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Optimal Responsiveness and the Specificity of Therapeutic Process
Instructor:  Howard Bacal, M.D.

Biography:
Howard Bacal obtained his medical degree from McGill University, psychiatric training at the University of Cincinnati and postgraduate training in psychotherapy at the Tavistock Clinic in London, where he was also involved in psychotherapy research with David Malan. Howard trained in adult and child psychoanalysis at the British Institute of Psychoanalysis, where he worked with - amongst others - Michael Balint, Donald Winnicott, Marion Milner, Wilfred Bion and J.D. (“Jock”) Sutherland.  After he returned to this side of the pond, Howard became interested in Self Psychology, and undertook a second period of training with Heinz Kohut in Chicago.  He introduced the perspectives of self psychology to the psychoanalytic community in Toronto, focusing on the integration of its sensibilities with theories of object relations.  Howard moved with his family to Los Angeles in 1995, to find a better climate, especially for new ideas.  

Howard is a Training and Supervising Analyst at the Institute of Contemporary Psychoanalysis and at the New Center for Psychoanalysis in Los Angeles, and Supervising Analyst at the Institute for the Psychoanalytic Study of Subjectivity in New York. He is in private practice in Los Angeles. Howard has authored many clinical and theoretical articles on therapeutic process, psychoanalytic research and training. He is co-author of the book, Theories of Object Relations: Bridges to Self Psychology (Columbia University Press, 1990), and editor of Optimal Responsiveness: How Therapists Heal their Patients (Jason Aronson, 1998).  Howard’s new book, The Power of Specificity in Psychotherapy: When Therapy Works – And When It Doesn’t (Jason Aronson, 2011), elaborates specificity theory - a contemporary psychoanalytic process theory of therapeutic efficacy.

Class Description:
This class introduces Specificity Theory.  Specificity theory is a contemporary psychoanalytic process theory whose focus is therapeutic effect. Specificity theory contrasts with traditional psychoanalytic theories that are based upon a structured concept of mind. Such theories prescribe and proscribe certain responses on the basis of their concepts, and designate techniques that offer methods and guidelines in order to obtain foreseen results. Specificity theory holds that each analyst-patient dyad constitutes a unique, unpredictable, and reciprocal relational system, and that its participants will optimally co-create, through the particularity of their process, what is therapeutically possible for them. In this way, as the specificities of their unfolding process unfold, a wide array of theoretical concepts may more usefully come into play. 
Specificity theory is consonant with Gerald Edelman's theory of the uniqueness of each brain and its formation: that the human mind is continuously created through ongoing selective interaction with itself and its environment.  Specificity theory is also significantly accordant with the findings of Tronick and Sander about infant-caregiver interaction.

Specificity theory regards therapeutic effect as centrally a function of the capacities and limitations of the particular therapist and patient to understand and respond to each other at any moment in time and over the course of the treatment. Attention to the specificity of process between that patient and that therapist enhances possibilities for achieving maximal therapeutic effect, and clarifies why this may not be happening.

Readings: 
From the book, "The Power of Specificity in Psychotherapy: When Therapy Works – And When It Doesn’t”, H. A. Bacal, 2011. Lanham, MD: Rowman & Littlefield - Jason Aronson.  (149 pages).

Chapter 1 - The Need For A New Theory Of Therapy

Chapter 2 - The Use Of Theory In Psychoanalytic Practice

Chapter 3 - How Specificity Theory Changes Clinical Practice

Chapter 4 - The Neurobiological Substrate Of Specificity Theory

Chapter 5 - The Evolution Of Specificity Theory:  A Professional And Personal Odyssey

Chapter 6 - The Foundational Perspectives Of Specificity Theory

Chapter 7 - Clinical Consequences Of The Shift From The Universality Of  Structure To The Specificity Of Process

Chapter 8 - How Specificity Theory Alters Our View Of Psychoanalytic Principles And How This Affects Therapeutic Action

Chapter 9 - Correlates Of Specificity Theory Within Infant Research

Chapter 10 - The Power Of Specificity In The Process Of Supervision


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