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Enactments: an evolving dyadic concept of acting out
1Clarke Institute of Psychiatry, Toronto, Ont.
American Journal of Psychotherapy
|January 1, 1996
Summary
Unspoken actions in therapy, like enactment and misalliances, can act as resistance or communication. Understanding this dyadic interplay is key for therapeutic change.
Area of Science:
- Psychotherapy research
- Psychoanalytic theory
- Clinical psychology
Background:
- Unspoken actions between therapist and patient significantly influence the psychotherapeutic process, often unconsciously.
- Mutual transferences can lead to acting-out behaviors, representing both transference wishes and defenses.
Observation:
- Acting-out behaviors can overshadow verbalization of intrapsychic conflict, functioning as resistance to introspection.
- These actions may also serve as non-verbal attempts to communicate significant past experiences.
- Enactment, actualization, and treatment misalliances are common during regressive periods in therapy.
Findings:
- Enactments may initially involve therapist participation before interpretation, aiding dynamic understanding.
- Therapist collusion through continued acting out or re-parenting fosters antitherapeutic misalliances.
- Such misalliances can perpetuate symptomatic behaviors and boundary violations.
Implications:
- Continuous self-inquiry by the therapist is crucial for facilitating therapeutic change.
- The therapist's internal world is the primary tool for analyzing and promoting positive patient change.