The voices of fellow travellers: Experienced therapists' strategies when facing difficult therapeutic impasses

Authors

  • Christian Moltu,

    Corresponding author
    1. Helse Førde, Psychiatric Clinic, Norway
    2. Department of Clinical Psychology, University of Bergen, Norway
      Christian Moltu, Helse Førde, Psychiatric Clinic, Vie, 6800 Førde, Norway (e-mail: christian.moltu@helse-forde.no).
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  • Per-Einar Binder

    1. Department of Clinical Psychology, University of Bergen, Norway
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Christian Moltu, Helse Førde, Psychiatric Clinic, Vie, 6800 Førde, Norway (e-mail: christian.moltu@helse-forde.no).

Abstract

Objective. We wanted to explore how psychotherapists from various theoretical affiliations handle difficult impasses in therapy, in a way that they experience helps the therapeutic process towards further constructive development.

Design. We purposefully sampled 12 highly skilled and experienced therapists from the leading theoretical affiliations in the field. We conducted semi-structured in-depth interviews to explore their recall of impasse experiences. Participants were interviewed individually about a specific impasse from their experience that later resolved successfully.

Methods. The transcribed interviews were analysed using a hermeneutically modified method of systematic text condensation. The results that come out of such analyses are ‘meaning patterns’ or ‘themes’. Analyses were technically carried out with the assistance of Nvivo 8 software.

Results. Analysing the needs of the therapists when working through the impasses, we found two general themes across the sample: (1) the need for a move – from confusion and bodily tension to shared systems of meaning, and (2) the need for a witness – to find a home for the stalemate scenario in another relationship. We present how having these needs met evokes the experience of (3) the vital clearing – an experiential space between self and impasse.

Conclusion. We discuss how our findings relate to contemporary psychotherapy theory concepts such as mentalization, mindfulness, and experiential capacity. We discuss our process of reflexivity in carrying out the study and suggest implications of our findings for further research.

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