Dissociative Attunement as a way of understanding an Impasse: Implications of Attachment Theory for the Clinical Encounter

Organized by Julie Gerhardt, PhD & Alison Cabell, MFT

Friday Feb 28, 6:45 PM – 9:00 PM

The overarching issue in Jacobs’ thoughtful clinically grounded paper is based on her claim that an understanding of attachment theory — in particular, the attachment of the disorganized child — has significant implications for the analytic encounter. Hence, Jacobs’ use of attachment theory to expand inchoate and unformulated experience. The analyst’s failure to confront the patient’s so- called acting out — consistent lateness to sessions — is thoughtfully discussed in terms of the analyst’s unconscious attunement to early relational experience. Jacobs invokes Hopenwasser’s (2008) idea of “dissociative attunement” as an implicit knowing of information within the therapeutic relationship which may not be available to conscious awareness. Hence, a countertransference enactment can be understood as an unconscious attunement to an implicit relational need in a patient who had suffered significant trauma. As a backdrop to Jacobs’ paper, Ferro’s theorizes the importance of first metabolizing primitive mental states before any interpretation. From the Bionian perspective on primitive mental states, Ferro argues that any interpretation that holds the patient responsible for creating an impasse (in terms of his masochism, guilt, attacks on growth, perversion, envy) will prove ineffective in resolving the impasse as it takes time/a micro-transformative process to begin to metabolize unformulated psychic states. The Kaplan paper is a beautiful overview of attachment theory and its relation to clinical process.