Use of the group in resolving the subjective countertransference

Subjective countertransference can sharply limit any group leader's effectiveness. However, a therapist can use the group itself to identify such a bias and to remove it as an influence. A five-step method for doing this is presented. These steps begin with introspection but hinge upon the analyst's turning to the group for the vital information that, in the end, clarifies the analyst's own perceptions and helps him or her free the group from the harmful effects of any bias.     

The influence of action observation on action execution: Dissociating the contribution of action on perception,perception on action,and resolving conflict

For more than 15 years, motor interference paradigms have been used to investigate the influence of action observation on action execution. Most research on so-called automatic imitation has focused on variables that play a modulating role or investigated potential confounding factors. Interestingly, furthermore, a number of functional magnetic resonance imaging (fMRI) studies have tried to shed light on the functional mechanisms and neural correlates involved in imitation inhibition. However, these fMRI studies, presumably due to poor temporal resolution, have primarily focused on high-level processes and have neglected the potential role of low-level motor and perceptual processes. In the current EEG study, we therefore aimed to disentangle the influence of low-level perceptual and motoric mechanisms from high-level cognitive mechanisms. We focused on potential congruency differences in the visual N190 ? a component related to the processing of biological motion, the Readiness Potential ? a component related to motor preparation, and the high-level P3 component. Interestingly, we detected congruency effects in each of these components, suggesting that the interference effect in an automatic imitation paradigm is not only related to high-level processes such as self-other distinction but also to more low-level influences of perception on action and action on perception. Moreover, we documented relationships of the neural effects with (autistic) behavior.     

Adolescent sexuality in a therapeutic community: staff countertransference issues

Issues connected with sexuality such as heterosexual relationships, homosexuality, sexual identity, and seductiveness, create conflict and countertransference dilemmas for staff who work with psychiatric patients in a therapeutic community. When the therapeutic community is composed of adolescents, these issues are exacerbated since sexual identity and sexual development are major concerns. The staff reacts strongly to the issue of self-determination and violation/infringement on a basic human need. These philosophical differences have their roots in countertransference feelings. Staff sometimes find it difficult to confront adolescents on emotionally charged issues that have a sexual coloring. A system is proposed for articulating and working through these feelings. A unique solution is posited for solving this conflictual attitude (based on object relations theory), whereby the residential treatment center serves as the analog of the home in order to allow adolescents to develop a sense of self before they can move on to the halfway house where heterosexual behavior is allowed (as part of the therapeutic process). This facilitates the meeting of the "self" with the "other." This procedure is explored in light of Sullivan's concept of intimacy.     

Tacit assumptions,countertransference and psychoanalytic technique. Part two: The influence of countertransference on theory and technique

In this article, the author examines bodily symptoms attributed to psychic mediating factors in the light of a psychoanalytic model of affect and sym- bolization. He uses clinical material from a consultation-liaison setting and a psychoanalytic treatment to illustrate how the model might help to understand different bodily symptoms as manifestations of different degrees of failure in the psychic elaboration of affect. On a more personal note, this could be seen as an attempt to understand, using a newly acquired conceptual tool, what went on in his 20 years of experience in the general hospital psychiatry setting.     

Supervision, transference and countertransference

The author discusses supervision, transference and countertransference as seen in the context of the clinical case of a patient who had been first seen as a training analysis case and who later, in a fortuitous way, was treated by the supervisor of the training analysis. The supervisor, who in the first instance did not recognize the patient, discusses the reasons for this unusual experience in terms of the presence and absence of transference during the analysis of this patient as a training case and the problems inherent in the task of supervising. The patient's feelings towards the first and the second analyst and the vicissitudes of transference and countertransference during the supervision of the training analysis and its influence on the presentation of the analytical sessions by the student are also detailed and discussed. The question of recorded supervision presentations and their possible influence on the dynamics of supervision is raised.     

Psychoanalytic goals,therapeutic action,and the analyst's tension

The author draws a distinction between the goals of psychoanalysis and its therapeutic action. Goals are consciously (or at least preconsciously) held by the analyst, and can be clearly articulated. Ideas about the mechanism of therapeutic action, in contrast, are hypothetical constructs, and cannot be completely spelled out. This is bound to leave analysts in a state of tension; we are certain about what we are trying to do, but what we are actually accomplishing is elusive. This tension may be optimal for the analyst, because attention must be paid simultaneously to the idiosyncratic relationship in the dyad and to the broader purposes of the analytic engagement.     

Transference, countertransference and mentoring: the ghost in the process

The concepts of transference and countertransference are used in this paper to explore some of the deeper dynamics of the relationship between mentor and mentee; it is hoped that this perspective gives a useful gaze on the mentoring process. Three aspects of the relationship are examined. The first is an exploration of the ambivalent relationship of mentor and mentee to the third party at the meeting--the organisation. The second is an examination of the mentoring process where transference theory illuminates aspects of the power, authority, control, affiliation and resistance in the freezing, unfreezing and refreezing aspects of the ebb and flow of transference and countertransference. The third aspect is an examination of the relationship between mentor and mentee with a glance at the narcissistic impulses of altruism and a sceptical brush with the dominant image of unconditional positive regard that is commonly supposed to flow from mentor to mentee.     

Freud, Dora, and the maid: a study of countertransference

Early advances in psychoanalytic knowledge, profound though they were, were incomplete structures to be built upon, modified, and partially discarded. In addition to errors due to insufficient knowledge, Freud's difficulties with Dora stemmed from countertransference. Dora's transference included an identification with a governess/maid. Important oedipal role played by a nursemaid in Freud's life made him vulnerable to being left by Dora. The maid, Monika, "the prime originator" of Freud's neurosis, seduced him, chastised him, and taught him of hell. In his self-analysis she was associated with Freud's mother who left him when she gave birth to his sister. When he was two and a half years old, Monika was discharged and jailed for stealing. I suggest that Freud's attraction to Dora revealed itself in his libidinal imagery of the treatment and his premature sexual interpretations, the effects of which he misjudged. Defending against his attraction, he pushed her away from him, did not act to keep her in analysis or allow her to reenter analysis later. In addition, since Dora had left him as he must have felt his childhood nursemaid had, he reacted as if she were that maid. Hurt, saddened, and angered, he used reversal and deserted her, thus damping his feelings.     

Anti-Semitism in the clinical setting: transference and countertransference dimensions.

Despite the salient presence of Jews in the history of psychoanalysis, literature on the subject of anti-Semitism in the clinical setting is surprisingly sparse. This paper attempts to comprehend the reasons for the dearth of literature on this important topic. A clinical section then breaks the silence surrounding expressions of anti-Semitism in the consulting room. The major focus is on transference and countertransference reactions that arise with regard to anti-Semitism in the clinical setting. Since the first section is concerned with silence in the psychoanalytic community, its focus is primarily on countertransference issues that may hinder the analyst's understanding and use of anti-Semitic material. The second, clinical section focuses on the ways both transference and countertransference reactions combine and influence one another and how they may, when properly attended to, serve as catalytic tools for advancing therapeutic goals.     

The disregarded analyst and the transgressive process: discontinuity, countertransference, and the framing of the negative.

This paper describes the difficulty of working with patients who have adopted conflict solutions common to perversion. These analysands' rapid shifts from one discontinuous mental state to another draw the analyst into a regressive transference/countertransference engagement characterized by alternations of actualized self and object representations. The analyst's disengagement from this regressive interaction is crucial, but difficult. A detailed clinical example illustrates the process of disengagement as well as the transformation of this transference into a more traditionally consolidated one. A technical approach is suggested and questions of representation and symbolization are explored.     

The colourless canvas: representation, therapeutic action and the creation of mind

Freud's initial formulations viewed psychoanalysis as working towards the rediscovery of psychic elements - thoughts, feelings, memories, wishes, etc. - that were once known - represented in the mind, articulatable, thinkable - but then disguised and/or barred from consciousness. His subsequent revisions implicated a second, more extensive category of inchoate forces that either lost or never attained psychic representation and, although motivationally active, were not fixed in meaning, symbolically embodied, attached to associational chains, etc. Following Freud's theory of representation, the author conceptualizes these latter forces as "unrepresented" or "weakly represented" mental states that make a demand upon the mind for work and require transformation into something that is represented in the psyche, if they are to be thought about or used to think with. This paper describes, discusses and presents illustrations of this transformational process (figurability),that moves intersubjectively from unrepresented or weakly represented mental states to represented mental states, from force to meaning, from the inchoate to mental order.     

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.     

On shame,countertransference, and analytic style

Some analysands experience a restricted space in the analytic situation with special counter-transferential consequences. The author discusses how shame is involved in these situations, and projected on to the analyst. This leads to an important choice of direction for the analyst regarding counter-transference acting out or conditions for a real analytic situation. Shame plays a special rôle in these choices of direction. The author illustrates the problem with a clinical vignette and shows how integration of shame is accomplished clinically, and continues with a discussion of the connections between the analyst's analytic style, his own communicative style as a defense against shame and the analytic styles of different analytic “schools”. A discussion of Liberman's concept, of “asymmetrical dialogue” and its connection with countertransference acting out and analytic styles, forms a conclusion to the paper.     

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.     

Reconsidering therapeutic action: Loewald, cognitive neuroscience and the integration of memory's duality

Both Loewald's relational theory of memory and the Self-Memory System (SMS) of cognitive neuroscience describe a dual memory system, one system that is experience-near sensory-perceptual, and the other, symbolic and conceptual. In contrast to perspectives that locate therapeutic action in either altering implicit procedural memories or interpreting explicit historical content, we argue that psychological health emerges from effective integration of both memory systems, achieved through a combination of transference dynamics and analytic insight. We support this position by elaborating four key assumptions of the loewaldian and SMS perspectives, followed by application to a clinical example. We highlight the power of certain integrative autobiographical memories called 'self-defining memories' in assisting an understanding of transference dynamics and providing metaphoric touchstones to guide subsequent treatment.