ABSTRACT
This chapter is concerned with the concept of dimensions within the therapeutic alliance, and specifically with the problems that arise when the therapeutic relationship is restricted to two dimensions. In psychoanalytic psychotherapy a space needs to exist between the therapist and the patient in order for progress to be made. Within this space, both therapist and patient can reflect on the issues that arise, allowing the therapist to develop insightful interpretations as the therapy progresses. In some situations, however, it becomes difficult or impossible to maintain this necessary distance. As a result, the psychoanalytic encounter may become claustrophobic for both parties, leaving no space for creativity (Symington, 1986). It becomes a situation where there is a lack of symbolic functioning, and primitive psychic mechanisms are brought into play. In theoretical terms, the situation lacks a third dimension, sometimes referred to as the “triangular space” (Britton, 1989)—a dimension within which a variety of desired therapeutic processes could occur. These processes allow for the possibility to make links. This refers to the ability to connect present experiences to past life events and for the patient to realize patterns of repetition, thereby allowing him/her to recover repressed thoughts and feelings. This process involves a transformation of unbearable elements in the patient’s experience into meaningful and tolerable states.
