Abstract: Relational psychoanalysis increasingly recognizes that the therapist's subjectivity significantly influences the therapeutic process and, on many occasions, facilitates therapeutic progress. The therapist's pregnancy, in particular, may be regarded as a vivid expression of her subjectivity in the clinical room and can yield both disruptive and facilitative effects for her patients. Mothers often become recipients of omnipotent projections and expectations of endless support when they meet others' needs, while simultaneously being represented as insensitive or depriving—receiving envy—when they fail to meet those needs. Comparable transference–countertransference dynamics may operate in the therapist–patient relationship. This article endeavors to (a) provide insight into the impact of the therapist's pregnancy in the clinical setting of combined individual and group therapy, (b) delineate the mutual vulnerability of female therapists and patients in their intersubjective interactions around themes of mothering, (c) support the benefits of combining individual and group therapy, and (d) emphasize the importance of a strong bond between cofacilitators in relationally oriented group psychotherapy, especially in managing "tyrannical" projections and existential anxieties that surface in such challenging therapeutic processes. Core transference–countertransference themes that emerged include anxiety, hostility, envy, identification, dependency, fear of abandonment, separation, and sibling rivalry. Similar transferential reactions have been found in other studies.
Abstract: This article presents case studies that illustrate how relational attunement fosters a democratic environment where the child's voice plays a central role in shaping the process of saying goodbye. One example explores a child who uses imaginative play to enact and process the emotional challenges of ending, while another case highlights the therapeutic repair of ruptures experienced during the final sessions. Additionally, a case involving an abrupt and enforced ending is presented. These moments of rupture and repair underscore the therapist's responsibility to remain flexible, attuned, and open to co-creating a space for the child's experience of ending. Ultimately, the "democratic goodbye" is not only an ethical practice but also a therapeutic one, allowing for a respectful, attuned conclusion to the therapeutic journey. This approach honors the child's voice, fostering empowerment, resilience, and healing.
Abstract: This article examines how the therapist's pregnancy, an inevitable and embodied self-disclosure, reshapes the analytic field and reveals the group processes inherent in individual therapy. The visible transformation of the therapist introduces a profound relational shift, activating transference, countertransference, projection, and shared unconscious meanings that reverberate beyond the dyad. When the pregnancy requires a transition to another therapist, the treatment evolves into a multiperson field that illuminates how even individual therapy unfolds within an interwoven network of internal and external figures—real, imagined, and transgenerational—challenging traditional notions of analytic neutrality. The article argues that such embodied disruptions can foster symbolic growth and reorganization, calling for a "group turn" in relational psychoanalysis that embraces complexity, multiplicity, intersubjectivity, and the living presence of the analyst as integral to the therapeutic process.
Abstract: According to Plato's Allegory of the Cave in his work The Republic , hostages perceive reality only as the shadows cast on a wall behind them, unaware of the world beyond. Similarly, in the analytic setting, patients may remain captive to internalized fantasies and distorted perceptions. This article explores the case of Katerina, a 28-year-old woman struggling with loneliness and social isolation. Growing up with a despotic, tyrannical mother, she experienced her home as a cave-prison and carried this dynamic into the therapeutic relationship. Through the new turn in relational psychoanalysis, dyadic therapy can be viewed as a "large-group" process in which both therapist and analysand represent multiple internalized others, so in this way, we were interacting in a world/room of multiple group attachments. The main challenge in Katerina's treatment was to protect the therapeutic bond from the internalized mother who continued to dominate her psychic life. Katerina was forbidden to express anger toward her parents, unable to recognize the oppression this entailed. Through the emergence of anger within the analytic dyad, both patient and analyst sought to identify and transform internalized bad objects. For the analyst, the task was to resist responding tyrannically to Katerina's projections, avoiding projective identification while acknowledging the unconscious invitation to reenact it. The question persisted: Could I truly see Katerina as herself, despite the intrusion of the tyrannical mother within the therapeutic space? Have we finally managed to find ourselves in a shared, democratically co-created, egalitarian space, or are we trapped in the cave of our projections?
Abstract: This article is the second in a planned, three-part series that explores the utility of tabletop role-playing games (TTRPGs) in therapy. It introduces collaborative role-playing integrative therapy (CRIT), a transtheoretical framework for utilizing TTRPGs in group therapy. Much like Yalom's common factors approach, this model identifies nine dialectical therapeutic factors that illustrate how TTRPGs foster interpersonal growth and psychological flexibility. These nine dialectical factors are self and system, intent and impact, play and work, reality and imagination, vulnerability and safety, ambition and equanimity, spontaneity and structure, generality and specificity, and here and now and there and then. As a novel therapeutic model, CRIT offers a rich landscape for future research and application, expanding the potential of TTRPGs as a transformative group therapy modality.
