September 16, 2007

Unsticking a Stuck Patient

All of us are bedeviled by patients who, no matter what we try, seem to make little progress.  They appear to be cemented in place.  This experience, frustrating for both clinician and patient, often results in one of two outcomes-either the treatment drags on endlessly, or unhappy termination occurs-from anger, lassitude or exhaustion.  In this presentation, Dr. Robert Hooberman describes another path, one that he feels can help move not only the intransigent but also other patients who inevitably reach those all too familiar rough patches in psychotherapy and  psychoanalysis.  Dr. Hooberman uses his conception of central fantasy, an important component of character structure, as an explication of the patient’s inner world.  Case examples are used to illustrate how these conceptions can assist in profitably altering the frustrating dynamic of therapeutic stagnation. 

Robert Hooberman, Ph.D, is  current VP for Education and Training, and a former President of MPC.  He practices psychotherapy and psychoanalysis in Ann Arbor where he works with adolescents, adults and couples.  He supervises candidates and other mental health professionals, and has been a supervisor at the University of Michigan Psychological Clinic and at the University of Detroit-Mercy Psychology Clinic.  Dr. Hooberman has presented numerous times, both nationally and locally.  He is the author of three books, the most recent being Competing Theories of Interpretation: An Integrative Approach. 

Ann Arbor Women's City Club. 1830 Washtenaw
Ann Arbor, Michigan

Directions to the Women's City Club

  Saturday, October 20, 2007

DAY LONG CONFERENCE

Our Appointment in Thebes:
The Analyst’s Fear of Harming
and the Need for Acknowledgement

Jessica Benjamin, Ph.D.

Case Presentation:  Peter Wood, LMSW

9:00 A.M.- 4 P.M.

This paper addresses the way in which the psychoanalytic therapist approaches the problem of her or his responses to the patient's dissociative and traumatized parts, which inevitably pull for dissociation or hyperarousal on the part of the therapist as well. Since the field has accepted the notion of projective identification, there has been considerable clinical thinking about how the therapist is affected by the patient. However, there is still controversy about how the therapist uses her or his own reactions and how much of them she or he conveys to the patient. Much of this turns on the question of whether enactments are inevitable and whether they are productive. This paper contends that enactments can be the most productive of therapeutic work as long as we acknowledge them to ourselves, personally and as a community, and find ways to convey our honest understanding to the patient.   The point of acknowledging our participation to the patient is not that it is a disclosure, but rather a confirmation of what the patient knows or suspects, which frees up the patient to examine honestly her or his own participation. The underlying issue here is shame and blame, and the need to step out of cycles of projection. The paper argues that this is possible in many instances without placing undue burden on the patient and that, as Ferenczi argued, it avoids the repetition in which the injuring caretaker denies responsibility and the reality of what the child has experienced.

Jessica Benjamin, Ph.D. is internationally recognized as a leading theorist of Intersubjectivity, gender and psychoanalysis.  She is a practicing psychoanalyst in New York City and is on the faculty of the New York University Postdoctoral Psychology Program in Psychology and Psychoanalysis.  She is a founding board member of the International Association for Relational Psychoanalysis and Psychotherapy (IARPP) and a co-founder of the Mitchell Center for Relational Studies in New York City.  She is currently writing on the subject of Acknowledgement and organizing a series of workshops between Israeli and Palestinian Mental Health Professionals.   She is the author of The Bonds of Love, Like Subjects and Love Objects and Shadow of the Other.

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Crowne Plaza Hotel
Novi, Michigan

Directions to the Crown Plaza

 November 18, 2007

  Freud's Little Oedipus:
THE ANOMALY OF LITTLE HANS

Karin Ahbel-Rappe,  Ph.D, MSSW

11 A.M.-1:00 P.M.

Freud’s 1909 case study, “The analysis of a phobia in a five-year-old-boy” is regarded by Freud and also by analytic readers and commentators as a prototype of his conception of the oedipus complex.  This essay, however, argues that the representation of the oedipus complex that comes through in Freud’s Hans paper differs from Freud’s essential view; that, unbeknownst to Freud, his effective interpretation of the oedipus in the Hans paper is, in fact, anomalous relative to his other work.  Thus the essay tries to make legible a sort of theoretical unconscious of Freud’s paper.  This is approached via a literary methodology—a study of Freud’s paper as text.  The essay shows that, in contrast to Freud’s typically tragic view of the oedipus complex (in the tradition of ancient Greek tragedy), the Hans’ study evokes a comic vision (in the tradition of Greek New Comedy).  Given the deep link between Freud’s oedipus concept and a tragic view of human life, this departure in the Hans paper constitutes a fascinating anomaly.

 
Karin Ahbel-Rappe is on the teaching faculty of the Michigan Psychoanalytic Council.  She has an independent practice in psychoanalysis and psychotherapy in Ann Arbor, Michigan.  Her current research focus is on Freud's language and theories.

University Club
East Lansing, Michigan

Directions to the University Club

January 20, 2008

  Transformation from Deadness to Human Relatedness:
A Case Presentation

Karen Baker, LMSW
Jerrold Brandell, Ph.D., discussant

11:00 A.M.-1:00 P.M.

Schizoid patients live in states of mind characterized by psychic and emotional deadness.  The process of change can be an arduous journey for the patient and the therapist.  This paper describes the points of transformation that moved the patient from emotional deadness to emotional relatedness.  A clinical case is presented discussing the process of change that resulted from the analysis of schizoid defenses and sadomasochistic defenses.  The points of greatest transformational change occurred within the transference/countertransference paradigm.

Karen Baker, LMSW is a Clinical Social Worker/Psychoanalyst in private practice in Ann Arbor where she sees children, adolescents and adults.  She is an analyst and on the faculty at the Michigan Psychoanalytic Council and is the current VP for Programs. She is a family consultant at the Allen Creek Preschool and also serves as a member of the Board of Directors.  Ms Baker is the Board Secretary of the American Association for Psychoanalysis in Clinical Social Work.  This paper  along with the discussion paper has been accepted for publication in the June/September 2008 issue of Smith College Studies in Clinical Social Work. 

Jerrold Brandell, Ph.D. is Professor and MSW Program Coordinator at Wayne State University School of Social Work, where he also chairs the psychodynamic practice track. He is Founding Editor of the journal, Psychoanalytic Social Work, and serves on the Editorial Boards of Israel Annual of Psychoanalytic Theory, Research, and Practice, Clinical Social Work Journal, and the Bulletin of the Michigan Psychoanalytic Council.  The author or editor of seven previously published books, his newest book, written with Shoshana Ringel, is titled, Attachment and Dynamic Practice.   

Ann Arbor Women's City Club. 1830 Washtenaw
Ann Arbor, Michigan

Directions to the Women's City Club

February 17, 2008

11:00 A.M.-1:00 P.M.

Time Out of Mind:
Dissociation and the Virtual World

Ellen Toronto, Ph.D.

This paper will examine patients’ intense involvement with virtual reality as a form of dissociation. As with other dissociative disorders individuals may retreat from the real world to a subjective state in which they can attempt to exercise control and aggressively capture the supplies they lack.

While patients’ engagement with the virtual world can be highly disruptive to productive functioning, it can prove difficult to engage in the clinical encounter. It can become sequestered outside of time, intensely private, couched in shame and under-reported. By way of illustration the paper will present three clinical vignettes in which the dissociated material is invited into the therapeutic dyad where it may become integrated into an ongoing biographical narrative.

Shame and the Internet
Batya Monder, Ph.D.

This paper examines some clinical vignettes of patients who have turned to the Internet in part as a way to explore their own sexual feelings. In this virtual world, and in the privacy of their own homes, they were able to navigate the Web and find sites that fit their particular desires and deficits. Ms. Monder will explore her thinking about this material and share what she has come to understand about four patients of different ages, two men
and two women, and what they, in turn, learned about themselves. She will also give some background on the literature on shame, a much overlooked affect until the 70s and 80s.