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Koen, S. Roveri, M.T. (1998). Enactments that Don't Appear as Enactments. J. Amer. Acad. Psychoanal., 26(1):85-94.

(1998). Journal of American Academy of Psychoanalysis, 26(1):85-94

Enactments that Don't Appear as Enactments

Silvana Koen, Ph.D. and Maria Teresa Bertozzi Roveri, Ph.D.

Psychiatric literature is rich in considerations and suggestions about the need to free the psychoanalytic practice from the unrealistic attempt of certain therapists to establish a relationship with their patients as if they were not affected (hampered) by their patients' human nature.

All that occurs in the therapeutic scene can often be interpreted on many different levels, some of which remain totally unexplored, regardless of the attention and care taken by the therapist.

By referring to the story of a multitraumatized patient, we highlight some aspects of the therapist-patient relationship in the belief that these aspects are relevant to the therapeutic experience.

Let us consider carefully those episodes in which it is possible to identify the presence of a truly new experience both for the patient and the therapist within a relationship that has grown over time and that is specifically between these two persons. Let us also consider the materialization on the analytical stage of those relational events that belong in different ways both to the story of the patient and to the therapist.

We think the inner world of the patient can more easily “resonate” with that of the therapist when these two persons have gone through experiences that are even vaguely similar. This would lead to some well-known implications: With a different therapist the patient would proceed through a different analysis, as the analytical scene, like any other relationship, is codetermined. In the case history we present, the patient has suffered the early loss of a parent, as well as sexual abuse perpetrated by a reference figure. More than other experiences attachment traumas and sexual abuse are likely to provoke the internalization of confused relational models, in which good and bad experiences are mixed in an overwhelming amalgam. The love and care received by the patient during childhood have been both good and bad and it is likely that the same person will continually repeat the same type of experiences over the course of his/her life.

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