Concerning Transference and Countertransference

This paper is presented primarily for its historical interest. The author's first attempted publication in psychiatry or psychoanalysis, it was submitted successively to two publications in 1949, rejected by each, and filed away until now. In it, the author suggests that transference phenomena constitute projections, and that all projective manifestations—including transference reactions—have some real basis in the analyst's behavior and represent, therefore, distortions in degree only. The latter of these two suggestions implies a degree of emotional participation by the analyst which is not adequately described by the classical view of him as manifesting sympathetic interest, and nothing else, toward the patient. It has been the writer's experience that the analyst actually does feel, and manifest in various ways, a great variety of emotions during the analytic hour. The analytic usefulness of this actual richness of emotional participation, by the analyst, is detailed.     

Understanding Transference and Countertransference

Abstract

Professional misconduct-especially misconduct involving client-worker boundary violationsgenerates serious costs for clinical social workers. It harms the very clients we aim to help; it frequently tarnishes the reputation of not only the individual social worker involved but also the face of the entire profession; and, it adds significantly to the overall costs of malpractice insurance. This paper defines the scope of the problem and provides support for understanding transference and countertransference as important contributors to prevention.     

Transference and Countertransference: New Horizons

In this exploratory study one set of patients (n – 50) was randomly assigned to either short-term group therapy or short-term individual therapy. Another set of patients was randomly assigned to either long-term group therapy or long-term individual therapy. All patients were rated prior to therapy on fifteen variables which were believed to be important for psychoanalytically oriented therapy. A comprehensive battery of outcome measures was administered both before and after therapy. Univariate and multivariate analyses were conducted in an effort to discover differential predictors of improvement for group therapy and individual therapy. None of the variables was found to be a significant predictor of improvement in one type of therapy and of nonimprovement in the other type. However, a number of variables were found to be significant predictors of improvement for one type of therapy but not for the other. It is suggested that for a given patient, a pattern of scoring on a number of such variables might tend to favor one type of therapy over another. The authors hope that the present study will serve to encourage further research work on the issue of assisting clinicians in their decisions concerning general and differential prediction of therapy outcome.     

Trauma Child on The Couch: Transference,Introjection, Identification

This paper attempts to explore some of the psychic processes at work with patients whom I identify as the “trauma child”. The term is a metaphor rather than a diagnosis of “traumatisation”, to indicate patients particularly resistant to maturational processes. They feel blocked and thereby find it difficult to evolve as creative adults. As opposed to the “traumatised” child no particular distressing event can be identified as a cause for emotional suffering. The malaise is often “low key” or silent but functions as a saboteur, undermining satisfactory existence. The trauma child is constantly seduced by regressive functioning and bound by numerous strategies of resistance of reality and often incapable of relinquishing the boundless pleasure of omnipotence. On the basis of my clinical work with the “trauma child”, I will explore the different processes of introjection in transference and counter transference, paying particular attention to the dynamics of identification between analyst and patient and its implications for object relations. Instead of “healthy” identification with the other, taking account of difference and reality, the mode of object relations can be that of “pathological imitation” based on fantasies of oral incorporation. A kind of regressive defense against “mature” relationships; it is an attempt to acquire a substitute identity through magical imitation. Analytical listening, associative work and interpretation stimulate maturational processes within the patient and help him/her to let go of immature relational modes fixated in childhood.     

Sexual Contact Between Psychologists and Their Former Therapy Patients: Psychoanalytic Perspectives and Professional Implications

Data was analyzed from the semi-structured interviews of 6 heterosexual male psychoanalytic psychotherapists who by self-report had not engaged in a post-termination sexual involvement. The focus of each interview was to elicit the participants' views about sexual contact between psychotherapists and their former therapy patients, as well as their related attitudes towards Standard 4.07 of the APA Ethics Code (1992). The results suggested great disparity of opinion regarding what might constitute acceptable, ethical behavior in this domain. Nonetheless, all the clinicians agreed that the potential for harm resulting from post-termination sexual involvements was great, They all shared the beliefs that transference did not resolve with termination, that professional responsibilities continued after treatment ended, and that power differentials between therapist and patient lingered, perhaps in perpetuity. However, it was determined to be premature to replace the current Standard 4.07 with an absolute prohibition against sexual involvements between therapists and their former patients.     

Hunger Pangs: Transference and Countertransference in the Treatment of Foster Children

In working with children, clinicians are often confronted with physical as well as psychological hunger—demands for real along with symbolic feeding. Foster children, who have suffered actual neglect and deprivation, often stir powerful and primitive feelings about the place and importance of the real and the symbolic in psychotherapy. These parentless children explicitly and implicitly announce that they need a family, not a therapist. In response, the therapist, particularly the young and inexperienced clinician, may devalue the therapeutic relationship and unconsciously move into a parental role, feeling that without the protection of a family the child will inevitably fall into the enormous emotional, economic, and systemic cracks in the world of foster care. Clinical material illustrates these points.     

From Introjection to Intropression: Evolution of a Theoretical Concept and Its Consequences for Psychoanalytic Technique

Here we try to offer a panoramic view on the evolution of the concept of introjection in Ferenczi's thinking, until its culmination in the last annotation of Notes and Fragments on December 26, 1932. In this final note, Ferenczi invented the neologism intropression in which he tried to articulate the notion of introjections with the devastating effects of violence and parental repression, and a definite way to conceive the analytical practice.     

Robert Waska: The Total Transference and The Complete Counter-Transference: The Kleinian Psychoanalytic Approach with More Disturbed Patients

The American Journal of Psychoanalysis -     

The Application of Therapists' Maternal Capacity in Prerepresentational Body-Based Transference and Countertransference

Abstract

The paper explores the maternal capacity of therapists in working with patients for whom developmental deficits render the traditional verbal tools of psychoanalytic treatment ineffective, particularly in the early phases of treatment. Viewed from the perspective of a mother in relation to an infant, the therapist's role is seen as providing a safe holding environment, often in non-verbal ways, for the patient. The capacity of male therapists to access their maternal capabilities is considered. The manifestation of preverbal transference and counter-transference is explored through the presentation of relevant clinical material.     

Psychoanalytic Couple Therapy: Classical Style

In this essay, the core concepts of psychoanalysis are set forth as the context for the application of classical psychoanalytic theory to the practice of couple therapy. Infantile sexuality and aggression are shown to have a powerful role in the interpersonal lives of family members. The repetition compulsion structures marital interaction and intergenerational dynamics. The intrapsychic emphasis of classical ego-psychology is viewed in the interpersonal arena, and the author suggests adding to the Oedipus and Narcissus myths a myth that resonates with this shift in emphasis. In introducing the “Pygmalion–Galatea process,” the author captures the universal attempt to change the psychic dynamics of the other or others. This ultimately mutual process begins with the infant's mirroring of its caretakers—which includes language acquisition. Much of human interaction is fueled by subsequent attempts to create others in our own images of them and by their reactive compliance or resistance to that dynamic. Three case illustrations are presented to show how these phenomena manifest themselves in marital interaction and in dreams.     

Religion, Spirituality and Therapy: Implications for Training

Religion and spirituality are recognized coping resources but are neglected in psychological training and practice. However, religion and spirituality can be successfully used to cope with psychological disorders, prevent unhealthy behaviors and promote resilience. This study explored and described two questions regarding the concepts of the terminology religion and spirituality, and the perceptions of the use of religion and spirituality in therapy. Purposive sampling was utilized in a qualitative study of 15 registered psychologists, and data were analyzed using Tesch’s model of qualitative content analysis. The concepts religion and spirituality appear difficult to define but the importance of their use as coping mechanisms in their own and their clients’ lives was recognized. These findings have implications for professional training.     

Projection,Introjection, and Projective Identification: A Reformulation

In this essay, the author recommends a reformulation of the psychoanalytic concept of pojection. The author proposes that projective processes are not merely defensive maneuvers that interfere with perception, but rather an essential means by which human perception is rendered possible. It is the manner in which human beings test and-evaluate reality in terms of their experiential structure, and their needs for survival and nourishment. Projection is the early phase of introjection.