Stark’s newest book speaks not only to patients who are fundamentally schizoid (concealing their true self behind a self-protective facade) but also to patients who, in the moment, have psychically retreated because their heart has been so badly hurt. Recognizing and responding to the patient’s self-protective ego, the therapist will foster a therapeutic regression, thereby enabling the patient to relinquish denial of object need.
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Working with Resistance
Resistant patients are patients who have not been able to confront the reality of past and present losses, disappointments, and frustrations, who instead protect themselves from the pain of their grief by clinging to their defenses. The resistant patient is a defended patient within whom there is conflict between those healthy forces that press “yes” and those unhealthy counterforces that insist “no.” Such patients resit feeling what they know they should feel and doing what they know they should do.
Working with Resistance integrates concepts drawn from classical psychoanalysis, self psychology, and object relations theory and presents a contemporary theory of therapeutic action that takes into consideration structural conflict, structural deficit, and relational conflict—all of which ultimately both fuel the patient’s progress in the treatment and oppose the patient’s movement toward health and the realization of his potential.
As part of the work to be done, patient and therapist must be able to understand and name, in a profoundly respectful fashion, both sets of forces—those healthy ones that impel the patient in the direction of progress and those unhealthy resistive ones that impede such progress. Before the defenses can be relinquished and the resistances overcome, the patient must come to appreciate his investment in the defenses, how they serve him, and the price he pays for holding on to them.
Martha Stark has always been interested in exploring the relationship between theory and practice—the ways in which theoretical constructs can be translated into the clinical situation. To that end, she proposes specific interventions for each step of the process by which the defenses are worked through and the resistances are rendered less necessary. conflict statements, for example, are empathic interventions that highlight the conflict within the patient between his knowledge of reality, informed by the present, and his experience of reality, informed by the past. It is the internal tension created through the patient’s awareness of that discrepancy that will provide, ultimately, the impetus for change.
Within the context of the safety provided by the relationship with his therapist, the patient will finally be able to feel the pain against which he has spent a lifetime defending himself. As he begins to confront the reality of the parental limitations, he begins to let go of the defenses around which the resistance has organized itself—he lets go of the past, lets go of the relentless pursuit of infantile gratification, and lets go of compulsive repetitions. Only as the patient grieves, doing now what he could not possibly do as a child, will he get better. (765 pgs).
Reviews
“Dr. Martha Stake is a phenomenon. Her courses in post-graduate education are legend, rivaling in popularity those of the venerable Boston institutions. Now, with this volume, she distills her teachings into an accessible and lively dialogue that captures her inimitable style. Drawing on classical, self psychological, and object relations theories, Dr. Stark’s clinical synthesis broadly defines resistance as those myriad forces that interfere with one’s movement toward health. And, in embedding her concept of resistance in the problems of grieving, Dr. Stark naturalizes the process of therapeutic healing and moves to the essence of what it means to struggle with one’s life. This lovely book is at once both scholarly and passionate—and bears the stamp of a true original.”
Alfred Margulies, M.D.—Harvard Medical School
“With rare artistry, Dr. Stark succeeds in conveying to the reader not only how a psychodynamic therapy is practiced but how it works. Her writing style conveys the same clarity and steadiness so apparent in her clinical work. Simply but simplistically, she successfully integrates the complexity of the most useful contemporary classical, object-relations, and self psychological perspectives with her rich clinical material. Every page of Working with Resistance is imbued with her personal tact and her deep respect for the patient as a person with choices. Dr. Stark’s crystal-clear thinking woven into the clinical material makes her writing a lucid gem. This book is destined to become a new standard for our field; it is a literary tour do force.”
Axel Hoffer, M.D.—Psychoanalytic Institute of New England, East
“Martha Stark is a gifted teacher, able to clarify without sacrificing complexity. No one is better at conveying the essence of psychoanalytic theory, through careful explanation and practical examples. In Working with Resistance Dr. Stark forges a unified basis for psychotherapy, drawing on strengths of the major schools of psychoanalysis. Beyond the rationale and method of our work, Dr. Stark captures its joy.:
Peter D. Kramer, M.D.—Author of Listening to Prozac
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
How Does Psychotherapy Work?
The premise of How Does Psychotherapy Work? is that psychodynamic psychotherapy affords the patient an opportunity – albeit a belated one – to master experiences that had once been overwhelming, and therefore defended against, but that can now, with enough support from the therapist and by tapping into the patient’s underlying resilience and capacity to cope with stress, be processed, integrated, and ultimately adapted to. (450 pp.)
Reviews
“Dr. Martha Stark has taken the fledgling field of comparative psychoanalysis into a new and important domain. She develops in great detail a framework for contrasting and exploring the major contemporary models of the analytic process. She takes us underneath the slogans and banners of the various schools so that we may compare their underlying concepts and presuppositions. And she demonstrates what different technical systems actually look like in live action by presenting a remarkably rich array of clinical examples. Her ideas will contribute to the enrichment of both the thinking and clinical sensibility of clinicians at all levels of experience and sophistication.”
—Stephen A. Mitchell Ph.D., New York, NY
“Dr. Martha Stark has brought together the three fundamental theories about how therapy works that prevail in our friend at present and has shrewdly drawn out the virtue of each. Her own integrated conception is at once sophisticated and practical. Therapists at every level of experience will profit from it. Engaging and convincing clinical vignettes bring Stark’s concepts alive, illustrating them in a way that resonates with a practitioner’s experience. Hers is a no-nonsense, deeply human, eminently useful study of what really happens in successful psychotherapy.”
—Owen Renik M.D., San Francisco, CA
“Dr. Martha Stark is a phenomenon. Her courses in postgraduate education are legendary. Now, with this volume, she distills her teachings into an accessible and lively dialogue that captures her inimitable style.”
—Alfred Marguiles M.D., Newton, MA
“Martha Stark is a gifted teacher—able to clarify without sacrificing complexity. No one is better at conveying the essence of psychoanalytic theory, through careful explanation and practical examples. In her books, she forges a unified basis for psychotherapy, drawing on the strengths of the major schools of psychoanalysis. Beyond the rationale and method of our work, Stark captures its joy.”
—Peter Kramer M.D., Providence, RI
“This book is much broader than the title would suggest. Stark describes the entire panorama of the therapeutic encounter in a style that is forthright, simple to understand and yet not oversimplified. Martha Stark manages to offer practical advice within the context of a sophisticated reading of psychoanalytic theory.”
—Arnold H. Modell M.D., Newton, MA
“A remarkable book, Dr. Stark illustrates the therapeutic action of the major psychoanalytic theoretical paradigms with many vignettes that clinicians will be readily able to recognize from their own practices. The clinical moments are described with extraordinary candor and vividness. This integration of theory and practice makes the book both highly relevant clinically and extremely instructive theoretically.”
—Anna Ornstein M.D. and Paul H. Ornstein M.D., Brookline, MA
“Dr. Martha Stark is a superb teacher whose scholarship and passion make her stand out in a crowded field of psychoanalysts. One of her gifts is to take complex material and communicate it in a clear, concise fashion that is immediately understandable to her audience.”
—Pamela Enders Ph.D., Boston, MA
“This is a book that should be required reading for any therapist in training and for any therapist in practice. The book is brilliant and covers so much therapeutic ground. I was fascinated by the material all the way through and have applied some of her relational concepts to my own practice with excellent results. Dr. Stark’s other books are brilliant as well. I had the good fortune of studying with her many years ago in Boston and through her books, others can partake of her extensive knowledge.”
—Roberta Finkel Keats, Boca Raton, FL
“I just completed Martha Stark’s 4 week online course, and it was marvelous! Martha presented us with a meta-theory of her own creation that captures the many disparate threads of psychoanalytic though and organizes them into several modes, all of which can be flexibly integrated into the therapeutic encounter and all of which are relevant and essential to therapeutic growth. How many people can do this? I am shaking my head. I found this class to be transformative for me as a clinician in that it infused me with new energy and an exciting way to conceptualize my work. I immediately began using the interventions in the room. It has brought me back to loving what I am doing, which was, to be honest, feeling a bit wan.”
—Louise Ryder Ph.D., Bozeman, MT
“I was ecstatic to learn that Martha Stark was teaching this course. It was professionally ‘transformative’ for me—highly interactive, intense, and thought-provoking. There is no other psychodynamic psychotherapy course like this one! Thank you!”
—Beverly Benedettii APRN, Easton, MA
“I have just completed Dr. Stark’s online course and words like outstanding, superlative, and powerful come to mind for me as I reflect on the theoretical and clinical integrations that were taught in an experience-near manner. I am a 1983 graduate of the Massachusetts School of Professional Psychology and this continuing education course ranks among the very best I have ever taken over the 30+ years of my practice.”
—Joan Thompson Psy.D., Newton Centre, MA
“I am not a professional, I am a client. I have read many books on psychology to understand what is wrong with my mind. This one is the best book I have ever come across. In fact, I read at least one page a day at work and one page at home. I carry this book with me all the time. It’s such a treasure, every line in the book is a lesson for my life.”
—Selvakumar Subramanian, Chicago, IL
“Dr. Martha Stark ‘practices psychiatry with skill and grace.’ Her extensive knowledge and depth of understanding about the mind and the body, her capacity to innovate and outside-the-box creativity, her tireless determination, and her ever-present good humor have freed me up to pursue—with passion—my dreams. I consider myself blessed to have been able to benefit from her expansive mind, her wisdom, and her generous worldview. Thank you!”
—Christine Amis M.D., Yarmouth Port, MA
“Your extraordinary productivity is to be much admired, as is your lucid, succinct manner of presenting this richly textured material.”
—Jeremy Nahum M.D., Cambridge, MA
Relentless Hope: The Refusal to Grieve
Martha Stark’s Relentless Hope: The Refusal to Grieve, could have been titled Transformation of Relentless Hope: A Relational Approach to Sadomasochism. At the end of the day and as will become clear in reading, relentless hope is ultimately a story about the patient’s masochism (here defined as a willingness to suffer if doing so will enable the patient to maintain her hope), and relentless outrage is ultimately a story about the patient’s sadism (here defined as the patient’s rageful and retaliatory reaction to having been thwarted in her desire). Masochism and sadism are not being used to describe what gets played out in the sexual arena, rather, the terms are being used to describe the dysfunctional relational dynamic that gets played out, to a greater or lesser extent, in most of the patient’s intimate relationships when early-on heartbreak (in relation to the parental object) is never fully processed, integrated, and adapted to and is instead defended against. (42 pp.)
The Transformative Power of Optimal Stress: From Cursing the Darkness to Lighting a Candle
“Martha Stark, a master clinician and gifted writer, offers a comprehensive integration of theory and clinical application in order to formulate a deeper understanding of three modes of therapeutic action of psychodynamic psychotherapy. The chapters contain many creative contributions, including novel characterizations of the differences between defense and adaptation and divergent and convergent conflict, of optimally stressful psychotherapeutic interventions, and of healing cycles of rupture and repair. I highly recommend this book to clinicians of all schools who are interested in expanding their therapeutic skills with challenging patients, especially those with a history of early relational trauma.”(208 pp.)
Allan N. Schore, Ph.D.
Reviews
“Dr. Stark’s vignettes are wonderfully transparent stories of her own work. They consistently remind me of my own growing edges as a therapist. She makes it clear that our humanity—with its gifts, failures, and limits—all contribute to the therapeutic equation. The more we, as therapists, recognize what we are doing as we do it, the better off everyone concerned is.”
—Edward J. Gutfreund, Jr., Cincinnati, OH
“Martha Stark’s course represents sharp scholarship, rich integration of theory, and the exceptional work of application. Her course presents an elegant review of major theories and new ideas about their real-life implementation. It is unusual for such material to be available in such an accessible way. After more than 30 years in the field, I am pleased to say that I learned a tremendous amount from this course!”
—Susan F. O’Neill Psy.D., Northampton, MA
“Dr. Martha Stark’s course on “The Transformative Power of Optimal Stress” was truly the best continuing education class I have ever taken—and I have practiced psychoanalytic psychotherapy for over 30 years. Not only was Martha’s class a theoretical masterpiece, but also it was incredibly useful in the real application of psychoanalytic treatment models. Martha’s class helped me to think about my cases differently—and I have been able to apply my learning already to many of my patients. I can’t express how rare this is after taking most continuing education courses. This experience was worth the tuition many times over!”
—Gail Hartman, Minneapolis, MN
