THE STARK METHOD of
PSYCHODYNAMIC SYNERGY
Integrating Traditional and Nontraditional Solutions
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THE STARK METHOD of PSYCHODYNAMIC SYNERGY:
A C.A.R.E.S. Approach to Deep Embodied Healing
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C – Cognitive
A – Affective
R – Relational
E – Existential
S – Synaptic
Martha Stark, MD – Summer 2024
Lecturer on Psychiatry (part-time) / Cambridge Health Alliance
Harvard Medical School
“Five Interdependent Modes of Therapeutic Action”
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Models 1, 2, 3, 4, and 5 all focus on transforming “psychological rigidity” into “psychological flexibility,” more specifically, “rigid defense” into “more flexible adaptation.”
At the end of the day, in all 5 Models the “therapeutic action” will involve creating – against the backdrop of empathic attunement and a solid therapeutic alliance – optimally stressful, growth-incentivizing “mismatch experiences” by provocatively “juxtaposing” the sobering and conditioned reality of “what is” with the enlivening and quantum possibility of “what could be.”
“Working through” these destabilizing “violations of expectation” will provide both “impetus” and “opportunity” for the patient to relinquish her “attachment” to old bad “defensive rigidity” in favor of new good “adaptive flexibility” such that internal tension can be resolved and homeostatic balance restored – in the process advancing the patient to ever more evolved levels of resilience and adaptive capacity.
Please note that in all 5 Models the defense starts with the letter “R,” the adaptation starts with the letter “A,” and the optimal stressor starts with the letter “D” – which makes my Psychodynamic Synergy Paradigm RAD!!
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Model 1 – the interpretive perspective of classical psychoanalytic theory
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The therapeutic action facilitates transformation of “resistance” (the defense) into “awareness” (an adaptation).
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The cutting edge of the work involves “cognitive dissonance” (the optimal stressor).
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Model 2 – the corrective-provision perspective of self psychology and other “deficit” theories
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The therapeutic action facilitates transformation of “relentless hope” (the defense) into “acceptance” (an adaptation).
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The cutting edge of the work involves “affective (optimal) disillusionment” (the optimal stressor).
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Model 3 – the intersubjective perspective of contemporary relational theories
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The therapeutic action facilitates transformation of “re-enactment” (the defense) into “accountability” (an adaptation).
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The cutting edge of the work involves “relational detoxification” (the optimal stressor).
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Model 4 – an existential-humanistic approach to mending brokenness and easing existential angst
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The therapeutic action facilitates transformation of “relational absence” (the defense) into “authentic presence” (an adaptation).
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The cutting edge of the work involves “existential dependence” (the optimal stressor).
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Model 5 – a quantum-neuroscientific approach to “analysis paralysis” and neural entrenchment
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The therapeutic action facilitates transformation of “refractory inertia” (the defense) into “action” and “actualization of potential” (an adaptation).
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The cutting edge of the work involves “quantum disentanglement” (the optimal stressor).
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FIVE PERSPECTIVES –
Model 1 – the interpretive perspective of classical psychoanalytic theory
Model 2 – the corrective-provision (or deficiency-compensation) perspective of self psychology and other “deficit” theories
Model 3 – the intersubjective perspective of contemporary relational theories
Model 4 – an existential-humanistic approach to mending brokenness and easing existential angst
Model 5 – a quantum-neuroscientific approach to analysis paralysis, inertia, and inaction
THE THERAPEUTIC ACTION AS –
Model 1 – enhancement of knowledge “within”
Model 2 – provision of experience “for”
Model 3 – engagement in relationship “with”
Model 4 – nurturing of surrender “to” moments of meeting “between”
Model 5 – envisioning of possibilities “beyond”
THE POINT OF EMOTIONAL URGENCY –
Model 1 – neurotic conflictedness
Model 2 – narcissistic vulnerability and woundedness
Model 3 – noxious relatedness and compulsive, unwitting re-enactment
Model 4 – nonrelatedness
Model 5 – nonaction and narratives that are outdated and disempowering
FOCUS – A C.A.R.E.S. Approach to Deep Healing
Model 1 – Cognitive
Model 2 – Affective
Model 3 – Relational
Model 4 – Existential
Model 5 – Synaptic and Shapeshifting
THE FOCUS –
Model 1 – structural conflict
Model 2 – structural deficit
Model 3 – relational conflict
Model 4 – relational deficit
Model 5 – neural entrenchment / psychic inertia / analysis paralysis
DEFENSES –
Model 1 – neurotic defenses
Model 2 – narcissistic defenses
Model 3 – characterological defenses
Model 4 – schizoid defenses and illusions of grandiose self-sufficiency
Model 5 – entrenched, conditioned, and disempowering narratives about self, others, and the world
EXEMPLARS –
Model 1 – Woody Allen
Model 2 – Kanye West
Model 3 – Johnny Depp and Amber Heard
Model 4 – John Nash (A Brilliant Mind)
Model 5 – Peter Pan
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THE PATIENT AS –
Model 1 – a (neurotically) conflicted self
Model 2 – a (narcissistically) vulnerable self
Model 3 – a (noxiously) re-enacting self
Model 4 – a (nonrelated) private self
Model 5 – a (nonactualized) entrenched self
THE PATIENT AS –
Model 1 – neurotically conflicted and jammed up
Model 2 – relentlessly pursuing and ever in search of the unattainable
Model 3 – compulsively and unwittingly re-enacting
Model 4 – hidden, lost, despairing, alienated
Model 5 – entrenched, disempowered, immobilized
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THE THERAPEUTIC ACTION AS –
Model 1 – knowledge
Model 2 – experience
Model 3 – relationship
Model 4 – surrender
Model 5 – possibilities
EXEMPLARS –
Model 1 – Sigmund Freud
Model 2 – Heinz Kohut
Model 3 – Stephen Mitchell
Model 4 – Rollo May / Viktor Frankl
Model 5 – Bruce Ecker
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THE THERAPEUTIC ACTION AS –
Model 1 – interpreting resistance
Model 2 – grieving relentless hope
Model 3 – negotiating re-enactments at the intimate edge (the intersubjective in-between)
Model 4 – overcoming the dread of surrender to analytic oneness and a blissful state of peaceful merger
Model 5 – release from the toxicity of the past and envisioning of possibilities for the future
THE LANGUAGE OF –
Model 1 – ego (strength)
Model 2 – self (consolidation)
Model 3 – self-in-relation (accountability)
Model 4 – private (true) self vs. social (false) selff
Model 5 – conditioned (disempowered) self vs. future (envisioned) self
THE NUMBER OF PEOPLE –
Model 1 – 1-person psychology
Model 2 – 1½-person psychology
Model 3 – 2-person psychology
Model 4 – 2-as-1 – analytic oneness
Model 5 – 3-person – the envisioned third
THE THERAPIST AS –
Model 1 – neutral object
Model 2 – empathic selfobject or good “mother” / object
Model 3 – authentic subject or relational object
Model 4 – facilitating environment or devoted presence
Model 5 – visionary alchemist or reality-based, action-oriented, goal-directed, solution-focused, future-oriented catalyst
PRIVILEGING OF THE THERAPIST’S –
Model 1 – neutrality and objectivity
Model 2 – empathy
Model 3 – authenticity
Model 4 – devotion and accommodation
Model 5 – vision
PROTOTYPICAL INTERVENTIONS –
Model 1 – conflict statements
Model 2 – disillusionment statements
Model 3 – accountability statements, relational interventions, Rule of Three
Model 4 – facilitation statements
Model 5 – quantum disentanglement statements
OPTIMAL STRESS provides both impetus and opportunity for –
Model 1 – gain-become-pain (as ego-syntonic becomes ego-dystonic)
Model 2 – good-become-bad (as illusion becomes disillusionment)
Model 3 – bad-become-good (as distortion becomes more reality-based)
Model 4 – lost-become-found (as hidden becomes seen)
Model 5 – entangled-become-disentangled (as envisioned becomes actualized)
*analytic oneness – Ofra Eshel
*moments of meeting – Harry Guntrip
*affective nonrelatedness – Arnold Modell
*relational conflict – Stephen Mitchell
*grandiosely self-sufficient – Arnold Modell
*intimate edge – Darlene Ehrenberg
*dread of surrender – Masud Khan
*blissful state of peaceful merger – Michael Balint
*self-in-relation – Stone Center (Wellesley College)
*facilitating environment – D.W. Winnicott
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