Concept Of Countertransference Research Articles

Therapeutic tool or a hindrance? A phenomenological investigation into the experiences of countertransference in the treatment of sexually abused children

ABSTRACT Since its inception in the 1900s, the concept of countertransference has been mired in controversy. Psychoanalytic literature is divided on its utility, significance and its clinical value in psychotherapy. While some psychotherapists have advocated for the importance of therapists’ expertise in the comprehension and processing of countertransference dynamics in the treatment of sexually abused children, others see no value in competency in countertransference in trauma treatment of sexually abused children. The purpose of this article is to explore whether countertransference is a useful therapeutic tool, or a hindrance in the treatment of sexually abused children. A qualitative paradigm, particularly interpretative phenomenology, was employed in this research to make meaning of the therapists’ experiences. The analysis of the results revealed the following five main themes that were supported by 18 superordinate themes. These themes reveal that therapists treating sexually abused children experience a myriad of feelings, including a) feeling emotionally overwhelmed, b) anger toward perpetrators and the need to protect and rescue their patients, c) the importance of social support and self-healing, d) feelings of empathy and identification with the client, and e) erotic countertransference. These findings reveal two contradictory findings. Firstly, they tell of variable utilisation of countertransference among participants and, secondly, they highlight a lack of application of countertransference in the treatment of sexually abused children. The implications of the current study are that there is a need to both highlight the importance of countertransference as a therapeutic tool and to incorporate it in the treatment of sexually abused children.

A critical analysis of the concept of transference in psychodynamic therapy

Transference is a central concept in psychodynamic theory and its role in the analytic work has provided fruitful discussion for later thinkers. In this paper, I discuss transference and holding the frame through the examination of case study material. Klein’s revisions to the concept of transference is considered alongside the enactment of defence mechanisms through the transference. However, the concept of countertransference has been less well examined: explanations here are also considered. I discuss the concept of transference as a possible interpretative model for the impact of domination or of unjust power structures on the individual’s subjectivity. In doing so, I critically review the development of transference in the literature and its usage in therapeutic practice.

Una investigación sobre la contratransferencia en psicoanálisis

La tesis de Maestría titulada “El concepto de contratransferencia en la obra de Freud y Lacan. Reflexiones sobre su lugar en la teoría y su valor clínico en psicoanálisis” surge del interés por interrogar la notable ausencia del término “contratransferencia” dentro del psicoanálisis orientado por la enseñanza de Lacan. Para ello, se historiza el surgimiento y desarrollo del concepto y se problematizan las lecturas establecidas respecto de la pertinencia del mismo para pensar la teoría y la clínica psicoanalíticas. Se realiza un rastreo del término en la obra de Freud y Lacan, analizando su estatuto y cuestionando las “lecturas consagradas” al respecto. A su vez, se abordan los desarrollos de los autores posfreudianos reconocidos como pioneros en la consideración de la contratransferencia como instrumento en la clínica, así como de los analistas con quienes Lacan polemizó al abordar la cuestión. A partir de esto, se sostiene una interrogación respecto de la validez de desterrar el concepto de la reflexión teórico- clínica del psicoanálisis, en beneficio de conceptos tales como “transferencia” y “deseo del analista”.

Countertransference and Psychoanalytic Technique

This paper examines the evolution of the concept of countertransference, with particular emphasis on its relationship to psychoanalytic technique. Freud’s original idea that countertransference means unconscious interference with an analyst’s ability to understand patients has been broadened during the past forty years: current usage often includes all of the emotional reactions of the analyst at work. Some factors that have contributed to this shift are the introduction of the structural hypothesis, the impact of Kleinian and interpersonal schools on the theory of technique, the effect of analysts’ experience in working with more severely ill patients, and the diffuse consequences of certain recent cultural and intellectual trends. The benefits as well as some potential disadvantages in this shift toward a more inclusive conceptualization are discussed.

Reflections, and relative examples, regarding countertransference, empathy, and observation

The intent of this article is to further explore and review the concept of countertransference, in its various, most commonly accepted meanings in the psychoanalytic literature. Major clinical and theoretical developments in this concept began in the 1950s, and have found centrality and coherence in Bion’s theory of containment. A basic issue in the discussion on countertransference is whether, and up to what point, analysts should allow themselves to be modified by the impact of their patients’ projections. Freud, Klein, Rosenfeld, and Bion all underline the importance of an impartial, balanced, and unstressed quality of the analyst’s receptivity with regard to the patient’s mental state, as well as the transformative complexity implicit in “trying to know.” In fact, the disturbance that is sparked in the analyst by his interaction with the patient is now considered unavoidable and has increasingly emerged as a specific topic of study. The author uses clinical illustrations from her work with children and adults, as well as observations from everyday life experiences, to exemplify the way countertransference interacts with the ability to observe empathetically, often hindering and distorting it, but also potentially enriching its depth and breadth.

Concept of Countertransference

Concept of Countertransference

Countertransference and therapeutic alliance in the early stage of adult psychodynamic psychotherapy

The primary objective of this study was to assess the relationship between countertransference (CT) and therapeutic alliance (TA) during the early stages of psychodynamic psychotherapy. A secondary objective is to assess associations between CT and variables related to therapist and patient and between CT and other patient variables investigated, which were defense mechanisms, symptomology and functionality. This was a cross-sectional study that enrolled 30 patients treated by 17 different therapists at the psychotherapy clinics of two psychiatry centers. Assessments of each patient-therapist pair were conducted between their fourth and 10th sessions. The CT distance domain exhibited a moderate negative correlation with TA, particularly its sub-dimension representing the patient's capacity for work in therapy. Moderate positive correlations were observed between CT distance and the splitting defense mechanism and between CT closeness and suppression defenses, in addition to moderate negative correlation between CT indifference and the fantasy defense mechanism. Another finding was higher scores for CT indifference in association with socioeconomic classes D and E. The quality of CT may provide a source of information about TA. A high degree of CT distance represents a low level of TA, particularly with relation to the patient's working capacity, although presence of the splitting defense mechanism can affect CT, to the extent that it constitutes a confounding variable. The concept of CT is useful to psychotherapists, providing a source of information about the patient's internal world and about certain elements of therapy, such as the quality of TA, which is important for good treatment results.

Countertransference as object of empirical research?

The concept of countertransference as a robust cornerstone of psychoanalytic work has gained momentum over the last five decades. It is a prime example of elastic concepts covering the range from microprocesses to global clinical phenomena. Empirical research on the treatment process has for a long time – and for good reasons – avoided even trying to measure countertransference. We report here on various efforts for approaching a methodology for measuring it. The paper organizes the various approaches in terms of stages of research.

Countertransference and changes in the conception of the psychoanalytic relationship

The concept of countertransference has a long history in psychoanalysis. This paper sketches the phenomenon referred to by countertransference and the development of the concept, from being signs of disturbance in the analyst to an important road to knowledge about the patient's inner life. The complexity of the questions discussed today – how to understand the concepts of neutrality, abstinence, and empathy; the relative subjective mutuality and symmetry of the analytic situation; the analyst's enactments and self-disclosure of feelings – reflects the complexity of the contemporary view of the patient–analyst relationship. In conclusion, the author presents a model illustrating the disturbing and informative aspects of countertransference together with the conceptual relationship between countertransference on the one hand and empathy and projective identification on the other. Finally, by differentiating between intuitive and irrational levels of functioning, an integrated model for countertransference is presented, synthesising the essence of the concept as it is used today.

The Interns Play: A Mimetic Approach to Introducing and Working with Countertransference in Professional Training

An approach is presented that introduces the concept of countertransference to predoctoral interns and externs in a unique way during their professional training. This approach goes beyond a didactic presentation of the concept and even beyond discussion of case material in supervision. Through an experiential role-play process called Mimesis, trainees are encouraged to enact scenes from literature that depict typical dilemmas that psychotherapists working in a psychodynamic framework must face. By using carefully chosen stories, supervisors can highlight aspects of the therapeutic process such as managing countertransference feelings. This approach fosters a more flexible and open inquiry into one of the most daunting aspects of professional development for both trainees and supervisors.

The Ordinary and the Extraordinary Countertransference

This is both a clinical and an epistemological inquiry into the concept of countertransference. A distinction is made between the ordinary countertransference, a transitory disruption residing within the analyst's consciousness, and the extraordinary countertransference, an impasse intolerable to the analyst to such an extent that it remains outside awareness. This distinction, rooted in the history of psychoanalytic thought, is here traced in a recorded psychoanalysis. The clinical material is examined from three perspectives, including empirical evaluation by computer-assisted monitoring of spoken language and two modes of psychoanalytic interpretive listening. Analytic sessions designated as ordinary were readily identified by quantitative measures. However, the threshold between the ordinary and the extraordinary countertransference was reached at the point where empirical observations broke down. Detailed psychoanalytic observation of the four sessions that lie beyond empirical validation led to a formulation of the analyst's state of consciousness during these pivotal hours.

On the edge: The psychoanalyst's transference

Countertransference is a central topic in analytic work and in the literature. The concept of countertransference includes a basic question which has been understood in different ways. The author attempts to differentiate between the psychoanalyst's transference and his countertransference in the analytic process. It is hard to draw a line between them; analysts are always on the edge. The analyst's transference will be explored and described using three approaches: narcissism, regression profile and the analyst's phase of life. Regression profile is a new concept developed by the author, which may help us to understand the core of the analyst's transference in the analytic situation. She illustrates the topic by clinical vignettes.

Compassion Fatigue and Secondary Traumatization: A Second Look

The recent special issue (September 2007) of ClinicalSocial Work Journal on ‘‘Compassion Fatigue’’ highlightsthe important topic of the social worker’s subjectiveresponse to the stressors that are inevitably encountered insocial work practice. Brian Bride, Charles Figley and theircolleagues have provided an important service to our pro-fession by highlighting these issues in a series of articles,books and research studies over the past 20 years. Whilesocial workers focus daily on caring for others, issues ofself-care are too often neglected. The constructs of‘‘compassion fatigue’’ and ‘‘secondary traumatization’’have played an important role in raising awareness of theseself-care issues throughout the social work profession: indirect practice, administration and academia.At the same time, our colleagues in the ‘‘compassionfatigue’’ realm have taken a largely ahistorical approach intheir scholarly pursuits, specifically neglecting a large bodyof literature on countertransference which greatly enhancesour appreciation of the self-care issues involved in socialwork practice. For example, in a recent NASW article,Brian Bride suggests that ‘‘secondary traumatization’’ isconceptualized as distinct from ‘‘pronounced counter-transference’’ (Stoesen 2007, p. 4). In this recent specialissue of CSWJ, countertransference is barely mentioned,although it is frequently discussed in this journal’s pages.Reviewing Figley’s extensive writings, it appears that heuses an outdated and limited definition of countertransfer-ence which suggest that the social worker’s past lifeexperiences trigger an emotional reaction to current workexperiences. According to Figley (2002), countertransfer-ence is ‘‘an emotional reaction to a client by the therapist—irrespective of empathy, the trauma, or suffering. It isdefined as the process of seeing oneself in the client, ofover identifying with the client, or of meeting needsthrough the client (Corey 1991). In contrast to compas/sionfatigue, countertransference is chronic attachment associ-ated with family of origin relationships and has much lessto do with empathy toward the client that causes trauma’’(pp. 1433–1434).Although Figley acknowledges that the concept ofcountertransference has emerged from ‘‘psychodynamictherapy,’’ his sole reference (to Corey’s book) is to thecounseling literature. In my limited review of Figley’swritings, I could not find a single reference to the volu-minous psychoanalytic or clinical social work literature oncountertransference.Figley’s differentiation of countertransference andcompassion fatigue is illustrated by a clinical vignette in anarticle written for psychotherapists (Figley 2002). Hereports on a client, Jane, a young graduate student incounseling psychology who ‘‘was not responding well to anassigned client’’ and was making ‘‘clinical errors’’ whichwere ‘‘associated more with how the client’s story wasupsetting her.’’ The client was a female college studentwho was having adjustment problems in separating fromher family. Jane’s supervisors noticed that ‘‘her client feltguilty about leaving her mother; that the client had beenover-functioning while the mother had developed a con-siderable dependency that needed addressing.’’ Jane oftenshifted the focus of therapy to other issues. In therapy,‘‘Jane wanted to talk about and face these clinical errors...and, reluctantly, her mother’s chronic illness. We quicklymoved to Jane’s feelings of guilt about her own mother’scondition...’’ (p. 1434).

Countertransference, Dialogue, and Gestalt Therapy

AbstractAn outgrowth of Freud's conception of transference, countertransference was originally viewed as a disruptive force in psychotherapy, one which interfered with the therapist's professional neutrality and objectivity. However, in Gestalt therapy theory and practice, the therapist's subjectivity is viewed as an inevitable and natural dimension of the therapeutic process. A conceptualization of countertransference that presupposes the subjective presence of the therapist to be an inherent obstacle to be overcome is incompatible with Gestalt theory and practice. Yet, we must acknowledge that, at times, some thoughts, feelings, and behavior growing out of the therapist's subjective experience do indeed have the potential to damage the therapeutic relationship and process. This article offers, as an alternative to traditional concepts of countertransference, one based on a dialogical approach to psychotherapy. Such an approach can serve as a useful model to assist the therapist in sustaining successful therapist-client dialogues within the framework of Gestalt therapy theory and practice.

Approaching countertransference in psychoanalytical supervision: A qualitative investigation

A recent examination of the literature concerning countertransference and its developments reveals its clinical usefulness in different psychoanalytical cultures. Nevertheless, a shortage of publications is apparent with respect to its approach in supervision. The authors aim in this study was to examine the concepts of transference and countertransference and how countertransference is approached in supervision, in the training of candidates, at an institute of psychoanalysis belonging to a society affiliated to the International Psychoanalytical Association (IPA). Qualitative research was carried out, interviewing supervisors and supervisees. Through analysis of the material acquired, the authors classifi ed the data into initial, intermediate and fi nal categories. The principal fi ndings were subdivided into three categories: the concepts of transference and countertransference, psychoanalytical listening and the complementarity of the phenomena, and the approach to countertransference. The concepts of transference and countertransference predominantly used by those interviewed are based on the totalistic outlook. Countertransference in supervision has been approached in a more direct and objective way when compared with the previous period, although great care is taken to delimit the boundaries between supervision and personal analysis. The main aim of supervision is to broaden comprehension and to deepen the interpretations directed towards the patient. These fi ndings suggest that the evolution of the concept of countertransference in different psychoanalytical cultures and developments in the analytical fi eld are contributing to this change.

Joseph Sandler's Contributions to The Concept of Countertransference

A few months before Joe Sandler's death, he participated in an American Psychoanalytic Association panel that focused on the Controversial Discussions that occurred in the British Psychoanalytic Society from 1941 to 1945. Our plan was to revisit the controversies in the context of British psychoanalysis some 50 years later. As we designed the panel, I suggested that we have one Kleinian panelist, one contemporary Freudian panelist, and a third panelist representing the Independents.

An Intersubjective Approach to Music Therapy: Identification and Processing of Musical Countertransference in a Music Psychotherapeutic Context

ABSTRACT: The role of music therapist is to be there for and with client in and outside music. This article describes how music therapist in musical interaction can be there for and with client at same time as he/she is there for him/herself. This is demonstrated through clinical examples that focus on defining, identification and effective work with musical countertransference as a tool of insight and assessment. The clinical settings include private practice, postgraduate training, internship training, and a short and long term rehabilitation facility. My hope is to reach graduate and postgraduate music therapy clinicians and educators. The educational basis for my work is a Master's degree in Music Therapy, a training in Analytical Music Therapy by lhe founder of AMT Mary Priestley, a Master's degree in Music Education, and 20 years of providing Analytical Music Therapy supervision. What is role of music therapist?'The answer is simple: Being there musically and, if needed, verbally for and with client. What could this mean? We will begin with a music example from work in private practice-a piece of music from end of second session with an adult client, Erik, a 29-year-old man, who was depressed, lonely and grieving. He is vocalizing and am accompanying him on piano. am being there for and with him? Make a judgment yourself. Scheiby excerpt #1, music therapist is playing improvised version of J. S. Bach: in B minor on piano. Client is crying during music. Before music asked Erik: How would you like to end session? He answered, I was thinking that perhaps you could play something for me-something lonely, Bach perhaps. chose to play J.S. Bach's Prelude in B Minor from The Well-Tempered Clavier. My initial reason for choosing that piece by Bach was my perception of its color of sadness that could possibly match client's feelings. Equally important was that it could perform a strong holding function that he needed at that point. Soon after music started Erik began crying and crying became more intense. He had been holding back his tears after first improvisation that we had played together in session. was surprised by intensity of his crying, and it affected me in a countertransferential way. As one can hear, there is a certain heaviness in way articulated tones. When played second part of piece and Erik cried again, this time more intensely, played in a faster tempo, as if wanted it to end quickly because intensity of his expression was too much for me. Erik was grieving because his father was dying. His father had left home due to a divorce and moved to another country when Erik was very young. As a result, he also tapped into his sadness about having had so little time with his father as a child. Moreover, he was depressed because his situation at that time was one of loneliness and isolation. He was also recovering from a liver dis ease that had left him feeling depleted. The concept of countertransference was originally identified by Freud (1910): Countertransference can be regarded as a result of client's influence on his {the analyst's} unconscious (p. 145). Analytical music therapist Mary Priestley (1975) defines countertransference as the therapist's identification with unconscious feelings, self-parts (instinctive self, rational self or conscience) or internal objects of client, which, being conscious in therapist, can serve him as a guide to client's hidden life (p. 240). In above example, my countertransference, that manifested itself in music by a heavy articulation and a sudden faster tempo, was elicited by my unconscious identification with client's strong emotional expression. My own father died when was three months old, and 1 had experienced feelings of loss and sadness that were related to missing strong masculine holding at an early age. …

Feelings in context: countertransference and the real world in feminist therapy.

The concept of countertransference has been seen as problematic by feminist therapists. However, feminist therapy theory is intensely interested in the symbolic levels of the relationships between therapists and clients, with an emphasis on how the here and now social context informs and transforms those symbols. This article describes a feminist perspective on the therapist's symbolic relationships to clients, and the positive and challenging ramifications of those symbolic encounters.

The lived experience of countertransference in psychiatric/mental health nurses

The purpose of this study was to evolve a structural description of nurses' experience of countertransference. The phenomenological method was chosen for the study. The sample consisted of 5 participants who met selection criteria. The participants gave audiotaped descriptions of their experiences in caring for patients for whom they experienced countertransference. The lived experience of countertransference emerged from the findings of this study as a process of the continuous growth of self-awareness. Initially, the experience entailed the struggle to abandon objectivity, emotional neutrality, and therapeutic omnipotence. It was the abandonment of these principles that enabled the nurse to begin to use the self's experienced emotions therapeutically in interactions with patients. For the participants, the feelings aroused in the self came to be understood as having meaning within the concept of countertransference and thus, came to be understood as normal responses to caregiving. It is the continuing ability of these nurses to transcend this normal, human response, and to use their growing self-awareness to provide an appropriate level of care to the patient, that is the hallmark of the lived experience.

Ferenczi's Contribution to the Concept of Countertransference

On the basis of a historical survey of Ferenczi's contributions to the concept of countertransference, the author highlights the most important theoretical shifts present in each of his contributions, from Freud's initial formulation in 1910 to the ?Clinical Diary?. Besides pointing to some key concepts and characteristics in Ferenczi's thinking, such as ?the control of the countertransference?, ?The transference-countertransference interaction?, ?the analyst's narcissism?, and in particular the view of countertransference as a useful therapeutic tool in itself rather than as an obstacle for the cure. The author discusses Ferenczi's significant influence on some later analysts, especially on Heimann, Winnicott, Racker and Searles who stood out precisely for, among other reasons, their contributions to the question of countertransference.