The analyst's countertransference to the psychoanalytic process1

There is countertransference, not just to individual patients, but to the process of psychoanalysis itself. The analytic process is a contentious topic. Disagreements about its nature can arise from taking it as a unitary concept that should have a single defi nition whereas, in fact, there are several strands to its meaning. The need for the analyst's free associative listening, as a counterpart to the patient's free associations, implies resistance to the analytic process in the analyst as well as the patient. The author gives examples of the self‐analysis that this necessitates. The most important happenings in both the analyst's and the patient's internal worlds lie at the boundary between conscious and unconscious, and the nature of an analyst's interventions depends on how fully what happens at that boundary is articulated in the analyst's consciousness. The therapeutic quality of an analyst's engagement with a patient depends on the freeing and enlivening quality, for the analyst, of the analyst's engagement with his or her countertransference to the analytic process.     

Trauma and the transference‐countertransference: working with the bad object and the wounded self

This paper focuses on the transference‐countertransference dynamics that manifest in work with those individuals who experienced severe early relational trauma and, in particular, childhood sexual abuse. The literature is surveyed from Davies and Frawley's (1992a) seminal paper through to more current trauma‐related and sensorimotor approaches, which deepen our understanding greatly. The rapidly shifting, powerful, conflicting and kaleidoscopic transference‐countertransference dynamics are explored in the light of these views and in relation to a lengthy clinical example. The author elucidates the dual‐aspect of the traumatic complex, whereby the abuser figure, which is disavowed by the patient, becomes manifest in prosecuting the analyst for the ‘wounds’ that the analysis evokes. The paper also explores the particular nature of the splitting processes, whereby pressure is put on the analyst to adopt an idealized role, in particular to act as a self‐object, in order to enable the patient to safely express and ‘be’ themselves in an attempt to make up for what was not possible in childhood; the analyst will necessarily fail in this task. In the context of powerful masochisto‐sadistic dynamics, the analyst's masochism is likely to be called up in the spirit of caring ‘humanity’ (another inevitable enactment), which can impede the progress of the analysis if not addressed. The extreme woundedness, intense affect and moral outrage associated with these dynamics are characteristic and compelling. Issues relating to disclosure, enactment and analytic attitude are also discussed.     

Fordham, feeling, and countertransference: reflections on defences of the self

This is a paper about the difficulties we as analysts get into when we find that a patient has activated something in our unconscious which we cannot resolve in our work with them. Fordham described at the end of his life, in a number of papers, his difficulties and discomfort at not being able to resolve an impasse with one of his patients. From the conversations we had about this situation I knew this caused them both a lot of pain. After Fordham's death his former patient consulted me. Arising from these consultations I describe how I have understood the impasse to have arisen between Fordham and his patient. This paper links character and clinical interests, personality and impasse, developmental failures and defences of the self. It is a personal statement in which I have struggled to represent the meaning in the pain these two men suffered during their analytic engagement, which lasted more than ten years. The theme of fathers and sons was central to the problem.     

The countertransference: When painful traumatic traces sustain the countertransference and reveal themselves to the psychoanalyst … 14 years later!

Although she experienced, as did the many psychoanalysts before her, the countertransferential dynamics of disgust towards a patient presenting great deficiency in terms of mentalization capacity, the author strives to understand what urged her to tolerate the patient, to invest in her and lead her to develop a capacity for internalization, after 6 years of analytic work filled with transgressive‐transferential acting‐out. Fourteen years later, she becomes aware of the way in which the revival of some grief related to traumatic traces in her own lived experience, sustained, without her knowledge, a saviour/countertransference, creating a specific transferential‐countertransferential spiral which rescued a situation whose advent could have been compromised. This could happen thanks to what she refers to as the unique inter‐relation between her and this particular patient.     

On the countertransference of the patient: Transformations of the psychoanalyst's 'theoretical self' and their possible articulations with the vicissitudes of the analytic relationship

In this paper the author examines one of the many levels of the analyst/analysand relationship: the possible interaction between the analyst's mental routes in relation to theories (also meant, but not only, as internal objects) and the vicissitudes of the psychoanalytic relationships with his patients. The author assumes that an important variable affecting the transformation of certain therapeutic relationships is the change that takes place in the relationship between the analyst and that part of his internal world where his theories find their place. He names this part of his internal world 'theoretical self', and 'precipitates of the analyst's theoretical self' those complex formations, akin to more or less cohesive conglomerates, that are formed by his relationship to theories and to psychoanalytic institutions, and by the various, 'personal' internalised objects. The psychoanalyst will relate to these precipitates in a variety of ways, and he will make use of them mostly at an unconscious level in his analytical work; and his patient is likely to 'react' to them, almost chemically. The author also offers some working indications: the psychoanalyst, despite his knowledge of some aspects of his own countertransference, is in fact lacking in knowledge, unless he constantly does some extra work focusing on how his mental position (i.e. the relationship with the precipitates of his theoretical self) may intervene in any of the therapeutic relationships that he establishes-not necessarily in the same way in each of them. The author also illustrates his reflections and conceptualisations by reporting dreams and excerpts from sessions taken from three psychoanalytic treatments in the course of several years.     

Beyond transference,countertransference, the silences and the opinion1

The author examines several works of an intersubjectivist trend, as well as writings by Hanly, Cavell and Bion, defending many of the named psychoanalysts' viewpoints. These viewpoints are expressed in the search and the struggle for truth, recognizing, like Popper, that truth exists but that we cannot know with certainty whether and when we touch upon it, only that this endless effort merits a lifetime's work because it is the attempt at an encounter with ourselves‐the true encounter. The author explains the criticisms by Green of Jacobs, and defends the maintenance of ‘a certain possible neutrality’ (Eizirik). He poses some questions with regard to Ogden's ‘third subject’, considering it, among other aspects, from the supervisory point of view, which may demonstrate the existence of ‘a certain possible objectivity’ of the emotional confl ict. He develops some criticisms concerning silence as an interpretative action by Ogden, and summarizes two case histories. Both were unconsciously attempting to manipulate the analyst intensely‐one of them to get the analyst to intervene in his love life, and the other to interrupt acting out.     

Inside and outside the window: some fundamental elements in the theory of psychoanalytic technique

The underlying concern of this paper is that psychoanalysis as practised today is in danger of losing its specificity and so losing its way. The author suggests this is possible for three reasons: the problem analysts face in responding to the strong emotional demands the great majority of patients necessarily place on them, the unintended consequences of the apparent success of 'here and now technique' and the absence of good clinical theory. The paper mainly discusses the author's ideas about some core elements of the clinical theory that all psychoanalysts must use when they are working and proposes (at the risk of being facile) some relatively simple heuristics related to them which are meant to be helpful. Recalling Kurt Lewin's maxim that 'there is nothing so practical as a good theory', he will suggest that continuous reflection on how one is using theory in daily practice is highly practical, if the theory is good enough. Theory in fact is a necessary 'third' in psychoanalytic practice which, if kept in sufficient working order close enough to clinical experience, provides an ongoing and very necessary check on our sense of reality. But, of course, as a third it can, like reality itself, be the focus of both love and hate with equally problematic consequences. The paper starts with a clinical example of a difficult but apparently successful analysis reaching its end, which will be used throughout the paper to illustrate and elaborate the theoretical ideas set out.     

Immersion in the surface1

In order to treat patients with a narcissistic structure showing a rigid shell of defence together with a lack of inner differentiation – insufficient subject/object constitution – one has to deal with a split kind of transference. Their compelling need for distance corresponds to their fragile self‐esteem. They feel threatened by the analysis and the analytic relationship. Because the seeming normality of these patients’ thinking and language is deceptive, a variation of psychoanalytic technique to facilitate the work with them is described and explained in detail. To transform their two‐dimensional ‘inner’ world, which functions in a PS modus, it is helpful to show them, with changing viewpoints step by step, their own manoeuvres, misconceptions and manipulative use of language within the analytic relationship. The gratifying extension of their self‐awareness leads to the introjection of the analyst’s alpha‐function. This makes possible a more distinct separation of subject and object representations and a transformation to a three‐dimensional, oedipally structured world with a strengthened capacity to symbolize. This method of working is grounded in Bion’s theory of thinking. A case vignette illustrates a development of this kind.     

The utility of the Psychopathy Checklist-Revised (PCL-R) facet and item scores in predicting violent recidivism

There is relatively limited research on psychopathy in non-Caucasian ethnic groups and even less on the utility of the Psychopathy Checklist-Revised (PCL-R) that focuses on PCL-R facet and item scores in predicting violent recidivism. In this study, we assessed the utility of the PCL-R in prospectively predicting violent versus nonviolent recidivism during an 11-year follow-up window. A high-risk sample of 451 incarcerated Korean male offenders was assessed on the PCL-R at baseline. A total of 445 were reconvicted after release (353 violent and 92 nonviolent recidivists). Psychopathy facet scores were higher in violent compared to nonviolent recidivists. Facet 2 (affective) showed the strongest effect size (Cohen's d = 0.53; Percentage change in odds = 22.6%) in predicting violent recidivism. Analyses of the four items constituting the affective facet indicated that callous/lack of empathy (Percentage change in odds = 134.4%) and failure to accept responsibility (Percentage change in odds = 94.5%) were the strongest predictors of violent recidivism. Findings are to our knowledge the first to document the utility of the PCL-R in distinguishing violent from nonviolent recidivism and highlight the role of affective impairment (particularly lack of empathy) in violent recidivism.     

From bastion to enactment: The ‘non‐dream’ in the theatre of analysis1

In this paper, the author's objective is to discuss models that express what occurs in the analytical situation. He demonstrates how early models relating to painting and sculpture, to history and archaeology, develop into other models that refer to the relationship between two people. He studies in depth the Barangers analytical eld with its obstructive bastions as a background to understanding what is currently valued as intersubjectivity in psychoanalysis. The container contained model and the phenomenon of recruitment are also discussed. The author uses clinical material to demonstrate how these models are linked to enactment, and a study of this concept provides evidence of the importance of the visual image, the dream and non‐dream, the affective pictogram, as privileged aspects for the understanding and evolution of thought in the analytical process. Its importance leads to a proposal of a model that uses the theatre as a metaphor for the analytical process. In this model, analyst and patient both participate as characters in the scenes, and simultaneously as their co–authors. The analyst should also be responsible for the direction of scenes, as well as acting as critic. His task is to prevent obstructive conspiracies (the non‐dream) and new meanings for the scenes, thus allowing the development of new scenes and plots, and the enlarging of the mental universe.     

Beyond the representation field

Abstract

This article outlines the importance of representation and several Freudian concepts such as Vorstellung, Trieb, and word and object representations. The author refers to the division of the analytical process into two main fields: the field of representation, and the field of the Real, which is characterized by impossibility. He then states that this field is the proper field of psychoanalysis. The author presents two clinical vignettes in an attempt to demonstrate the significance of the analytical act as a tool to deal with such extreme psychic situations.     

‘Telepathic’ phenomena and separation anxiety

By discussing a treatment characterized by its difficult ending, the author strives to show the dynamic impact of separation on phenomena that can be seen as ‘telepathic’. Led to develop some inalienable attachment to her analyst in the primary transference, the analysand found herself caught up in the contradiction of her visceral dread of dependency, which compelled her to interrupt the work in progress. She then began to work out her analyst's comings and goings and to run into him in public places, as if to be assured of his immovability. This phenomenon arose with high frequency as the effect of some idealization of the maternal object aiming to deny the spatiotemporal gap. The chance that the experience of rejection via indifference may be repeated also entailed the transferential unfurling of a fantasy involving a double, undifferentiation counterbalancing the lived experience of separation. Furthermore, a ‘telepathic’ dream occurred as confirmation of this twin relationship which illustrates the analysand's refusal to renounce her narcissistic object. Projective identifications, agglutinated ego nuclei along with primitive cross‐identifications could, among other concepts, account for such phenomena which are projective in nature yet real all the same. Such mechanisms could have the power to relay thoughts the moment undifferentiated parts of the ego – if not unborn parts of the self – were activated in a potentially symbiotic zone. Marked by a feeling of dispossession, the analyst's countertransference not only seemed to underscore this hypothesis, it also gave a partial explanation for it. Until the analyst could recognize his own nostalgia for a symbiotic relationship, he had to encourage the occurrence of those unexpected meetings which stemmed from a convergence between the transference and the countertransference.     

内隐联想测验中他人重要性对自我心理表征的影响

联合采用联想匹配任务和内隐联想测验（IAT）任务，考察了自我—他人分类中的他人重要性对自我—高奖赏相似性的影响。研究将中性的几何图形与自我、不同重要性的他人（实验一为陌生人，实验二为朋友）建立联结，并将自我（暂时建立联结的图形）高奖赏联合任务与自我低奖赏联合任务下的反应差异（即IAT值）作为自我—高奖赏相似性的指标，结果表明：（1）联想匹配任务中自我和朋友以及自我和陌生人之间都存在显著的自我优势效应；（2）IAT任务中，自我和高奖赏只在他人为朋友的自我—他人分类判断时才具有相似性，而他人为陌生人时二者不具有相似性。这说明他人重要性改变了自我的心理表征。     

An interruption in unconscious communication in the analytic couple

The authors describe an interruption in communication in the analyses of two patients, which gradually brings the analytic process to a halt/standstill. They propose several hypotheses for understanding this situation. One explanation is mutual identification of primitive superegos in the analytic couple which generates a moralizing effect thereby hindering investigation and discovery. They emphasize the importance of countertransference involvement which partly provokes this particular type of impasse. They also suggest the idea of shared acting out, with complementary participations of analyst and patient. In this way the analytic couple supports a 'bastion' which protects against the risk of breaking the omnipotence of patient and analyst or contributes to this omnipotence. Their shared unconscious phantasy feeds collusion linked to unconscious persecutory guilt. The authors also describe movements to break free from this impasse. The enclave created by the analytic couple is detected and subsequently worked through by way of the patient's contribution of dream material and the analyst's work with her countertransference.     

中和思想与可持续发展的普遍和谐观

中和思想博大精深,作为中国古人调节人与自然、人与社会、人与他人及自身内部各种矛盾关系的高级哲理,与可持续发展有共同的哲学根据,与可持续发展所揭示的动态平衡与协调发展不谋而合。     

Parental styles,gender and the development of hope and self‐esteem

We examined the developmental trajectory of trait hope and self‐esteem over 4 years and the impact of gender and perceived parental styles on these trajectories. Participants were 884 high school students. There was a general decline in hope and self‐esteem over time, with females declining more rapidly than males. Girls had higher hope than boys in Grade 7, but lower hope by Grade 10. Perceived parental authoritativeness at Time 1 was related to high hope across the 4 years, whilst perceived parental authoritarianism was related to low self‐esteem. We discuss the importance of perceived parental styles for adolescent well being, as well as possible explanations for changes in hope and self‐esteem. Copyright © 2008 John Wiley & Sons, Ltd.     

Being, thinking, creating: when war attacks the setting and the transference counter-attacks

When trauma enters into the reality of the analyst and of the analysand, when it attacks the setting, what becomes of the analyst’s role? How can transformations be brought about? With reference to three clinical situations, the author attempts to explore how the articulation between transference and countertransference – the inter‐relation – structures the situation; the analyst must remain in his or her role as analyst through managing to create and to reflect upon the clinical aspects of that situation when faced with the unpredictability of what war brings in its wake. It then becomes possible to see how the work of the negative can be confined to the outer limits of the setting.     

Los Degradados: Out,down, dead: Transmitted and inflicted trauma as encountered in the analysis of a 6‐year‐old girl1

The author presents the analysis of a precocious traumatized little girl, which reveals the ways in which historical trauma is transmitted and intrafamilial trauma is both disguised and represented. The play as it evolves is seen to simultaneously communicate what the child struggles with and to resolutely try to hide what has actually happened. Analyst and child together participate in play which utilizes displacement, enactment and interactive enactment, the latter play mode being the very hallmark of profound traumatic experience. Carlotta, the child, helps the analyst to follow her quest for meaning making even as the interaction between them adheres to and departs from the deepening pentimenti of traumatic experience, which needs to be unraveled and reconstructed in order that her own developmental progression can be rejoined. The analysis facilitates Carlotta's capacity to play in a more unfettered fashion and to assist her family's recovery as well.     

Designing interventions that include delayed reinforcement: implications of recent laboratory research

The search for robust and durable interventions in everyday situations typically involves the use of delayed reinforcers, sometimes delivered well after a target behavior occurs. Integrating the findings from laboratory research on delayed reinforcement can contribute to the design and analysis of those applied interventions. As illustrations, we examine articles from the Journal of the Experimental Analysis of Behavior that analyzed delayed reinforcement with respect to response allocation (A. M. Williams & Lattal, 1999), stimulus chaining (B. A. Williams, 1999), and self-control (Jackson & Hackenberg, 1996). These studies help to clarify the conditions under which delayed reinforcement (a) exercises control of behavior, (b) entails conditioned reinforcement, and (c) displaces the effects of immediate reinforcement. The research has applied implications, including the development of positive social behavior and teaching people to make adaptive choices. DESCRIPTORS: delayed reinforcement, response allocation, stimulus chains, self-control, integration of basic and applied research