Intuition and insight : the therapist's experience of psychotherapy

The purpose of this study was to describe the essential aspects of the therapist's experience of striking events in therapy. Thirteen psychotherapists, v/ho practice psychodynamic or insight-oriented therapy, were interviewed about experiences they had that stood out for them. Nearly sixty instances were gathered in this manner. As a first step, experiences were categorized into four major types: Losing Control, Merging, Connecting, and Recognizing. In Losing Control experiences, there often was a struggle with the patient over who had control of the therapy. In Merging experiences, the therapist usually experienced a frightening confusion of boundaries. In Connecting experiences, deep, empathically attuned communication was established. In Recognizing experiences, the therapist came to see, recognize, or understand something about his or her patient.

These categories provided the preliminary basis for finding the essential themes that described these experiences. By examining the experiences in each category for what held them together as a group, one major and three subsidiary themes were discovered. The overarching theme was Oneness/Separateness. It was most readily seen in Merger experiences where it was characterized by the dialectical pair, fusing/ separating. Other pairs related to this theme of Oneness/Separateness were described for other categories. From these descriptions, three sets of pairs emerged as irreducible: the pair Fusing/ Individuating, which concerns identity or Being, the pair Intuiting/Thinking, which concerns awareness or Knowing, and the pair Undergoing/Acting, which concerns agency or Doing.

These pairs of aspects were discussed in terms of how they clarified some long-standing controversies in the psychoanalytic literature and suggested directions for teaching psychotherapy, communicating psychotherapy experiences, and understanding psychotherapy processes. An effort was made to describe how these opposed aspects are held together in the therapists' experiences. The irreducible tension constituted by these pairs argued for a greater need by psychotherapists to properly heed and find room for non-personal, non-conceptual, and non-intentional aspects in their approach to psychotherapy events.