Martha Stark, MD, a graduate of Harvard Medical School and the Boston Psychoanalytic Institute, is an Adult / Child Psychiatrist and Psychoanalyst in private practice in Boston, Massachusetts.
Martha has been on the Faculty at Harvard Medical School for the past 36 years, is Co-Director of the newly created Center for Psychoanalytic Studies at William James College, and has numerous teaching affiliations (as Adjunct Faculty) with local, regional, and national psychodynamic / psychoanalytic training programs. She was formerly a Teaching Analyst at the Boston Psychoanalytic Institute and a Teaching / Supervising Analyst at the Massachusetts Institute for Psychoanalysis.
Martha is the author of three highly acclaimed books on psychoanalytic theory and technique (Working with Resistance; A Primer on Working with Resistance; and Modes of Therapeutic Action) – books that have become “required reading” for candidates at various psychoanalytic training institutes across the United States and for students in various psychodynamic psychotherapy training programs both here and abroad.
Reviewers have enthusiastically endorsed her books:
“I have never read a better book about the essential complexity and beauty of the therapeutic process” (Bessel van der Kolk, MD);
“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 Margulies, MD);
“Every so often a book emerges from the vast sea of analytic writings that startles in its creativity and usefulness” (Anne Alonso, PhD); and
“This book is destined to become a new standard for our field; it is a literary tour de force” (Axel Hoffer, MD).
Martha’s fourth book – an eBook entitled The Transformative Power of Optimal Stress: From Cursing the Darkness to Lighting a Candle and just released on freepsychotherapybooks.org – is a distillate of what she has learned over the course of her decades of experience as a holistic psychiatrist / psychoanalyst and reflects her attempt to capture the essence of what she believes must happen if true healing is to take place.
As Martha has evolved, so too her understanding of the healing process has evolved – from one that emphasizes the internal workings of the mind to one that is more holistic and appreciates the complex interdependence of mind and body.
Long intrigued by the idea that superimposing an acute injury on top of a chronic one is often exactly what the body needs in order to heal, Martha has come to appreciate that, so too with respect to the mind, the therapeutic provision of “optimal stress” – against the backdrop of an empathically attuned and authentically engaged therapy relationship – is sometimes the magic ingredient needed to overcome the inherent resistance to change so frequently manifested by clients with longstanding emotional injuries and scars.
And so it is that Martha encourages therapists to recognize the transformative power of “superimposed” optimally stressful psychotherapeutic interventions specifically designed “to precipitate disruption in order to trigger repair.” Strategically formulated to provide just the right combination of challenge (whenever possible) and support (whenever necessary), these anxiety-provoking but ultimately growth-promoting interventions can be therapeutically utilized again and again to induce ongoing cycles of destabilizing disruption followed by restabilizing repair. At the end of the day, working through these healing cycles will incite clients to evolve to ever-higher levels of integration, functionality, and adaptive capacity.
Behind this “no pain / no gain” approach is Martha’s firm belief in the underlying resilience that clients will inevitably discover within themselves once they are prompted to tap into their inborn ability to self-correct in the face of optimal stress – an innate capacity that will enable them ultimately to advance from cursing the darkness (a less-evolved defensive reaction) to lighting a candle (a more-evolved adaptive response).
What doesn’t kill you inevitably makes you stronger…
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.
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).
“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
Ordinarily, a classically trained, interpretive therapist strives to maintain her neutrality and objectivity. But when working with a patient’s relentlessness, it behooves the therapist to assume a more vigorously interpretive stance, resorting even to bold challenge and direct confrontation if necessary. The therapist’s intent is to highlight the issue of the patient’s accountability (the patient as agent), that is, the patient’s taking of responsibility for her refusal to relent and its dire consequences.
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.)
“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.”
As patient and therapist navigate the turbulent waters generated by their engagement at the intimate edge of their relentless relatedness, the therapist will inevitably find herself impacted by the force field created by the patient’s need to be now failed as she was once failed. In other words, the therapist will find herself unwittingly drawn in to participating in the patient’s re-enactments as an intractably bad object—a transference / countertransference entanglement that is necessary if the relentless patient is ever to rework the original traumatic failure situation.
For a patient denied the early-on experience of having her every need recognized and responded to, it is crucial that the patient now, within the context of the therapy relationship, be able to encounter a new good object that she can possess and control.