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Transforming Destructiveness (301) Spring 2021
Tuesday, March 30, 2021, 7:10 PM - 8:40 PM EST
Category: Courses

Transforming Destructiveness:
Psychoanalytic Psychotherapy with the Difficult to Treat Patient
Instructor: Peter Perault, MD 

This 16-week course will explore advances in contemporary psychoanalysis in understanding and helping individuals with narcissistic and borderline personalities, attachment disorders, and trauma. It will examine how we listen; the nature of empathy; the treatment of narcissistic and borderline personalities; the clinical application of infant and attachment research; the dynamics of shame, hatred, and othering; dominance and submission; dissociation and trauma. Readings include the work of Winnicott, Bion, Kohut, Fonagy, Kernberg, Benjamin, Bromberg, van der Kolk, Akhtar, and others.

Class discussion and reading:

  • 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 instructor will encourage lively discourse, a stance of "not knowing," and ample opportunity for the presentation of case material.
Register Here

: This course is for PCC matriculated students or graduates, or clinicians who receive permission from the instructor. It will be at an intermediate through advanced level.

Training Program Credit: Students who successfully complete this course can earn credit in both the psychoanalysis and psychoanalytic psychotherapy training programs.

Where:     VIA ZOOM
When:      January 19 - May 10, 2021
Time:       7:10p - 8:40p
CME Credits: 24 / CE: 24 clock hours/ NBCC: 24 clock hours / All others: Letter of Attendance

About the Instructor: Peter Perault, MD 

Syllabus  Click here.

Registration and Tuition Deadline deadline is January 12.  $25 Registration Fee is due at the time of application.
Tuition: $650  
$485 for students matriculated in the training programs 
$600 for residents and graduate students
Payment plans can be arranged with the Administrator
Matriculated students aren't charged a course registration fee.  Students who register for more than one course in a semester pay only one registration fee.  In special circumstances, we may accept registrations after the registration deadline, but there will be an additional $20 late registration fee.
Course Cancellation Policy

Register Here

Course Learning Objectives: Class participants will be able to


  1. Describe the term “widening scope” and how this relates to working with trauma.
  2. Describe how the theory of narrative is useful in the development of how therapists listen to their clients.
  3. Describe the concept of empathic listening.
  4. Discuss the role of empathic listening toward achieving successful treatment.
  5. Describe the empathic mode of perception.
  6. Explain how shame develops over time according to infant research.
  7. Discuss the unbearable nature of shame and its impact on therapeutic work.
  8. Discuss the juncture between psychoanalysis, attachment, and trauma.  
  9. Describe some of the neurobiological underpinnings for personality disorders.
  10. Explain a mentalization-based approach to treating borderline personality disorder.
  11. Discuss various approaches to the treatment of borderline personality disorder.
  12. Discuss aspects of the nature of hatred and rage, its motivations, and its emergence in treatment.
  13. Explain dissociation and its impact on the clinical process.
  14. Discuss trauma and dissociation as it arises as a result of childhood sexual abuse.
  15. Describe the impact of trauma on transference and countertransference.
  16. Describe how neuroscience may impact how we consider the treatment of trauma and its aftermath.


 Updated 2020

CE & CME Information

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of American Psychoanalytic Association and Psychoanalytic Center of the Carolinas. 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 Credit ™. 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 Psychoanalytic Center of the Carolinas has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6518. Programs that do not qualify for NBCC credit are clearly identified. The Psychoanalytic Center of the Carolinas is solely responsible for all aspects of the program.


Contact: [email protected]