Hope When There Is No Hope: Discussion of Jill Scharff's Case Presentation

Jill Scharff's case material is viewed and discussed here from the vantage point of the two partners being an interpenetrating unit held in the grip of an “enactment”—a coconstructed event in which the analyst's participation sometimes becomes so enmeshed with the patient's in an ongoing way that analyst and patient seem to be trapped together in a narrow and concrete tunnel of reality from which they cannot find an escape, gradually making the treatment feel more and more hopeless because it is immune to interpretation of internal conflict. In the language of enactment, analyst and patient are held conjointly in the grasp of a shared dynamic that is a central hallmark of dissociation—an intrapsychic phenomenon that is played out interpersonally. The relationship between trauma, dissociation, shame, and affect regulation is explored in the context of impasse, repair, and psychoanalytic “technique.”