poppy flower
CPD Credits
7.5
Event Type
Recorded Event
Location
Your TR Together account
Standard
£150.00
Trainee/NHS
£127.50
Buy Recording
poppy flower

Clinical Impasse Series

A five-part series exploring why, with some clients, the therapy ‘gets stuck’. 

With Salman Akhtar, Narendra Keval, Anthony Bass, Jill Sallberg, Steven Kuchuck & Zack Eleftheriadou (Chair)

A therapeutic impasse can lead to self-doubt among therapists, as well as concerns that the client may terminate the therapy prematurely. Our speakers demonstrate that these challenging moments can offer great insights for both client and therapist, if they can be worked through.

More recently impasses, collisions, and collusions have been acknowledged as inherent and valuable aspects of clinical practice. This means that the experience of getting stuck or encountering a therapeutic impasse can actually help the therapist to understand more about the client's inner world and potentially shed light on how the histories of both the client and therapist are interacting unconsciously. Identifying, naming, and making sense of these clinical impasses can serve as a way forwards

Our speakers cover themes including the recognising unconscious dynamics between therapist and patient which maintain a stasis in the therapy, the impact of intergenerational transmissions on progress, the phenomenon of "othering" within the context of relational psychoanalysis and racialized enactments, and the delicate art of being affected by the therapeutic process without becoming overwhelmed by it.

The primary objective for this series is to support therapists' capacity to navigate and work through these challenging phases. By participating in this series, therapists can gain the confidence and skills necessary to effectively address moments when they and their clients find themselves in the challenging position of feeling "stuck."

Programme

 
 
Jill Salberg
Clinical Impasse as an Inevitable part of Therapeutic Action

Perhaps the greatest shift in clinical practice and literature is organised around a shared understanding across theoretical divides regarding the inevitability of impasses, collisions, and collusions in the treatment relationship. In this session, Jill will consider how inter-generational transmission affects both patient and analyst, infiltrating the treatment, disrupting alliances and blocks forward movement. Jill brings clinical material that  illustrates how a mother’s early death came to haunt the lives of subsequent generations of mothers and daughters. She addresses the impact of attachment rupture, trauma, envy, and shame as they reflect transgenerational transmission phenomena and how they were worked on, repaired, and utilised as therapeutic action.

Discussion with Zack Eleftheriadou

Zack will discuss the presentation with the speaker and draw out some themes for exploration inspiring the group discussion.

Q&A with participants
 
Steven Kuchuck
The Analyst’s Negation of Self and “Other”: Sex and Love on the Upper East Side

Although the patient you will be introduced to in this recorded session entered treatment in his later years, he was still very much searching for the boy he had not yet been while on his way to becoming a man. It was only recently that he came to accept a truth he had been running from for years. Banished by parents and society, his sexuality had been forced underground for most of his life.  Consequently, this tale is one of loss and painful longing. The analyst’s tendencies to Other in this treatment will be tracked as both an impediment to and component of the therapeutic action.

Discussion with Zack Eleftheriadou

Zack will discuss the presentation with the speaker and draw out some themes for exploration inspiring the group discussion.

Q&A with participants

 

Salman Akhtar
Disruptions & Interruptions in Treatment

This presentation opens by defining and distinguishing ' Interruptions' and 'Disruptions'. Devoting greater attention to the latter, the presentation highlights six psychodynamic triggers that set it into motion. This includes unconscious guilt, anxious retreat from higher level conflicts, envious and sadomasochistic attack on the therapist's calm and creativity, fear of separation from the therapist by improvement, shift in the patient's structural organization from a conflict-based to a deficit-based sector and failure of analyst's empathy and attunement. Therapeutic interventions directed at resolving each type of 'disruption' are discussed and the various proposals made are anchored in psychoanalytic developmental theory and highlighted with the help of clinical vignettes.

Discussion with Zack Eleftheriadou

Zack will discuss the presentation with the speaker and draw out some themes for exploration inspiring the group discussion.

Q&A with participants

 

Narendra Keval
Impasse as Enactment: Shaping the Destiny of the Racial Moment

Whilst it is in the nature of our clinical work that we will experience moments of impasse, these difficulties can become challenging to think about when they take the shape of a racialised moment. The different kinds of emotional predicaments and pressures they create makes it particularly difficult to listen with curiosity to some of the relational dangers associated with racial difference conveyed by the patient. Such moments can however become the place where the most crucial work can happen if it is possible to remain receptive enough to be emotionally affected but not infected to continue thinking, potentially shaping the destiny of the moment.

Discussion with Zack Eleftheriadou

Zack will discuss the presentation with the speaker and draw out some themes for exploration inspiring the group discussion.

Q&A with participants

 

Anthony Bass
Growth, Impasse, Analytic Change and the Changing Analyst - The Mutuality of Relations at the heart of Analytic Change

In this presentation Anthony Bass  considers aspects of impasse, in therapies in which either therapist or patient comes to feel that they have reached a point of diminishing returns, or that the therapy has come to do more harm than good, from a two-person, intersubjective perspective that locates such problems and their possible solutions in therapist and patient mutually.  Therapy at such times requires working through of the problem from both sides, with special attention to the dialogue of unconsciouses between therapist and patient as a source of illumination. Psychoanalytic therapies, when they are most helpful, are processes of personal discovery for both participants. Therapist and patient come to know more about themselves as a function of their encounter with one another, and both participants change as a result.  Either patient or therapist may be the first to change, initiating an expansion of transitional space and therapeutic potential.  Dr Bass considers such moments and some ways in which he believes a therapist can use him or herself to re-initiate change, growth and healing in the patient, therapist and therapeutic couple that can make possible a resumption of genuinely affecting therapeutic work.  

Discussion with Zack Eleftheriadou

Zack will discuss the presentation with the speaker and draw out some themes for exploration inspiring the group discussion.

Q&A with participants