This Scientific Meeting will address the challenges met when working with patients who cannot “work together” with an analyst, who are not sufficiently able to symbolize and mentalize. We will address both patients who suffer disturbances in the area of self-other definition, continuity and regulation of self, as well as patients who can appear to be more related and reflective, but harbor sequestered self states that are dominated by areas of unrepresented and unsymbolized trauma and neglect.
This presentation will present the position of the unobtrusive relational analyst who companions the patient in the emergence of illusion, fragmentation and non-relatedness and privileges the inner world of the patient that becomes the signature and defining sculptor of the clinical interaction and process.

Unrepresented and unformulated trauma and neglect announce themselves in the flow of mutual enactive engagement and rather than seek to move the patient into greater relatedness and insight, the analyst companions the patient in the emergence of yet to be known and thought narratives of trauma and fragmentation. The tilt is toward an ontological position that privileges being-with the patient rather than epistemological where meaning can be symbolized and interpreted.