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Presence and Enactment as a Vehicle of Psychotherapeutic Change

Received January 27, 1999; revised April 16, 1999; accepted April 22, 1999. From Cornell University Medical College, Columbia Psychoanalytic Center for Training and Research, New York. Address correspondence to Dr. Viederman, 525 East 68th Street, New York, NY 10021.

This article addresses an aspect of psychoanalytic and psychotherapeutic process that leads to change. Focusing on an aspect of the patient-therapist interaction that the author calls "presence" of the therapist, it demonstrates how the experience of this may lead the patient to unconscious enactment of early wishful fantasies concerning the good parent. The gratification of these wishes implicit in the interaction influences the therapist-patient relationship and plays a significant role in change.

Key Words: Presence • Enactment • Psychotherapeutic Change • Psychoanalytic Concepts

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