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Distance Learning Program of the Chicago Institute

The Distance Learning Program of the Chicago Institute is be a comprehensive, closely monitored, selective admission, two year didactic and clinical program in psychoanalytic psychotherapy. It follows the model established in other programs at the Chicago Institute for Psychoanalysis, differing from them primarily in its electronic form of information delivery. The Distance Learning Program is conducted through software that allows students and teachers, sited at their individual computers wherever that might be in the world, to participate in an audio-video real-time class. Classes are held weekly during the academic year for one three hour session that is divided into three one hour classes. At the end of the two year course a certificate of completion will be awarded. CME credits will be available to students of the program.

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• Curriculum
• Admission to Program
• Ethics
• Language
• Certificate

Curriculum

There will be three elements to the curriculum:

1. Didactic Theory Courses
2. Didactic Clinical Theory Courses
3. Continuous Case Conferences

1. Didactic Theory Courses

The theory portion of the program will be oriented around an historical axis, focusing on psychoanalysis as a body of evolving ideas. Over the course of two years we study various analytic theories and pay particular attention to the transitions that occurred from one theory to the next. In this study we note the dissatisfactions of successive theorists and attempt to understand their need to develop their new theory. In this way we hope to provide our students with an integrated sense that psychoanalytic theories exist as a continuum rather than a series of ideas with unclear connections.

In the first year of the program, the students spend two quarters on an in depth study of selected works of Sigmund Freud and the classical line of analytic thought that moved toward ego psychology.

Freud's work is not be offered as a working model for doing psychotherapy. Rather we offer it for its grounding historical axis and for the relevant clinical and theoretical insights Freud provides. We attempt to update the Freud readings, whenever appropriate, with contemporary selections in an effort to keep the material fresh and relevant to contemporary ideas about psychotherapy. For example, when reading Dora we also assign a more recent paper that discusses hysteria from a contemporary view.

1st Quarter

• Freud's Introductory Lectures

2nd Quarter

• Dora
• Remembering, Repeating and Working Through
• Three Essays in Childhood Sexuality
• Recommendations to Physicians
• Further Recommendations to Physicians
• Mourning and Melancholia
• The Ego and the Id

3rd Quarter of Year 1 and 2nd and 3rd Quarter of Year 2

The third quarter of the first year begins the study of our section on Object Relations Theory. This will continue for two quarters and will be carried in to the first quarter of the second year. The second and third quarters of the second year will take up the study of Contemporary Psychoanalytic theories such as Self Psychology. Intersubjectivity, and Relational Analysis.

2. Didactic Clinical Theory Courses

The clinical theory section of our studies addresses topics that arise within the clinical situation such as the formation of the therapeutic alliance, resistances, transference, etc. We simultaneously focus on the process of psychoanalytic psychotherapy beginning in the first year with issues that relate to the opening phase of treatment.

The syllabus below is a guide. Teachers will be free to make changes, add or subtract as they see fit. Because we privilege mastery of the material over getting through the syllabus the teachers work at a pace that allows the material to be covered and integrated.

The syllabus, therefore, forms a skeleton of suggested topics to be covered in the first year. Several sessions have been allotted to nearly each topic. The initial session of each topic is a selected reading, the following sessions are a mix of clinical examples from the teachers' practices as they relate to the topic of the moment. Students are invited to offer their own material. The emphasis in this course is upon clinical experiences.

The first year of the course, the theme is The Opening Phase. The readings address the general topic under consideration, such as therapeutic alliance, however, after discussing the concept the discussion focuses on how the particular topic emerges or is dealt with in the early phase of the treatment.

1st Quarter

Session

1. Assessment for psychoanalytic psychotherapy
   
   1. Presenting complaint and its relation to personal history
   2. Current pains as expression of old, unconscious issues
2. Assessment for psychoanalytic psychotherapy
   
   1. Nature of past relationships
   2. Nature of capacity to work
3. Assessment for psychoanalytic psychotherapy
   1. Strengths needed to enable psychoanalytic psychotherapy
   2. Capacity for reflection
   3. Capacity to bear affects
   4. Perhaps read old Sterba paper (1932) "Fate of the Ego"
4. Prescription of appropriate treatment
   1. Supportive Rx
   2. Insight oriented Rx
   3. Relationship between medication and psychotherapy
5. Setting the arrangements for treatment
   1. The Fee, an area of often untapped meaning
   2. Read paper on the fee by Allen Siegel, unpublished
   3. How much to charge
   4. Charge/no charge policy
   5. No charge ( see Kurt Eissler in fee paper above)
6. Continue discussing arrangements for treatment
   1. Scheduling sessions
   2. Vacations
   3. Furnishings, seating arrangements
   4. Relationships with third parties:
      1. Families
      2. Office Secretaries
7. Therapeutic Alliance
   1. Greenson; Working Alliance and Therapeutic Alliance
   2. Zetzel
   3. Sterba
8. Therapeutic Alliance
   1. What to instruct patients?
   2. Clinical examples of alliance formation early in Rx
9. & 10. Transference
   3. Sandler's review in "The Patient and the Analytic Situation"
   4. Freud's definition of transference
   5. Kohut's idea of transference free area (APN)
      1. Area for unconflicted internalizations
   6. Transference as an expression of drives
   7. Transference as defense
   8. Transference as expression of needs
11. & 12. Clinical examples of Transferences early in Rx

2nd Quarter

Session

1. Countertransference
   1. Sandler, (old view, current view)
   2. Other papers, definitions
   3. Countertransference as therapist's transference to patient. Not necessarily patient's responsibility
2. Clinical examples (both teacher's and students') of early countertransference
3. Listening stance, metaphor as expression of unconscious
4. Listening continued
5. Empathy
   1. How to conceptualize it
   2. Therapeutic activity?
   3. Data collecting instrument?
6. Therapeutic action of psychotherapy
   1. What effects health?
7. Early improvements
   1. Flight in to health?
   2. Resolution of crisis
   3. "I'm better now, should I leave or stay?"
      1. how do we proceed from here?
8. Acting out versus acting up (enactment versus affect dysregulation)
   1. Sandler
9. Examples of early acting out
10. Examples of early acting up
11. & 12. Working through - Sandler - Clinical Examples

3rd Quarter

Session

1. Resistances and Protection
   1. Freud
   2. Kohut (How Does Analysis Cure?)
2. Examples of resistance and defenses early in treatment
3. Interpretation
   1. Theory
4. & 5. Examples of interpretations early in treatment
6. Provision versus interpretation
   1. Theory
7. Provision versus interpretation
   1. Examples early in treatment
8. Self disclosure
   1. Theories
9. Examples of self disclosure early in treatment
10. Negative therapeutic reaction
    1. Sandler
    2. Freud
    3. Disruptions
11. & 12. Failures early in the process
    1. Hindsight view of what might have been done differently

The first two quarters of the second year focus on the middle and termination phases of treatment and include topics such as the multitude of issues surrounding the fee, issues related to missing or coming significantly late to sessions, the role of secretaries in the treatment, issues of confidentiality, third party payers, the relationship of other family members to the treatment, cultural issues related to the treatment etc.

Difficult clinical situations such as the erotized transference, the borderline patient, and impasses in the treatment are also studied. The termination phase is studied in the last quarter of the second year.

3. Continuous Case Conferences

Each quarter, to further study the various phases of treatment, an ongoing treatment is presented to the class for study and discussion.

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Admission to Program

1. Criteria for Admission

1. Applicants must have their country's equivalent of an MD Psychiatrist, MSW, MA in Psychology, or an MA in Counseling.
2. Applicants must have at least 3 years of clinical experience. The clinical time spent in the applicants' respective training programs will be counted as time that meets this requirement.
3. Applicants must be licensed by their local licensing governmental agency.
4. Applicants must speak English.
5. Applicants must have medical backup in place to cover the possibility that their patients might need either medication or hospitalization.

2. Admission procedures

1. Applicants must submit a copy of their transcripts.
2. Applicants will be required to submit letters of recommendation.
3. Applicants will be required to have a personal interview. The interview will be in person if possible or via the internet if travel to Chicago is a hardship.

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Ethics

Prevention of ethical violations is as impossible in an Internet training program as it is in on-site Chicago Institute educational programs. There is, however, a need for a formal organization that can pursue ethical complaints should they arise. This oversight function will best be performed by whatever professional organization prevails in the student's locale. Each applicant, therefore, must identify a local ethics committee to which he or she owes allegiance. Any ethical complaint, should one arise, will be channeled to the designated local ethics committee.

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Language

The classes will be taught in English only.

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Certificate

With the completion of the two year program, the students will receive a certificate that will adhere to the model of certificates awarded in other Chicago Institute for Psychoanalysis programs. It will not certify competence. It will be a statement of completion of a prescribed course of study. Its wording will state: "All who read this shall be notified that -------------- has attended a two year distance education course of study in psychoanalytic psychotherapy with the Chicago Institute for Psychoanalysis.

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