Theory and practice at the psychoanalytic psychotherapy »site« - an attachment perspective

Abstract

In sum, the psychoanalytic »site« can be defined by a number of common aspects. A therapeutic relationship, the task of meaning-making in which the client begins to make sense of problematic or symptomatic experiences and behaviours and the therapeutic action or change, which helps to promote the client's capacity to »mentalise« his own feelings and actions and those of others, which assists the reintegration of the clients repressed, disowned or projected affects or parts of the self with resulting greater sense of vitality, efficacy and »real-ness« and enhances the emotional articulacy, including mourning and processing past losses and traumata. Features characteristic of psychoanalytic psychotherapy include the above, but in addition encompass: Acknowledging from the outset with the limitations of reality, working with extra-transferential material, theoretical eclecticism, awareness of contributions from related disciplines, embracing transparency and the need for research, both qualitative and quantitative, to guide and improve outcomes for their clients, accepting the phases of the therapist's developmental process, from early naïve enthusiasm, through the 'straight and narrow' of training and strict model-adherence, to more mature, relaxed and creative integrationism. This paper started with considering the problematic relationship between theory and practice in psychoanalysis. With its emphasis on relationship rather than putative intra-psychic mechanisms, and on what can be observed rather than inferred, attachment theory has a significant contribution to make to this new field.