Releasing the Gordian Knot: Working with the Encapsulated Representation of a Parent with Susan Baxt – October 2, 2021

WBCPS 2021 Scientific Meeting #3:

Psychoanalytic work with patients who make extensive use of dissociation to protect themselves from experiencing affect can take on a superficial feel. The resulting countertransference impression of ‘stuckness’ puts pressure on the analyst to reformulate the treatment approach in order to find a way to move beyond the impasse, if possible. This paper describes one thread in the 12+ years of psychoanalytic work with “Liz”.* Although I will be discussing only one of her many themes, this thread was central to the loosening of the Gordian Knot that bound together all her dynamic issues, structural deficits, and defences. This motif revolved around the encapsulated internalized relationship with her psychotic and abusive father that initially manifested in our work as an idealized fantasy of their actual relationship. Accessing and working through this primitive identification was aided by my curiosity about a certain subset of her dreams. Liz described these dreams as so realistic they were difficult to distinguish from reality. My attempt to conceptualize what these dreams were about, combined with our work on affects and images related to certain transformative events in her life, brought us eventually to the “Gordian Knot” of her encrypted father. Neither the realistic dreams she reported nor the events were particularly unusual in themselves. It was their frequency and timing in the sessions which suggested to me their potential importance. Following a brief review of the relevant literature, and a description of her family members, I present Liz’s realistic dreams and a discussion of their relevance to the psychoanalytic process. Chronologically, the transformative, real life events, occurred after the realistic dreams had faded from her material. These experiences are presented and integrated into an understanding of her progress. Explanations for Liz’s capacity to work in and benefit from her treatment for such a lengthy period of time, are offered in the closing paragraphs.

*The analytic work was preceded by six years of once-weekly psychoanalytic psychotherapy.

Sue Baxt is a member of the Ottawa Psychoanalytic and Quebec English Societies. She is in private practice in Montreal where she offers adult and adolescent short term and long term psychotherapy, and psychoanalysis. Her practice also includes parent work, couple and family therapy, and EMDR. She also teaches and supervises in Ottawa and Montreal. At present she is completing her training in child psychoanalysis at the Michigan Psychoanalytic Institute.

Learning Objectives:
At the end of this seminar participants will be able to:

1. Understand some of the differences in psychic structure between patients such as Liz, and patients functioning closer to a neurotic level.
2. Understand the comparison of unrepresented states and unconscious processes.
3. Understand the need to modify psychoanalytic technique in order to help such patients progress in treatment

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