There are authors whose books change me. For instance, I got it, finally – when I got the truth in Ta Nehisi Coates’ exhortation in Letter to my Son, “Here is what I would like for you to know: In America, it is traditional to destroy the black body – it is heritage.” With this statement, Coates crystalized what had previously been an incoherent set of facts in my mind.
Reading within our field, Philip Bromberg has the same effect on me: He explains and I get it….And I am filled with gratitude toward a man I’ve never met for his finding the words to broaden my grasp and aptitude.
Richard Chefetz likewise does it for me. He is in a closer circle to me: located in DC, a founding member of ICP+P and a colleague who presented a pre-conference workshop during our 2016-2017 Embodied Self Institute. With other study group members, I spent five months carefully digesting Rich’s 2015 masterpiece, Intensive Psychotherapy for Persistent Dissociative Processes and ever since, I feel myself a notably better-skilled therapist. Rich is a masterful storyteller. One can sense his earlier career as a family doctor as he advocates for health. His open-mindedness and his clear heart form a foundation as he helps even deeply disturbed patients find a way through and forward; his love of humanity shows in how he thinks, how he organizes his ideas and in the words he chooses. He has experience and hope, and he uses this book to pass on knowledge to others. Rich exhorts clinicians to “keep treating their challenging patients and not refer them to a specialist for treatment. One doesn’t need to be a specialist. One just needs to gather some special knowledge and add it to the important basics without which no special knowledge is particularly useful. Besides, it’s all about the relationship, in the first place and all the way through” (p. viii).
Rich’s writing is intended to provide us with the knowledge to help us with our challenging patients. I am grateful for his careful expression. He writes,
An approach to psychotherapy that appreciates dissociative process, compartmentalized function…and self-states will also be sure to investigate the moment-to-moment subjective experience of not wanting to do something and still doing it….I conversationally frame the overall constellation as “different ways of being you.” The words are important because the phrase acknowledges differences while the context remains an integrative “you” – one person. (p. 66)
…in the initial period of their clinical presentation, the responsibility for increasing consciousness for the subjective experience of dissociative process is a central pillar of treatment. Attention to affect metabolism is part of that consciousness. The particulars and peculiarities of each self-state tend to sustain relatively core beliefs and create a significant impediment to developing a coherent sense of self and the world. This lack of coherence was perhaps once of value as a cloud inside which could be hidden great fears and painful humiliations. However, as childhood fades into the background, adult requirements of living make the incoherence of childhood nearly intolerable….Lack of coherence is a central issue when dissociative process fills a mind’s wallet with seemingly blank cards and runs a life long after the operating license has expired. (pp. 94-95)
By absorbing Rich’s book at a just-right pace, I learned much about the process and recognition of dissociation. I’ve integrated the concept of “different ways of being you” in almost all my work. And sometimes, when patients mention an incongruous experience of themselves, I now may ask how old they feel themselves to be in that experience. So often, the patient answers without hesitation, then looks at me with astonishment tinged with apprehension, as if to say, “Where did that come from and what the *#%! is it saying about me?” Rich’s explications showed me how to stay in the moment with curiosity as opposed to apprehension. Like my patient, I don’t know what it’s saying about him or her, but I’m calm, open and curious to find out. Like seeing a shooting star, at these moments, I nod my appreciation toward Rich for bringing home to me dissociation and its role in trauma.
So you can imagine how keenly I anticipate January 26, when Rich will present “Attackments: Subjugation, Shame and the Attachment to Painful Affects and Objects” at ICP+P’s third conference of the academic year. I know he has a packed speaking engagement calendar, and his willingness to share his clinical wisdom with us is a hallmark of his great generosity. This will be a special morning of learning from a special man, and as a free-to-members conference, a time to gather as the learning community that is the heart of what ICP+P is all about. I’ll be there, and hope to see you too!
Upcoming Training + Education
Attackments: Subjugation, Shame, and the Attachment to Painful Affects & Objects
Featuring Richard A. Chefetz, MD
Saturday, January 26, 2019 from 9:30 am-12:30 pm ~ Silver Spring Civic Building at Veterans Plaza, Silver Spring, MD
Sometimes a patient vacillates between angry attacks on the therapeutic relationship and tenacious attachment to it. As a participant in the relationship, the therapist will inevitably also experience difficult feelings. The clinical atmosphere can be so poisoned by such extremes of push and pull between the participants that it can cause emotional exhaustion, shame and fear of humiliation, intolerable loss, intense dislike, disgust, and contempt.
As we now know, patients who have experienced frightening parents and disorganized/disoriented attachment in their early development will likely demonstrate a degree of chaos in their present attachment relationships. But when shame-contempt dynamics are present, the behaviors we see may exceed even the predictable, and establish patterns of “baiting” between therapist and patient. In this conference, Dr. Chefetz will describe these dynamics and how to identify them. Additionally, he will offer suggestions for understanding and working with patients when our clinical relationships include these types of extremely difficult dynamics.
At the conclusion of this conference, participants will be able to:
1. Describe the difference between the words affect, feeling, and emotion as well as the clinical utility of distinguishing between them.
2. Describe the parental contribution to each of the four major infant attachment styles and their clinical relevance to adult psychotherapy and the exploration of a traumatic past.
3. Explain how “attackment” describes a shift from proximity seeking in the attachment paradigm to guaranteeing distance when domination-submission, power and control, dynamics overwhelm the interpersonal world of a child.
Group therapy can be integrated with, or follow, individual treatment to expand and broaden the client’s therapeutic experience beyond the traditional dyad. This workshop is an exciting opportunity for clinicians who may or may not run groups themselves: to learn specific ways in which participating in group may be beneficial; to explore having a dialogue with clients about group; and to connect clients with a group experience, if appropriate.
This workshop explores a process for answering three basic questions: Is a client suitable for long-term, open-ended, psychodynamic group therapy? If yes, is the client suitable for the specific group I have in mind? If yes, are they ready to join the group now? Tools for identifying potential group members, assessing readiness for group, and preparing new members for group entry will be demonstrated.
At the conclusion of the short course, attendees will be able to:
Evaluate potential group members’ suitability for long-term, open-ended, psychodynamically-oriented group therapy.
Prepare exclusion and inclusion criteria.
Conduct a clinical interview for pre-screening.
Identify items required for preparation prior to group entry.
This program is appropriate for introductory and intermediate level clinicians and offers 3 CEs.
January 26, 2019, Conference – Attackments: Subjugation, Shame, and the Attachment to Painful Affects & Objects, with Richard Chefetz, MD, Silver Spring Civic Building, 9:00am-12:30pm, 3 CEs. Register Here Now.
February 8, 2019, Short Course – To Group or Not To Group: Assessment and Preparation of Potential Group Members, with Rob Williams, LICSW, CGP, Liz Marsh, MSW, LICSW, Art Therapist, David A. Heilman, PsyD, and Jennifer McLish, LCSW, ICP+P Office, 12:30-3:45pm, 3 CEs. Register Here Now.
March 1, 2019 – Short Course – The Female Gaze in/on the Female Body in Art and Psychoanalysis: The Case of Paula Modersohn-Becker and Epistemic Injustice, with Sandy Hershberg, MD, ICP+P Office, 2 CEs.
April 5, 2019 – Short Course – Congruent with material presented during our Embodied Self Institute, Mary Choi, LICSW, will discuss and demonstrate the use of somatic psychotherapy techniques to uncover client dynamics. ICP+P Office, 3 CEs.
April 28, 2019 – Psychoanalytic Training Program / Joint Institutes Candidates’ Committee (JICC) 22nd Annual Conference, Washington DC Metropolitan Area, 3:00-6:30 pm, 3 CEs.
May 4, 2019, Annual Conference, with Steven Stern, Chevy Chase, MD, 9:00am-4:30pm, 6 CEs.
September 28, 2019, Conference with Mark J. Blechner, PhD, Silver Spring Civic Building, 9:00am-12:30pm, 3 CEs.
December 7, 2019, Conference with Anton H. Hart, PhD, Silver Spring Civic Building, 9:00am-12:30pm, 3 CEs.
News + Notes
If you missed Sandra Hershberg’s presentation of her paper, The Female Gaze in/on the Female Body in Art and Psychoanalysis: The Case of Paula Modersohn-Becker and Epistemic Injustice, in Vienna at the 2018 IAPSP meeting or in June at the 2018 IARPP meeting you will have two additional opportunities to hear it — at the 2019 American Psychoanalytic Winter Meetings in New York City on Friday, February 8 from 2–3:30 pm (where Rosemary Balsam will serve as discussant) and on March 1st in Washington DC. More details will be available soon.
Mauricio Cortina will be teaching the short course, Erich Fromm: Social critic, radical humanist and clinician, at the Washington School of Psychiatry February 1, 8, 15, and 22, 2019 from 12:30-3:30 PM each day. Click here to learn more.
Jan Gump will present The Breadth and Depth of Slavery’s Wounds on Saturday, March 3, 2018, 10:00 am – 6:00 pm in Rockville, MD. She will discuss the experience of slavery, its emotional burden still haunting us through the transgenerational transmission of slavery’s traumas, its relevance and effect on our clinical work, and the ethical imperatives to confront it. Click here to learn more.
Cozy, sunny office available for rent in Washington Professional Group suite beginning on July 1, 2018. 112 sq ft office overlooks Washington Circle across from GWU and Foggy Bottom metro stop. Within walking distance of Georgetown. Paid parking is available in an underground garage in the building. Nightly cleaning, wi fi, and use of a printer is included. Contact Virginia Voigt, 410-808-3422 for more information.
Space available in therapy suite a block from the Tenleytown metro. Situated behind the Best Buy & Container Store in a professional building with a garden courtyard and easy neighborhood parking for your clients. The nicely appointed suite has been recently renovated and has a waiting room and kitchenette. Available Mondays & Fridays, Wednesday after 12 and Thurs evenings. Images of the building and one of the offices can be found here: https://www.kirstenchadwick.com/location/. Please contact Jennifer Grosman, firstname.lastname@example.org or Kirsten Chadwick, email@example.com.
Beautiful DuPont Circle Office Available to Rent in the Corcoran House Building at the corner of 18th and Corcoran Sts. NW, all day Friday + additional half day on Tuesday. Spacious, recently painted and re-decorated, a sunny office, waiting room and private bathroom. Many other amenities available, including wi-fi and fax. Excellent location, 2 blocks from DuPont Circle metro. 2 parking spaces available (1 inside bldg. and 1 outside for patients). If interested, please contact Sarah Pillsbury by email, firstname.lastname@example.org or by telephone at (202) 904-7510. Photos are available. Thank you.
Available for immediate long term, full time sublease, a large sunny office in our suite of five, and are hoping to find a psychodynamically oriented colleague join us. We’re located in the West End neighborhood of DC, convenient to the blue/orange and red lines of Metro, downtown, GW and Georgetown. Our suite is in a medical building with easy after hours and Saturday access. Please contact any of us for more information: Becky Bailey, email@example.com ~ Bill Pinney, firstname.lastname@example.org ~ Lucy Pugh, email@example.com ~ Steve Van Wagoner, firstname.lastname@example.org.
Consultation Group for Group Therapists. This group is a combination of case presentations, process group, the business side of group, and journal readings/discussion. This is the group for you if you lead groups or want to start a group. Our goal is to gain first-hand insight into group dynamics allowing us to be more secure and effective in our own groups. Cases presented in the supervision group are worked with by association through the parts that are stimulated in the group members. This parallel material is then used to gain insight into what has taken place in the case presented and to inform future work with the group. The group meets biweekly at 1801 Connecticut Ave NW, on Fridays, 9 – 11 am. Contact Rob Williams for information: (202) 455-5546, email@example.com, or this http://aida-therapy.com/aida/group-therapists/.
Supervision Group Opening starting in January: Looking for seasoned therapist to join our group. Supervised by Michael Wannon, the group meets alternate Wednesdays, 11:45 am-1:15 pm in Chevy Chase at Michael’s office. Couples and Individual cases are all welcome. Send an email with any questions to: firstname.lastname@example.org or email@example.com.
Groups for Area Clinicians Facilitated by: Trish Cleary & Ginger Sullivan – Process Group for Therapists: experiential opportunity to grow in relational awareness, self-reflection, and expressive connection. For more information: https://bit.ly/2NCe2J0 ~ Supervision/Case-Consultation Group: provides a confidential setting to explore clinical cases. For more information: http://bit.ly/2N1VUZC.
Tybe Diamond, firstname.lastname@example.org, has openings in two mixed, interpersonal, experiential groups. A pre-group evaluation is necessary to determine a good mutual fit. Tybe is happy to discuss any referral in more detail to help you determine the appropriateness of group therapy for your client. Individuals can also self-refer. Please forward this announcement to any interested client or colleague.
Space for men and women age 30 – 65 in a long term interpersonal group from 7-8:15 pm on Tuesday in upper NW DC. Group members are high functioning, creative professionals, who are motivated and seek personal and professional growth. Group interactions are processed in real time with a focus on relational development, interpersonal dynamics, self-reflection and self-awareness.
A second, women’s group (age 28 – 60) is starting at the end of September and meets from 6:30 – 7: 45 pm though the time of the group will be determined based on the possible times for members. High functioning women will be included in this interpersonal, process group where the focus is on relational development, interpersonal dynamics, self-reflection and self-awareness.