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Addressing the Wish to Suffer

  • Saturday, January 09, 2021
  • 9:00 AM - 4:00 PM
  • Zoom


Registration is closed

Addressing the Wish to Suffer

CE/CMEs - 5.5 Credit Hours


What do we do when a patient justifies her suffering? How do we work with a patient who thinks hurting himself is good? In this workshop, we will look at videotapes of three cases to learn how to address splitting and projection in self-destructive patients. If you talk about how defenses hurt these patients, they may argue with you, shrug their shoulders, or even act as if you are crazy. It’s as if all the anxiety and sanity in the room is in you, while the patient is quite content and calm with their self-destructiveness and suffering. Any attempt to interpret falls on deaf ears. Your attempts to rescue the patient only seem to deepen the patient’s self-harm!

In these videotaped cases, we will look at three examples of how to identify projections and deactivate them. And you will learn how to mirror the absence of conflict in order to mobilize conflict in the patient. And you will learn how to identify and deal with common countertransference reactions these patients evoke.

Learning Objectives 

1. Identify self-destructive defenses

2. Identify absence of conflict in the patient

3. Apply the process of mirroring the resistance

4. Demonstrate an effective focus on the resistance


Jon Frederickson, MSW
, is on the faculty of the Intensive Short Term Dynamic Psychotherapy (ISTDP) Training Program at the Washington School of Psychiatry. Jon has provided ISTDP training in Sweden, Norway, Denmark, Poland, Italy, Switzerland, India, Iran, Australia, Canada, the U.S., and the Netherlands. He is the author of over fifty published papers and four books, Co-Creating Change: Effective Dynamic Therapy Techniques, Psychodynamic Psychotherapy: Learning to Listen from Multiple Perspectives, The Lies We Tell Ourselves, and Co-Creating Safety: healing the fragile patient. His book, Co-Creating Change, won the first prize in psychiatry in 2014 at the British Medical Association Book Awards, and it has been published in Farsi, Polish, and Slovak, and is currently being translated into Hebrew and Spanish. His book The Lies We Tell Ourselves has been published in Polish, Farsi, Norwegian, and Danish, and is currently being translated into German. He has DVDs of actual sessions with patients who previously failed in therapy at his websites and There you will also find skill-building exercises designed for therapists. He writes posts on ISTDP at . His forthcoming skill-building book for therapists, Healing Through Relating, will come out in 2021.

Participant Confidentiality and Disclosure Acknowledgement

On behalf of the Washington School of Psychiatry, we are pleased to offer you the opportunity to attend this training in Short-Term Dynamic Psychotherapy.

Your registration acknowledges your understanding that the information and patient disclosures presented during this training are of a highly sensitive nature and are presented for educational purposes. The audio-visual portion of this training is provided by patients who volunteered the use of their treatment sessions for purposes of teaching others these techniques. Their willingness is based on the assurance of complete confidentiality of their identities and histories. You are entrusted with the confidentiality of their identities and histories and the material you will see and hear in this seminar.

In consideration of your registration as a participant in this seminar:

1. The undersigned agrees that no copies will be made or retained of any course materials and patient information regardless of its form.

2. I acknowledge that all videotaped material to which I am permitted access during this seminar is the sole and exclusive property of the presenters. In consideration of my admittance to this seminar, I hereby agree that I shall not electronically or in any other way (eg. transcription) copy or duplicate such material. I further agree that I shall not refer to any specific patient seen, heard or described in such material otherwise. This information shall not be disclosed to anyone regardless of their affiliation to you or the Washington School of Psychiatry including but not limited to employees, legal representative or consultants unless they agree to execute and be bound by the terms of this agreement.

3. I acknowledge that violation on my part of this agreement could cause irreparable injury to The undersigned acknowledge that the unauthorized disclosure of the confidential information whether orally or in writing either in whole or in part, could cause irreparable harm to the Patients; the Presenter; Washington School of Psychiatry, its agents or assigns; Faculty, Clinicians, and Instructors.

4. I therefore agree that in the event of such violation, the presenter shall have the absolute right to obtain from any regulatory body or court having jurisdiction appropriate decrees enjoining any further violation of this agreement.

5. Any posting, reproductions, publishing, distribution, display, and or transmission course materials would constitute an unauthorized disclosure.

6. You hereby agree to indemnify, defend and hold harmless the Washington School of Psychiatry from and against any and all liability and costs incurred by the Washington School of Psychiatry in connection with any claim arising out of any breach or alleged breach of any of your obligations set forth herein. You shall cooperate as fully as reasonably required in the defense of any claim. The Washington School of Psychiatry reserves the right, at its own expense, to assume the exclusive defense and control of any matter otherwise subject to indemnification by you and you shall not in any event settle any matter without the written consent of The Washington School of Psychiatry.

6. Furthermore, if the patient is known to me in any way, personally or professionally, I will immediately excuse myself from the training


Participants should claim only the credit commensurate with the extent of their participation in the activity.

The Washington School of Psychiatry is approved by the American Psychological Association to sponsor continuing education for psychologists. The Washington School of Psychiatry maintains responsibility for this program and its contents.

The Washington School of Psychiatry is authorized by the Board of Social Work Examiners in Maryland to sponsor social work continuing education learning activities and maintains full responsibility for this program. This training qualifies for Category I continuing education units.

The Washington School of Psychiatry has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6388. Programs that do not qualify for NBCC credit are clearly identified. The Washington School of Psychiatry is solely responsible for all aspects of the program.

The Washington School of Psychiatry is accredited by MedChi, The Maryland State Medical Society to provide continuing medical education for physicians.

The School designates the program for a maximum of 5.5 AMA PRA Category I Credit(s)â„¢. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure of Commercial Support and the Unlabeled use of a commercial product. No member of the planning committee and no member of the faculty for this event have a financial interest or other relationship with any commercial product.

The Washington School of Psychiatry is an independent non-profit organization. It is not affiliated with the government of the District of Columbia or the government of the United States.

The Washington School of Psychiatry is approved to operate by the Higher Education Licensure Commission of the District of Columbia.

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The Washington School of Psychiatry is an independent non-profit organization. It is not affiliated with the government of the District of Columbia or the government of the United States.

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