In this five-part series we will explore why, with some clients, the therapy ‘gets stuck’. 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 will 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."
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 will discuss clinical material that illustrates how a mother’s early death came to haunt the lives of subsequent generations of mothers and daughters. I will address 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.
Although the patient you will be introduced to in this 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, sexuality had been forced underground for most of his life. Consequently, today’s 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.
This presentation will open by defining and distinguishing ' Interruptions' and 'Disruptions'. Devoting greater attention to the latter, the presentation shall highlight 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' will be discussed and the various proposals made shall be anchored in psychoanalytic developmental theory and highlighted with the help of clinical vignettes.
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.
In this presentation Anthony Bass will consider 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.