The Internal Object and the Problem of Deficits: when therapy gets stalled

A one-day seminar with Dr Anne Alvarez

London, February 2^nd 2018, Friday, 10:00AM to 4:00PM

Quite often, our therapeutic progress with a client can grind to a halt when we seemingly meet passivity, lack of curiosity and lack of hope. Is the client despairingly giving up on us, on therapy and / or herself? While we are cognizant that our therapeutic response needs to be different in such situations – how do we differentiate between defensive retreat and despair?

While classical psychoanalysis has taught us much about the passions – sexuality, jealousy, envy, guilt and reparation; what has received less attention is the lack of passion; often mindless and empty states which certain passive clients present to us.

At this practical seminar that would be relevant for psychotherapists, clinical psychologists, counsellors and psychiatrists, Dr Alvarez uses the Internal Object and the Problem of Deficits to focus our attention on techniques that can potentially solve therapeutic impasse. She uses a vivid case vignette as an illustrative example to highlight how the effect of neglect or self-neglect is different from that of trauma. She helps us comprehend:

• Self-involved states: how do we get through?
• Internal object representations in such cases and how these can be our guide to therapeutic progress
• The technicalities of fostering development in light of the sense of agency
• Interpretations of the interestingness of internal objects
• Deficits and the issues of meaning and value
• When is a defensive strategy replaced by a sense of despair? How do we work with that?
• How do we distinguish between a passivity born out of lack of curiosity and lack of hope?
• Therapist responses in face of passivity
• the emergence of complex and nuanced narratives over the course of therapy

The workshop links these understandings with case vignettes, thus illustrating the practical implications of our theoretical discussions.

About the speaker

Dr Anne Alvarez, PhD, M.A.C.P is a Consultant Child and Adolescent Psychotherapist, retired Co-Convener of the Autism Service, Child and Family Department, Tavistock Clinic, London and an honorary member of the Psychoanalytic Centre of California. She is author of Live Company: Psychotherapy with Autistic, Borderline, Deprived and Abused Children and has edited with Susan Reid, Autism and Personality: Findings from the Tavistock Autism Workshop. A book in her honour, edited by Judith Edwards, entitled Being Alive: Building on the Work of Anne Alvarez was published in 2002. She was Visiting Professor at the San Francisco Psychoanalytic Society in November 2005 and her latest book, The Thinking Heart: Three Levels of Psychoanalytic Therapy with Disturbed Children was published in April 2012 by Routledge.

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