ISTDP-Akademiet “warmup”: Johannes Kieding (gratis for medlemmmer)

Johannes Kieding gæstede i september 2022 ISTDP-Akademiet, og vi modtog megen positiv feedback samt ønsker om at se mere til Johannes. Som opvarmning til vores næste semester i 2023, har det Danske Selskab for ISTDP derfor inviteret Johannes tilbage for at holde endnu en præsentation for os – denne gang udvidet til 4 timer, den 9. januar kl 15.00 til 19-00 via zoom.

Præsentationen er en julegave fra det Danske Selskab for ISTDP til vores medlemmer, som er velkomne til at deltage gratis. Medlemmer behøver ikke tilmelde sig, men modtager et link via mail inden præsentationen. Deltagelse er også åben for medlemmer af det Svenske Selskab for ISTDP.

Vores næste semester starter officielt den 1. februar 2023, hvor Patricia Coughlin præsenterer om “Handling resistance without contributing to it”. Tilmelding til semesteret for danske medlemmer kan foretages her: https://istdp-danmark.dk/store/

Om Johannes Kieding:
Johannes skriver: “I trained with Marvin Skorman, LMHC, from 2012 to 2021. Marvin was one of Dr. Davanloo’s right-hand men in the late 1980s. I supervise faculty at the Rochester Institute of Technology, and I work intermittently with Arizona State University by supervising their master’s level social work interns. My clinical approach aims to be very collaborative and relational while still addressing resistance head-on. After being sanctioned to teach by Marvin in 2017, I have been supervising others in both individual and group format. I had the privilege of meeting Dr. Davanloo and seeing his work in 2012 and again in 2013. I have a special interest in making ISTDP more accessible to a wider swath of clinicians by emphasizing the flexibility of the model. My idea of a good time is to sit close to an ocean, hearing the clucking and crashing of waves while reading a good book.”

Om præsentationen: “Leveraging UTA/Connection and Pressure to Awareness of existing Emotional Closeness”

In this webinar I will showcase the case of ‘the man who disobeys by obeying and whose entire life has been an emotional drought’ over the course of 3-4 therapy sessions.

In this webinar I will highlight a way of leveraging connection and directly appealing to the unconscious therapeutic alliance through using pressure to awareness of existing emotional closeness and collaboration in the service of undoing projections, mobilizing the unconscious and the complex transference feelings.

The patient we will learn from is prone to pull for enactments as a substitute for reflecting on his experience, though he does tend to ‘bounce back’ quickly with an ability to self-reflect and a real willingness to collaborate. When in his defenses, the patient tends to look for reasons to disqualify me and distance from me; he tends to try hard to engage me in an interpersonal conflict, tends to become highly oppositional, and has fairly low thresholds for going into splitting and projection with mild concomitant paranoid ideation. The patient suffers from a severely self-punitive tendency with intensely distressing intrusive obsessional thoughts.

In this webinar you will see how I address a major conflict for the patient around allowing himself to make progress — in one moment he will allow closeness, collaboration, and common ground and experience progress but then he will experience intense anger (positive feelings too but they tend to be less prominent) that I, the therapist, gets satisfaction from his progress, and he tends to respond to these sequences by going back into his defenses to stall progress and ensure that I cannot get satisfaction from his progress.

I will show how projections can be undone by being different from them. You will see how internal pressure builds up within the patient, often not through an active application of pressuring interventions on my part, but through continuously rendering myself a target where the patient’s projections cannot stick — whereas had I applied active pressure at some of these times, I would have reinforced the projections.

Of particular note is that the patient had been through a previous treatment course with an ISTDP therapist which resulted in transference neurosis, making it particularly important for me to use flexibility and ensure that I do not get into old shoes.

The case will also demonstrate the importance of facilitating insight into the nature of the patient’s self-punitive tendencies, how the same self-punitive mechanism functioning to get even with the parents operates with me in the transference, and in the third you will see an eventual breakthrough into torturous rage and painful, healing guilt.

Because of the patient’s intense aversion to closeness, you will see the patient trying to distance from me again after the breakthrough of the complex transference feelings — you will see the patient attempting to end the session on a dissonant note as a way to ensure I do not feel too good about myself as ‘the one who could help the patient’, and you will see how I drive home insight into this mechanism while supporting the patient’s mixed emotions towards me.

This case demonstrates a way of working with a lower ego-adaptive capacity, regressive defenses, defiance and oppositional behavior based primarily on a projective foundation, resistance in the service of self-punishment and a backdrop where common ISTDP interventions were contaminated by the patient’s negative associations to those interventions from a previous course of treatment.

In the presentation, we will be focusing on:

*Getting out of the Shoes and not going along with rules for an insecure attachment
*Embodying ways of Relating that address the core wound of needing to be an extension of someone else’s needs and agendas in order to preserve the relationship
*Slowing down so that the treatment can ultimately speed things up
*Describing the main thing going on and accepting the patient the way he is instead of trying to change or fix the patient
*Leaning into the Real relationship/Being Conversational as opposed to Technique-y
*Addressing defiance with a lower ego-adaptive capacity patient
*Restructuring projections by being different from them (and when to begin to address resistance more verbally)
*Mobilizing the unconscious by inviting an awareness of a fundamentally intact reality testing and an existing emotional closeness and collaboration
*Use of flexibility to deal with the patient’s contaminated views of common ISTDP interventions due to a transference neurosis from a previous ISTDP course of treatment
*Therapist’s use of self and ample use of affective mirroring to facilitate therapeutic movement
*A unique blend and ratio of encouragement and graded challenge tailored to the unique factors of the patient
*Looking at how portraiting can be therapeutic even when the rise of the complex transference feelings is not at an optimally altitude