A View of the “Disengaged” Patient as Already Engaged

Abstract

With the help of a detailed clinical example I offer a vantage point on the difficult-to-engage or disengaged patient, as already engaged. In developing my position I draw on contributions of attachment research bearing on avoidant/dismissive styles of attachment and salient contributions of self-psychology. I consider and illustrate the implications this viewpoint carries from a countertransferential perspective and for the analyst's therapeutic stance.