The persecutory therapist re-visited: The damage done by trauma to a patient’s sense of agency and the implications for psychotherapy practice
An often neglected aspect of psychodynamic psychotherapy is its potential contribution to the development of self-agency, which, in healthy development passes through a series of stages from the physical to the representational and autobiographical. One of the most devastating effects of trauma, especially various forms of early relational trauma, is the profound damage done to this agentive developmental process and the patient’s sense of self-agency in the world and in relationships. In this paper I shall explore Meares and Hobson’s description of the specific ways in which psychotherapists may enact a persecutory role, examining these in terms of their impact on the patient’s self-agency in the therapeutic relationship. I suggest that Meares’ model of analogic relatedness, based on associative, imaginative and non-linear patterns of thought, is fundamental to the gradual re-emergence of the patient’s experience of self-agency. It provides the essential space in which the patient’s own motivation and meaning-making processes can emerge, rather than passive compliance with a coercive powerful other. The neuroscience that underpins these developmental processes will be discussed.
