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. Courses he has taught at the University of Cincinnati include the following. 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 Current Course:

 

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.