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PubMed1978

Staff countertransference to borderline patients on an inpatient unit.

Borderline patients evoke unique countertransference responses among members of the treatment team: pejorative behavior, undue optimism, and pessimistic nihilism to these patients, along with difficulties in limit-setting, and fragmentation of the treatment team are common. Frequent meetings and open communication within the treatment team are recommended in order to minimize the splitting that is central to these countertransference constellations.

Acting Out↗
PubMed1988

Countertransference and the obese patient.

Psychotherapy with obese patients requires management of the therapist's feelings about obesity. These feelings are multiply determined. Fostering an awareness of one's attitudes towards obesity, reviewing countertransference as a source of information about the patient, and using countertransference to formulate interventions may improve the therapeutic outcome with the obese patient.

Attitude of Health Personnel↗
PubMed1993

Basic principles of psychotherapy. II. The patient model, interventions, and countertransference.

This paper (Part II) discusses the details of techniques used in achieving the goals of creating an individualized patient model, making effective interventions and monitoring countertransference. Models of patients' functioning can be created by using selection strategies regarding patients' characteristics and drawing on general models to explain these phenomena. Interventions are based on this model and should increase patients' understanding but are selected on the basis of goals and the individual's current state. Countertransference is a universal phenomena that can be managed in a variety of professional ways.

Adaptation, Psychological↗
PubMed1994

Indirect communication as a therapeutic technique: a novel use of countertransference.

This paper presents a technique to deal with therapeutic impasse in the treatment of resistant or very troubled patients. The novel feature of this technique is the indirectness with which therapists communicate with their patients. Therapists think aloud while not looking at their patients; patients "overhear" rather than hear. In their soliloquies, therapists make use of their countertransference for therapeutic purposes. Direct communication in such situations is often impossible or counterproductive and continued silence may not be in the patient's best interest. This paper provides the background for these ideas, describes the productive use of this technique in three clinical situations, and provides a theoretical rationale for them. The conceptual frameworks draws from Winnicott's ideas of the True and False Self, play as it relates to therapy, and the regulating functions of a positive holding environment for disequilibrating countertransference. Several factors contribute to therapists' concerns about employing this technique: the need to appear sane, fears of relinquishing eye contact, and apprehension over exploring the projective field. Instances when the use of indirect communication is not indicated, ill-advised, or contraindicated are discussed.

Acting Out↗
PubMed1994

Transference-countertransference issues with adolescents: personal reflections.

The concept of transference-countertransference is an important theoretical construct and critical for therapists to understand and utilize when working psychotherapeutically with adolescents. Freud introduced the concept, hypothesizing that the patient "transferred onto the analyst feelings and thoughts resulting from a reactivation of previous psychological experiences, usually a recapitulation of early unconscious libidinal impulses." Jung included sociocultural aspects by stating that "by virtues of the collective content and symbols, transference transcends the individual's personality and extends into the social sphere." Fromm-Reichmann viewed transference as "transferring onto the therapist as a present-day partner, early experiences of interpersonal relatedness," and Sullivan believed that in any therapeutic interaction "two ... persons come to deal with the issues of one." It is my position that transference-countertransference is a phenomenon that exists in every encounter with a child and adolescent patient and includes the full spectrum of emotions and reactions--eager anticipation, dreaded waiting, envy, joy, anger, love, and hate. Working with and through this phenomenon creates a corrective emotional experience for the patient and the opportunity for him or her to mature in a more normative healthy fashion.

Adolescent↗
PubMed1998

Countertransference and life-and-death issues in group psychotherapy with child Holocaust survivors.

People, now in their fifties and sixties, who were children during the Nazi Holocaust in WWII, endured persecution, massive traumatization, the constant risk of being killed, as well as the violent loss of (most of) their family members. They have internalized the resulting ongoing confusion and conflicts as to whether they should be alive or dead. This is maintained as an integral part of the child component of their compound personality, described in this paper. During the three years of the psychotherapy group, on which we focused here, these issues were expressed in different ways, such as suicide threats, occasional intolerance to physically remaining in the group, and outbursts of annihilating rage at the therapists. The confusion and conflicts about the legitimacy and risks of their survival came to a head during the termination process we insisted upon. Much attention has also been given to the intricacies of our countertransference--further complicated by our own connection to the Holocaust. We learned, and described, just how essential it is to acknowledge and process this countertransference in order to both contain the intense affects of anxiety, rage, and mourning in the groups, and enable them to be safely expressed. We imagine similar dynamics can be expected in group therapy with other populations who suffered massive, man-made traumatization.

Adaptation, Psychological↗
PubMed2002

Complementary dreams: a window to the subconscious processes of countertransference and subjectivity.

The British psychoanalysts were the first to be interested in reciprocal and interpersonal interactions of psychotherapy. The Freudian mirror model was progressively questioned in the 1940s and 1950s. Throughout the 1950s, positions and terms were created that either defended or attacked the use of subjectivity and countertransference in psychodynamic psychotherapy. The objective of this article is to discuss the participation of the therapist's subconscious mind, as it is involved in communication with the patient's subconscious mind during psychodynamic treatment. Specifically, this takes the form of complementary dreams, a clinical phenomenon that I will describe as secondary to the therapist identification with the patient infantile object relations. Complementary dreams will be discussed as a helpful therapeutic tool used to understand the subjective communication that happened between patient and therapist in two separate cases. Complementary dreams will be presented as a helpful therapeutic instrument in containing countertransference enactment.

Adult↗
PubMed2000

Passion, countertransference enactment, and breakdown in the psychoanalysis of a young woman.

Transference-countertransference involvement with patients the analyst finds "pleasurable" is examined. Analysis of such patients courts the danger that pathological identifications will go unrecognized and the analysis end at a point where the opportunity for decisive change, which to the patient appears physically and psychically catastrophic, is forgone. A presentation of one aspect of the analysis of a young woman reveals the psychic pain experienced by analysand and analyst when the feared breakdown places a pathological identification in doubt, and the difficulties that can ensue in treatment. Other psychodynamic lines of interpretation and differential diagnostic considerations are put aside in favor of an examination of the special role of enactment and countertransference enactment and their impact in promoting development or strengthening defense.

Adult↗
PubMed1987

Countertransference during an analyst's brief illness.

This paper describes an example of acting out of countertransference during a brief but unexpected serious illness. My emphasis is on the regression that occurred with hospitalization and how it dovetailed with a particular patient's transference. A confluence of my residual neurosis, the patient's neurosis, her transference state, her other characteristics (that she was female, for example), plus the fact that she was the last patient contacted, all conspired with the regression from the trauma of being hospitalized to produce the countertransference reaction. This presentation is also intended to add to the very sparse literature on a distasteful subject of supreme importance.

Countertransference↗
PubMedDate not supplied

Awareness of ageism, motivation, and countertransference in the care of elders with Alzheimer's disease.

This article focuses on the importance of a practitioner's awareness of ageism, motivation, and countertransference in working with elders with dementia. These factors have the capacity to significantly affect a professional's performance. Additionally, they may also affect the type and quality of services a memory-impaired client receives. Ageism is discussed at the micro, mezzo, and macro level, and practitioners are urged to develop an increased awareness of the effects of ageism on client/service options and as well as practitioner's beliefs. Monitoring professional motivation and being aware of countertransference are important considerations in practitioner-client relationships. Professionals are encouraged to incorporate personal introspection and consultation or supervision to ensure that clients receive the most appropriate service available. Case examples are provided to illustrate concepts.

Aged↗
PubMed1996

"Things were different then": countertransference issues for younger female therapists working with older female clients.

Older, pre-feminist women have different expectations about marital fulfillment and their role in society than younger women who have grown up with feminist ideals. These differences can emerge within the clinical encounter between a younger female therapist working with an older female client, especially as the latter reviews her life and marital history. This paper discusses the countertransference reactions cross-generational disparities engender in the younger female clinician. The author posits that these need to be examined and addressed in order to build a therapeutic alliance and temper empathic failure on the part of the therapist. The literature on countertransference reactions with the elderly and the role of the life review process is reviewed. The impact of the women's movement and implications for clinical practice are discussed.

Adult↗
PubMed2001

On misreading and misleading patients. Some reflections on communications, miscommunications and countertransference enactments.

This author focuses on an aspect of transference-countertransference interaction that enacted covertly is often overlooked. He argues that conflicts, needs and biases that may go undetected for lengthy periods of time are not infrequently contained within the analyst's accurate and technically correct interventions and that for defensive reasons, patients often suppress, deny or rationalise their accurate perceptions of these countertransference elements and fail to confront their analysts with them. The mistakes, miscommunications and misperceptions that arise as a consequence of the unconscious collusions that develop between patient and analyst can have a profound effect on the analytic work. Several clinical examples are presented to illustrate the operation of such covert communications in analysis and their impact on the treatment process.

Communication Barriers↗
PubMed2003

Countertransference and the female triangular situation.

This paper represents an attempt toward reconciling contemporary changes in psychoanalytic understandings of female development, particularly in respect to separation issues, with their clinical applications to female patients. Psychoanalytic thinking typically has categorized separation conflicts as pre-oedipal, but the authors suggest that these are an integral part of the triangular situation of the girl. The authors argue that an allegiance to erroneous theory and/or individual blind spots have led to the infantilization, pre-oedipalization or cultural stereotyping of females, which constrains the effectiveness of their analyses. The authors present a selected review of the literature on gender-based countertransference biases in both male and female analysts, with reference to female 'oedipal' material. Analytic case material of two women is presented which demonstrates how theoretical misperceptions and countertransferences to triangular separation conflicts can produce an impediment to progression in analysis.

Adolescent↗
PubMed2003

Psychoanalytic peregrination VI: "the effect on countertransference of the collapse of civilization".

There is an aspect to countertransference that has not been discussed very much in the literature of psychoanalysis, one that is becoming increasingly important. This centers around the effect on the analyst's countertransference of the deterioration of the culture in which he or she is immersed. I discuss the decline of Western civilization as it is described by a number of contemporary authors in order to show how changes in the value system of the psychoanalyst or his or her turning a blind eye to the injustices and barbarism of the cultural surround both affect the capacity to immerse in the creative process of psychoanalysis, and send a tacit message to the patient about the permissability of hiding certain material. All this contradicts the "fundamental rule" of psychoanalysis, and disturbs the analyst's listening process. The impact of the dumbing down and deterioration of the educational, cultural, and home upbringing milieu of the new generation of psychoanalysts will be profound in influencing the future practice of psychoanalysis.

Civilization↗
PubMed1999

Countertransference problems in the treatment of a mixed group of war veterans and female partners of war veterans.

AIM: Analysis of countertransference problems in the treatment of a heterogeneous group of war veterans. METHOD: The method used in this work was psychodynamic clinical observation and analysis of countertransference phenomena in group therapy. RESULTS: In the beginning of our work, we faced with a regressive group, which was behaving as it was re-born. The leading subject in the group was aggression and the need for hospitalization to protect them and their environment from their violence. With the development of group processes, a feeling of helplessness and lack of perspective appeared, together with suicidal ideas, which, because of the development of group cohesion and trust, could be openly discussed. With time, the group became a transitional object for its members, an object that gave them a feeling of safety but also a feeling of dependence. CONCLUSION: The role of the therapist is to support group members in becoming independent. The therapist's function is in controlling, containing, and analyzing of the destructive, regressive part and in encouraging the healthy parts of the patient. With the integration of good therapeutic process, the healthy parts of the patient gain control over his or her regressive parts.

Countertransference↗
PubMed2000

From countertransference to "passion".

Bion's ideas may be extended to describe an emotional phenomenology of the analyst's subjectivity and a methodology which helps differentiate countertransference enactments from fuller emotional participation. Bion called the process of integrating and utilizing one's most basic and important emotions to make meaning, "passion." The analyst's primal feelings--of love, hate, and curiosity--serve as a central organizer of meaning in the analytic interaction. These feelings involve pain, and to the extent the analyst unconsciously decides to evade or foreclose the evolution of the feelings, such that they remain unintegrated in the thinking process, the analyst is liable to become mired in repetitive transference-countertransference experiences without establishing fresh meaning. A case example illustrates the relevance of "passion" to contemporary relational theory and practice.

Adult↗