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Elective in Psychodynamic Psychiatry
The Elective in Psychodynamic Psychiatry is designed to provide students of psychiatry (including both medical students and psychiatric residents) with psychodynamic perspectives that complement the medical model that is dominant in mainstream psychiatric approaches to major psychiatric illness.
A Unique Training Opportunity
During the Elective in Psychodynamic Psychiatry, students join the Therapeutic Community in a psychoanalytic residential treatment center. In this context, you have an opportunity to learn how a patient-centered, psychodynamically-informed approach is able to capitalize on issues of meaning, relationships, and patient authority in order to optimize treatment outcomes for patients who have typically been seen as “treatment-resistant.”
The elective course is intended to provide you with an understanding of how developmental issues and maladaptive efforts to cope with developmental stress can foster psychopathology. You’ll learn how psychodynamics affect not only individual psychology, but also shape group functioning (including the function of clinical treatment teams), medication responsiveness, and other aspects of psychiatric practice. By attending staff and team meetings, case conferences, individual supervision, and other educational opportunities, you’ll learn about the psychotherapeutic role, deepen your understanding of the importance of psychotherapeutic boundaries, and understand more about the struggles and techniques involved in attaining a therapeutic alliance. Didactic experiences complement this learning and help you develop a deeper understanding of psychoanalytic theory.
The psychiatry elective experience may be tailored to the specific interests of more advanced students and residents, including a broader focus on learning about psychodynamic approaches to treatment-resistance or the psychodynamic perspectives of groups and therapeutic community treatment. Students may also conduct interviews with patients aimed at developing a psychodynamic formulation that appreciates the adaptive value of the patient’s psychopathology, transference and countertransference implications emerging from the patient’s history, and an appreciation of how the patient’s dynamics contribute to treatment-resistance, including resistance in relation to pharmacotherapy.
The varied educational experience at Riggs typically includes:
- Involvement in the therapeutic community program as participant observers
- Learning about psychotherapy and dynamic formulation
- Learning about the psychodynamics of psychopharmacology
- A focus on patients' strengths
- Didactic experiences
- Integration of the entire learning experience through supervision/mentorship by therapy staff
At the conclusion of the elective, you will be expected to:
- Demonstrate a basic understanding of the process of psychodynamic psychotherapy
- Demonstrate a general grasp of psychoanalytic theory and concepts
- Express a basic knowledge of transference and countertransference
- Demonstrate a clear understanding of the importance of boundaries in psychiatry
- Convey an understanding of the fundamental principles of psychodynamic psychopharmacology
“My third year of medical school was particularly challenging because I struggled to practice medicine in the way I had envisioned. But when I arrived at Austen Riggs, it felt like I could finally breathe again—like I had found people who spoke the same language as me. You all truly care about patients, encouraging them to love and embrace their authentic selves rather than forcing them into society’s version of normalcy. I hope to carry all these insights and the magic of Riggs with me as I continue making my way in this world.” - Vivian Lee, LMHC, former elective student
Applying for the Elective
To be eligible for this rotation you will need to have already completed a core clinical rotation in psychiatry and be in good standing in your LCME-accredited training programs.
Begin the Process
Begin your application with this easy-to-use form.
To be eligible for this rotation you will need to have already completed a core clinical rotation in psychiatry and be in good standing in your training programs. If you’re interested in the elective, you should complete and submit the online application along with the requested documentation. If you have any questions, please contact the elective’s administrator, Summer Heller.
Frequently Asked Questions
Below are answers to some frequently asked questions about the Elective in Psychodynamic Psychiatry
How long is a typical elective?
Most students come for a four-week elective, but we can also accommodate students for up to eight weeks. We do not offer an elective for less than four weeks.
Are there particular months or time frames when the elective is offered?
In the 2025-2026 academic, the elective is open to psychiatric residents for the following dates: 9/9/25-10/24/25, 11/3/25-11/26/25, 3/30/26-4/24/26. It is open to medical students for the following dates: 1/5/26-1/30/26, 2/2/26-2/27/26, 3/2/26-3/27/26.
Are interinstitutional agreements required?
Typically, yes. For medical students, the AAMC Uniform Clinical Training Affiliation Agreement Implementation Letter is sufficient. For residents, a Program Letter of Agreement is required.
What does the typical weekly schedule look like?
What does the typical syllabus look like?
What are the objectives of the elective?
By the end of the elective rotation, students should be able to:
- Appreciate the importance and use of boundaries in psychiatric practice
- Understand how the human dimension (developmental histories, defenses, adaptations) shapes illness manifestation and response to treatment
- Demonstrate an understanding of the process and unique challenges of psychodynamic psychotherapy with complex patients
- Demonstrate a grasp of psychoanalytic concepts applicable to work with difficult-to-treat patients
- Express an advanced understanding of transference and countertransference dynamics and how this impacts treatment with complex patients
- Convey an understanding of the fundamental principles of psychodynamic psychopharmacology
What clinical responsibilities will I have in the elective?
Students in the elective have no patient care responsibilities. Students do, however, have significant interaction with patients as co-members of the Therapeutic Community (e.g., participating in the Community Meeting and other Patient-Staff groups) and students are authorized to participate in groups from their student role as participant-observers.
Is there a cost for the elective?
There is no charge for attendance in the elective. Neither is there a stipend.
Are accommodations provided?
Under normal circumstances, we are unable to provide housing for students in the elective. In some circumstances, housing may be available, but certainly should not be counted on. Given that the Berkshires are a vacation destination in the summer, fall, and winter, we do try to help connect students with affordable housing in the local community.
Is the elective open to international medical graduates?
No.
How far ahead of time should I submit an application?
There is no formal application period. However, we are unable to accommodate more than four students at a time, and so the elective may fill up. For maximum flexibility in scheduling, we find that a lead time of 6-10 months is usually adequate to have your pick of available slots, and we may be able to accommodate students with a much shorter lead time, depending on whether the elective is full.
What Former Elective Students Have to Say