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Dynamic Therapy with Self Destructive Borderline Patients: An Alliance Based Intervention for Suicide

November 23, 2019 @ 9:30 AM - 12:00 PM

Dynamic Therapy with Self Destructive Borderline Patients:
An Alliance Based Intervention for Suicide

Eric Plakun, MD – Director/CEO Austen Riggs Center

Saturday November 23, 2019

9:00 am — Registration/Coffee
9:30 am — 12 pm — Presentation


In the past 25 years there has been a 25% increase in suicide in the United States. Although there are several manualized behavioral and psychodynamic therapies found efficacious in treatment of suicidal and self-destructive borderline patients, few clinicians are familiar with these.

This presentation offers nine practical principles helpful in establishing and maintain a therapeutic alliance in the psychodynamic psychotherapy of self-destructive borderline patients. The approach engages the patient’s negative transference as underlying suicidal and some self-destructive behavior. The principles are: (1) differentiate therapy from consultation; (2) differentiate lethal from non-lethal self-destructive behavior; (3) include the patient’s responsibility to stay alive as part of the therapeutic alliance; (4) contain and metabolize the countertransference; (5) engage affect; (6) non-punitively interpret the patient’s aggression in considering ending the therapy through suicide; (7) hold the patient responsible for preservation of the therapy; (8) search for the perceived injury from the therapist that may have precipitated the self-destructive behavior, and (9) provide an opportunity for repair. These principles are noted to be congruent with shared elements identified by an expert consensus panel review of behavioral and psychodynamic therapies for suicidal patients with borderline personality disorder.


About the Presenter
Eric M. Plakun, M.D. is Medical Director/CEO of the Austen Riggs Center and former Harvard Medical School clinical faculty member. He is the editor of two books, including Treatment Resistance and Patient Authority: The Austen Riggs Reader (Norton, 2011), author of over fifty published papers and book chapters, and has presented over a hundred scientific papers. Dr. Plakun is a Distinguished Life Fellow of the American Psychiatric Association and an elected member of its Board of Trustees. He is past chair of the APA Committee on Psychotherapy by Psychiatrists, APA Bylaws Committee, and past leader of the Psychotherapy Caucus. He is a past member of the APA Assembly Executive Committee, and past chair of the Assembly Committee of Representatives of Subspecialties and Sections. Dr. Plakun has been honored as the Outstanding Psychiatrist in Clinical Psychiatry by the Massachusetts Psychiatric Society. He is a leader in organized psychiatry and psychoanalysis and an advocate for the value of psychotherapy and other psychosocial treatments. Before entering psychiatry, Dr. Plakun served as a rural general practitioner in Vermont—where he made house calls on skis.

Plakun, EM. (2009). A View From Riggs: Treatment Resistance and Patient Authority, Paper XI: An alliance based intervention for suicide, Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry. pp. 539-560.
Plakun, EM. (editor). (2011). Treatment Resistance and Patient Authority: The Austen Riggs Reader. New York. Norton Professional Books.
Plakun, EM. (2001). Making the alliance and taking the transference in work with suicidal borderline patients. Journal of Psychotherapy Practice and Research. 10: 269-276.
Plakun E.M. (1994). Principles in psychotherapy of self-destructive borderline patients. Journal of Psychotherapy Practice and Research. 3 (2): 138-148
Plakun, Eric M. (2001). Making the alliance and taking the transference in work with suicidal patients. Journal of Psychotherapy Practice and Research. 10 (4): 269-276.

Learning Objectives

After attending this intermediate-level program, participants will be able:

1.Utilize principles of an Alliance Based Intervention for Suicide as part of psychodynamic therapy of self-destructive borderline patients.

2. Engage the symptom of suicide in borderline patients as an event with interpersonal meaning and as an aspect of negative transference.

3. List shared elements in treating self-destructive borderline patients derived by an expert consensus panel study of behavioral and dynamic psychotherapies.


Sponsorship and                                                                   Image result for NBCC Logo
Continuing Education

2.5 CE credits are available to psychologists and psychoanalysts, and 2.5 CE credits will be provided for social workers and LMHCs.

Division 39 is approved by the American Psychological Association to sponsor continuing education for psychologists. Division 39 maintains responsibility for this program and its content.

Division 39 is committed to accessibility and non-discrimination in its continuing education activities. Division 39 is also committed to conducting all activities in conformity with the American Psychological Association’s Ethical Principles for Psychologists. Participants are asked to be aware of the need for privacy and confidentiality throughout the program. If program content becomes stressful, participants are encouraged to process these feelings during the discussion periods. If participants have special needs, we will attempt to accommodate them. Please address questions, concerns or any complaints to Jyoti Swaminathan, Psy.D. (518) 461-2081.

WMAAPP is the local chapter of Division 39 (Psychoanalysis) of the American Psychological Association.
WMAAPP is committed to following APA ethical guidelines.


WMAAPP brochure Plakun 11-23-2019

Pre-registration has ended.


November 23, 2019
9:30 AM - 12:00 PM
Event Category:


The Red Lion Inn
30 Main Street
Stockbridge, MA 01262 United States
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