You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
In this reply I deepen my articulation of how to move through an impasse from a relational frame of mind. I find myself in agreement with Williams’ theories of psychosis, his clinical insights, and the importance of shame, but I am in disagreement with Atwood regarding his depiction of the Judge and his assumption that the impasse could have been avoided. I clarify that the impasse was an inevitable enactment. The only way forward was to have Pat’s warring internal states enacted between us. Trying to be too good, or too fearful of harming, is a perilous path that will not allow for the patient’s unbearable experiences to be repeated and thereby worked through.