Transference neurosis vs enactment

In this video I respond to a question posed by a subscriber regarding differences between a transference neurosis and an enactment.
Happy Holidays to all!
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[@-istdp.yuvalalon5954]

thank you dear Patricia, once again - you clarify the importance of taking the healthy stance + encourage the patient so a corrective emotional experience can take place. a pleasure to work with you and to learn from you. happy holidays and best wishes.

[@staciwashington3212]

This is a very important topic. Im glad you addressing this.🦋

[@jonathaninchina3693]

Hi, Dr. Coughlin! This video was quite interesting, I also wanted to add to your list of questions to be answered. In your ISTDP Demonstration (I bought the video), you talk about deepening or intensifying the emotions that the patient was having, or "staying with them" and I was wondering how that is actually done. I often find that I get the client to declare the feeling, having a feeling of energy in the body, but then there is no real visceral connection to that emotion.

[@christinepetzholtz9019]

What helps in my experience is to just slow down, give space and welcome the emotion emerging...and as a therapist not to DO something but to BE.

[@patriciacoughlinphd1852]

Then they are defending against that experience - and this must be taken up. So you say you feel angry (or sad or jealous) but don't experience that feeling. Where is it going? What is the effect of this kind of detachment? Make sure all three corners of the triangle of conflict are in view - the feeling, the anxiety about the feeling and the defenses being employed against the experience of that feeling. The cost of these defenses must be linked to the patient's presenting problem.

[@darshh.poetry2193]

nice explanation

[@patriciacoughlinphd1852]

Glad you found it helpful.

[@patriciacoughlinphd1852]

Thanks for letting me know!

[@joelmasantos879]

Your videos are have helped me so much. Thank you! 🙏

[@patriciacoughlinphd1852]

I'm so glad!

[@Faiza.A.R]

Thank you so much for these videos.

[@patriciacoughlinphd1852]

You are so welcome!

[@rightmindset-]

Would it be possible to discuss erothic countertransference, or it doesn't exist? Thank you

[@patriciacoughlinphd1852]

Of course that exists. What is your question?

[@rightmindset-]

@@patriciacoughlinphd1852 The question would be: how can one distinguish between (counter)tranferential reactions and real feelings towards a person who, under other circumstances, the therapist might have been attracted to? Not sure if it's clear...

[@patriciacoughlinphd1852]

@@rightmindset- There are a number of definitions of counter transference but, broadly speaking, it refers to the therapist's conflictual feelings and their impact on the therapeutic process. If the therapist likes and is attracted to the patient but is not anxious about these feelings and has no need to defend against them - and they are in no way undermining the process, it's not a problem. However, if the therapist is anxious and acts out, either by being seductive or, alternatively, shuts down and is distant, there are acting out their countertransferential feelings.

[@rightmindset-]

@@patriciacoughlinphd1852 I see - thanks for the explanation. Complex subject, it seems to me. Worth discussing further. Happy 2022!

[@LearningForPsychotherapists]

Great!

[@patriciacoughlinphd1852]

Thanks for the question.

[@ruthbarnes9999]

If the patient has got into full blown neurosis. How does the therapist then help the client out of the neurosis.

[@patriciacoughlinphd1852]

Big question requiring a very detailed response depending upon the case formulation and goals.

[@NE-pz4ku]

I enjoy your videos. Not a therapist. But I’ve read much of Joyce Mcdougall, Graeme Taylor. Remember MASH Dr Freedman, he’d help Hawkeye with psychosomatic symptoms in a 30 min show. I know something emotional is bothering me 4 months now, causing physical symptoms appetite loss jaw clenching, crying, feel like it’s on the tip of my consciousness. Ever help someone get a breakthrough like this?

[@patriciacoughlinphd1852]

I would suggest getting Howard Schubiner's book Unlearn Your Pain. Many have found Sarno's books remarkably helpful too.

[@staciwashington3212]

Tom.

[@crm317]

I was reading an article by Lewis Aron who asserted that all Psychoanalytic processes involving an enactment but some are little e or big e enactments. It would appear based on my reading and experience, nothing in therapy is not an enactment-instead, it depends on the enactment continuum in which it falls. I was wondering if you could speak on this.

[@patriciacoughlinphd1852]

I don't agree. It is not only possible but preferable to detect destructive patterns as soon as they emerge so they can be blocked and a new and corrective experience facilitated in its place. This is the secret to every penetrating therapeutic result, according to Alexander and French.