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Michigan Psychoanalytic Institute & Society

Psychodynamic Considerations in the Treatment of a Young Person with Autistic Spectrum Disorder

Leon Hoffman, M.D. (New York)
Training and Supervising Analyst, New York Psychoanalytic Society and Institute

Discussant: Mary Adams, L.M.S.W.
Lecturer, Michigan Psychoanalytic Institute

Saturday, March 10, 2012
2:00 - 4:00 PM
2 CME and CE Credit Hours
Michigan Psychoanalytic Institute, 32841 Middlebelt Rd., Farmington Hills

Practice Gap/Need: That psychodynamic concepts can be utilized in the multi-modal treatment of children with autistic spectrum disorders (ASD) almost seems to be an oxymoron in the contemporary general mental health community. It may very well be that the mother-blaming/refrigerator-mother conceptions of the 1940s and 1950s turned the mental health community, as well as parents, away from psychodynamic considerations in the treatment of ASD to treatments other than dynamic.

This is a report of a patient with ASD who was interviewed on video by his therapist/analyst at the age of 19 after obtaining informed consent. The interview reviews their work together which had begun when the patient was three and a half and who was not really talking well past his 6th birthday. Some mental health professionals caring for him early in life expressed the view that a dynamic play/talking therapy was a "waste of time." Selected elements of the interview illustrate that the addition of a psychodynamic approach contributed to the developmental gains. Whether or not his course of development proves or disproves this is, of course, scientifically impossible to maintain. However several elements were present in the individual treatment which illustrate the value of adding a psychodynamic orientation to the behavioral treatment he received in his school setting.

After attending this presentation, participants should be able to:
1) Recognize that a psychodynamic orientation in the treatment of ASD can promote an in-depth, ongoing, reliable relationship with another person, aid verbalization of feelings, and promote freedom of expression through play and activity, and consider the usefulness of acting on the stage during adolescence.
2) Appreciate the importance of understanding the meaning of behavior and activity, particularly causes for outbursts during early years.
3) Identify the use of defensive maneuvers (maladaptive coping strategies), particularly denial, projection, and, secondarily, avoidance and rationalization.
4) Describe a useful approach to problems with gaze aversion.

About the presenter:
Leon Hoffman, M.D. is a Training and Supervising Analyst at the NYSI, Supervisor of Child and Adolescent Psychoanalysis, Co-Director of the Research Center and Co-Director of the Pacella Parent-Child Center. Dr. Hoffman is assistant lecturer at Mt. Sinai School of Medicine, Chief Psychiatrist at West End Day School, and co-chair of the Committee on Research Education (APsaA). Among his many publications, his most recent (2011) is with Murphy, S. and Zweifach, J. on The Everyday Concerns of Mothers of Young Children and the Motivation to Seek Ongoing Parenting Support from Experts.