Dancing in the dark, moving towards the light: complex patterns of dyadic interaction in psychotherapy sessions

Attachment research is now a secure base at the heart of psychodynamic psychotherapeutic thinking. Listening with an ear for attachment is crucial in understanding our intersubjective states of mind, especially when we end up out deep or lost in the dark and the way forward must be closely discerned. Yet while the transference-countertransference may be a relational expression of procedural memory, an activation of earlier experience where the deep past and the surface present coexist, attachments take a long time to shift. So moment-by-moment we try to shift the complex dance and music of the interactions towards greater liveliness, playfulness and the integration of trauma. We hope to optimize these “moments of meeting”. 

A Parent-infant research instrument such as the CARE-Index developed by Crittenden tracks the synchrony between the care-giver and infant in short videoed segments of play. It describes the patterns of interaction, operationalizing the ways the dyad connect. This paper will outline early work within the Conversational Model, with a necessary nod to Winnicott, in developing an adaption of this framework to sessional moments in adult psychotherapies, as observed in the moment, in analysis of sessional fragments (including digitally audio-recorded psychotherapeutic material, and some transcripts, deidentified, disguised and used with permission).

The aim is to improve the sensitivity and responsiveness of the therapist, helping the dyad move towards a playspace and potentially to improve the quality of reflective practice and supervision. The attachment template is at the foreground at difficult moments, and guides the therapist, but there is still more to discern about the patterns of dyadic connectivity: how to “see” them and shift them.