Young adults re-enacting in psychotherapy their relationship with a mentally disturbed parent

The present study aims at exploring what characterizes psychoanalytic psychotherapy with young adults who grew up with a mentally disturbed parent, with regard to the following aspects: the therapeutic process; specific problems in the therapeutic collaboration; helpful and hindering factors; and patterns of transference and counter-transference. All patient cases (n = 3) who had the specific family background of parental mental disorder were selected from a sample of 46 cases, in which patients and therapists were interviewed pre- and post-therapy. Interviews with patients and therapists conducted at the onset of treatment and at its termination were analysed qualitatively. All patients had characteristic ways of acting in the relationship with the therapist that caused problems and hindered the therapeutic work. These behaviours probably evolved during childhood and adolescence in relation to the disturbed mother. These patterns could be interpreted as re-enactments of early relationship themes. The therapists varied in their attention to, co-enacting in, and ways of managing these enactments. The conclusion is that successful therapy seemed to be associated with the therapist enduring the patient's negative transference and accepting negative counter-transference, and in so doing being able to detect the patient's re-enactments and interpret those.