COURSE DESCRIPTION:

This course exposes students to British Object Relations theories that will help them understand and engage their patients’ internal worlds, with internal self, affect states, and object constellations. It also will help them to analyze the American view of the separation-individuation process, related to external self, affect, and other relationships, and how it influences the internal world of their patients. It will help students in the process of evaluation of the current relationships and self states of the patients.

The critical role of object loss, and self-destructive rage can be understood through the readings offered in this course, through the lens of the British view of split-off parts and failures in self-integration, and the American view of self-integration that depends on an adequate separation-individuation process.

The developmental mourning theory which concludes this course’s syllabus shows how British and American thinking come together, when speaking about mourning object loss vs. failure to mourn due to traumatic primal level loss. All the readings contribute to therapists’ understanding of how and why patients avoid feeling and facing their trauma, and how it is for them to feel and suffer that which needs to be felt and suffered.  

SYLLABUS:

1^st WEEK: Ronald Fairbairn (British/ Scottish Object Relations theorist): Structural theory; bad objects; addiction to bad objects. Learning Goals: At the end of this educational activity, its participants will be able to: 1. Discuss the role of an internal object world in relation to primal parental trauma. 2. Analyze the role of bad object addiction in transference acting out in clinical treatment.

Readings: 1) Fairbairn, R.W. (1952). The Repression and the Return of Bad Objects (with special references to the war neuroses). Chapter III. In R.W. Fairbairn, Psychoanalytic Studies of the Personality.

2^nd WEEK: Michael Balint (American Object Relations theorist): Malignant vs. benign regression. Malignant (vs. benign) regression is the theory proposed by Michael Balint in his book, The Basic Fault (1979). Learning Goals: At the end of this educational activity, its participants will be able to: 1. Discuss the concept of malignant regression and provide examples from life and practice. 2. Compare the difference between a malignant regression enactment with the therapist and a benign regression authentic affect experience.

Readings: 1) Balint, M. (1968). The Basic Fault: Therapeutic Aspects of Regression. Evanston, IL, US: Northwestern University Press.  “Malignant vs. Benign Regression”. Reading of one section on “Malignant vs. Benign Regression.” 2)* Kavaler-Adler, S. (2017). The Beginning of Heartache in Character Disorders: On the Way to Relatedness and Intimacy through Primal Affects and Symbolization. International Forum of Psychoanalysis, DOI: 10.1080/0803706X.2016.1270468. * – marks the optional readings

3^rd WEEK: Wilfred Bion (British Object Relations theorist): Attacks on linking; and psychoanalytic container and the analyst as psychic processing container. Learning Goals: At the end of this educational activity, its participants will be able to: 1. Discuss the psychoanalyst’s role as container and the patients’ attacks on linking. 2. Analyze how the psychoanalyst’s role as container allows for the patient’s awareness of their own attacks on linking.

Readings:  1) Bion, W. Attacks on linking. International Journal of Psycho-Analysis, 40, 308-315. 2) W. Bion (1970). Attention and Interpretation. Northvale, NJ: Jason Aronson (pp. TBA). 3)* Kavaler-Adler (2003). Mourning, Spirituality and Psychic Change… (pp. TBA). Chapters: Three Chapters on “The Case of June.” 

4^th WEEK: Melanie Klein (British Object Relations theorist), Otto Kernberg and Susan Kavaler-Adler (American Object Relations theorists): Envy/ oral envy/ oral envy in a narcissist. Learning Goals: At the end of this educational activity, its participants will be able to: 1. Discuss how oral envy is defined as an unconscious dynamic that plays a major role in the narcissistic character and universal narcissistic dynamics. 2. Apply the concept of oral envy to discussion of unconscious dynamics of narcissistic character pathology.

Readings: 1) Klein, M. (1957). Envy and Gratitude. In M. Klein, Envy and Gratitude and other works, 1946-1963, London, Tavistock. (pp. TBA)  2) Kernberg, O. F. (1995). Aggression and transference in severe personality disorders. Unpublished. 3) *Kernberg, O. F. (1975). Borderline conditions and pathological narcissism. Kernberg on “Oral Envy” (pp. TBA). 3) *Kavaler-Adler, S. (1998). Vaginal core or vampire mouth. The visceral level of envy in women: The protosymbolic politics of objects relations. In N. Burke (Ed.). Gender and Envy (pp. 221-238).

5^th WEEK: Donald D. W. Winnicott (British Object Relations theorist): The use of the object, and the true and false self. Learning Goals: At the end of this educational activity, its participants will be able to: 1. Analyze how Winnicott’s ideas on object survival relate to true self development. 2. Apply Winnicott’s ideas on the use of the object and object survival and their relationship to true self development to one of the clinical cases discussed in the course or outside of the course.

Readings: 1) Winnicott, D.W. (1968). The Use of the Object and Relating through Identifications. In D. W. Winnicott, Playing and Reality (pp. 86-94). London: Tavistock. 2) Winnicott, D.W. (1965). Ego distortion in terms of true and false self. In D.W. Winnicott, The Maturational Processes and the Facilitating Environment (pp. 140-152). 

6^th WEEK: Donald D. W. Winnicott (British Object Relations theorist), James Masterson and Susan Kavaler-Adler (American Object Relations theorists): Pathological narcissistic mirroring; and mirroring vulnerability. Learning Goals: At the end of this educational activity, its participants will be able to: 1. Discuss the concepts of developmental mirroring (mirroring vulnerability) and narcissistic mirroring (mirroring grandiosity). 2. Compare the concepts of developmental mirroring (mirroring vulnerability) and narcissistic mirroring (mirroring grandiosity).

Readings: 1) Winnicott (1971). Playing and Reality (pp. TBA). 2) Masterson, J. (1981). Narcissistic and Borderline Disorders. Chapter on mirroring vulnerability. 3) Kavaler-Adler, S. (2014). The Klein-Winnicott Dialectic:  Transformative New Metapsychology and Interactive Clinical Theory. Chapter on “Narcissistic mirroring as a perversion of developmental mirroring” (pp. 209-223). 3) *Kavaler-Adler, S. (2005). From benign mirror to demon lover:  An object Relations view of compulsion versus desire. American Journal of Psychoanalysis, 65, 31-52. 4) *Kavaler-Adler, S. (1985). Mirror Mirror on the Wall… Journal of Comprehensive Psychotherapy, 5, 1-38. 5) *Kavaler-Adler, S. (1985). Lord of the mirrors and the demon lover. American Journal of Psychoanalysis, 48(4), 366-370).

7^th WEEK: Althea Horner (American Object Relations theorist): the core relationship problem as resistance; and constructing the developmental hypothesis. Learning Goals: At the end of this educational activity, its participants will be able to: 1. Discuss how a core relationship problem can be seen in developmental terms. 2. Analyze the core relationship problem as a resistance.

Reading: 1) Horner, A. (2005). Dealing with Resistance in Psychotherapy. NY: Rowman and Littlefield. Chapter: The Core Relationship Problem as Resistance. Chapter: Constructing the Developmental Hypothesis (pp. 1-27).

8^th WEEK: Donald D. W. Winnicott (British Object Relations theorist): Holding environment phenomenon, and the holding environment in treating character disorders. Learning Goals: At the end of this educational activity, its participants will be able to: 1. Define the holding environment phenomenon and provide clinical examples utilizing this phenomenon.  2. Discuss how the holding environment allows containment for treating those with primal developmental trauma.

Readings: 1)  Winnicott, D.W. (1958). The Capacity to be Alone. International Journal of Psycho-Analysis, 39, 416-420. 2) Modell, A. (1976). The holding environment and the therapeutic action of psychoanalysis. Journal of the American Psychoanalytic Association, 24, 285-307. 3) *Kavaler-Adler, S. (2005). The case of David: Nine years on the couch for sixty minutes, once a week. American Journal of Psychoanalysis, 65, 103-134.

9^th WEEK: James Masterson (American Object Relations theorist): Treating the borderline conditions; and transference acting out and working through. Learning Goals: At the end of this educational activity, its participants will be able to: 1. Discuss transference acting out and illustrate it with clinical examples. 2. Compare transference acting out to working through in the treatment of the borderline character.

Readings: 1) Masterson (1981). The Borderline and Narcissistic Disorders. Northvale, NJ: Jason Aronson. Chapter: The Borderline Personality Disorder. (pp. 129-164). Chapter: Transference Acting Out and Working Through (pp. 165 – 181).

10^th WEEK: Susan Kavaler-Adler (American Object Relations theorist): The developmental mourning theory. Learning Goals: At the end of this educational activity, its participants will be able to: 1. Discuss how developmental mourning relates to healing primal object loss, and later losses, while also making unconscious trauma and conflict conscious. 2. Illustrate developmental mourning idea.

Readings: 1) Kavaler-Adler, S. (2006). “My Graduation is My Mother’s Funeral”: Transformation from the paranoid-schizoid to the depressive position in Fear of Success, and the Role of the Internal Saboteur. International Forum of Psychoanalysis, 15, 117-130. 2) Kavaler-Adler, S. (2003). Mourning, Spirituality and Psychic Change: A New Object Relations Theory of Psychoanalysis. London & New York: Routledge. Two Chapters on the Case of Phillip  (pp. TBA).

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