Back to the Beginning: An exploration of the treatment and effects of therapeutic regression to dependence in psychotherapeutic practice




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De Montfort University


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Peer reviewed


This research builds upon and explores an enigmatic set of experiences which theorists in the Object Relations tradition have characterised as regression to dependence, a return to a primitive, pre-verbal relational process presenting in some clients in psychotherapy. This research is a study of the concept of regression to dependence, its manifestation within the psychotherapy process, and facilitation within the therapeutic relationship. The Psychoanalytic theoretical positions on regression to dependence are explored, together with the Relational/Developmental perspective which recognises regression and its importance within psychotherapy. This exploration seeks to understand the experience of regression to dependence, how regression to dependence can be effectively worked within Integrative Psychotherapy, and makes recommendations for Integrative practitioners and theorists related to effective facilitation of clients, showing how the Relational/Developmental approach can effect repair. The study employs a qualitative methodology. A heuristic study was undertaken in which eleven practicing psychotherapists were interviewed and data was collected via semi-structured interviews. Most participants were interviewed twice, with a view to collecting data on both their personal experience as a client in psychotherapy and also their experiences as practitioners when working with clients who were experiencing regression to dependence. The transcripts from these interviews were analysed for emergent themes. The themes are discussed in the context of and with reference to the Psychoanalytic theoretical position and the Relational/Developmental perspective. An account is offered of how these experiences have come to be understood as recollecting difficulties in early infantile relationships. Reflections are made on the essence and qualities of a therapy that can facilitate regression to dependence in order to promote healing. Recommendations are made for the practice of Integrative Psychotherapy and the training of Integrative Psychotherapists in order to prepare them for this work. These recommendations for therapists include; having sufficient preparation, knowledge and understanding to be able to recognise and work with a regressive process emerging in the client; having an understanding of the need to facilitate this process for some clients; and to be aware of the need for particular adaptations in the therapeutic stance in some circumstances, and the difficulties which may arise. Recommendations are also offered regarding the support needed for the therapist whilst working with this process, which include the need for ongoing personal therapy, and supervision. The researcher’s personal story is an intrinsic part of the research, and as an integral part of this study is in accordance with the heuristic and autoethnographic styles, and with the practice of Integrative Psychotherapy, where the use of self is seen as a crucial clinical tool in the therapeutic process. Throughout this study reflexivity has been used regarding the personal experiences of the researcher as client, therapist and researcher.



Regression, Dependency, Shame, Boundary, Trauma, Terror, Object Relations, Integrative Psychotherapy, Relational/Developmental, reflexivity, Heuristic, Relational Repair, Therapeutic Facilitation, Psychotherapy Training, Psychotherapy Supervision



Research Institute