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The Third Rail: Working with Shame in Addiction Treatment

  • PPSC 80 5th Avenue, Room 1408 New York, NY, 10011 United States (map)

Renée Obstfeld, PhD, LP, ATR-BC, LCAT, CASAC

*This talk has been approved by New York State for 2 hours of Continuing Education Credit for LCSWs, LPs, LMSWs and LMHCs and 2 Contact Hours by the American Psychological Association for Psychologists.

This talk will explore the paradoxical role of compulsive substance use in alleviating unbearable feelings of isolation, shame, and vulnerability while simultaneously facilitating their embodied expression.

Whereas substance use disorders (SUDs) can often be traced back to histories that feature frank trauma or neglect, in many instances the precursors to addictive disorders are more nuanced and do not fit neatly into such categories. Case material will explore the developmental impact of early attachment and social learning, particularly the effects of shaming experience and the sense of being other, alien, toxic, or unwanted. Emphasis will be placed on the role played by substance use in ameliorating emotions borne out of humiliation, enhancing compensatory grandiosity, and creating conditions under which excruciating relationships can be tolerated.

Features specific to the psychoanalytic treatment of SUD are essential catalysts in working with individuals at all stages of recovery. These include exploration of the patient’s subjective experience of their drug use, it’s personal significance and subjective meaning to them; identifying and modulating polarized self states; and making implicit processes available for reflection. Special attention is paid to the patient’s grieving process, as self-blaming narratives and beliefs that sustained essential early relationships (and current ones) are questioned and transformed.

Renée Obstfeld, Ph.D., LP, ATR-BC, LCAT, CASAC is a licensed psychoanalyst and art therapist, currently maintaining a practice in Manhattan. She has worked extensively with people struggling with compulsive behaviors and substance use disorders in addition to treating groups of female veterans, survivors of attempted suicide and people affected by suicide, and facilitating art therapy groups at Bellevue Hospital’s World Trade Center Clinic and Program for Survivors of Torture. Renée has presented internationally on addictions, dissociative defenses and vulnerability to repeated trauma, creative processes in the treatment of addiction and trauma, and intergenerational trauma. She serves on the faculty of the Psychoanalytic Psychotherapy Study Center, Hebrew Union College, and the Graduate Art Therapy Programs of New York University and the School of Visual Arts

*For a refund to a PPSC Annex event, we must receive cancellation notice 7 days prior to the event. Please contact if you want to cancel within this time frame. Please note: A $5 surcharge will apply for those paying at the door, but we suggest buying your ticket in advance as the event may reach capacity before the date of the presentation.

*Psychoanalytic Psychotherapy Study Center is recognized by the New York State Education Department’s State Board for Social Work and for Mental Health Practitioners as an approved provider of Continuing Education for Licensed Social Workers #SW-0054 and for Licensed Psychoanalysts #P-0040 and for Licensed Mental Health Counselors #MHC-0166.

Psychoanalytic Psychotherapy Study Center is approved by the American Psychological Association to sponsor continuing education for psychologists. Psychoanalytic Psychotherapy Study Center maintains responsibility for this program and its content.

*This PPSC event is wheelchair accessible, and any participant with a special need should contact PPSC at 212-633-9172 or in advance. PPSC does not discriminate on the basis of race, color, religion, sex, sexual preference, national or ethnic origin, or analytic orientation in the administration of its admissions and educational policies.