171 research outputs found

    An Application of the Concept of the Therapeutic Alliance To Sadomasochistic Pathology

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    This paper traces the history of the therapeutic alliance concept, examining how it has been used and misused, at times elevated to a central position and at others rejected altogether. The loss of this concept created a vacuum in classical psychoanalysis that has been filled by rival theories. The continuing usefulness of looking at the treatment process through the lens of the therapeutic alliance, particularly in relation to the manifold difficulties of working with sadomasochistic pathology, is suggested. To this end, revisions of the theory of the therapeutic alliance are suggested to address some of the difficulties that have arisen in conceptualizing this aspect of the therapeutic relationship, and to provide an integrated dynamic model for working with patients at each phase of treatment. This revised model acknowledges the complexity of the domain and encompasses the multiple tasks, functions, partners, and treatment phases involved. The utility of the revised theory is illustrated in application to understanding the sadomasochistic, omnipotent resistances of a female patient through the phases of her analysis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66889/2/10.1177_00030651980460031301.pd

    An indication for conjoint treatment: An application based on an assessment of individual psychopathology

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    Conjoint treatment is advocated as the treatment of choice for a particular class of patients who do not seem able, at least initially, to benefit from individual exploratory psychotherapy. These people identify a person or persons, usually a spouse, as the primary cause of their difficulty. They show no initial capacity for self-observation. Their needs are childlike, and they show limitations in skills and a striking inability to sustain mutually gratifying relationships. The conjoint situation seems capable of initiating self-observation by confronting them with the reality of the person about which they are making claims. As a therapy, it also initiates an improvement in their marital relationship, thereby helping them potentially to gain that which they crave so desperately, but had been unable to realize except in compromise form, that is, in fantasy or in a relationship with a therapist.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43988/1/11126_2005_Article_BF01071657.pd
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