Experience in the Third Space with a Psychotic Patient

The author suggests that a paradigm shift in therapists' understanding of therapeutic efficacy from making the unconscious conscious to repeating past experience in the transference/counter-transference has resulted in counter-transference enactment and analysis being considered as central in the resolution of repressed introjected pathological object relations. This shift marks a return to Ferenczi's early technical innovations and ideas concerning a repetition in the transference of past traumatic object relations but with a new and benign object, the analyst, resulting in a different outcome. The author outlines the analysis of a regressed patient in which the analyst's immersion into the patient's world of paranoia, magical thinking, dissociation and the uncanny, analysis of counter-transference enactment, and role reversal contributed to a resolution of pathological introjects in the context of a new object relationship with the analyst. Experiencing the patient's tortured inner world and the analyst's ability to symbolize the experience resulted in a new-found ability in the patient to reflect on and analyze his internal object relations.