Collusion Revisited: A Narrative Review of Dyadic Collusions

• Published in: Journal of contemporary psychotherapy 2023-12, Vol.53 (4), p.333-341
• Main Authors: Stiefel, F., Bourquin, C., Saraga, M.
• Format: Article
• Language: English
• Subjects: Clinical Psychology; Collusion; Medicine; Medicine & Public Health; Personality and Social Psychology; Psychiatry; Psychotherapy; Public Health
• ISSN: 0022-0116; 1573-3564
• DOI: 10.1007/s10879-023-09585-8

Collusion is a specific and potentially harmful transference-countertransference interaction. At its core is an unconscious, unresolved issue shared by two or more participants, who are interlocked in a defensive maneuver. The issue at stake, which is avoided at the intrapsychic level, externalized, and circulating in the interpersonal space, may pertain to control, intimacy, loss, or domination, among other possibilities. Collusion occurs not only in psychoanalysis, psychotherapy, psychiatry, and medicine but also in couples and both within and between groups. This critical narrative review is based on a comprehensive consultation of the literature and our experiences as psychotherapists, supervisors, and researchers. We situate and delineate collusion, engage in a critical dialog with the literature and question some conceptual aspects of collusion. The aim of this review is to stimulate the interest of clinicians, supervisors, and researchers in this somewhat neglected phenomenon and to demonstrate and illustrate the challenges and pitfalls that clinicians face in collusive encounters. Finally, we provide clues to identify and ways of working through collusion in the context of psychotherapy and supervision.