Treating Borderline States in Marriage

Treating Borderline States in Marriage: Dealing with Oppositionalism, Ruthless Aggression, and Severe Resistance

 

Personality disordered couples often seem impervious to change, leaving even the most skillful therapist frustrated, entangled, and at wit’ send. Unable to tolerate their fear and pain, these couples reactively act out and engage in ruthless personal attacks agains self, spouse, and therapist. Charles McCormack has constructed a new therapeutic approach to work with the acting-out primitive defenses, and undifferentiated dyadic relationships characteristic of these troubled and troublesome couples. In therapy, the underlying dynamics and motivations of such provocative behavior are brought to awareness, as the therapist allows himself to identify with his own primitive self. McCormack describes this process with detailed clinical vignettes of both the verbal exchanges of the couple and the therapist’s inner experience. Entering the relationship with the couple via the countertransference enables the therapist to understand both partners from the inside out, and to offer the necessary attuned responsiveness. Creating a holding environment, and engaging in separate dyadic exchanges in which the therapist interacts sequentially with each individual, are just some of the techniques offered in this unique and valuable book that will enhance the capacities of every therapist.

 

Seeing Red

Fictional psychoanalyst, Sandra Krasnapol, navigates an initial interview. Follow along as she uses her analytic skill and countertransference to establish a working relationship with a tricky client.

This piece was originally published in Constellations: a Journal of Poetry and Fiction  Synthesis (Volume 10, Fall 2020)

 

Review
“Reading Susan’s writing is an exercise in savoring – you relish the experience and don’t want it to end! Thankfully, she is prolific, offering gripping stories and complex journeys, all with the psychological depth befitting a psychoanalyst.”

Andrea Celenza, PhD.
Training and Supervising Analyst, Boston Psychoanalytic Institute and Society;
Faculty, Massachusetts Institute for Psychoanalysis;
Assistant Clinical Professor, Harvard Medical School.

Interpreting the Countertransference

Interpreting the Countertransference organizes the varieties of listener (therapist) responsiveness along a developmental axis of human relatedness possibilities. He offers fresh alternatives to long-standing problems of countertransference responsiveness and provides specific ways for the professional listener to being systematically considering his or her emotional reactions to clients.

Hedges defines a paradigm shift of major proportions that characterizes psychoanalytic thought in the last two decades. A key idea among the rich offerings this book provides is that intense, persistent, and troubling listener-responsiveness can be considered as originating from a preverbal symbiotic level of relatedness expression that belongs to the speaker’s early life history. Through nonverbal emotional relatedness, the speaker in analysis communicates to his or her listener what Christopher Bollas has called “the unthought known.” It is the listener’s task to perceive and to being the joint process of articulating crucial formative and enduring patterns of experience from the speaker’s infantile past. In this undertaking the countertransference is shown by Hedges to be a key informer.

Hedges maintains that knowing how to interpret the countertransference is a critical new skill required for understanding all intense emotional relationships, especially those encountered in psychotherapy and psychoanalysis.

Reviews

“Hedges clearly and beautifully delineates the components and forms of countertransferences and explicates the techniques of carefully proffered countertransference-informed interventions. This significant paradigmatic shift is that countertransference and relatedness replace the older medical model of objectivity. Thus, the patient, now the ‘experiencing speaker,’ and the analyst, now the ‘experiencing listener,’ are inextricably bound together as a pair. The analyst’s countertransference is the quintessence of that experience and a most valuable contribution to the outcome for the treatment. Another paradigmatic shift is his view that all countertransferences, no matter how much they belong to the analyst, are unconsciously evoked by the patient who avails himself of the analyst’s real personality attributes in order to live out unconscious scenarios.”

James Grotstein, M.D.

“By shifting focus to process, forms of relatedness, patterns of engagement, and modes of exchange, Dr. Hedges captures and helps create a major new therapeutic paradigm. He systematically demonstrates how the therapist-listener can make use of his/her own feelings to understand the speaker and help the speaker see and ultimately change lifelong forms of relatedness. This exciting new consciousness extends what has gone before and is supported by a plethora of fascinatingly presented case material.”

Charles Coverdale, Ph.D.

“This book is more than a textbook. It is a powerful means for the psychotherapist to move himself into the world of the patient and to be committed to eternal learning.”

Rudolf Ekstein, Ph.D.

“In his book, Interpreting the Countertransference, Dr. Hedges extends the current understanding of countertransference into a new dimension. He accomplishes far more than that. He challenges the ‘well doctor-sick patient’ assumptions of current psychotherapy practice, and with a combination of passion and scholarly brilliance guides the reader through the most creative thinking of our time and into a new ‘self and other’ paradigm for doing psychotherapy.”

Virginia Wink Hilton, Ph.D.

Psychoanalytic Clinical Practice

In his fifteenth book, this well known author and international lecturer sums up his 45 years of psychoanalytic clinical practice in a series of chapters demonstrating his procedures and therapeutic style with the types of patients most frequently seen in the offices of mental health professionals today. All aspects of psychoanalysis and psychodynamic therapy are illustrated. Detailed cases are presented of narcissistic personalities, eating, psychosomatic, schizophrenic and schizoid, borderline and other personality disorders. The author also focuses on the therapist’s countertransference, including a chapter on his ongoing self-analysis, a dramatization of the countertransference dangers that arise in the treatment of borderline patients, and a discussion of impasses and failures in psychoanalytic treatment. The introductory chapters outline his views about what is psychoanalysis and intensive psychotherapy. His five channel approach to psychoanalytic listening and the language of interpretation is illustrated in the case presentations. This book will have an immediate practical appeal to all mental health practitioners hoping to improve their psychotherapeutic skills and to better understand the difficulties and pitfalls involved in psychoanalytic therapy.

Psychotherapy with Borderline Patients: An Overview

The main question raised in the literature on intensive psychotherapy with borderline conditions is whether borderline patients can be treated by psychoanalysis or whether they require some form of psychotherapy. Intimately linked with this question is the delimitation of what is psychoanalysis and what is not. (45 pp.)

Psychotherapeutic Moments: Putting the Words to Music

PSYCHOTHERAPEUTIC MOMENTS offers the reader a glimpse of what takes place in the office of a psychoanalyst who, although trained in the tradition of maintaining neutrality and striving always to keep the countertransference at bay, has evolved over the course of the decades into a much wiser, much more accessible, much more generous, and, ultimately, much more humane participant in both the ongoing healing process and those watershed moments that will inevitably emerge when two people deliver themselves, heart and soul, into the intimate space between them. (149 pp.)

Reviews

“Dr. Stark brilliantly describes the psychoanalytic process moment-to-moment in real time, as we sit with our patients. This gives the learning a personal depth hardly to be found in the field. Martha pays equal attention to internal healing by the patient and internal healing by the analyst (or dynamic therapist). This provides a huge release for people in our field. It becomes a source of profound optimism for practitioners at every level. Martha’s approach to depth learning is a truly optimistic antidote to compassion fatigue and therapeutic burnout. And it initiates a turning point to the future of our field, indicating how teaching psychoanalysts will look and feel in the coming decades.”

—Jack Danielian Ph.D., San Antonio, TX

“Many years ago, Dr. Stark inspired me to shift my psychotherapy focus towards psychoanalytic psychotherapy and, ultimately, towards training in psychoanalysis. Her classes and individual supervision made the field of psychoanalysis alive for me. Dr. Stark is a profoundly generous, insightful, and intelligent teacher and mentor. My psychotherapy practice would not be as rich and rewarding without her influence.”

—Carolyn Stack Psy.D., Cambridge, MA

“I want to express my appreciation for the extraordinary learning experience that Dr. Stark’s course has afforded me. It has had a profoundly transformative effect on both my way of working clinically and my understanding of the complex territory of analytic though. I am truly grateful for this exquisite experience.”

—Laurie Scheck, Pittsburgh, PA

“You are a rock star, Martha! Thank you from the bottom of my heart!”

—Jennifer Edwards Psy.D., Norfolk, MA

“I registered for Martha’s course because I am aware of the originality and depth of her theoretical—and practical—approaches to psychoanalytic psychotherapy. I saw this as an excellent opportunity to consolidate and extend my knowledge of her models.”

—Bruce Thompson Ph.D., Providence, RI