In the realm of psychodynamic psychotherapy, the therapeutic relationship is central to the process of healing and self-discovery. Weekly sessions provide a structured and reliable framework within which clients can explore their unconscious thoughts, feelings, and behaviours. However, when this regularity is interrupted—whether due to the therapist’s absence or the client’s own breaks—the impact can be profound, often stirring up complex unconscious dynamics. In this post, we will explore these dynamics, drawing on classic psychoanalytic theory, as well as object relations and attachment theories. We will consider the unconscious thoughts and feelings that may arise for both therapist and client during these breaks, and discuss how these can be addressed within the therapeutic context.
The Therapeutic Frame and Its Significance
In psychodynamic psychotherapy, the ‘therapeutic frame’ refers to the consistent and predictable structure of therapy—regular weekly sessions at the same time and place, with clear boundaries and expectations. This frame is crucial because it creates a safe and stable environment where the client can project and explore their internal world. It mirrors the early attachment relationship between a child and their primary caregiver, which is foundational for emotional development. Any disruption to this frame, therefore, can evoke unconscious responses related to earlier attachment experiences.
Negative Transference: The Client’s Response to Breaks
When a therapist announces a break—perhaps for a holiday or personal reasons—clients may experience a range of unconscious responses, often rooted in what is known as ‘negative transference’. Negative transference occurs when the client unconsciously transfers feelings and expectations from past relationships, particularly with early caregivers, onto the therapist.
For some clients, the therapist’s absence may unconsciously trigger feelings of abandonment, rejection, or betrayal. This might be especially pronounced in individuals with insecure attachment styles, who may have experienced unreliable or inconsistent care in childhood. These clients might react with anger, disappointment, or even feelings of worthlessness, believing that the therapist does not care for them, much like they perceived their caregivers in the past.
Other clients might experience heightened anxiety, fearing that the therapist’s absence signifies a permanent loss, reminiscent of past separations that felt devastating. These reactions are not always immediately obvious to the client; they may manifest in subtle ways, such as a reluctance to discuss the upcoming break, or an apparent indifference that masks deeper, more painful emotions.
The Therapist’s Role in Addressing Transference
It is crucial for the therapist to recognise these potential unconscious responses and to create a space where they can be explored and understood. The therapist might gently invite the client to talk about their feelings regarding the upcoming break. This can be done by asking open-ended questions like, “How are you feeling about the break next week?” or “What thoughts have come up for you as we’ve discussed my time away?”
By encouraging the client to voice their concerns, the therapist can help bring unconscious feelings into conscious awareness. For instance, if a client expresses anger or disappointment, the therapist might explore whether these feelings relate to past experiences of being let down by others. This process can be deeply therapeutic, as it allows the client to make connections between their current emotional responses and earlier life experiences, facilitating greater self-understanding and emotional growth.
Moreover, this exploration can be extended beyond the therapeutic relationship to consider how the client handles separations or changes in other areas of their life. This might include examining their responses to holidays, the end of relationships, or other significant life transitions. By making these connections, the therapist helps the client develop more adaptive ways of coping with separations and losses, both within and outside of therapy.
The Therapist’s Experience: Negative Feelings and Their Implications
Breaks in therapy are not only challenging for clients; therapists too can experience complex emotions, particularly when a client takes an extended break or refuses to pay for missed sessions. From a psychoanalytic perspective, therapists are not immune to transference-like feelings, and may unconsciously experience what is known as ‘countertransference’.
A therapist might, for example, feel frustration or resentment if a client takes a prolonged holiday and does not pay for missed sessions. These feelings could be linked to the therapist’s own unconscious anxieties about financial stability or being valued in the therapeutic relationship. Alternatively, the therapist might feel abandoned or rejected, mirroring the client’s own fears when the therapist takes a break.
It is essential for therapists to be aware of these feelings and to reflect on their origins. Supervision or personal therapy can be invaluable in helping therapists manage their countertransference, ensuring that these emotions do not interfere with the therapeutic process. By acknowledging and working through their own responses, therapists can maintain a professional stance and continue to provide a containing environment for their clients.
Moving Forward: Embracing the Therapeutic Journey
Breaks in therapy, while challenging, offer a unique opportunity for both therapist and client to deepen their understanding of the unconscious dynamics at play in the therapeutic relationship. By exploring the feelings and thoughts that arise during these times, clients can gain valuable insights into their attachment patterns and emotional responses, leading to greater self-awareness and resilience.
For therapists, these breaks serve as a reminder of the importance of maintaining a reflective stance and being attuned to the unconscious dynamics that shape the therapeutic encounter. In doing so, they can support their clients more effectively, fostering a therapeutic relationship that is both robust and transformative.
If you are interested in learning more about the intricacies of psychodynamic psychotherapy and the unconscious processes that influence our lives, we invite you to follow our blog. We regularly publish informative posts that delve into various aspects of psychotherapy, offering insights and guidance for both practitioners and those interested in understanding their own psychological journey. Stay tuned for our next post, where we will continue to explore the rich and complex world of psychodynamic therapy.
By Ari Sotiriou M.A. psychodynamic psychotherapist co-founder Online Therapy Clinic