Psychoanalytic Education Center of the Carolinas

Psychoanalytic Education Center of the Carolinas

Transforming Destructiveness:
Psychoanalytic Psychotherapy with the Difficult to Treat Patient

Spring 2014
Instructors: Ernie Braasch, MD & Sally Comer, PhD, LCSW
Course Description:
This 16-week course will focus on how to successfully help patients whose "under-structured" personality organization presents special challenges to the developmental goals of a psychoanalytic treatment.
Class discussion and reading will cover:
  • We will look at various "languages" used to describe these patients in different psychoanalytic models of the mind, with readings on borderline personality disorder and attachment theory.
  • We will especially focus on the therapist stance, emphasized in relational psychoanalysis, which requires a particular way of listening that allows the patient-therapist dyad to make contact with parts of their own and each others' minds in useful ways.
  • The course instructors will encourage lively discourse, a stance of "not knowing," and ample opportunity for the presentation of case material.
Prerequisite:This course is for PECC matriculated students, graduates of the Psychoanalytic Institute or the PPSC AC, clinicians who have completed the Psychoanalytic Institute or PPSC AC coursework, or clinicians who receive permission of the instructor. It will be at an intermediate through advanced level.
Time: Tuesday, 5:30 pm - 7:00 pm
Dates: January 21 - May 6, 2014
Class Size: Class will be limited to 10 students.
Location: Center for Psychological & Family Services, Chapel Hill
CME Credits: 24
CE Credits: 9 Category A & 15 Category B
NBCC CE Clock Hours: 24
Training Program Credit: Students who successfully complete this course can earn credit in both the psychoanalysis and psychoanalytic psychotherapy training programs.
Registration Fee: $25 for non-matriculated students
  • Matriculated students aren't charged a course registration fee.
  • Non-matriculated students who register for more than one course in a semester pay only one registration fee.
  • Non-matriculated students should include the registration fee with the course application.
  • We are unable to accept credit card payments. Please send a check payable to PECC.
Registration Deadline: January 7, 2014
In special circumstances we may accept registrations after January 7, but there will be an additional $20 late registration fee.
Tuition: Due January 14
$485 for students matriculated in the training programs
$600 for psychiatry residents and graduate students
$650 for non-matriculated students
Payment plans can be arranged with the Administrator.
  • The registration fee is non-refundable.
  • Students who cancel after the registration deadline but before class begins will be given a tuition refund less a $40 administrative fee.
  • There will be no refunds for cancellations after class begins.
  • Students who drop the class after it begins are expected to pay the full tuition.

PEP-Web Fee: (optional) $15 for non-matriculated students
  • The optional PEP-Web fee will give non-matriculated students access to the PECC library computer, and they can download syllabus readings that are on PEP-Web.
  • Students will have access to the library computer until the end of the course.
  • The library computer is located at 501 Eastowne Drive, in the suite where class is being held.
  • Students will need to make an appointment to use the library computer. Full instructions will be sent to students after the fee is paid.

Syllabus: To download click here.

Required Texts:

If you click on a book title, you will be linked to the book's page at, though other bookstores also carry this book.

Jurist, Elliott L.(editor), Slade, Arietta (editor), & Bergner, Sharone (editor) (2008) Mind to Mind: Infant Research, Neuroscience, and Psychoanalysis. Other Press, New York.

Clarkin, John F., Teomans, Frand E. and Kernberg, Otto F. (1998)
Psychotherapy for Borderline Personality. Wiley, New York.

Casement, Patrick J. (current paperback, 1991)
Learning from the Patient. The Guilford Press, New York.

About the Instructors:
Ernie Braasch, MD is a past president of the North Carolina Psychoanalytic Society. He did his adult psychiatry residency training at John Umstead Hospital and Duke Medical Center. He is a graduate of the UNC-Duke Psychoanalytic Education Program and training and supervising analyst of PECC. Currently, he is in private practice in Raleigh. Recently, he has been integrating mindfulness and EMDR into his work with patients. Psychoanalytically, he has always integrated classical, self psychological, and relational models of understanding patients.

Sally Davis Comer, PhD, LCSW is a graduate of the Advanced Curriculum of the Psychoanalytic Psychotherapy Study Center. She received her MSW from UNC-Chapel Hill and her PhD from the Smith College School for Social Work. Sally?s long term interest in object relations and attachment theory led to her dissertation topic on family environment and attachment relationships. She was chosen to present her dissertation at the Society for Social Work Research in January 2013. Sally was selected from her doctoral class to attend the Smith College-Sanville Institute Colloquium, which included consultation from Drs. Judith Schore, Alan Schore, and Judith Nelson. She also was selected to attend the University College of London's Research Training Program in Berlin. She has been adjunct faculty in both the UNC-Chapel Hill and East Carolina University MSW programs. She is in private practice in Raleigh, where she sees adults in individual and couples therapy and also works with adolescents.

Course Objectives:

Class participants will be able to:
  • Describe the symptoms, ego structure, and defense mechanisms of patients with diagnoses involving under-structured personality organizations.
  • Increase their understanding of the differential diagnosis for borderline personality disorder.
  • Gain an appreciation for historical developments in psychoanalytic technique and theory which address the specific challenges of under-structured personalities.
  • Promote critical thinking about the advantages and disadvantages of different therapeutic interventions in the treatment of under-structured personality organization.
  • Learn the effect of attachment trauma on infant development and on the subsequent development of ego structure.
  • Recognize the mutual influence that therapists and patients exert on each others' transferences and counter-transferences in the consulting room.
  • Come to appreciate the value of a relational stance which privileges an attitude of "not knowing."
  • Understand how emotional storms are destructive to a mentalizing process, the management of which is essential for success when working with patients with under-structured personality organization.
  • Apply clinical techniques that foster the development of mentalizing skills in under-structured personalities.

For additional information or if you have special needs
please contact:

Lisa Long, Administrator
Phone: (919) 490-3212

CE & CME Information:
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the American Psychoanalytic Association and the North Carolina Psychoanalytic Society. The American Psychoanalytic Association is accredited by the ACCME to provide continuing medical education for physicians.
The American Psychoanalytic Association designates this Live Activity for a maximum of 24 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
IMPORTANT DISCLOSURE INFORMATION FOR ALL LEARNERS: None of the planners and presenters of this CME program have any relevant financial relationships to disclose.
The North Carolina Psychoanalytic Society is approved by the American Psychological Association to sponsor continuing education for psychologists. The North Carolina Psychoanalytic Society maintains responsibility for this program and its content.
The North Carolina Psychoanalytic Society is an NBCC-Approved Continuing Education Provider (ACEPTM) and may offer NBCC-approved clock hours for programs that meet NBCC requirements. The North Carolina Psychoanalytic Society is solely responsible for all aspects of the program.

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