Mutuality refers to the idea that the therapeutic relationship is a two-way street, in which both the analyst and patient are active participants. While the concept of mutuality is important in relational and intersubjective approaches to psychoanalysis, there is a risk that an excessive focus on mutuality may lead to boundary violations and other ethical problems.
Enactment, on the other hand, refers to situations where unconscious dynamics in the therapeutic relationship are unconsciously acted out or reenacted. While enactment can provide important information about the patient's inner world, it can also contribute to therapeutic excess if the analyst is not aware of the ways in which their own unconscious processes are influencing the therapeutic relationship.
So while mutuality and enactment may be key factors in situations of therapeutic excess, it's important to remember that there are many other factors that can contribute to these problems, including countertransference, boundary violations, and inadequate training or supervision. To address these issues, psychoanalysts must remain vigilant about maintaining appropriate boundaries and ethical standards in the therapeutic relationship, while also remaining attuned to the unconscious dynamics that may be at play.
