Doctoral Dissertations
Date of Award
5-1990
Degree Type
Dissertation
Degree Name
Doctor of Philosophy
Major
Psychology
Major Professor
Leonard Handler
Committee Members
Bob Wahler, Mark Hecktor, James Gorney
Abstract
The purpose of this study was to describe and analyze therapists’ experiences of patients who entered benign and malignant regressions in therapy. Eight experienced therapists were interviewed to obtain their descriptions, determinants, and explanations of the phenomenon. A phenomenological procedure organized the interview data into 27 content categories. These contents were analyzed, to identify all meaningful elements and themes, and presented in a detailed summary. Three underlying themes were then identified which integrated all the findings. The first theme, attachment versus detachment, was defined as the presence or absence, respectively, of a solid bond, trust, and alliance between the patient and therapist. The second theme, integration versus disintegration, was defined, respectively, as the maintenance or dissolution of self and ego structures, functions, and boundaries in the patient and therapist. These themes were tied to regression as a process in therapy. The third theme, primary and secondary process, involves two coexisting modes of experience and functioning which define regression as a fundamental psychological phenomenon. Regression appears to be a natural, unitary phenomenon involving the primary processes becoming figural relative to the secondary processes. Along a continuum of regressive phenomena, benign regressions are characterized by patients maintaining an attachment to the therapist, structural and functional integration, and the operation of secondary process while primary process becomes figural. At the other end of this continuum, malignant regressions reflect a detachment from the therapist, a structural and functional disintegration, and the loss of secondary process operations when primary process is figural. The discussion detailed an integrated model of regression in therapy focusing on structural and relational factors which establish regressive potentials. In this model primary process was described as the patient's direct "lived experience" and secondary process the detached "observed experience." Emphasis was placed on the need to directly rework constantly emerging past, primary process interpersonal experiences, through the therapeutic relationship. The therapist's reworking or recapitulation, respectively, of earlier object failures were considered precipitants for benign versus malignant regressions. Therapists were urged to attend to the patient's continual regressions and to view the phenomenon positively as an essential therapeutic tool.
Recommended Citation
Trasente, Arnold Donald, "The therapist's experience of the patient's regression in therapy. " PhD diss., University of Tennessee, 1990.
https://trace.tennessee.edu/utk_graddiss/11516