In Praise of Ambivalence

Abstract

With the help of a clinical case, the author describes the phenomenological experience of ambivalence in the therapeutic setting and discusses its treatment in five steps: (1) recognize and legitimize the ambivalence; (2) differentiate between being uncertain and being confused; (3) accept the ambivalence, abstaining from resolving it immediately; (4) respectfully analyze the two poles of the ambivalence; and (5) recognize their fundamental unity because the two poles usually constitute the two faces of the same drive toward well-being. The case study shows how to deal not only with the patient’s ambivalence but with the therapist’s as well. The model of intervention described shows its usefulness for understanding both the transference and the countertransference dynamics of the therapeutic dyad. Necessary precautions are considered for successful completion of the analytic process, and the usefulness of empathic neutrality toward the two poles of ambivalence is described.

Keywords:

• Relational psychotherapy
• ambivalence
• impasse
• transference
• countertransference
• seduction
• games
• transactional analysis

Disclosure Statement

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Notes on contributors

Marco Mazzetti

Marco Mazzetti, MD, specialized in pediatrics, psychiatry, and psychotherapy; is a Teaching and Supervising Transactional Analyst (TSTA-P and TSTA-C); has been a member of the ITAA since 1988; and is past-president of the European Association for Transactional Analysis. He is the author of several books and articles on transactional analysis and received the Eric Berne Memorial Award in 2012 for his theoretical work on supervision. Marco is the didactic director of the master’s degree in psychotherapy at the Turin Institute of Transactional Analysis (ITAT), Italy; the head of the rehabilitation service for torture victims “Invisible Wounds” at the Caritas Health Service in Rome; and works in private practice as a psychiatrist, psychotherapist, and trainer in Milan, Italy, where he founded and runs the Milan Institute for Transactional Analysis. Marco can be reached at Via Nicastro 7, 20137 Milan, Italy; email: [email protected]. An earlier version of this article was published in Rivista Italiana di Analisi Transazionale, XXXVI(33), pp. 11-23, June 2016. The author wishes to thank his colleague and friend Pierluigi Imperatore, probably the most learned man he knows. His erudition is equal only to his generosity, and his help was invaluable in finding the appropriate theoretical references for this article.