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Kayatekin, M.S. Plakun, E.M. (2009). A View From Riggs: Treatment Resistance and Patient Authority—X: From Acting Out to Enactment in Treatment Resistant Disorders. J. Amer. Acad. Psychoanal., 37(2):365-381.
    

(2009). Journal of American Academy of Psychoanalysis, 37(2):365-381

A View From Riggs: Treatment Resistance and Patient Authority—X: From Acting Out to Enactment in Treatment Resistant Disorders

M. Sagman Kayatekin, M.D. and Eric M. Plakun, M.D.

Patients with treatment resistant disorders pose a major problem to clinicians of all theoretical perspectives, including psychodynamic therapists. Treatment of such patients often results in stalemates and impasses, and acting out is a frequent phenomenon. This paper addresses the value in work with such patients of looking beyond the concept of acting out, which is a one-person definition of a problem, toward the concept of enactment, which recognizes the roles both therapist and patient play in the phenomenon of treatment resistance.

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