307: Further Explorations in Empirical Research
Instructors
Shuli Sandler, Psy.D.
Jess Olson, Ph.D., L.P.
June 23 – June 30, 2025
Mondays, 8:35 – 10:00 pm
Co-requisites
Candidates must have or have had at least two cases in supervised psychoanalysis to be eligible for upper level courses.
Course Description
In this course we will discuss the practice/researcher interface, discuss the development of a manual for the assessment of defenses in the play of young children, and provide a hands-on experience in class to demonstrate the value of the collaboration between clinicians and researchers. We will attempt to integrate clinical observations and systematic evaluations of the language utilized by patients and clinicians. Second and third year students combined. This course alternates with 210: Neuropsychoanalytic Explorations.
Educational Objectives
Upon the completion of this course, participants should be able to:
1. critically evaluate research.
2. describe how empirical approaches can inform clinical theory and technique.
Evaluation Method
Each student’s participation in class discussion and his or her demonstration of understanding of the course objectives and reading material is assessed in a written evaluation by the instructor(s).
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.
READINGS NOT YET CONFIRMED.
I. Conception of Unconscious Processes: Research findings, conceptual, critiques, and contemporary psychoanalytic theoretical formulations
In this meeting we will study an article by one of the most important contemporary authors who has attempted to integrate clinical and empirical findings. Understanding the nature and impact of unconscious processing is a core notion in psychoanalysis. This article discusses a variety of approaches and empirical studies with regard to unconscious mental functioning. What is the difference between unconscious and implicit? The supplementary reading is by an analyst who is well versed in neuropsychology. The concept of priming is very important in understand the nature of unconscious fantasy and the impact of the past on the present.
CLASS 1: March 27, 2023
REQUIRED READINGS
Eagle, M. N. (2013). The Implications of Conceptual Critiques and Empirical Research on Unconscious Processes for Psychoanalytic Theory. Psychoanalytic Review, 100:881-917.
SUPPLEMENTAL READINGS
Erreich, A. (2017). Unconscious Fantasy and the Priming Phenomenon. Journal of the American Psychoanalytic Association, 65:195-219.
II. Clinical Meaning and Empirical Science
CLASS 2: April 3, 2023
In last week’s discussion, Eagle described the nature of subliminal studies and their critique. Barry and Fisher outline the work of Howard Shevrin and the applicability of subliminal studies to understanding of unconscious mental activity. Are you convinced of its value or of the critique? In a systematic clinical study Rudden and Bronstein discuss the utilization of transference approaches and relationship approaches. Zilcha-Mano addresses a very important issue w regard to therapeutic alliance – differentiating “trait-like” component (how a person relates in general) and “state-like” component (what develops during treatment). What approach do you think is most effective in analytic/therapeutic work – the evolution of the alliance v analysis of the transference? How can they be integrated conceptually and clinically? In the next section we will discuss the work of Høglend in terms f addressing transference systematically. Towards the end of the course, Chris Christian will discuss the relationship of language measures in understanding what occurs during “ruptures and repairs” in the therapeutic alliance. An important question which needs to be understood relates to the nature and impact of the analyst’s/therapist’s intervention.
REQUIRED READINGS
Barry, V. C. & Fisher, C. (2014). Research on the Relation of Psychoanalysis and Neuroscience: Clinical Meaning and Empirical Science. Journal of the American Psychoanalytic Association, 62:1087-1096.
Rudden, M. G. & Bronstein, A. (2015). Transference, Relationship and the Analyst as Object: Findings from the North American Comparative Clinical Methods Working Party. International Journal of Psychoanalysis, 96:681-703.
Zilcha-Mano, S. (2017). Is the alliance really therapeutic? Revisiting this question in light of recent methodological advances. American Psychologist, 72(4): 311-325.
Press, M. (2019). Discussion of Dr. Sigal Zilcha-Mano’s Research on Therapeutic Alliance. New York Psychoanalytic Society and Institute. May 9.
III. Outcome Studies
CLASS 3: April 10, 2023
The Sandell paper which has been marked up by LH gives an outline of outcome studies in psychoanalytic/psychodynamic treatments and some limitations. The Ulberg et al paper is from the Høglend group in Oslo, Norway. He has published widely, including in the American Journal of Psychiatry on the effectiveness of transference interpretations (more important in “sicker” patients that in “less sick patient”—against the common wisdom). This paper is from that study which is described and searching for role of insight (another important construct of analytic work). The Stone paper is a historical piece. He has treated BPD for a long time. I do not know what Otto Kernberg and his group think of Stone’s work but a 50 year follow-up is amazing. Look at page 285 and on for his ideas of positive and negative indicators for doing well/not well.
REQUIRED READINGS
Sandell, R. (2012). Research on Outcomes and Psychoanalysis-Derived Psychotherapies. Textbook of Psychoanalysis. American Psychiatric Publishing, Inc. 2nd edition, pages 385-403.
Ulberg, R., Amlo, S., Dahl, H. S. J., & Høglend, P. (2017). Does insight mediate treatment and enhance outcome?. Psychoanalytic Inquiry, 37(3), 140-152.
SUPPLEMENTAL READINGS
Stone, M. H. (2017). Borderline Patients 25 to 50 Years Later: With Commentary on Outcome Factors. Advances in Psychodynamic Psychiatry, (45)(2):259-296.
IV. Outcome Studies (NYPSI Involvement)
CLASS 4: April 17, 2023
The introduction to the RFP-C Manual describes the rationale for the development of the manual. The supplementary reading describes the clinical work which eventually led to the creation of the manual. The discussion will include how one can go from a clinical insight to studying it systematically. The second paper is the result of the RCT of the treatment. The paper by Barbara Milrod is similar to the work of Høglend. Milrod is a real pioneer in the empirical study of psychodynamic treatments. This paper addresses the value of direct interventions versus a more open-ended approach. This is an important issue for analytic work in which we try to be more open-ended until we have more evidence. Compare these ideas with what you have learned about TFP.
REQUIRED READINGS
Hoffman, L., Rice, T., & Prout, T. (2015). Manual of Regulation-Focused Psychotherapy for Children (RFP-C) with externalizing behaviors: A psychodynamic approach. Routledge. [Read Chapter 1: Rationale for RFP-C with Children with Externalizing Behaviors]
Keefe, J. R., Solomonov, N., Derubeis, R. J., Phillips, A. C., Busch, F. N., Barber, J. P., Chambless, D. L., & Milrod, B. L. (2019). Focus is key: Panic-focused interpretations are associated with symptomatic improvement in panic-focused psychodynamic psychotherapy. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 29(8): 1033–1044.
Prout, T. A., Rice, T., Chung, H., Gorokhovsky, Y., Murphy, S., & Hoffman, L. (2022). Randomized controlled trial of Regulation Focused Psychotherapy for children: A manualized psychodynamic treatment for externalizing behaviors. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 32(5): 555–570.
SUPPLEMENTAL READINGS
Hoffman, L. (2007). Do Children Get Better when we Interpret their Defenses against Painful Feelings?. Psychoanalytic Study of the Child, 62:291-313.
V. Process Studies: “What treatment, by whom, is most effective for this individual with that specific problem, under which set of circumstances, and how does it come about?” (Paul, 1967, p. 111).
CLASS 5: April 24, 2023
In addition to outcome studies (where we study whether a particular treatment works) we engage in process studies (studying how w treatment works). The ideal study would be a combination of outcome and process study. We saw that in the Høglend and Milrod work: what are the elements in the actual treatment which led to greater success. In this session we discuss two perspectives about process. In the first. Two very prominent CBT researchers discuss the shift away from a one-size fits all approach to a more individualized approach within the CBT perspective. As you can see the terms psychodynamic nor psychoanalytic do not appear, even though analytic/psychodynamic concepts appear such as idiographic, therapeutic relationship. It provides us with a good history of mental health treatment and approaches. In the supplementary article we discuss an integrating the two perspectives. The Buchholz article is an introduction to a variety of process approaches. The Prout et al article addresses how to try to integrate psychodynamic and behavioral approaches.
REQUIRED READINGS
Buchholz, M. B. (2019). Psychodynamic Psychotherapy Process Research: A quick ride through what you should know about process. Journal of Analytical Psychology, 64(5): 798-822.
Hofmann, S. G., & Hayes, S. C. (2019). The future of intervention science: Process-based therapy. Clinical Psychological Science, 7(1): 37-50.
Prout, T. A., Chacko, A., Spigelman, A., Aizin, S., Burger, M., Chowdhury, T., Ramakrishnan, A., Peralta, S., Vardanian, M. M., Rice, T. R., & Hoffman, L. (2018). Bridging the divide between psychodynamic and behavioral approaches for children with oppositional defiant disorder. Journal of Infant, Child & Adolescent Psychotherapy, 17(4): 364–377.
VI. Process Studies (continued) Study of Language Measures at NYPSI
CLASS 6: May 1, 2023
Guest Instructor: Wilma Bucci, Ph.D.
In this session we will look at a classic case in the empirical psychoanalytic literature. Mrs. C was a case which was recorded and transcribed and studies by many psychoanalytic researchers over the decade. Wilma Bucci was one of these researchers. In the “Research Itch” she describes her contemporary view of the case based on the language measures which she, Bernard Maskit, and many colleagues have systematically developed over the years. The paper begins with a discussion of the measures. As supplementary readings there is a paper on Mrs. C by Leon Hoffman and another case which Bucci and others have analyzed clinically and with the language measures. This is a classic case by Carl Rogers who began recording treatments in the 1940s.
REQUIRED READINGS
Webster, J. & Petrovska, E. (2021). Seeing Mrs. C: Introduction to the Sessions, Part Two. Division Review, 24:12-18.
Bucci, W. (2021). The Research Itch: Looking within the Psychotherapy Process. Division Review, 24:48-57.
SUPPLEMENTAL READINGS
Bucci, W., & Crisafulli, G. (2021). Linguistic Measures of the Therapeutic Process in Carl Rogers’s Case of Miss Vib. Journal of Psycholinguistic Research, 50(1): 169–192.
Hoffman, L. (2021). From Penis Envy as Bedrock to Metaphor: A Close Process Examination of the Analysis of Mrs. C. Division Review, 24:28-33.
VII. Discussion of Process material: Clinical and Linguistic Analysis of Sessions
CLASS 7: May 8, 2023
Guest Instructors: Christopher Christian, Ph.D. & Wilma Bucci, Ph.D.
In this meeting we will continue to discuss the use of the language measures. We will discuss our Clinician Research Seminar, which is a response to the well-known tension between science and practice in psychotherapy. At the Pacella Research Center of NYPSI we have been trying to bridge that gap. For several years we have conducted a Clinician/Researcher Collaborative Process Seminar. In very general terms, the project involves clinicians providing session material which might be verbatim transcripts or process notes, and researchers analyzing this material using currently available tools. Clinical and research perspectives are discussed and compared. Chris Christian will discuss his utilization of the linguistic measures to further understand clinical work, including rupture and repair in sessions. This is a very important concept which we use every day in our analytic and psychotherapeutic work. In the supplementary reading, there is an up-to-date review of the Referential Process by Bucci and Hoffman discusses the clinical possibilities of its utility.
REQUIRED READINGS
Christian, C., Barzilai, E., Nyman, J., & Negri, A. (2021). Assessing key linguistic dimensions of ruptures in the therapeutic alliance. Journal of Psycholinguistic Research, 50(1): 143-153.
SUPPLEMENTAL READINGS
Bucci, W. (2021). Overview of the referential process: The operation of language within and between people. Journal of Psycholinguistic Research, 50(1): 3-15.
Hoffman, L. (2019). Analytic Process from the Perspective of Conflict and Interpersonal/Relational Theory: A Potential Linguistic Indicator. Contemporary Psychoanalysis, 55:349-372.
VIII. Development of defense manual on young children’s play
CLASS 8: May 15, 2023
Guest Instructor: Tehela Nimroody, Ph.D.
In this, our last session, we will discuss the process by which Tehela Nimroody and colleagues developed a manual for evaluating defense mechanisms in young children based on children’s doll play.
REQUIRED READINGS
Nimroody, T., Hoffman, L., Christian, C., Rice, T. & Murphy, S. (2019). Development of a Defense Mechanisms Manual for Children’s Doll Play (DMCP). Journal of Infant, Child & Adolescent Psychotherapy, 18:58-70.
Defense Mechanisms Manual for Children’s Doll Play (DMCP) Coding Manual. Nimroody, T., Hoffman, L., Christian, C. and Rice, T. and the Pacella Research Center of the New York Psychoanalytic Society and Institute∗ January 2019