Leaps and bounds: Impasse and intersubjectivity

Abstract

This paper explores the effects of a two‐person, intersubjective psychology on how clinicians deal technically with treatment impasses. The therapist's stance towards neutrality in the treatment dyad is reviewed historically as are the solutions to impasse which follow from the stance. The intersubjective position appears to shift the responsibility for impasse from the patient to the therapist. The paper examines four clinical examples from the literature in which the clinician takes a “heroic leap” to resolve the impasse. These leaps are marked by deviation from the therapist's normal stance, by lack of certainty of outcome, and by risking disapproval of the therapist's peers. How the authenticity and mutuality of intersubjective theories serves to encourage these leaps is explored. The willingness of the therapist to share the responsibility and to demonstrate an authentic caring are seen as beneficial for resolving treatment impasses.

Notes

Jaine L. Darwin, Psy.D. is Clinical Instructor in Psychology, Department of Psychiatry, Harvard Medical School and member, Massachusetts Institute for Psychoanalysis, as well as private practice.