identify strengths and vulnerabilities of individual patients and to think analytically of how the therapeutic alliance can come about. Transference and countertransference dynamics are at the center of psychoanalytic treatment giving access to the mind of the patient and to the way the analyst discovers, with the patient, the unfolding of analytic process. Aspects of narrative, free association, and the enactment process help clarify experiences of the here and now that takes place in the room. Readings include Freud, Busch, Ogden, Greenson, Jacobs, Chused, and Feldman.
Psychoanalytic Human Development II: Eighteen Months to Six Years
The second development course studies the toddler and the phallic/oedipal child. Normal developmental tasks as well as pathological development are considered. Specifically, the anal and genital phases, character structure and symptoms and concomitant issues such as basic trust, mentalization, drive theory, attachment theory and gender are included. Attention is paid to both classical and contemporary thinking about issues of pre-oedipal and oedipal periods, male and female development, and superego formation. The study of “Little Hans” from multiple perspectives as well as adult analytic cases may be used for discussion. Many of the above theorists are used as well as Bornstein, Klein, and A. Freud.
Introduction to Ethics
In this seminar candidates will be provided with opportunities to explore the links between the recognized ethical principles of psychoanalysis and their emerging identities as psychoanalysts. Areas to be covered are confidentiality, boundary violations, professional relationships, competency, and ethical violations. Special attention is paid to ethical dilemmas as they arise within the context of institute life and candidacy. The candidates are introduced to the “Principles and Standards of Ethics for Psychoanalysts” as well as other contemporary writing, i.e. Gabbard, Kantrowitz, and Keenan.
Year Two
Listening III and IV continue as described above in Analytic Listening
Theory of Psychoanalytic Technique I
This course is an introduction to psychoanalytic technique. Areas to be explored include therapeutic action and what is curative. Attention is given to the concept of working through and the role of the analysand’s relationship to the therapeutic object. We will consider the concepts of insight and support in guiding therapeutic interventions. The complexity of interpretation in the midst of resistance, regression and enactment in an unfolding analysis is examined. Additional aspects of technique related to understanding unconscious fantasy, dreams and the place of silence in therapeutic process is discussed. Seminar participants will debate the place of reconstruction relative to the place of transference interpretation in analytic work. The course will include the technique papers of Freud. Readings also include the writings of Arlow, Brenner, Kris, Foray, Loewald, Strachey, Stern, Schafer, Greenacre, Poland, Boesky, Busch, Rangell, McLaughlin and Richards.
Psychoanalytic Human Development III: Latency and Adolescence
Normal development as well as the pathological aspects of early, middle and late latency are studied. Issues of post-oedipal transformation, school-age and pre-teen issues are considered. Is this truly the “quiet time”? Adolescent transformation in male and female development is followed, including issues of bodily changes and psychic development, sexual integration and the second separation-individuation. Issues of identity, ego-ideal and the superego are included. Readings are taken from Furman, Kramer, Laufer, Benson, Buxbaum, Novick, Parens, Pine and Levy-Warren.
Theory of Psychoanalytic Technique II
This course considers technical approaches in psychoanalysis for those patients who are non-symbolizing, concrete and therefore hard to reach. The interface of pathology and technique are highlighted. Seminar participants will gain an understanding of the challenging resistances to the treatment posed by patients who rely excessively on projective identification or who may be described as having borderline, severe narcissistic pathology or psychotic features. There is consideration of the importance of the frame, the role of containment, and the topic of negative therapeutic reaction. The course also includes ways to work with the patient’s dreams. Bass, Bion, Blum, Fonagy, Joseph, Grossman, Ogden, O’Shaughnessy amongst other authors are included.
Psychoanalytic Human Development IV: Early, Middle and Late Adulthood
This period is understood as the “third individuation” and includes the study of career achievement, pregnancy, maternal and paternal identity, menopause, mid-life crisis, aging, death and dying. The interaction between the life cycle and psychic structure, both normal and pathological, is studied. Readings include articles written by Erikson, Jacques, Colarusso, Diamond, Pine, Goldberger, Gould, Kernberg, and Valenstein.
Freud Cases
In this course candidates read Freud’s case histories in order to follow the development of his theoretical and clinical understanding. Recent commentaries, which expand, evaluate and deepen the understanding Freud provided, are included. Studying these early works has the goal of broadening the candidates’ understanding of the history of psychoanalytic thought and the ways in which contemporary thinkers have furthered the development of Freud’s ideas. Cases studied may include Dora, “Rat Man,” and “Wolf-Man.”
Year Three
Continuous Case Seminars (Each semester during Year 3 and 4) The case seminars of the third and fourth years of training build on the listening classes of the first two years. Candidates continue to deepen the way they hear the mind of the analysand and resonances in their own minds. Each semester a case is followed to demonstrate the unfolding of analytic process. Candidates present the dialogue of sessions including reflections on their own internal awareness. The ‘here and now’ attention provided by process notes brings the class members into contact with the way uncovering and interpretation evolve. Special attention will be paid to finding where transference and countertransference come into play and the many ways that the unconscious and conflict become available including in dreams and through enactments.
During the third year, attention is paid to the beginning of treatment in order to help candidates attend to issues of frame, alliance building, and establishment of an analytic process. In order to learn about the beginning of treatment, the instructor and class can decide if it is more useful to present different cases that are early in development or to concentrate on one case.
During the fourth year, attention to the unfolding of unconscious fantasy, early object relations, and the presence and absence of symbolization will be more available. Dream work and traumatic experiences will also be seen as the analytic process deepens and evolves. Understanding of how to use variations in technique becomes apparent as the class listens to the way an analytic pair has intensified the treatment experience.
Diagnostic Thinking
This course defines various types of adaptations and pathologies of character and symptom formation that bring patients to psychoanalytic treatment. Topics covered are: object relations, difficulties with affect and depression, relation of psyche and soma, and the presence of primitive pathology in the mind. The important place of anxiety in creation of psychic conflict and the way it appears in obsessional and hysterical symptomatology is covered.
Diagnostic Thinking I
This course introduces psychoanalytic and phenomenological approaches to understanding psychopathology. Candidates learn how psychoanalysts formulate thinking about the stories patients present during consultations and sessions. Patients develop adaptations and defenses throughout all phases of development, pre- oedipal and oedipal, that appear in symptoms and character organization. Particular disturbances are presented including neurotic compromises, obsessional and hysterical disorders, affect difficulties such as depression and manic states, and personality problems including borderline, narcissism, and schizoid organization. It is important for psychoanalysts to be able to recognize and assess the presence of concrete thinking, capacities for symbolization, ego flexibility, and creative regressions. All patients present combinations of vulnerabilities and strengths that are brought into the establishment of an analytic process. Readings include Kernberg, Segal, Arlow, Joseph, McDougall, Winnicott, Rangell, Brenner, Zetzel, and Freud.
Diagnostic Thinking II
This course continues presentation of the way psychoanalysts think about diagnostics and pathology. The Anna Freud metapsychology framework is presented in order to see the categories such as ego strengths and weaknesses, superego harshness, affect regulation, and identifications and internalizations that are used to organize adaptations and defenses. The specific place of traumatic experiences and their sequelae in creation of dissociation and concrete thinking is presented. Diagnostic clues are found in the analysands’ mood and tensions, and in transference and countertransference configurations. This course emphasizes the way the individual lives with psychic pain and the defensive patterns developed throughout childhood that come to be recognized in psychoanalytic treatment. Readings include Krystal, Faimberg, Davies, Goodman, and Ellman.
Development of Psychoanalysis: Freud I
This course focuses on the concepts Freud first defined and explored. Fundamental ideas about the nature of neurosis and symptoms, along with the identification of mechanisms involved in defining how the mind functions are studied. Freud’s topographic model of the mind is presented demonstrating the importance of unconscious, pre-conscious, and conscious and of secondary and primary process thinking. Freud’s thinking on narcissism, melancholia, and character organization is presented. His theory of sexuality helps understand early sources of conflict. Freud papers on technique cover the handling of dream interpretation, beginning of treatment, the repetition compulsion, and working through.
Development of Psychoanalysis: Freud II
Freud revised some of his theory of mind and this course proceeds from his 1920 papers. Freud’s structural theory is fully explicated. Revised theoretical ideas about anxiety and neurosis grow out of the concepts of ego, id, and superego and the tensions between them. The theory of sexuality continued to evolve in Freud’s thinking and in his papers on perversion new ideas of ego splitting and disavowal take on significance. Freud ideas on technique continue to evolve including the special place of transference and countertransference.
Year Four
Continuous Case Seminars (Each semester during Year 3 and 4.
For description see Year 3)
Theoretical Controversies I and II
This course is a year-long exploration of current controversies in psychoanalytic theory and technique. Current convergences and divergences in psychoanalytic technique are considered. The course begins with a look at historical controversies and the fate of dissonant theorists such as Ferenczi as well as the issues at stake in the Freud- Klein Controversies in London in the 1940’s and the development of Bion’s thinking. Current controversies include: topics of reconstruction, attachment theory, and understandings of the infant and the place of infant observation. The course looks at current views of the role of reconstruction in psychoanalytic technique. Varying understandings of mechanisms of therapeutic action are examined. The course also looks at the contribution of relational theorists and debates around the role of self-disclosure. The course ends with turning again to the questions of common ground given the many current paradigms in psychoanalytic thinking. The aim of the course is that candidates in their last year of classes become conversant with debate and pluralism in the psychoanalytic world today.
Post-Freudian Theoretical Development I and II (Topics covered over two semesters)
This fourth year coursework focuses on post Freudian theoretical developments. Candidates learn about the evolution of psychoanalytic thought and how each development alters or privileges different models of the mind.
1. Ego Psychology
Candidates study the development of ego psychology, focusing on influential theorists in this field. Candidates deepen their learning about Freud’s structural theory with attention to the ego psychologists’ elaboration of the functions of the ego, its capacities for defense, adaptation and identity formation. The theories of Heinz Hartmann, David Rapaport, Ernst Kris, Edith Jacobson, Hans Loewald, and Roy Schafer are studied.
2. Object Relations Theory
Candidates investigate the importance of the early relation to the object for ego development and growth. Candidates read papers by Sandor Ferenczi, Ronald Fairbairn, D.W. Winnicott, Michael Balint, Harry Stack Sullivan, Heinz Kohut and learn how each theorist understands the nature of the object as it is internalized.
3. Kleinian and Post Kleinian Theory, including Bion
Candidates study the theory and clinical technique of Melanie Klein. Candidates follow the development of her theory in its historical context with attention to the controversies her ideas elicited in the British psychoanalytic community. Klein believed her ideas developed Freud’s work, yet her work described a somewhat different theory of the mind with an emphasis on early capacity for unconscious phantasy, a focus on the maternal, an awareness of object relating from birth and with attention to the death instinct, aggression, envy and the archaic oedipal. Candidates study Klein’s view on the paranoid schizoid and depressive position and read clinical papers by contemporary Kleinians who have developed and shaped Klein’s theory and practice. Candidates learn about Bion’s ideas of containment and alpha functioning and the place of primitive mental life.