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Frankel, S.A. (2006). The Clinical use of Therapeutic Disjunctions. Psychoanal. Psychol., 23(1):56-71.

(2006). Psychoanalytic Psychology, 23(1):56-71

The Clinical use of Therapeutic Disjunctions

Steven A. Frankel, M.D.

Disjunctions are subtle blocks to therapeutic progress. At any moment analysis can be derailed as the analyst and patient work at cross-purposes. Disjunctions may arise from internal conflict dealt with, for example, through repression coupled with projection, splitting, or dissociation; from surface incongruities such as differences between the therapist's and patient's styles and cultures; or from harder to classify factors separating therapist and patient. The concept of disjunction is descriptive. Disjunction refers strictly to the restricted capacity of the analyst and patient to work together therapeutically. Conceptualizing therapeutic impasses as disjunctions rather than as primarily manifestations of transference-countertransference adds depth and texture to the analytic operation. It encourages partners to work cooperatively as they resolve analytic blocks, regardless of their nature.

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