Advances in Relational Psychotherapy

Affect regulation, mindfulness and enactment in psychoanalyzis

In this presentation, Jeremy Safran describes how he faced a sudden incapacity to empathize with a long-term patient – a relational breakdown which resulted in intense and conflicting emotions for both. He identifies this as an enactment, “the repetitive interactional patterns between patients and their therapists that reflect their unique personal histories, conflicts, and ways of relating to the world”. These interactional patterns, he suggests, can be very destructive, obstructing therapeutic progress and potentially re-traumatizing the patient. At the same time, they afford a tremendous opportunity for therapeutic change if they are worked with in a constructive fashion. Dr Safran describes the multifaceted inner and interpersonal skills that therapists require to facilitate this type of collaborative exploration, emphasizing the importance of the therapist’s inner work. He suggests that mindfulness is an essential skill for the therapist’s own affect-regulation and their capacity to work through and talk about internal processes in a meaningful, therapeutic fashion.