Reflections on Elgan Baker, Ph.D.'s presentation on "Intensive Psychotherapy for Restructuring Personality:  A Developmental

Approach for Increasing Affect Regulation, Boundaries and Self Capacities" given on April 26-27, 2003 

by Rhonda Sabo, Psy.D.

	Those fortunate to be in attendance at his all-day workshop will be aware that there is no possibility in the space to summarize the content of 

Dr. Elgan Baker's workshop and master class!  Instead, I will attempt a mini overview and a few "associations" as I reflect back on his visit to

 NESTTD last spring.  A clear and eloquent presenter, Elgan was able to guide us through the complex analytic terrain of his integrative

 developmental model of a maturational continuum of psychic structuralization, based on, among others, the work of Mahler, Greenacre, Gould,

 Pine, Rinsley, and the British object relations school, especially Guntrip and Winnicott.

	In his workshop Elgan chose to focus particularly on two critical structure-maturing developmental tasks that have profound impact on

subsequent personality--- object permanence (representational and evocative) and object constancy (representational and evocative). 

He reviewed how problems occur at these critical points, leading to structural deficits, which correspond to particular character styles/Axis II.

He proposed that carefully designed interventions, targeted at the lowest level of their developmental arrest, can be highly effective in moving 

clients along the developmental continuum.  These interventions included containment and boundary interventions, the use of transitional objects

 and transitional space phenomena in treatment, and balancing transference and non-transference components of the therapy relationship.  

	While Elgan admitted readily to enjoying talking about theory, he balanced this with well-chosen case material. Based on his 

developmental maps and supported by references to research, he employed vivid clinical examples to present suggestions for increasing 

self-capacities in our clients.  Eschewing "pat protocols", he gave examples of specific psychotherapeutic and hypnotherapeutic interventions

 to treat specific pieces of unfinished developmental business. In his follow-up ½ day Master Class, Elgan expanded on his (original and

 elegant!) hypnotherapeutic interventions.

	 Now some free associations….forgive me if they are pretty loose…First of all, isn’t it interesting that, from Elgan to Ellert, we are all 

talking about self-structure and the importance of intervening at the structural level with our trauma patients?…and interesting was Elgan’s use of

 the language of parts (introducing his work to a client by saying:  “Parts of you are still small and I am going to help them to mature”)…..and nice 

to hear Elgan’s emphasis on a “phenomenologically near” experience of alliance, created by the therapist’s attunement and tracking…sounds

 familiar to those who have been following the sensorimotor approaches to trauma treatment…..and, of course,.Elgan’s emphasis on symbolization

 in psychotherapy is consistent with our field’s emphasis on the transfer of wordless experience to verbal narrative…. and his use of hypnosis with

 clients who struggle with primary process thinking and early developmental arrest is inspiring, and gives validation to my experience of the powerful

 role that hypnosis can play with severely disorganized trauma patients….

	Finally, a memory of a recent clinical hour with a borderline client who was really struggling.  After a brief trance induction, I spoke to her 

for a long while using a sequence inspired from Elgan’s workshop.  I didn’t have my notes or the tapes and I wasn’t sure what to include, but I said

 something about my client and I and the room and the color of the walls and what changes about us and what remains the same.  When she was 

again alert she looked at me and said, “I have know idea why, but what you just said was about the best thing that you have ever done to help me.”

 And I haven’t stopped experimenting with these interventions since…  If you have had similar experiences let me know. 

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