“Reflective network therapy is literally an application of child analysis in the real-life setting of a preschool.”
Gilbert Kliman MD.
San Francisco
Episode Description:
Harvey Schwartz welcomes Dr. Gilbert Kliman a child and adult psychoanalyst who has focused his career on providing measurable outcomes from his clinical work, which he discusses in this episode.
Dr. Kliman has a Distinguished Life Fellow status in the American Psychiatric Association, the American Academy of Child and Adolescent in Psychiatry and the American Psychoanalytic Association. He is a graduate of the Interdisciplinary Fellowship in Science and Psychiatry and Albert Einstein Medical College in New York. Dr. Kliman is the recipient of the American Psychoanalytic Association’s 2020 Humanitarian Award, the Anna Freud Award for Child and Research in 2016, the Dean Brockman Award in 2014 and the French Psychoanalytic Society Award in 2014.
Dr. Kliman has been a major contributor to the field of child analysis, child therapy and essentially to the well-being of the people whose lives he touches. He has discovered and created a new method of intervening in children’s lives called The Reflective Network Therapy.
Key Takeaways:
[3:45] Dr. Kliman talks about his evidence-based findings of the effects of child analysis and RNT in the cognition of preschoolers.
[6:13] Dr. Kliman talks about Reflective Network Therapy, the treatment program that has made radical changes in the lives of many preschoolers.
[9:33] There is no privacy in the progress of the sessions.
[11:30] At the end of the session, there is a debriefing, where the child and the analyst try to explain to the teacher and other students what they have been doing.
[13:55] The teachers receive training to follow the guidelines of Reflective Network Therapy.
[17:10] Dr. Kliman shares a case example.
[21:53] Care and tenderness have been the key to the success of the treatment.
[25:42] Reflective Network Therapy is tuned analytic work in a classroom.
[27:18] The observing children in the classroom become incredibly altruistic as a result of participating in the therapeutic process.
[28:07] Dr. Kliman shares the example of a preschool in San Mateo.
[31:17] Dr. Kliman talks about personal experiences and professional trajectory which motivated his passion for psychoanalysis.
[36:28] Hard measures in psychoanalysis.
[39:55] Dr. Kliman talks about the liveliness of working in a preschool.
[41:40] Children learn to learn in small networks, not in dyads.
Mentioned in This Episode
IPA Off the Couch – www.ipaoffthecouch.org
Visit Children Psychological Health Center for publicly viewable videos. Write to gilbertkliman2008@gmail.com for confidentiality agreements and instructional videos.
Recommended Readings
Garber, Howard L. (1988) The Milwaukee Project: Preventing Mental Retardation in Children At Risk. National Inst. of Handicapped Research (ED), Washington, DC. ISBN-0-940898-16-0 88.
Heinecke, C.M. (1966) Frequency of Psychotherapeutic Session as a Factor Affecting the Child’s Developmental Status. Psychoanalysis. Stud. Child 20, 42-98.
Heinecke, C.M. and Ramsey-Klee, DM. (1986) Outcome of Child Psychotherapy as a Function of Frequency of Session. J. A.A.C.P. 25(2), 247-253.
Jeffery, E. (2001) J Am Psychoanal Assoc vol. 49 no. 1 103-111
Kliman, G. (2011) Reflective Network Therapy in the Preschool Classroom. U. Press of America. Lanham, MD.
Kliman, G (2014) A unifying new theory of posttraumatic stress disorder. Am. Coll. Psychoanalysts. Joint meeting with Am. Acad. Psychoanalysis and Psychiatry. Paris.
Kliman, G. (2015) Meta-analysis of IQ change data from eight sources, control and comparison studies.
Kliman, G. (2018) Reflective Network Therapy for Preschoolers with Autism or Posttraumatic Stress Disorder. Neuropsychoanalysis. August 2018.
Skeels, H.M. and Dye, H.A. (1939) A study of the effects of differential stimulation in mentally retarded children. Proc. Am. Assoc. Mental Deficiency. 44, 114-136.
Spitz, R.A. (1945). Hospitalism—An Inquiry Into the Genesis of Psychiatric Conditions in Early Childhood. Psychoanalytic Study of the Child, 1, 53-74.
Zelman, A. Samuels, S. & Abrams, D. (1985) IQ changes of young children following intensive long-term psychotherapy. Am. J. Psychotherapy 39(2), 215-217.
Zelman, A. and Samuels, S (1996) Children’s IQ changes and long-term psychotherapy: A follow up study. In Zelman, A. Early intervention with high-risk children. Northvale, NJ Jason Aronson
I love your podcast program and I loved your interview with Gil Kliman, who I have known and worked with in different projects at different times since 1980. I feel that this is a wonderful interview and presentation of Gil’s creative visionary work and youthful adventurous spirit.
However, I suggest that the interview podcast could benefit from a Part II, because we did not hear about Gil pioneering the new field of “Preventive Psychiatry” in the 1960’s, when he founded the Center for Preventive Psychiatry to work in “primary prevention” with children under 6 years of age (which included the RNT nursery innovation) and in “secondary prevention” with his Situational Crisis Service (with children of divorce, children who lost a parent through death, and other forms of serious life crises) in White Plains, NY and Yonkers, NY, and later he founded the Psychological Trauma Center and the Psychological Health Center in San Francisco, California.
His early books, “Children and the Death of a President” (with Martha Wolfenstein, 1965) and “Psychological Emergencies of Childhood” (1968) dealt with childhood trauma and he founded the Journal of Preventive Psychiatry that further helped to establish this psychiatric specialty at a time in the 1960’s through the 1990’s when early childhood treatment and crisis intervention were rarely done or even thought about.
As an example, following a high school student’s suicide, Gil’s staff would immediately go out of the office to provide crisis intervention to the school and the student’s family from the 1960’s on, when this did not become common practice in mental health until well into the 1990’s.
Gil’s (1980) book with Albert Rosenfeld, “Responsible Parenthood: The Child’s Psyche Through the Six Year Pregnancy” is considered one the best books for parents on the child’s life from birth to 6 years of age, which also had aspects of paradigm shift thinking about parenting.
Another area of Gil’s trailblazing innovation is in forensic child and adult post trauma evaluation and expert psychiatric testimony, which Gil pioneered perhaps from the 1970’s onwards and he has testified in high profile cases of national attention, disasters and horrific trauma, such as the recent separation of parents and children at the Mexican border.
Gil mentioned having established the psychiatric and psychoanalytic understanding of early childhood mourning. But he did not mention his seminal publication with Thomas Lopez of the mourning process in a maternally bereaved 4 year-old girl, which is recognized as one of the great classic cases in the Psychoanalytic Study of the Child. See below:
Lopez, T. and Kliman, G.W. [1979]. Memory, Reconstruction, and Mourning in the Analysis of a 4-Year-Old Child — Maternal Bereavement in the Second Year of Life. Psychoanal. St. Child, 34:235-271).
There are other important areas to mention. The podcast features how Gil’s adaptation of child psychoanalysis “Reflective Network Therapy” (RNT) brings about such a significant rise in IQ is an important demonstration of the efficacy of a form of child psychoanalytic treatment. Gil mentioned how the use of a coordinated “network” of index child, analyst, teacher, parents and other children in the nursery is an example of what is now called psychoanalytic “field theory” (Katz, S.Montana, 2016. Contemporary Psychoanalytic Field Theory). It should also be noted that the treatment’s “reflective” process and creative use of “briefing” and “debriefing” are prescient examples of what is now called “mentalization treatment” more recently developed out of the Anna Freud Centre.
The best introductions to Reflective Network Therapy (RNT) also called the Cornerstone Method) are the following:
Kliman, G.W. (1975). Analyst in the Nursery—Experimental Application of Child Analytic Techniques in a Therapeutic Nursery: The Cornerstone Method. Psychoanal. St. Child, 30:477-510..
Lopez, T. and Kliman, G.W. (1980). The Cornerstone Treatment of a Preschool Boy from an Extremely Improverished Environment. Psychoanal. St. Child, 35:341-375.
Kliman, G.W. (2011). Reflective Network Therapy in the Preschool Classroom. Latham: University Press of America.
Therefore, I appreciate how well you highlight Gil as a creative, innovative, pioneering and visionary psychoanalyst in and “Off the Couch” out of the office and I just suggest that it would be even better as a Part I that could be followed up by a few more minutes of a Part II.
Appreciatively and respectfully,
David M. Abrams
This experience is incredibly interesting. Some extra hypotheses and ideas hit me, while listening to this podcast.
I work with children ( in Brazil) who have lived a great part of their primary years of life in shelter homes and later on are addopted. I’ve noticed, through the years, many times, that some of the difficulties those children and their families face is the adaptation of the kids in different circles, like school for instance. So, it occurred to me that, proposing a network approach with all of the people envolved in this scenario would be of very good help. I’d really like to learn a lot more about this approach and technic.