Basic Psychoanalytic Concepts: IV. Counter-Transference

Abstract

In previous papers in this series we have discussed two concepts which have been used in connection with aspects of the relationship between the patient and his doctor. These were the treatment alliance (Sandler, Holder and Dare, 1970) and transference (Sandler, Dare and Holder, 1970). Although these two clinical concepts originated within the psychoanalytic treatment situation they are capable of extension outside it. Both relate to and emphasize processes occurring within the patient and tend to stress one side of the relationship only. Even the concept of treatment alliance, although nominally appearing to include the roles of both patient and doctor, has tended to be regarded from the point of view of processes and attitudes in the patient; the aspect of the therapist's attitudes, feelings and professional stance have to a large extent been omitted. However, in recent years more attention has been paid in psychoanalytic and other writings to the relation of the doctor towards his patient. Just as the term ‘transference’ is often used loosely as a synonym for the totality of the patient's relation to his therapist, so is the term ‘counter-transference’ often used in a general sense (both within psychoanalysis and outside it) to describe the whole of the therapist's feelings and attitudes towards his patient, and even to describe facets of normal, non-therapeutic relationships (Kemper, 1966). Such a usage is very different from what was originally intended, and as a consequence confusion has arisen about the precise meaning of the term. It is the purpose of this paper to examine the concept in the light of its origins and development within psychoanalysis and to comment briefly on some possibilities of its extension outside the psychoanalytic treatment setting.