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PubMed2002

Countering countertransference: a forensic trainee's dilemma.

Forensic psychiatry involves an adaptation to a role that is very different from the psychiatrist's previous clinical experiences. To render an unbiased forensic opinion, psychiatrists have to rise above their countertransference feelings. This takes years of practice and experience. The following is an account of a forensic trainee who faced several countertransference problems as he evaluated a patient charged with attempted murder. The case report is interspersed with a review of the relevant literature.

Adult↗
PubMed1992

[Importance of countertransference in the initial psychoanalytic interview].

The author points out the responsibilities and difficulties an interviewer faces in the initial psychoanalytic interview and discusses different theoretical positions in dealing with countertransference. Apart from "free floating attention" and "free floating responsiveness" he emphasizes the important diagnostic and therapeutic factor of "free floating introspectiveness". Finally, with a clinical example, he demonstrates that countertransference should already be taking place at the beginning stage of an interview.

Countertransference↗
PubMed1992

Roles played by music as revealed during countertransference facilitated transference regression.

Clinical and experimental investigations have demonstrated that music may serve subtle and complex psychological functions, the sounds per se serving more primitive roles than the themes and lyrics. The present study offers data obtained during the psychoanalysis of a musically talented man who had suffered life-threatening croup and asthma until the age of 5 or 6. Regression that was achieved as the result of interpretations based on the analyst's countertransferential responses revealed that the analysand was unable to achieve psychological separation from his mother and that music served predominantly the function of retaining a life-supporting connexion with her. Presumably as the result of a complex elaboration of respiratory and auditory introjection, music came to symbolize the noise of air-flowing through tubes into the steam tents and blood coursing through the umbilical cord, conceptualized as connecting him with his mother and making them permanently interdependent. The early ego defect was overcome through a transference-countertransference interaction that is delineated in detail. Then, the less primitive meanings and psychological uses of musical themes and lyrics were elucidated, again in response to interpretations based on countertransference reactions.

Adult↗
PubMed1991

The influence of theory on the psychoanalyst's countertransference.

The emotional reaction in the analyst occurs in shared analytic work under the influence of the patient's transference phantasies and is the analyst's creation and contribution. The idea that the analyst has emotions introduced directly into the analyst by the patient such that the analyst contains somebody else's feelings is refuted. Examples have been offered to show how the analyst's working theory influences the countertransference. If the analyst is unaware of this, the analyst may mistakenly attribute negative countertransference to the patient's projection.

Conflict, Psychological↗
PubMed1990

[Transference and countertransference at a therapeutic community for young adult psychiatric patients].

Transference and countertransference especially occur in therapeutic communities. Different forms of transference are described here. Experiences and possibilities to deal with are discussed by the example of the work in a therapeutic community. Results of research are considered as well. Finally the course of treatment of an inhabitant with borderline disorders will be recorded with regard to transference and countertransference.

Adolescent↗
PubMed1975

The role of testicular conflicts in a countertransference reaction.

A case is presented in which a patient's presenting symptoms of impotence and a pervasive inhibition of productivity are dynamically related to a cryptorchild condition which was discovered and treated during childhood. The importance of the cryptorchid condition and its relationship to the patient's later psychopathology are examined. However, it is the therapist's reaction to the clinical material that is the paricular focus of his paper. The therapist obtained the history of cryptorchism in the fifth month of treatment, and then subsequently repressed this data. In addition, a persistent countertransference reaction developed that threatened to disrupt the treatment relationship. In reviewing the course of the therapy, it was possible to determine that the therapist's repression of the patient's cryptorchism and his subsequent countertransference response were directly related to his own repressed testicular conflicts. The implications regarding the existence of similar conflicts in other therapists are discussed.

Anxiety↗
PubMed1989

Countertransference dilemmas with borderline patients. The contribution of psychological testing.

Although originally regarded pejoratively, countertransference has come to be viewed as an indispensable clinical tool, especially in the treatment of borderline patients. These patients typically evoke powerful negative experiences in their therapists. Psychological testing can help treaters go beyond such limiting (if not disruptive) reactions to achieve a constructive use of countertransference with borderline patients.

Adult↗
PubMed1986

Kohut's case of Mr Z: overcoming countertransference in self psychology.

This paper has attempted to discover if the two analyses of Mr. Z by Kohut do in fact substantiate the clinical efficacy of his theoretical model. A brief overview was presented, as were critical assessments. The major point was developed, that a creative working-through of a complementary countertransference was largely responsible for the success of a second analysis after a first phase was seriously undercut by interfering material which rigidified the therapist's interpretation. It was concluded by noting how Kohut's need to overcome the countertransference played a vital role in catalyzing the evolution of his new theory.

Adult↗
PubMed1987

Disguised countertransference in institutions.

The manifest reason for the hospitalization of psychiatric patients is that someone decides that they are in danger of suicide or homicide, or that they are unable sufficiently to care for or manage themselves. From another perspective, however, hospitalization can be understood as a consequence of limitations on the part of the family, the community, or the therapist in managing the affects generated in relation to these patients' behavior and communications. In other words, it is possible that patients may be hospitalized primarily because people in their lives (and often they themselves) cannot stand their own reactions to them and to their behavior. A less readily recognizable aspect of the institution, then, may be its use as a place to lock away unacknowledged, or at best uninterpreted problems of unbearable human responses to patients' psychopathology. In therapeutic relationships, where these issues are condensed, such responses are termed countertransference. The connections between individual relationships and institutional behavior are complex and inevitably contentious. In this paper, we suggest that a study of these connections may reveal disguised elements and illuminate some of the parameters of the complex phenomenon of countertransference.

Countertransference↗
PubMed1985

Countertransference as compromise formation.

Countertransference is a ubiquitous phenomenon, a set of compromise formations comprising the analyst's transference to the patient(s). Some consequences of this fact are discussed, including the factors responsible for those instances when countertransference impedes analysis.

Countertransference↗
PubMed1985

Countertransference and the myth of the perfectly analyzed analyst.

Countertransference is an inevitable feature of every psychoanalysis. Psychoanalysts are (and need to be) only human; psychoanalytic work is arduous and replete with stresses, strains, and deprivations; analysands tend to probe for vulnerabilities in their analysts that can be exploited in the interest of acting out neurotic wishes instead of analyzing them; and a training analysis cannot completely immunize a psychoanalyst against countertransferential reactions that impede analytic progress. Psychoanalysts must be vigilant to the emergence of countertransference reactions so that they can analyze and overcome them. Two illustrative clinical examples are provided.

Adult↗
PubMed1985

Adolescent sexuality in a therapeutic community: staff countertransference issues.

Issues connected with sexuality such as heterosexual relationships, homosexuality, sexual identity, and seductiveness, create conflict and countertransference dilemmas for staff who work with psychiatric patients in a therapeutic community. When the therapeutic community is composed of adolescents, these issues are exacerbated since sexual identity and sexual development are major concerns. The staff reacts strongly to the issue of self-determination and violation/infringement on a basic human need. These philosophical differences have their roots in countertransference feelings. Staff sometimes find it difficult to confront adolescents on emotionally charged issues that have a sexual coloring. A system is proposed for articulating and working through these feelings. A unique solution is posited for solving this conflictual attitude (based on object relations theory), whereby the residential treatment center serves as the analog of the home in order to allow adolescents to develop a sense of self before they can move on to the halfway house where heterosexual behavior is allowed (as part of the therapeutic process). This facilitates the meeting of the "self" with the "other." This procedure is explored in light of Sullivan's concept of intimacy.

Adolescent↗
PubMed1979

Remarks on transference-countertransference in psychotic states.

Clinical material of patients in psychotic states indicates that in those states the transference is directed into the therapist's body. The emotional experience thus created in the therapist, which is usually called countertransference in its broad meaning, should rather be seen as very early forms of object relationships. The complexities of the above easily influence the analyst in her role of interpreter. Therefore in the actual work with these patients the verbal interpretation, which represents an elaboration of the transference, in the author's view should be seen as countertransference.

Adult↗
PubMedDate not supplied

Countertransference difficulties in a time-limited psychotherapy.

A dramatic episode of patient-therapist interaction near the conclusion of a brief, time-limited psychotherapy is described with the help of a verbatim transcript. Our understanding of these events is based primarily on an awareness of the therapist's countertransference. The traumatic nature of the event that brought the patient to therapy, his narcissistic and borderline character structure, the therapist's own personal vulnerabilities to feelings of loss and guilt, and the additional difficulty for both therapist and patient of a brief, time-limited psychotherapy were factors contributing to the development of these countertransference disturbances.

Adult↗
PubMed1995

Integrating feminist and psychodynamic principles in the treatment of an eating disorder patient: implications for using countertransference responses.

Patients who struggle with a tenacious eating disorder commonly stir strong countertransference feelings in therapists. The author describes a patient who for a number of years had been unresponsive to traditional treatment interventions for anorexia nervosa and bulimic tendencies. By combining principles derived from psychodynamic treatment and contemporary feminist thought, the therapist was gradually able to help the patient engage in the treatment process. Managing a variety of strong countertransference feelings was instrumental to the process. The author underscores the need for patients to take greater personal responsibility, develop self-critical and self-analytical capacities, learn to embrace contradictions in the self, and disavow the tendency to harbor fantasies of utopia, perfection, and "cure."

Adult↗
PubMed1994

[Countertransference problems with suicidal patients in inpatient psychiatric treatment].

Transference is an effective protection against suicidal impulses of psychiatric patients. However, suicidal patient's highly ambivalent attempts at establishing a relationship with the therapist lead to significant transference and countertransference problems. During the course of therapy the therapist often is used as a selfobject, an experience that alters the narcissistic equilibrium. Suicidal patients create a selfobject transference by means of attacks on the therapist similar to those they themselves had experienced in their childhoods. The hidden attacks are very troublesome to the therapist's own feeling of selfworth and his state of self may be changed in the sense of a selfobject countertransference.

Adult↗
PubMed1993

Referral patterns of dentists: transference-countertransference.

The doctor-patient, doctor-doctor dental relationships are discussed from the viewpoint of transference-countertransference psychodynamics. The dental referral process is a triad of patient, general practitioner and specialist and, in many ways, is dependent upon Freud's concept of transference-countertransference. The unconscious distortions of this process may affect the patient's treatment as well as the interpersonal and intraprofessional relationships.

Countertransference↗
PubMed1993

Transference-countertransference implications in Freud's patient's recall of Weber's der Freischütz.

Based on findings in my previous work, biographical data have been linked with material presented by Freud on the interpretation of songs. His patient's parapraxis of her evocation of Agathe's aria in Act II of Weber's Der Freischütz was interpreted and discussed as reflecting the here-and-now in the session, expanding the classical interpretation of transference-countertransference data. The material suggested that both members of the therapeutic dyad were experiencing positive transference-countertransference states and that treatment was on the verge of an impasse at that moment.

Adult↗