Dr. Klafter's Teaching Experience

Dr. Klafter was recruited in 2000 by the University of Cincinnati College of Medicine Department of Psychiatry to teach psychotherapy in the residency training program. He served as a full time faculty member, Director of Psychotherapy Training, and Assistant Training Director. In 2008, he left the University but has continued teaching part time as a Clinical Associate Professor of Psychiatry since then. In addition to providing psychotherapy for residents, he has taught the following courses at the University of Cincinnati:

• Long term Psychodynamic Psychotherapy

• Brief Psychodynamic Psychotherapy

• Cognitive Behavioral Therapy

• Supportive Psychotherapy

• Psychodynamic Case Formulation

• Psychoanalytic Theory

• Ethics and Boundaries

• Process and Change

• Immigration and Cross Cultural Psychiatry

At the Cincinnati Psychoanalytic Institute (CPI), Dr. Klafter serves as a Training and Supervising Psychoanalyst, Track Leader for the Technique Curriculum in the Psychoanalytic Training Program, and Chair of the training program in Advanced Psychodynamic Psychotherapy. He has taught the following courses at CPI: 

• Survey of Psychoanalytic Theories

• Psychodynamic Technique

• Psychodynamic Theory

• Ego Psychology

• Transference and Countertransference

• Narcissism, the Self, and Self Psychology

• Continuous Case Conference

• Mechanisms of Therapeutic Action:

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Syllabus for Recent Courses:

Fundamentals of Clinical Psychoanalytic Technique:
Free Association and Resistance,
Transference and Countertransference,
and Interpretation of Dreams.

Andrew B. Klafter MD
Analytic Training Program, 2nd Year Psychoanalytic Candidates:
Cincinnati Psychoanalytic Institute
Spring, 2025
Fridays, 09:45-11:15 

The purpose of this course is to help psychoanalytic candidates deepen their understanding of the fundamentals of clinical psychoanalytic technique in order to work toward proficiency with these skills during the remainder of their psychoanalytic training. Although candidates are already familiar with these techniques and have begun working with them, the goal of this course is to achieve a greater level of competence and confidence using them. These techniques are technical skills that require extensive, deliberate practice for many years in order to achieve mastery. If you have ever pursued the intensive study of a musical instrument, voice, fiction, poetry, painting, sculpture, dance, pottery, or athletics, then you realize that regardless of your innate talent, there is no substitute for deliberate practice under the supervision of a more experienced coach or instructor.  It is best to think of psychoanalytic technique in the same manner. Over the course of your analytic training, you will probably conduct between one and two thousand hours of psychoanalytic sessions, along with thousands of hours of less intensive psychotherapies in your other clinical work. This may include hundreds of dreams, and many thousands of free associations with countless manifestations of resistance to them – all in the context of transferences, countertransferences, projective identifications, and enactments. No psychoanalyst has an intuitive, natural ability to work with all of this material productively. It needs to be learned and deliberately practiced. Much like a jazz pianist cannot start improvising solos before he or she knows how to play every chord with all its inversions and arpeggios, and every scale in every key and mode so well that they can be done in his or her sleep, so too in psychoanalysis: Unless you have learned how to identify the symbols in a patient’s dream and how to help the patient elaborate his or her associations to them, then you will never learn to decode and decipher the patient’s dream or how to interpret it. Unless you have learned how to identify a lapse or distortion in the patient’s free associations, will cannot know how to determine what is causing the patient’s resistance, and you therefore cannot really make a “decision” to deviate from this conventional analytic frame for a given patient or during a specific treatment hour.

Learning Objectives:
By the end of this course, candidates should be able to do the following:

• Identify lapses and distortions in the patient’s free associative processes, work with the patient to determine what conflicts or emotional discomfort is causing this, and integrate this into the patient’s overall analytic work.

• Use one’s subjective emotional experience to the patient’s way of relating to the analyst (i.e. countertransferences, and projective identifications) as a way of understanding how the patient manages uncomfortable feelings in relationships.

• Make clinical use of the patient’s dreams by the use of forced associations to dream symbols in the manifest content and also to the dream’s underlying thematic structure.

 Session 1:  01/17/2025
Dreams and the Dynamic Unconscious

1.      Quinodoz, Jean-Michel (trans. David Alcorn). “The Interpretation of Dreams (1900 a); On Dreams (1901 a),” in Part I of Reading Freud: A Chronological Exploration of Freud’s Writings, pp. 36-44
2.       Meissner, W.W. “The Dynamic Unconscious: Psychic Determinism, Intrapsychic Conflict, Unconscious Fantasy, and Symptom Formation.” Chapter 2 in The Textbook of Psychoanalysis (Person, Cooper, and Gabard eds. First edition, 2005). Pp. 21-38.
3.     Brenner, Charles (1976). Analysis of Dreams, Symptoms, Fantasies, & Similar Phenomenon. Ch. 6 in, Psychoanalytic Technique and Psychic Conflict. I.U.P., 133-166.

Session 2:  01/24/2025
Basics of Dream Theory

1.      Greenson, Ralph (1970).   The Exceptional Position of the Dream in Psychoanalytic Practice. Psa. Quarterly 39:519-549
2.       Altman, Leon (1975). A Summary Review of Dream Theory. Ch 1 in, The Dream in Psychoanalysis (Revised Edition).  I.U.P., 9-39.
3.       Sharpe, Ella F. (1937).  Evaluation of Dreams in Psycho-Analytic Practice.  Ch. 3 in, Dream Analysis: A Practical Handbook for Psychoanalysts. London: Hogarth Press, 66-96.

Session 3:  01/31/2025
Defense, Transference, and Countertransference in Dreams

1.     Goldberger, Marianne (1989).   On the Analysis of Defenses in Dreams.   Psa. Quarterly 58:396-418.
2.     Charles Weinstock (1976). Dreams Stimulated by the Analyst-Patient Relationship J. Am. Acad. Psychoanal. Dyn. Psychiatr., (4)(2):161-170
3.     Whitman R, Kramer M, and Baldridge B (1969). Dreams about the Patient. Journal of the American psychoanalytic Association (17) 702-727.
4.     Gillman, Robert (1980).   Dreams in Which the Analyst Appears as Himself.   Ch. 2 in The Dream in Clinical Practice, pp. 29-44.

02/07/2025 – No classes (APsA Annual Meeting, San Francisco, CA)

Session 4:  02/14/2025
Technique for Working with Dreams Part I – The Classical Period
1.     Freud, S. (1923). Remarks on the Theory and Practice of Dream-Interpretation. Standard Edition, (19):107-122
2.     Freud, S. (1911). The Handling of Dream-Interpretation in Psycho-Analysis. S.E. 12:89-96.
3.     (Optional: Wilhelm Stekel and John Lind M (1917). The Technique of Dream Interpretation. Psychoanal. Rev., (4)(1):84-109) 

Session 5:  02/21/2025
Technique for Working with Dreams, Part II – The Modern Period
1.     Walter Bonime MD (1986). Collaborative Dream Interpretation. J. Am. Acad. Psychoanal. Dyn. Psychiatr., (14)(1):15-26
2.     Robert Stolorow (1978). Themes in Dreams: A Brief Contribution to Therapeutic Technique. Int. J. Psychoanal., (59):473-475.
3.     Stolorow, Robert (1992). "Dreams and the Subjective World" Chapter 12, in Essential Papers on Dreams, (M.R. Lansky., ed.) N.Y.U. Press, 272-294

 Session 6:  02/28/2025
Transference and Countertransference – Contemporary Overviews
1.     Steven H. Goldberg. “Transference.” Ch. 5 in Textbook of Psychiatry, 2nd Edition (Gabbard, Litowitz, and Williams, eds. 2012), pp. 65-78
2.     Lawrence J. Brown. “Countertransference, and Instrument of the Analysis.” Ch. 6 in Textbook of Psychiatry, 2nd Edition (Gabbard, Litowitz, and Williams, eds. 2012) pp. 79-92
3.     Adrienne Harris. “Transference, Countertransference, and the Real Relationship.” Ch. 18 in Textbook of Psychiatry, 2nd Edition (Gabbard, Litowitz, and Williams, eds. 2012), pp. 265-268.

 Session 7:  03/07/2025
Freud Conception of the Transference
1.     Freud S (1912). The Dynamics of Transference Standard Edition, (12):97-108.
2.     Freud S (1914). 156 Remembering, Repeating and Working-Through (Further Recommendations on the Technique of Psycho-Analysis II) Standard Edition, (12):145-156.
3.     Freud S. (1915). Observations on Transference-Love (Further Recommendations on the Technique of Psycho-Analysis III) Standard Edition, (12):157-171

Session 8:  03/14/2025
Hate and Hostility in Transference and Countertransference
1.     Winnicott, D. W. (1949) Hate in the Counter-Transference. International Journal of Psychoanalysis 30:69-74
2.     Searles, H. F. (2017) Concerning Transference and Countertransference. Psychoanalytic Dialogues 27:192-210

Session 9:  03/21/2025
Projective Identification.
1.     Primary Reading: Ogden, T. H. (1979) On Projective Identification. International Journal of Psychoanalysis 60:357-373
2.     Secondary reading: Mendelsohn, R. (2012) Parallel Process and Projective Identification in Psychoanalytic Supervision. Psychoanalytic Review 99:297-314. (The Ogden reading will take up most of our discussion but I thought you’d want to learn about the power you have to torment your supervisors!) 

Session 10:  03/28/2025
Enactments
1.     Chused, J. F. (2003) The Role of Enactments. Psychoanalytic Dialogues 13:677-687
2.     Chused, J. F. (1991) The Evocative Power of Enactments. Journal of the American Psychoanalytic Association 39:615-639

Session 11:  04/04/2025
Resistance to the Psychoanalytic Process – A Modern Overview
1.     Peter Goldberg. “Process, Resistance, and Interpretation.” Ch. 20 in Textbook of Psychiatry, 2nd Edition (Gabbard, Litowitz, and Williams, eds. 2012), pp. 283-304.

Session 12:  04/11/2025
Interpretation of Resistance as an Innovation of Ego Psychology
1.     Paul Gray M.D. (1982). J. Amer. Psychoanal. Assn., (30):621-655. "Developmental Lag" in the Evolution of Technique for Psychoanalysis of Neurotic Conflict.
2.     Kris, A. O. (1992) Interpretation and the Method of Free Association. Psychoanalytic Inquiry 12:208-224

 04/18/2024 – Spring Break

 04/25/2025 – CPI Program (Workshop with Jane Kite)

Session 13: 05/02/2025
Free Association as the Basic Psychoanalytic Frame
1.      Adler, E. & Bachant, J. L. (1996) Free Association And Analytic Neutrality: The Basic Structure Of The Psychoanalytic Situation. Journal of the American Psychoanalytic Association 44:1021-1046
2.     Hoffman, I. Z. (2006) The Myths of Free Association and the Potentials of the Analytic Relationship. International Journal of Psychoanalysis 87:43-61. (a critical view)

Session 14: 05/9/2025
Free Association and Other Analytic Perspectives
1.      Busch, F. (1995) Resistance Analysis and Object Relations Theory: Erroneous Conceptions Amidst Some Timely Contributions. Psychoanalytic Psychology 12:43-53.
2.     Kernberg, O. F. (2015) Narcissistic Defenses in the Distortion of Free Association and Their Underlying Anxieties. Psychoanalytic Quarterly 84:625-642

Session 15 (Final): 5/16/2025
Resistance Analysis
1.     Busch, F. (1992) Recurring Thoughts on Unconscious Ego Resistances. Journal of the American Psychoanalytic Association 40:1089-1115.
2.     Busch, F. “Chapter 5: Resistance Analysis,” and “Chapter 6: Actions and Analysts” in The Ego at the Center of Clinical Technique (Northvale, NJ: Jason Aaronson Publishing. 1995), pp. 93-144.

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PSYCHOANALYTIC MECHANISMS OF THERAPEUTIC ACTION
Cincinnati Psychoanalytic Institute
Analytic Training Program, 4th year Candidates
Andrew B. Klafter, MD

This course is intended to provide candidates with a solid understanding of the mechanisms by which psychoanalytic treatment can effect therapeutic changes. This is a vast literature, with important contributions by a great number of highly prominent psychoanalytic scholars. Therefore, I have chosen to focus on readings by thinkers who represent the most influential schools of thought in the American and British traditions. We will start with Sigmund Freud’s emphasis on the analysis and resolution of transference, and then explore a few other early analytic thinkers who proposed alternative psychanalytic theories about additional curative factors. We will then study Hans Loewald’s classic paper on therapeutic action very closely, and read a discussion of its significance by Arnold Cooper. Loewald’s paper represents a major shift in analytic thinking from a one-person psychological model toward a two-person conception of the analytic process where the analyst is acknowledged as a real person whose her presence and engagement in the treatment is understood as an important factor in how psychoanalysis catalyzes therapeutic change. We will then examine a series of contrasting views of analytic mechanisms of therapeutic action, including Brenner’s modern conflict theory, contemporary ego psychology (as represented by Busch and Gray), the neo-Kleinians, self-psychology, mentalization, intersubjectivity, and relational analysis. We will conclude with a consideration of pluralism and how some highly innovative, contemporary analysts have succeeded in integrating conflicting ideas and seemingly mutually exclusive theories about the mechanisms of therapeutic change.

Learning Objectives:

By the end of this course, candidates will be able to do the following:
1.      Define the following clinical phenomena and describe how the following contribute to psychoanalytic mechanisms of therapeutic action: transference, countertransference, free association, resistance, interpretation, working-through, corrective emotional experience, suggestion, compromise formation, enactment, empathy, narcissistic injury, empathy, transmuting internalization, and psychoanalytic love.
2.      Identify the distinctive conceptions of curative mechanisms of change according to each of the following: Sigmund Freud, James Strachey, modern conflict theory (Arlow and Brenner), Hans Loewald, Busch and Gray, the neo-Kleinians, Winnicott, Object Relations Theories, Self-Psychology, Mentalization. Intersubjectivity, and Relational Analysis.
3.      Compare and contrast psychoanalytic approaches which conceive of therapeutic change according to a one-person vs. a two-person psychology, and describe the important place of Hans Loewald’s as a transitional figure in the history of psychoanalytic thinking about therapeutic action.
4.      Explain the challenge of pluralism in psychoanalytic theory and offer your opinion on whether it is truly possible and/or wise to integrate conflicting approaches.

COURSE SCHEDULE AND READINGS:

Session 1: (a) Introduction and Overview; (b) Fantasies of Therapeutic Cure
1.      Pulver, Sydney. “The Psychoanalytic Process and Mechanisms of Therapeutic Change.” Chapter 5 in Moore BE and Fine BD. Psychoanalysis: The Major Concepts. New Haven: Yale University Press, 1995, pp. 81-94.
2.      Greenberg, J. (2012) “Theories of Therapeutic Action and their Clinical Consequences.” Chapter 19 in Gabbard, Litowitz, and Williams, eds. Textbook of Psychoanalysis, Second Edition, pp. 269-282.
3.      Abend, S.M. (1979). Unconscious Fantasy and Theories of Cure. J. Amer. Psychoanal. Assn., 27:579-596.

Session 2: Sigmund Freud’s Theory of the Analysis and Resolution of the Transference
1.      Freud, S. (1914). Remembering, Repeating and Working-Through (Further Recommendations on the Technique of Psycho-Analysis II). The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913): The Case of Schreber, Papers on Technique and Other Works, 145-156.
2.      Freud, S. (1912). The Dynamics of Transference. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913): The Case of Schreber, Papers on Technique and Other Works, 97-108.
3.      Abend, S.M. (2009). Freud, Transference, and Therapeutic Action. Psychoanal Q., 78:871-892.

Session 3: Other Classical Conceptions of Therapeutic Action
1.      Glover, E. (1931). The Therapeutic Effect of Inexact Interpretation: A Contribution to the Theory of Suggestion. Int. J. Psycho-Anal., 12:397-411.
2.      Strachey, J. (1934). The Nature of the Therapeutic Action of Psycho-Analysis. Int. J. Psycho-Anal., 15:127-159.
3.      Jacobs, T.J. (1990). The Corrective Emotional Experience — Its Place in Current Technique. Psychoanal. Inq., 10:433-454.

Session 4: Hans Loewald’s Conception of the Analyst as Object and Agent of Change
1.      Loewald, H.W. (1960). On the Therapeutic Action of Psycho-Analysis. Int. J. Psycho-Anal., 41:16-33.
2.      Cooper, A.M. (1988). Our Changing Views of the Therapeutic Action of Psychoanalysis: Comparing Strachey and Loewald. Psychoanal Q., 57:15-27.

Session 5: (a) Modern Conflict Theory, and (b) Contemporary Ego Psychology
1.      Arlow, J.A., Brenner, C. (1990). The Psychoanalytic Process. Psychoanal Q., 59:678-692.
2.      Abend, S.M. (2007). Therapeutic Action in Modern Conflict Theory. Psychoanal Q., 76S:1417-1442.
3.      Busch, F. (2013). Changing views of what is curative in 3 psychoanalytic methods and the emerging, surprising common ground. Scand. Psychoanal. Rev., 36:27-34.
4.      Gray, P. (1990). The Nature of Therapeutic Action in Psychoanalysis. J. Amer. Psychoanal. Assn., 38:1083-1096

Session 6: Neo-Kleinian Conceptions
1.      Hinshelwood, R.D. (2007). The Kleinian Theory of Therapeutic Action. Psychoanal Q., 76S:1479-1498.
2.      Eizirik, C.L. (2007). On the Therapeutic Action of Psychoanalysis. Psychoanal Q., 76S:1463-1478. (Latin American approach, French and Kleinian Influences)

Session 7: (a) Winnicott’s “Holding Environment”; and (b) Object Relations
1.      Modell, A.H. (1976). "The Holding Environment" and the Therapeutic Action of Psychoanalysis. J. Amer. Psychoanal. Assn., 24:285-307.
2.      Summers, F. (1997). An Object-Relations Model of the Therapeutic Action of Psychoanalysis. Contemp. Psychoanal., 33:411-428.
3.      Guntrip, H. (1996). My Experience Of Analysis With Fairbairn And Winnicott: (How Complete A Result Does Psychoanalytic Therapy Achieve?). Int. J. Psycho-Anal., 77:739-754.

Session 8: (a) Self-Psychology, and (b) Mentalization
1.      Newman, K. (2007). Therapeutic Action in Self Psychology. Psychoanal Q., 76S:1513-1546.
2.      Sugarman, A. (2006). Mentalization, Insightfulness, and Therapeutic Action: The importance of mental organization. Int. J. Psycho-Anal., 87:965-987

Session 9: Intersubjective and Relational Conceptions of Therapeutic Action
1.      Stern, D.N., Sander, L.W., Nahum, J.P., Harrison, A.M., Lyons-Ruth, K., Morgan, A.C., Bruschweilerstern, N., Tronick, E.Z. (1998). Non-Interpretive Mechanisms in Psychoanalytic Therapy: The ‘Something More’ Than Interpretation. Int. J. Psycho-Anal., 79:903-921.
2.      Spezzano, C. (2007). A Home for the Mind. Psychoanal Q., 76S:1563-1583.
3.      Renik, O. (2007). Intersubjectivity, Therapeutic Action, and Analytic Technique. Psychoanal Q., 76S:1547-1562.

Session 10: Pluralism and Integration of Conflicting Views of Therapeutic Action
1.      Gabbard, G.O., Westen, D. (2003). Rethinking therapeutic action. Int. J. Psycho-Anal., 84:823-841.
2.      Akhtar, S. (2000). From Schisms Through Synthesis to Informed Oscillation: An Attempt at Integrating Some Diverse Aspects of Psychoanalytic Technique. Psychoanal Q., 69:265-288.
3.      Friedman, L. (2005). Is There a Special Psychoanalytic Love?. J. Amer. Psychoanal. Assn., 53:349-375.
         Supplemental Readings:
         a.      Greenberg, J. (2007). Therapeutic Action: Convergence without Consensus. Psychoanal Q., 76S:1675-1688.
         b.     Goldberg, A. (2007). Pity the Poor Pluralist. Psychoanal Q., 76S:1663-1674.