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Finding our way: Patients and therapists interviewed in the midphase of psychoanalytic psychotherapy

Jennifer Copeland Nash, University of Massachusetts Amherst


As relational theory (set out by Greenberg and Mitchell, 1983; Mitchell, 1988) challenges psychoanalytic psychotherapists to reconsider mutual influences in therapeutic interaction (Aron, 1996), this research explores those effects using methods consistent with new psychoanalytic technique. The midphase was studied from patient's and therapist's perspectives, emphasizing (1) the patient's perceptions of the therapist's contribution, (2) the patient's experience of technique and the therapist's authenticity, (3) the conditions in which the pair involve a third in the treatment, (4) attitudes of psychotherapists in private practice to the study, and (5) the effects of research intervention on treatments underway. Unstructured interviews were conducted with volunteer pairs from a psychoanalytically oriented mental health clinic and, following ethnographic interviews of therapists in private practice, with two therapists in private practice and five of their patients. Most psychotherapists who participated in interviews with patients identified themselves as Control-Mastery practitioners (viz., Weiss, Sampson, and the Mount Zion Psychotherapy Research Group, 1986), a phenomenon possibly related in part to theoretical emphasis on the patient's autonomy and the theory's empirical roots (making therapists more likely than others to create an environment in which patients would volunteer). Patients at the transference threshold (briefly, when patients acknowledge emotional complication in the relationship) were anxious about upcoming problems in the therapy relationship and were relatively ignorant of the therapeutic utility of the transference. The patient who volunteered in a transference muddle feared his treatment had reached an impasse after much work in the transference. Most patients used interviews to evaluate the appropriateness of their and their therapist's emotions in the treatment, to compare their therapists with another therapist, and as an opportunity for trial disclosures. Many were much closer to termination than their therapists knew. Patients preferred authentic interaction with therapists and had much to say about them, leading the researcher to question the proportion of repression to discretion in patients' conduct in treatment. It was felt that research interviewing of this kind could be very productive empirically and clinically when including open exploration among all participants regarding the potential and function of the encounters.

Subject Area


Recommended Citation

Nash, Jennifer Copeland, "Finding our way: Patients and therapists interviewed in the midphase of psychoanalytic psychotherapy" (1996). Doctoral Dissertations Available from Proquest. AAI9721483.