Dear Colleagues, on September 26, the first seminar of our new Clinical Seminar Series took place:
Love, Sex and Aggression
Lecturer — Otto Kernberg, M.D.
We would like to share what participants found most memorable, what resonated with them, and what encouraged them to look at their own clinical work from a new perspective. Here are some of their thoughts and reflections:
Anna Shurinova, clinical psychologist, TFP therapist, Katathym Imaginative Psychotherapy (KIP) therapist, IRSGP psychotherapist, and multimodal supervisor:
“On Saturday, another seminar by Dr. Kernberg from the series Love, Sex and Aggression: From Normality to Pathology took place at the Ukrainian Institute for Personality Disorders Studies. This time, the seminar focused on homosexuality, narcissism, perversions, and the pathology of sexual functioning more broadly.
We conducted the seminar together with Oleksii Lemeshchuk, Head of TFP Ukraine, @alexei.lemeshchuk. I am grateful for the trust and for the incredibly well-coordinated teamwork—it was a real pleasure to work together.
This was not the first lecture by Dr. Kernberg that I have attended. Not our first meeting. Not my first opportunity to listen to him, ask questions, and express my gratitude. One might think that by now I would have become accustomed to his way of thinking and teaching. Yet each time, I notice how much love he brings to what he does.
His thinking moves deeply. It is fascinating to follow. He distinguishes between things that can easily be confused. He finds precise words for what often appears complicated in clinical work. Without unnecessary complexity. Clearly. Without premature certainty.
This time, Dr. Kernberg once again brought us back to the person and their relationships. A fantasy that may seem unusual to someone can be part of a vital sexual life. That is why it is important to explore not only what arouses a person. Can they feel tenderness toward the person they desire? Does desire remain when the partner becomes close and important? What happens to love when dependency, envy, and anger emerge?
Similar sexual difficulties may arise from very different internal conflicts. This is precisely why it is so important not to overlook the patient’s sexual fantasies and experiences—areas that therapists sometimes barely explore.
I was particularly struck by his thoughts on change in patients with narcissistic pathology. When a person begins to recognize their own envy and the ways in which they devalue their partner, they may gradually begin to see their own contribution to the destruction of the relationship. Feelings of guilt may then emerge, along with a desire to restore the bond—and a capacity to love for which there had previously been almost no room.
After seminars like this, what I want to return to is not ready-made answers, but more attentive clinical work. To listen again to the patient where they speak freely—and where, for the moment, they remain silent about what matters most.”
Daryna Lema, psychiatrist and TFP therapist:
“Yesterday, I listened to Otto Kernberg as part of the Love, Sex and Aggression seminar series.
This is far from the first lecture of his that I have attended.
And once again, what is interesting is that you begin by listening to one topic and end up thinking about something entirely different.
This time, it was sexuality. But perhaps even more than that, it was about what happens to our representation of the Other when we desire them.
Another idea particularly resonated with me: the question is not so much what exactly arouses us, but whether we can integrate it with love, intimacy, and the perception of the Other as a whole person.
And this makes sexuality a remarkably precise domain in which the organization of object relations becomes visible.
Who am I in relation to the desired Other?
Who do they become?
Do we need a third person between us?
What happens to desire when someone who was unavailable becomes available?
And does the Other remain truly Other when I desire them intensely?
Perhaps this is what I value most about his lectures—and why he is worth listening to: afterward, you are not left with the feeling, ‘I wrote this down, and now I know it,’ but with several questions that begin to live on in your own clinical work.
There are still two meetings ahead—and then the end of a program that I do not want to end at all.
But perhaps this is precisely how a good professional program should end: not with the feeling that ‘everything is clear,’ but with the desire to keep thinking.”
We are grateful to every participant for taking part and for sharing their reflections. They show how learning from Otto Kernberg combines the study of theory with the development of clinical thinking, helping us broaden the horizons of our own psychotherapeutic practice.
Our next meeting is coming very soon. In the meantime, the recording of the September seminar is already available to participants. Its topics included:
1. General Theory of Sexuality and the Components of Sexual Experience
- Criteria for mental health and personality functioning
- The three-dimensional structure of mature sexual experience
- Psychodynamic-neurobiological model (following M. Solms)
- Four basic components of sexual identity
- Pathological conflicts between these components
2. Psychosexual Development: Pre-Oedipal and Oedipal Dynamics
- The pre-Oedipal period and infantile polymorphous eroticism
- The Oedipal period and triangulation dynamics
- The dynamics of childhood masturbation and passion
3. Classification and Symptomatology of Sexual Disorders
- Male sexual dysfunctions
- Female sexual dysfunctions
- Severe sexual pathology
4. Psychopathology of Sexuality Across Levels of Personality Organization
- Neurotic level
- Borderline level (Borderline Personality Organization)
- Narcissistic level (Narcissistic Personality Structure)
5. Psychodynamics of Couple Relationships and Special Topics
- The disappearance of sexual life in couples
- Narcissistic-masochistic couple dynamics
- Couple dynamics involving two narcissistic partners
6. Contemporary Psychoanalytic Perspectives on Homosexuality and Bisexuality
- The evolution of the concept of sexual orientation in psychoanalysis
- Sociocultural and historical context
- Exploration of homosexuality as a normal sexual orientation
- Relationship dynamics and triangulation
7. Psychotherapeutic Technique and Clinical Work with Sexual Orientation and Gender Identity
- The principle of technical neutrality
- Narcissistic pathology and bisexual fantasies
- Differential diagnosis of transsexuality
8. Psychodynamics and Theory of Perversions (Paraphilias)
- Normality vs. pathology in infantile sexuality
- Clinical definition of perversion
- Psychoanalytic concepts of the origins of perversions
- Defense mechanisms in perversions
9. Clinical Classification, Levels of Personality Organization, and Legal Boundaries
- The influence of personality structure
- Severity of primitive aggression
- Legal, ethical, and therapeutic boundaries
The lecture component of the seminar was complemented by a supervision session and a one-hour Q&A with participants. This provided an opportunity to continue the discussion and clarify important aspects of the material relevant to clinical practice.
We thank all participants for taking part and for sharing their reflections. Your thoughts illustrate how learning from Otto Kernberg combines the study of theory with the development of clinical thinking and helps us view our own psychotherapeutic practice from new perspectives.
There are still two meetings ahead, while the recording of the September seminar is already available to participants.
(c) Yuliia Holopiorova,
Ukrainian Association of Transference-Focused Psychotherapy