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Michigan Psychoanalytic Institute & Society

APT Conference - How Do Patients Get Better?

By Gene Hudson, M.A.

Dr. Martha Stark, professor of psychiatry at Harvard Medical School and a practicing psychoanalyst, suggested in a most engaging and memorable presentation an answer to this question at the annual APT workshop held April 25-27, 2005. She postulated there are historically three modes of working in the therapeutic process that promote change in the patient: through enhancing knowledge (by way of the therapist's interpretations), through sharing parts of the therapist's ego with the patient, and through the use of the real relationship that develops in the therapy. While some would suggest that these modes are mutually exclusive, or that the relational mode is moving too far away from fundamentally sound technique, Dr. Stark clearly proposes that the most effective therapy occurs when the therapist is able to move easily between each of these modes to facilitate meaningful change in his/her patients.

The later part of Dr. Stark's presentation was focused on the theme of "Relentless Hope: The Failure to Grieve". In her thesis, she discussed how the inability to grieve the loss of the idealized mother, or experience the inevitable failings of the real mother, leads to the repetitive compulsion to "relentlessly hope" for a current relationship to fill that longing to recapture the idealized maternal object. This then leads to a sado-masochistic interplay in ensuing relationships, something that can only be overcome by working through the grieving process of the lost idealized maternal object.