Exploring the Vicissitudes of Safety and Danger in Psychoanalysis: Developing Trust Through Mutual Engagement

ABSTRACT

One of the essential features of a therapeutic change process is the ability to establish, within the therapeutic relationship, a sense of safety from which patients can engage and explore the many issues that bring them into therapy. Efforts to gain our patients’ trust so that they feel safe enough to expose their vulnerabilities and engage in a healing process remain at the center of the analytic enterprise, no matter the theoretical position of the therapist. In fact, in an otherwise diverse and sometimes fractious psychoanalytic field, the importance of safety is one of the few areas of near consensus. In our approach, we acknowledge the intersubjective nature of all relational experience and appreciate the powerful processes of mutual influence that reverberate between the analytic couple. As we see it, clinical engagement requires both partners to take risks, tolerate a sense of danger, learn to trust each other, and seek emotional safety through connection and understanding. In this article, we explore a number of perspectives related to building and restoring a shared sense of safety despite what we consider to be the necessary, inherent dangers of psychoanalytic engagement. We include two clinical vignettes that elaborate our views more fully.

Notes

¹ According to Strozier (2001), at the time of Kohut’s writing, many mainstream analysts dismissed their patients’ developmental longings as a way of defending against infantile longings and related oedipal conflicts.

Additional information

Notes on contributors

Elizabeth M. Carr

Elizabeth M. Carr, A.P.R.N., M.S.N., B.C., is a founding member and a training and supervising analyst, Institute of Contemporary Psychotherapy and Psychoanalysis, Washington, DC, a faculty member at the Minnesota Institute of Contemporary Psychotherapy and Psychoanalysis, and Associate Editor, Psychoanalytic Inquiry.

Janna Sandmeyer

Janna Sandmeyer, Ph.D., is the Chair of the Contemporary Approaches to Psychodynamic Psychotherapy program at the Institute of Contemporary Psychotherapy and Psychoanalysis, where she is also the Chair of the Sexual Diversity Task Force. She serves on the Editorial Board of Psychoanalytic Inquiry and is a reviewer/contributor for Psychoanalysis, Self and Context. She is faculty and supervisor at the Washington School of Psychiatry and maintains a private practice in Washington, D.C.