Psychotherapy stirs up new awareness and challenges existing beliefs. I find this stirring-up enlivening and exciting. Teaching provides a means to realize what I do not know, and a means to continue learning. Through teaching, I share my excitement in the process of thinking and feeling, enriching my work, and learning from students. In this way my work is fresh and enlivening.

RECENT CLASSES:

  • Introduction to Psychodynamic Thinking
  • The Use of the Frame in Psychodynamic Psychotherapy
  • Projective Identification: Communication and Defense
  • Symbolic Function
  • Bion: Attacks on Linking

September - December, 2017

Psychodynamic Perspective on The Body, Sexuality and Technology

Location: 47 Marchwood Rd., Suite 1E, Exton, PA 19341
4 sessions - 10 CE hours

Co-sponsored by the Pennsylvania Society for Clinical Social Work and the Philadelphia Psychotherapy Study Center, an affiliate chapter of the International Psychotherapy Institute, Washington, DC

COURSE DESCRIPTION:

This seminar will be structured around the careful reading and study of four papers by Alessandra Lemma about the development of an embodied identity, and the effects of technology, body piercings and transsexuality on developmental processes.

The body is the primary experience of self-representation, rooting the ego in bodily experiences and sensations. From this primary root, the development of the mind and the self takes hold. Using attachment theory and object relations, Lemma considers the psychological experience of embodiment, and its role in the development of the mind. In her work with adolescents, Lemma considers the wider social context for adolescent sexuality, particularly the effects of the internet, and the "black mirror" of the computer, its plasticity and immediacy as a mirror to portray and project a phantasy of the "perfect" body. She offers an alternative model, based in attachment theory, to aid the therapist to "see" and understand the psychic experience of body identity, self , body piercings and transsexuality.

Lemma's detailed and compelling accounts of her clinical sessions with patients illustrate her discoveries of the body as the medium of exchange between herself and her patients. The transference and countertransference, then, are used as essential sources for understanding the patient's state of mind. The therapist's countertransference provides clues leading to the discovery of traumatic experiences disruptive to the developmental process, and inscribed in the body, but not yet represented in the mind.

In addition to lecture and discussion of the readings, participants will be invited to share relevant case material for illustration and elaboration of the themes we will be studying.

 

COURSE OBJECTIVES:

    1) Discuss and elaborate the impact of technology on the experience of embodiment, specifically on the development of sexuality during adolescence in the digital age.

    2) Explicate the unconscious dynamics and phantasies driving people to compulsively modify their bodies through piercings and tattoos.

    3) Define and apply a developmental model rooted in attachment theory and object relations theory as an alternative way of understanding transsexuality.

    4) Through the discussion of shared case material, participants will further discuss and elaborate the themes and concepts being studied.


COURSE OUTLINE AND SYLLABUS:
    1) Lemma, A. 2010. An Order of Pure Decision: Growing up in a Virtual World and the Adolescent's Experience of Being-In-A-Body; Journal of the American Psychoanalytic Association, 58 (4): 691-714. ( have a pdf of this one)

    2) Lemma, A. 2017. The black mirror: Becoming sexual in the digital age; from "The Digital Age On the Couch: Psychoanalytic Practice and New Media", Routledge, NY.

    3) Lemma, A. 2010. "Ink, holes and scars"; in "Under the Skin: A Psychoanalytic Study of Body Modification", Routledge, NY.

    4) Lemma, A. (2013). The Body One has and the Body One is: Understanding the Transsexual's Need to be Seen. Int. J. Psycho-Anal., 94(2):277-292.

Dates:

Saturday September 23, 2017
Saturday October 28, 2017
Saturday November 18, 2017
Saturday December 16, 2017

Times:
9:00 – 11:30 am

Location:
47 Marchwood Rd, suite 1E
Exton, Pa. 19341

Cost: $210.00

 

CE CREDIT:

For Pennsylvania Social Workers, Marriage and Family Therapists, and Professional Counselors, this program is approved for credit for professional workshops sponsored by the Pennsylvania Society for Clinical Social Work, a state affiliate of the Clinical Social Work Association listed in Section 47.36 of Title 49, Chapter 47 of the PA Code, State Board of Social Work Examiners. This program is also approved for credit for professional workshops for marriage and family therapists (Section 48.36) and professional counselors (Section 49.36).

For New Jersey Social Workers: This program is approved for credit. Programs approved for credit by boards that license social workers in other states are a valid source of continuing education credit (N.J.A.C. 13:449-6.4(c)).

For psychologists: The International Psychotherapy Institute (IPI) is approved by the American Psychological Association to offer continuing education for psychologists. IPI maintains responsibility for the program.

Karen Fraley, MSS, LCSW, BCD, is in private practice in Exton, PA, providing psychoanalytic psychotherapy to individuals and couples, and clinical supervision to therapists. She holds certification in Object Relations Therapy from the International Psychotherapy Institute (IPI) in Washington, DC. She is also an active faculty member at IPI and a founding member of the Philadelphia Psychotherapy Study Center. She is a Fellow member of the Pennsylvania Society for Clinical Social Work.

For more information contact: Karen Fraley at (610) 952-0435 or kfraley55@icloud.com.

GROWING PAINS AND THE USE OF THE OBJECT: A CONTEMPORARY READING OF D. W. WINNICOTT

COURSE DESCRIPTION:

This seminar will be structured around the careful reading and study of 4 of D.W. Winnicott's enduring and useful papers, and 4 papers by Thomas Ogden about his reading of the Winnicott's papers. The course will be designed both to introduce Winnicott's ideas and theories to those who are unacquainted with his contributions as well as to deepen the understanding of those who are already familiar with his work.

A major focus of the seminar will be to explicate and illustrate the ways in which Winnicott's ideas are manifest and useful in the clinical encounter. In addition to lecture and discussion of the readings, participants will be invited to share relevant case material for illustration and elaboration.

Retreat and Emergence: The Work of John Steiner

COURSE DESCRIPTION:

This seminar will be structured around the reading and the study of two books by John Steiner: Psychic Retreats (1993) and Seeing and Being Seen: Emerging from a Psychic Retreat (2011).
In these books Steiner describes the psychic retreat as a psychic structure -- that is, a highly-organized set of interlocking defenses geared toward alleviating what are felt to be unbearable anxieties and toward protecting the patient from the catastrophic persecution, fragmentation, and depression that are feared will follow if those defenses are given up. He illustrates how primitive feelings of shame, humiliation, and narcissistic injury arise as the defenses of the psychic retreat begin to shift, and he emphasizes the importance of mourning in facilitating emergence from the retreat.
In addition to lecture and discussion of the readings, participants will be invited to share relevant case material for illustration and discussion.

 

OVERCOMING TRAUMA: THE WORK OF BESSEL VAN DER KOLK

COURSE DESCRIPTION:

This seminar will be structured around the careful reading and study of Bessel van der Kolk's recent book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. In this book Dr. van der Kolk describes how recent advances in neuroscience have increased and sharpened our understanding of the ways in which trauma not only affects but leaves a palpable imprint on the brain, the mind, and the body of the victim. His book provides a comprehensive approach to the treatment of trauma victims that integrates traditional talk therapy with psychopharmacology, body therapies, and EMDR.

We will augment the chapters in The Body Keeps the Score that deal with treating victims of childhood abuse with selected chapters from two other books: Soul Murder: the Effects of Childhood Abuse and Deprivation, by Leonard Shengold; and, Treating the Adult Survivor of Childhood Sexual Abuse, by Jody Messler Davies and Mary Gail Frawley.

In addition to lecture and discussion of the readings, participants will be invited to share relative case material for illustration and discussion.

 

The "I" of the Hawk: One Woman's Journey of Mourning, Dreaming and Self-Discovery

COURSE DESCRIPTION:

This seminar will be structured around the reading and the study of Helen Macdonald's recent memoir, H Is For Hawk. In that book, Macdonald chronicles her coming to terms with the sudden death of her father. An experienced and life-long falconer, she decides, in the aftermath of his death, to train, for the first time, a goshawk. As a part of that endeavor, she studies T.H. White's account of his attempt to train a goshawk decades before. Macdonald also explores and describes how White's abusive childhood impacted both his life and his finally failed attempt to train his hawk, and she contemplates and contrasts his story as a shadowy subtext to her own.

We will augment our study of Helen Macdonald's book with selected papers on mourning, dreaming, and the mid-life passage by Freud, Thomas Ogden, Elliott Jaques, Otto Kernberg, and Jay Greenberg.

In addition to lecture and discussion of the readings, participants will be invited to share relevant case material for illustration and elaboration of the themes we will be studying.

 

Psychodynamic Understanding of Trauma and Its Aftermath

COURSE DESCRIPTION:

This seminar will be structured around a careful reading and discussion of the book, Understanding Trauma, edited by Caroline Garland. The primary focus of each of the chapters in this book is to explicate the many and complex ways in which traumatic events are experienced by -- and interpreted by -- each particular individual according to the structure and nature of his or her internal world. We will consider modes of treatment and choices of interventions that might best facilitate the integration of the traumatic event into an overall narrative or view of the individual's self and life. We will also consider therapeutic strategies for engaging trauma-related themes such as identification with the aggressor, difficulties in symbolizing the traumatic experience, grievance and the wish for justice, restitution and/or revenge, mourning for the lost, pre-trauma self, and the symbolic repetition of the traumatic event in the transference/countertransference.

Reason, Passion, and Freedom of Thought: the Work and the Legacy of Hanna Segal

COURSE DESCRIPTION:

In this seminar we will read and study some of the major papers by Hanna Segal, who was one of the most influential psychoanalytic thinkers of the twentieth century. In studying these papers we will follow Segal's careful and concise explication of the work of Melanie Klein as well as her own expansion and elaboration of Klein's ideas. We will give particular attention to the many ways in which Segal links Kleinian theory to the clinical situation and how Kleinian concepts can be useful in guiding and structuring our interventions and interpretations.

In the course of our discussions participants will be invited to share clinical material to highlight and illustrate the concepts and ideas we will be studying.

Going to Extremes: Ethical Perspectives on Unusual Interventions

COURSE DESCRIPTION:

This seminar will be structured around the careful reading and study of Salman Akhtar's recent book, Unusual Interventions: Alterations in the Frame, Method, and Relationship in Psychotherapy and Psychoanalysis.

Each of the nine contributors to this volume present their views on a particular unusual or unorthodox intervention. We will study each of these contributions and consider the ethical issues and dilemmas that the use of these interventions contain and imply. We will not so much judge each unusual intervention as being right or wrong as much as we will seek to establish guidelines for ourselves when we consider such interventions, in order to help us to distinguish when those interventions might indeed be useful to our patients and clients and when they might reflect countertransference reactions and/or may further contribute to enactments that might be better handled by means of containment and symbolization.

We will also consider how to listen for our patients' unconscious, symbolic commentary on our interventions--both usual and unusual--in their material following an intervention as a way to help us to determined how our interventions have been received.

Work, Play, and Paradox: The Enduring Legacy of D.W.Winnicott, CE seminar.

COURSE DESCRIPTION:

This seminar will be structured around the careful reading and study of 15 of Winnicott's most lasting and useful papers. The seminar is designed both to introduce Winnicott's ideas and theories to those who are unfamiliar with his work and to deepen the understanding of those already familiar with his contributions. A major focus of the course will be to explicate and illustrate the ways in Which Winnicott's ideas are manifest and applicable in the clinical situation.

In addition to lecture and discussion of the readings, participants will be invited to share relevant case material for illustration and elaboration.

Seeing It Through: Essential Elements for Establishing, Protecting and Sustaining Psychodynamic Psychotherapy, CE seminar.

This seminar will focus on the clinical and technical issues involved in establishing the conditions and parameters necessary for a dynamic psychotherapy to come to life and to grow and develop. We will also consider the ways in which therapy founder or come to impasse when those conditions and parameters are not properly established and/or sustained. We will give particular attention to engaging situations where patients are about to terminate treatment prematurely or precipitously.

The seminar will be structured around a careful reading of Salman Akhtar's book, Turning Points in Dynamic Psychotherapy, as well as several chapters from Herbert Strean's book, Don't Lose Your Patients!: Responding to Patients Who Want to Quit Treatment.

Suffering and Sacrifice in the Therapeutic Encounter

The Scapegoat

The "scape- goat"- term comes from an ancient ritual of sacrifice and cleansing, in which two goats were chosen as sacrificial victims. One goat carried the sins for the group and was sent off into the wilderness to survive on its own. The other goat, pure and innocent, was sacrificed to the god or gods, in order to ensure the safety and goodness of the group. The goat sent off into the wilderness was the "escape- goat", the origin of the word "scapegoat". This goat carried the pain and suffering of the group, so that the group could live in harmony and peace together. Although we no longer practice animal sacrifices, we continue to think that we can banish unacceptable feelings, such as hate or anger. The scape-goat part of the self is banished to the wilderness, never to be seen or heard from again. Psychologically, this sacrifice is an act of denial of the part of the self deemed as un-acceptable to others.

  • A client said: "I felt like the scarecrow in the Wizard of Oz- stuffed full of straw with no back-bone. I did everything my husband wanted to try to please him so he would not be angry anymore."
  • Depression and anxiety can result from taking care of others through sacrificing ourselves.
  • Women often say they have to be perfect in order to be loved. Or, they can only be happy if the people they love are happy first.
  • These strategies are part of a security program designed to protect our loving relationships from conflict.
  • The downside of this strategy is a loss of self agency.
  • The Merriam-Webster dictionary defines "agency" as "the capacity, condition, or state of acting or exerting power".
  • A client said: "My life is dictated by others, not by me. I have to do what others want me to do".
  • Psychotherapy is the process of re-claiming and re-storing self agency and self authority.
  • A client said: "My car is a mess, and I cleaned it out. I thought, I am in this car everyday and I do not take care of it. I realized I do not take care of myself."
  • This woman is empowering herself to take action on her own behalf. This act of self agency will in turn benefit those she loves.