Introduction to conducting a psychoanalysis

This is the 200 syllabus for, “Introduction to Conducting A Psychoanalysis”.


I. Introduction to Conducting a psychoanalysis

The conduct of a psychoanalysis is as much an art as a science. In fact, analysts differ markedly in their views as to what constitutes psychoanalysis and how an analysis ought to be conducted. Psychoanalytic training, with its tripartite model of training analysis, supervision and coursework, is devoted to examining these technical and theoretical issues. This introductory course provides a preliminary exposure to the technical, theoretical and conceptual considerations in evaluating whether and how to offer a prospective patient psychoanalysis.

Readings will examine such issues as: for whom is psychoanalysis most helpful (e.g.suitability), establishing the analytic frame (e.g. recommending analysis, negotiating frequency, setting fee and the use of the couch), differences and similarities between psychoanalysis and psychotherapy, the impact of candidate status on the analytic process and the theory of technique. Candidates will present clinical material derived from evaluating patients for analysis.

Course Goals

This course places an emphasis on the integration of theory of technique and clinical practice. A primary goal is to familiarize candidates with the considerations in beginning a psychoanalysis. A secondary goal is to provide a forum for class discussions regarding the technical, practical and ethical considerations involved in initiating a psychoanalysis. An ancillary goal is to help candidates to develop a preliminary level of comfort in discussing their clinical work in class.

Course Objectives

During this course candidates will become familiar with:

  • 1. Some of the clinical and technical controversies regarding what constitutes psychoanalysis
  • 2. Perspectives on the goals of psychoanalysis
  • 3. Some theoretical views about the distinctions between psychoanalysis and psychotherapy
  • 4. Controversies and views surrounding the creation of analytic patients, including, ideas about conversion
  • 5. Current thinking regarding how one might present the recommendation for psychoanalysis
  • 6. A preliminary exposure to the literature on setting fees
  • 7. Views on using and recommending the couch
  • 8. Ethical and professional considerations in the conduct of psychoanalysis
  • 9. Some thinking about the impact of analytic training on the treatment of control cases
  • 10. Literature about patient/therapist match
  • 11. The therapeutic efficacy of psychoanalysis
  • 12. Additional topics related to the conduct of analysis to be announced

Course Requirements


Required readings have been intentionally kept brief with the thought that candidates will complete each reading with careful attention. Also, a key component of the class entails applying the readings to case presentations. Each candidate will present several times. Thus, in an effort to allow for time for presentations as well as the careful integration of clinical material the amount of reading is limited.

Course Presentations

Candidates will regularly be asked to present patients who they are considering for analysis. In presenting patients, candidates are encouraged to attend to the following considerations, the patient’s:

  1. early relationships with primary caretakers
  2. defenses (high, mid-level, low)
  3. current/historical functioning
  4. capacity for relationships
  5. evidence of object constancy
  6. relatedness to the analyst
  7. motivation
  8. range of affect
  9. curiosity
  10. previous treatment history
  11. vulnerability to decompensation (e.g. suicide attempts; psychoses)

These presentations are for didactic purposes. Actual decisions as to whether a patient is suitable as a control case are made in consultation with the candidate’s supervisor.

Reading List

Class Schedule

What is psychoanalysis? And, for whom is it appropriate?


Class One

Jacobs, T. (2001), Reflections on the Goals of Psychoanalysis, the Psychoanalytic Process, and the Process of Change. Psychoanalytic Quarterly, 70: 149-181.

Class Two – (September 17, 2005)

Kernberg, O. (1999), Psychoanalysis, psychoanalytic psychotherapy and supportive psychotherapy: contemporary controversies. International Journal of Psychoanalysis, 80: 1075-1092.

Class Three (September 24, 2005)

Rothstein, A (1994), A perspective on Doing a Consultation and Making the Recommendation of Analysis to a Prospective Analysand. Psychoanalytic Quarterly, 63: 680-695.

Optional readings

Ogden, T.(2003), What’s true and whose idea was it? International Journal of Psychoanalysis, 84: 593-606.

The frame, the couch, the fee and other assorted boundary and technical issues

Class Four (October 1, 2005)

Ross, J. M.(1999), Once more on to the couch. JAPA, 47: 91-111.

Class Five (October 8, 2005)

Earle, J. (1993), On the Setting of Analytic Fees. Psychoanalytic Quarterly, 106-108.

Rothstein, A. (1995), Psychoanalytic Technique and the Creation of Analysands: On Beginning Analysis with Patients Who Are Reluctant To Pay the Analyst’s Fee. Psychoanalytic Quarterly 64: 306-325.

Class Six (October 15, 2005)

Dewald and Clark (eds) (2001), “Confidentiality” and “Avoiding Exploitation” in Ethics Case Book of the American Psychoanalytic Association, 21-62.

The candidate experience, selecting cases and obtaining supervision

Class Seven (October 22, 2005)

Ehrlich, J. (2003), The impact of being a candidate on analytic process. JAPA 51, 177- 200.

Caligor E. (2003), Converted and clinic patients as control cases. JAPA 51, 201-220.

Class Eight (October 29, 2005)

Kantrowitz (2002), The external observer and the lens of the patient-analyst match. International Journal of Psychoanalysis 83: 339-350.

Vaughn S and Roose S. (2000), Patient-therapist match. JAPA 48: 885-900.

Therapeutic action and the role of theory

Class Nine (November 5, 2005)

Busch, F. (2003), Telling stories. JAPA 51: 25-42.

Renik, O. (2001), The Patient’s Experience of Therapeutic Benefit. Psychoanalytic Quarterly, 70: 231-241.

Class Ten (November 12, 2005)

Fonagy, P. (2003), Some Complexities in the Relationship of Psychoanalytic Theory to Technique. Psychoanalytic Quarterly. 72: 13-47

Dr. Lynn Friedman

Dr. Lynn Friedman, Ph.D., FABP, is a Clinical Psychologist, a Supervising and Training Analyst, and a Clinical Supervisor in full-time, private practice. She provides evaluation, psychotherapy and psychoanalysis as well as supervision to psychoanalysts-in-training and other mental health professionals. Beyond this, she is a board certified, psychoanalyst who teaches at Johns Hopkins University and the Washington Baltimore Center for Psychoanalysis.

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