About our theme: Projective Methods and Psychotherapy
Bruce Smith, Ph.D., Discussant
Bruce L. Smith, Ph.D., ABAP is a Clinical Associate Professor at the University of California, Berkeley, Past President of the ISR, and in private practice of psychoanalytic psychotherapy, assessment, and forensic psychology. His research interests focus on the use of the Rorschach in various settings.
Probably no use of the Rorschach and projective tests is more important than its role in the planning and evaluation of psychotherapeutic treatment. The three lectures to be presented this year discuss three different aspects of this topic—the use of projective methods in planning treatment and anticipating issues and potential pitfalls in work with children and adults, and the ongoing evaluation of the outcome of therapy in terms of various dimensions of personality structure. The lectures and subsequent case discussions will greatly enhance participants’ ability to utilize these methods in their ongoing clinical work.
Lecturers and Presentations
Lily Rothschild Yakar, PhD., Department of psychology, University of Haifa, Israel
Prof. Rothschild Yakar is a Clinical Professor in the Department of Psychology at Haifa University, Israel, a co-chair of the Israeli branch of SPA, and a senior psychologist teaching and supervising psycho-dynamic oriented psychotherapy and personality assessment. Prof. Rothschild Yakar authored several publications in personality assessment, with particular attention to using personality assessment measures in examining psycho dynamic concepts.
Therapeutic change in personality dynamics: Coping, distress, relatedness and mentalizing
The presentation will focus on assessing therapeutic change along several constructs of personality dynamics, using implicit (Rorschach and TAT) and explicit (self-reports) measures. The discussion will follow theoretical conceptualization of personality dynamics, based on object relations and mentalization theory, and the meaning of various assessment variables will be elucidated based on these frameworks. The discussion will also address research data on the issue of phases in the course of a disorder. The principles of the theory and research will be demonstrated by two protocols of a female adolescent (late adolescence) with ED, one in the beginning of treatment and the other at the end of hospitalization.
Barbara L Gamble, MS, LLP, Ann Arbor, MI, USA
Clinical Psychotherapist in private practice, Advanced Candidate in Child, Adolescent, and Adult Psychoanalysis at the Michigan Psychoanalytic Institute. Ms. Gamble has masters degrees in Educational Psychology and Clinical Psychology, and her undergraduate degree is in Psychobiology. Ms. Gamble’s training, interests, and practice emanate from a developmental perspective, informed and inspired by raising her three young adult children.
Use of Projective Measures in Assessing Children for Treatment Planning
At a time when many people eschew use of projective measures in psychological assessment, it is especially important for us as a field to know the history of their use and utility, and to build on and celebrate the unique contribution they offer in contemporary practice in understanding and treating children. Projective measures will be discussed within a psychoanalytic/psychodynamic assessment framework, bringing out the richness and depth of all assessment data when considered experientially as well as normatively. The uniqueness of child assessment and treatment will be fleshed out, with the necessity of a developmental framework, and aspects of working with parents. Finally, the contribution of projective measures to developing a narrative leading to treatment planning and mutative change, with several examples, will be discussed. All of these ideas will be illustrated and brought to life with the case of a 10-year-old girl twin and her family who suffered consequences from a traumatic birth which were then resolved.
Harald Janson, Ph.D, Oslo, Norway
Harald Janson, Ph.D., is a psychologist and a researcher. He holds a position as a psychologist at an outpatient treatment unit for psychological trauma at Uddevalla, Västra Götalandregionen, Sweden, and is also employed as a researcher at the Norwegian Center for Child Behavioral Development, Oslo, Norway, in addition to having a private practice. His clinical work is mainly trauma-focused; he is a certified EMDR Consultant. He has worked with the Rorschach (Comprehensive System and R-PAS) since 1992.
How Rorschach findings can assist treatment planning for psychotherapy with respect to structural dissociation of the personality
Adolescents and adults with a long-standing history of neglect, abuse, and exposure to adverse life events may present with a complicated clinical picture with symptoms that could fit several diagnostic categories, including borderline personality disorder, depression, complex trauma, and dissociative disorders. The theory of structural dissociation of the self (van der Hart, Nijenhuis, & Steele, 2006) attempts to explain fragmentation of the developing personality in parts with varying degrees of co consciousness, ranging from mild (e.g., single split-off emotional states) to severe (e.g., dissociative identity disorder), following exposure to overwhelming strain. The degree of structural dissociation of the personality has far-reaching treatment implications; a prolonged phase-oriented treatment is indicated in the more severe cases. This presentation identifies specific factors to consider in treatment planning with respect to structural dissociation of the personality, along with general factors, with their possible expressions on the Rorschach. The Rorschach assessment of a woman with severe traumatization and long-standing problems is presented, and participants are invited to identify and reflect about specific and general findings that may contribute to treatment planning.