Use of audiotape recording in impasses with severely disturbed patients

The psychoanalytically oriented treatment of patients with severe personality disorders is characterized by impasses and by efforts to resolve them. Patient audiotape recording and review of sessions can be a particularly useful technical parameter in such situations. When judiciously employed, it is unusual, if not unique, in that it selectively amplifies the power of traditional elements of technique as well as some of the constructive elements of the analytic process itself, while reducing the power of some of the destructive elements of the transference. Indications for using this parameter are discussed, case illustrations presented, and hypotheses advanced about its mode of action. No single element of technique is responsible for the success or failure of analysis. The most that can be expected of tape recording is that it help break up the treatment log jam and facilitate further work.