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CE: “The Art and The Science of Working Through in Psychodynamic Psychotherapy” – Dr. Martha Stark, M.D.

February 23, 2024 @ 10:00 am - 1:30 pm PST

Sponsored by
The WILA Alumni Association


The following is in the words of Dr. Stark:

I will rather boldly attempt to formulate an “overarching conceptual framework” for the working
through process in psychodynamic psychotherapy and in any depth psychology for which the
ultimate goal is deep and sustained healing. I will therefore be presenting a theoretical framework
that outlines a series of steps whereby psychological rigidity (rigid and unevolved defense) will
incrementally evolve into psychological flexibility (more flexible and more evolved adaptation).

The process of getting from rigid defense to more flexible adaptation is never a straight-line
progression. Rather, evolving from psychological rigidity to psychological flexibility will involve the
therapist’s strategic provision of not just support but also an artfully conceived combination of
challenge and support – namely, optimal stress.

Against the backdrop of empathic resonance and a collaborative alliance, the therapist will
therefore repeatedly offer the patient optimally stressful interventions mindfully formulated to
generate destabilizing internal dissonance and homeostatic imbalance. In essence, by
continuously juxtaposing “healthy but anxiety-provoking challenge” of the patient’s defenses with
“less healthy but anxiety-assuaging support” of them, the therapist will be creating growth-
incentivizing “mismatch experiences” for the patient – the ongoing working through of which will
prompt the patient to re-equilibrate at ever-higher and ever-more evolved levels of resilience and
adaptive capacity.

Indeed, I will hope to demonstrate that psychodynamic psychotherapy affords the patient both
impetus and opportunity, albeit belatedly, to master traumatic experiences that had once been
overwhelming – and, therefore, defended against – but that can now, by virtue of the synergy
between the therapist’s loving support and the patient’s underlying resilience and innate capacity to
adapt to stress, be revisited, re-enacted, grieved, reprocessed, and recontextualized, such that the
patient will eventually be able to “reposition” herself in relation to them. As a result, growth-
impeding defenses, once necessary for survival, can be gradually transformed into growth-
promoting adaptations – accompanied by a strengthening at the broken places.

In essence, the patient will be incentivized to return, in an embodied fashion, to the scene of the
original crime but will now be able to negotiate, in the context of her relationship with a therapist
who not only cares deeply but also has the courage to provide optimal challenge, a new, different,
and better ending (an adaptive resolution) – from “constricted” and “defended” to “expansive” and
“wide open.”

In the uplifting words of Rollo May, “The purpose of psychotherapy is to set people free.” 


Upon completion of the program participants should be able to:

  • identify the three stages in the working through process
  • explain the importance of cultivating dual awareness
  • highlight the distinctions between defensive, mindless reactions and adaptive, mindful
  • define optimal stress
  • describe what it means to be embodied
  • clarify the distinction between surviving and thriving
  • explain the relationship between traumatic growth-impeding stressors and defensive
  • highlight the relationship between optimal growth-promoting stressors and adaptive
  • describe what is meant by post-traumatic growth
  • explain why we can say that the problem always holds elements of the solution
  • clarify what is meant by the statement that optimally stressful interventions effectively
    superimpose an acute injury on top of a chronic one
  • explain why the patient’s return to the scene of the original crime is an important step in
    working through traumatic early-on stressors
  • describe the difference between the sobering reality of “what is” and the enlivening
    possibility of “what could be”
  • clarify the importance of generating, and then working through, mismatch experiences
  • explain the relationship between the Sandpile Model of Chaos Theory and ascending the
    steps of a spiral staircase
  • speak to the importance of therapeutic memory reconsolidation
  • enumerate the five modes of therapeutic action in the Psychodynamic Synergy Paradigm
  • explain the reason that the Psychodynamic Synergy Paradigm is described as a C.A.R.E.
    approach to deep healing
  • create a minimally stressful intervention
  • formulate an optimally stressful intervention
  • design an intervention that applauds and celebrates adaptive resolution


MARTHA STARK, MD, a graduate of Harvard Medical School and the Boston Psychoanalytic Institute, is a Holistic Psychiatrist (Adult, Adolescent, and Child) and Integrative Psychoanalyst in private practice in Boston, MA.

Martha is Faculty, Harvard Medical School; Co-Founder and Co-Director, Center for
Psychoanalytic Studies, William James College; Faculty, Psychiatry Redefined; Faculty and Scientific Advisory Board, Academy of Comprehensive Integrative Medicine; Adjunct Faculty, Smith College School for Social Work; Former Faculty, Boston Psychoanalytic Institute and Massachusetts Institute for Psychoanalysis; Advisory Board, Sensorimotor Psychotherapy Institute; Originator and Developer, Psychodynamic Synergy Paradigm: A C.A.R.E. Approach to Deep Healing.

Martha is an award-winning author of nine highly acclaimed books (including Relentless Hope: The Refusal to Grieve) on the integration of psychodynamic theory with clinical practice – several of which have become “required reading” in psychoanalytic training institutes and psychodynamic psychotherapy programs in the United States and abroad. She also has numerous teaching affiliations with local, regional, national, and international psychoanalytic/psychodynamic training programs.

Board Certified by the American Association of Integrative Medicine, Martha also contributes chapters to integrative medicine textbooks and articles to peer-reviewed toxicology /environmental medicine journals. Additionally, she serves on the editorial / advisory boards of various holistic health publications. Periodically, she is called upon to offer expert witness testimony on various toxic environmental exposures (including pesticides, volatile organic compounds, and mold).


  • 3 CE credits
  • This CE is at the intermediate AND advanced level
  • To receive CE credit you must attend the entire event

Wright Institute Los Angeles is approved by the California Psychological Association to provide continuing professional education for psychologists. The California Board of Behavioral Sciences accepts continuing education credit granted by the California Psychological Association or by any of its Approved Providers. Wright Institute Los Angeles maintains responsibility for this program and its content.


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February 23, 2024
10:00 am - 1:30 pm PST
Event Category:


Zoom (link will be emailed upon registration)


WILA Alumni Association
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