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Psychoanalysis On and Off the Couch

Feb 23, 2020

Harvey Schwartz welcomes Dr. Leon Hoffman, who is a Training Analyst, and a child, adolescent and adult Psychoanalyst at the New York Psychoanalytic Society and Institute, and he is also the Co-Director of the Pacella Research Center. Dr. Hoffman is the Chief Psychiatrist and Psychoanalyst at the West End Day School in New York City and he is the Co-Developer of the ongoing clinician research seminar at the New York Psychoanalytic Society and institute.  


The focus of todays conversation is on Dr. Hoffmans role as the Co-Investigator of the Evaluation of Regulation Focused Psychotherapy for Children, which is a key part of his lifes work. As you will hear in this episode, Dr. Hoffman brings his warmth, enthusiasm, and his deep feeling for understanding the inner lives of children, even when they make that very difficult, even when their disruptive behavior leads them to be not listened to by many, Dr. Hoffman is committed not only to listen to them but to train others to learn how to listen to them. 


Key takeaways: 

[3:55] Dr. Hoffman shares his own thoughts about the advantages and disadvantages of a manualized approach and the clinical challenges he and his team have faced after creating the manual. 

[9:20] Dr. Hoffman talks about his work taking key aspects of child analytic work and bringing them to a broader community, in terms of clinicians and patients. 

[9:51] Children with behavioral problems are experts in bringing up the weak spots of the therapist. 

[10:40] Dr. Hoffman and his team developed a manual meant to help analysts with her or his countertransference. 

[13:31] Dr. Hoffman explains children tell a story in a disguised way through play. 

[14:00] Dr. Hoffman shares a case example where defense was addressed from the start. 

[19:05] The pros and cons of a short term treatment. 

[21:58] Positive transference is not interpreted, only disruptions and countertransference. 

[26:04] Dr. Hoffman details how the therapist addresses in the play the patients response to her scary feelings. 

[27:35] The triangle of defense. 

[29:53] Listening and understanding the emotions behind the childs behaviors lead to great improvements in a short period of time. 

[31:43] Stop, look and listen. 

[32:15] What brought Dr. Hoffman to child analysis? 


Mentioned in this episode: 

IPA Off the Couch   


Recommended Readings: 

Hoffman, L., Rice, T. R., with Prout, T. A. (2016). Manual of regulation-focused psychotherapy for children (RFP-Cwith externalizing behaviorsA psychodynamic approach. New York, NY: Routledge.  


Berta Bornstein's Frankie: The Contemporary Relevance of a Classic to the Treatment of Children with Disruptive SymptomsThe Psychoanalytic Study of the Child 68:152-176  


Rice, TR, and Hoffman, L.  (2014). Defense Mechanisms and Implicit Emotion RegulationA Comparison of a Psychodynamic Construct with One from Contemporary Neuroscience. J Am Psychoanal Assoc 62: 693-708. 


Prout, T. A., Bernstein, M., Gaines, E., Aizin, S., Sessler, D., Racine, E., Spigelman, A., Rice, T., & Hoffman, L. (2020). Regulation Focused Psychotherapy for Children in clinical practiceCase vignettes from psychotherapy outcome studies. International Journal of Play Therapy, 29(1), 4353 


Prout, T. A., Rice, T., Murphy, S., Gaines, E., Aizin, S., Sessler, D., ... & Hoffman, L. (2019). Why Is It Easier to Get Mad Than It Is to Feel Sad? Pilot Study of Regulation-Focused Psychotherapy for Children.American journal of psychotherapy,72(1), 2-8.  


Regulation Focused Psychotherapy for Children