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Having a PEP-Web subscription grants you access to IJP Open. This new feature allows you to access and review some articles of the International Journal of Psychoanalysis before their publication. The free subscription to IJP Open is required, and you can access it by clicking here.

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Nicolai, N.J. (2017). Psychotherapy with People Who Have Disorganised Attachment Patterns in a Psychodynamic and Attachment Theory Informed Setting. Att: New Dir. in Psychother. Relat. Psychoanal., 11(1):35-50.

(2017). Attachment: New Directions in Psychotherapy and Relational Psychoanalysis, 11(1):35-50

Psychotherapy with People Who Have Disorganised Attachment Patterns in a Psychodynamic and Attachment Theory Informed Setting

Nelleke J. Nicolai, M.D.

The story of my work with a woman who has a dissociative disorder is presented from an attachment perspective. Someone with a disorganised/disoriented attachment status requires a different approach. Within an attachment and psychoanalytic psychotherapy approach I describe how by centring on issues of self-regulation (dissociative withdrawal) and interactive regulation, when the patient was in a highly helpless and frightened state, an enactment emerged that mirrored the interactions she had had with her parents. Within our growing mutual understanding of the mosaic of the transference-countertransference matrix a pattern was discernible: each time the therapist felt pressured to act she was caught in a repetition of earlier frightening and perverse relationships. Thinking and reflecting on these enactments enabled the patient to differentiate between past and present and helped her to verbalise her unmentalized feelings.

[This is a summary or excerpt from the full text of the article. PEP-Web provides full-text search of the complete articles for current and archive content, but only the abstracts are displayed for current content, due to contractual obligations with the journal publishers. For details on how to read the full text of 2016 and more current articles see the publishers official website.]

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