The Patient Who Had Me Committed: A Mutually Influential Relationship Between Patient and Analyst in the Context of a Broadening Analytic Frame

Abstract

Patients and analysts frequently become locked in enactments generated by their reciprocal dissociations. Emerging from this quagmire often entails the capacity of the dyad to confront each other and negotiate out of these impasses. When discussing the analyst’s role in facing her own dissociations, much of the analytic literature refers to minor omissions or blind spots that are effectively dealt with by slight attitude adjustments toward the patient. I suggest that in some instances the therapist’s willingness to grapple with her deeper and more profound dissociations, while struggling and negotiating with her patient’s, could lead to intense mutual influence and spirited collaboration between the two, including invitations to participate in architecting the therapy itself. Broadening the analytic frame to include external environmental factors could further advance this deep relational and collaborative process. A detailed case vignette is presented.