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Published Online:https://doi.org/10.1176/ajp.109.4.283

1 The difficulty in making a clear working agreement is described.

2. It is suggested that this difficulty is related to the therapist's lack of experience and reluctance to take responsibility.

3. An adequate working agreement is outlined.

4. The difficulty in focusing on the interaction and the associated belief that the patient is helpless in his current regressed state are described.

5. It is suggested that these deprive both the therapist and the patients of constructive experiences.

6. It is further suggested that they may be defensive maneuvers on the part of the therapist.

7. Some other manifestations of defensive behavior in the therapist are mentioned.

8. The specific role of the therapist in overcoming resistances is outlined.

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