Dreams and change processes in an ex-prostitute under relational psychoanalytic psychotherapy: Ferenczian and relational views

Abstract

This paper explores the change processes that took place in a woman, an ex-prostitute, in the context of psychotherapeutic treatment over a period of over three years. The treatment took place within a relational psychotherapeutic setting influenced by the ideas formulated by Sándor Ferenczi regarding trauma, as well as by his intense involvement with and commitment to his patients, as expressed in his Clinical Diary of 1932 (Ferenczi, 1988). Zoe, the current patient, was a woman born in Latin America who emigrated to Spain at the age of 28 and became trapped, for nearly a decade, in a mesh of prostitution networks. She eventually entered regular psychotherapeutic treatment at the age of 39. Her change process is an example of the mutual influence between the factors of resilience that characterized her and the opportunity for co-creation that the treatment signifies. The marks of the intense traumatic burden of Zoe's history and the rays of sunlight and hope that she is currently experiencing become intermingled in the dreams evoked and brought to the treatment setting. Zoe's capacity for resilience and the potential for founding self-object relations, ethically implied, that therapists can offer construct a scenario that brings back to life the essence of Ferenczi from 1932.

Key words:

• Dream functions
• psychotherapy process
• resilience
• Sándor Ferenczi
• relational psychoanalysis

Notes

^†Paper presented at the International Ferenczi Conference “Faces of Trauma,” May 31 – June 3, 2012, Budapest. English translation from the Spanish original by Luis Sandoval.

¹ The clinical material for this paper has been compiled, developed, and discussed by Rosa Domínguez, Zoe′s psychotherapist, with Zoe's express permission. Any information that could lead to identification of the patient′s identity has been altered to protect her privacy, taking care to retain sufficient equivalences to allow a reconstruction of the shades of meaning of the environments and experiences lived by both patient and therapist during their work.

² The SAPP is organized by the Institute of Relational Psychotherapy in Madrid, as a social aid program as well as an instrument to support professional training for psychotherapists. Professionals in charge of the service (both psychotherapists and supervisors) do not receive any remuneration for their work.

³ Zoe entered treatment seeking a secure basis for widening her real but insecure change motivation. She needed a therapeutic environment that would facilitate a second opportunity for development, a bond with a kind of “enough-good mother” that would provides holding and contention, while setting limits and deepening her reflective capacities. This treatment environment needed to be available as regular sessions over a number of years – as shown in this paper – but also as an extended follow-up frame.

Additional information

Notes on contributors

Alejandro Ávila

Authors

Alejandro Ávila, PhD, is full professor of psychoanalytic psychotherapy at Complutense University, Madrid, and a training member and honorary president of the Institute of Relational Psychotherapy (Madrid, Spain). He is also a board member of International Association for Relational Psychoanalysis and Psychotherapy (IARPP) and chair of the IARPP chapter in Spain.

Rosa Domínguez

Rosa Domínguez is a clinical psychologist and psychoanalytic psychotherapist. She is a full member of the Institute of Relational Psychotherapy (Madrid, Spain) and a member of IARPP.