Citation

Pollock PH. Clin. Psychol. Psychother. 2001; 8(3): 214-229.

Copyright

(Copyright © 2001, John Wiley and Sons)

DOI

10.1002/cpp.278

PMID

unavailable

Abstract

Dysfunctional patterns of attachment have been implicated as substrates for interpersonal violence within relationships, often termed ‘violent attachments’ (Meloy, 1992). Within the therapist–patient relationship, a patient may demonstrate grave complications within the attachment to the therapist, in some cases, manifest as an intense and gross disturbance expressed as obsessive, unrequited affection or love. A lack of reciprocation by the therapist can solicit the patient to pursue, harass or even attack the therapist. A number of mental disorders are encountered in these patients. An illustrative case is presented in which a female patient, who demonstrated one such condition, borderline erotomania, stalked and attempted to kill her therapist, was treated using Cognitive Analytic Therapy (CAT; Ryle, 1990, 1995, 1997). The complications that emerged within the therapeutic relationship are understood through a CAT reformulation and the process of therapy described. The relative benefits of relational models of psychotherapy such as CAT with dysfunctional forms of relating within relationships that can lead to serious interpersonal violence are discussed. Commentary is made regarding clinical threat management for therapists dealing with such cases. Copyright © 2001 John Wiley & Sons, Ltd.