To work with the severely disturbed is to be frightened, angry, depressed, bored, discouraged, or confused because the patients are frightened, angry, depressed, bored, discouraged, or confused, although patients also deal with their confusion by clinging to premature closure. False beliefs usually solve an immediate problem but in the long run make a satisfying life impossible.
Rarely are student therapists told that being confused is essential to successful work with severely disturbed patients. Moreover, good therapy with severely disturbed patients almost always involves improvisation. If what we try works, we continue it. If it does not work, we stop and try something else.
Also discussed will be conscious resistance (the most important
difference between working with psychotics and working with neurotics), its sources and handling, phrasing of interpretations, and frequency of sessions.
Bertram Karon, Ph.D Professor, Psychology, Michigan State University. Former President, Division of Psychoanalysis (39) of APA and of the Michigan Psychoanalytic Council. Approximately 160 publications including the book (with G.R. VandenBos) Psychotherapy of Schizophrenia: The Treatment of Choice, and the 2001 Fromm-Reichmann Memorial Lecture at the Washington School of Psychiatry, “The Tragedy of Schizophrenia Without Psychotherapy.” He has received awards for clinical insights and technique, research, and teaching from Division 39, APA Graduate Students, the American Psychological Foundation, the United States chapter of the International Society for the Psychological Treatment of Schizophrenia and other psychoses, the International Center for the Study of Psychiatry and Psychology, the International Federation for Psychoanalytic Education, the Appalachian Psychoanalytic Society, and the New York Society for Psychoanalytic Training. Dr. Karon is in
private practice in East Lansing.
The panel will consist of approximately 40 minutes of excerpts from the film Stage Beauty followed by two ten-minute discussion of selected issues.
The film, set in Shakespearean England, focuses on the play Othello played by an all-male cast. Mr. Kynestan who plays Desdemona is declared to be the most beautiful woman on the London stage. His dresser and assistant, Margaret Hughes who longs to be an actress herself, worships the star and watches his every move. The story follows the relationship of the two lovely young actors as they vie for the role of Desdemona and struggle to understand their feelings for each other.
The first discussion will address the trajectory of the young man as he struggles through a range of gender roles to find an authentic identity. The second discussion will focus on the vicissitudes of heterosexual passion as the two actors grapple with competition, jealousy, curiosity, bisexuality and love.
Batya Monder, MSW, BCD, is a Training and Supervising Analyst at the New York Freudian Society, a member of the Institute for Psychoanalytic Training and Research and Editor of The Round Robin, the newsletter for the Section of Psychologist/Psychoanalyst Practitioners of the Division of
Psychoanalysis of the American Psychological Association. She is in private practice in Manhattan.
Ellen Toronto,Ph.D. is a founding member and past president of MPC. She is past president of the Section of Women,Gender and Psychoanalysis of the Division of Psychoanalysis of the American Psychological Association. She is co-editor of Psychoanalytic Reflections on a Gender-free Case: Into the Void. (Routledge, 2005) She is in private practice in Ann Arbor, Michigan.
The relationship between psychoanalysis and psychotherapy remains confusing, ambiguous, and problematic for psychoanalysts and psychotherapists. Volumes devoted to this topic have not been helpful in promoting an understanding of the similarities and differences of the therapies because the concepts and formulations that have been used are on a level of abstraction that is distant from clinical experience. With an experiential perspective and the clinical theory of psychoanalysis, greater clarity can be achieved in understanding the relationship of the two therapies. In developing my premise, I demonstrate that my approach and technique with all patients whether the therapy is psychotherapy or psychoanalysis is similar, i.e. to reduce the effect of resistances against telling one’s story that will increase the capacity to be in touch with oneself and experience an increase wholeness and solidity of self.
In psychoanalysis and at times in psychotherapy an emotional relationship develops, that becomes the subjective organizing center of the psychoanalysis and psychotherapy. The subjective organizing center promotes the progress of the therapy and envelopes the resistances that retard the progress of the therapy. For the author, the term psychotherapeutic third captures this subjective entity. In psychoanalysis in addition to the development of a psychotherapeutic third a co-construction of an ideal fostered by the analyst also develops.
The ideal is based upon a conviction that by consistently applying the analytic attitude the resistances that analyst and patient are struggling to overcome which are enveloped in the psychotherapeutic third will be reduced enabling the patient and analyst the achievement of greater freedom and autonomy. This conviction of the analyst that becomes the catalyst for the co-constructed ideal generally develops in psychoanalytic training while being immersed in the psychoanalysis of several patients with the support of an institute and the guidance of supervisors.