March 11, 2017 @ 9:00 am – 12:00 pm
141 Herrick Road
Newton Centre
MA 02459
Lauren Lukason
617-266-0953 x107
2017 Psychotherapy Conference -- "I think I'm losing her!": Navigating the threat of premature termination @ BPSI


“I think I’m losing her!”: Navigating the threat of early termination

How do therapists understand and respond to pressures for premature termination, especially when the request is embedded in a “real life” developmental event?  This paper traces the evolution of maternal transference themes that are enacted in reverberating layers between client, mother, daughter, therapist, and supervisor. As conflicts related to attachment, separation, and aggression unfold, the author examines the echo of her client’s anxiety about being a perfect mother in her own anxiety about “holding” the patient in therapy. Ultimately, the patient presses for early termination of the therapy when her pregnancy abruptly ends in an emergency premature delivery, and the therapist must consider multiple tensions: the patient’s wishes to terminate, concerns about whether termination is in the patient’s best interest, and acknowledgment of the therapist’s own wishes for continuing the treatment.

Drs.  Brown and Epstein will respond to the case material by illuminating multiple facets of intersubjectivity, attachment, and maternal subjectivity.


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Ann Kraybill, LICSW (Presenter) is a post-seminar student in the Advanced Training Program in Psychoanalytic Psychotherapy at BPSI. She is the Social Work Graduate Education Training Director at the VA Medical Center in White River Junction, Vermont and a staff psychotherapist there. She is also a Clinical Assistant Professor in Social Work at the Smith College School for Social Work, Clinical Instructor of Social Work at Simmons School of Social Work, and a Clinical Instructor in Psychiatry at the Geisel School of Medicine at Dartmouth. She has a private practice in Norwich, Vermont.

Ann Epstein, MD (Discussant) is a child psychiatrist and adult analyst on the BPSI faculty and a supervisor in child psychiatry at the Cambridge Health Alliance.  Dr. Epstein has a long-standing interest in early development, attachment theory, and the origins of intersubjectivity and is a founding faculty member of the Infant Parent Training Institute at Jewish Family and Children’s Service. She has a private practice in Cambridge.

Lawrence Brown, PhD (Discussant) is a child and adult analyst, and supervising child analyst on the BPSI faculty. He is also on the faculty of Massachusetts Institute for Psychoanalysis and President of the Boston Group for Psychoanalytic Studies.  His book, Intersubjective Processes and the Unconscious: An Integration of Freudian, Kleinian and Bionian Perspectives, was published in 2011 and he has another book in progress, Contemporary Psychoanalysis: The Theory and Technique of Transformations to be published by IPA Publications and Karnac. He has a private practice in Newton Centre.

Alan Pollack, MD (Moderator) is an adult analyst on the faculty at BPSI, where he was Director of Psychotherapy Training for 24 years. He is currently in private practice in Newton.


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Learning Objectives

At the conclusion of this program, participants will be able to:

  1. Describe three challenges in responding to a patient’s press for termination.
  2. Describe two examples where transference/countertransference dynamics became organized around separation-individuation challenges.
  3. Evaluate the additional pressure brought to bear on the negotiation of termination by the patient’s pregnancy.



9:00 am – 9:15 am: Introduction; 9:15 am – 10:15 am: Presentation; 10:15 am – 10:30 am: Coffee Break; 10:30 am – 10:50 am: First Discussant; 10:50 am – 11:10 am: Second Discussant; 11:10 am – 12:00 pm: Discussion with Audience



Balsam, R.H. (2000). The Mother Within The Mother. Psychoanal Q., 69:465-492.

Bass, A. (2009). “It Ain’t Over ‘til It’s Over”: Infinite Conversations, Imperfect Endings, and the Elusive Nature of Termination. Psychoanal. Dial., 19:744-759.

Kite, J.V. (2012). A Case for Analysis with the Baby in the Consulting Room. J. Amer. Psychoanal. Assn., 60:501-508.

Winograd, Wendy (2016). Demeter’s Compromise: Separation, Loss, and Reconnection in Mothers with Daughters Entering Adulthood. Psychoanalytic Social Work 23: 23-41.


Continuing Education

Physicians: 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 the American Psychoanalytic Association and the Boston Psychoanalytic Society and Institute. The American Psychoanalytic Association is accredited by the ACCME to provide continuing medical education for physician. The American Psychoanalytic Association designates this Live Activity for a maximum of 3 AMA PRA Category 1 Credit(s)™. 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.

Psychologists: The Boston Psychoanalytic Society and Institute is approved by the American Psychological Association to sponsor continuing education for psychologists. The Boston Psychoanalytic Society and Institute maintains responsibility for this program and its content. This program fulfills the requirements for 2.5 hours of CE.

Please note: Per APA requirements, psychologists must attend 100% of a course in order to be eligible for continuing education credit.

Social Workers: Please contact the Boston Psychoanalytic Society and Institute’s Administrative Office at 617/266-0953 or office@bpsi.org for more information.

Please note: Per NASW requirements, social workers must attend 80% of a course in order to be eligible for continuing education credit.

Grievance Policy

Please address any questions or concerns about your experience at this or any program or event you have attended at the Boston Psychoanalytic Society and Institute to the Program Chair, via the Senior Administrator/ Director of Continuing Education, BPSI, 141 Herrick Road, Newton Centre, MA 02459; office@bpsi.org; 617.266.0953.

Cancellation Policies & Procedures

Any program participant requesting their individual program registration be canceled, must submit their request in writing via email to Drew Brydon at dbrydon@bpsi.org. For fee-based events, a request for cancellation (and refund using the original form of payment) must be received no later than 48 hours in advance of the event. Requests received later than 48 hours prior to the event will not be processed or accepted.

All approved refunds are subject to a $10.00 administrative fee.

If BPSI cancels an event, all registrants will receive a full refund of fees paid (no administration charge) no later than two business days following the scheduled date of the event, using the original form of payment.

The Boston Psychoanalytic Society and Institute, Inc., 141 Herrick Road, Newton Centre, MA 02459, does not discriminate on the basis of race, creed, color, sex, age, sexual orientation, national origin or handicap in the admissions, administration of its educational programs, scholarship and loan programs or employment.