Tracking Changes in the Disruption/Repair Sequences: Important Aspects of Clinical Work

Abstract

ABSTRACT In keeping with the movement toward refining clinical theories and working with experience-near phenomena in the analytic situation, in this paper we are asking how we recognize change and how we know what particular interactional sequences between analyst and analysand have transmutative power. Following disruption-repair sequences in the therapeutic relationship sheds light on the process of change. Disruption-repair sequences not only re-establish the connection between therapist and patient, they also promote new levels of understanding for both parties in the dyad. Because such sequences are frequent in the course of treatment, they are particularly useful in creating and recognizing modifications in the patient’s defenses and related symptoms. In this paper, we track verbatim interchanges between analyst and analysand during two specific episodes of disruption-repair as a vehicle for understanding and illustrating the process of therapeutic change. This close tracking allows us to notice shifts in self-states within the analysand between trailing edge archaic selfobject mergers and forward edge strivings and transference as well as shifts in the therapeutic relationship.