Betty Joseph has been influential within the Kleinian tradition. Her approach to listening and interpretation is based on the idea that the wish to change and mature often goes hand in hand with the opposing satisfaction that comes with holding onto the current state of affairs, even when the situation is a painful one. Joseph was sensitive to the variety of subtle pressures placed on her by patients to join them in repeating familiar interactions. By focusing on moment-to-moment sequences in individual sessions, as well as by taking a ‘second look’ at longer blocks of treatment, she was able to offer her patients fresh and helpful observations about their unconscious efforts to get her to think, act and to interpret in predictable ways.

Working in this way may include making interpretations with which the patient strongly disagrees. Accordingly, her clinical theory challenges the very prevalent tendency to accompany interpretations with explanations based on the patient’s remembered history of his childhood.

Objectives:

1. The student will be able to describe with examples from their own work or the literature the tendency of patients to maintain their current psychic equilibrium despite the psychic pain it causes.
2. From the perspective of Joseph’s clinical theory, the student will be able to explain how psychic change comes about.
3. The student will be able to illustrate what it means for the treater to remain with the alive and immediate experience in the session.
4. The student will be able to compare working in the ‘here and now’ in contemporary Kleinian work with the way the same the same concept is understood in North American ego-psychology.

Course Level: Advanced

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