Positive Transference Research Articles

What Should Health Professions Students Know About Countertransference in Inpatient Psychiatric Environments?

Inpatient psychiatric units are heavily regulated physical environments designed around the twin aims of treatment and containment. Less formally regulated but no less important are emotional norms and tones that also contribute significantly to psychiatric care environments. Inpatient psychiatric units are co-created by patients and clinicians, but clinicians have authority that patients do not. This means that clinicians' management of their own transference and reactions is clinically and ethically important. This article defines transference reactions and draws on case examples to canvass how positive and negative transference reactions can influence inpatient care of patients who are suicidal.

Transference and client attachment to therapist in psychodynamic psychotherapy.

Although there are theorized connections between client transference and their attachment to their therapists (Bowlby, 1969/1982), limited empirical research exists examining their association over the course of psychotherapy. We thus examined the association between positive and negative transference and client attachment to therapist across the course of open-ended psychodynamic psychotherapy for 49 cases with doctoral student therapists and adult community clients who had at least 32 sessions. Using a Bayesian multilevel structural equation model framework, results indicated that client secure attachment increased and avoidant-fearful attachment decreased across the course of psychotherapy. For clients with higher preoccupied-merger attachment at the beginning of therapy, therapists perceived more fluctuation in negative transference over time than for clients with other attachment styles. Implications for research, practice, and therapist training are offered. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Skill transference and learning curves in novice learners: a randomized comparison of robotic and laparoscopic platforms.

While well-established protocols direct laparoscopic training, there remains arelative paucity of guidelines for robotic education. Furthermore, it is unknown how exposure to one platform influences trainees' proficiency in the other. This study aimed to compare and quantify (1) learning curves and (2) transference of skill between the two modalities in novice learners. Thirty pre-clinical medical students were randomized into two groups. One group performed the peg-transfer task using the robot first, followed by laparoscopy, while the other group performed the same task laparoscopically first. Participants completed five repetitions with each methodology. Participants were timed and errors were recorded. We hypothesized that laparoscopic experience with the peg-transfer task would assist in completing the task robotically, and there would be a higher degree of skill transference from the laparoscopic to robotic platform. Peg-transfer task completion was consistently faster and more accurate with the robot compared to laparoscopy (p < 0.01). We observed a positive transference of skill from the laparoscopic to robotic platform. However, exposure to the robot-hindered students' ability to perform the task laparoscopically, evidenced by significantly increased time and errors when compared with baseline laparoscopic performance (p < 0.01). These findings encourage surgical residency programs to treat robotic and laparoscopic training as discrete entities and consider their unique learning curves and skill transference when designing an efficient curriculum. While these effects are observed in novices, future directions include uncovering the trends among resident trainees and practicing surgeons.

The Therapist’s Struggle to Hold Hope When All Seems Lost

ABSTRACT In our paper we discuss the therapeutic dilemma that arises when relational patterns and attachment bonding are based exclusively on positive transference. When the harmful absence of negative transference is overlooked, rage and aggression become sequestered in the unconscious field. It is also well understood in the broader psychoanalytic community that conflict and aggression, when experienced, acknowledged, and processed inside a safe therapeutic relationship, is a powerful antidote to helplessness and hopelessness. We also suggest that an overemphasis on the impact of trauma may run the risk of making it the “essence” of the therapy, unconsciously encouraging clients to feel nailed to their wounds, as if they have completely lost their capacity for self-agency. This is the story of Claire, a young woman with severe and chronic relational trauma with whom Adriano worked for six years. When both Adriano and Claire suffered a loss of faith and the therapy became stymied by its limitations in providing an answer to this dilemma, Adriano called upon the philosophy of Hegel, whose valuing of the restorative power of “tarrying” with despair gave him support and comfort as he struggled with his own helplessness and fear in the face of Claire’s abject darkness. As a footnote, we are happy to report that at the time of this paper’s publication, Claire is now a practising psychologist and has been married to her husband for three years.

Psychoanalytic perspective on the clinical case of a boy with attention deficit hyperactivity disorder (ADHD) and suspected Fragile X

The objective of this paper is to describe and analyze, from the psychoanalytic theory point of view, the clinical history of Jonas, nine years old, who came to the psychotherapeutic service with complaints of learning difficulties, hyperactivity and attention deficit disorder (ADHD). Jonas is Mara and Mauricio's son, he is in the fourth grade of elementary school, lives with his mother, a kindergarten teacher. His father is a drug user. Jonas was diagnosed more than two years ago as having ADHD, has low school performance, and uses methylphenidate 20mg. His pediatrician suspects fragile X syndrome and referred him for specific tests. The psychotherapeutic follow-up was done through play in the psychoanalytic clinic, because through this technique it is possible to express fantasies, desires, and experiences symbolically. During the sessions, we noticed Jonas' interest in participating in the games and in the dialogues, and he showed affection for the psychotherapist. These data suggest positive transference. Jonas arranged his toys to play with, suggesting an attempt at internal organization.

Ego States and Projective Identification: A Six-Stage Relational Methodology

This article presents a two-part framework to support relational transactional analysis practitioners in understanding and working through projective identification in clinical practice. It begins with a brief description of projective identification as communication and emotional regulation, including how it may be understood as part of a two-person psychology. The models presented are supported by diagrams illustrating intrapsychic and interpersonal dynamics as well as by clinical vignettes. The framework is applied to examples of negative and positive transference.

Patient personality dimensions, relational patterns and therapeutic alliance in clinical practice: An empirical investigation.

Transference (meant in this context, as the patient relational patterns expressed towards the clinician) and therapeutic alliance play a crucial role in the treatment of personality pathology. To date, no empirical study examined the association between these two dimensions of the clinical relationship and patients' personality maladaptive traits in psychotherapy. A national sample of therapists (N = 100) of different theoretical orientations assessed dysfunctional personality features of a patient in their care using a comprehensive and empirically grounded dimensional diagnostic approach from the Shedler-Westen Assessment Procedure-200 (SWAP-200). Moreover, they filled in the Psychotherapy Relationship Questionnaire (PRQ) to identify interpersonal patterns expressed early in treatment by the patients and the Working Alliance Inventory (WAI-T) to evaluate quality of therapeutic alliance. Overall, the most severe and maladaptive dimensions of patients' personality were associated with more negative clinician-patient dynamics and poorer levels of therapeutic alliance in statistically significant and clinically relevant ways. Notably, the hostile transference was predicted by both SWAP Hostility and Psychopathy, whereas the SWAP Narcissism was the strongest predictor of the special/entitled transference. The latter was also predicted by SWAP Emotional Dysregulation; conversely, the SWAP Dysphoria was the most robust predictor of anxious/preoccupied pattern. The SWAP Schizoid Orientation and Psychopathy predicted avoidant/dismissing attachment pattern; moreover, they were strongly and negatively related to the SWAP Psychological Health that was the best predictor of positive transference and alliance. Findings support that therapists' careful understanding of patients' interpersonal ways during early treatment stages may meaningfully inform diagnostic and therapeutic processes.

Learning graphic symbols in two languages: Effects of monolingual teaching

Purpose Limited research exists to guide augmentative and alternative communication (AAC) intervention for children from multilingual backgrounds. When a graphic symbol-based AAC system is provided to children, they need to learn the meaning of the graphic symbols. This study determined the effect of teaching the association between a graphic symbol and a spoken word in one language on the ability of bilingual children without disabilities to transfer this learning to their second language. Method A one-group pre-test-post-test design was used. The ability of 30 English-Afrikaans bilingual children aged 4–5 years to provide the spoken words associated with nine graphic symbols in English and Afrikaans was evaluated before and after teaching them the symbol-word associations in English. Result Correct symbol-word associations in English increased from a median of 0–9 post-teaching, while correct symbol-word associations in Afrikaans increased from a median of 0–6. A moderate positive relationship was identified between children’s performance on symbol-word associations in Afrikaans during the post-test and their use of Afrikaans in the home. Conclusion Results suggest the presence of positive transference of graphic symbol-word associations learnt in one language to another known language. The implications of this finding on the provision of multilingual AAC intervention are discussed.

Understanding avoidant attachment in a patient with terminal cancer: a psychoanalytic perspective

Describing the course of a short-term supportive-expressive psychotherapy of a male patient with terminal cancer, this study aimed to illustrate the clinical presentation of avoidant attachment behavior and to identify potential challenges in treating these patients from a psychoanalytic perspective. We analyzed eight therapy sessions, recorded and transcribed as part of a randomized controlled trial, following the explication technique of qualitative content analysis. We analyzed a patient with high attachment avoidance as assessed by the Experiences in Close Relationships Scale measuring adult attachment. We found that ‘attachment avoidance’ subsumed different defense mechanisms, which helped the patient to reduce his fear associated with (1) feelings of dependency: denial, (2) overwhelming distress: isolation of affect, displacement, (3) feelings of guilt and shame: repression, (4) regulating his interpersonal relationships: projective identification. Adding psychoanalytic interpretations to the existing material helped to identify rigid defense mechanisms interfering with sharing his fears about death and dying. Still, the low intensity setting offered him a reliable and tolerable therapeutic relationship. Contributing to the understanding of the specific challenges in treating avoidant patients, our findings underline the importance and feasibility of establishing a holding environment and fostering a positive transference relationship to engage in a joint mourning process.

Maternal Erotic Transferences and the Work of the Abject.

Kristeva's profound and comprehensive understanding of maternal eroticism allows us to examine the ways in which a negative maternal transference, structured through the work of the abject, can be viewed as a maternal erotic transference in its devitalizing form. Through the use of a clinical case, the revitalizing experiences of maternal eroticism within analytic process facilitate the emergence of a maternal erotic transference in its vitalizing form. The lack of erotic dimensions in maternal transferences, it is argued, may be viewed as present absences, and the development of a positive maternal erotic transference as an achievement. André Green's visual-spatial metaphor of foreclosed space is extended as an imploding force wherein abject signifiers do their devitalizing work. In contrast, the usable space of a healthy psychoanalytic process is viewed as the envelope around which abject signifiers emerge, becoming available for psychoanalytic work. A transformation related to the author's experiences with her dying mother is shown to have expanded her containing capacities, including new areas of patience and receptivity. These dynamics are placed within the context of a multiverse conception of maternal eroticism, including the analyst's disciplined receptivity, viewed as an eternal signifier of the maternal.

Salt-in-Ionic-Liquid Electrolytes: Ion Network Formation and Negative Effective Charges of Alkali Metal Cations.

Salt-in-ionic liquid electrolytes have attracted significant attention as potential electrolytes for next generation batteries largely due to their safety enhancements over typical organic electrolytes. However, recent experimental and computational studies have shown that under certain conditions alkali cations can migrate in electric fields as if they carried a net negative effective charge. In particular, alkali cations were observed to have negative transference numbers at small mole fractions of alkali-metal salt that revert to the expected net positive transference numbers at large mole fractions. Simulations have provided some insights into these observations, where the formation of asymmetric ionic clusters, as well as a percolating ion network, could largely explain the anomalous transport of alkali cations. However, a thermodynamic theory that captures such phenomena has not been developed, as ionic associations were typically treated via the formation of ion pairs. The theory presented herein, based on the classical polymer theories, describes thermoreversible associations between alkali cations and anions, where the formation of large, asymmetric ionic clusters and a percolating ionic network are a natural result of the theory. Furthermore, we present several general methods to calculate the effective charge of alkali cations in ionic liquids. We note that the negative effective charge is a robust prediction with respect to the parameters of the theory and that the formation of a percolating ionic network leads to the restoration of net positive charges of the cations at large mole fractions of alkali metal salt. Overall, we find excellent qualitative agreement between our theory and molecular simulations in terms of ionic cluster statistics and the effective charges of the alkali cations.

Frequency and importance of interpersonal communication about a school-based intervention with parents, peers, and teachers: application of social interface model

ABSTRACT Social interface model (SIM) explicates the important roles of family, peer, and school microsystems in intervention research. The present study used surveys to explore how Nicaraguan adolescents who participated in a school-based substance use and violence prevention intervention communicated about the intervention with parents, peers, and teachers. Latent class analysis was run to identify distinctive typologies of interfaces characterized by occurrence and importance of conversations. Five latent classes (N = 109) were discovered: optimal transference (21%), neutral transference (17%), limited positive transference (17%), negligible neutral interface (28%), and negligible adverse interface (16%). The optimal transference and neutral transference groups reported having conversations with all three microsystems (i.e. their mother, father, best friend, and teachers) and that those conversations resulted in seeing the curriculum the same way or as more important. The negligible neutral interface and negligible adverse interface groups reported minimal or no conversation across microsystems, which resulted in viewing the curriculum as not important or less important. The limited positive transference group reported selective conversations mostly with their mother and teachers, which was evaluated as important and/or neutral. Findings discuss the application of SIM in prevention research and provide a more nuanced understanding of how intervention messages are recalled and processed post-delivery.

Using phonics to develop the emergent English literacy skills of Spanish learners

Phonics is well established in the English-speaking world, but to date it has beenimplemented to only a limited extent in contexts where English is a foreign language.This study aimed to evaluate the appropriateness of phonics for developing literacy skills of Spanishlearners of English. An experimental pre-test – post-test design was used to determine the method’sadded value. The sample consisted of two equivalent groups in a Spanish bilingual state primaryschool, a control and a treatment group, where a phonic method was implemented by the researcher.Data were collected through tests measuring emergent Spanish and English literacy skills. Non-parametric tests and correlations were used for data analysis.The treatment group presented a significant improvement in phonological awareness, naming andletter and pseudo-word reading in the Spanish and English post-test. These 7-year-old childrenattained a level in English literacy skills equivalent to English children aged 5.8. The findings alsosuggested a positive transference of skills between English word reading and Spanish pseudo-wordreading.The present study can serve as a possible proposal to help improve our Spanish bilingual programmesthrough the use of phonics in the early years in order to increase learners’ English reading level.

НЕКОТОРЫЕ ОСОБЕННОСТИ ОБУЧЕНИЯ ИСПАНСКОМУ ЯЗЫКУ КАК ВТОРОМУ И ПОСЛЕДУЮЩЕМУ ИНОСТРАННОМУ ЯЗЫКУ НА БАЗЕ АНГЛИЙСКОГО ЯЗЫКА

The article considers teaching the Spanish language as a second foreign language to those students who already speak English as their first foreign language. The relevance of the work lies in the fact that at present new techniques of teaching students who speak two or more foreign languages should be reconsidered. It is also necessary to actively use the skills, knowledge and abilities that have already been developed while learning the first foreign language. The aim of the work is to identify the necessary techniques that can make teaching Spanish as a second foreign language to students studying English as their first foreign language more effective. The article compares English and Spanish in order to determine the factors contributing to a positive transference when learning Spanish as a second language, as well as those that complicate this process. Based on the analysis, a number of exercises are presented, which include those for initial perception, formation of speech skills and habits, development of the same and further training, which takes into account the factor of positive influence of the first foreign language and addresses the negative ones. The exercises presented include comparing and contrasting the two languages. The observation carried out while teaching two groups of students showed that taking into consideration the mutual influence of the two foreign languages, as well as including teaching materials for native English speakers in the learning process, increases students’ interest in the language and culture, and allows one to facilitate the process of learning Spanish.

The Internalization of a Representation of the Therapist as an Element in Psychotherapeutic Gain

This paper illustrates the beneficial effect of a positive benevolent transference in the development of an internalized representation of the therapist/analyst in a variety of patients in psychodynamic treatments ranging from consultation to psychoanalysis itself. This is described in patient presentations. In those who have had substantial early nurturant life experience and now find themselves in a dysphoric state due to crisis, the effect lies in the transference reactivation of these positive object relations that relieve their distress. In those who have been deprived of such early experience, the positive transference may emerge during the intensive work of psychoanalysis and may lead to the internalization of a new positive object representation of the analyst generated in the transference that persists after termination of treatment. In both of these situations, the patient discovers a sense of greater harmony with self and the world. The special conditions that permit and facilitate this process are described since this does not occur in all psychodynamic interventions.

‘Multi‐∑QEME of Human Biodynamic Molecular Cell Sustainability in Psycho‐Neuro‐ Endo Processes’

A healthy biological system, whether human or animal, is biodynamic aand must remain in a state of fine tuning with natural bio‐electromagnetic frequencies. A well‐tuned human body is capable of continuous adaptation. The application a controlled dose of modulated coherence quantum bio‐electromagnetic energy was investigated to determine subtle alterations within the properties of the tissue and internal organs, and bring their characteristic frequencies to corresponding levels of healthy tissues. The Quantum of Electromagnetic wave emitted by modulated wave object and a bsorbed by a human body serves as the “messenger” so that any detrimental changes in the biological state of the body can be swiftly corrected by a natural repair of the degree of tuning‐in.Neuro‐Immune Stimulation Therapy involves the process of reversing the destructive effects of negative quantum energy within the body by the intentional transference of natural high frequency bio‐electromagnetic field resonance or positive quantum energy transference. In this research ∑ Bio‐Psycho‐Neuro Quantum Energy model for naturally occurring heart‐brain phenomenon transfer represented in the third step of G. P. Einstein’s mathematical function for: (3∑) Integrated Quantum Bio‐Energy Therapy (∑ IQBET) = = ∑BEM‐Phy.QE × ∑BEM‐CHQE × ∑BEM‐Psy.NQE Our body serves as a receiver and can absorbed the specificBioelectromagnetic Energy for Dynamic Health. Our Neuro ‐ Immune System has ability to accept and correctly interpret the subsequent sets of incoming signals. It can be carefully monitored and repaired when necessary through the Modulated Quantum Bio‐Electromagnetic Waves. At peak performance, the immune system is the primary defense against any disease.Dynamic Coherence of ∑ Quantum BEME Human Physiological SystemFigure 1Dynamic influences of biophotonic influences of food,nutrient, and water on the organisms master systems.Figure 2

The Great Reveal: The Experiences of a Registered Music Therapist with a disability: an arts-based research project

Disability is a human phenomenon experienced not by a small minority but a large percentage of our global population. Disability is encountered by people of all ethnicities, religions, genders (and non-conforming), sexualities, socio-economic backgrounds, and ages. Recent music therapy literature has advocated for a diverse workforce and others describe the value in music therapists adopting an intersectional lens, which considers the interconnectedness of social and political identities. However, there is limited dialogue featuring lived experiences of music therapists of underrepresented identities, such as disability. This research sought to canvass the experiences of Australian Registered Music Therapists who identify as having a disability and to explore how their disability may impact or inform their practice. One Australian Registered Music Therapist (RMT) who identified as disabled was interviewed. The student-researcher engaged with arts-based research through music composition to allow an embodied analysis and to present results in an accessible format. Several themes were revealed, including; hidden disability, disclosure of disability, alliance, positive transference, visibility, and identity. These findings demonstrate the importance of lived experiences in the music therapy community and calls to amplify diverse voices of those with disabilities and other intersecting identities within our profession. Acknowledging the work of disabled music therapists may further challenge ableist attitudes in our society and provide options to participants who might prefer to work with therapists who have relevant lived experience.

Political Divide in the Consulting Room.

This paper addresses a treatment relationship that tests the analyst's capacity for empathy within an impinging political context. It involves a Ferenczian "relaxation of technique" within the analytic frame, while the analytic couple attempts to negotiate a polarized transference and countertransference. Specifically, within a long-term treatment imbued with positive transference, my patient becomes openly outraged by my insensitive anti-Trump remarks. Increasing confrontations around the expression of political views illuminate our otherness. He complains of psychic ostracism within a liberal cultural context, which tolerates no divergence from mainstream liberal ideas or discourse. I come to embody the oppressive other: the liberal "thought police", "silencing" him for his perspective. Empathic breaches between us take center stage: how I don't see the world as he does, and don't see or hear him.

Protagonist-patient and servant-doctor: A medicine for the sick doctor-patient relationship

The doctor-patient relationship (DPR) is very ill; it is in need of emergency assistance. Although there have been change in this relationship, no current model is satisfying. In 1972, Robert Veatch defined some models of DPR. Likewise, Pierloot, in 1983, and Balint, in 1975 and ultimately, Mead and Bower, 2000 with the model of Person-center-care (PCC) medicine.ObjectiveEvaluate the different kinds of DPR described in the literature and propose an abduction-based model of the Servant DPR, in which patients are protagonists in their treatment.MethodsPubmed literature review of the last forty years with the keyword ‘physician-patient relations’.DiscussionWhile nursing care advanced in its professional efficacy through Watson's human care and through the leader servant model, the DPR models demonstrated that the doctors are lost in their posture, even feeling as abused heroes. Models that include the patient in decision-making and that value the patient as a person (PCC) promise a revolution in the medical realm. Nevertheless, the PCC model is not enough to heal the DPR itself, because the role of the doctor must be changed to adapt to the relationship, otherwise, the PCC by itself can increase the burden upon the doctor. Doctors with a role of remunerated servant (not slave), like any other professional who delivers a service with excellence, focusing in the main actor, the patient, can heal the DPR.ConclusionThe Servant DPR gives a positive counter transference, increasing the doctor's motivation and giving him back the sense of purpose in medicine, increasing the health system's effectiveness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The termination phase: Therapists' perspective on the therapeutic relationship and outcome.

The termination phase of treatment is recognized as a significant aspect of the therapy process and yet remains vastly understudied in psychotherapy literature. In the present study, therapists' perspectives were used to examine how 3 elements of the therapy relationship (working alliance, real relationship, and transference) during the termination phase relate to perceived client sensitivity to loss, termination phase evaluation, and overall treatment outcome. Self-report data were gathered from 233 therapists, recruited from 2 Divisions of the American Psychological Association. Therapists completed measures for their work with a client with whom they could identify a termination phase of treatment. Results revealed that the working alliance and real relationship during the termination phase related positively to termination phase evaluation and overall treatment outcome, whereas negative transference during the termination phase related negatively to overall treatment outcome. Therapists' perceptions of client sensitivity to loss related positively to both negative and positive transference during the termination phase. Post hoc analyses revealed only the working alliance during the termination phase uniquely predicted overall treatment outcome in a model with the 3 therapy relationship elements examined together. On the other hand, all 3 therapy relationship variables during the termination phase uniquely predicted termination phase evaluation, when examined together. Limitations and implications of these findings are discussed, and recommendations for future study are suggested. (PsycINFO Database Record