Response to Co-creation of Dreams, posted May 22

One can imagine that the fences in the patient’s dream are less about “unspoken boundaries” between the patient and his father and more about those that stand between the patient and the therapist. One can imagine the patient feeling the intimate confines of the consulting office and a desire for therapeutic boundaries to vanish leaving him and the therapist free to explore the vast horizons beyond.

In my mind, the two benevolent white-haired men could symbolize wisdom and morality. They have perhaps ascended from above to give the patient an understanding of both the permeability of the boundaries that he and the therapist have co-created and his understanding their moral necessity. 

The therapist, too, in her dream, is reaching out past the boundaries and, like her patient, understands the need to maintain them and consequently turns away.

Interestingly, by disclosing her dream to the patient, she is in fact reaching past the boundaries and thereby simultaneously expanding them and reaffirming that they are there. Her disclosure reveals her trust that he understands the limits of the therapeutic relationship and the necessity of those limits. Her sadness demonstrates that, despite the application of clinical terminology like “transference,” “counter transference,” and “therapeutic alliance,” underneath are real people with real emotions, which are sometimes intense and sometimes bump up against the therapeutic boundaries. This is, as the patient says, romantic, at least in the sense that true love involves walking the boundary between the selfish desire to possess and the selfless sacrifice of putting the other’s happiness above that selfish desire.

Therapeutic relationships sometimes walk this line, but a patient whose relationship with his father was distant probably benefits more from experiencing the reality beneath the “therapeutic alliance” than he does from any clinical assessment of his psychological history. I suspect that while he most likely grieves the lack of a relationship with his father, what he desires now is real connectedness. The lack of a relationship with his father may explain his desires for connectedness, but it doesn't satisfy it. The emotional reality behind the therapeutic alliance demonstrates that such connectedness is possible, that he is a person who is worth investing in emotionally, and that limits around the connectedness do not diminish its worth. 

The emotions “stirred up” (dare I say ignited) in the therapeutic relationship are indeed the mutual property of the therapist and the patient, but I wonder if Dr. Alexander-Guerra understands her role in the co-creation process (for it is an evolving process). Does she understand that by making the therapist’s session with the patient blog-worthy, she has added a layer of legitimacy to the emotions? I wonder if as a result, the therapist feels more secure in her relationship with the patient and if the patient reciprocally feels more secure. I wonder if Dr. Alexander-Guerra understands if she is now part of the co-creation between the therapist and the patient. I wonder if the patient has read this and feels a mutuality with Dr. Alexander-Guerra. I would if I were the patient.

         submitted anonymously