Applied Cinematherapy: The Patient-Audience Relationship and the Space in Between

Dr Ruth Manasseh D.Psych.Psych – Doctorate in Psychoanalytic Psychotherapy Faculty of Social Sciences, Centre for Psychoanalytic Studies, University of Essex 19th May 2014.


This NHS supported research explores my original clinical methodology as formulated over several years working in psychological trauma and as a filmmaker. I call it Applied Cinematherapy (AC).

My aim was to investigate the effects of using film extracts as a supplement to analytic group work with severely traumatised patients who remain in impasse, despite having undergone previous pharmaceutical, cognitive and psychodynamic interventions – all pre-requisite patient inclusion criteria for the clinical trial.

The key innovation of AC is the controlled way film extracts were introduced into a traditional brief, trauma-focused, group psychotherapy setting governed by established psychoanalytic psychotherapy practices.

The thesis examines whether implementation of this form of therapy is possible, what effects it has on the group and individual process, and what indications there are of the mechanisms that might be at work in creating these effects.

When defining the methodology, I conceptualised the Patient-Audience Relationship (PAR) (Manasseh, 2010) to describe the theoretical space created between the patient (as a patient) and the patient as an audience when extracts from films are introduced into therapy. PAR is founded on three established psychoanalytic concepts: Transitional space and object (Winnicott, 1953); Third position and internal triangular space (Britton, 2004); and Reverie (Bion, 1962). My hypothesis was that PAR, might help trigger identificatory processes that could be utilised in therapy to enhance the patients’ ability to reflect, without being too overwhelmed.

My findings, analysed using the Pragmatic Case Study approach (Fishman, 1999), indicate that AC enabled a containing, transitional space for the patients to gradually work through the more concealed parts of their trauma. From being a central preoccupation, the patients’ trauma became more integrated with other parts of their everyday life.

Applied Cinematherapy potentially offers a way for trauma patients who are in impasse to re-engage in treatment through PAR.