On the Beginning of Dyadic Therapy

Abstract Psychodynamic psychotherapy is viewed as a microcosm of the larger life experience, including the reliving and working through of early life events and conflicts. Whether the child will grow up to be an emotionally healthy or disturbed adult depends in part on the nature of the early relationships; whether dependency needs have been gratified or frustrated, and whether independent development has been encouraged. The healthy therapist-patient relationship mirrors the early mother-child holding enviroment and contains the patient, while being attuned to the patient's sensitivities, thus allowing growth and maturity. It is the establishment of a secure frame that aids in the development of a healthy holding enviroment. Free association, anonymity, neutrality and abstinence, and other aspects of the frame are discussed in detail. Personal opinions of the therapist are discouraged, as well as limiting patient rumination and acting out. On the other hand, keeping the focus on the patient and his/her problems, as well as the boundaries of the relationship, are encourged. The paper spells out the basic ground rules. A case example stresses flexibility rather than rigidity in the handling of the therapeutic relationship.