Ambivalence, Resistance, and Alliance Ruptures in Psychotherapy: It's Complicated

• Published in: Psychoanalytic psychology 2019-04, Vol.36 (2), p.139-147
• Main Authors: Urmanche, Adelya A, Oliveira, João Tiago, Gonçalves, Miguel M, Eubanks, Catherine F, Muran, J. Christopher
• Format: Article
• Language: English
• Subjects: Ambivalence; Client Attitudes; Female; Human; Psychotherapeutic Resistance; Psychotherapy; Therapeutic Alliance
• ISSN: 0736-9735; 1939-1331
• DOI: 10.1037/pap0000237

Ambivalence, resistance, and alliance ruptures are three terms commonly used in psychotherapy, across different theoretical approaches and modalities. However, it is still not clear how those terms are related and how the connection can be used to maintain a therapeutic alliance while addressing clients' ambivalence. This paper aims to briefly describe ambivalence and resistance, describing their impact on psychotherapy process; reintroduce the theory of resistance as a manifestation of ambivalence (Engle & Arkowitz, 2006); and relate it to the concept of alliance ruptures. An original study is presented to further demonstrate this interaction between process and content in psychotherapy sessions. Moreover, this paper will discuss the implications of this relationship, offering directions for psychotherapists in addressing both ambivalence and ruptures in their work. 摘要 摘要:矛盾情感, 阻抗和联盟破裂是心理治疗中跨越不同理论流派取向的三个常用术语. 然而,尚不清晰的是,这些术语是如何相关联的,以及在处理患者的矛盾情感时这种连接是如何用于维持治疗联盟的. 本文旨在简要描述矛盾情感和阻抗,描述它们对于心理治疗过程的影响;再次介绍将阻抗作为一种矛盾情感的表现形式的理论(Engle & Arkowitz, 2006);并将它与联盟破裂的概念联系起来. 在此呈现的一项独创性研究进一步证明了心理治疗会谈的过程和内容之间的相互作用. 此外,本文还将讨论这种关系的含义,为心理治疗师在工作中处理矛盾情感和破裂提供方向.