Anne Alvarez, Ph.D., M.A.C.P. is a Consultant Child and Adolescent Psychotherapist (and retired Co-Convener of the Autism Service, Child and Family Department Tavistock Clinic, London). She is author of Live Company: Psychotherapy with Autistic, Borderline, Deprived and Abused Children and has edited with Susan Reid, Autism and Personality: Findings from the Tavistock Autism Workshop. A book in her honor, edited by Judith Edwards, entitled Being Alive: Building on the Work of Anne Alvarez was published in 2002. She was Visiting Professor at the San Francisco Psychoanalytic Society in November 2005 and her latest book, The Thinking Heart: Three Levels of Psychoanalytic Therapy with Disturbed Children was published in April 2012 by Routledge.
This attempt to formulate a schema of three levels of analytic work arises out of the clinical failure to reach extremely damaged patients with more ordinary explanatory (a la Freud, 1905) or locating (Klein, 1946) interpretations. It has been learned that such people were not capable of the kind of spatial, temporal and causal thinking involved in what Bruner calls two- tracked thinking, (Bruner, 1968). The assumptions that the person had an ego and self to whom one could speak, and a clear sense of an object to which one could refer, proved false – as did the assumption that they could understand, or not be overwhelmed by, `why-because’, or `who – you’ comments. It shall be suggested, therefore, that historical developments in levels of interpretation may need to be reversed when clinical, psychopathological and developmental considerations are taken into account.
A second level of containment or empathic description of the` whatness’ or `isness’ of experience (Bion, Winnicott,Joseph, Stern) may be necessary, therefore, when the patient is able to manage only one `track’ at a time. The importance of positive transferences shall be discussed and countertransferences for emotional and cognitive development. The importance of distinguishing different types of violence and the implications for technique shall also be discussed.
With certain cut-off or lost patients, a third, more intensified and vitalizing level of work which recalls the patient to life and to himself, and which may help him to get on track, via a sort of `Hey there!’- may be needed. Some discussion of moments of birth or rebirth of psychic life shall be included. The timing of these different levels of intervention may coincide to some extent with the course and development of the treatment, but it may also need to shift from moment to moment within a single session as the patient moves from more dissociated, fragmented or unintegrated states to moments of greater integration.
LEARNING OBJECTIVES - At the conclusion of the event the participants will be able to:
1. Differentiate three different levels of psychoanalytic technique: an explanatory level, (`why- because’), a descriptive/attuning/amplifying level, attending to the `whatness or `isness’ of experience, and an intensified level, which aims to call the patient into live contact with his experience, his being, and with others.
2. Appraise the preconditions in the patient to enable them to use or to need these three different types of intervention.
3. Discuss through clinical examples the differing mental states relevant to the use of the various levels of intervention.
This presentation is designed for mental health professionals, including psychologists, psychiatrists, and social workers, with a $25 registration fee.
CONTINUING EDUCATION CREDITS AUTHORIZED: 3.0 (M.D., Ph.D., Social Work) 
For more information contact Alicia Zaludova  at 413-931-5230.
Saturday Morning Workshops are open to licensed mental health professionals. Workshops require advance registration with payment of a non-refundable fee of $25.00. Register online for Saturday Morning Workshops, or call (413) 931-5273. Space is limited.