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PubMedDate not supplied

Transference, countertransference, and abuse in psychotherapy.

The complex factors that can lead to either creative or destructive experiences in psychotherapy for both patients and therapists are explored with reference to the treatment of patients with a history of abuse. Particular emphasis is placed upon the formation of an intermediate space, in which a safe therapeutic environment is established, allowing for the creative interplay of past and present. The concepts of the transitional object, transitional phenomena, and projective identification are defined and amplified in explaining how they help to determine whether a safe therapeutic space is achieved, or whether destructive, abusive experiences are re-created, for both patient and therapist. In addition, the importance of the therapist's capacity to tolerate the ambiguity and uncertainty of psychotherapy is elaborated. The relationship between these formulations and the therapist's countertransference is emphasized. Also described is the importance of supervision in helping therapists--during training and throughout professional life--to discuss shame-arousing experiences with their patients.

Borderline Personality Disorder↗
PubMed1999

Countertransference and limits of therapy in war situation.

Psychotherapy of war traumas and their specific emotional and psychological experiences is a challenge for the therapist. The two partners of the therapeutic dyad may undergo the same difficulties and suffer from the same anxieties, and be affected by the transference and countertransference processes. The conditions of neutrality that should be maintained in the treatment are thus prone to changes. The therapist may protect himself/herself from unconscious guilt, omnipotent fantasies and feelings of being overwhelmed by different modes of defenses. The historical and social context of the trauma have to be taken into account. A chronology to be introduced in the narrative is the first step in the process of reindividuation as the victim's identity has been attacked by the trauma as well as his/her physical integrity. The therapist may find in this intervention a reflection of his/her own needs. The aims of psychotherapy in war situations may be close to those of crisis intervention and at the same time deal with the reactivation of previous infantile traumas. The past plays a significant part in the readaptative process as much as it is relevant to the present. The therapeutic intervention is in essence a message of hope as it implies a potential future to be created.

Adult↗
PubMed1992

Countertransference: the analyst's retreat from the patient's vantage point.

As analysts, we may agree with certain basic tenets: we should not impose our truths, whether or not theory-laden; we should maintain the focus on the patient's inner reality, not on how he or she lives in the world--out there; we should be prepared to be surprised, to learn something that hadn't occurred to us; we should look for multiple cues in the clinical data, pay attention to affect and state as may be expressed within the moment, and listen for subtleties that may convey something about how we are being experienced in the transference. But again and again, we fail to adhere to these precepts. Despite our best intentions, we seem to have a fundamental disinclination to maintaining these positions. I have tried to consider some reasons for this difficulty and its relation to the countertransference. Drawing upon several clinical examples, I have attempted to examine ways of enhancing our attunement to verbal and non-verbal cues from the patient which may direct us, sooner, to dimensions of our counter-transference responses otherwise overlooked.

Adult↗
PubMed2005

In the belly of the beast: traumatic countertransference.

The authors discuss their work together in a consultation process. One author led many groups that were created to facilitate recovery for persons directly impacted by the terrorist attacks on September 11, 2001; the other acted as consultant to the therapist/leader. The leader was a resident of New York City at the time of the attacks; the consultant lived in a distant Midwestern city and the two had never met prior to the work. They describe their experience of working together and the role of this collaboration in the lives of the leader and the groups. Well aware that little exists in the literature about groups led by leaders having experienced the same trauma as group members, the authors pay special attention to the countertransference that each underwent and raise questions about the effects of that on the group process.

Countertransference↗
PubMed2005

The effect of trauma on the conductor of the group: a type of identificatory countertransference.

Trauma affects the conductor of the group as well as the group members. This identificatory countertransference of the group conductor is a resultant of the coming together of the conductor's internal and external worlds, the interplay of introjections, projections, and empathy. It is inconceivable that a conductor of a group can project a "blank screen " of technical neutrality when trauma impinges upon everyone. From a psychodynamic perspective, this article explores groups under the throes of trauma, the interplay of that trauma with the conductor's feelings, and the effects on his or her role in the group. The article also explores the effect of trauma upon the affective process within the group and upon the cognitive processes of the conductor and group members.

Affect↗
PubMed2005

Countertransference in the context of the fourth basic assumption in the unconscious life of groups.

The treatment of choice for traumatized and difficult patients is psychoanalysis or psychoanalytical therapy followed by intensive group analysis for an unlimited period of time. The group is able to help the analyst make therapeutic use of inevitable difficulties in countertransference processes. Also, traumatized and difficult patients are likely to create the basic assumption of Incohesion: Aggregation/Massification, and to personify the roles associated with it. These processes can be used in order to provide such patients with appropriate therapeutic attention involving both containment and holding, and interpretation. Extensive clinical data from psychoanalysis and group analysis are used to illustrate both this clinical approach and the author's theory of Incohesion.

Countertransference↗
PubMed2005

Relational perspectives regarding countertransference in group and trauma.

A relational/constructivist view incorporates contemporary trends toward viewing countertransference and co-transference as results of mutual intersubjective influence. It moves toward a view of the socially constructed nature of human reality, toward recognizing the therapist's as well as the members' irreducible individuality and initiative taking; and toward therapy as about meaning-making rather than scientific discovery of The Truth. General clinical examples, and examples of working specifically with trauma, are given.

Countertransference↗
PubMed1992

[Significance of the transference-countertransference constellation in motivation for participation in an epidemiologic field study of psychogenic disorders: a report of experiences].

The present article deals mainly with problems arising from the motivation of individuals for the participation in an epidemiological field study and their solutions on the basis of psychological-psychiatric findings. Subsequent to a more detailed survey of the research project in question formal and technical aspects of the motivational efforts (home visits, phone contacts) which had to be performed by the research group are mentioned. In the following the authors focus on the scientific concepts and orientations of their motivation work including the specific attention paid to the constellation of transference and countertransference. Particular importance is attributed to the presentation of several case studies which illustrate the influence of different psychoanalytical character traits on the motivational process. Finally the authors concentrate on specific problems regarding the sex of the probands as well as on their experiences with so-called hesitators i.e. individuals who for a longer period of time cannot decide whether to participate in the study or not.

Adult↗
PubMed1990

Erotized transference reconsidered: expanding the countertransference dimension.

A reconsideration of the erotized transference from a contemporary perspective has been presented utilizing detailed case material provided by Stoller. The main thesis is that this type of transference, traditionally conceived as a product of a particular kind of patient often felt to be borderline, is better understood as arising in a specific intersubjective context involving both participants in the psychoanalytic situation. The focus is on the intricate interaction of analyst and patient, recognizing that either may serve as a selfobject for the other. This view assumes a more expanded countertransference role than recognized in the earlier literature. The psychoanalytic situation can be erotized by either or both participants. A corollary thesis is that the details of a patient's fantasy should also be viewed as codetermined and that imbedded within it might be the patient's subjective experience of the psychoanalytic interaction. Alluded to peripherally is that the erotized transference in the interaction between male analyst and female patient is, in part, a manifestation of traditional roles assumed in situations involving a male authority figure in close engagement with a female who perceives herself as relatively powerless. This issue has recently received considerable attention from writers who have addressed themselves to the important gender issues in psychoanalysis.

Adult↗
PubMed1989

Countertransference and technique in working with the regressed patient: further remarks.

In working with regressed patients, the most effective interpretations are based frequently on information gathered through transference-countertransference interactions, interactions that often depend on the patient's projective and the analyst's introjective identification. A group of regressed analytic patients seek to rid themselves of tension predominantly by evacuating their unconscious fantasies or projecting them into the analyst. A fragment of the analysis of such a patient illustrates how her fantasies could not be adequately contained by the analyst because they revived in him inadequately resolved conflicts from early childhood, conflicts that resembled closely those being relived by the patient. His reacting by falling asleep created an emergency that was resolved by his making an unplanned interpretation that proved to be significantly mutative, a 'turning point'.

Adult↗
PubMed1989

Countertransference and psychoanalytic technique.

This paper examines the evolution of the concept of counter-transference, with particular emphasis on its relationship to psychoanalytic technique. Freud's original idea that countertransference means unconscious interference with an analyst's ability to understand patients has been broadened during the past forty years: current usage often includes all of the emotional reactions of the analyst at work. Some factors that have contributed to this shift are the introduction of the structural hypothesis, the impact of Kleinian and interpersonal schools on the theory of technique, the effect of analysts' experience in working with more severely ill patients, and the diffuse consequences of certain recent cultural and intellectual trends. The benefits as well as some potential disadvantages in this shift toward a more inclusive conceptualization are discussed.

Countertransference↗
PubMed1989

Tolerating the countertransference: a mutative process.

The paper examines the technical problem of how to deal with the patient who evokes powerful feelings in the analyst. It describes how 'tolerating' such countertransference can, by itself, produce psychic change in the patient. This occurs through inevitable partial acting out by the analyst, and the patient's observation of this. Implications of this interaction in the understanding of the mother-baby relationship are discussed.

Acting Out↗
PubMed1986

Transference and countertransference issues in treatments involving older patients and younger therapists.

In this paper, I have described certain transference fantasies found in treatments involving older patients and younger therapists. These include the defense against the loss of objects, the resurrection in fantasy of prior lost objects, the bolstering of one's sense of oneself as phallic and masculine or as more acceptably feminine, and the fantasy of oneself as being younger and not likely to be nearing death. For individuals with a significant degree of envy of those younger than they are, the wish to steal the therapist's youth or to emasculate his therapeutic efficacy may lead to a need to defeat the therapy. The use of the analysis of dreams and fantasies as a means of monitoring countertransference feelings is of particular importance for the younger therapist working with the older patient, who may mobilize unresolved feelings toward both parental figures and the former analyst of the therapist.

Age Factors↗
PubMed1986

Working with women survivors of the Holocaust: affective experiences in transference and countertransference.

This paper describes and discusses some late effects of massive traumatization on two women survivors of the Holocaust. Both had appeared to recover from their affective experience of psychic death and hopelessness in Auschwitz and to have moved towards a resumption of further stages of the life cycle. The normal transitional crises of adolescence, when children emotionally separate from their parents, led to severe breakdown in both these patients. Analysis showed that denial, repression and splitting had enabled them to distance themselves from the overwhelming horror of their past, but it had also led to concrete thinking as opposed to metaphorical, and to non-differentiation of psychic and somatic pain. Their inability to dream and the absence of fantasy life in the material could neither facilitate the analytic task of working through these patients' unbearable experience, nor enable them at first to face and recover unbearable affects during the course of the analysis. Hence the analyst's acceptance of an unbearable countertransference and careful monitoring of the affects evoked proved to be an invaluable tool.

Affect↗
PubMed1985

Working through in the countertransference.

This paper is intended as a development of Strachey's classic paper 'The nature of the therapeutic action of psycho-analysis'. Strachey states that the full or deep transference experience is disturbing to the analyst; that which the analyst most fears and most wishes to avoid. He also stresses that conveying an interpretation in a calm way is necessary. The area addressed is the task of coping with these strong countertransference experiences and maintaining the analytic technique of interpretation. The clinical illustrations attempt to show something of the process of transformation or working through in the analyst, as well as showing that the patient is consciously or unconsciously mindful as to whether the analyst evades or meets the issues. The contention that the analyst is not affected by these experiences is both false and would convey to the patient that his plight, pain and behaviour are emotionally ignored by the analyst. It is suggested that if we keep emotions out, we are in danger of keeping out the love which mitigates the hatred, allowing the so-called pursuit of truth to be governed by hatred. What appears as dispassionate may contain the murder of love and concern. How the analyst allows himself to have the experiences, work through and transform them into a useful interpretation is the issue studied in this paper.

Child Development↗
PubMed1978

Countertransference examples of the syntactic expression of warded-off contents.

This is a preliminary statement of the hypothesis that syntax in speech may act as an "incidental stimulus" in the communication of mental contents which the speaker is motivated both to conceal and to express. Ten clinical examples, taken from verbatim transcripts of one psychoanalyst's interventions in a recorded case, illustrate the expression of countertransference attitudes by syntactic and other linguistic properties such as: the agentless passive, pronominal ambiguity, yes/no questions, extraposition, the pseudocleft construction, delaying tactics, the passive construction and conceptual focus, lists and logical complexity, foregrounding, syntactic and lexical ambiguity, subordinate clauses and syntactic opacity.

Communication↗
PubMed1981

[Training of psychotherapists with special reference to the phenomena of transference and countertransference].

The interaction between transference and countertransference, and between real and imaginary level of relations is elucidated from different angles. It is emphasized, that the therapist must learn to oscillate between his conscious purposeful thinking and the state of free floating attention in order to facilitate development of a far-reaching congruency of communication which has to supplement the necessary openness.

Countertransference↗