Psychodynamic Psychotherapy Training and Supervision

About the group

Emphasis on advanced psychodynamic listening skills to enhance psychodynamic diagnosis and conceptualization—e.g., analyzing nonverbal communication, listening to latent content, listening to enactment, listening to countertransference,

• Emphasis on experiential psychodynamic techniques, helping patients learn from experience (rather than from authority or pseudo-omniscience)
• Emphasis on creativity in intervention, developing your own style
• Emphasis on clinical thinking skills—developing our ability to reflect about clinical material and our own countertransference to form hypotheses about the interaction and tailor interventions to the patient; challenging unconscious biases that interfere with tailoring our approach to the patient
• Emphasis on using relational concepts as a lens for understanding clinical process and effective intervention

Details

The fee is split between the members. Ideally we have 5 folks, so the fee comes out to $46/session, or $276 per 6-session block. Members commit to a full block at a time to facilitate group cohesion, and there is the option to continue together for multiple blocks of the group wishes to do so.

Format: There is one presenter each meeting, presenting for 40 minutes. Videotape, audiorecording, transcript, or free associative presentation are all acceptable. I offer supervision throughout that time. Then there is 10 minutes left for group discussion. Each member presents once each block.

Group process: The 6th session of each block is a group process session, in which we have an opportunity to discuss our reactions to learning together.

The Ear, The Eye, the Heart, and the Hand: a core training in EDT and ISTDP

This IEDTA-certified core training will focus on mastery of the underlying principles of experiential dynamic therapy and ISTDP, and of the strategies for listening and intervening that can be derived from those principles. Participants can expect to graduate with a strong comprehension of these core principles and of the ways these principles find expression in the treatment techniques of Davanloo and others. They will be supported to apply these principles and strategies with their own patients in their own idiom—to live out these core concepts in their own unique way. The overarching goal of the training is to help therapists help their patients to more deeply experience and integrate previously repressed and dissociated aspects of their life and mind, and a broad spectrum of theoretical and technical ideas will be brought to bear for achieving this goal. We will train the ear and eye to receive unconscious communication, train the heart to experience and make sense of countertransference, and train the hand to reach out to the unconscious through skilled intervention.

Admission criteria: All core-trainees must be licensed/registered or in a recognized degree program that leads to licensure/registration, and be able to produce proof of this. They must be willing and able to attend all meetings.

Program structure: This 3-year, year-round core training will feature twice-monthly 4-hour online training sessions, and once-annual in-person immersions outside Philadelphia, PA, USA.

Twice monthly Zoom meetings: There will be a 4-hour session on the first Wednesday and third Friday of every month, year-round. The goal of these more-frequent meetings is to provide continuity and increase frequency of repetition, as this may enhance learning. These 4-hour sessions will consist of 2 didactic hours, 1 supervision hour, and 1 hour of group process. They will occur from 9am-12:50pm EST.

Annual in-person immersions: The immersions will consist of one 8-hour day (Friday) and one 5-hour day (Saturday), and will occur once per year of core training. The Friday schedule during immersions will include 4 hours of didactics, 3 hours of supervision, and 1 hour of group process, and the Saturday schedule will include 1 hour of didactic, 3 hours of supervision, and 1 hour of group process. This half-day Saturday will enable students to spend the afternoon exploring the local area (Delaware County, Pennsylvania, close to Philadelphia, Chester, and Montgomery counties), which has much to offer. Social events and/or shared meals out will be planned according to group interest.

IEDTA Certification: Over the 3 years of training, participants will receive 159 hours of didactic training, 15 hours of individual supervision, 75 hours observing group supervision, and 78 hours of group process, qualifying them for certification as “core trained” by the IEDTA.

Fee: The cost/year of training is $3,350 (USD). (The cost of this amount of content, if one was to obtain it through individual and group supervision and participation in other courses I offer, would be roughly $5,000/year). Payments are non-refundable.

Curriculum: The curriculum will be shaped to the needs of the participants, and is subject to change as we go, but the following is a general plan:

Each month of the 3 year program will have a specific focus, so there will be 12 major content areas covered each year, 36 in total. Didactic seminars will consist of reviews of the readings, discussions of theory, skill building exercises, role play, with heavy emphasis on viewing clinical vignettes of the trainer’s clinical work. Participants can expect about 60 pages of readings/month, tailored to the topic of the month and/or to other interests that emerge in the group.

Here is a general map of the course content for each year. While we will likely pursue the topics in something close to this order, topics will inevitably be interlaced due to the nonlinearity of psychotherapy learning:

Year 1, “The ear, the eye, and the heart”:

Core themes: ISTDP “metapsychology” (resistance and Unconscious Therapeutic Alliance (UTA), response to intervention, psychodynamic clinical thinking, listening for the 5 channels of unconscious communication, case formulation, establishing an effective focus

1. Psychodynamics, the science of unconscious conflict (Triangle of conflict, Triangle of person)
2. Transference and transference resistance
3. UTA #1: Listening for unconscious conflict in manifest content
4. UTA #2: Listening for unconscious conflict in process a) Anxiety — unconscious anxiety, non-verbal signals of anxiety, response to intervention, psychodiagnosis, pathways of anxiety discharge
5. UTA #3: Listening for unconscious conflict in process b) Defenses — defenses, non-verbal indicators of defense, response to intervention, psychodiagnosis
6. UTA #4: Listening for unconscious conflict in process c) Feelings and Impulses — unconscious vs conscious emotions, the role of emotions in psychic life, psychodiagnosis
7. UTA #5: :Unconscious supervision”, “dream work”, response to intervention
8. UTA #6: Understanding countertransference: turning our experience inside-out, response to intervention
9. UTA #7 Unconscious enactment, response to intervention
10. Will and Conscious Therapeutic Alliance
11. Rise in the transference, Davanloo’s spectra diagnostic system
12. Establishing an effective therapeutic focus

Year 2, “The hand”:

The second year will focus on intervention strategies for achieving the aims of experiential dynamic therapy and ISTDP, namely regulating excessive anxiety and interfering with the functioning of pathogenic resistances, so that repressed material can be experienced and enter consciousness.
Core themes: intervention, tailoring intervention to psychodiagnosis, response-to-intervention

1. Anxiety regulation, thresholds
2. Regulating the anxiety caused by superego pathology and projection of superego
3. Formulating task, conscious therapeutic alliance
4. Pressure to (task, will, consciousness, acceptance, feelings, etc.)
5. Pressure against (defenses and resistance)
6. Spectrum of challenge, from subtly “casting doubt” and “calling into question” to “No”
7. HOC—“Undoing”, deactivating interventions, “a conversation about reality”
8. Navigating barriers to closeness, tailoring our interventions to particular resistances
9. Counterprojective maneuvers—working with paranoid patients
10. Counterenactive and “indirect” maneuvers—working with unconscious resistance
11. The role of interpretation
12. Consolidation, psychic integration

Year 3, Advanced topics:

The third year will take on advanced topics that can now be better understood and put to use with a foundation of principles of listening and intervention in place.

Core themes: Clinical thinking, complex cases, advanced stages of therapy, advanced psychodynamic clinical concepts

1. Clinical thinking #1: hypothesis development and testing
2. Working with fragility and severe personality disorders: splitting and splitting-based defenses
3. Regression and regressive or defensive affects
4. Internalized Object Relations, their role in psychodiagnosis of the transference
5. Projective identification—how patients attempt to induce feelings and roles in therapists
6. Unconscious enactment/counterresistance—the therapist’s unconscious collusion with defenses and resistance
7. Clinical thinking #2: our relationship to our theory
8. Compliance, defiance, passivity, and dependency: Power dynamics in therapy
9. Therapist stance: anonymity and neutrality as they relate to ISTDP
10. “Breakthrough into the Unconscious”
11. Couples therapy
12. Termination

Supervision: Participants are expected to present their clinical work in group supervision five times per year, according to a schedule that will be set at the start of each year. Video recordings of sessions are the only acceptable format for presentation. Trainees must present session videos from at least 2 different patients over the 3 years. A maximum of 1x/year a student may present in some other format (e.g., audio recording, transcript), and should do so only if the patient that they want help with will not authorize video recording. A sample informed consent for recording will be provided to students upon request.

Supervision sessions will be 50-minutes each, with the first 40-minutes involving direct supervision between the participant and the trainer, and the last 10-minutes open for group discussion. In addition to supervision based on the video presented, supervision may also include role-play and prescription of deliberate practice exercises.

Each year I will offer two 6-month “post-core” trainings that I am calling “Advanced Psychodynamic Concepts and Skills for EDT Practice”. The trainings will take place once monthly via Zoom. My hope is to introduce participants to concepts and tools from the broader psychoanalytic literature that will augment and be complementary to what they learned in ISTDP core training. This program will be for students who have completed core training in any EDT (or who can demonstrate an equivalent level of acumen), and who wish to continue to improve their psychodiagnostic and intervention skills with like-minded colleagues. The training modules will consist of didactics (including video presentation), supervision, and group process. Readings will be assigned before each module.

Schedule: The group will consist of 6 modules and meet on the 1st Friday of the month

Fee: $2000/participant

Curriculum: The didactic curriculum will focus on advanced psychodynamic concepts related to listening, conceptualization, and intervention that can be helpful to master as we strive to embody the values of experiential dynamic work. Students will learn concepts and skills that go beyond the basic EDT curriculum, and that can be usefully integrated with their current approach.

Fall semester

Module #1: Unconscious alliance: in this module we will draw on psychoanalytic ideas to try to expand our ability to “hear” unconscious communication, cultivating the mental set that is the therapist’s contribution to the UTA. To better sensitize ourselves to unconscious communication, we will examine the myriad ways that unconscious meaning presents itself in conscious content, behavior, and through countertransference. We will apply these listening skills to our cases (main readings: Freud, Searles)

Module #2: Response to Intervention: in this module we will return to Davanloo’s ideas about response-to-intervention, and augment them with complementary ideas from the larger psychoanalytic literature. We will apply these ideas in listening to our patient’s responses to interventions (readings: Abbass; Langs)

Module #3: Clinical thinking: in this module we will learn psychoanalytic ideas about the process of psychodiagnosis (data gathering, conceptualization, and intervention planning), and discuss some unconscious biases that can interfere with this process. We will apply these ideas to our psychodiagnostic approach (Readings: Peterfreund, Rubovits-Seitz, Tansey & Burke, Meehl)

Module #4: Therapist stance: in this module we will learn about Freud’s concept of “evenly hovering attention”, Bion’s concept of “without memory, desire, preconception or understanding, Sandler’s “evenly hovering responsiveness”, and Greenberg’s interpersonal definition of neutrality in an effort to shed light on our unconscious listening biases and reflect on how our mental set impacts listening to patient’s responses. We will examine our own listening stances and compare them to these concepts as we view case material (readings: Freud, Bion, Sandler, Greenberg)

Module #5: Internalized object relations: in this module we will discuss how memories of experiences with important people in our lives can be reenacted in the context of therapy, and examine the myriad ways these memories can emerge in the transference and countertransference. We will practice our skills for detection of internalized object relational patterns in our cases (readings: Kernberg, Bird, Klein)

Module #6: Enactment and counterenactment: in this module we will learn about the psychoanalytic concept of enactment, and explore the technical concepts of counterprojection/counterenactment. We will apply the concept of enactment as a lens for understanding our clinical work, and learn counterenactive intervention skills (readings: Levenson, Havens)

Spring semester

Module #1: Projective identification: In this module we will use videotaped case material so we can learn about projective identification by seeing it in action, tracking it moment-by-moment. We will discuss subtle, everyday occurrences of projective identification that are often missed in clinical work, and discuss strategies for supporting patients to become more conscious of that which they unconsciously “relocate” and attempt to evoke in others. (Readings: Grotstein, Kernberg, Bion)

Module #2: Regressive defenses and defensive affects: In this module we will study regression to early modes of relating and examine the varied ways this can manifest clinically. We will put special emphasis on understanding regressive or defensive affects, affects that emerge as a result of a regression. (Readings: Kernberg; Rosenfeld)

Module #3: “Unconscious supervision”: In this module we will study a manifestation of the UTA known as “unconscious supervision”, in which the patients’ narratives can be seen to unconsciously provide helpful feedback for the therapist. We will discuss the importance of listening to and analyzing descriptions of situations in “the C” in order to learn more about the patient’s experience of “the T”. (Readings: Langs, Searles, Gill)

Module #4: Interpreting “dreams”: In this module we will discuss Freud’s dream work, the process of unconscious compromise that allows a dream to enter consciousness, and we will examine analogous processes that occur while awake, shaping consciousness. We will discuss how patients’ dreams, daydreams, and other imagistic experiences they share can help us learn about their unconscious conflicts and their experience of the therapy. (Readings: Freud, Grinstein, Ogden)

Module #5: Conflict and compromise: In this module we will examine different theories of unconscious conflict, and discuss the way conflicts between unconscious forces create symptoms and presenting problems and play a determining role in all of psychic life. We will increase our skills for psychodiagnosing syntonicity, dystonicity and all the degrees of conflict that exist between them, and practice tailoring our interventions to the patient’s exact level of conflict. (Readings: Brenner, Busch, Freud)

Module #6: Unconscious power dynamics: Compliance and defiance: Undetected or mismanaged compliance and defiance can cause misalliance and treatment failure. In this module we will sensitize ourselves to the signals of compliant and defiant transferences and learn strategies to counter them throughout the therapy process. We will also discuss the power dynamics inherent in therapy and all other relationships, and discuss strategies for tracking and attempting to alter these dynamics. (Readings: Sullivan, Havens, von Korff)

Structure of meetings: Each meeting will start with 80 minutes of didactics, followed by a 10 minute break. Then we will have three 50-minute supervisions, each with a subsequent 10 minute break. During supervisions, I will supervise for the first 40 minutes, and the final 10 minutes will be used for group discussion of questions that come up in the supervision. The final 50 minutes of each meeting will be an opportunity for group process, for reflecting about and working on the reactions we have to learning together.

Sample schedule:

9-10:20am: Didactics
10:20-10:30am: Break
10:30-11:20am: Supervision 1
11:20-11:30am Break
11:30-12:20pm: Supervision 2
12:20-12:30pm: Break
12:30-1:20pm: Supervision 3
1:20-1:30pm: Break
1:30-2:20pm: Process group

Supervision schedule: The 6 members of the group will be split into A and B groups, and the 6 sessions will alternate between A days and B days. Group A will present on A days and group B will present on B days. Throughout the course, each participant will receive 3 supervisions in front of the group, and be able to observe 15 others.

Contact: The 6 openings will be given away on a first-come first-served basis. If you’re interested, or have any questions for me, please contact me at mauricelouisjoseph at gmail dot com, or through my website at mauryjoseph.com.

Our interventions can only be as effective as the listening and conceptualization process that informs them. Unconscious messages come to us through diverse channels, including the verbal, nonverbal and countertransferential. In order to “follow the unconscious” of the patient, to form and test hypotheses about the hidden meanings of their speech and behavior, we need a mind that is “well-stocked” with diverse approaches for assessing these channels. This online course will offer students an opportunity to deepen their listening process with the goal of sharpening their psychodiagnostic and conceptualization skills, so that they can better tailor their interventions to the mind of the patient.

In this 6-module online course, participants will 1) study psychoanalytic ideas about listening for unconscious communication, 2) see these strategies in action through video-based presentations, and, 3) through case consultation, apply these listening heuristics to their own EDT and ISTDP learning and clinical technique.

Curriculum

Module #1: Listening for unconscious conflict in the manifest content

When we listen to patients’ narratives, we can hear the ways that unconscious conflicts between unconscious forces affect their lives. We can see how compromises between these forces create their symptoms and presenting problems. And we can assess syntonicity and dystonicity by examining the relationship between sides of a conflict. All of these listening skills are essential for effective intervention. In this module, we will improve our skills for detecting and assessing unconscious conflict in the patient’s manifest content. (Readings: Frederickson, Malan, Brenner)

Module #2: Listening for unconscious conflict in the clinical process: Unconscious anxiety and unconscious resistance

Defense and resistance are invisible psychological events. We infer their presence based on shifts in the patients narratives and behavior. Anxiety, however, thanks to Davanloo’s innovations, is quite visible. In this module we will learn how to track unconscious anxiety signals and changes in the content of patients’ speech to help us hypothesize about the presence and functioning of conflicting unconscious forces, namely unconscious anxiety and defense. We will look at this history of this way of working in psychoanalysis, and underscore Davanloo’s important contribution. (Readings: Gray, Busch, Pray et al.)

Module #3: Listening for unconscious supervision: Latent content and “dreaming the session”

The mind has associative properties—when we have an experience, other experiences like it come to mind. When we listen for latent or encoded content, we listen for the ways patients’ narratives may indirectly provide clues about how they are experiencing our work and our interventions—what images of relationships come to mind when they are with us? This has been called “unconscious commentary” or “unconscious supervision” because this approach helps the therapist gain feedback about unconscious feelings that might not be made explicit in response to direct inquiry. In this module, we will study the history of this concept, and learn to listen for patient’s unconscious supervision of our interventions and approach. (Readings: Langs, Gill, Dorpat, Livingstone-Smith)

Module #4: Listening through countertransference experience: Projective identification

Without meaning to, our patients make an emotional impression on us. Their speech and behavior can unconsciously evoke feeling responses in us that can help us understand their minds, histories, and current transference more deeply. In this module, we will read important papers in the history of countertransference analysis, and we will learn to turn our countertransference experience “inside out”— to use our feelings as potential sources of data about unconscious feelings and memories in the patient. (Readings: Ogden, Searles, Heiman)

Module #5: Listening to enactment: The therapist’s unconscious participation

Sometimes the unconscious mind and history of the patient reveals itself most clearly not in the content or process of their speech, but in the interpersonal process that emerges unconsciously between patient and therapist. We learn about their unconscious transference and the history that it conveys only when we realize we have been accidentally enacting a role in it! The ability to detect and work one’s way out of enactment is an essential clinical skill, as the presence of these unconscious, pathogenic repetitions renders our conventional interventions ineffective. In this module, we will study clinical theory about unconscious enactment, and discuss strategies for detecting and evading unconscious enactments. (Readings:
Levenson; Bromberg; Havens)

Module #6: Clinical thinking: Metacognizing about our listening

We try to work in a scientific way, focusing on response to intervention to test and modify our hypotheses. By listening from multiple perspectives, we can get an increasingly clearer and more useful understanding of the unconscious dynamics impacting the patient and the therapy. At the same time, listening for unconscious meaning is not an objective science. It is perspectival, subject to many biasing influences, and therefore quite fallible. In this module, we will study the literature on clinical thinking, examining the metacognitive processes through which we increase our understanding of the therapy interaction, and familiarizing ourselves with the biases that can impact this process. (Readings: Rubovits-Seitz, Peterfreund, Spence)

Schedule: The group will meet from 9am-2:20pm EST on fourth Friday of every month, or the following dates in 2024: February 23, March 22, April 26, May 24, June 28, July 26 (NB for non-US participants: daylight savings changes may impact the start time in your country beginning in March 2024)

Fee: $2000/participant. Each participant receives 3 hours of individual supervision, 15 hours of observing supervision, 9 hours of didactics, and 6 hours of group process. PDFs of readings are also provided.

Who is this course for? This course is for any EDT therapist seeking to deepen their psychodynamic listening and intervention skills. It may be appropriate for EDT trainees at the pre-core, core training, and post-core training level, as the topics are fundamental to all psychodynamic work and the instruction will be tailored to your current growth needs.

Structure of meetings: Each meeting will start with 80 minutes of didactics, followed by a 10 minute break. Then we will have three 50-minute supervisions, each with a subsequent 10 minute break. During supervisions, I will supervise for the first 40 minutes, and the final 10 minutes will be used for group discussion of questions that come up in the supervision. The final 50 minutes of each meeting will be an opportunity for group process, for reflecting about and working on the reactions we have to learning together.

Sample schedule:

9-10:20am: Didactics
10:20-10:30am: Break
10:30-11:20am: Supervision 1
11:20-11:30am: Break
11:30am-12:20pm: Supervision 2
12:20-12:30pm: Break
12:30-1:20pm: Supervision 3
1:20-1:30pm: Break
1:30-2:20pm: Group process

Supervision schedule: The 6 members of the group will be split into A and B groups, and the 6 sessions will alternate between A days and B days. Group A will present on A days and group B will present on B days. Throughout the course, each participant will receive 3 supervisions in front of the group, and be able to observe 15 others.