title: A view from Riggs: treatment resistance and patient authority--X: from acting out to enactment in treatment resistant disorders.
abstract: Abstract Patients with treatment resistant disorders pose a major problem to clinicians of all theoretical perspectives, including psychodynamic therapists. Treatment of such patients often results in stalemates and impasses, and acting out is a frequent phenomenon. This paper addresses the value in work with such patients of looking beyond the concept of acting out, which is a one-person definition of a problem, toward the concept of enactment, which recognizes the roles both therapist and patient play in the phenomenon of treatment resistance.
authors: The Austen Riggs Center, Stockbridge, MA, USA. sagman.kayatekin@austenriggs.net
authors: M Sagman
authors: MS
authors: Kayatekin
authors: Eric M
authors: EM
authors: Plakun
mesh_terms: D000184:Acting Out; D006801:Humans; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D010349:Patient Compliance; D011369:Professional-Patient Relations; D013811:Psychotherapeutic Processes; D011613:Psychotherapy / Q000379:methods*