Making Sense of the Space Between: A Qualitative Study of Therapist’s Experience and Use of Therapeutic Enactments

<p>This study sought to examine a particular category of technical challenge in therapy: enactments. Enactments, broadly defined, are moments or stretches of time in therapy where both the patient and therapist cannot put their conflicts into words, and instead act them out within the therapeutic milieu. These phenomena frequently elicit shame and guilt on the part of the therapist, and can prove detrimental to treatment. Equally, however, investigation of these moments within treatment can be of considerable clinical utility. In this qualitative phenomenological study, 6 therapists were interviewed about their experiences working with enactments in clinical practice. The strategies which therapists utilized to resolve enactments were investigated, as were the challenges they encountered. A countertransferential sense of the patient’s fragility was found to be associated with therapists’ feeling unable to utilize many of their normal therapeutic techniques, in a way which made treatments considerably more challenging. Collusive enactments were identified as a particularly intractable subset of enactments, and were associated both with a sense of the patient’s fragility, and difficulty on the part of the therapist with accessing their negative emotions towards the patient. It was found that therapists’ experience of shame in treatment, if acknowledged and processed, was often of considerable clinical utility, and allowed them to successfully resolve enactments. Conversely, shame which was disavowed by the therapist often resulted in pathologization of the patient, and rigidity of therapeutic technique.</p>

Name thesis:degree_name

Doctor of Philosophy (Ph.D.)

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Psychology

Year dc:date.available

2024

Author dc:creator

• LaFreniere, Paul Ballantyne

Contributors dc:contributor

• Steven Tuber

• Clinical Psychology

Repository record dc:identifier

https://academicworks.cuny.edu/cc_etds_theses/1185

OAI identifier oai:identifier

oai:academicworks.cuny.edu:cc_etds_theses-2261