An examination of therapists' experience of impasse in psychological therapy
Whilst therapy impasse has been analysed by a number of clinicians based on their interpretations from case studies, there has been a lack of research studies investigating this phenomenon. The clinical literature points to different aspects of the therapy frame and contract, individual client and therapist factors, the alliance and therapeutic interaction which combine in an idiosyncratic way in each case of impasse. The aims of this research was to examine the accounts of a small number of therapists currently experiencing therapy impasse in order to understand the role that these or other factors play in individual cases of impasse as well as to investigate the meaning and effects of an impasse experience for the therapist. A qualitative methodology was chosen in order to undertake a more in-depth analysis, and four participating therapists were interviewed on two separate occasions. The principles of Interpretative Phenomenological Analysis informed both the design of the study and its analysis. The analysis identified that the early development of problematic transferential patterns of relating was associated with impasse. In these cases of impasse therapists appeared to have a powerful personal engagement with their clients and they experienced strong affect in relation to the therapy process. The role of the therapists' ideal self which comes under threat during impasse was highlighted and the management of impasse was associated with therapists' regaining their therapeutic stance and attending to the therapy process. The implications of the study, in terms o f how clinicians may recognise and respond to cases of impasse at an early stage, are addressed, along with a theoretical discussion of how we might define and understand therapy impasse. A critical analysis of the study is included and suggestions for further research are offered.