On Transforming the Reparative Quest

This article presents the therapeutic process of transforming a self-protective intent, the reparative quest. In pursuing this intent, patients attempt to repair their experience of the past by trying to eradicate the pain resulting from previous trauma and seeking to ensure against re-traumatization. This intent reflects a disavowal of past trauma and is bound to falter, leading to the patient's need to integrate painful affect from the traumatic past and mourn these experiences. I outline a self psychologically oriented approach of integrating affirmation of the patient's passionate yearning with a willingness to inquire about the patient's underlying anxiety about re-traumatization and a welcoming of the patient's dissociated pain and rage when it emerges. By providing the patient with the “holding environment” that was missing in early development, the therapist enables the patient to integrate previously dissociated affect and mourn the traumatic past. Through engaging in these processes, the patient is able to transform his or her do-or-die attempt to eradicate the painful past into the more grounded pursuit of meaningful goals, as well as an increased ability to accept vulnerability and depend upon the therapist.