Acute enactment as a ‘resource’ in disclosing a collusion between the analytical dyad

Abstract

The author discusses various aspects of the function of enactment in analytical practice, reviewing the concept, then describing a borderline patient with whom the analytic process seemed to be developing productively. Following a change in the setting, an intense, acute enactment took place. Understanding this led to observation of an unconscious collusion, in which a symbiotic relationship had been established between the patient, the analyst and his family, as a chronic enactment. This relationship had prevented the analyst from touching on highly destructive unconscious fantasies and archaic traumatic situations. Comprehension of the enactment enabled the collusion to be dissolved. The author suggests that, besides the resistance aspect, the collusion may have been useful in strengthening the patient's mental mechanisms and trust in the analytical work, which required some time. The acute enactment arose, unveiling the collusion, when the patient and the analyst felt able to face the terrible feelings related to the triangular situation. He speculates that both enactments may occur in the analysis of these kinds of patients, as part of the 'natural history' of the analytical process, and their function is to relive archaic experiences in the analysis, also with the aim of working them through. Finally, the author proposes a classification of enactments: normal, pathological, acute and chronic.

On the Use of Reflection in Supervision

“…For a long time, analytic supervision has been portrayed as an important way to increase analytic clinician's capacity of reflection and contemplation upon the sum of transference-countertransference events as a whole, explaining particular phenomena from a safe and calm distant perspective, focusing on associations and verbal symbols. And yet a lot of the clinical activity takes place in physical levels, such as implicit nonverbal communications, posture, facial expressions, patterns of movement and vocalization, as demonstrated by the concept of enactment [28]. This physical system of communication of immediate unconscious interpersonal messages without the mediation of secondary processes, obligates the therapist to act immediately and spontaneously.…”

“…Speaking is considered a type of an action and actions as a form of communication [24][25][26]. In addition, action in analytic therapy was brought into the focus of attention by such concepts as enactme [27,28]. Bass [29] explains that from the relational perspective, enactment is omnipresent in the analytic process and relevant to each manifestation of transference and countertransference.…”

Procedimentos, colocação em cena da dupla ("Enactment") e validação clínica em psicoterapia psicanalítica e psicanálise

“…O referencial teórico utilizado remete à atual teoria das relações objetais em sua vertente intersubjetiva 7-11 e ao conceito de "enactment" [17][18][19] , partindo-se do pressuposto de que o desfazer "enactments" normais e patológicos, ampliando a capacidade de pensar, nos indica a adequação de seu efeito. 14,[17][18][19]38 RESULTADOS -MATERIAL CLÍNICO Mulher, 32 anos, vivendo com companheiro e filhos menores, com diagnóstico psiquiátri-co de Transtorno Obsessivo-Compulsivo.…”

“…Os patoló-gicos podem ser classificados em 1. agudosquando aparecem com grande intensidade, mobilizando violentamente a dupla analítica, podendo levar a impasses, mas durando apenas instantes se compreendidos; 2. crônicos -quando se prolongam, numa colusão que demora até ser identificada, ou se resultam em impasse, por vezes impossível de ser desfeito. 18,19 Dessa forma, "enactments" normais implicam a quase concomitância de sua formação com sua compreensão, sendo desfeitos instantaneamente pelo trabalho analítico. A percepção desse fato se revela no aumento da capacidade de simbolização e de articulação de elementos do pensamento e afeto, ampliandose a capacidade de pensar, isto é, o acesso ao mundo interno e a novas configurações simbóli-cas 20 .…”

“…14,[17][18][19]38 RESULTADOS -MATERIAL CLÍNICO Mulher, 32 anos, vivendo com companheiro e filhos menores, com diagnóstico psiquiátri-co de Transtorno Obsessivo-Compulsivo. Do ponto de vista psicanalítico, o diagnóstico inicial refletia possibilidade ou não de analisabilidade, resolvendo testar-se a hipótese em trabalho experimental, fato comum no trabalho analítico.…”