Welcome by Jean Petrucelli, Ph.D., CEDS-S, Director, and Co-Founder of EDCAS, Training & Supervising Analyst, Faculty
The Interpersonal Perspective in Clinical Treatment
Anton Hart, Ph.D. Training & Supervising Analyst, Faculty
(This session only.)
Note: This class is a hybrid meeting–in person and virtual–at the William Alanson White Institute, 20 W. 74th Street.
Meet and greet participants and faculty. Wine and cheese reception.
Instructor: Jean Petrucelli, Ph.D., CEDS-S
Weeks 2 and 3
September 23 and 30th
Using clinical case material, this course will present a detailed, practical exploration of how to work analytically with anorexic, bulimic, and binge-eating patients beyond symptom alleviation. Understanding the neurobiological underpinnings and the implications of these findings in clinical treatment, the concepts of attachment theory, self regulation and affect regulation will be viewed as interpersonal constructs. The need for novelty will be illustrated in clinical moments where the relational field shifts. The ongoing exploration of interactions between patient and therapist, the many “bodies” in the room, why a particular intervention is chosen, as well as transference and countertransference concerns will be discussed. Issues of the often neglected work with male eating disordered patients, body obsession, diagnosis, assessing the level of care, and techniques involving contracts, food charts, and food language as metaphor, will be viewed as part of the bridge one builds to enter the ritual-filled world of the eating disordered patient.
Instructor: Jacqueline Ferraro, D.M.H.
This class will focus on puberty and developmental issues in girls, taking into account efforts to develop an identity and sense of self as girls move through this critical period in their lives. Significant changes in physiology, body image, and cognition, accompany this transition, along with social and emotional elements. Coping with these changes can involve efforts to control weight (restricting and/or bingeing), cutting, drug and alcohol use, and sexual experimentation and activity. Relevant vignettes will be incorporated into class discussion.
Instructor: Judith Brisman, Ph.D.
Weeks 5 and 6
October 14 and 21
Owing to the complexity of eating-disordered patients’ dynamics and the urgency of life-debilitating symptoms, treatment often involves extension of the boundaries of traditional analytic work—both with the individual and the family. This class will present an interpersonal approach to the treatment of anorexia, bulimia, and binge eating disorder in children, adolescents, and young adults, with a particular focus on the role of the family. Direct symptom intervention within the framework of an interpersonally-based analytic approach is discussed. Work with the family in that regard will be considered, contrasting it to the evolving family-based treatment models in which direct re-feeding by parents is urged. Questions regarding treatment choice will be explored and complications, roadblocks, and treatment goals will be considered to develop an understanding of how best to reach these often-unreachable patients.
Instructor: Janet Tintner, Psy.D.
High relapse rates and repeat bariatric surgeries highlight the intractability of achieving lasting weight loss through this intervention. Meta-analysis of research indicates that although short-term weight loss is achievable, crucial long-term maintenance is elusive. Bariatric surgical options will be reviewed as a tool (not a solution) in working with despair and intransigence in treating obesity. Pre- and post-surgical psychological concerns will be described. Clinically, this class demonstrates the use and import of the detailed inquiry as a way to facilitate awareness of eating in the here and now, as well as a means to demonstrate enactments of childhood experiences in current patterns.
Instructor: Stephanie Roth Goldberg, LCSW-R, CEDS
This class will explore the range of bingeing experiences through a Health at Every Size lens. We will consider the pressure of our culture to be thin and apply an analytic framework to our thinking about how this cultural influence contributes to dissociated hunger in patients. The range of bingeing experiences will be explored, including those that are part of a bulimia or a binge eating disorder diagnosis, as well as those that follow a period of anorexia. In addition, participants will examine the embodied and disembodied experiences of patients during binges and connect that to the range of emotional experiences with the aim of providing an interpersonal/relational perspective on treatment
Instructor: Tom Woolridge, Psy.D., ABPP, FIPA, CEDS-S
Although eating disorders are usually associated with women, many men also suffer from these disorders. We will discuss the role of identification in the development of gender identity, including identification with the father, and how the patient’s experience may be addressed in treatment. Muscle dysmorphia, a disorder that occurs more commonly in men than in women, will also be discussed.
Sara Schoen, Ph.D.
This class will consider how cultural, developmental, and psychological forces influence the relationship between eating and gendered identity. The focus will be on how feelings about eating and bodies are tied to a person’s experience of their gender. For people with eating problems, experiences of self as desiring and desirable are often played out in relationship to food and body size. Clinical material will be used to explore how both the patient’s and therapist’s gendered selves, including feelings about their bodies and appetites, shape and transform the interpersonal field.
Moderator: Jean Petrucelli, Ph.D., CEDS-S
Guest speakers: Judy Schwartz, MD; Karen Rosewater, MD; Wendy S. Ziecheck, MD; Theresa Kinsella, MS, RD.; Robin Millet, MS, RD, CDN; Marina S. Kurian, MD, FACS
(This session only.)
A multi-disciplinary approach to treatment involving the use of adjunct modalities will be examined in a roundtable discussion. Guest speakers will include nutritionists, internists, a gynecologist, and a bariatric surgeon.
Instructor: Elizabeth Halsted, Ph.D.
This class will explore the deep and complex psychological elements that constitute the dynamic body image. We will identify the vital functions produced by a stable body image and the symptoms that arise from an unstable body image. Students and the instructor will offer clinical material and formulate interventions that generate the creation of new and more resilient body images.
Course Instructors: Elizabeth Halsted, Ph.D. & Steven Tublin, Ph.D.
Psychoanalysis, with its emphasis on meaning and understanding, can be considered a top-down model of human experience. What we call “the mind” is the central player. Somatic psychology begins with bodily experience–sensation, kinetic impulses–and physiological models of emotion and phenomenology. With the body as central player, somatic approaches are thought to be bottom up. The two approaches combined provide a more thorough understanding of experience and a wider array of clinical interventions than either one alone. In this class, we will introduce a somatic model and some interventions derived from it, that support emotional regulation and facilitate psychoanalytic inquiry.
Instructors: Sarah Schoen, Ph.D.; Jean Petrucelli, Ph.D., CEDS-S; and members of the EDCAS Steering Committee
This class will use transference and countertransference data to bridge theoretical knowledge and clinical experience. Students will be encouraged to raise clinical dilemmas in an informal and spontaneous discussion. Themes in clinical material that integrate interpersonal and relational concepts in work with eating disordered patients will be highlighted.
Instructors: Sharon Kofman, Ph.D. & Caryn Gorden, Psy.D
Participants in this class will explore the increased incidence of eating disorders within the Orthodox Jewish population from a psychoanalytic perspective. Contemporary sociocultural, historical, and religious factors that contribute to Jewish identity will be examined. The role of ritual and eating practices, family and gender dynamics, and cultural issues specific to the body, desire, and sexuality will be discussed. In addition, we will consider the role of unconscious historical influences, such as the legacy of persecution, genocide, and intergenerational transmission of trauma, as critically contributing to this symptom picture in survivor families. Discussion will cover noteworthy clinical features, treatment dilemmas, and countertransference experiences.
Instructor: Carrie Gottlieb, Ph.D.
This course will examine the similarities and differences between cognitive behavioral and dialectical behavior therapies and interpersonal psychotherapy. The integration of these therapies will be explored as they pertain to treatment and conceptualization of individuals with eating disorders.
Instructor: Sandra Buechler, Ph.D.
Emotions are a primary means of intrapersonal and interpersonal communication. As clinicians and as human beings, how can we best hear and use their messages? How can we learn to modulate them, to bring out their potential to enhance life, rather than detract from it? These questions will be explored, with an emphasis on their clinical applications and a focus on the emotional cues that form a vital part of the fabric of the treatment interchange, as well as the rest of human experience.
Instructor: Sue Kolod, Ph.D.
The impact of hormones on the psyche, of particular relevance to sexuality, appetite and self-experience, has been largely avoided in contemporary psychoanalytic thought. Psychoanalytic treatment has focused on the ways in which the mind affects the body, i.e., how psychological conflict can be expressed through physical symptoms. This class will explore how the body can affect the mind. Research will be cited from evolutionary biology and endocrinology, and case material will be used to demonstrate how an inquiry into hormonal experience can inform clinical work.
Instructors: Toni Andrews, Ph.D. and Rosa Lim, Ph.D.
Eating disorders are not just an illness of white, middle-class, heterosexual, cisgender, and able-bodied, young girls. This class explores personal, political, and clinical issues of race in eating disorder treatment, including differences between the impact of oppression and assimilation stress on identity development, and culturally relevant treatment implications.
Instructors: Julia Shiang, Ed.D., Ph.D. and Zeynep Catay, Ph.D.
(Hybrid meeting: virtual and in-person attendance)
Learning to listen to the impulses of our body movements provides a way to know our interior landscapes in our role as therapists. This landscape is made up of many identities, many selves, all in interaction. Can we become conscious of which self is operating in each moment? The ability to witness these various selves and to discern their assumptions may lead the therapist to new paths of self-knowledge and, in the process, further attune to the here-and-now of the therapist-client relationship. Participants will engage in experiential exercises within a body movement structure to uncover cultural frames, biases, and unwitting contributions to ruptures, and to acquire a wider way of seeing, bringing greater self-knowledge to the therapist’s contribution to the process of change.
Instructors: Discussion by EDCAS faculty members and class participants
Instructor: Anton Hart, Ph.D.
This class will present an overview of the concept of cultivating curiosity and address the ways in which addictive and compulsive symptoms can be seen as problematic mechanisms for dealing with the difficulties of lived experience. Practical considerations for cultivating curiosity in patients with addictive and compulsive exercise and body-image symptoms will be presented.
Instructor: Phillip Blumberg, Ph.D.
This class will situate online addictions within the broader context of sexual compulsions. Psychobiological and psychodynamic processes, including impairments in self-regulating systems, as well as separation-individuation conflicts which have been associated with on-line compulsions, will be reviewed. Participants will examine the virtual nature of cyber sexuality—including chat rooms, interactive games, erotic e-mail, and web cams—and what it indicates about the changing nature of the contemporary American social character.
Instructor: Todd Essig, Ph.D.
A treatment strategy will be presented in which both the gains and losses of technology-mediated sexual experiences will be explored and three general questions addressed: How can technology successfully mediate relationship experience? How and when does such mediation fail? What are the important differences between technologically-mediated relationship experiences and those experiences that come from being bodies together? Clinical examples in which seemingly compulsive technologically-mediated sexual activity is later understood to have served crucial developmental and transitional functions will serve as a foundation for class discussion.
Instructor: Richard B. Gartner, Ph.D.
This course will explore how sexual abuse, sexual compulsivity, and sexual dysfunction are interrelated factors in understanding compulsive, “anorectic”, and/or kinky sexual behavior. We will focus on clarifying and sorting through the potential meanings of patients’ sexual expression. Additionally, we will look at treatments that either develop alternate sexual expression or help the patient feel more comfortable with sexual patterns that he or she perceives as shameful or abnormal.
Instructor: Jean Petrucelli, Ph.D., CEDS-S
The treatment of substance abuse, be it alcohol or drugs, presents clinicians with patients who are psychotherapeutically difficult to reach and who create unique transference/countertransference patterns. Case material will be used to explore the interplay between attending directly to the addiction and disengaging from the pull to do so that occurs between therapist and patient. The emphasis in treatment is on how relational interactions contribute to and maintain addictive patterns. Using a multiple-states dissociative model, this class will focus on various treatment issues and concerns including: how the addiction functions as an attempt to repair, the myths of addiction, affect regulation, and the concepts of mindfulness, helplessness, and powerlessness.
Course Instructors: Patricia Bellucci, Ph.D. & Michelle Kennedy, LCSW
This class will address questions of use and abuse of drugs and alcohol among young adults and adolescents. Developmental conflicts, self-medication, and the social context in which this population functions—i.e., school, peer group, family—will be discussed. The use of consultation, transference, countertransference, and referral for adjunct treatments will be considered.
Instructor: Debra Rothschild, Ph.D.
Harm reduction therapy is a form of treatment for substance misuse that expands the traditional disease concept model to one that allows for an individualized approach based on the needs of each patient. Harm reduction therapy aims to reduce any harm or risk that substance use may impose on the user or on others. Its practice is collaborative and emphasizes respect for the individual and treatment of a whole person. Thus, it differs from the traditional treatment of alcoholism or substance abuse that has focused on the elimination of misuse or addiction. We will introduce and review psychoanalytic theories specific to the treatment of substance misuse and show how they dovetail with harm reduction therapy. Clinical material will be used to demonstrate an integrated approach to treatment based on the converging principles of harm reduction and relational psychoanalysis.
Instructor: Jeffrey Guss, M.D.
This class will consist of a close reading of Lawrence Fischman’s foundational paper “”Seeing without self: discovering new meaning with psychedelic-assisted psychotherapy”, published in Neuropsychoanalysis in 2019. This paper introduces core phenomena of the psychedelic experience in psychoanalytic and neuropsychoanalytic terms. Concepts examined include ego dissolution, oceanic union/connection, primary process, defense mechanisms, regression and mentalization as they occur in psychedelic work, but described in the language of psychoanalysis. Participants will acquire fluency with a variety of experiences common in psychedelic work as they are described in psychoanalytic terminology.
Instructors: A. Mittsi Crossman, M.D. & Melanie Israelovitch, M.D.
The psychopharmacology of substance disorders, including those involving food, encompasses a complex interplay between biological, psychological, and sociological factors intrinsic to the disorders and to their treatments. This class will address the indications and contraindications use of a variety of psychopharmacological agents as a component of treatment. Participants will be encouraged to present questions from their own practices.
Instructor: Annie Chanler, Ph.D.
This class will focus on the interface of spirituality, with particular attention paid to mindfulness and psychoanalysis when working with patients in recovery. We will consider the value of loving kindness while peeling away the layers of deeply embedded feelings of inadequacy, pain and anger. Spirituality helps addicts connect to suffering with compassion. Like psychoanalysis, it encourages reflection and non-judgmental self-awareness. It creates an internal spaciousness through non-reaction and helps build self-respect. Both inspire a generosity towards self, self-confidence, and a positive self-identity. Participants will explore how the interpretation of events, not the events themselves, cause distress.
Instructor: Sheldon Itzkowitz, Ph.D., ABPP
Patients at the extreme end of the continuum of dissociative disorders often display noticeable self-state changes/switches that can be dramatic and disarming. These switches function to keep information (feelings, thoughts, memories) compartmentalized as a means of maintaining a level of emotional equilibrium, staving off further emotional dysregulation. Pathological dissociation caused by un-processable shock and betrayal trauma results in the mind becoming compartmentalized and structured by dissociation. Dissociated self-states/alter personalities become islands of “personified selves” that are most frequently unknowable to each other. Using video clips of his work with patients who suffer from DID (Dissociative Identity Disorder) Dr. Itzkowitz will show how shifts in self states occur and demonstrate how he engages these states to help patients loosen their defensive reliance on dissociation.
Instructor: Shelly Goldklank, Ph.D.
Birds of a feather flock together and opposites attract. Clinical couples often present with a similarity of underlying fears and a complementarity of styles in dealing with those fears. Thus, in some clinical couples, addictions or eating disorders present in one partner are consistent with attributes that initially attracted that partner to the other because of shared unresolved dilemmas. They have fundamentally similar issues which they have coped with in opposite styles. The complaints about the disorder are, therefore, not only telling about the partner who has them, but also about unresolved issues in the mate. Participants in this class will use this understanding to gain leverage in helping the couple change.
Part One: Searching for Love from the Outside In
Instructor: Sivan Baron, J.D., LCSW
Part Two: In Love and Fantasy
Instructor: Evelyn Hartman, Ph.D.
Part one of this class will explore the ways in which patients with eating disorders, compulsions, and addiction are in “”relationship”” with their object of abuse/addiction. We will also look at the way that fantasies about romantic love/partnership operate as solutions to conscious and unconscious depressive anxieties. In fantasy, the romantic partner becomes the object that magically delivers happiness, wholeness and even thinness. Case material will be presented for discussion.
Part two of this class will examine addictions and obsessions with different types of fantasies of love, whether actualized or not, that impede having fulfilling love relationships. The focus will be on understanding the factors that contribute to creating these fantasies as well as the power that sustains them.
Instructor: Jill Howard, Ph.D.
This course will use Fairbairn’s theory of the exciting-rejecting object as a way to think about addictive relationships. Participants will consider this dynamic as one explanation for the behavior of people who are unable to commit to marriage or sustain long-term monogamous relationships. Readings and case material will aid in this exploration.
Instructor: Mark Blechner, Ph.D.
This class argues that the mind and brain should be understood as a single unit–the “mindbrain”–which manipulates our raw perceptions of the world and reshapes that world through dreams, thoughts, and artistic creation. Participants will explore how dreams are key to understanding mental processes, and how working with dreams clinically, both with individuals and groups, provides an essential route towards achieving transformation. Covering such key topics as knowledge, emotion, metaphor, and memory, this class sets out a radical new agenda for understanding the importance of dreams in human thought and their clinical importance in psychoanalysis. The instructor will draw on the latest neuroscientific findings to show how the mindbrain constructs reality, and to provide guidance on how clinicians can best understand their patients as well as their own dreams.
Instructor: Discussion by EDCAS Faculty members and class participants
Note: This class and the graduation ceremony may be attended virtually or in person at the William Alanson White Institute, 20 W. 74th Street, New York, NY