MISA Workshop 2023

The Masterson Therapist in the Clinical Setting


The Masterson Institute of South Africa invites you to an experiential and participatory workshop that will explore the therapist’s experience in working with, and through, the conflicts that are central to the pre-oedipal experience.

The pre-oedipal patient presents to the treating therapist a unique dilemma: the self’s experience is acted out in relation to the object in a rigid and receptive expectation of validation. The self is caught up in a destructive pattern of relating, that represents the infantile wish for acknowledgement from the object as a separate and real entity. Pathology of relating presents with repetitive and exuberant acting-out behaviours that are aimed at avoiding the pre-oedipal disappointments within the original object relations. Masterson (Masterson Approach), Kernberg (Transference Focused Psychotherapy) and Linehan (Dialectical Behaviour Therapy) are all clinicians that realised that the disorder that resides within the self needs to be treated with a different approach. Masterson describes the pre-oedipal condition from a developmental, self and object relational perspective and postulated a unique approach in acknowledging the real self. Masterson facilitated for the false self/defensive self to let go of the defences aimed at holding on to the pathological self’s relation to the phantasy of acceptance, and through therapy open a painful space for the real self to slowly emerge.

It is this approach that led to a misunderstanding of what really happens in the treatment room of the Mastersonian therapist. The following Searles quote serves as a good example:

I am particularly interested in the ways in which Dr. Masterson’s more global and objective stance, in conducting work with borderline patients or at least in conceptualizing such work, stands in contrast to my own relatively high degree of immersion in the feelings that one experiences in the course of this work. I should say, once again, that I found his paper highly instructive to me and I am necessarily, however, slanting my comments toward what I can say in the way of addition.It is fair to say that Dr. Masterson reports to us extremely little of the feelings which the therapist experiences in doing this work, in much contrast to my own previously expressed views as to the degree in which the therapist or analyst necessarily shares in the therapeutic symbiosis with these patients, or at times feels himself a child threatened with abandonment by the patient as a mother, or feels threatened by the intensity of the patient’s images of him as being an abandoning bad mother.”

The aim of this workshop is to address and illustrate how Searles’s comment is missing the core of the Masterson approach. Four senior faculty members will share their personal experience through case presentations. The focus will be on the therapeutic process, countertransference and countertransference acting-out behaviour as experienced by the therapist. There will be four presentations: Borderline-, Narcissistic-and Schizoid Disorder of the Self on the first day, and a complex trauma case on the second day. Throughout the workshop attendees will be encouraged to participate in the discussion taking place. The aim will be to facilitate the process of reverie as a containment experience and what is being heard by the attendees.


Friday 9 June 2023

08:30-10:30 – Reality of the rejected

Sean Moorcroft will present his work with a borderline disorder of the self patient. As a therapist working with the often volatile and explosive nature of the self within the therapeutic relationship, the therapeutic process can be a daunting walk to self-activation or self-destruction. Sean will guide us through the initial reward-seeking acting-out behaviour in his case presentation, and how the therapist had to work with his own countertransference to hold on to theory and create a holding/facilitating environment. The destructive experience of not being good enough, as felt in the object relations of the borderline disorder of the self, will be illustrated. The therapist will share the constant attack through the projective nature of the negative self experience on the therapist. Sean will be interviewed by Loray Daws during the second hour of the presentation and the audience will be encouraged to share their own thoughts on the process.

10:30-11:00 – Tea

11:00-13:00 – Sameness, shame and masculinity

JP Theron will share the therapeutic process and internal experience (impacts, countertransference, reveries) of the psychotherapy with a patient whom exhibits self-esteem and vulnerability dilemmas, the narcissistic disorder of the self. He will illustrate the therapeutic pitfalls that allow the patient to get in contact with the vulnerability that encapsulates the real self. The patient’s wish for sameness (Kohut’s twinship), the accompanied shame (inadequacy/emptiness) and his search for sexual identification and masculinity (in idealisation and identification with the therapist, fantasies) will be the main areas covered. JP hopes for a thought-provoking discussion that might resonate with other therapists doing this work, or to stimulate creativity; a real self product that is continuously to be called upon so as to find an entry point with each unique patient, given their own intricate defensive armour. JP will be interviewed by Sean Moorcroft during the second hour of the presentation and the audience will be encouraged to share their own thoughts on the process.

13:00-14:00 – Lunch

14:00-16:00 – Discussing the presence of a receptive dream

Loray Daws will share the journey of a schizoid disorder of the self patient in returning from exile. The patient’s struggle with relating to the object, the fear of enslavement and reactive projections of his paranoid experiences can be seen in Loray’s discussion of his own dreams. The presentation will focus on creating a therapeutic reality with a patient that is deeply withdrawn within the phantasy world, and how phantasy can create a substitute relation. The impact of this can go beyond the borders of the therapy room. Loray will discuss the therapist’s response to the patient entering his own dream world, and the counter-tranferential struggle to separate self from projection. Loray will be interviewed by JP Theron during the second hour of the presentation and the audience will be encouraged to share their own thoughts on the process.

Saturday 10 June 2023

8:30-10:30 – The death of a doctor

William Griffith presents a case that focuses on both the therapeutic and legal aspects in working with a young patient who has lost a parent to a violent crime. William will discuss his own countertransference in a therapeutic process that is characterised by hate and painful attempts by a young person to put together their life after losing both parents. The difficulty of navigating adolescence and reworking one’s individuation is a daunting task in human development. To do that without a reference/guide (meaning parents) complicates any developmental stage, the patient’s attempts at individuation and splitting defences will be discussed in detail. The therapist will highlight the loss of dreams, the feeling of being lost and how this was projected onto the therapist as an uncontainable expectation of hope. And how the reality of finding a dream again means to be confronted with not hope, but dreams to be filled with violence and destruction.

10:30-11:00 Tea

11:00-13:00 – Group facilitation/discussion

Members of the Masterson Institute will facilitate an interactive discussion that will answer questions related to the presentations, but will also focus on creating a shared experience. The attendees will be encouraged to share own thoughts on the workshop and experiences of the shared case material.

The Workshop is accredited for 10 general CEU’s.

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