May 2019 Newsletter – Full Text Version

by Rosemary Segalla

It has been an exciting quarter century at ICP+P. The ongoing richness of spirit among our members is exactly what Joe Lichtenberg and I were hoping for when we launched this new Institute in 1994.

From the beginning, with the very important help of our founding members, our organization flourished. Without their lively enthusiasm, we would not be celebrating our twenty-fifth year! As an organization, we are indebted to these founding members. A very special thank you to them!

These comments bring me to some thoughts that have been emerging over the past several years. My big concern is that our beloved organization may be losing touch with its original purpose, to create a non-hierarchical organization that encourages all members to flourish personally and professionally.

What has prompted this concern for the health and longevity of ICP+P? The answer is very simple; we seem to have lost some of our original vigor characterized by a willingness to take a leadership role in the organization. We have had trouble filling the Director position, and some other positions as well. I want to be clear — the people who are in leadership positions have taken on their roles willingly, and are doing a wonderful job!

As a mental health professional, I have always felt that these roles are an important part of who we are as members of a noble profession. Not only do they create environments that aid us in obtaining our continuing education requirements and keep us current with advances in our field,  but they also offer a true community of caring colleagues who sustain us in our ongoing work.

To do all of this, we need men and women who are willing to step up and rise to the challenge of keeping ICP+P vital. It is only with your help that we can continue to flourish. We have attempted to structure our organization in a way that does not burden one person. We are also very grateful to have an outstanding administrator, Nancy Der, who is instrumental in keeping ICP+P on course.

Please, think about your participation in ICP+P, and consider taking a role that will help us to continue to grow. I checked a dictionary for a definition of a volunteer. Here is what I found, “a volunteer is a person who freely offers to take part in an enterprise or undertake a task.” Please consider giving freely to ICP+P!

I would like to again thank all the members who over our twenty-five year history have done so much and continue to do so much to keep ICP+P alive and growing!

Rosemary Segalla co-founded ICP+P, with Joe Lichtenberg, in 1994. She served as director, and has continued to serve generously in various roles including ongoing co-chair of the Ethics Committee, leader of groups, trainer of group leaders, organizer of conferences, and consultant to those in leadership roles.

by Shoshana Ringel

Mauricio Cortina, one of our own ICP+P members, has been named the recipient of the Bowlby/Ainsworth 2019 award for his contributions to attachment theory and research, especially in the area of attachment, evolutionary psychology, and intersubjectivity. This is a highly prestigious award that, over the years, has included luminaries such as Mary Main, Alan Sroufe, Peter Fonagy, Mary Bretherton and many other distinguished attachment researchers. Over his career, Mauricio has published four books (one in process), eight chapters, and numerous papers and essays, several of them with his friend and collaborator Giovanni Liotti, who passed away last year. It is beyond the scope of this article to describe all of Mauricio’s accomplishments, his mentoring of South American colleagues, and his leadership at the attachment center in the Washington School of Psychiatry. I have chosen to focus here only on a number of contributions to the attachment field and to clinical practice. Unlike many other recipients of the award, Mauricio is a clinician-scholar, not a researcher, and has contributed to integrating attachment theory, evolutionary psychology, neuroscience, and intersubjective concepts with the clinical process. On the personal level, Mauricio has always been a supportive and encouraging presence in my own quest to deepen my knowledge of attachment theory, and in my work using the AAI to examine patterns of unresolved loss.

Mauricio’s work has contributed to enhancing the range and complexity of Bowlby’s attachment theory, which is based on evolutionary, developmental, and clinical factors.  Like Bowlby, Mauricio has sought to expand attachment theory across disciplines, utilizing evolutionary psychology and neuroscience to expand our knowledge of multi-motivational systems and their impact on human development and communal behaviors.  Mauricio’s motivational theory examines additional motivational systems that inform our human species.  In this work, Mauricio collaborated with his close friend and associate, Giovanni Liotti, and their work both influenced and was inspired by Joe Lichtenberg’s theory of motivational systems, which includes physiological regulation, attachment, sexuality/sensuality, exploration, and aversive motivational systems, later adding caregiving and affiliative motivational systems.  Lichtenberg and colleagues’ expansion of their motivational theory to caregiving and affiliative systems was actually related to Cortina and Liotti’s earlier work.  As well, Mauricio also collaborated with the analyst Mario Marrone on several publications.

Cortina’s motivational systems theory includes three levels. The first is associated with the reptilian brain, and includes systems of physiological regulation, defense of a non-social type (e.g., fight/flight/freeze response), exploration of the environment (not linked to use of attachment as a secure base), and sexual reproduction (not involving pair bonding). The second level is associated with the Mammalian brain, and includes the attachment system, the caregiving system, the competitive/ranking system, the egalitarian/cooperative system, and the sexual-mating system.  The third and most advanced level is associated with the prefrontal cortex and includes the intersubjective meaning system.

In their motivational theory, Liotti and Cortina expand on a more complex attachment/relational system, building on motivational theories previously proposed by Lichtenberg and others, and focusing on conceptualizing altruism, communication, cultural affiliation, the need for validation, and other communal aspects of motivational systems.  They included competitiveness as a primary and intrinsic motivation, based on the desire for power, control, and domination as a prevalent factor in human societies and relationships. This perspective on motivation has immediate clinical application. When attachment-related trauma precludes creating a secure base for exploration in therapy (as the attachment relationship in therapy automatically activates trauma) we have other prosocial motivations for developing intersubjective cooperation and sharing by focusing on other techniques that do not focus on a care-seeking attachment system. Instead we can focus on a variety of somatic and affect-regulating strategies as equals (a twinship relation, in self psychology’s terms) where we can begin to develop trust and modes of interaction that don’t prematurely activate the attachment system.

This insight came from the Liotti-Cortina collaboration that deepened the inquiry into our understanding of the complexity of intersubjectivity, starting from the mother/infant communication system of shared affects, gestures and vocalization, to later exploration of material and interpersonal work, and finally through language and symbolic capacities and imagination.

In findings that are very relevant to our times, Cortina and Liotti highlight the motivational pull towards cooperation emerging from the evolutionary need for physical survival, and later used to facilitate the transmission of information and other types of communication in human societies.  These skills are so urgently needed right now in order to protect our global environment and work cooperatively to heal political and social ruptures in our national and international realms.  In Mauricio’s own words regarding the new book he is working on, The Cooperative Mind: How Prosocial Motivations, Shared Social Norms and Perspective-Taking Abilities Made Us Human, he states: 

The main thesis of the book is based on multidisciplinary work done in the last 30 years that is radically changing our views of human evolution and human nature. Climate change that took place two plus million years ago (the Ice ages) affected East and South Africa, the cradle of humanity, producing fluctuating weather conditions with severe droughts and monsoons. This forced our hominin ancestors to become highly adaptive species in order to survive in these new environments such as the African Savannah. The main strategy that our ancestor species used to survive was to cooperate in sharing resources and protect each other among small groups of nomadic hunter-gatherers. This put strong selective pressures in developing prosocial instincts, shared norms supporting cooperation, and the ability to “read” the minds of others based on perspective-taking abilities.  Very prolonged childhoods, a system of cooperative care (it takes a village) and long term pair bonding (“monogamy”) were the other key adaptions that supported cooperation. These adaptations and abilities paved the way to develop language and symbolic capacities approximately 1.9 million years later and create cultural environments in which we live.

We share with mammals and some species or birds attachment instincts for protection and care. The new social instincts that developed among our human ancestor species were strong affiliative bonds to groups, our ability to identity with them and use them as a secure base for foraging and exploration. From an evolutionary and motivational point of view, this is what made us human.  For better or worse we are tribal animals. It is much easier to cooperate with people who are “like us” and much harder to cooperate with people who are not perceived as being “like us”. This a key strength and vulnerability of our species.

Aside from the enormous importance of understanding human nature for psychoanalysis and the social sciences, there are two other main reasons for writing this book. Our new understanding of our tribal origins helps us understand why in-group cooperation and solidarity can easily turn into out-group hostility. The result is an “us versus them” mentality that we are witnessing all over the world. Their aim of these movements is to divide us for short term social and political gains. The second message that comes out of this new understanding of human nature is that if we are to survive the catastrophic effects of human-made climate change, we have to move beyond (not renounce) our tribal and national identities, and identify with humanity as a whole to create a common ground for cooperation.  The climate crisis is not only a clear and present danger for our species (and other species as well), it is also providing this opportunity to develop a common ground that can unite us.

In summary, Mauricio Cortina’s work in attachment theory, evolutionary development, and intersubjectivity is always informed by his clinical engagement with patients and, unlike many other attachment researchers, his concepts are rooted in direct practice and in lived clinical knowledge.  By integrating research, theory, and clinical practice he has made a significant contribution to our field.

Shoshana Ringel is an analyst in private practice in Columbia, MD and is an associate professor at the University of Maryland, Baltimore. She is also a graduate of ICP+P’s psychoanalytic training program.

by Leslie F. Smith

Each year, ICP+P conducts training for our faculty to assist them in growing and learning for themselves and our students. This year’s faculty workshops focused on Gender and Sexuality. In the fall, Jonathan Stillerman and Jennifer Unterberg led a workshop entitled “The Expanding Universe: Modern Perspectives on Gender and Sexuality in the Therapeutic Encounter”. They contrasted traditional and modern psychoanalytic perspectives on sexuality and gender and presented clinical examples from their own work. They invited us to begin to identify our own assumptions and feelings about diverse expressions of gender and sexuality. Their presentation provoked rich discussion and group members voiced interest in finding ways to keep exploring the subjects.

This prompted a follow-up workshop in the spring, “Reflecting on Gender; Exploring our Countertransference Reactions to Trans and Gender Fluidity” that I facilitated. We addressed the idea that in our work, we are so accustomed to accepting uncertainty and ambiguity, but when it comes to gender, there continues to be a strong urge to categorize. Male or female? Through clinical vignettes, small group process and discussions, the workshop focused on creating a safe space to recognize and explore our own reactions to non-binary gender expressions. As a faculty, we are attempting to prepare ourselves to be more open to diverse expressions of gender in our patients, our students, our supervisees and ourselves.

Leslie F. Smith is the Co-Coordinator of Faculty Training and on the faculty of the Psychoanalytic and CAPP Training Programs.

by Michael Wannon

Many experienced therapists feel energized to engage in couples therapy. Yet as time passes, they often feel overwhelmed or “stuck.” Those trained and familiar with couples’ work know this phenomenon all too well. As the couple’s issues around communication, sex, trauma, affairs, rage and hopelessness unfold in the therapist’s office, the work can feel taxing and overwhelming, often deskilling the most seasoned therapist.

ICP+P’s Couples Therapy Training Program is focused on training that integrates psychodynamic theory and specific clinical skills so that clinicians can feel effective in therapeutically addressing the challenges of this work. The program consists of weekly meetings where the writings of leading couples therapists are discussed. Senior clinicians lead and enhance the discussion, as well as provide weekly group supervision on active couples cases. Participants and graduates of the program belong to a community with regular professional and social events. Many graduates of the program continue to collaborate and work together on clinical cases long after the program is completed. The program is one academic year – but has become a professional home base for many of the graduates.

The Couples Therapy Training Program is a one-year course comprised of both theoretical seminars and clinical group supervision. The trainees learn the material through lectures, case write ups and presentations and group participation. The trainees meet together for 3 hours per week from September to May. The emphasis of the program is on the application of self-psychological and relational concepts applied to the clinical practice of treating couples.

If you are interested in learning more about the program and the possibility of becoming a member of the upcoming class, please contact the Chair of the program, Michael Wannon, PhD, menaw1@aol.com.

The program is designed for practicing clinicians, residents, interns, and advanced graduate students from mental health fields including psychology, psychiatry, social work, counseling, and nursing. The Fellowship gives participants a feel for the types of learning experiences available in ICP+P’s training programs and professional community.

To learn more about the topics, benefits, CEs, when and where the meetings are held, click here to go to our website.

Applications are being accepted now with a deadline of July 15th.

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The results are in and thank you to all the members who took the time to vote for the Board positions. Welcome to the incoming Board members:

Co-Secretaries: Avi Margolies and Raquel Willerman (shared position)
CE Chair: Michelle Levine

Your new Board members will begin their terms in May after they have had a meeting with the existing Board to facilitate a smooth transition. Our elections committee has reached out to new members and members who have been with the organization for many years to create an energetic and inspired Board to lead our organization for the next two years.

If you are interested in joining the Board in the future, please consider next year’s elections when the following positions will be open: Director, Associate Director of Administration, Associate Director of Member Relations (currently a shared position), Associate Director of Outreach and Publicity, Study Group Coordinator, and two Board Members At Large.

For those Board Members leaving, David Chen as CE Chair, and Michelle Levine who will be transitioning her position from Secretary to CE Chair, we truly appreciate all the work you have done in your roles on the Board of ICP+P!

ICP+P Nominations and Elections Committee

25th Annual Conference

Needed Relationships, The Forward Edge, and the Transformation of Traumatized States

with Steven Stern, PsyD

Saturday, May 4, 2019

Registration: 8:30-9am ● Program: 9am-4:30pm

National 4-H Conference Center

7100 Connecticut Avenue ● Chevy Chase, MD 20815

About the Conference:

Dr. Steven Stern will present his richly integrative clinical approach organized around the principle of co-creating needed relationships uniquely with each of our patients. His model is deeply rooted in self psychology and intersubjective systems theory, but is equally grounded in neighboring theories, including Winnicottian, Bionian and Relational theories, a non-linear dynamic systems perspective, and especially Louis Sander’s developmental process principles. At the center of Stern’s approach is the idea of “meeting the patient” – a process which, paradoxically, requires the full complexity of multiple psychoanalytic theories and frames of reference (vertices) in order to provide the “simply human” responses our patients need from us.

Dr. Stern will begin with an overview of the major elements of his model, interspersing theory with illustrative clinical material. He will then present an extended clinical example — a challenging case in which the nature of what was needed only emerged over a long period of time.

This conference aims to stimulate our capacity to develop, integrate and hold in mind a range of theoretical models while remaining open and curious to discover the unique path of growth for each of our patients.

In addition to the talk and clinical illustration by Dr. Stern, our format includes smaller discussion groups and members’ clinical vignettes for Dr. Stern’s and audience members’ commentary and discussion.

At the conclusion of the conference, attendees will be able to:

1. Apply the principles of co-creating needed analytic relationships with traumatized psychotherapy patients to their therapy practice.
2. Orient and respond to traumatized patients using a multi-theoretical, relationally-integrative framework.
3. Develop competence in the process of “meeting” traumatized patients in ways that are “fitted to” and transformative of their most traumatized states.
4. Apply an expanded, more fully relational understanding of the concept of “the forward edge” in work with developmentally traumatized patients.
5. Apply the concepts of “contouring” and “necessity” in work with relationally traumatized patients.
6. Respond to traumatized patients with greater freedom of both apprehension and expressiveness, exercised within a fundamentally empathic stance.

This conference is appropriate for mental health professionals at all levels of experience and offers 6 CEs.

Other 2019 ICP+P Training

• May 4, 2019, Annual Conference – Needed Relationships, The Forward Edge, and the Transformation of Traumatized States, with Steven Stern, PsyD, National 4-H Conference Center, Chevy Chase, MD, 9:00am-4:30pm, 6.0 CEs. Contact administrator@icpeast.org for questions. Walk in registration will be available the morning of the conference.
• June 2, 2019, ICP+P Training Graduation – Maggiano’s Little Italy Chevy Chase, 5333 Wisconsin Avenue, NW, Washington, DC, 11:00 am-2:00 pm.
• September 27, 2019, Pre-Conference – with Janna Sandmeyer, PhD with Mark Blechner, PhD as discussant. Dr. Sandmeyer will present her Ralph Roughton award winning paper, “Understanding Homophobia in our Forefathers: Rethinking How Kohut Actually Worked.” In this presentation, we will consider Kohut’s perspective on homosexuality, as well as grapple with ethical considerations in addressing the history of homophobia in psychoanalysis. Silver Spring Civic Building, 3:30-5:30 pm, 2 CEs. Fulfills LGBTQ/Diversity credit requirement.
• September 28, 2019, Conference – The Evolving Landscape of Gender and Sexuality: Clinical Implications Conference with Mark J. Blechner, PhD, Silver Spring Civic Building, 9:00am-12:30pm, 3 CEs. Dr. Blechner will discuss gender and sexual fluidity, and how attitudes and social norms about sexuality and gender identification have changed over the last 50 years. In his clinically focused presentation, Dr. Blechner will address how this has led to changes in psychotherapeutic aims and practices, and he will outline countertransference dilemmas and ways that clinicians can use them productively. Fulfills LGBTQ/Diversity credit requirement.
• December 7, 2019, Conference – with Anton H. Hart, PhD, Silver Spring Civic Building, 9:00am-12:30pm, 3 CEs. Fulfills Diversity credit requirement.

Laurie Paul will present The Elephant in the Room: Working with the Culturally-Different Client for the District of Columbia Psychological Association on May 17, 2019 at 10:00 am at The Chicago School of Professional Psychology in Washington DC.

Space

1. Three half days and one full week day available in beautifully furnished and spacious office suite in Dupont Circle neighborhood. Private waiting room, en suite bathroom, microwave and fridge. Steps from the red line train at both Dupont Circle exits. 24-hour doorman residential building, with offices on the first floor. In door and outdoor parking available at additional charge. Contact Sheila Cahill, sheilacahill@mac.com.
2. 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, pillsburysarah@gmail.com or by telephone at (202) 904-7510. Photos are available. Thank you.

Groups

1. Space available in a longterm, experiential process group of high functioning, creative professionals. The age range is from 30 – 56 at present. This group meets on Tuesday evenings from 7 – 8:20 pm. Most clients are in concurrent, individual psychotherapy with me or the referring therapist. Therapists have self-referred themselves for the group. Clients are motivated for increasing relational capacity and personal development. The focus of the group is interpersonal. I’d be happy to talk with you if you have questions about whether this group might fit your client’s needs. ~ Tybe A. Diamond, MSW, BCD | O: 202.966.1381 |M: 202. 213. 9871 | http://www.tybediamond.com | 5225 Connecticut Ave., NW, Ste. 214, Washington, DC 20008.
2. Opening in ongoing psychotherapy supervision group. From a broadly psychodynamic standpoint, our group focuses on the use of the therapist’s self in psychotherapy, while also paying attention to contextual and cultural factors surrounding the clinical work. Group members present cases on a rotating basis, and also serve as case consultants to other members. Group process will be used to illuminate the psychology of client, therapist, and their jointly created relationship, and also to clarify the therapeutic process itself. The group meets weekly on Tuesdays, 10:00–11:15 am in Friendship Heights. If interested, or have questions, please contact Barbara Wayne, (202) 363-0185, bhwayne@verizon.net or Cherian Verghese, (202) 296-2822, cverghese@mindspring.com.
3. Process Group for Therapists – This long-term experiential group promotes self-reflection and relational awareness needed for clinical insight and therapeutic expertise. Contact Trish Cleary for more information, trishcleary@comcast.net or
4. 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, rob.williams.msw@gmail.com, or this http://aida-therapy.com/aida/group-therapists/.