Hidden Faults: Recognizing and Resolving Therapeutic Disjunctions
Psychosocial Press (an imprint of International Universities Press), 2000

A Book for Psychotherapists
— Theoretically Innovative
— Inherently Practical

Hidden Faults explores ways to resolve stalemate and further progress in psychotherapy.

About Hidden Faults

Disjunctions: the spectrum of breaches in therapy, from subtle to devastating, when therapist and patient miss and confound each other. Disjunctions may briefly confuse the therapeutic partners, or even grind the therapy to a halt. Always, they provide unique opportunities for therapist and patient to understand each other and bring their work to ever more profound levels!

Hidden Faults explores therapeutic disjunctions and their place in resolving stalemate and furthering progress in psychotherapy. Disjunction is a concept that can be used with any psychodynamic system supporting a two-person view of therapy, where the inner life of both participants is open for inquiry and change. Little of significance will happen in therapy if the therapist is not willing to be fundamentally influenced by the patient, since transformation in the therapist is the most powerful sign to the patient of being taken seriously. Steven Frankel illustrates this central point using extensive case material showing therapist and patient in their human, often agonizing struggles to bring about creative change.

The author calls his picture of the mind, “the self and other unit model.” The major activities in working within this structure are recognizing the multiple relational configurations each partner brings to the therapy field, and identifying and resolving the inevitable disjunctions that interfere with therapeutic movement. In contrast to traditional models where the patient’s wisdom may be minimized, Dr. Frankel holds that heartfelt initiation from each partner in recognizing and healing failures in rapport leads to developmental momentum and lasting creative change.

What Others Say about Hidden Faults

“Hidden Faults is a brave and wise book. Steven Frankel sets before the reader every clinician’s dread and every clinician’s experience -– times when disjunctions between analyst’s and patient’s experiences and expectations threaten to undermine or end the therapy -– and he carefully elaborates his theories about how such disjunctions can be addressed. Frankel’s absolute honesty about his own mistakes and misunderstandings, along with the extended and rich case examples he weaves throughout the book, make a compelling and persuasive read.”
~ Nancy D. Chodorow, Ph.D.

“The timeliness, originality, and importance of Hidden Faults lie in Steven Frankel’s highly readable integration of the personal and interpersonal, the individual and the interpersonal field, the unitary self and multiple self states. Any reader who adopts and explores Frankel’s central concept, the self and other unit (SO), will be convinced that mind and relatedness must never again be considered separately. And yet from cover to cover Frankel maintains a thoroughly clinical focus. He makes the case that the crucial parts of treatment are one particular kind of problematic SO, the therapeutic disjunction. Frankel’s honest, appealing, and straightforward discussion of his own clinical experiences will be of enormous assistance to his readers in recognizing and resolving these therapeutic snags.”
~ Donnel Stern, Ph.D.

“Dr. Frankel has written a book of enormous usefulness to psychotherapists. He delves into the inevitable lapses in the therapist’s understanding of the patient, opening himself to the learning that emerges from an acceptance of not knowing. The compelling case examples show that the good therapist heals, not by having the answers, but by being willing to be profoundly affected and changed in the relationship with the patient. This book can transform the therapist’s (and hence the patient’s) experience of the therapeutic process, giving it new depth and vitality. Its message resonates long after one has finished reading it.”
~ Alicia F. Lieberman, Ph.D.

“In Hidden Faults, Dr. Steven Frankel writes candidly, respectfully and insightfully about his experience that a psychotherapeutic process is first and foremost a human event involving a complex, often frightening, often passionate relationship between two people. The therapist is half of the therapeutic relationship and must be emotionally capable of taking responsibility for his or her half of it. When the therapist becomes aware of a fissure between the patient’s and his own understanding of and response to what it is that is happening between them (at a conscious and unconscious level) he or she must have the courage to put it plainly on the table for jointly reflective consideration. In Frankel’s discussion of the ways in which the relationship between therapist and patient inevitably collapses into various sorts of mutual alienation, he convincingly demonstrates that such “disjunctions” become opportunities for therapeutic repair or, when left unrecognized for long periods of time, usually result in the end of the possibility of psychological change on the part of either the patient or the analyst. Too often, the latter outcome has been viewed as evidence of the patient’s ‘unanalyzability.’

“There is a freshness and aliveness to this book. No’‘psychotherapeutic rule’ is assumed to hold validity until Frankel comes to believe over time that it has demonstrated its value in his own clinical work (regardless of who its original author was or how long it has been around). Such openness to new possibilities is a rare event in the history of psychoanalysis and spending time with Dr. Frankel as he describes this work is a great pleasure.”
~ Thomas H. Ogden, M.D.

HIDDEN FAULTS: Table of Contents

Fault Lines: An Introduction to Therapeutic Disjunctions
Fractures: The Nature of Disjunctions
Through a Microscope: Recognizing Disjunctions
Tracing the Cracks: Arriving at a Consensus
Mending: Working with Disjunctions
Pulling Together Under Stress: Relational Consequences of Working with Disjunctions
Irreparable Damage: Patients Trapped by Disjunctions
Detailed Mapping: Using the SO Model in Working with Disjunctions
Altering the Landscape: Using Disjunctions to Create Change