Jamie Kyne, PhD
presents a Saturday Morning Seminar
Who is Healing Whom?
and Davoine & Gaudilliere
Illuminate a Treatment of
February 10, 2018
9:00am - 12:15pm
University of Tennessee Medical Center
Morrison Education and Conference Center
1924 Alcoa Highway
Knoxville, Tennessee 37920
This presentation will be organized around reflections on an ongoing, long-term psychotherapy case. Material from this case will be illuminated by references to the work of Martha Stark, Darlene Ehrenberg, and Francoise Davoine and Jean-Max Gaudilliere.
Martha Stark has worked to develop an integrative model of therapeutic action that takes into consideration schools of thought from the history of psychoanalytic theory and practice that are often considered more competing than complementary. Stark says, in the introduction to her text, Modes of Therapeutic Action, “It is my belief that most psychotherapeutic models boil down to advocating either … enhancement of knowledge, provision of experience, or engagement in relationship -- as the primary therapeutic agent” (Stark, 1990).
Stark’s (2015) work illuminates the complementarity of these three therapeutic agents in a way that is relevant to our work with virtually any patient while showing how particular patients need relatively more or less of each of these agents.
Over the course of a long treatment (ten years plus), the presenter has found Martha Stark’s writing, teaching, and supervision especially helpful towards better understanding and making use of powerful and frightening enactments. Stark’s “Model 3,” the engagement in relationship or relational aspect of her system, has served this therapy especially well and will be a focus of this presentation. Stark (2015) writes of Model 3:
Model 3, the intersubjective perspective of contemporary relational theory, emphasizes authentic engagement with others; its goal is to offer the patient an opportunity to play out, on the stage of the treatment, her unresolved childhood dramas and ultimately to encounter a response different from what she had both expected and feared. As the patient is confronted with the sobering reality of the dysfunctional dynamics that she unwittingly and compulsively delivers into her relationships, she will be forced to evolve to a place of greater accountability for her actions, reactions, and interactions. (p.17)
Additionally, Darlene Ehrenberg’s (1992) writing in the service of deepening the authenticity of the working alliance between therapist and patient will be used to add perspective to this case presentation. Ehrenberg’s “interactive perspective” supports and enriches Stark’s Model 3 (2015, Stark gives Ehrenberg a lot of credit in helping the former develop her Model 3). Ehrenberg writes:
An interactive perspective also helps to clarify why in some instances the analyst’s “abstinence” carries as much risk of negative iatrogenic consequences as does active intervention. Although silence at times obviously can be respectful and facilitating, at other times it can be cruel and sadistic, or it can be based on fear of engagement, among a host of possible other meanings and functions.
In this case presentation the matter of giving and receiving (information, psychic contents, warmth, pain) vs. abstinence and withholding figures prominently. The presenter’s own experience of learning and growth (modifying interpretations of his countertransference and counter-resistance for more workability) will be discussed.
DAVOINE & GAUDILLIERE
Finally, Francoise Davoine and Jean-Max Gaudilliere, in History Beyond Trauma (2004), apply war psychiatrist Thomas Salmon’s principles of Proximity, Immediacy, Expectancy, and Simplicity to the treatment of trauma survivors. Almost two years ago in the case to be discussed, an explosively aggressive interaction erupted between the presenter and the patient. The architecture of the working alliance changed dramatically and in such a direction that Davoine and Gaudilliere’s insights were required to provide a way forward with the treatment. They assert that the treatment of severe trauma makes requirements of the therapist along the lines of (a) becoming personal with their patients, (b) working in a way that includes an awareness of and use of their own personal flaws, and (c), bring their own history of trauma into the work in a manner that respects the structure of the therapy.
Intersubjective accountability, deep authenticity, and frequent confrontations with the therapist’s flaws and limitations have featured prominently in the ongoing, long-term treatment that will be the focus of this presentation.
Jamie Kyne, PhD, earned his doctorate in clinical psychology and an M.A. in theology from Fuller Theological Seminary in Pasadena, California. He and his wife moved to Nashville in 1993 where he has been in private practice seeing patients in individual, couples, family, and group psychotherapy, providing individual and group supervision to therapists, and psychologically oriented consultation to organizations. He has served on the Boards of the Nashville Psychotherapy Institute and the Nashville Rowing Club. He and his wife, Carolyn, have two children currently in college.
8:30am Registration and Continental Breakfast
8:50am Welcome and Introduction
9:00am Case Presentation and Discussion
10:45am Case Presentation and Discussion
12:15pm Complete Evaluations and Adjourn.
After attending this intermediate-level seminar in full, participants will be able to:
1. Describe the dynamic relationships between relentless hope and masochism on the one hand and relentless outrage and sadism on the other.
2. Describe how a therapist provides, to further the treatment, a model of interpersonal accountability to a patient who is in need of increased interpersonal accountability.
3. Identify at least two countertransferential obstacles to more authentic engagement with patients and describe possible approaches for navigating these obstacles.
4. Describe the therapeutic values of relenting (by both patient and therapist) and describe therapist characteristics included in the capacity to relent.
Selected References/Recommended Reading
Davoine, F., & Gaudilliere, J. (2004). History Beyond Trauma. New York: Other Press.
Ehrenberg, D. B. (1992). The Intimate Edge: Extending the Reach of Psychoanalytic Interaction. New York: W. W. Norton & Company.
Ehrenberg, D. B. (2006). The Interpersonal/Relational Interface: History, Context, and Personal Reflections. Contemporary Psychoanalysis, 42 (4): 535-550.
Ehrenberg, D. B. (2010). Working at “The Intimate Edge.” Contemporary Psychoanalysis. 46 (1): 120-141.
Stark, M. (2015). The Transformative Power of Optimal Stress: From Cursing the Darkness to Lighting a Candle. Chevy Chase, MD: International Psychotherapy Institute E-Books.
Stark, M. (2006). “Transformation of Relentless Hope: A Relational Approach to Sadomasochism.” (an unpublished presentation given by the author - Dr. Stark authorized distribution to the APS audience).
This program is open to all APS members and other interested mental health professionals who may not be members. It is not limited to individuals practicing in a predominately psychoanalytic mode. The material will be appropriate for clinicians with intermediate levels of experience and knowledge.
Professional and Scholar Members:
$45 until February 5, 2018,
$55 after February 5, 2018.
Early-Career Professional Members:
Free if registered by February 5, 2018,
$10 after February 5, 2018.
Graduate Student Members: Free.
$60 until February 5, 2018,
$70 after February 5, 2018.
Although walk-ins will be accepted, please register online at www.aps-tn.org in advance to assure adequate food and seating.
If you prefer to pay by check, please mail your payment to:
Scott Swan, PhD
1005 Kenesaw Avenue
Knoxville, TN 37919.
Refunds honored with written/electronic notice at least 24 hours before date of conference. Contact Scott Swan, PhD.
Contact the APS President Bill MacGillivray, PhD to negotiate fees, if needed.
Facility is accessible to persons who are physically challenged. Reasonable accommodations will be made for persons requesting them.
Eligible professionals can join APS or renew their membership for the 2017-2018 program year for $80. Scholars can join/renew for $50 and Early-Career Professionals can join/renew for $45. Graduate students may join or renew for $25.
American Psychological Association Approval Statement
Division 39 is approved by the American Psychological Association to sponsor continuing education for psychologists. Division 39 maintains responsibility for this program and its content.
This program, when attended in its entirety, is available for 3.0 continuing education credits. With full attendance and completion of a program Evaluation and Learning Assessment, a certificate will be issued. Psychologists will have their participation registered through Division 39.
APS and Division 39 are committed to conducting all activities in conformity with the American Psychological Association’s Ethical Principles for Psychologists. APS and Division 39 are also committed to accessibility and non-discrimination in continuing education activities. Participants are asked to be aware of the need for privacy and confidentiality throughout the program. If program content becomes stressful, participants are encouraged to process these feelings during discussion periods.
If participants have special needs, we will attempt to accommodate them. Please address requests, questions, concerns and any complaints to APS President Bill MacGillivray, PhD.
There is no commercial support for this program nor are there any relationships between Division 39, APS, presenter, program content, research, grants or other funding sources that could reasonably be construed as conflicts of interest. During the program, the validity/utility of the content and risks/limitations of the approaches discussed will be addressed.