Challenges in treating patients with psychosomatic disorders: Some patterns of resistance

Yasky, Jaime, King, Robert and O'Brien, Tom (2013) Challenges in treating patients with psychosomatic disorders: Some patterns of resistance. Psychoanalytic Psychotherapy, 27 2: 124-139. doi:10.1080/02668734.2013.796567

Author Yasky, Jaime
King, Robert
O'Brien, Tom
Title Challenges in treating patients with psychosomatic disorders: Some patterns of resistance
Journal name Psychoanalytic Psychotherapy   Check publisher's open access policy
ISSN 0266-8734
Publication date 2013-07
Year available 2013
Sub-type Article (original research)
DOI 10.1080/02668734.2013.796567
Open Access Status
Volume 27
Issue 2
Start page 124
End page 139
Total pages 16
Place of publication Oxon, United Kingdom
Publisher Routledge
Collection year 2014
Abstract The treatment of people suffering from psychosomatic disorders poses important clinical challenges to psychoanalytic practice, including early abandonment, difficulties in engagement and superficial involvement in the treatment. The lack of systematic research on the subject suggests that a better understanding of the resistances and dynamics involved in such episodes is needed. Using supervision group to study treatments and inspired by action-research paradigm, this paper presents the results of an 18-month mixed-method qualitative clinical research on treating 22 cases. Thematic analysis revealed a frequent pattern of resistance to experience emotions that presented in two states: failure of repression (thin-skin) and massive repression (thick-skin). Narcissistic dynamics in the therapeutic relationship taking the form of 'resistance to transference' and a tendency to action were evident in both presentations. Symmetric and complementary counter-transference reactions, which compromised treatment, were also identified. Some technical implications are highlighted, such as the need to focus in the recovery of the patient's actual emotional experience and to understand such experience in the context of the 'here and now' of the therapeutic encounter. These findings suggest the need for a flexible approach to therapeutic work that moves between an 'intrapsychic' and a 'relational' focus.
Keyword Counter-transference resistance
Narcissistic transference
Psychosomatic disorders
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
School of Psychology Publications
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