The Paradox of Holding and Recognizing and the Local Moving Along of the Therapeutic Process

In an attempt to provide a first incomplete answer to the question raised by the editors as to “what cures traumatized patients,” I join my voice to that of the many authors who associate therapeutic action with the process of affect regulation that develops within the analytic dyad. I believe that we are yet to find effective ways of describing the therapeutic process so that the fundamental elements can be reflected upon and studied by therapists. This is especially important when we are working with severely traumatized patients. One of the challenges we are facing today has to do with the way in which therapists communicate such experiences to each other. In our reflections, it all depends on the level at which we situate ourselves, if the therapist places himself/herself at the local level of the interactive process he/she needs to learn to stand in the uncertainty of the security and change paradox relying on the intersubjective process itself. With traumatized patients the challenge in psychotherapy almost always involves the ‘treatment that hurts’ paradox.