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Abstract:

This Plenary will showcase a film of Stephen Mitchell speaking about his vision of the Future of Psychoanalysis. Filmed in 1989 at the Boston Division 39 Meeting, This talk concentrates on Mitchell’s departures form traditional psychoanalytic concepts and sets the stage for many of the constructs that have become germane to our current thinking and the Relational Endeavor. These ideas will be further considered by two discussants who will consider the specific ideas Mitchell addresses in the film and will elaborate upon them with clinical material.

At the conclusion of this panel participants will be able to:

1. Establish a greater familiarity with specific departures from Classical theory as conceptualized by Mitchell
2. Have a clearer understanding of the basic tenets of Relational thinking as these were envisioned by Mitchell
3. Establish a clear link between Relational theory and clinical practice and better understand the interface between the two.

Abstract:

Serving Time, Deborah Agrest

The author explores the ways in which a patient’s experience of time plays out in a relational treatment, impacts the analyst, and ricochets back to the patient. Both inhabit multiple self-states as they find themselves in a parallel flow of time. The use of the deep transferencecountertransference matrices and enactment in mending a sense of time are discussed. How are we to extrude experience into language or, indeed, the printed word? This contribution was shaped to deliberately veer off the course of the prevailing structure of psychoanalytic literature. The reader is invited to immerse her/himself in an experience, as we might allow baroque music to wash over us in a darkened concert hall or in the privacy of our own living room. Themes repeat, in spirals, in scores of variations. I have written with those in mind who listen intensely to material that is at first confusing, repetitious, to be sat with, and allowed to wash over them.

Educational Objectives:

At the conclusion of my presentation, the participant will be able to:

1. Describe how to elicit and engage with patients’ multiplicity of self-states with different temporal lines.
2. Describe how the deep transference/countertransference matrices and therapeutic enactment can retroactively re-work patients’ early organizing relational paradigms, in this case, a patient’s sense of herself in time.

Rarefied, Luminous Spaghetti: The “Swoosh” as You Enter the Future and the Future Enters You, Christina Emanuel

Broke, broken, stuck, and undead, Parker came to me five years ago, an overmedicated zombie who persistently wanted to die. A precocious and clever child, Parker was deflated, degraded, and disappointed too many times by a family in which emotions and alcohol were shaken, not stirred. He entered treatment struggling with the suicide of a dear friend and mentor, a series of unfulfilling relationships that ended in debilitating depression, and, significantly, the trauma of having been seduced by his previous therapist. In this paper I describe how my patient Parker becomes “stuck in time,” his temporal response to the difficulties he has endured, and how, through our work, “time comes in.” Drawing inspiration from, among others, Kurt Vonnegut’s Slaughterhouse-Five, Adrienne Harris’ article “You Must Remember this,” and Freud’s concept of nachtraglichkeit, I suggest new ways of thinking about time in an analysis, including adding the concept of “beforeness” to accompany “afterwardsness.”

Educational Objectives:

1. Describe the concepts of “temporal parts,” “afterwardsness,” and “beforeness” and explain how they can be used in psychoanalysis.
2. Describe the concept of “temporal bandwidth” in psychoanalysis, explaining the difference between narrow and broad bandwidth when considering a patient’s experience in time.

Abstract:

If what binds us together as human beings is the shared knowledge that we must die, what simultaneously sets us apart, dividing us in opposing, if not warring camps, are the strategies or belief systems we use to cope with this reality of existence. For many, religion provides the needed palliative through its assurances that in one way or another death is not the end. For non-believers, there is no such solace. The logic that if one no longer exists, one ceases to have a consciousness of one’s state of being (or lack there of) does not readily find a home within the human psyche. Freud addressed this difficulty by declaring that the mind simply cannot conceive of its own nonexistence, setting the stage for a long standing relationship between psychoanalysis and death that has been ultimately abandoning of the secular mind’s need to be joined psychoanalytically in grappling directly with its own mortality. This essay emanates from an interest in psychoanalytic process, specifically in relation to the existential dimension of experience, as it is lived between analyst and patient. I explore what happens when the fact of death finds its way into analytic discourse and becomes an object of scrutiny, as it does, in the treatments I describe. How can minds engage and help one another in considering non-existence? How might relational psychoanalytic thinking inform a response to this question? In presenting clinical material concerning a patient who was terrified of death, I attempt to consider the interplay between the analyst’s omnipotent self and his more vulnerable mortal self, as both aspects of his subjectivity engaged with the patient’s fear of death. This paper considers the nature of the relatedness between analyst and patient that fosters and facilitates the development of the patient’s “existential self.”

Educational Objectives:

1. At the conclusion of my presentation, the participant will be able to explain how the fear of death has been understood in psychoanalytic theory.
2. At the conclusion of my presentation, the participant will be able to describe a form of therapeutic engagement with the patient that can help the patient to deal more adaptively with the fear of death.

Abstract:

Clinical Attitudes and the Transformation of Shame, Margy Sperry

Contemporary psychoanalytic theorists differ in how they understand shame and these differences have important clinical ramifications. Most contemporary thinkers believe that shame is initially generated in interaction with caregivers. They diverge, however, in how they believe that shame is elicited and maintained throughout life. Whereas some argue that sensitivity to shame is intrapsychically maintained and evoked, others believe that shame is shaped and elicited in an ongoing way by one’s relational milieu. This paper explores three attitudes that derive from process (contextualist) theories, including intersubjective systems theory and psychoanalytic complexity theory, and illustrates the role that these attitudes play in clinical work with shame-prone individuals. It is concluded that the attitudes associated with contextualist theories help to derail the shame-blame cycle, and support the patient’s capacity to face her throwness and to embrace authentic existence.

At the conclusion of this presentation, participants will be able to define three attitudes that are associated with contextualist theories and the role that these attitudes play in the mediation and transformation of shame; and recognize the difference between attitudes which emanate from an intrapsychic model of shame and those that emanate from a contextualist (process) model of shame.

Forgiveness Revisited: A Relational Platform for Integrating Forgiveness into Psychoanalytic Theory, Sharon Ziv Beiman

This paper will present a case, on the basis of which I would like to propose forgiveness as a vital therapeutic process, especially in therapeutic contexts in which the patient has been profoundly hurt by significant others. In these cases injured self-states crystallize, dominated by a prevailing sense of worthlessness and helplessness, alongside the perseveration of interpersonal dyads in which the patient experiences herself as a victim. I will attempt to show that forgiveness adds an additional and vital dimension to the therapeutic process, which is bound to and affected by concepts such as reparation, empathy, containment, mutual recognition, working through, and creation of meaning, though it does not overlap with them. After screening the historical and conceptual barriers that have hindered the incorporation of the concept of forgiveness into psychoanalytical discourse, as well as outlining contemporary efforts to integrate it into therapeutic theory, I will suggest that forgiveness calls forth and requires a creative stance. This stance combines a philosophical-ethical position that views forgiveness as a mutually releasing process, and stresses its contribution to the reinvigoration of mentalization processes that were blocked as a result of trauma. A relational conceptualization of forgiveness as a dialectical process that enables and promotes an infinite oscillation between blaming and forgiving self-states, between the positions of victim and perpetrator, between the intra- and the interpersonal, between the emotional and the sexual – heading towards mental movement and liberation from the constant repetition of pain and injury – will be delineated.

Educational objectives:

At the conclusion of my presentation the participant will be able to:

1. Recognize the historical and conceptual barriers that have hindered the incorporation of the concept of forgiveness into psychoanalytical discourse, and outline contemporary efforts to integrate it into therapeutic theory.
2. Describe the relational theory’s contribution in conceptualizing forgiveness as a dialectical process and in constructing it as a meaningful and integrative dimension of the therapeutic endeavor.

Abstract:

A Journey from Extreme Solitude to Relatedness: A Case of Hikikikomori, the Japanese Shut-in, Danielle Knafo

This paper describes the fascinating treatment of a singular young Japanese man, Hisoka, who epitomized the phenomenon of Hikikikomori. The hikikikomori are young people who live extremely solitary lives, never leaving their homes and hardly coming out of their rooms. At the onset of therapy, Hisoka only emerged for his therapy sessions and even then he hardly participated in a usual manner. The therapeutic work involved the creation of a safe holding space within which Hisoka learned to face the derailments of his early attachments and to engage in a mutual relationship. He gradually took steps to interact with the analyst and the outside world. The experience transformed both him and the analyst.

Educational Objectives:

At the conclusion of my presentation, the audience will be familiar with the Japanese culturalbound syndrome called Hikikikkomori, an extreme schizoid condition; and more conversant with therapeutic ways to work with severe isolation and solitude.

A “Miri”, Many “Miris”, and Their Dance Together on a Stage, Valeria Pulcini

The last decades have seen the rise of different approaches in the contemporary psychoanalytic field, due, among others, to the creative contribution of Stephen Mitchell. The case report hereby presented, concerns a severely traumatized, and dissociated patient with whom the traditional approach turned out to be hardly applicable. Beginning with a metaphor by Mitchell, applying his multiple Self theory, and also using several works by other Authors, I’ve put to test various methods, and some non-interpretative tools during the treatment, thanks to which my patient and I were able to achieve considerable change. This exploration from multiple perspectives, namely the implicit, the explicit, the “play space”, the “improvisational moments”, the “moments of meeting”, all together on a “metaphorical stage”, allowed us to understand and to create an intense relationship between us, and enabled her dissociated Selves to come to light, and “dance” together with me, in a movement of cohesion.

Educational Objectives:

At the end of my presentation the participant will be able to:

1. Appreciate Mitchell’s relevant perspective on “Multiple Self”;
2. Discuss some non-interpretative tools helpful in accessing the otherwise inapproachable inner dissociated world of my patient;
3. Analyze and discuss the risks related to the use of these non-conventional techniques, referring to this case of dissociation in which the collusion with the split parts might’ve been possible;
4. Consider these instruments as a possible way to approach the procedural memory.

Abstract:

Review of Phenomenology Psychoanalytic Intersubjectivity, Gabriel Vallejo Zeron

This paper addresses the influence of phenomenology on psychoanalysis starting with the critique that the former has made of positivism in the latter intent to eliminate the subjectivity of the observer. The contribution of phenomenology concerning the experience of the other not mediated by conscious representations is enhanced. This suggests the existence of a corporeal subject and a primary intersubjectivity in which phenomenological empathy is based. The incarnated subject is related to affects and their regulation in an intersubjective yield. In the search for the conscious and unconscious meanings of the psychoanalytic experience this has determined that psychoanalysis has moved towards a phenomenological contextualism. A clinical vignette is presented to illustrate the Concepts related to the phenomenological turn to end with a discussion in which jive concepts that guide the practice of a phenomenological oriented psychoanalysis are put forward.

Educational Objectives:

1. Discern the difference between RELATIONAL Intersubjectivity vision, compared to the positivist view in psychoanalysis, phenomenology, hermeneutics, poetic, etc.
2. Arguing about the deep value and strength of the relational view and its philosophical underpinning.
3. Show a case where inter-relational approach show and difference from the classical approach in psychoanalysis.

The Ethical Turn in Psychoanalysis: Contemporary Pragmatism and the Engagement With Otherness, Elizabeth Corpt

In this paper, I intend to explore what I am calling the ethical turn in psychoanalysis; a turn that again calls up Pragmatism’s influence. In light of this, I believe a revisiting of some of the contemporary tenants of Pragmatism is in order, not only as it pertains to the plurality within psychoanalysis, but more importantly, as it pertains to the pragmatics of responding to intimate pluralities – the actual engagement of otherness - in the consulting room.

Educational Objectives:

At the conclusion of the presentation, participants will be able to:

1. Comprehend the meaning of the ethical turn in psychoanalysis and it’s relevance to psychoanalysis.
2. Understand and apply the pragmatics of engaging otherness in the consulting room.

Abstract:

Patient and Analyst in Crises: A Mutual Transformation Reflected in a Clinical Narrative and St. Exupery's “The Little Prince,” Phyllis DiAmbrosio

In this paper I will describe and illustrate how personal crises of patient and analyst, in contrast to the more commonly recognized detrimental effect, can actually facilitate a mutually transformative process. While I was in the throes my own personal crisis, a very challenging patient arrived for treatment. How that analysis evolved over the course of 12 years to become a mutually transformative and creative process for both the patient and myself is the focus of this paper. To augment delineation of this process, I will use St. Exupery's The Little Prince as a literary depiction of what I believe to be the essential healing elements involved, poignantly illustrated through presenting a film clip from the cinematic version of the book.

At the conclusion of my presentation, participants will be able to discuss the circumstances in which psychoanalysis can potentially be a mutually transformative experience for both the patient and the analyst; and describe how an attitude of creativity, mutuality and openness can help to create a mutually healing environment in an analysis.

The Patient Who Had Me Committed: A Mutually Influential Relationship between Patient and Analyst in the Context of a Broadening Analytic Frame, Alan Sirote

Patients and analysts frequently become locked in enactments generated by their reciprocal dissociations. Emerging from this quagmire often entails the capacity of the dyad to confront each other and negotiate out of these impasses. When discussing the analyst’s role in facing her own dissociations much of the analytic literature refers to minor omissions or blind spots that are effectively dealt with by slight attitude adjustments toward the patient. I suggest that, in some instances, the therapist’s willingness to grapple with her deeper and more profound detachments while struggling and negotiating with her patient’s dissociations could lead to intense mutual influence and spirited enlivening collaboration between the two, including invitations to participate in architecting the therapy itself. This thoroughgoing relational process could be further advanced by broadening the analytic frame to include external environmental factors. A detailed case vignette is presented.

Educational Objectives:

At the conclusion of my presentation the participant will be able to illustrate the advantage of embracing a more comprehensive relational and environmental approach to therapeutic action. There are two educational objectives in this: (1) The therapist’s willingness to grapple with her deeper and more profound detachments while struggling and negotiating with her patient’s dissociations could lead to intense mutual influence and spirited enlivening collaboration between the two, including and especially invitations to participate in architecting the therapy itself. (2) This thoroughgoing relational process could be further advanced by broadening the analytic frame to include external environmental factors.

Abstract:

Limping Along, Together: Finding a Balance in the Consulting Room, Ruth Livingston

This paper explores the issue of the disabled therapist. Specifically, the author considers how her limp enters the analytic process, both with patients who also have gait problems and with those who do not. Using the “limp” as a metaphor for feelings of unsteadiness and vulnerability, internally and relationally, the author considers the ways in which her disability is incorporated by her patients to understand their own feelings of being “off balance”, and how this and the concept of “moving unsteadily” often refer to the process itself. One question is how cultural images of “lameness” are translated within the intersubjective field by both participants, sometimes resulting in mutuality, at other times leading to disconnection. Case vignettes illustrate the complex dynamics that ensue when this analyst’s limp becomes a conscious focus or is dissociated in the consulting room.

Educational Objectives:

At the conclusion of my presentation, the participant will be able to:

1. Discuss how the analyst’s limp may impact the psychoanalytic relationship, and how stereotypical images of disability are dissociated or enacted in the clinical encounter.
2. Describe how an analyst with a mobility disability might use the metaphor of imbalance and “lameness” to explore intrapsychic dynamics and interpersonal relatedness with patients who themselves have mobility challenges and with those who do not.

The “River Banks” Parental Function - Development in the Shadow of Unrecognized Permissions, Etan Lwow-Maier

The lecture is an attempt to offer a novel understanding of the self-other co-construction of the self’s healthy or pathological development. We are accustomed to see the relational impact between two subjects as reflecting a web of hidden and overt intensive interactions between two worlds of emotionally charged psychological motives and forces flowing between the two subjects; one subject’s motives acting, reacting and interacting with the subjective world of the other subject and vice versa in a reciprocal-circular way. The paper suggests that the other’s subjectivity has also a different critical function, as a kind of “potential space” for the development of the self.

The view of the other’s subjectivity not only as a source of intersubjective motives for the self, but also as a critical potential space for the development of the self, changes the arena of treatment. This perspective has allowed for the development of an innovative therapeutic treatment - mediated by the parents - for children, adolescents, or young adults who refuse treatment or suffer from resistant psychological disturbances. A developmental and a clinical example will illustrate the concepts of the paper.

Educational Objectives:

1. At the conclusion of my lecture, the audience will understand a clinically useful, critical function of the significant other in the co-construction of individual developmental psychopathology
2. The lecture will generate interest in an important but usually overlooked parental intersubjective function, essential for promoting a stable “direction” toward health and maturity for the developing self; as well as in the applicable interventions towards that aim.

Abstract:

Finding My Own Voice Working as a Couple Therapist, Helene Beinoglou

The paper I present links my work as an analytical psychotherapist with my personal history. I attempt to describe briefly the notion of transgenerational transmission of trauma and repetition. Repetition is a desperate attempt to find a pathway in life where the consequences of traumas have been dissociated. It is a potentially destructive way of regaining a psychic foothold. Finally it is the perpetuation of a scenario that prevents a sense of freedom, aliveness and creativity. Submission to the past imprisoned me, leaving me powerless as a child. The internalization of the bad internal objects used to fill the void of the absent other, creating a false self personality and containing the sense of vacuum inside. This is a journey from a sense of isolation and emptiness to a feeling of aliveness and creativity by [re]connecting to the traumatized parts of myself.

In the second part of my paper I describe two vignettes of Couples Therapy with deeply traumatized couples (sexual and non-sexual abuses) with violent behaviors. These couples needed to discover a way to [re]connect their violence to their past abuses. In both cases, secrets had destroyed their capacity for association or symbolization and their traumatic history was perpetually repeated within the couple relationship. I try to show that these repetitions reinforced a sense of total estrangement and absolute aloneness in relation to their environment. I describe how the creation of a protective shield in therapy was necessary before they dared acknowledged their violent, hateful, fearful traumatized parts of self. The therapeutic work is concentrated on the countertransferential feelings and non-verbal elements of the sessions, used to access unelaborated material.

Educational Objectives:

At the conclusion of my presentation, the participants will be able to:

1. Relate feelings of estrangement and aloneness to the transgenerational repetition of past traumas.
2. Explain the importance of the acknowledgement of the therapist’s personal history and the way she relates to it.
3. Describe how the elements of the personal history of the therapist can create transferential and countertransferential bridges with couple.
4. Describe how accessing our traumatized parts of self can foster our sense of creativity and aliveness.

Taking Into Therapy Only the Parents or Also the Son/Daughter? A Criterion for Choosing During the Assessment with the Parental Couple, Marco Bernabei

In the paper I suggest some criteria that can be used during the assessment of a therapeutic plan for psychotherapeutic treatment during development when the decision needs to be made as to whether one should continue to see only the parents or involve their son/daughter in the treatment as well. The criterion for suggesting one setting or the other depends on the image which the parents offer to the therapist of their child: when the image of “the mother’s son” does not appear to be too discrepant from that of the “father’s son”, it is possible to suggest that one continue to see only the parents. On the contrary, the need for the therapist to see also the son/daughter arises when the image of the child (or boy/girl) presented by one of the parents is so different from that of the other that one gets the impression one is dealing with two different children, that of the mother and that of the father. In this regard, I explain that the reason for deciding to see also the child is that, coming directly into contact with some of his/her traits, bypassing the filters introduced by the father or mother, will allow the therapist to present them again to both parents in less of a dissociated way so that together they may start a process to reconstruct more of a shared image of a child-son/daughter. Mitchell’s (Mitchell, 1993) statements regarding the repercussions of the differences between the mother’s child and the father’s son within the universal conflict among the different self-organizations are associated with the idea that underpins this paper, according to which when the mother’s child is altogether different from that of the father the result is not a mere conflict among self-organizations but an actual dissociation between such self-organizations (reference is made to non-communication among rigidly dissociated self-organizations, as postulated by Bromberg) (Bromberg, 2006). I also posit that the onset of such dissociated self-organizations depends on how the parents-child identification processes are played out. In the paper, I suggest that when it comes to choosing a setting, the best way to proceed, if one begins to notice that the conflict among the child’s self-organizations (arising from his/her identifications with the discrepant views the parents have of his/her unripe self) runs the risk of resulting in, or indeed has already resulted in dissociation, is to take into therapy both the parents and the child. I have become convinced that, when instead the views of the child produced by the two parents are only slightly different, it is not only possible but indeed advisable to try to work only with the parents. As the clinical vignettes of therapeutic treatments involving only the parents show, in these cases the therapeutic work will focus primarily on reducing the discrepancy between their views of the child. I describe how, in the setting which involves only the parents, seeing them alternately, first individually and then as a couple, allows the therapist to serve as a shuttle between the parents and their images of the child which are conveyed from one to the other during their individual sessions and are then shared with both so that they may be discussed together during the couple sessions.

Abstract:

Emily Bronte: A Private Self in the Context of an Insular Family: A Focus on the Effects of Creativity, Barbara Feld

Thinking about the life of Emily Bronte, the author of one of the most famous novels in the English language, Wuthering Heights, is helpful in understanding the creative transformation of the experience of traumatic loss. In this presentation, I will illustrate the basis for Emily’s entrapment in the sequence of traumatic losses through death of family members, and discuss several themes that can be observed in her development. Other additional theses I have developed include her struggle to find freedom and individuate in the midst of intense dependency, and her ability to transform trauma into art through her creative fantasies. Her imagination, creativity, wanderings on the moors, and her extensive writing were fertile ground for the expression of her will. Her poems and her novel Wuthering Heights were integral to her moments of individuality.

Learning objectives:

1. A listener will learn about the development of creativity in a family context and it’s use in dealing with traumatic loss.
2. A listener will come to understand the parallels between life and art in Emily Bronte’s creations.

Creativity, Passion, and Romance: Reading Thomas Hardy Through the Lens of Stephen Mitchell, Barbara Schapiro

Three themes in Stephen Mitchell’s work—creativity, passion, and romance—resonate closely with those of the British Victorian writer Thomas Hardy. Both Mitchell and Hardy explore the perpetual tension between our inner subjective world, with its fantasies, passions, and creative projections, and an inexorable external reality. Reading Hardy’s fiction through the lens of Mitchell’s theorizing can shed light on Hardy’s passionately romantic characters and illuminate a complex psychodynamic tension at play in his novels. Equally it is hoped that this discussion will further appreciation of Mitchell’s ideas as they find expression in fictional form.

Educational Objectives:

At the conclusion of my presentation, the participant will be able to explain Stephen Mitchell’s ideas about the dialectical relationship between fantasy and actuality and to describe how that dialectic operates in Thomas Hardy’s fiction; and explain how idealization and aggression inform Stephen Mitchell’s ideas about romance, and they will be able to illustrate those ideas through examples from Hardy’s fiction.

Heinz Kohut and Creativity: At the Frontier of Self Knowledge, Charles Strozier

Paper addresses the theme of creativity in the life and work of Heinz Kohut. In the first part the story is how he himself embraced music, art, and literature in profound ways in his own life, including his favorite artists and musicians, as well as the reading that most appealed to him. The second part of the paper describes the creative transformation of Kohut’s ideas about psychoanalysis in the 1960s and how the new theory, culminating in his greatest work, The Analysis of the Self in 1971, went along with a remarkable change in the kind of literature and art that had meaning for him.

Learning objectives:

1. A listener will learn about the workings of creativity in psychoanalytic theory and how personally challenging it can be to engage new ideas.
2. A listener will come to understand some aspects of the intellectual journey of Heinz Kohut.

Abstract:

Why Can Even A Fluttering of a Butterfly's Wings Change Everything: A Chaos Perspective and A Complexity of Therapeutic Relations, Luis Guerra Cid

Along the history of psychoanalysis there has been a tendency to think that the processes that take part in therapy (diagnostics, etiology of psychopathology, transference, processes and phases of treatment) have lineal tendencies of “The therapist interprets and the patient accepts what the analyst says and experiences insight or, ultimately, resists” type. This has two consequences: an illusion of linearity based on the fact that the therapist and the patient move always in the same segment forwards and backwards; and a more static role in both with some default rules (patient’s free association that needs to comprehend the objective reality that the therapist proposes and the therapist’s abstinence and neutrality that is interpreted when the “objective truth” is known”). S. Mitchell (1993) commented that apart from the importance of the insight we are to evolve towards the observation of other elements like the relational expansion and the experiential part that it connotes. The hard sciences that have been working for a long time with the Nonlinear dynamic systems theories (NLDS) bring forward the importance of the complexity and relative chaos that exists in the complex systems. The contemporary psychoanalysis can also work from this perspective provided that the existing difference between our object of studies (a human being immersed in relations) and the elements studied by the hard sciences are taken into consideration as various authors do, putting that into practice from the relational perspective (Selligman, 2005; Lyons-Ruth, 2010; D.B. Stern, 2010 Marks-Tanlow, 2011). In this way, the NLDS shows that different actions, enactments and all the shared relational knowledge indicate implicit dynamics, nonlineal and dynamic in the therapeutic processes. So as to explain all that issues we will start with a simile that comes from certain approaches from the recent theories of hominization in anthropology. Those apply to certain aspects of the complexity and of the NLDS in the human evolution. Hereupon we will provide divergent explanations to the classic ones on the etiology and maintenance of psychopathologies and of some characteristics of the relation as a technique itself for the progress of the treatment.

Educational Objectives:

Describe and explain which are the consequences of taking the NLDS models and the theory of complexity both in etiology and maintenance of psychopathology and in the therapeutic relation. With this presentation it is intended that the participant learns throughout this theories the mechanisms that cause the progress of a therapeutic relation or change the registers (for example, over moment to moment interactions or because of the accumulation of emotional feedbacks between the therapist and the patient).

Psychodynamic Formulation in the Age of Neuroscience: A Dynamical Systems Model, Yakov Shapiro

Dynamical systems approach to neural network functioning offers the most comprehensive foundation for psychotherapy available to us today. Recurrent patterns of thinking, feeling, and relating can be analyzed by modeling cortical and subcortical network processes. Dynamical Systems Therapy (DST) stands as a trans-theoretical model with the explanatory power to integrate systems of synaptic networks with systems of meaning. It powerfully argues for shifting the emphasis from maladaptive patterns as the problems in themselves – to seeing them as patients’ imperfect solutions to their inner and relational conflicts. Patients are seen as active agents who create the subjective meaning of their experiences based on specific developmental templates. Therapeutic relationship becomes our tool in re-shaping the topology of the patient’s neural network landscape and re-establishing self-organizing process.

Educational Objectives:

At the conclusion of this presentation, the participants will be able to:

1. Carry out a comprehensive psychiatric assessment without the artificial separation into biological vs. psychological domains in order to construct a unique individualized treatment plan for the patient integrating both psychotherapeutic and biological interventions.
2. Use DST framework as a trans-theoretical teaching tool to help psychiatric trainees see beyond the manualized assessment, and incorporate the patient’s unique subjectivity into biopsychosocial case formulation.

Abstract:

The Psychotherapist, The Patient and The Lover: Caught in the Web of Virtual Relationships, Etziona Israeli and Stanley Rabin

The Internet has created a new kind of social space where people are "meeting and mating" in new ways. The meeting between people on the web is unique in that there is no corporeal body, no touch, no sensual impressions, this in contrast to real-life meeting, in which one detects something out of the ordinary, reacts to body language, reacts to verbal and nonverbal communication. The thrust of our presentation will be to consider the actual significance and meaning of the cyberspace encounter as told by the patient and its interwoven expression in the psychotherapeutic relationship. Our paper will attempt, through the presentation of a case, to trace the development of this new phenomenon of virtual romantic love relationships on the internet.

Educational objectives:

1. Through the virtual relationship of the patient, the therapist understands the patient's difficulties in forming relationships.
2. Through the emotions that the therapist feels in the therapeutic session he/she learns about the dynamic processes that occur in the patient therapist relationship.

The Unseen Spouse: Pitfalls and Possibilities for the Individual Therapist, Carla Leone

Individual therapists frequently hear a great deal about their patients’ spouses or partners, and naturally develop ideas and beliefs about that person and about the causes of any relationship difficulties. However, problems arise when therapists lose touch with the fact that their impressions of an unseen spouse are only constructions that have emerged from the transference-countertransference field, based on only partial or limited information – not veridical truths. They can then begin to speak about the patient’s partner or relationship issues in ways that can ultimately do both patient and spouse a disservice and perhaps distract from the patient’s own issues and analytic goals. This paper discusses several factors that seem to contribute to the development of this problematic dynamic, including various qualities of the transference-countertransference field, and offers suggestions for avoiding or reducing it. Clinical material is used to illustrate key points.

Educational Objectives:

By the end of this presentation, participants will be able to:

1. Discuss the problems that can occur when individual therapists develop strong feelings or opinions about an individual patient’s spouse or partner, despite having never met that person.
2. List several factors that contribute to the development of this problematic dynamic or phenomenon
3. List several ways to avoid or minimize the development of the problem

“[T]he self is created from meanings assigned to experience; one cannot begin to understand a life, a person, without an appreciation of those experiences and what they provide in terms of possibilities and constraints. But the meaning of those experiences is not given; it is composed, created, designed. The self is not produced by motives and causes; there is also the creative will of the individual.” (from Relational Concepts in Psychoanalysis,1988, p. 257)

Abstract:

This panel will explore the dialectical interplay in the analyst's experience of finding himself or herself "feeling inclined" to act and proactively exercising will to influence the process. Sometimes what seems to be in the foreground is the sense of "unbidden" experience that is the impetus for new understanding and action (Stern's emphasis), sometimes what is in the foreground is a sense of determination to affect the patient and the analytic relationship in a particular way (Hoffman's emphasis). The wellspring for the analyst's experience can never be fully known and yet certain moments become inspirational for creative exploration of new possibilities.

1. Attendees should be able to define relational freedom and apply the concept to clinical situations in their own experience.
2. Attendees with gain understanding of how analytic therapists' proactive, creative efforts in a constructivist framework to inspire change in their patient’s lives can be integrated with a critically reflective analytic attitude and with awareness of the never fully known or controlled foundations for changing perspectives.
3. Attendees will gain understanding of how analytic therapists' explicit expressions of loving affirmation can do battle with the destructive effects of persecutory introjects and provide fertile ground for the emergence in the patient of new possibilities and new hope.