Psychoanalytic Grand Rounds at Stanford 2011 - 2012

Stanford Psychiatry and Behavioral Sciences Building, Room 2213*
401 Quarry Road
6:15-7:30PM

Admission: Free
1.25 CME/CE Credits available: Members/Community Members/Candidates: $ 12.50; Non-Members: $15 

For more information contact: Maureel Ruffell, M.D. 650-329-8834

September 28, 2011 - PSYCHOANALYTICALLY ORIENTED TREATMENT OF THE SUBSTANCE ABUSING PATIENT
Susan Hamlin, L.C.S.W.

The aim of this talk is to support psychodynamically oriented clinicians (who are often at odds with the substance treatment community and vice versa) in their work with substance abusing patients. Obviously, conflict between the therapist and the substance treatment team can cause serious problems for the patient, including feelings of hopelessness and greater likelihood of relapse. As we look at the critical history of this problem, participants will develop the skills to incorporate psychodynamic aspects of treatment (such as awareness of transference and countertransference phenomena). They will become comfortable using the behavior and management skills that are often necessary for treatment with substance abusing individuals.

October 26, 2011 - MATERNAL AMBIVALENCE: A NORMAL, UBIQUITOUS AND DISTURBING PHENOMENON
Barbara Almond, M.D.

Maternal ambivalence is a normal phenomenon that results from tensions between the differing needs of mothers and their children. In the current atmosphere of demanding and competitive parental standards, ambivalence is experienced as very disturbing, producing anxious and depressive affects. Normalizing this phenomenon can set the stage for therapeutic intervention, understanding and relief.

November 16, 2011 - THE ROLE OF SADISM IN THERAPEUTIC TECHNIQUE
Lee Grossman, M.D.

This review of the concept of sadism will emphasize its role as a way of preserving a relationship to an important object. We will then consider the thesis that "sublimated" sadism is a necessary component of most of what we identify as therapeutic technique. Clinical examples will be used to distinguish two different but complementary affective positions -- loosely, technical and empathic -- taken by the therapist in the course of treatment, in order to locate the constructive role played by the therapist's sadism.

January 25, 2012 - MAURICE SENDAK'S TRILOGY: MASTERING EARLY TRAUMA AND THE FEAR OF BREAKDOWN THROUGH CREATIVITY
Era A. Loewenstein, Ph.D.

Maurice Sendak, one of America's most creative and beloved children's books authors and illustrators has dedicated his prolific artistic career to discovering who he was as a child and how the young child within him formed and informed his life and art. The presentation will illustrate Sendak's life-long commitment to facing his fear of death and breakdown. This talk will illustrate these themes in what Sendak considers to be his Trilogy: the three books, Where the Wild Things Are, In the Night Kitchen and Outside Over There. This talk will describe how Sendak was able to transform some profoundly incomprehensible and painful early experiences into his art with playfulness and exuberance. Familiarity with Where the Wild Things Are and In the Night Kitchen will enhance your participation in the discussion.

February 29, 2012 - PROCESS NOTES: PSYCHOLOGICAL AND ETHICAL ISSUES IN AN ERA OF TRANSPARENCY
Michael Donner, Ph.D. and Dena Sorbo, L.C.S.W.

Process notes are invaluable for supervision and consultation and can also serve the psychological function of containment for the therapist and space for reflection on the relationship between therapist and patient. Although process notes may not be available to patients, they are discoverable if subpoenaed. This discussion will review the risks and benefits of maintaining process notes, the legal and ethical issues and consider one of the presenter's experience of copying and releasing a 1500 page psychoanalytic record.

March 28, 2012 - THE FUNCTION OF SUFFERING AS PORTRAYED IN THE SCARLET LETTER AND REFLECTED IN CLINICAL WORK
Diane Donnelly, Ph.D.

The function of suffering is not only to alleviate unconscious guilt but also to avert loss of ego functions and loss of mental stability. The historical background for this paper is Freud's observations of characters who were wrecked by success and Weiss' ideas about mutual love as a threat to mental stability. Using Hawthorne's portrayal of Arthur Dimmesdale in The Scarlet Letter, biographical material about Hawthorne, an entry from Hawthorne's diaries, and material from a psychotherapy case and two analyses, the presenter suggests that Hawthorne intuitively grasped the dual function of suffering both to alleviate guilt and to prevent mental breakdown in the face of mutual love.

April 25, 2012 - WHEN HELP HURTS: UNDERSTANDING UNCONSCIOUS ATTRACTION TO PAIN
Cheryl Goodrich, Ph.D. and Maureen Smith Ruffell, M.D.

In this talk, we will discuss and illustrate clinical theory and technical guidelines for understanding patients who come to us with histories of apparent masochism and who develop an experience with the therapist of feeling victimized. We will describe these individuals as having made an adaptation to a disturbed environment in childhood that is marked by an attachment to a pain-inducing object, where they defend against their aggression by turning it on themselves and concurrently derive gratification from coercing the object to respond to their pain. Using the rubric of the therapeutic alliance from the beginning of treatment through to termination, this approach continually attunes and re-attunes toward a reality-oriented relationship between two separate and fallible people rather than repeating the control and submission characteristic of a sadomasochistic relationship.

May 30, 2012 - THE ORIGINS OF PREJUDICE IN NORMAL DEVELOPMENT
Ricardo Winkel, Ph.D.

* Please note change of venue