The Fo rward Edge of Self Psycho by fjzhxb


									32nd Annual International Conference on The Psychology of The Self
3670 Clairemont Drive, Suite 10 San Diego, CA 92117

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32nd Annual International Conference on The Psychology of The Self


a r d E d g e o f S e l f P s y ch For w

olog y

SaN DIeGO, Ca PeRmIT NO. 51


The Forward edge


SelF PSychology

Dear Colleagues, Please join us in Chicago, Illinois on October 22 - 25, 2009 for the annual IAPSP Conference on the Psychology of the Self. This year’s conference, “The Forward Edge of Self Psychology” honors the contributions of Marian Tolpin and addresses the development of self psychology in broader neuroscience, relational and multicultural perspectives. On Thursday, full-day and half-day Pre-Conference Sessions will allow participants to choose morning and afternoon sessions that approach the theme from different perspectives.After a welcome reception on Thursday evening, the main meeting begins with a keynote lecture entitled “Reflections on Marian Tolpin and the Forward Edge” by Frank Lachmann. Panel presentations begin Friday morning and continue on Saturday, with a summation of the panels on Sunday morning. Panel I will focus on Empathy and the Forward Edge: 21st Century Perspectives on Empathy; Panel II will highlight “The Forward Edge of Theory: Self Psychology and Relational Responses to a Clinical Case”; and Panel III will address “Social Issues and Cultural Diversity: The Expanded Realm of Self Psychology”. Following the second and third panels, attendees will break into small discussion groups to consider the presentations. Original paper workshop sessions are scheduled on Saturday afternoon and Sunday morning. Anna Ornstein will deliver The Kohut Memorial Lecture entitled “What Do We Inherit? Comments on the Intergenerational Transmission of Values and Ideals,” with an introduction by James Fisch. The conference will end Sunday afternoon following a “Plenary Summation“ by Judith Guss Teicholz. 2009 Conference Co-Chairs: Amy Eldridge, PhD & Paula Fuqua, MD Special Mention 2009 Planning Committee Members: Jill Gardner, PhD (Pre-Conference Program Chair); Hans-Peter Hartmann, PhD, MD; Sandra Hershberg, MD; Christine Kieffer, PhD, ABPP (Paper Session Program Chair); Tessa Phillips, PhD; Estelle Shane, PhD; Sanford Shapiro, MD, and the Midwest Study Group. 2009 Paper Review Committee Members: Peter Buirski, PhD; William Coburn, PhD, PsyD; Scott Davis, MD; Marcia Dobson, PhD; Elizabeth Feldman, PhD; James Fisch, MD; Lucy Freund, PhD; Henry Friedman, MD; Martin Gossmann, MD; Hans Peter Hartmann, MD, PhD; Sandra Hershberg, MD; Christine Kieffer, PhD, ABPP; Carla Leone, PhD; M. David Liberman, PhD; Carol Mayhew, PhD, PsyD; Linda Marino, PhD; Karen Martin, MA, LCSW; Sheldon Meyers, MD; Wolfgang Milch, MD; Caryle Perlman, LCSW; Judith Pickles, PhD, PsyD; Gary Rodin, MD, FRCPC; Rosemary Segalla, PhD; R. Dennis Shelby, PhD; Allen Siegel, MD; Malcolm Slavin, PhD; Maria Slowiaczek, PhD; Brenda Solomon, MD; David Solomon, MD; Mark Smaller, PhD; Dorienne Sorter, PhD; David Terman, MD; and Ernest Wolf, MD

This conference is intended for psychoanalysts, psychiatrists, psychologists, social workers, psychiatric nurses, marriage and family therapists, professional counselors and clinical professional counselors. The conference is organized to facilitate maximum opportunity for questions, comments and dialogue between the audience and the presenters, allowing clinicians to engage in an extensive variety of topics relevant to the field of Self Psychology.

The conference is organized into two parts: Thursday Pre-Conference and Thursday-Sunday Main Conference program. Registration includes the Thursday evening opening reception, continental breakfasts, and refreshments at all scheduled breaks. NEW! On-Line Registration Available! You can now register on-line via the web site We encourage you to take advantage of this secure and easy process. A confirmation letter will be sent via email within two weeks of receipt of your registration and payment information. On-line registration will open June 2009. SESSION SELECTIONS Due to the number of concurrent sessions and limited space, session assignments will be made strictly on a first-paid basis. Early registration is strongly advised to ensure a place in your preferred sessions. Once we have reached maximum capacity, no further admissions will be allowed. Please refer to the program to make your selection and then indicate your selection on the registration form. Return your completed form with payment information no later than September 22, 2009, to be eligible for the early registration fees.

At the conclusion of this conference, participants will be able to: A. Describe and examine the concept of the forward edge in theory and treatment. B. Present the latest findings of neuroscience regarding empathy and examine the application of these findings to clinical practice. C. Present applications of self psychology in multiple cultural and socioeconomic settings. D. Promote discussion and dialog among participants at the conference. E. Promote the development of clinical and professional skills among participants. F. Compare and contrast relational and self psychological views on psychoanalytic treatment.

This event is offered as an optional event at an additional fee. The Conference Reception and Talent Show will feature light appetizers, music, dancing, and performances from conference attendees. Please see the Conference Registration Form for fee information.

Personal audio taping will not be permitted at the PreConference or Main Conference. Violation of this policy may result in expulsion from the conference without refund. Content Management Corp. is contracted to audiotape all sessions, except those sessions designated as confidential. Facilities will be available at the conference to purchase the tapes. For further information about audiotapes, contact Audio Archives at (818) 957-0874; FAX (818) 957-0876.

If your entire registration must be canceled, a refund less $75 will be allowed if requested in writing by September 22, 2009. We regret that refunds cannot be allowed after this date.

This conference is presented by IAPSP and co-sponsored by The Institute for Psychoanalysis of Chicago. Physicians: The Institute for Psychoanalysis of Chicago designates this educational activity for a maximum of 24.75 Category 1 credits in category 1 credit toward the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. Psychologists: The Institute for Psychoanalysis of Chicago is approved by The American Psychoanalytic Association to offer continuing education credit for psychologists. The Chicago Institute for Psychoanalysis maintains responsibility for the program. Full attendance at the Pre-conference and/or Main conference is required to receive CE credit. Partial credit will not be awarded. Psychologists will be responsible for reporting their own hours to MCEP on an annual basis. Social Workers and MFTs: The Institute for Psychoanalysis of Chicago is approved as a continuing education sponsor for social workers by the Department of Professional Regulation of the State of Illinois. The Institute designates this continuing education activity as earning a maximum of 24.75 hours Continuing Education. The Institute for Psychoanalysis of Chicago is approved as a continuing education sponsor for Professional Counselors and Clinical Professional Counselors by the Department of Professional Regulation of the State of Illinois. The Institute designates this continuing education activity as earning 24.75 hours Continuing Education. Attendees must sign in and sign out of EACH section of the program, and complete and return the conference evaluation form to receive American Psychological Association continuing education credit. Continuing Education Credit Hours Awarded: Thursday, One Pre-Conference Course = 3 CE Hours Total Pre-Conference Program = 6 CE Hours Thursday-Sunday Main Conference Program = 18.75 CE Hours (including Saturday luncheon) Thursday-Sunday Main Conference Program = 17.75 CE Hours (excluding Saturday luncheon) There is an additional 1.0 Hours of credit awarded for the luncheon presentation on Saturday. Purchase of the luncheon ticket is required to be eligible for the associated CE credits. IMPORTANT DISCLOSURE INFORMATION FOR ALL LEARNERS: None of the planners and presenters of this CME program have any relevant financial relationships to disclose.

The 2009 Self Psychology Conference will take place at the Hyatt Regency McCormick Place located within walking distance from Chicago’s famous Museum Campus including the Field Museum, Shedd Aquarium, Adler Planetarium, and Soldier Field. This luxury hotel offers complimentary shuttle to local attractions such as Navy Pier, world-class shopping on Michigan Avenue’s Magnificent Mile, and the nearby museums. Set in the South Loop, this hotel has an indoor heated lap pool, sauna, sun deck, and work-out facilities. The Hyatt Regency McCormick Place is offering the 2009 IAPSP Self Psychology Conference attendees special conference rates of $215.00 single or double, plus applicable state and local taxes, currently 15.4%. Please be sure to mention the IAPSP Self Psychology Conference to receive these discounted rates. IAPSP Self Psychology discounted group rates apply until the reservation deadline of September 20, 2009 or until all so-designated rooms are booked, whichever occurs first. Reservation requests received after this date will not be guaranteed and will be confirmed based on space and rate availability. IAPSP/Self Psychology discounted group rates apply until the reservation deadline of September 20, 2009 or until all rooms in the group have been reserved, whichever occurs first. A first night’s room deposit or credit card will guarantee your reservation. Check-in time is 3:00pm. BE SURE TO MENTION THE IAPSP/SELF PSYCHOLOGY CONFERENCE TO QUALIFY FOR THE GROUP RATE!

To make reservations, contact the hotel directly: Hyatt Regency McCormick Place Phone: (800) 233-1234 CULTURAL AND LINGUISTIC COMPETENCY
This activity is in compliance with California Assembly Bill 1195 which requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. Cultural competency is defined as a set of integrated attitudes, knowledge, and skills that enables healthcare professionals or organizations to care effectively for patients from diverse cultures, groups, and communities. Linguistic competency is defined as the ability of a physician or surgeon to provide patients who do not speak English or who have limited ability to speak English, direct communication in the patient’s primary language. Cultural and linguistic competency was incorporated into the planning of this activity. Additional resources on cultural and linguistic competency and information about AB1195 can be found at

American Airlines is offering a special discount for participants of this the International Self Psychology Conference. To receive a discount off the lowest fare for which you are eligible, you or your travel agent may phone: American Airlines Meeting Services Desk at (800) 433-1790 (From anywhere in the US, or Canada) Be sure to mention Authorization Number A79H9AB.


Avis has assigned a specific discount number for the Self Psychology Conference in Chicago, IL. The Avis Worldwide Discount (AWD) # is G028267. Special discounted rates are available for conference attendees. Be sure to protect your transportation needs by making a reservation at least two weeks in advance. Phone the Avis Meeting & Group Sales Desk at (800) 331-1600 for reservations and further information.

Nilou Mostofi Conference Manager 3670 Clairemont Drive, Suite 10 San Diego, CA 92117 Phone: (858) 270-3503 Fax: (858) 270-3513 Email: Web:


15 minute break at 10:45 a.m. For a full description of pre-conference titles & objectives, please visit the Self Psychology Website before making your selection at A. The Essential Tools of Self Psychology: Working With Selfobject Transferences Co-Leaders: James Fisch, MD, Elizabeth Feldman, PhD & Allisun Noe Conant, PsyD B. Brandchaft’s Emancipatory Psychoanalysis Co-Leaders: Shelley Doctors, PhD & Dorienne Sorter, PhD C. The Interface of Self Psychology & Neuroscience Leader: Judith Rustin, LCSW D. Art, Creativity & Self Psychology Co-Leaders: George Hagman, MSW Carol Press, EdD & David Shaddock, PhD E. The Uses and Abuses of the Body in Current Psychoanalytic Thinking Co-Leaders: Ruth Burtman, PhD; Phyllis DiAmbrosio, PhD; Sandra Kiersky, PhD JP Cheuvront, PsyD F. Ethical Dilemmas in Clinical Practice Co-Leaders: Brenda Solomon, MD & John Riker, PhD G. Can Self Psychology Embrace Group Therapy? Leader: Rosemary Segalla, PhD 12:30–2:00 Lunch (on your own)

PRE-CONFERENCE WORKSHOPS 9:15 a.m. – 12:30 p.m.


MAIN CONFERENCE BEGINS 6:00 p.m. – 9:00 p.m.
6:00 p.m. – 7:00 p.m.
Opening Conference Wine & Cheese Reception
Estelle Shane, PhD, President, IAPSP Paula Fuqua, MD, Conference Co-Chair Amy Eldridge, PhD, Conference Co-Chair David Terman, MD, President, Institute for Psychoanalysis, Chicago

CONFERENCE PROGRAM SATURDAY, October 24, 2009 8:30 a.m. – 5:45 p.m.
7:30–8:30 Registration Opens Coffee & Breakfast Roll

Sessions B–C are All Day

8:30 – 10:45 a.m.


PANEL THREE Social Issues and Cultural Diversity: The Expanded Realm of Self Psychology
Presenters: Tessa Philips, PhD Mark Smaller, PhD Chair/Moderator: Jill Gardner, PhD 10:45–11:15 Coffee Break 11:00–12:00 Post Panel III Discussion Groups Registrants will meet in small groups to discuss Panel III. Sessions will be assigned at random.

KEYNOTE PRESENTERS Honoring the Work of Marian Tolpin: The Leading Edge Concept
Chair/Moderator: Paula Fuqua, MD Presenter: Frank Lachmann, PhD


FRIDAY, October 23, 2009 8:15 a.m. – 4:45 p.m.


Registration Opens Coffee & Breakfast Roll

12:15 – 2:00 p.m.

PANEL ONE Empathy and the Forward Edge: 21st Century Perspectives on Empathy
Presenter: Oliver Turnbull, PhD Discussants: Lucyann Carlton, PsyD, JD, Estelle Shane, PhD & David Terman, MD Chair/Moderator: Dorienne Sorter, PhD 10:45–11:15 Coffee Break 12:00–1:15 Lunch (on your own)

8:15 a.m. – 12:00 noon

OPTIONAL LUNCHEON Kohut Memorial Lecture
What Do We Inherit? Comments on the Intergenerational Transmission of Values and Ideals
Introduction: James Fisch, MD Presenter: Anna Ornstein, MD This is an optional ticketed event at an additional fee. (See Registration Form.) Only those attendees purchasing a ticket for the luncheon will receive 1 hour of continuing education credit for the luncheon lecture. Those who do not elect to eat, but who wish to attend the lecture after the meal, may do so based on space availability.


15 minute break at 3:30 p.m. H. Self Psychology: Roots & Transformations Co-Leaders: James Fosshage, PhD & Anna Ornstein, MD I. Brandchaft’s Emancipatory Psychoanalysis (Continued from Morning Session B) J. The Interface of Self Psychology & Neuroscience (Continued from Morning Session C) K. Staying Connected in Hard Times: Helping Couples Cope with Economic Stress Co-Leaders: Carla Leone, PhD & David Shaddock, PhD L. Intergenerationally Transmitted Trauma in Self Psychological Practice Co-Leaders: Doris Brothers, PhD Elizabeth Corpt, LICSW & Michael Reison, PhD M. Psychoanalytic Skills in an Age of Complexity Co-Leaders: Lynn Preston, MS & Ellen Shumsky, LCSW N. Understanding Specificity Theory Through Clinical Exploration Leader: Howard Bacal, MD, FRCPC

PRE-CONFERENCE WORKSHOPS 2:00 p.m. – 5:15 p.m.

Sessions I-J are Continuations

1:15 – 3:30 p.m.

PANEL TWO The Forward Edge of Theory: Self Psychology & Relational Responses to a Clinical Case
Presenter: Lynne Jacobs, PhD, PsyD Discussants: Richard Geist, EdD & Joyce Slochower, PhD Chair/Moderator: Christine Kieffer, PhD 3:30–4:00 4:00–4:45 Coffee Break Post Panel II Discussion Groups

For a full description of pre-conference titles & objectives, please visit the Self Psychology Website before making your selection at

1. Defiance, Creativity and the Origins of Resilience: the Path from Abuse to a New Life
Presenter: Bruce Herzog, MD, FRCPC Moderator: Wolfgang Milch, MD Discussant: Jacqueline Gotthold, PsyD

Registrants will meet in small groups to discuss Panel I & II. Sessions will be assigned at random. All faculty information as well as a detailed program will be available on the Self Psychology website:

2. Putting Our Heads Together: Mentalizing Systems
Presenter: Margaret Sperry, PsyD, MFT Moderator: Scott Davis, MD Discussant: Jeffrey Stern, PhD

SATURDAY, October 24, 2009 2:15 p.m. – 3:45 p.m.
3. Heinz Kohut’s Crucial Period: 1971-1977


SATURDAY, October 24, 2009 4:15 p.m. – 5:45 p.m.
1. Kohut’s Vision and the Nuclear Program of the Self
Presenter: Frank Summers, PhD, ABPP Moderator: Sanford Shapiro, MD Discussant: Volker Kraft, PhD


7:00 p.m. – 11:00 p.m.

A light appetizer buffet followed by a talent show, and dancing and music. (This is an optional ticketed event at an additional fee. See Registration Form.)

Presenters: James Anderson, PhD & Sivan Schneider, MA Moderator: Karen Martin, MA, LCSW Discussant: Michael Clifford, MDiv, LCSW

4. Compassion and Dialogue: Bridging the Psychoanalytic and Philosophical Understanding of the Other
Presenter: Roger Frie, PhD, PsyD Moderator: Lester Lenoff, MSW Discussant: John Riker, PhD

Presenter: Leslie Lampe Long, MEd, LMHC Moderator: Andrew Morrison, MD Discussant: Joye Weisel-Barth, PhD, PsyD

2. Career Dysphoria: The Emotional Wounds of Work Disruption and the Forward Edge

SUNDAY, October 25, 2009 8:30 a.m. – 10:00 a.m.
7:30–8:30 Coffee & Breakfast Roll


1. Meaning Making and Change: A View of Psychoanalysis From Systems Theory and Neuroscience
Presenter: Nancy Bridges, LICSW Moderator: Judith Pickles, PhD Discussant: Henry Friedman, MD

5. That’s Me: Self Psychology and the Problem of Identity
Presenter: Arnold Goldberg, MD Moderator: Paul Ornstein, MD Discussant: David Solomon, MD

3. Holding, Dropping, Catching, and Holding On: Three Transformations in the Arc of a Therapeutic Engagement
Presenter: Deborah Sherman, MS Moderator: Carol Munschauer, PhD Discussant: Jeffrey Trop, MD

2. Eroticization as a Pre-Phase in Re-engaging the Forward Edge
Presenter: Linda Marino, PhD Moderator: Jane Jordan, PsyD Discussant: R. Dennis Shelby, PhD

6. A Ship Made of Paper: Sailing the Seas of the Forward Edge
Presenters: Christine Kieffer, PhD, ABPP Moderator: James Fosshage, PhD Discussant: Amy Joelson, LCSW

Presenter: Amy Joelson, LCSW Moderator: Rosalind Chaplin Kindler, MFA Discussant: Marcia Dobson, PhD

4. Complex Elektra: Orchestrating a Murderous Mother-Daughter Bond

3. At the Outer Limits of Empathy: Interrogating Evil in SelfPsychological Practice

7. Pregnancy, Lesbianism, and Intrusion: A New Look at Some Old Themes
Presenter: Jane Reid, PhD, MSW Moderator: Annette Richard, MPs Discussant: Sandra Kiersky, PhD

Presenter: Judith Teicholz, EdD Moderator: Elizabeth Carr, MSN Discussant: James Anderson, PhD

5. Dancing on the Edge: Engaging With Forward & Trailing Elements of Transference

Presenter: Doris Brothers, PhD Moderator: Carolyn Clement, PhD Discussant: Hans-Peter Hartmann,MD,PhD

4. Mindsharing and Self Deficits
Presenter: Joseph Palombo, MA Moderator: Lucy Freund, PhD Discussant: Carol Mayhew, PhD, PsyD

8. How Does It Happen? An Expansive Proposal of Therapeutic Actions in My Own Analysis
Presenter: Carol Levin, MD Moderator: Brenda Solomon, MD Discussant: Sheldon Meyers, MD

6. Psychoanalytic Complexity and The Forward Edge: It’s (Almost) All About Attitude
Presenter: William Coburn, PhD, PsyD Moderator: Christa Paulinz, MA, PAD Discussant: Paula Fuqua, MD

5. Everything You Ever Wanted To Know About Money But Were Afraid to Ask
Presenters: Sandra Hershberg, MD Nancy VanDerHeide, PhD, PsyD

9. Pathologizing Twinship: An Exploration of Robert Stolorow’s Traumatocentrism
Presenter: Ilene Philipson, PhD Moderator: Amy Eldridge, PhD Discussant: Steven Knoblauch, PhD

Presenter: Carol Press, EdD Moderator: Bertram Cohler, PhD Discussant: Howard Baker, MD

7. Psychoanalysis, Creativity and Hope: Forward Edge Strivings in the Life and Work of Paul Taylor

6. A Curvature of Intersubjective Space: Emmanuel Levinas and the Psychoanalytic Vocation
Presenter: Donna Orange, PhD, PsyD Moderator: Kate Schechter, PhD, LCSW Discussant: Maxwell Sucharov, MD,FRCPC

10. Being-Toward-Life: A Twice-told Story of Death, Intergenerational Trauma and the Resolution of an Analytic Crisis
Presenters: Moderator & Discussant: Ruth Gruenthal, MSS 3:45–4:15 Coffee Break Doris Brothers, PhD Jane Lewis, LCSW

8. School Based Treatment for Maltreated Children: A Self Psychology Ecological Fusion

7. Meet the Author: Moral Stealth: How “Correct Behavior” Insinuates Itself into Psychotherapeutic Practice
Presenter: Arnold Goldberg, MD Moderator: Jeffrey Stern, PhD

Presenters: Janet Morrison, MA Charlene Cook, MPH & Faye Mishna, PhD Moderator: Mark Smaller, PhD Discussant: Susanna Federici-Nebbiosi, PhD

8. The Forward Edge, Connectedness, and the Therapeutic Process
Presenter: Richard Geist, EdD Moderator: Raanan Kulka, MA Discussant: Martin Gossmann, MD 10:00–10:30 Coffee Break

9. Worlds of Probability Versus “Absolutisms of Everyday Life: ”A Review of Robert Stolorow’s Book: “Trauma and Existence”
Presenter: Philip Ringstrom, PsyD, PhD Moderator: Michelle Sweet, PhD Discussant: Hazel Ipp, PhD

For a full description of preconference titles & objectives, please visit the Self Psychology Website before making your selection at

10:30 – 12:00 p.m.

10. Implicit Affective Engagement: Past, Present and Future
Presenter: Maria Slowiaczek, PhD Moderator: Arthur Gray, PhD Discussant: Ruth Burtman, PhD

FINAL SUMMARY PANEL Trends and Surprises: Thoughts on the 2009 Conference
Presenter: Judith Guss Teicholz, EdD

32nd Annual International Conference on The Psychology of The Self Thursday, October 22 - Sunday, October 25, 2009 • Chicago, Illinois
Please keep a copy of the registration form and send the original. Alternatively, register on-line at Last Name _______________________________________________ First Name ___________________________ MI ____ Degree(s) ______________________________
(To be printed on your nametag)


Address ________________________________________________________________________ IAPSP Membership Number ____________________________________ City ___________________________________ State/Province ____________ Postal Code _____________________ Country__________________________________ Phone Number _______________________________ Fax Number _______________________________





E-Mail ___________________________________________

Profession ____________________________________ State/Professional License No. ____________________________ (For Continuing Education Certificate)

IAPSP MEMBER RATE Professional: Full Day Half Day Student:* Full Day Half Day NON-IAPSP MEMBER RATE Professional: Full Day Half Day Student:* Full Day Half Day By Sept. 22 After Sept. 22 ❏ $110 ❏ $125 ❏ $55 ❏ $70 ❏ $70 ❏ $85 ❏ $35 ❏ $50 By Sept. 22 After Sept. 22 ❏ $170 ❏ $185 ❏ $85 ❏ $100 ❏ $100 ❏ $115 ❏ $50 ❏ $65

Payment must accompany registration form. Fees in U.S. dollars. FEE TOTALS: Thursday Pre-Conference(s) Thursday – Sunday Main Conference Kohut Memorial Lunch Ticket(s) Saturday Reception & Talent Show Optional Breakfast(s) Tickets(s) for Guest (Registrants do not need to purchase Breakfast) Panel Paper Set TOTAL AMOUNT DUE No. _____ $ ________ $ ________ $ ________ No. _____ $ ________ No. _____ $ ________ No. _____ $ ________ No. _____ $ ________


THURSDAY AM SESSION: 9:15 a.m. - 12:30 p.m. Select Workshop Preference (Workshops A-G) 1st Choice______ 2nd Choice______ THURSDAY PM SESSION: 2:00 - 5:30 p.m. Select Workshop Preference (Workshops H-N) 1st Choice______ 2nd Choice______ SESSIONS B & I & SESSIONS C&J MUST BE TAKEN TOGETHER IF TAKING SESSION A, SESSION H IS RECOMMENDED.

❏ ❏

Check Enclosed. Payable to: IAPSP (A $25.00 U.S. fee will be assessed for returned checks) Credit Card:


❏ MasterCard


Account # _______________________________________________________ Exp. Date __________ 3 or 4 Digit Security Code# __________________
(on back for MC or VISA, on front for AMEX)

IAPSP MEMBER RATE Professional: Student:* NON-IAPSP MEMBER RATE Professional: Student:* By Sept. 22 After Sept. 22 ❏ $395 ❏ $425 ❏ $230 ❏ $245 By Sept. 22 After Sept. 22 ❏ $495 ❏ $525 ❏ $280 ❏ $295

Signature _______________________________________________________ ________________________________________________________________ Street Address on Credit Card Billing Statement ________________________________________________________________ City, State or Province Country Zip/Postal Code

❏ Check here if you will require ADA accommodations: Please list your

requirements: ________________________________________________________________ Refunds will be given less a $75 administration fee if request is received in writing via email, fax or mail by September 22, 2009.
*A letter must accompany Student registrations from the training director verifying full time-status. Photocopies of student ID will not be accepted.

(Indicate your preferred choice and two alternatives for each session)

PAPER SESSION A: Saturday 2:15 - 3:45 p.m. 1st Choice______ 2nd Choice______ 3rd Choice______ PAPER SESSION B: Saturday 4:15 - 5:45 p.m. 1st Choice______ 2nd Choice______ 3rd Choice______ PAPER SESSION C: Sunday 8:30 - 10:00 a.m. 1st Choice______ 2nd Choice______ 3rd Choice______

IAPSP 3670 Clairemont Drive, Suite 10 • San Diego, CA 92117 • USA Phone: (858) 270-3503 Fax: (858) 270-3513 Email: Web:

Kohut Memorial Luncheon Ticket Reception & Talent Show Optional Guest Breakfast Ticket Panel Papers

❏ $65 ❏ $55 (Saturday Reception) ❏ $30 (Non-registered guests) ❏ $40/Each Set

Note: Please make hotel reservations directly with the Hyatt Regency McCormick Place, Chicago, IL. See Location and Accommodations for details. Are you a newcomer to the Self Psychology Conference? Would you like to be contacted by someone from our Welcoming Program? If so, please email Maria Slowiaczek at

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