Leon Hoffman's guest appearances

Leon Hoffman

Psychoanalysis On and Off the Couch

Kerry Sulkowicz

Gita Vaid

Chris Heath

Michael Maccoby

Michael Diamond

Linda Emmanuel

Yehudah Fraenkel

Carine Minne

Steven Marans

Shahrzad Hashemi

Rosa Famini

Randall Paulsen

Jorge Ulnik

Kathryn McCormick

Gilbert Kliman

OwlTail

“The basic principle in defense analysis is that one approaches what is going on right now -  it's an experience-near technique. You don't make conjectures about what would be called experience-distant phenomenon until you have a lot of material, a lot of knowledge about the patient. As the treatment goes on you really stick with what the patient is doing right now.”   Episode Description: Leon shares with us what he sees as the fundamental method of analytic treatment, which "regardless of the manifest theoretical orientation of the therapist ... are effectively utilizing the technique of interpreting defenses against unwelcome affects." He emphasizes the importance of being interested in the patient's defenses and less so the warded-off content. We consider the term 'protection' in place of 'defense'; how these interventions are an amalgam of clarification and interpretation; and the source of the bad reputation that attaches to the concept of 'defense interpretation’. He shares with us how this approach links with the neurosciences and the concept of implicit emotion regulation. We discuss the work of Berta Bornstein, who introduced the importance of defending against unpleasant affects. He discusses two cases of disruptive children and their use of aggression in an effort to avoid sadness and loneliness. We close with his sharing his view of our field and his conclusion that "analysis will survive - it's too powerful a tool."   Our Guest:  Leon Hoffman, MD, is a psychiatrist and child and adolescent psychiatrist. He is a Training and Supervising Analyst at the New York Psychoanalytic Society and Institute. He is the Co-Director of the Pacella Research Center of NYSI. Among many publications, he is co-author with Timothy Rice and Tracy Prout of Regulation Focused Psychotherapy for Children (RFP-C): A Psychodynamic Approach and with Timothy Rice Defense Mechanisms and Implicit Emotion Regulation: A Comparison of a Psychodynamic Construct with One from Contemporary Neuroscience. In 2022, he presented the Norbert and Charlotte Rieger Psychodynamic Psychotherapy lecture at the American Academy of Child and Adolescent Psychiatry on “Helping Parents Spare the Rod: Addressing Their Unbearable Emotions” based on a paper he authored with Tracy Prout. He presented the Paulina Kernberg Memorial Lecture at Weill Cornell Medicine Child &amp; Adolescent Psychiatry Grand Rounds. On Regulation Focused Psychotherapy: An evidence-based psychodynamic treatment for children with disruptive behaviors. And The Bruce A. Gibbard Lectureship in Psychiatry, University of Vermont, Department of Psychiatry.   Linked Episode:    Episode 38: A Psychoanalyst Studies ‘Why is it easier to get mad than it is to feel sad?’ with Leon Hoffman   Recommended Readings: 1.      Hoffman, L. (2007) Do Children Get Better When We Interpret Their Defenses Against  Painful Feelings? Psychoanalytic Study of the Child 62:291-313.   2.      Hoffman, L. (2014).  Berta Bornstein’s Frankie: The Contemporary Relevance of a Classic to the Treatment of Children with Disruptive Symptoms. The Psychoanalytic Study of the Child 68:152-176   3.      Rice, T. R., &amp; Hoffman, L. (2014). Defense mechanisms and implicit emotion regulation: a comparison of a psychodynamic construct with one from contemporary neuroscience. Journal of the American Psychoanalytic Association, 62(4), 693-708.    4.      Prout, T. A., Rice, T., Chung, H., Gorokhovsky, Y., Murphy, S., &amp; Hoffman, L. (2021)  Randomized controlled trial of Regulation Focused Psychotherapy for Children: A manualized psychodynamic treatment for externalizing behaviors. Psychotherapy Research, 32(5), 555-570.    5.      Hoffman, L. (2020). How can I help you? Dimensional versus categorical distinctions in the assessment for child analysis and child psychotherapy. Journal of Infant, Child, and Adolescent Psychotherapy, 19(1), 1-15.   6.      Leon Hoffman, Tracy A. Prout, Timothy Rice &amp; Margo Bernstein (2023):  Addressing Emotion Regulation with Children: Play, Verbalization of Feelings, and Reappraisal, Journal of Infant, Child, and Adolescent Psychotherapy, DOI: 10.1080/15289168.2023.2165874   7.      Prout, T. A., Malone, A., Rice, T., &amp; Hoffman, L. (2019). Resilience, defenses, and implicit emotion regulation in psychodynamic child psychotherapy. Journal of Contemporary Psychotherapy, 49(4). 235-244.    8.      Hoffman, L., &amp; Prout, T. A. (2020).  Helping parents spare the rod: Addressing their unbearable emotions. Psychoanalytic Study of the Child, 73(1), 46-61. 

“The basic principle in defense analysis is that one approaches what is going on right now -  it's an experience-near technique. You don't make conjectures about what would be called experience-distant phenomenon until you have a lot of material, a lot of knowledge about the patient. As the treatment goes on you really stick with what the patient is doing right now.” Episode Description: Leon shares with us what he sees as the fundamental method of analytic treatment, which "regardless of the manifest theoretical orientation of the therapist ... are effectively utilizing the technique of interpreting defenses against unwelcome affects." He emphasizes the importance of being interested in the patient's defenses and less so the warded-off content. We consider the term 'protection' in place of 'defense'; how these interventions are an amalgam of clarification and interpretation; and the source of the bad reputation that attaches to the concept of 'defense interpretation’. He shares with us how this approach links with the neurosciences and the concept of implicit emotion regulation. We discuss the work of Berta Bornstein, who introduced the importance of defending against unpleasant affects. He discusses two cases of disruptive children and their use of aggression in an effort to avoid sadness and loneliness. We close with his sharing his view of our field and his conclusion that "analysis will survive - it's too powerful a tool." Our Guest:  Leon Hoffman, MD, is a psychiatrist and child and adolescent psychiatrist. He is a Training and Supervising Analyst at the New York Psychoanalytic Society and Institute. He is the Co-Director of the Pacella Research Center of NYSI. Among many publications, he is co-author with Timothy Rice and Tracy Prout of Regulation Focused Psychotherapy for Children (RFP-C): A Psychodynamic Approach and with Timothy Rice Defense Mechanisms and Implicit Emotion Regulation: A Comparison of a Psychodynamic Construct with One from Contemporary Neuroscience. In 2022, he presented the Norbert and Charlotte Rieger Psychodynamic Psychotherapy lecture at the American Academy of Child and Adolescent Psychiatry on “<a href="https://www.tandfonline.com/doi/full/10.1080/00797308.2020.1690867" rel="nofollow" target="_blank">Helping Parents Spare the Rod: Addressing Their Unbearable Emotions”</a> based on a paper he authored with Tracy Prout. He presented the Paulina Kernberg Memorial Lecture at Weill Cornell Medicine Child &amp; Adolescent Psychiatry Grand Rounds. On Regulation Focused Psychotherapy: An evidence-based psychodynamic treatment for children with disruptive behaviors. And The Bruce A. Gibbard Lectureship in Psychiatry, University of Vermont, Department of Psychiatry. Linked Episode:  <a href="http://ipaoffthecouch.org/2020/02/23/episode-38-a-psychoanalyst-studies-why-is-it-easier-to-get-mad-than-it-is-to-feel-sad-with-leon-hoffman/" rel="nofollow" target="_blank">  Episode 38: A Psychoanalyst Studies ‘Why is it easier to get mad than it is to feel sad?’ with Leon Hoffman</a> Recommended Readings: 1.     <a href="https://pubmed.ncbi.nlm.nih.gov/18524096/" rel="nofollow" target="_blank"> </a>Hoffman, L. (2007) <a href="https://pubmed.ncbi.nlm.nih.gov/18524096/" rel="nofollow" target="_blank">Do Children Get Better When We Interpret Their Defenses Against  Painful Feelings?</a> Psychoanalytic Study of the Child 62:291-313. 2.      Hoffman, L. (2014).  Berta Bornstein’s Frankie<a href="https://pubmed.ncbi.nlm.nih.gov/26173332/" rel="nofollow" target="_blank">: The Contemporary Relevance of a Classic to the Treatment of Children with Disruptive Symptoms.</a> The Psychoanalytic Study of the Child 68:152-176 3.      Rice, T. R., &amp; Hoffman, L. (2014). <a href="https://journals.sagepub.com/doi/10.1177/0003065114546746" rel="nofollow" target="_blank">Defense mechanisms and implicit emotion regulation: a comparison of a psychodynamic construct with one from contemporary neuroscience.</a> Journal of the American Psychoanalytic Association, 62(4), 693-708.  4.      Prout, T. A., Rice, T., Chung, H., Gorokhovsky, Y., Murphy, S., &amp; Hoffman, L. (2021) <a href="https://www.tandfonline.com/doi/abs/10.1080/10503307.2021.1980626?journalCode=tpsr20" rel="nofollow" target="_blank"> Randomized controlled trial of Regulation Focused Psychotherapy for Children: A manualized psychodynamic treatment for externalizing behaviors</a>. Psychotherapy Research, 32(5), 555-570.  5.      Hoffman, L. (2020). <a href="https://psycnet.apa.org/record/2020-08350-001" rel="nofollow" target="_blank">How can I help you? Dimensional versus categorical distinctions in the assessment for child analysis and child psychotherapy.</a> Journal of Infant, Child, and Adolescent Psychotherapy, 19(1), 1-15. 6.      Leon Hoffman, Tracy A. Prout, Timothy Rice &amp; Margo Bernstein (2023): <a href="https://www.tandfonline.com/doi/full/10.1080/15289168.2023.2165874?src=" rel="nofollow" target="_blank"> Addressing Emotion Regulation with Children: Play, Verbalization of Feelings, and Reappraisal</a>, Journal of Infant, Child, and Adolescent Psychotherapy, DOI: 10.1080/15289168.2023.2165874 7.      Prout, T. A., Malone, A., Rice, T., &amp; Hoffman, L. (2019). <a href="https://link.springer.com/article/10.1007/s10879-019-09423-w" rel="nofollow" target="_blank">Resilience, defenses, and implicit emotion regulation in psychodynamic child psychotherapy</a>. Journal of Contemporary Psychotherapy, 49(4). 235-244.  8.      Hoffman, L., &amp; Prout, T. A. (2020). <a href="https://www.tandfonline.com/doi/abs/10.1080/00797308.2020.1690867?journalCode=upsc20" rel="nofollow" target="_blank"> Helping parents spare the rod: Addressing their unbearable emotions.</a> Psychoanalytic Study of the Child, 73(1), 46-61.

The Role of Defense Analysis in Child (and Adult) Treatment with Leon Hoffman, MD (New York)

Harvey Schwartz welcomes Dr. Leon Hoffman, who is a Training Analyst, and a child, adolescent and adult Psychoanalyst at the New York Psychoanalytic Society and Institute, and he is also the Co-Director of the Pacella Research Center. Dr. Hoffman is the Chief Psychiatrist and Psychoanalyst at the West End Day School in New York City and he is the Co-Developer of the ongoing clinician research seminar at the New York Psychoanalytic Society and institute.    The focus of today’s conversation is on Dr. Hoffman’s role as the Co-Investigator of the Evaluation of Regulation Focused Psychotherapy for Children, which is a key part of his life’s work. As you will hear in this episode, Dr. Hoffman brings his warmth, enthusiasm, and his deep feeling for understanding the inner lives of children, even when they make that very difficult, even when their disruptive behavior leads them to be not listened to by many, Dr. Hoffman is committed not only to listen to them but to train others to learn how to listen to them.   Key takeaways:  [3:55] Dr. Hoffman shares his own thoughts about the advantages and disadvantages of a manualized approach and the clinical challenges he and his team have faced after creating the manual.  [9:20] Dr. Hoffman talks about his work taking key aspects of child analytic work and bringing them to a broader community, in terms of clinicians and patients.  [9:51] Children with behavioral problems are experts in bringing up the weak spots of the therapist.  [10:40] Dr. Hoffman and his team developed a manual meant to help analysts with her or his countertransference.  [13:31] Dr. Hoffman explains children tell a story in a disguised way through play.  [14:00] Dr. Hoffman shares a case example where defense was addressed from the start.  [19:05] The pros and cons of a short term treatment.  [21:58] Positive transference is not interpreted, only disruptions and countertransference.  [26:04] Dr. Hoffman details how the therapist addresses in the play the patient’s response to her scary feelings.  [27:35] The triangle of defense.  [29:53] Listening and understanding the emotions behind the child’s behaviors lead to great improvements in a short period of time.  [31:43] Stop, look and listen.  [32:15] What brought Dr. Hoffman to child analysis?   Mentioned in this episode:  IPA Off the Couch www.ipaoffthecouch.org  Recommended Readings:  Hoffman, L., Rice, T. R., with Prout, T. A. (2016). Manual of regulation-focused psychotherapy for children (RFP-C) with externalizing behaviors: A psychodynamic approach. New York, NY: Routledge.    Berta Bornstein's Frankie: The Contemporary Relevance of a Classic to the Treatment of Children with Disruptive Symptoms. The Psychoanalytic Study of the Child 68:152-176    Rice, TR, and Hoffman, L.  (2014). Defense Mechanisms and Implicit Emotion Regulation: A Comparison of a Psychodynamic Construct with One from Contemporary Neuroscience. J Am Psychoanal Assoc 62: 693-708.   Prout, T. A., Bernstein, M., Gaines, E., Aizin, S., Sessler, D., Racine, E., Spigelman, A., Rice, T., &amp; Hoffman, L. (2020). Regulation Focused Psychotherapy for Children in clinical practice: Case vignettes from psychotherapy outcome studies. International Journal of Play Therapy, 29(1), 43–53   Prout, T. A., Rice, T., Murphy, S., Gaines, E., Aizin, S., Sessler, D., ... &amp; Hoffman, L. (2019). Why Is It Easier to Get Mad Than It Is to Feel Sad? Pilot Study of Regulation-Focused Psychotherapy for Children. American journal of psychotherapy, 72(1), 2-8.    Regulation Focused Psychotherapy for Children 

Episode 038: A Psychoanalyst Studies 'Why is it easier to get mad than it is to feel sad?' with Leon Hoffman