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PubMed1995

[50 years after Anne Frank: reactive of a transgenerational trauma in countertransference].

Traumatizations suffered in the course of the atrocities perpetrated by the National Socialists defy symbolization and, if unresolved, are passed on to subsequent generations. With reference to the psychoanalytic treatment of a forty-year-old homosexual of the "second generation", the author traces the problematic of the transgenerational handing-down of unresolved traumatizations. The son of a Jewess whose brother was murdered in a concentration camp, the patient had to stand in for his lost uncle and remained caught up in a "symbiotic illusion" with this omni-present/absent object and with the mother, thus being unable to attain to a personality of his own and achieve the Oedipal triad. The article concentrates entirely on this case and provides an impressive record of the mechanisms of transference and counter-transference involved and the various stages of the psychoanalytic process.

Adult↗
PubMed1994

Countertransference in the treatment of the borderline personality.

The emotional pressure and transferences of patients to their physicians and other caregivers are natural, inevitable occurrences that are not restricted to therapeutic situations in which one is using a dynamic approach. Transferences are present in all relationships but are scrutinized in intensive dynamic psychotherapy. This article presents clinical examples that illustrate the intense pressures, often near-psychotic, exerted by certain borderline patients, which are unconsciously targeted to force a specific type of response from the therapist.

Adult↗
PubMed1994

[Countertransference in psychoanalytic supervision].

The author discusses the relationship between analysand, analyst and supervisor as a three-way constellation in which one person is always absent and at the same time present. He introduces the term "analysand counter-transference reaction" in an attempt to conceptualise the specific reactions of the analysand to characteristic behaviour on the part of the analyst, which in the author's view need to be carefully distinguished from other transference phenomena. The author illustrates the complexities of the transference dynamics involved with reference to three case histories, two of them reported briefly, the third in detail.

Adult↗
PubMed1995

Countertransference as instrument and obstacle: a comprehensive and descriptive framework.

A comprehensive and descriptive approach to counter-transference phenomena is proposed. Three types of mental activity are distinguished: the objective-rational attitude is an adaptive, relatively nondefensive mode of observation; the reactive mental state corresponds to the classical notion of unconscious counter-transference as an obstacle and a defense; by contrast the reflective attitudes involve preconscious and conscious psychical activity. Reflective activity involves four phases: (1) during emergence, an inner reaction appears; (2) immersion, through a regressive exploration, leads to introjective identification; (3) integrative elaboration involves a shift in cathexis, more distance, and an organization of the regressed contents, while (4) an interpretation is forming in mind. Three case examples from the literature serve to illustrate.

Countertransference↗
PubMed1996

Munchausen-by-proxy syndrome: countertransference as a diagnostic tool.

The authors report on an unusual reaction in clinicians interviewing known perpetrators of Munchausen-by-proxy syndrome (MBPS): an uncanny, ego-dystonic, and cognitively dissonant sense that the parent could not be the perpetrator, despite all clinical/forensic evidence. The authors suggest that this reaction can have various sources: One may be "as-if" character pathology in the parent, with the capacity to evoke, unconsciously, disbelief in the clinician. Given the poor treatment outcome reported in MBPS perpetrators, the authors suggest that, if confirmed, this finding will lead to more accurate psychiatric diagnosis of the parent, and more informed treatment of this potentially harmful or lethal syndrome.

Adult↗
PubMed1977

Countertransference aspects of pharmacotherapy in the treatment of schizophrenia.

Emphasis is placed on largely unconscious aspects of the therapeutic relationship which determine the inappropriate or untimely use of psychotropic drugs, particularly on the therapist's response to the regressive modes of relating and sharing emotional experience which characterize therapeutic work with schizophrenic patients. Case examples illustrate the use of drugs to establish interpersonal boundaries, to disavow frightening feelings within the self, and to renounce forbidden regressive pleasures-thus defending against the regressive pull of the developing symbiotic relationship. The effect of postpsychotic depression on the therapeutic relationship is explored with regard to the dynamics of psychotropic drug usage in treatment.

Adult↗
PubMed1997

Vicissitudes of remembering in the countertransference. Fervent failure, colonisation and remembering otherwise.

The author argues that certain kinds of transference can have great impact on the analyst's ego functioning. One such effect is impairment of ready recall of the analytic material, such as life historical data, the analytic process itself, and his or her role as analyst. The analyst strives to remember otherwise by analysing the patient's projective identifications and other defensive, manipulative strategies. When successful, these strategies may be said to colonise the analyst's mind. Although other ego functions are often affected by colonisation, remembering is of particular interest owing to its importance in building up and keeping ready at hand the contexts within which balanced and timely interpretations can be formulated with some hope that they will be heard and used effectively and progressively by the threatened, phantasy-ridden patient. Special attention will be paid to themes of failure; other themes, such as omnipotence and erotised transferences will be considered later on. Clinical illustrations are included.

Adult↗