On The Impact of Psychotherapy on Psychological Growth: The Waning of Defenses

ABSTRACT

A discussion of Micheal Reison’s “The Subjective Importance of Accommodation and Non-Accommodation: Expanding Brandchaft’s Ideas of Pathological Accommodation” explicates Dr. Bernard Brandchaft’s signature contribution—the defense of pathological accommodation. The imperative need to maintain attachment is seen as the primary goal of this defense. Pathological Accommodation is seen as a mode of maintaining attachments to caretakers, an unconscious, compulsively self-limiting behavior which occurs when a child experiences threats to his bond with a needed parent. In Kohutian terms, pathological accommodation functions to protect the self a child has been able to construct despite formidable obstacles. The term “accommodation” is traced through writings by Atwood, Stolorow, and Brandchaft. Accommodation, in Brandchaft’s terms, refers to the child’s response to relational trauma suffered when his or her emotional expressions and/or actions regularly evoke profoundly malattuned parental responses which threaten the child’s attachment bond. Dr. Reison’s case is reviewed through the lens of these ideas and Dr. Reison’s emotional attunement and genuine appreciation of his patient is appreciated. His genuine empathic understanding of his patient is seen as the foundation of the considerable psychological development and growth demonstrated in Reison’s very fine case report. Indeed, the genuine psychological growth demonstrated eventually made the defense of pathological accommodation unnecessary.

KEYWORDS:

• Pathological Accommodation
• psychological growth
• waning of defenses
• relational trauma
• illustrative case report

Additional information

Notes on contributors

Shelley R. Doctors

Shelley R. Doctors, P.h.D., a clinical psychologist/psychoanalyst, is a faculty member and Supervising Analyst at the Institute for the Psychoanalytic Study of Subjectivity, the National Institute for the Psychotherapies and at the Institute for Contemporary Psychoanalysis and Psychotherapy in Washington, D.C. The immediate past President of the International Association for Psychoanalytic Self Psychology, she co-wrote and co-edited Toward an Emancipatory Psychoanalysis: Brandchaft’s Intersubjective Vision, and more than 40 book chapters and journal articles. She has lectured nationally and internationally on over 180 occasions, practices in New York City, and maintains supervisory study groups for clinicians, utilizing the Internet to communicate Internationally.