Psych. 671. Spring 2008, pg. 10
PSYCHOTHERAPY II:
TECHNIQUE, THEORY, AND RESEARCH
NASH (SPRING 2008)
Psychology 671 Dr. Michael R. Nash
Spring 2007 Room 219
Monday 9:00 to Noon
Room: 226-E
COURSE DESCRIPTION: THE FOUR WINDOWS
Arguably the more you know about human nature the better therapist you will be. From a clinical training perspective, we have four domains of knowledge, all of them windows, on the nature of the human condition. The Psychotherapy II course supports student access to three of these windows. Approaching the fourth is a personal matter.
Window #1. Happily, as you begin to do psychotherapy properly you immediately access a privileged window on human nature, in part because you are listening with a peculiar mix of whimsy and gravitas, and in part because by so doing you have an opportunity to overhear yourself on a regular basis. Thoughtful supervision and earnest self-reflection not only yields the novice clinician hard-won insight into the patient’s condition, but inevitably acquaints him with aspects of his own interior world which might otherwise escape attention. Hence the mere act of doing therapy well inevitably enriches your grasp of human experience both as object (i.e., observing patterns of others), and as subject (observing patterns you yourself experience in response to others). By focusing on solid therapeutic technique and an attitude of receptivity, this course provides the student entree to this window on human nature which can support a lifetime of professional and personal maturation.
Window #2. There is another window on human nature which is similarly situated between self and object and which enriches our knowledge of human change. This is the world of the humanities: myth, theater, art, dance, music, religion, and great literature. In this course we touch on great literature. As Harold Bloom points out imaginative literature invites us to over-hear ourselves- - which is not the same as hearing ourselves. We read a sonnet without any self-consciousness, and we are visited by unbidden feelings or thoughts which are quite surprising. It is possible (as James, Freud, Fromm-Reichman, Bandura, and others suggest), that therapeutic change always arises out of the unexpected. This could be the unexpectedness of self-knowledge gained through over-hearing oneself in therapy, or it may be something imposed by the therapeutic context or by external events. Either way, a capacity to embrace surprise is at a premium in therapy. Hence, each week we begin by reading one or two brief and provocative short stories to prepare ourselves to be surprised by our own reactions, to learn how to welcome the unexpected, and to refine our ability to master change and surprise others. We will be keeping good company: Updike, Le Guin, E. B. White, Hemmingway, Fitzgerald, Joyce, Hawthorne, and others will point the way.
Windows #3 and #4. Finally, there are two other windows on human nature: science and your own therapy. The former we will examine in this course; the latter you must explore on your own. In the course we read research because science can reveal the lawfulness of our patients’ enactments: their clinical presentation, the determinants of their misery, and the conditions under which therapeutic change occurs. Here the perspective is human experience as object (i.e., as we observe it to be in the consulting room and the laboratory). You approach the fourth window when you seek therapy for yourself. Here the perspective is human experience as subject (i.e., as you experience it to be in therapy). By pursuing therapy as part of your training you willfully anticipate the unexpected, and further prepare yourself for surprises of the interior sort.
Method
The course will be structured in an advanced seminar format, with students expected to discuss the assigned readings in light of their own clinical work, both present and past. While the instructor will guide and clarify the discussion, he will not lecture. His participation will be consistent with a Socratic process (as defined by philosopheratlarge Mortimer Adler).
Each week one or two students will be responsible for stimulating the discussion. They will meet with the instructor from 8:30-9:00 A.M. on the Friday before their class to explore how to approach the readings. Preparation for discussion coordinators should typically include: 1) a brief and thoughtful summary of the reading material; 2) questions and observations; 3) and perhaps, how the material relates to the student's current or past clinical experiences. Remember, your objective is to provoke and not lead the discussion.
Evaluation
At this level of training it is expected that genuine curiosity and striving for excellence has replaced grade anxiety as the primary motivator of class performance. To receive a good grade in this course (a “B”) what you need to do is thoughtfully read the assigned materials, and make an effort to share your reactions with the class. Most, if not all people will do this, and will receive a “B.” Receiving anything less than a “B” will require that work be quite a bit sub-standard (see below). If I feel that a student is flirting with something less than a “B” I will inform him or her privately at mid-term or earlier. An “A” is given for work which is almost always exceptional throughout the course.
1. Weekly Response Sheet. Since there are no tests and no required papers for this class, the core of the learning experience is the thoughtful reading of all the assigned material. Discussion becomes quite irrelevant if we do not have a common base from which to respond. Accordingly, each week the student will e-mail to me a response sheet. On this sheet will be at least one question or comment on each of the assigned readings. The questions or comments must be sufficiently thoughtful to communicate that a goodfaith attempt was made to understand the readings. The response sheet must be in Dr. Nash's electronic mail box no later than 1:00 AM on the day of the class. Because a sensitive reading of the material is the foundation of this course, students must not neglect to write and submit the response sheet. Failure to do so on only one occasion will have no consequence. But woe be unto him who repeats. A second occurrence will result in an automatic drop of one letter grade for the course. Subsequent occurrences will have a similar effect. Rules aside, what I want you to do is engage these readings, and be thoughtful and discerning.
2. The Discussion. While some variability is inevitable from week to week, the student is expected to participate fully in the seminar format. If the instructor observes that a student is habitually withdrawn and making no substantive contribution to the discussion, that student will be asked to meet with the instructor to explore the problem. The student must be aware that lively interaction and critical thinking is the flesh and blood of this course.
3. Discussion Coordinator. The student's performance as a discussion coordinator and his/her understanding of the material will be evaluated.
4. The Practice-Research Integration Project (The PRIP): To pass Psychotherapy II the student must submit to Dr. Nash a fully satisfactorily completed and mentor-approved PRIP plan. The final mentor-signed plan must be submitted to Dr. Nash by April 14. Dr. Nash will then forward the document (with comments) to the Clinical Faculty just in time for the annual student evaluation meeting. Only under grave circumstances will Dr. Nash grant an Incomplete. As per the Student PRIP Manual, the PRIP Plan consists of four of the 12 sections of the PRIP:
· Section 1: Focus and rationale for the study
· Section 2: Review of relevant clinical and research literature study
· Section 6: Clinical research questions
· Section 7: Research Design
Each section of the Plan should be of journal-submission quality. That is, The Plan ought to be suitable for eventual submission to a learned journal upon study completion. Though Plan length depends on the anticipated case-based study itself and the writing style of the student, one might imagine the Plan to be 15-25 pages in length with references. The process leading to the final plan is as follows:
· By February 04 The student informs Dr. Nash of mentor identity.
· By March 24 7-8 page preliminary draft/outline to Dr. Nash
w/table of DVs: # and freq of observations, Mentor-signed
· By April 07 OPTIONAL: Draft of Plan to Dr. Nash for comment.
· By April 16 Formal & Final Submission of Plan to Dr. Nash. Mentor signed
Text and Reading Materials (all books required)
Gay, P. (1989). The Freud Reader. New York: Norton.
Malan, D. H. (1995). Individual psychotherapy and the science of psychodynamics, (second edition). London: Butterworths.
PSYCHOTHERAPY II:
TECHNIQUE, THEORY, AND RESEARCH
NASH (SPRING 2008)
THE READINGS
JANUARY 14 INITIAL MEETING
Bring seminar syllabus. Send reaction e-mail to Nash by January 11
01 Literary prompt:: Maxwell, William (1994). The man who lost his father. In: All the Days and Nights.
01a Misch, D. A. (2000). Great expectations: Mistaken beliefs of beginning psychodynamic psychotherapists. American Journal of Psychotherapy, 54, 172-203.
02 Breuer, J., & Freud, S. (1895). Studies in hysteria. (Fraulein Anna O.) In The Freud reader. P. Gay (Ed.), New York: Norton. pages 61-78.
03 Freud, S. (1895). The girl who couldn't breathe. (Katharina) In H. Greenson (Ed.), Great cases in psychotherapy, 1973, New York: Aronson, pages 13-24.
JANUARY 28 MORE CASES AND TECHNIQUE
04 Literary prompt:: Maxwell (1994). The Carpenter.
05 Freud, S. (1905). On beginning the treatment. In The Freud reader. P. Gay (Ed.), New York: Norton. pages 163 - 178.
06 Freud, S. (1905). Fragment of an analysis of a case of hysteria (Dora). In The Freud reader. P. Gay (Ed.), New York: Norton. READ PAGES 172-173 AND 234-239.
06a Decker, H. S. (1998). Freud’s “Dora” case: The crucible of the psychoanalytic concept of transference. In: Freud: Conflict and culture—essays on his life, work, and legacy. M. Roth (Ed.), New York: Knopf (105-114).
07 Freud, S. (1918) History of an infantile neurosis. (The "Wolf Man"). In The Freud reader. P. Gay (Ed.), New York: Norton. pages 400-426.
08 McWilliams, N. (1999). Psychoanalytic Case Formulation: The relationship between case formulation and psychotherapy. 09-29.
08a OPTIONAL: Buckley, P. (1989). Fifty years after Freud: Dora, the rat man, and the wolf-man. American Journal of Psychiatry, 146, 1394-1403. READ EVERYTHING EXCEPT “RATMAN”.
08b OPTIONAL: Buirski, P., & Haglund, P. (1998). The wolfman’s subjective experience of his treatment with Freud. Psychoanalytic Psychology, 15, 49-62.
FEBRUARY 4 UNCONSCIOUS COMMUNICATION – THE TWO TRIANGLES
09 Literary prompt:: Updike, J. (2006). My father’s tears. The New Yorker, Feb. 27., 71-76.
Malan, D. H. (1995). Individual psychotherapy and the science of psychodynamics. London: Butterworths. Pages 1-105.
FEBRUARY 11 THE SUPPORTIVE RELATIONSHIP
10 Literary prompt: Williams, W. C. (1932). A night in June. In: Make light of it. NY: Random House 136-143.
11 Luborsky, L. (1984). Principles of psychoanalytic psychotherapy. New York: Basic Books. Pages 61-89.
12 Schafer, R. (1983) The analytic attitude. New York: Basic Books. Pages 14-33 (the atmosphere of safety: Freud’s ‘Papers on technique’ (1911-1915).
13 Schafer, R. (1983) The analytic attitude. New York: Basic Books. Pages 34-57.
14 Greenson, R. R. (1960). Empathy and its vicissitudes. International Journal of Psycho-Analysis, 41, 418-424. Pages 243-249.
15 Winnicott, D. (1956) On transference. International Journal of Psycho-analysis, 31, 386-388. Pages 455-458.
16 Winnicott, D.W. (1984). The development of the capacity for concern. In Deprivation and Delinquency (pp. 100-105). London: Tavistock Publications. (Original work published in 1963).
16a OPTIONAL: Decety, J., & Jackson, P. L. (2006). A social-neuroscience perspective on empathy. Current Directions in Psychological Science,15, 54-58.
FEBRUARY 18 EXPRESSIVE TECHNIQUES
17 Literary prompt: Joyce, J. (1914). Araby, In: Dubliners.
18 Freud, S. (1912). The dynamics of transference. S.E., 12, 97-108.
Malan, D. H. (1995). Individual psychotherapy and the science of psychodynamics. London: Butterworths. Pages 106-153.
19 Luborsky, L. (1984). Principles of psychoanalytic psychotherapy. New York: Basic Books. Pages 90-141.
20 McWilliams, N. (1999). Psychoanalytic Case Formulation: Assessing defenses. 85-101.
21 Eagle, M. N. (2003). The postmodern turn in psychoanalysis: A critique. Psychoanalytic Psychology, 20, 411-424.
21a OPTIONAL: Lane, R. C., Koetting, M. G., Bishop, J. (2002). Silence as communication in psychodynamic psychotherapy. Clinical Psychology Review, 22, 1091–1104.
21b OPTIONAL: Pesant, N., & Zadra, A. (2004). Working with dreams in therapy: What do we know and what should we do?. Clinical Psychology Review, 489 – 512.
FEBRUARY 25 PSYCHOTHERAPY OUTCOME RESEARCH
22 Literary prompt:: Waddington, P. (1978). The Street That Got Mislaid, In: Fireside Reader 173-178.
23 Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007). Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study, American Journal of Psychiatry, 161, 1-7.
24 Abbass, A. A., Hancock, J. T., & Kisley, S. (2006). Short-term psychodynamic psychotherapies for common disorders. Cochrane Review, 1-20.
25 Luborsky et al. (2002). The dodo bird verdict is alive and well-mostly. Clinical Psychology: Science and Practice, 9, 2-12.
26 Peterson, D. R. (2004). Science, scientism, and professional responsibility. Clinical Psychology: Science and Practice, 11, 196-210.
27 Westen, D., & Bradley, R. (2005). Empirically supported complexity. Current Directions in Psychological Science, 14, 266-271.
28 Kazdan, A. E. (2006). Arbitrary metrics. American Psychologist, 61, 42-49.
29a OPTIONAL: Norcross, J. C. & Prochaaka, J. O, (1984). Where do behavior (and other) therapists take their troubles?: II. Behavior therapist, 7, 26-27.
29b OPTIONAL: Westen, D., Novotny, C. M., & Thompson-Brenner, H., K. (2004). The Empirical Status of Empirically Supported Psychotherapies: Assumptions, Findings, and Reporting in Controlled Clinical Trials. Psychological Bulletin, 130, 631-663.
29c OPTIONAL: Chambless, D. L., Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685-716.
MARCH 03 ANALYSIS OF THE TRANSFERENCE
30 Literary prompt:: O'Connor, Frank (1980). My Oedipus complex. In Collected stories. pages 282-292.