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Salman Akhtar, MD

In Leaps & Bounds: Psychic Development And Its Facilitation In Treatment

August 14th - August 18th, 2023

This course is only offered In-Person


This course is no longer available.





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15 Hour In-Person Course

Monday - Friday: 9:00a.m. - 12:30p.m. EDT / 30-Minute Break Daily

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Course Description

This set of presentations is about the up-to-date psychoanalytic understanding of psychic development and its application to treating patients in psychotherapy or psychoanalysis. It will cover the entire human life span beginning from the 'pre-self' (the prenatal determinants of personality) to the 'post-self' (the posthumous persistence of self as an internal object of others). Interspersed between these two poles shall be the psychosocial tasks of infancy, toddlerhood, oedipal phase, latency, and adolescence. However, unlike the customary ending at this point, the course will go on to a piecemeal deconstruction of adult development, focusing upon the major milestones of marriage, parenthood, midlife, changing relationships with parents and children, aging, infirmity, and death. The clinical utility of these ideas shall be established by the presentation of ten specific therapeutic measures that un-block thwarted development or create it in the first place. Ample illustrations from daily life, poetry, movies, and clinical practice will be provided.


The 'Pre-Self', Infancy, and Toddlerhood

The opening session of this series will focus upon the presenter's novel concept of the 'pre-self'. This notion refers to the vague outlines of the psychic self sketched out by pre-natal variables such as race, socioeconomic status, family myths, parental fantasies, birth order, and so on. The shadows and echoes of such factors will be shown to contribute to the post-natal self as it enters into interactional cycles with its caregivers. Early infantile development will be traced from the achievement of self-nonself discrimination and reality constancy to the establishment of dual unity and symbiotic experience. Subsequent phases of separation-individuation and move towards self and object constancy will also be highlighted. Clinical applications of these concepts will be emphasized and illustrated.


Oedipus, Latency, and Adolescence

This session will seek to explain the elusive or caricatured concept of the oedipus complex in its phenomenological and psychodynamic details. Mistakes made in the early conceptualization of this developmental challenge and the misogyny of some of those errors shall be highlighted and corrected by presenting alternate and newer models of understanding the issues involved here. Results of a successful shift from a dyadic to a triadic sense of family structure as well the consequences of the failure (or distortions) of this task will be noted. Subsequent phases of latency (with its emphasis upon engagement with external reality, conventionality, and school life) and adolescence (with its focus upon a second individuation, life-dream evolution, and merging affection and lust to arrive at the capacity for romantic love) will also be discussed.


Young Adulthood, Midlife, and Aging

This session will tackle the sub-optimally discussed realm of adult psychic development. Dividing adulthood into young adulthood, midlife, and old age shall set the ground to highlighting the specific psychosocial tasks of each subphase. Young adulthood subsumes the assumption of a wage-earner and householder status, marriage, and the pleasures and pains of becoming a parent. Midlife involves changing relationship to one's body, one's parents, and the re-working of oedipal anxieties now appearing in their inverted form and involving one's offspring. This period of life also stirs up a greed-asceticism dilemma which needs to be resolved. And, then there is old age with illnesses, infirmities, losses but also freedom from life's demands, joys of grandparenthood, and accrued wisdom.


Development-Facilitation Interventions

This session will offer the details of ten therapeutic interventions that are intended to facilitate the resumption of thwarted development or to set it into motion for the first time. These interventions include 1) providing nonverbal ego-strengthening measures, (2) creating psychic space for thinking, (3) helping the patient find words for inner experiences, (4) continuing to work despite what might seem reprehensible in the patient's material, (5) recognizing that an occasional regression is integral to development, (6) validating the patient's reality, (7) restraining the greed for interpretation, (8) seeing goodness in the patient, (9) enhancing the sense of personal agency in the patient, and (10) facilitating conversation about mortality, death, and dying.


Dying, Death, and the 'Post-Self'

This session will focus upon end-of-life issues. Six misunderstandings in psychoanalysis regarding death will be elucidated and discussed. The importance of graves, epitaphs, alternate forms of disposal of dead bodies, living wills, inheritance etc. will be discussed. All this would lead to the concept of 'post-self,' which refers to the posthumous persistence of one's self as an internal object of others. The responsibility of creating a "good" post-self would be brought up, and the variations of psychic immortality will be discussed. Clinical relevance of such proposals will be highlighted.

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Salman Akhtar, MD

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What Alumni are Saying...

“Dr. Akhtar’s humor and storytelling skills were so engaging. I really appreciated that he provided deep theoretical knowledge as well as technical information.” - 2018 Participant

“This was the most clinically helpful workshop I’ve ever attended. Salman distilled the emotions to the essential elements and also presented them from different theoretical perspectives. But he did so in the most accessible and clear manner so that I can use the concepts presented and apply them directly to my patients.” - 2018 Participant

“I found the course inspiring and informative. The lectures were excellent - Dr. Akhtar is extremely engaging, and tempers difficult topics with appropriate humor.” - 2018 Participant

Learn more about the Cape Cod Institute from former participants



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