Dissociation : Volume 10, No. 4, p. 214-222 : Dancing the dance with dissociatives: some thoughts on countertransference, projective identification and enactments in the treatment of dissociative disorders
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Therapists working with dissociative patients, with their complex, overlapping transferences, frequently encounter countertransference conundrums. Further complications arise as the dissociative patient frequently uses the defense of projective identification, whereby the therapist is left "holding the bag," experiencing the patient's unwanted feelings or unacceptable impulses. Patient and therapist become the inevitable participants in transference enactment, each unwittingly playing a role written from the patient's past. However, projective identification and enactment may both be viewed as a powerful type of communication, allowing the therapist to understand the experience of the patient in a uniquely empathic way. By creatively welcoming inevitable enactment, the playing out of the patient's unconscious dynamics in the therapy, the therapist and patient can work through otherwise uninterpretable clinical material. This paper proposes that in the transpersonal field of therapy with dissociative patients, therapist and patient, "dancing together," can rework old patterns and arrive at new, deeper understanding and change. Case material is presented to illustrate this thesis.