205: Study of Recorded Analyses

Course Description

Instructor

Sherwood Waldron, Jr., M.D.

October 30, 2023 – December 11, 2023
Mondays, 8:35 – 10:00 pm

Co-requisites

Candidates must have at least one case in supervised psychoanalysis to be eligible for second year courses.

Course Description

The course provides an opportunity for candidates to hear, while reading the transcripts, of senior analysts at work. A case from an analysis conducted many years ago illustrates the establishment of the analysis in the first four sessions. Then sessions from early, middle and late phases of a current analysis provide an opportunity to study a variety of points about technique with the analyst. The changes in the course of the analysis, both in the way the patient works in the analysis and in life will be evident.

Educational Objectives

Upon completion of this course, participants should be able to:
1. Describe the different kinds of analyst communications.
2. Describe the moderating conditions which contribute to their beneficial effect in advancing the participation of the patient and the analytic unfolding of their personal difficulties.

Evaluation Method

Each student’s participation in class discussion and his or her demonstration of understanding of the course objectives and clinical material is assessed in a written evaluation by the instructor.

Schedule of Classes & Course Readings

These articles are protected under relevant copyright regulations. They are available in the New York Psychoanalytic Society & Institute Electronic Reserve for your convenience, and for your personal use.

Recorded sessions can be accessed at: www.psychoanalyticresearch.org

I. Introduction / Reading and Listening to case of “Annie”, Sessions 1 & 2

CLASS 1: October 30, 2023

The first class will require more preparation time than usual, as we will normally only study two recorded sessions for each subsequent class. This additional time will give an opportunity for more coherence as we start the study of recorded work.

REQUIRED READINGS

“How Psychotherapy Works” – from tab on www.psychoanalyticresearch.org

ACCESS THE READING

[The particular required reading was chosen because, in the experience of the research group I lead, the components of psychodynamic psychotherapy overlap greatly and perhaps indistinguishably with those of psychoanalysis. Judge for yourselves as you read this section.]

Following this introductory reading, please read and listen to the first two sessions of the case of “Annie”, to be found under the “case studies” tab on the website. This first class will provide opportunity to discuss any aspect of this material desired by the class.

NOTE: you will find instructions on how you may pause the audio to allow reading the comments included in the transcripts.

ACCESS THE CASE MATERIAL

SUPPLEMENTAL READINGS

Gazzillo, F., Waldron, S., Gorman, B. S., Stukenberg, K., Genova, F., Ristucci, C., Faccini, F., Mazza, C. (2018). The Components of Psychoanalysis: Factor Analyses of Process Measures of 27 Fully Recorded Psychoanalyses. Psychoanalytic Psychology, 35: 184-195.

DOWNLOAD THE PDF

Waldron, S., Gazzillo, F., & Stukenberg, K.W. (2018). Advancing Psychoanalysis and Psychotherapy through Research. In Axelrod, S., Naso, R., & Rosenberg, L. (Eds.) Progress in Psychoanalysis: Envisioning the Future of the Profession (pp. 151-180). New York, NY: Routledge.

DOWNLOAD THE PDF

II. The Case of  “Annie”, Sessions 3 & 4

CLASS 2: November 6, 2023

ACCESS THE CASE MATERIAL

SUPPLEMENTAL READINGS

Waldron, S., Gazzillo, F. & Stukenberg, K. (2015). Do the Processes of Psychoanalytic Work Lead to Benefit? Studies by the APS Research Group and the Psychoanalytic Research Consortium. Psychoanalytic Inquiry, 35:169-184.

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[We attempted to synthesize our knowledge from the PRC’s store of recorded conversations between psychoanalysts and patients, the various scales we had developed to describe the therapeutic process (APS, DIS) and measure how it can be helpful (PHI, RADIO), and the prior research studies we had already completed with these measurement instruments. By articulating a history of how we came to develop our thinking, we hope to inspire others to contribute to further understanding of psychotherapy, via recording of psychotherapy and psychoanalysis, or further research using our and other research instruments.]

III. Case I9 – sessions 1 and 2

CLASS 3: November 13, 2023

Confidential material available at the following link (except that the last 5 digits have been replaced by upper case Xes). The replacement characters will be distributed in class.

https://www.mediafire.com/folder/81n85vpcXXXXX/NYPSI

SUPPLEMENTAL READINGS

Waldron, S., Gazzillo, F., Genova, F. & Lingiardi, V. (2013). Relational and Classical Elements in Psychoanalyses: An Empirical Study with Case Illustrations. Psychoanalytic Psychology, 30:567-600.

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[Particularly since the 1980s, psychoanalysts have made important distinctions between an earlier, Freudian or ‘classical’ approach by psychoanalysts, and a later-developing approach, often described as ‘relational’ psychoanalysis. We examined two recorded treatments, which occurred about two decades apart from one another. The earlier one could be characterized as more classical, and the other as more relational. Relational thinking has highlighted the importance of the interaction between patient and therapist in conversation, and specific conversational elements that are distinct from a sum of the contributions of each participant in the conversation. These concern cultivating an openness, intimacy, and warmth in the relationship between patient and therapist, and a focus on both participants feeling understood in this context, rather than the illuminating or understanding of a hidden insight about the patient. Using these, new Dynamic Interaction Scales (DIS), our previously-reported Analytic Process Scales (APS), and our assessments of overall improvements in personality health (PHI), we understood sometimes-subtle, but important differences in the process of developing a helpful conversation between patient and analyst in each case, and meaningful differences in results of relational and classical psychoanalytic approaches.]

IV. Case I9 – sessions 3 and 4

CLASS 4: November 20, 2023
SUPPLEMENTAL READINGS

Jaffe, L. (2021). Freud and Therapeutic Action Reconsidered: Current Applications. Journal of the American Psychoanalytic Association, 69: 573-593.

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[A reconsideration of the varieties of therapeutic action and the way Freud had considered them all at different times of his life. In this way the author integrates different mechanisms of action which may be found in a variety of therapeutic modalities, and argues that they need not be automatically considered antithetical to one another. The role of working through is particularly emphasized.]

V. Case I9 – sessions 281 and 282

CLASS 5: November 27, 2023
SUPPLEMENTAL READINGS

Josephs, L., Anderson, E., Bernard, A., Fatzer, K. & Streich, J. (2004). Assessing Progress in Analysis Interminable. Journal of the American Psychoanalytic Association, 52:1185-1214.

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[Abstract: A case study is provided of a schizoid patient in her mid-sixties who in a lengthy analysis had made significant clinical improvement. The treating analyst’s impression of clinical improvement was independently verified through systematic analysis of transcripts of audiotapes of thirty-six sessions over a four-year period of treatment. The patient showed significant improvement on measures of character pathology, object relations, mentalization, and superego anxiety. The results suggest that some patients with entrenched character pathology who seem to be in analysis interminable may still make clinically significant improvement. It is suggested that the scientific status of psychoanalysis would be greatly enhanced if the anecdotal evidence generated in private practice were supported by independent verification. The current study illustrates one methodology, “case study plus,” for providing independent verification while retaining the richness of the traditional case study.]

Wallerstein, R. S. (2000). Forty-Two Lives in Treatment: A Study of Psychoanalysis and Psychotherapy. Forty-Two Lives in Treatment: A Study of Psychoanalysis and Psychotherapy, 56:1-768. [This monumental, sophisticated and thorough clinical study is fascinating reading.]  (on PEP)

Wallerstein, R.S. (1989) The Psychotherapy Research Project of the Menninger Foundation: an overview. Journal of Consulting and Clinical Psychology, 57 (2), 195-205. [Shorter version of above reference.]

[Patients benefited substantially (see WALDRON, S. Book Review: (1989) Psychoanalytic Quarterly 58: pp. 643-647 for an interesting way of assessing the degree of benefit). Two limitations: there was no comparison group, and there was no recording of the treatments to make possible detailed process assessments. Nevertheless, the study demonstrated strikingly that long term change took place as much with supportive elements as insight.]

VI. Case I9 – sessions 283 and 284

CLASS 6: December 4, 2023
SUPPLEMENTAL READINGS

Grande, T., Dilg, R., Jakobsen, T., Keller, W., Krawietz, B., Langer, M., Oberbracht, C., Stehle, S., Stennes, M., & Rudolf, G. (2009). Structural change as a predictor of long-term follow-up outcome. Psychotherapy Research, 19(3): 344–357.

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[This report comes from the Hamburg based Operationalized Psychodynamic Diagnosis group, whose very thorough and well thought out measures of psychological functioning developed over more than 30 years deserve careful study, as their methods are complex, but very sound.]

VII. Case S8 – sessions 1873 and 1874

CLASS 7: December 11, 2023
Introduction

This course provides an opportunity for candidates to hear, while reading the transcripts,  senior analysts at work. A case from an analysis conducted many years ago illustrates the establishment of the analysis in the first four sessions. Then sessions from early, middle and late phases of a current analysis provide an opportunity to study a variety of points about technique with the analyst. The changes in the course of the analysis, both in the way the patient works in the analysis and in life will be evident.

Familiarity with the words and voice of an actual analysis brings alive in a way perhaps no other modality the actual relationship as well as the work performed by both parties, along with the fluctuation from moment to moment in the unfolding. To protect the identity of the patient, since transcripts of the first four sessions of the first case are in the public domain, actors have first listened to the recordings, then recreated the two characters using their actual words, which are provided along with the performed audio. Comments by other analysts about the technique are included in the transcript as well.

To provide shared categories for thought and discussion, students are asked first to take a look at what we call the components of psychoanalytic work, derived from detailed study of session recordings. This material, along with the material from the first of the two cases whose recordings will be studied, is to be found on the website of the Psychoanalytic Research Consortium: www.psychoanalyticresearch.org.