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The Dialogue of Unconsciouses in Clinical Impasse

Clinical Impasse Series

With Anthony Bass & 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. We aim to 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."


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.  I will consider such moments and some ways in which I believe 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