In the relational playground of psychotherapy, negotiating therapeutic distance is crucial for the process as well as the outcome of treatment. The challenge of navigating this closeness and distance may be accentuated during emotionally charged interactions in therapy. Therapist and client may get locked in complementary, rigid positions, leading to either submission or resistance to the others’ demands. The therapist’s ability to respond appropriately to these pushes and pulls is supported by their ability to mentalize, which is their ability to attend to and understand their own states of mind while being aware of others’ states of mind. Therapists are expected to maintain a mentalizing stance throughout and despite the relevance and impact of therapist mentalization, there is relatively less research, training, or practice-related guidance on how to maintain this balance. We use case illustrations to demonstrate therapeutic interactions that can trigger non-mentalizing for the therapist and reflect on ways of recognizing and addressing these patterns related to closeness and distance. We also share recommendations for reflective practice and supervision, training as well as research on therapist mentalization.

中文翻译：

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推和拉：治疗师心理化在引导治疗距离中的作用

在心理治疗的关系领域中，协商治疗距离对于治疗过程和结果至关重要。在治疗中情绪激动的互动过程中，驾驭这种亲密和距离的挑战可能会加剧。治疗师和来访者可能会陷入互补、僵化的立场，导致要么屈服，要么抵制对方的要求。治疗师对这些推拉做出适当反应的能力得到了心理化能力的支持，心理化能力是他们在意识到他人心理状态的同时关注和理解自己心理状态的能力。尽管治疗师心理化具有相关性和影响力，但治疗师应该始终保持心理化立场，但关于如何保持这种平衡的研究、培训或实践相关指导相对较少。我们使用案例插图来展示可以触发治疗师非心理化的治疗互动，并反思识别和解决这些与亲密和距离相关的模式的方法。我们还分享关于反思性实践和监督、培训以及治疗师心智化研究的建议。