Concept
Therapeutic symbiosis
Harold Searles's name for a phase in the psychotherapy of schizophrenic and other deeply disturbed patients in which patient and therapist become bound in a mutual, deeply regressed dependency, so that for a time it is not possible to say which feelings belong to whom. In the sequence of phases he described, treatment moves from the patient's early pathological symbiosis, through an out-of-contact or autistic phase, into therapeutic symbiosis, and from there to individuation. Searles saw this phase as the core of the deepest therapeutic work. He thought both participants resist it, and that in it each contributes to the other's growth.
Development
Undated
introduced by Harold Searles
Searles described therapeutic symbiosis as a phase of mutual, deeply regressed dependency between patient and therapist. It comes after the patient's early pathological symbiosis and an out-of-contact phase, and before individuation. He placed it at the heart of the deepest therapeutic work.
In Countertransference and Related Subjects: Selected Papers (1979)
Relations
- introduced by Harold Searles
Searles described therapeutic symbiosis as a phase of mutual, deeply regressed dependency between patient and therapist. It comes after the patient's early pathological symbiosis and an out-of-contact phase, and before individuation. He placed it at the heart of the deepest therapeutic work.
Works
- 1979
Countertransference and Related Subjects: Selected Papers
Countertransference and Related Subjects (New York: International Universities Press, 1979; paperback 1999) is the second collection of Harold F. Searles's papers, following his Collected Papers on Schizophrenia and Related Subjects (1965). Its twenty-four chapters, with an introduction, come from his later career. Most concern the intensive psychoanalytic psychotherapy of schizophrenic and borderline patients, and the analyst's own emotional participation in that work. Searles treats the analyst's feelings, including guilt, hope, dedication and the urge to heal, as clinical evidence about the patient and the relationship rather than as interference to be eliminated. Several papers trace the phases of treatment from autism and pathological symbiosis, through ambivalent symbiosis, to a therapeutic symbiosis from which individuation can develop. Others take up delusional transference and the patient's realistic perceptions of the analyst; identity formation and dual or multiple identity in borderline functioning; paranoid processes within a hospital treatment team; violence in schizophrenia; and transitional phenomena. The volume also includes the long paper "The Patient as Therapist to His Analyst". Searles argues there that every person has a therapeutic striving toward others, that psychological illness is bound up with the frustration of that striving, and that the analyst must allow the patient to help them. Book reviews, discussions and an essay on unconscious processes in the environmental crisis widen the range. Library Journal praised its plain, jargon-free prose and vivid clinical portraits, and its sense of the humanity patients share with their therapists.
See also
People
References
- Countertransference and Related Subjects: Selected Papers1979Evidence for a relation