Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Countertransference”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 703 records · Page 39Linked to original sources
PubMed2006

Perverse dreams and dreams of perversion.

This paper (1) posits the occurrence of perverse dreams as a type of mental phenomenon in the constellation of perverse processes; (2) considers manifest dreams of frank perversion as a type of perverse dream within the class of perverse dreams as a whole; (3) relates the subtype of perverse dreams without manifest perversions to the occurrence of perverse defenses and the development of a perverse transference; and (4) suggests that consideration to perverse dreams in the psychoanalytic process finds application in identifying and differentiating perverse defenses from neurotic and other characterologic patterns; in identifying and tracing the vicissitudes of difficult perverse transference-countertransference constellations; and in furthering perverse patients' recognition and understanding of particularly troublesome and seemingly intractable issues in their psychic makeup. Clinical material illustrates perverse dreams and their usefulness in the often arduous process of analyzing perverse defenses.

Countertransference↗
PubMed2002

Compassion fatigue: psychotherapists' chronic lack of self care.

Psychotherapists who work with the chronic illness tend to disregard their own self-care needs when focusing on the needs of clients. The article discusses the concept of compassion fatigue, a form of caregiver burnout among psychotherapists and contrasts it with simple burnout and countertransference. It includes a multi-factor model of compassion fatigue that emphasizes the costs of caring, empathy, and emotional investment in helping the suffering. The model suggests that psychotherapists that limiting compassion stress, dealing with traumatic memories, and more effectively managing case loads are effective ways of avoiding compassion fatigue. The model also suggests that, to limit compassion stress, psychotherapists with chronic illness need to development methods for both enhancing satisfaction and learning to separate from the work emotionally and physically in order to feel renewed. A case study illustrates how to help someone with compassion fatigue.

Burnout, Professional↗
PubMed2001

Connection: the double-edged gift of presence.

Questioning various implications of the conventional term countertransference, the author proffers the idea of client-inspired therapist contributions and gives several clinical examples.

Countertransference↗
PubMed1986

'Sick people' and 'trolls': a contribution to the understanding of the dynamics of physician explanatory models.

This paper describes and interprets a case in which the mutual influences of countertransference and physician explanatory model (EM) are identified, as are their roles in negotiating the clinical relationship and in clinical decision-making (assessment, diagnosis, treatment, expectations of outcome). The author argues that physicians' EMs do not derive exclusively from the official and professionally ideal biomedical model, but are shaped by situational, historical, and subjective influences. Patient-typing (e.g., the widespread distinction between "sick people" and "trolls"), together with its associated emotions (e.g., empathy and disdain, respectively), pervades medical education and practice, and often supersedes the biomedical model. Physicians' subjective responses to patients can affect biomedical diagnosis. Failed empathy can lead to missed diagnosis. Finally, the case study illustrates the validity and vitality of the ethnographic approach in clinical teaching and supervision, both in eliciting physicians' own complex EMs, and in facilitating the process of reinterpretation as well.

Attitude of Health Personnel↗
PubMed1989

The use of contracts in the inpatient treatment of the borderline personality disorder.

This paper reviews and describes the clinical, administrative, and psychodynamic aspects of the use of contracts. The particular focus is on how the characteristic difficulties which borderline personality disorder patients encounter on inpatient services are helped by contracting. The use of contracts facilitates the therapeutic alliance, and aids in the avoidance of excessive regression and acting out. The improved stabilization of the patient permits a more constructive use of transference and countertransference, and facilitates a clearer examination of Axis I diagnosis and the use of medication. The contracting process can be a useful addition to the inpatient treatment of borderline personality disorder patients.

Acting Out↗
PubMed1984

Aspects of teaching psychotherapy to medical students.

Much concern has centered on medical students' failure to choose psychiatry as a career. Little of this discussion focuses on the challenges of treating psychiatric patients. Although all students of psychotherapy face difficult training, the medical students' preparation is unique, especially in experiencing, tolerating, and using countertransference. Understanding and caring for psychiatric patients (whether pharmacologically, psychodynamically, or otherwise) involves exposure to extremes of emotion. A therapeutic response demands skills quite different from those culled by the medical admission process and the preclinical years. Appropriate handling of consequent problems is hampered when some of the psychotherapeutic aspects of clerk-patient relations go unrecognized and when supervisors avoid discussion of the student's reactions as an integral part of the work. Without specific attention to these areas, many students feel inadequate or frightened in the clerkship. With supervisory aid, such unwelcome situations can be converted to diagnostic and therapeutic tools of great value.

Clinical Clerkship↗
PubMed1994

The integration of behavioral principles and a psychodynamic viewpoint in the treatment of adolescents on an intermediate inpatient unit.

This paper describes an approach to setting up an inpatient intermediate-term unit integrating behavioral methods with a psychodynamic viewpoint to facilitate the treatment of severely disturbed adolescents. The need to provide a safe and structured environment for these youngsters is critical to the establisment of what Erikson has described as basic trust. The milieu needs to feel safe and predictable to provide a synergistic relationship with other modalities of treatment. This can usually be accomplished by utilizing behavioral principles within the milieu. Case examples are provided in which interventions on the unit can provide increased feelings of security which then translate into the patient being able to understand, express and work through feelings and decrease the probability of acting these feelings out. An important consideration is also given to intra and inter-staff dynamics and countertransference reactions which impede the exploration of feelings and encourage patients to act out the staff's forbidden unconscious impulses.

Acting Out↗
PubMed2006

What does the analyst want? Free association in relation to the analyst's activity, ambition, and technical innovation.

The author traces the history of free association, the "fundamental rule," through the Freud-Ferenczi relationship and controversy. The use of "activity," first proposed by Freud in 1910 with phobic and compulsive patients, was then championed by Ferenczi in the early twenties. The goal of activity was to enhance-or, more accurately, "to force"--the associations into the analysis. Subsequently, Ferenczi reversed himself, concluding that his analysis was re-creating the traumatic parental environment which originally caused the patient's neurosis. The far-reaching results of Ferenczi's change of heart included a redefinition of countertransference and added the techniques of "indulgence" and "relaxation" to soften Freud's emphasis on "abstinence" and "frustration. A vignette from the analysis of a dangerously self-destructive bulimic patient illustrates the value of free association in helping a patient feel understood by the analyst without pressure to give up her symptoms. Constantly monitoring his therapeutic ambition, the analyst demonstrates the value of free association in enhancing the patient's understanding of herself and of the survival value of her symptoms. This vignette highlights the fact that the analyst's therapeutic ambition makes freedom to associate even more difficult for the patient and inevitably intrudes on the analyst's evenly hovering attention. Of course for the analyst to have a therapeutic wish is necessary and desirable but for the analyst to demand change promotes compliance and hidden rebellion which limits the analysis.

Adult↗
PubMed2006

Reflections on Janet Zuckerman and Lisa Horelick's "the affective experience of the analyst in the extra-analytic moment".

A review and amplification of the article by authors Horelick and Zuckerman regarding the clinical phenomena of encountering patients (analysands) outside of the physical boundaries of the consultation room. Their clinical examples and the literature used to buttress their position and in particular the open disclosure of the deeply personal reactions they experienced are examined and used as launching points for further understanding. Ferenczi, Balint, Freud and other luminaries are incorporated into the topic of extra-analytic encounter, in an attempt to further demystify this inevitable and unplanned moment of disclosure, which, much like resistance and countertransference offer more opportunity than obstacle.

Affect↗
PubMedDate not supplied

The challenge of self-mutilation: a review.

The challenge of self-mutilation among humans arises from the imprecision of much of the existing literature, as well as the countertransference such disturbing behavior mobilizes. Self-mutilation is defined as an individual's intentionally damaging a part of his or her own body apparently without a conscious intent to die. The importance of understanding this behavior is reflected in the frequency with which it is encountered among psychiatric patients, particularly those diagnosed with borderline personality disorder or schizophrenia. The distinguishing characteristics of dermal, ocular, and genital self-mutilation illustrate the diverse clinical settings in which mutilation arises. Numerous explanations with differing degrees of complexity and merit have been offered; yet, no clear consensus has emerged. Psychotherapy, behavior therapy, and chemotherapy, while controversial, remain the most compelling treatment options. Salient areas for further study include epidemiology both for specific groups and the general population, possible biologic bases for the behavior, and additional management options.

Countertransference↗
PubMed1992

Individual psychodynamic psychotherapy with older adults: perspectives from a nurse psychotherapist.

This report reviews both historical and current literature pertaining to individual psychodynamic psychotherapy with older adults. Demographic projections for significant increases in the geriatric population are presented and linked with implications for mental health. Barriers to geriatric psychotherapy are examined, and themes common among older persons are identified. Benefits of psychotherapy to patients and psychotherapists are summarized. Literature on adult developmental theory is explored. Unique aspects of gender issues, transference, countertransference, and termination as described in the literature are presented. Implications for nursing practice include a recommendation for increased nursing efforts in the areas of practice, research, and theory building.

Aged↗
PubMed2001

The "A-B-C's" of the cluster B's: identifying, understanding, and treating cluster B personality disorders.

This article is a summary of some of the more recent research on the diagnosis, etiology, and treatment of Cluster B personality disorders (antisocial, histrionic, borderline, and narcissistic). Research on psychological, psychosocial, and biological perspectives of these disorders is presented. Individual psychotherapy, group psychotherapy, and other forms of multi-person therapies are also discussed. Finally, perspectives on issues of countertransference when treating these personality-disordered patients are addressed.

Countertransference↗
PubMed2005

The psychodynamics of borderline personality disorder: a view from developmental psychopathology.

This article provides a contemporary view of the psychodynamics of borderline personality disorder (BPD) from a developmental psychopathology perspective. We first briefly describe the evolution of the borderline construct in psychoanalysis and psychiatry. Then we provide clinically and empirically informed model of domains of personality function and dysfunction that provides a roadmap for thinking about personality pathology from a developmental psychopathology standpoint and examine the nature and phenomenology of BPD in terms of these domains of functioning. Next, we describe prominent dynamic theories of etiology of BPD and examine these in relation to the available research. Finally, we describe psychodynamic conceptions of treatment and the way BPD phenomena manifest in treatment, followed again by consideration of relevant research, particularly on transference-countertransference constellations empirically identified in the treatment of patients with BPD.

Adolescent↗
PubMed2003

Secondary traumatic stress effects of working with survivors of criminal victimization.

This paper focuses on the consequences for providers of working with survivors of traumatic events, particularly criminal victimization. The paper reviews the relevant research and treatment literature associated with secondary traumatic stress (STS) and related variables (burnout, compassion fatigue, vicarious trauma, and countertransference). The latter part of the paper identifies the most important mitigating factors in the development of STS. These include good training specific to trauma work, a personal history of trauma, and the interpersonal resources of the worker. Implications for treatment, prevention, and research are discussed.

Burnout, Professional↗
PubMed2004

[Interviewing the patient--an "impossible" task].

A patient with atypical facial pain (conversion symptom) is presented, who had to suffer for more than 10 years, because physicians were unable to conduct a biopsychosocial interview. The characteristics of hard and soft data are mentioned. The significance of empathy for the data collection is stressed. The relationship between empathy and countertransference feelings is briefly discussed.

Aged↗
PubMed1994

Ethnic-minority lesbians and gay men: mental health and treatment issues.

Clinical psychological research has been a part of a significant growth of scholarly literature in mental health that appropriately explores relevant cultural variables and their effects on both the mental health and treatment of ethnic minority group members. A similar expansion of material seeking to develop affirmative perspectives in the treatment of gay men and lesbians has also found its way into the psychological literature. Scarcely any research seeks to explore the particular psychological strengths and vulnerabilities of men and women who are members of both groups. This article reviews literature pertinent to the cultural proscriptions of several ethnic minority groups and their relevance to mental health issues and treatment of gay and lesbian members, as well as a review of potential countertransference dilemmas for therapists.

Countertransference↗
PubMed1994

Morality in group and family therapies: multiperson therapies and the 1992 ethics code.

Although virtually every psychotherapeutic approach or orientation has adapted group and family therapy to its conceptions of psychological dysfunctions and how to treat them, levels of training of practitioners in all of these approaches are often insufficient to meet the requirements of ethically as well as technically responsible conduct of treatment for persons in groups and families. The new ethics code (American Psychological Association [APA], 1992) does include a few issues specific to multiperson therapies, but other issues critical to the competent practice of group and family therapy remain unaddressed. The result can be confusing to those applying standards for individual therapy to multiperson therapies. It is argued that the classical ethical concerns of psychotherapists, informed consent, confidentiality, countertransference reactions, aand intrusions of therapist values, require special sensitivity to how they are expressed in mulitperson therapies. Practitioners of group and family therapies must be better sensitized to the technical distinctions and the associated ethical vulnerabilities of the modalities they use. Future planning for revision of the APA ethics code should take these factors into account.

Codes of Ethics↗