title: The ripple effect: patients influencing others.
abstract: This paper deals with what seems an insufficiently explored aspect of psychoanalytic practice: the ripple effect of a patient's evolution on the present and future of his or her significant others. Clinical vignettes are provided to illustrate patients' influence on relatives; patients acting as therapists; psychoanalysis by proxy; the ripple effect in psychotherapy; and some countertransference problems. The psychic lives of individuals not in treatment may be considerably affected by their interactions with our patients; seemingly, extraclinical character adjustments may ensue. Sociological findings and plausible psychodynamic explanations are discussed. A psychoanalytic perspective may not only help the analyst understand how therapeutic influence extends beyond the identified patient, but may also help guide interventions that are ripple-effective, even when they depart from classical analytic technique.
authors: Department of Psychiatry, Madrid University, Spain. paniagua@arrakis.es
authors: Cecilio
authors: C
authors: Paniagua
mesh_terms: D000328:Adult; D003379:Countertransference; D005195:Family Relations; D005260:Female; D006801:Humans; D007062:Identification, Psychological; D007207:Individuation; D007857:Leadership; D008297:Male; D008388:Marital Therapy; D008393:Marriage / Q000523:psychology; D008875:Middle Aged; D009769:Object Attachment; D010287:Parent-Child Relations; D011573:Psychoanalytic Interpretation; D011574:Psychoanalytic Theory; D011575:Psychoanalytic Therapy; D014167:Transference, Psychology