Open Door Review III

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A$<<$0*D%0*_!/>_!G!K0%32%(_!=>![+,-,^>!"#0%21$6(6Ä!Y$0Z!):!(#0%210B($7!27($)*!$*!1647#)2*2<4($7!1647#)(#0%214! Z$(#!4)B*D!2&B<(6>! '(A?-",-%#@:A^&1-%"#AO&3%(%@#?-O&'#@?,)?%O&1#@)+)+L _!]d_!.d,h.b.>! /2<96($0%*2_!V>_!G!K0%32%(_!=>![+,-P^>!QB77066:B! '(A?-"@+@BA,)?&'(A?-",-%#@:A _!+d_!+-h],>!! K0%32%(_!=>_!G!A0Y2*&0%_!Q>![+,,g^>!"Z)!60(6!):!1%$Y2(0!(#0)%$06!$*!2*2<462*&6!2*&!(#0$%!2*2<46(6?!R()1$2*! Y0%6B6!2((2$*23<0!7B%06>! '(A?-"@+@BA,)?&'(A?-"B"LA _!+P_!-,bh-+d>!! K0%32%(_!=>_!G!A0Y2*&0%_!Q>![+,--^>!V$7$66$(B&06!):!$&026!):!7B%0!$*!2*2<462*&6!2*&!(#0$%!2*2<46(6?!=!<)*D$(B&$*2! .+,%#+@,)"+@B&N">#+@B&"!&'(A?-"@+@BA()( _!\+_!-]..h-]b->! >-001(3! This research program aims to explore patient and therapist views of helpful and hindering factors in psychoanalysis and psychoanalytic psychotherapy, applying rigorous qualitative methods. A series of studies was based on periodical interviews with seven analysands and their analysts (Werbart & Levander, 2006, 2011). Double sets of private theories of cure were found among analysands and their analysts. Ideas of utopian cure involved a profound transformation of the personality by way of deep regression. Ideas of an attainable and more limited cure included new ways of managing old problems and new ways of thinking and reflecting. The ongoing treatment was then seen as the ‘next-best solution’. Both parties’ mourning of the preferred but abandoned utopian theories of cure seems to be an important ingredient in the psychoanalytic process. Furthermore, the utopian fantasy of creating ‘the new person’ by means of ‘proper’ psychoanalysis or analytic training has far-reaching consequences for psychoanalytic education and supervision. Further studies focused on young adults in psychoanalytic psychotherapy. Patients experienced as curative talking openly in the context of a safe relationship, which led to new relational experiences and expanding self-awareness. Hindering factors included difficulties “opening up,” experiencing the therapist as too passive and that something was missing in therapy. According to the therapists, the core curative factor was the development of a close, safe and trusting therapeutic relationship, while patients’ fear about close relationships emerged as the sole hindering factor from the therapists’ perspective (Lilliengren & Werbart, 2010). In a study of overcoming depression, positive changes experienced by young adult psychotherapy patients extended beyond symptom relief and included finding out how they wanted to live and forming their lives in that direction. Dissatisfied psychotherapy patients described abandonment by a therapist felt to be insufficiently flexible, a therapy lacking intensity, and links missing between therapy and everyday life. They lacked confidence in their relationship with the therapist, wanted more response from the therapist, and concluded that their therapies lacked direction. Conversely, the most successful cases described a secure therapeutic relationship where growth could take place. The patients and their therapists experienced the therapeutic work in a strikingly similar way, worked actively towards joint goals, overcame obstacles to their collaboration, explored what was painful and actively promoted the use of new skills after termination (Palmstierna & Werbart, 2013).

In a two-stage mixed-method study of clinically nonimproved patients, “Spinning One’s Wheels” emerged as a core category. The patients described the therapeutic relationship as distanced and

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