ABSTRACT
As we observed in the previous chapter’s introduction of forms presented within the clinical setting, the therapist is repeatedly faced with the difficult task of negotiating what are often transitory and subtly fused aspects of the patient-therapist interaction. These involve an ongoing dyadic relationship in which (1) the therapist attempts to discern within herself a complex array of thoughts, affects, and fantasies/phantasies generated in the presence of the patient, while (2) approaching and attempting to understand the patient’s similar complexities. These become the recurring basis for (3) the therapist’s situating dyadic experience with the patient in the context of the therapeutic relationship. As we later explore in relation to d elements in the clinical setting (Chapter 5), such dimensions of fusion and de-fusion in the encounter between patient and therapist may be met combatively through the patient’s pathological dominance of persecutory action or against the patient’s tentative and precarious equilibrium of personality, tenaciously defended before the interpretation and working through of fusional states give way to the more obvious emergence of d elements in de-fusion.
