From moment to moment, we are continuously deciding how best to position ourselves in relation to our patients and the maladaptive defenses to which they cling – once necessary for them to survive but now interfering with their ability to thrive.
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Course Description
On the one hand, we have respect for our patients and for the choices, no matter how unhealthy, that they find themselves continuously making; on the other hand, we have a vision of who we think they could be were they but able/willing to make healthier choices for themselves. Indeed, we are always struggling to find an optimal balance within ourselves between wanting our patients to change and accepting the reality of who our patients are.
Whether we are working within the interpretive framework of classical psychoanalytic theory (a 1-person psychology with its emphasis on “interpreting resistance,” “developing insight,” and “resolving internal conflict”), the corrective-provision framework of self psychology (a 1½-person psychology with its emphasis on “absence of good,” “grieving heartbreak,” and “filling in deficit”), or the intersubjective framework of contemporary relational theory (a 2-person psychology with its focus on “presence of bad,” “negotiating the in-between,” and “resolving relational conflict”), we are ever busy deciding whether we should “be with our patients where they are” (Herzog’s homeostatic attunement) or “direct their attention to elsewhere” (Herzog’s disruptive attunement) – a critically important balance that is necessary if the analytic endeavor is to be advanced.
Ever appreciating the importance of translating theory into practice, Martha will highlight the ways in which the therapist's ongoing attunement to the level of the patient's anxiety can be used to construct “optimally stressful” interventions that offer just the right balance between anxiety-provoking challenge of the patient's defensive structures (in order to provide impetus for their destabilization) and anxiety-assuaging support of them (in order to provide opportunity for their restabilization at a more robust level of resilience and adaptive capacity).
Snippets of clinical material will be offered that demonstrate how judicious, strategic, and ongoing use of these growth-incentivizing “mismatch experiences” will generate iterative healing cycles of disruption and repair and, ultimately, evolving of the patient from “resistance" to "awareness" (Model 1), "relentless hope" to "acceptance" (Model 2), and "re-enactment" to "accountability" (Model 3).
The material presented will be based upon Martha's award-winning Modes of Therapeutic Action – “required reading” (both in the US and around the world) for candidates in psychoanalytic training institutes and students in psychodynamic psychotherapy programs.
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Objectives
Upon completion of this activity, participants will be able to:
- Highlight the distinction between defensive, mindless reactions and adaptive, mindful responses.
- Explain the importance of cultivating dual awareness.
- Clarify the importance of generating and working through optimally stressful but growth-incentivizing “mismatch experiences.”
- Elaborate upon the reason that “optimally stressful” interventions provide both impetus and opportunity for transformation and growth.
- Design an optimally stressful conflict statement that both challenges and supports the patient’s defense.
- Construct an optimally stressful disillusionment statement that facilitates the patient’s grieving and coming to terms with a painful reality.
- Formulate an optimally stressful accountability statement that spotlights one of the patient’s dysfunctional relational patterns.
- Speak to the distinction between “being with patients where they are” and “directing their attention to elsewhere.”
- Explain the useful of the Rule of Three.
- Clarify the difference between projection and projective identification.
- Describe the relationship between the elaborated paragraph and the narcissistic alliance.
- Elaborate upon the concept of “no pain / no gain.”
- Highlight the distinction between defensive, mindless reactions and adaptive, mindful responses.
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Agenda
Date Schedule Monday,
February 16, 20268:30–9:00 a.m. Registration
9:00–10:45 a.m. Review of basic constructs: knowledge, experience, relationship as curative factors; supporting (homeostatic attunement) by being with the client where she is vs. “challenging” (disruptive attunement) by directing her attention to elsewhere.
10:45–11:00 a.m. Coffee Break
11:00 a.m.–12:15 p.m. Continuation of: Review of basic constructs...
Tuesday,
February 17, 20269:00–10:45 a.m. The process of transforming defense into adaptation; the importance of awareness (wisdom), acceptance, and accountability; therapist as a neutral object, empathic self-object, authentic subject; prototypical interventions designed to facilitate the grieving process.
10:45–11:00 a.m. Coffee Break
11:00 a.m.–12:15 p.m. Continuation of: The process of transforming defense into adaptation...
Wednesday,
February 18, 20269:00–10:45 a.m. Working through the negative transference and disruptions to the positive transference; transforming infantile need into mature adult capacity; focusing on the contributions of both patient and therapist to the transference/countertransference entanglements that will inevitably emerge at their intimate edge.
10:45–11:00 a.m. Coffee Break
11:00 a.m.–12:15 p.m. Continuation of: Working through the negative transference...
Thursday,
February 19, 20269:00–10:45 a.m. Use of instructor’s process recordings to demonstrate the role of knowledge, experience, and relationship in strengthening the ego, consolidating the self, and resolving relational difficulties.
10:45–11:00 a.m. Coffee Break
11:00 a.m.–12:15 p.m. Continuation of: Use of instructor’s process recordings...
Friday,
February 20, 20269:00–10:45 a.m. The therapeutic process as involving iterative cycles of defensive collapse and adaptive reconstitution at ever higher levels of integration and balance.
10:45–11:00 a.m. Coffee Break
11:00 a.m.–12:15 p.m. Continuation of: The therapeutic process as involving iterative cycles...
12:15 p.m. Adjourn
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Faculty
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Venue Information
The Sunny is an oceanfront boutique hotel in Sunny Isles Beach, Florida, blending modern, thoughtful design with a legacy of warm, personalized hospitality. Family-owned for three generations, this vibrant beachfront retreat offers thoughtfully crafted spaces and exceptional service - welcoming anyone looking to relax and unwind under the sun.
Guests can enjoy our newly renovated oceanside pool with full-service dining, break a sweat in our state-of-the-art fitness center with dedicated studio spaces, and savor every meal at ¡VIVA!, our signature restaurant serving breakfast, lunch, dinner, and craft cocktails. Just steps away, the historic Newport Fishing Pier offers Miami Beach’s only over-the-ocean dining experience - making every stay at The Sunny feel effortlessly special.
The Sunny Hotel
16701 Collins Avenue, Sunny Isles Beach, Florida 33160
Toll Free: 1-800-327-5476
Email: info@thesunnyhotel.com
Hotel website: https://www.thesunnyhotel.comA block of rooms has been reserved for the conference participants at a discounted rate. Use the booking link below to receive a discounted rate.
Rates start at just $309 and go up to $429. Please note the discounted room rate expires on January 14, 2026.
UM Department of Psychiatry 2026 – Winter Seminars
- Group Direct Booking Link - No login/Attendee Code needed
- Group General Booking Link - User will be required to enter Attendee Code (UMPSY)
You may call the hotel at 800-327-5476 and mention you are with the University of Miami Miller School of Medicine, Department of Continuing Education, Psychiatry and Behavioral Sciences. Please let them know if you are attending the Winter Seminars for a discounted hotel rate. You can also email James at james@lemonadehospitality.com.
Please note that the hotel is currently undergoing a name change from Newport Beach Hotel to The Sunny Hotel.
Inquiries
Please email Tonia Attard at psychcme@med.miami.edu or call 941.539.0500, 10 a.m.–4 p.m. (ET) Monday–Friday.
Things to Do in Miami
- Everglades
- Miami Double Decker City Tour
- Miami Zoo
- Miami Aquarium
- Miami Heat Game
- Miami Dolphins Game
- Miami Boat Show
- South Beach Food and Wine Festival
Golf Courses
- PGA National Resort
- Trump National Doral Miami
- Normandy Shores Golf Club
- Miami Shores Country Club
- JW Marriott Miami Turnberry Resort – Soffer Course
- Miami Beach Golf Course
Tennis Courts
- Flamingo Park
- Margaret Pace Park
- Crandon Park Tennis Center
- Fisher Island Club
- Morningside Tennis Center
Restaurants
- Nobu Miami
- Cecconi’s Miami
- Ocean Social by Chef Tristan Epps
- Prime 54
- Donna Mare Trattoria
- Santorini – Best Happy Hour in Town
Misc Fun Things to Do
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Registration
Seminar Format
Meets Monday–Friday: 9:00 am–12:15 pm. Offered in-person only.
Special Requests
If special arrangements are required for an individual with a disability to attend this conference, contact Kim Miele at psychcme@med.miami.edu at least 15 days prior to the conference.
Tuition
Winter Seminars – Registration Information
Early Bird Rates (Available through December 19, 2025)
- Physicians, Nurse Practitioners, and Other Health Professionals: $995
- Residents, Fellows-in-Training, and Full-time Students: $795
Standard Rates (Effective December 20, 2025)
- All Registrants: $1,095
- Residents, Fellows-in-Training, and Full-time Students: $795
Additional Fees
- Second Week Registration: $750
- Non-refundable Administrative Processing Fee: $20 (applies to all registrations)
Payment Method
- Registration must be completed by credit card (Visa, MasterCard, or American Express).
Refund Policy
Refunds, less an administrative fee of $100, will be issued for all cancellations received two weeks prior to the start of the course. Refund requests must be received by email. Please email psychcme@miami.edu. No refund will be issued should cancellation occur less than two weeks prior. “No shows” are subject to the full course fee, and no refunds will be issued once the conference has started.
Registration Information Link
To register, click the link below
Electronic Syllabus
We provide all attendees with complimentary access to all slide presentations in digital PDF format prior to the conference. This is an environmentally friendly alternative that helps lower costs for all attendees. The e-syllabus will be available for 30 days after the conference. You can purchase a printed copy at the time of online registration for $75.
Please note that we will not have hard copies of the syllabus available for purchase at the conference.
Be sure to include an email address that you check frequently. Your email address is used for critical information, including registration confirmation, evaluation, and certificate.
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Accreditation
Week-Long Seminars
Meets Monday–Friday: 9:00 a.m.–12:15 p.m.
Offered in-person only.
Physician Credit
University of Miami Leonard M. Miller School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
The University of Miami Leonard M. Miller School of Medicine designates these live activities for a maximum of 15 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The Royal College of Physicians and Surgeons of Canada recognizes conferences and workshops held outside of Canada that are developed by a university, academy, hospital, specialty society or college as accredited group learning activities.
Through an agreement between the American Medical Association and the European Union of Medical Specialists, physicians may convert AMA PRA Category 1 Credit™ to an equivalent number of European CME Credits® (ECMECs®). Information on the process of converting AMA PRA Category 1 Credits™ to ECMECs® can be found at: www.eaccme.eu.
Psychologists
The University of Miami Leonard M. Miller School of Medicine is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. The University of Miami Leonard M. Miller School of Medicine maintains responsibility for this program and its content. 15.00 CE credits will be awarded to psychologists for attendance at these seminars.
Nurse Practitioners and Registered Nurses
These activities have been submitted to ANA Massachusetts for approval to award contact hours. ANA Massachusetts is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. For more information regarding contact hours, please email psychcme@med.miami.edu.
- Clinical Psychopharmacology: Beyond Conventional Wisdom
- Thinking Through Alzheimer’s: Exploring Cognition, Psychopharmacology, and Geriatric Psychiatry
- Advanced Psychopharmacology: From Neurobiology to Personalized Treatment
THE HOLDING and THE PROVOCATION: Navigating the Edge Between Support and Challenge in Contemporary Psychodynamic Therapy meets the specifications of the Board of Registration in Nursing (244 CMR).
Social Workers
Application for social work continuing education credit has been submitted. Please contact Kim Miele at psychcme@med.miami.edu with any questions.
National Board of Certified Counselors
University of Miami Miller School of Medicine Department of Psychiatry and Behavioral Sciences has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7482. Programs that do not qualify for NBCC credit are clearly identified. University of Miami Miller School of Medicine Department of Psychiatry and Behavioral Sciences is solely responsible for all aspects of the programs.
Inquiries
By phone at 941-539-0500, Monday–Friday, 9 a.m. to 4 p.m. (ET), or by email at psychcme@med.miami.edu.
Disclosure and Conflict of Interest Mitigation
The University of Miami Leonard M. Miller School of Medicine has assessed conflict of interest with its faculty, authors, editors, and any individuals who were in a position to control the content of this CME activity. Any identified relevant conflicts of interest have been mitigated.
The University of Miami Leonard M. Miller School of Medicine planners, content reviewers, and editorial staff disclose no relationships with ineligible entities. All the relevant financial relationships for these individuals have been mitigated.
ABMS/ACGME Competencies
All seminars are designed to meet the following American Board of Medical Specialties (ABMS)/ Accreditation Council for Graduate Medical Educational (ACGME) competencies:
- Patient Care and Procedural Skills
- Medical Knowledge
- Practice-based Learning and Improvement
- Interpersonal and Communication Skills
Target Audience
The winter seminars are a series of seminars for health professionals in psychiatry, psychology, neurology, medicine, surgery, geriatrics, pediatrics, nursing, social work, and counseling.
