Psychoanalytic Training: Coursework: Year 4: Seminars on Lived Clinical Experience
SFCP Psychoanalytic Training Program:
Year 4 Curriculum
The theme of Year 4 courses is ‘Lived Clinical Experience.’ In Year 4 seminars, candidates and instructors will collaborate to articulate their own psychoanalytic values, clinical sensibilities, and the challenges they have encountered in their clinical work, making use of the contemporary psychoanalytic literature to compare, contrast, and integrate approaches.
Individual Seminars on ‘Lived Clinical Experience’
- Values and Aims in Psychoanalysis (7 weeks): This seminar focuses on the following questions as they relate to lived clinical experience: (a) What values — notions of the “the good life” — animate our efforts as psychoanalysts? (b) In what ways are our psychoanalytic values shaped by sociocultural contexts, e.g., by the relative degrees of emphasis a culture places on individualism (e.g., separation, autonomy and the individual mind, etc.) or collectivism (e.g., interdependence and the group mind)? (c) How do these values inform the aims of analysis? What is the relation between the analyst’s conscious, public values/ aims and his or her unconscious, implicit, or private values and aims? (d) What public and private values and aims have brought each of us to psychoanalytic work, and how do these inform the ways we work with patients?
- Psychoanalytic Process and Therapeutic Action (9 weeks): This seminar will explore various perspectives on psychoanalytic process (the personal, dyadic, and encompassing group processes that characterize clinical psychoanalysis), as well as perspectives on therapeutic action (the processes thought to be in play when the patient experiences meaning meaningful growth and development via a psychoanalytic processes). In relation to psychoanalytic process, there may be exploration of concepts such as the relationship between frame and process; phenomena of transference and countertransference; remembering, repeating and working through; regressive phenomena; and processes of failure and repair; . Examples of concepts to be addressed in relation to therapeutic action include exploration of such concepts as the vicissitudes of interpretation and insight; the holding environment and regression to dependence; play; and various forms of interpretation.
- Supervising (6 weeks): This course will explore the work of supervising psychoanalytic casework, addressing questions such as: (a) How do we conceptualize ways in which supervisions foster the clinical growth and development of trainees, and how may this inform the supervisor’s stance? (b) What are points of analogy and distinction between the supervisory and clinical work? (c) What are the respective roles of teaching, identification, holding, containment, play and other psychological processes in successful supervision, and how does understanding of these processes affect supervisory stance? These questions will be primarily explored by discussing material from supervisions conducted by instructors and candidates. Ideally, candidates will emerge from this experience with a deepened understanding of, identification with, and capacity for supervisory work. In addition, candidates may leave the course with a more-highly-developed perspective on their own experiences as supervisees.
- Obstacles to Change (9 weeks): This course will explore clinical work with elements of the psychoanalytic situation that, if left unattended, may impede therapeutic action. These may include phenomena described by such terms as resistance and counter-resistance; impasse and negative therapeutic reaction; trauma and dissociation; transference and countertransference enactments; complementarity; false self and fear of breakdown; narcissism and perversion; erotized transferences; malignant regressions; psychic retreats and pathological organizations. The course will maintain a focus on how these phenomena are manifested in lived clinical experience.
- The Frame and Framing (9 weeks): This course will explore those elements of the psychoanalytic situation described as the setting or frame, and those elements of the analyst’s activity which might be described as “framing.” The following are examples of queries that may be considered: (1) How has the concept of “frame” or “setting” been defined over time? (2) What elements of the psychoanalytic situation comprise the frame? Examples might include time arrangements, the spatial setting, the analyst’s “internal frame” (personality, attitude, demeanor, theory, experience, ethics, history, etc.), and the frameworks established by the sociocultural surround (e.g, the law, professional organizations, the analyst’s community, etc.) (3) What are the possible therapeutic and counter-therapeutic functions of the frame? (4) What do these various queries imply for clinical work?
- Language (5 weeks): This course will explore how clinical psychoanalysis may be informed by the analyst’s understanding of the roles of language within the psychoanalytic situation. Specifically, instructor and candidates will explore questions such as: (a) What are the relative roles of verbal elements, paraverbal elements, and the preverbal “language of action” in clinical communication? (b) What are the non-communicative functions of language in clinical work? (c) How are concrete and symbolic uses of language distinguished? (d) What are the clinical implications of listening to the patient’s associations as an unconscious text that the analyst is to translate? (e) In what ways may language serve as a vehicle for contact with aspects of the patient’s personality that reflect preverbal aspects of development? (f) How does the analyst’s use of language affect the patient’s ability to use interpretations and the analyst’s other verbal productions? (g) How do the foregoing considerations affect clinical decisions about speaking: whether to speak, what to say, etc.?
- The Analyst’s Emotional Tasks (9 weeks): This course will focus attention on the emotional tasks which characterize full engagement in meaningful psychoanalytic work. These may include such concepts as the hatred involved in provision of a holding environment; the suffering involved in containment of psychotic anxieties; the challenges of negative capability, of oscillations between “patience” and “security”; the analyst’s experiences of living through painful enactments; and the need for the analyst to grow and change alongside the patient. In addition to focusing on study of the literature, the course will also invoke candidate and instructor clinical material to maintain a focus on how these phenomena are manifested in lived clinical experience.
- Ongoing Learning and Community Building within Psychoanalysis (6 weeks): This course will focus on how we communicate psychoanalytic thinking, clinical approaches, and identity. Areas of study will include: (a) How does group study facilitate the development of psychoanalytic knowledge, identity and capacities; (b) How are psychoanalytic ideas and practices most effectively communicated to learners? (c) What approaches are relevant to welcoming new learners into the psychoanalytic community? (d) What are the obstacles to effective work, learning, community, and development of leadership within psychoanalytic organizations? (e) How must psychoanalysis engage its intellectual and cultural surrounds in order to maintain its own vitality and to contribute to society?
- Termination of Psychoanalytic Treatment (7 weeks): This course will explore various perspectives on endings in psychoanalysis such as: (1) How does termination differ in quality from premature rupture of treatment; (2) What conscious and unconscious processes may initiate the termination process? (3) What defensive processes may counterproductively hasten or delay termination? (4) What are the practicalities and implications of setting a termination date? (5) What realities and limitations must be mourned in the decision to terminate, and in the process of termination? Candidates finishing this course should have some sense of clinical considerations relevant to the lived experience of termination. In parallel, the consideration of endings, realities, and limitations may resonate with the process of ending psychoanalytic coursework.
Case Conference Sequence (21 weeks)
Candidates in Year 4 will participate in a series of three case conference modules. Each case conference group integrates candidates from Years 2, 3, and 4 and focuses on the close examination of ongoing cases in psychoanalytic treatment. At least three of the nine modules during Years 2, 3, and 4 will focus on cases of children or adolescents in psychoanalytic treatments. Candidates will present clinical process from their own cases, and discussions will be led by seasoned clinicians with different psychoanalytic points of view. Candidates will be encouraged to formulate their own psychoanalytic perspectives on the clinical material under discussion. The impact of sociocultural issues on the treatment will be explored.
Elective (7 Weeks)
Candidates in Year 2, Year 3, and Year 4 will have the opportunity to choose one elective from several offerings each year to explore individual interests (prior electives have included psychoanalytic perspectives on Groups, Misogyny, Film, Culture, etc).
Case Formulation and Writing (7 weeks)
Each year of candidacy will conclude with a writing course in which candidates will be prompted to write in a way that makes explicit their psychoanalytic thinking and their lived clinical experience. Facilitated by the instructor, candidates will read and discuss each other’s writing. Ideally, candidates will leave this course feeling that the process of writing, and of reflecting upon that writing with their group and instructor: (1) has contributed to the growth of their capacities for describing, conceptualizing, and emotionally-processing aspects of their clinical experience, including formulation and analytic process; (2) has strengthened the engagement of their group; and (3) has helped individual candidates, and candidates as a group, to metabolize what they have learned and experienced together over the course of the year.