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Object relations, projective identification, and dynamic work with personality-organised difficulty.
The most demanding clinical work is with clients whose difficulties are not episodes but organisations: personality-level patterns laid down early, held in an internal world of relationships, and lived out with everyone, including the therapist. This course teaches the object relations tradition that illuminates such work and the evidenced treatments built on it, for experienced practitioners.
You will study the internal world as a cast of internalised relationships, and projective identification as the primitive communication it is: the client's unbearable experience arriving inside the therapist's own feeling, ahead of words. The second module examines the two best-evidenced depth treatments for personality-organised difficulty, Transference-Focused Psychotherapy and Mentalization-Based Treatment, comparing their mechanisms and methods, and then turns honestly to the practitioner such work requires: the containment, supervision and self-knowledge without which depth work becomes hazardous to both parties. Throughout, the emphasis is on capacities you can actually take into the room: reading the internal cast from repetition, receiving projection without enacting it, and surviving, in Winnicott's full technical sense, what this work asks the therapist to survive.
Extended written lessons with key points and supervision-level practice tasks, supported by a study tutor throughout. Fourteen hours of CPD, around a year of access, a final assessment, and a personalised certificate on passing. Demanding, and intended to be.
▶ See inside the digital classroom1 minute 36 seconds · how a course is laid out, how each lesson is taught, and how the tutor helps
Before you start
This is an Advanced course in the psychodynamic pathway. It assumes that you already work with the approach at Practitioner level and want complexity, process and supervision-level thinking rather than the method itself, which is what Working Psychodynamically teaches. What it adds is complex presentations, comorbidity, ruptures and impasses, the research and process literature, and the judgement needed to supervise or lead the work; it revisits the foundations only as far as it needs to before building on them, so it does not repeat the course below.
A caution. Taking an Advanced course without the foundational understanding will make it harder to follow and to complete, and you will get less from it. If you are new to this approach, begin at Foundation; if you hold the foundations but have not yet used the approach with clients, begin with Working Psychodynamically. Choose the level that matches your existing experience and knowledge.
The psychodynamic pathway. The working model of mind and the therapeutic relationship as contemporary psychodynamic therapy uses them, taught for practice: foundations, working psychodynamically with clients, then advanced practice.
14 study hours14 CPD hours certified12 months of accessAI tutor in every lessonCertificate on completion (pass mark 70%)
What you will be able to do
✓Conduct sustained psychodynamic work with personality-level difficulty and early relational damage
✓Work with primitive defences, projective identification and powerful countertransference pulls without losing the analytic stance
✓Judge the balance of supportive and expressive technique for each client and moment
✓Use object relations and attachment thinking to understand and survive negative therapeutic reactions
✓Hold the frame under attack, and think clinically about fee, boundary and contact pressures
✓Critically engage with the psychodynamic evidence base and its contemporary integrations
What you will study
Module 1: Object Relations and Primitive Communication
This module explores internal object relations, projective identification, and the co-creation of the analytic third.
Object relations: the internal castThe psyche's units are internalised self-with-other templates
Projective identification: communication before wordsProjective identification evacuates unbearable states into the other
Containment, Reverie, and the Transformation of Projective IdentificationContainment transforms the patient's raw beta elements into thinkable alpha elements through the analyst's reverie.
The Integration of Splitting and the Consolidation of the SelfSplitting acts as a defensive structure to manage the overwhelming influx of primitive projective identifications; the therapist's containment of the projection allows the patient to internalise alpha-function and integrate fragmented self-states; the consolidation of the self is achieved through the internalisation of the holding environment, moving from projection to psychic reality.
The Analytic Third: Co‑creating a Shared Internal Space for Primitive CommunicationThe analytic third is a co‑created intersubjective field that transforms projective identification into symbolic meaning.
Module 2: Somatic and Unconscious Processing
This module examines somatic communication, countertransference, and the transition from primitive states to symbolisation.
Introjection and the Internalisation of Primitive CommunicationsIntrojection is the unconscious incorporation of the other's affective content, transforming external projective communication into an internal, reflective representation.
Somatic Communication of Primitive Affects: The Body as a Language of Projective IdentificationSomatic signals function as a primary medium for projective identification when verbal expression is insufficient.
Defensive Projective Identification and the Therapeutic Use of CountertransferenceDefensive projective identification is a control mechanism where the patient projects unbearable self-states into the therapist to avoid feeling them themselves.
Symbolisation and the Transition from Primitive Communication to Verbal ThoughtSymbolisation is the mental operation that converts raw affective experience into thinkable, communicable forms.
Dreams as a Vessel for Primitive Communication: Accessing and Transforming Projective Identification through the Unconscious NarrativeDreams function as a symbolic container for projective identification, allowing primitive affect to be expressed in a tolerable form.
Module 3: Core Strategies in TFP and MBT
This module introduces Transference-Focused Psychotherapy and Mentalisation-Based Treatment through core technical strategies and case formulation.
TFP and MBT: two evidenced depth treatmentsTFP: name the alternating dyads in the transference, inside a firm contract
The practitioner this work requiresRequired: tolerating hatred, holding the frame, surviving in Winnicott's sense
Transference, mentalizing and the therapeutic frame: core technical strategies in TFP and MBTTFP uses clarification, confrontation and transference interpretation within a tightly contracted frame; MBT prioritises the therapist’s mentalizing stance and collaborative inquiry to restore reflective functioning.
Therapeutic Rupture and Repair in Transference-Focused Psychotherapy and Mentalisation-Based TreatmentTherapeutic ruptures are inevitable in work with personality‑organised difficulty and, when repaired, promote integration of split self‑states.
Case Formulation and Integrated Treatment Planning in TFP and MBTFor
