CLINICAL TRAINING IN ADULT PSYCHOANALYTIC PSYCHOTHERAPY

COURSES

Courses are held in instructors’ private offices on Mondays and Wednesdays, from 6:25 PM to 7:55 PM and from 8:35 PM to 10:05 PM.* There are two (2) semesters per year, Fall and Spring, each consisting of fifteen (15) weeks of classes. The course of study may be completed in three (3) years. Most candidates train on a part-time basis and extend their training over a longer period. All courses are taught with an emphasis on clinical relevance. Small classes allow for individual attention. All courses are 15 weeks unless stated otherwise and have been approved for 22.5 contact hours (CEUs). See course descriptions below regarding the number of contact hours for shorter courses. 

*Courses will be offered based on adequate candidate enrollment.

FIRST YEAR - FALL

Freud’s Writings I
The development of Freud’s thought is traced through 1914 with an emphasis on the interdependence of clinical and theoretical advances. The first part of the course traces the progress of Freud’s self-analysis in order to demonstrate the inseparability of theory and practice in psychoanalysis. The remainder of the course focuses on the clinical aspects of Freud’s thought through 1914.

Psychoanalytic Technique I: Beginning the Treatment
The beginning of the course will be devoted to the cultural context of psychoanalytic psychotherapy and will aim to sensitize clinicians to different populations. The balance of the course will focus on beginning the treatment with a perspective on how psychoanalytic theory informs technique. The consultation, opening phase, and practical aspects of treatment will be considered. Emphasis will be placed on the therapeutic stance, active listening, understanding of transference manifestations, and how the therapist engages the patient in the process of therapy. Candidates will be exposed to the broad range of analytic literature dealing with these issues and candidate case material will be used.

Psychoanalytic Theories of Development I
This course offers an overview of the beginning psychological development of the human infant from a psychoanalytic perspective. Early development will be considered from the vantage point of psychosexual stages and of drive and ego development in the oral and anal phases and from the standpoint of Attachment Theory. The development of object relations and the emerging sense of self will be addressed. The contributions from infant research will be covered. Readings will include Freud, Anna Freud, Melanie Klein, Spitz, Winnicott, Mahler, Pine, and Kohut. Candidates will have the opportunity to think about clinical material from various theoretical perspectives.

FIRST YEAR - SPRING

Freud's Writings II
Freud’s basic theoretical thinking from 1914 to 1937 is studied intensively through a close reading of his essential papers. Central concepts such as narcissism, the dual instinct theory, “beyond the pleasure principle,” masochism, and the structural model are highlighted. Application and relevance to clinical practice are emphasized. 
Prerequisite: Freud’s Writings I or with permission from the Director of MITPP.

Psychoanalytic Technique II: Classical and Contemporary Approaches
This course focuses on the basic components of psychoanalytic treatment: transference, countertransference, resistance, acting out, and working through. Each concept is explored theoretically and clinically, integrating classical and contemporary thought. The course emphasizes the application of theory to clinical work.
Prerequisite: Psychoanalytic Technique I or with permission from the Director of MITPP.

Psychoanalytic Theories of Development II
This course continues an exploration of Freud’s basic stage theory and its ramifications for normal and psychopathological character structure. There will be emphasis on the Oedipus complex as the nucleus of neurotic conflict. The writings of Freud, as well as the writings of more contemporary theorists will be studied. This will include readings and discussions of gender and sexuality, including contemporary theories of femininity, female sexuality, and homosexual and lesbian perspectives.
Prerequisite: Psychoanalytic Theories of Development I or with permission from the Director of MITPP.

SECOND YEAR - FALL

Psychopathology I: Theory of Psychic Conflict
The psychoanalytic theory of psychic conflict will be studied from the perspective of the various contemporary models of the mind in order to lay the groundwork for an understanding of psychopathology, specific diagnostic entities, and clinical treatment. Using readings from the literature, class discussion, and case presentations, concepts covered will include: psychic structure, id, ego and superego functioning, unconscious processes, anxiety, conflict, regression, defense mechanisms, symptom formation, psychopathology, and character structure.
Prerequisite: Completion of all First Year courses or with permission from the Director of MITPP.

Psychoanalytic Technique III: Technique With the More Disturbed Patient
This course will focus on the unfolding treatment process with an emphasis on issues encountered in the treatment of patients with a variety of ego structures. Work with pre-verbal experiences, identifications, and primitive defenses will be explored. The nature of the therapeutic atmosphere will also be considered. Candidates’ clinical material will be used in combination with readings from Freud, Mahler, Spitz, Pine, Leowald, Winnicott, McDougall and Riviere.
Prerequisite: Completion of all First Year courses or with permission from the Director of MITPP.

Psychoanalytic Theory of Dreams
Both theoretical and clinical aspects of the use of the dream in psychotherapy will be covered. Approximately half of each class meeting will be devoted to a discussion of an aspect of dream theory and half to clinical case material. Readings will cover historical and current theoretical issues including the works of Freud, Sharpe, Erikson, Altman, Jones, Brenner and Arlow, and Grinstein. Ample opportunity will be provided to each candidate to present pertinent case material including dreams.
Prerequisite: Completion of all First Year courses or with permission from the Director of MITPP.

SECOND YEAR - SPRING

Psychopathology II: Neurosis
The psychoanalytic theory of neurosis will be reviewed and discussed in order to develop an understanding of the classical neuroses, e.g., hysteria, obsessive-compulsive neurosis, anxiety and phobias, etc., their etiology or origin in earlier developmental conflicts and their role in the formation of character. Critical concepts such as the Oedipus complex, infantile neurosis, drives vs. object relations, and the role these concepts and developmental issues play in the formation of neurosis will be considered. The adequacy and relevance of the classical formulation of neurosis in the context of changing patient presentations (e.g., borderline and the more severe character disorders) which seem to predominate in treatment at this time will be addressed. The course will draw on readings from the literature, case presentations, class discussion, and presentation of assigned material.
Prerequisite: Completion of all First Year courses or with permission from the Director of MITPP.

Psychoanalytic Technique IV: Transference and Countertransference With the More Disturbed Patient
Special transference and countertransference problems in the treatment of patients who present borderline, narcissistic, and psychotic pathology will be addressed. Specific technical problems with these patients, e.g., acting out, negative therapeutic reactions, eroticized and psychotic transference, silences, perversions, and treatment crises will be considered. Readings will be drawn from authors who are making or have made major contributions to the literature on transference and countertransference. Candidates will be expected to organize, write about and orally present a case following the Outline for Final Case Presentation.  Candidates will attempt to meet the Standards for Final Case Presentation, which are available from MITPP (info@mitpp.org.) When they request the Standards, they will also receive the Procedures for Final Case Presentation and Outline for Final Case Presentation.
Prerequisite: Completion of all First Year courses or with permission from the Director of MITPP.

Unconscious Processes
This course will study primary process, fantasy, and symbolism as essential keys to understanding the unconscious. This study will attempt to enhance the capacity to listen for unconscious conflict and fantasy and to decipher their meaning in the clinical material. Both Freudian and Kleinian approaches toward fantasy and symbolism will be discussed. Emphasis will be placed on the relevance of understanding character pathology and differential diagnosis in order to communicate effectively to the patient about unconscious fantasy.
Prerequisite: Completion of all First Year Courses or with permission from the Director of MITPP.

THIRD YEAR - FALL

Psychopathology III: Borderline and Narcissistic Disorders
Narcissistic and borderline disorders will be studied from the point of view of psychic structure, developmental deficits, the aggressive drive, and the world of internal objects. Attention will be given to the dynamics of the treatment process, transference and countertransference problems special to this group, and the use of parameters.
Prerequisite: Completion of all First and Second Year courses or with permission from the Director of MITPP.

Integrative Case Seminar I
This seminar integrates psychoanalytic theory with clinical practice in preparation for the Final case Presentation.   Each candidate will select an appropriate case for presentation. There will be an emphasis on understanding the significance of the history of the patient and the unfolding of the therapeutic process as well as on a diagnostic formulation and conceptualization of the case. Candidates will organize the patient's history and the progression of the treatment with clarity. Each candidate will have a number of class meetings in which to discuss the selected case and to present one or more preliminary versions of the written presentation.   By semester's end, it is anticipated that each candidate will have achieved a clear sense of direction with regard to writing the Final Case Presentation.
Prerequisite: Completion of all First and Second Year courses or with permission from the Director of MITPP. 

Object Relations Theory
This course will examine the concept of the object and object relations in the work of different theorists. Freud’s concept of the object will be the starting point; further attention will be given to Mahler, M. Klein, Fairbairn, Winnicott, M. Balint, Bion, Leowald, and Ogden. How each theorist’s understanding of the importance of the object in individual development conditions his/her understanding of pathology, diagnosis, and treatment approach, especially in regard to the use of transference, will be studied.
Prerequisite: Completion of all First and Second Year courses or with permission from the Director of MITPP.

THIRD YEAR - SPRING

Psychopathology IV: Psychosis
More serious psychopathology, e.g., schizophrenia and severe ego disturbances, is viewed in terms of differential diagnosis. Drive derivatives, affect states, and internalized object relations are considered. Clinical material is used to enhance understanding of psychotic states, with an emphasis on how technique must be adapted to work with these conditions.
Prerequisite: Completion of all First and Second Year courses or with permission from the Director of MITPP.

Integrative Case Seminar II
This seminar will continue where Integrative Case Seminar I left off, with special emphasis on the Final Case Presentation. Readings may be suggested where appropriate. The focus will be on finalizing each candidate's case presentation through class presentation and discussion. Once Final Case Presentations are completed, those who have not yet presented before a committee will continue work on their cases. An additional focus will include the termination process to help candidates who may be ending treatment with their patients.
Prerequisite: Completion of all First and Second Year courses or with permission from the Director of MITPP.

Self Psychology
This eight-session course will focus on the historical development of both the theory and clinical practice of self psychology. Emphasis will be given to such key issues as the empathic mode of observation, self-object transferences, and psychic structure building. A re-evaluation of major concepts will include countertransference, resistance, drive theory, and the self as the superordinate agency of the mind. Candidates’ clinical work will be discussed in depth to demonstrate self-psychologically informed psychoanalysis. Readings will include the writings of Kohut, Ornstein, Wolf, Bacal, Fosshage, and Stolorow. This course has been approved for 12 contact hours (CEUs). 
Prerequisite: Completion of all First and Second Year courses or with permission from the Director of MITPP.

Relational Perspectives in Psychoanalysis and Psychotherapy
This seven-session course will provide an overview of relational perspectives in psychoanalysis. The evolution of relational ideas will be traced from their beginnings to contemporary theory with its roots in object relations and interpersonal psychology. Concepts of the two-person transference-countertransference matrix, mutuality and a shift in views about authority, the role of affect, trauma, and the phenomenon of neurological information processing will be explored. Readings will be drawn primarily from Ferenczi, Fromm, Mitchell, Bromberg, Aron, and Altman. Clinical applications of theoretical concepts will be emphasized. This course has been approved for 10.5 contact hours (CEUs). 
Prerequisite: Completion of all First and Second Year courses or with permission from the Director of MITPP.