COUNTERTRANSFERENCE IDENTIFICATION AND FANTASY IN PSYCHOANALYTIC PROCESS

The development of more nuanced understandings of psychoanalytic process is among the primary tasks of contemporary psychoanalytic theorizing. One piece of this complex undertaking involves the examination of moments when the analyst's countertransference position changes. Shifts in the analyst's feelings and thoughts in relation to the patient are complex events in which experiences registered at many levels of organization and via many modes of perception combine to contribute to meaning‐making and furthering of the treatment process. The author explores the role of fantasy in giving form and meaning to alterations experienced as a change of attitude or affect, through close examination of one such moment of shift.     

Countertransference as object of empirical research?

Abstract

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.     

Wilhelm Reich and Anna Freud: His expulsion from psychoanalysis

This article describes the growth of hostility towards Wilhelm Reich in the psychoanalytic community over his Marxist ideology and activism as well as disagreements over the death instinct. It brings to the fore the behind the scenes political manipulations between Ernest Jones and Anna Freud to effect the expulsion of Reich both from the Vienna and Berlin local psychoanalytic societies and from the International Psychoanalytic Association (IPA). It describes Reich's reactions to these events and the pressure placed on other psychoanalysts to stop supporting him and also the revision of history about the expulsion. It discusses the use of the term "crazy" as it was used in the psychoanalytic movement. Further the article discusses personality attributes of Anna Freud leading to counter-transference possessiveness to children and women, especially patients. It briefly touches on the attitudes of both Sigmund and Anna Freud toward sex and how this furthered the clash with Reich. It discusses the similarity between Anna's actions toward the Burlingham children and what happened to the children of Reich.     

Tom Thumb in hospital: The fairy tale workshop in a paediatric oncology and haematology ward

Abstract

Definitions of and attitudes towards countertransference have changed throughout the twentieth century. From being seen as a contaminant in the analytical process, countertransference has come to be seen by many therapists as a potentially useful source of information about a client and his or her problems. There are dangers as well as benefits associated with analysis and utilization of countertransference. This article reviews these issues and proposes some guidelines that therapists may find useful when contemplating their countertransference reactions to clients, and when considering how best to utilize these.     

Marco Conci interviews Stefano Bolognini

Abstract

This paper suggests that the understanding of intersubjectivity, which refers to “the dynamic interplay between the analyst's and the patient's subjective experiences in the clinical situation”, is crucial for psychoanalytic work. The analyst's inner experiences, from the first moment that he or she thinks about or meets the patient, belong to an intersubjective situation. Not only are these experiences a valuable channel through which the inner experiences of the patient can be understood, but—as Theodore Jacobs puts it—they are often complementary to that which comes from the patient. The author tries to illustrate the above through the study of the analytic process in the psychoanalytic therapy of a severely disturbed patient. This therapy from its very early phase led to the reawakening of some of the analyst's old conflicts. The patient's difficulties in tolerating the limits of the analytic setting and using free association are discussed, as are his enactments. The analyst's close observation of the interaction between her and the patient, the permanent engagement with her countertransference, and the use of her inner experiences with the patient helped her to contain the enactments, defined the nature of her interventions, and contributed to the analytic process.     

Psychoanalyst's Values and Countertransference

On the subject of countertransference we attempt to establish a line of continuity between Freud's own expression "blind spot" and Fromm's idea of "counterattitude". It is pointed out that both expressed the idea of the analyst's unconscious as an "instrument" for understanding the patient's unconscious. It follows that the decision to openly use or not to use countertransference in analysis also depends on the concept we have of it and on its extent. The psychoanalyst's real and illusory values and his convictions with regard to human nature influence the countertransference and the analytic relationship. Analytic listening itself may be distorted by it. We must be highly aware of this to avoid enclosing what the patient says in a theoretic scheme. What is needed, therefore, is an open theoretic scheme, more oriented towards understanding than interpretation. Aspects of analytic communication and of the relationship between language, thought and insight are examined. A humanistic point of view is assumed in distinguishing between the transferral and the real plane, and the reasons behind the legitimacy of such a distinction are expounded.     

Psychodynamic perspectives on teacher stress

Melanie Klein's concept of projective identification is now in common use by counsellors and psychotherapists. Julia Segal describes her own hypothesis about the way it works as well as her use of it in her practice, working as a counsellor for people with multiple sclerosis, members of their families and professionals working with them. When a person cannot bear to feel an emotional state they can evoke the feeling in someone else, not only a therapist or counsellor but also others within the family. Segal describes the way powerful emotions can be evoked in the counsellor; in particular the feeling that a certain idea cannot be shared with a client. She also describes working with clients who are on the receiving end of such projected feelings, sometimes evoked by illness within the family. She also points out that unresolved emotional states suffered in childhood can leave adults unable to bear certain feelings. If the feelings threaten to re-emerge in adulthood, perhaps triggered by their own children reaching a certain age, parents sometimes attempt to rid themselves of the emotional state by projective identification and in the process, evoke a version of the feelings in their own children. This may, for example, exert pressure on parents to divorce just as their own children reach the age they were when they themselves lost a parent.     

On counsellors' investment in theory

Abstract

Working as a counsellor presupposes some kind of relationship to theory. No such relationship could be acquired without considerable investment of personal resources. But sometimes the significance with which theories or theoretical outlooks are invested can interfere with actual communication, as, for instance, when the awkward issue of theoretical difference can seem to become the real agenda in discussions ostensibly about clinical material. Such occurrences are the product of strong mutual influence between individuals' investments and the current interpersonal situation.     

Handling and self-handling: An object relations perspective on leisure exercise

This paper considers participation in exercise activities as a form of ‘self-handling’. The focus is on individual exercise rather than on activities, such as those involved in some sports and martial arts, which involve pair or group interaction.

The author suggests that the way in which physical activity is used, abused, or avoided in adult life is linked to the quality of primary relationships and in particular to childhood experiences of handling (Winnicott 1962a, 1970). She suggests that exercise evokes ‘memories-in-feeling’ (Klein 1957) of early experiences of handling and is thus essentially object related. A number of different psychic functions of exercise are considered in relation both to theory, particularly Winnicottian theory, and to clinical material.

As we are all aware, not everything a client does in the external world is raised for consideration in the context of the therapeutic relationship. The author reflects on the need to consider the meaning of the client's introduction of the subject of exercise into the therapeutic discourse, as well as the meaning of the physical activity itself.     

The fear of the body in psychotherapy

This paper identifies the fear of attending to and engaging with the patient's body and the therapist's body, regardless of therapeutic orientation, as a topic rarely explored in books and articles but pervasively experienced because of the cultural norms brought to the consulting room. It explores how we might name the constituent parts of this fear and describes how they inter-link. A case study then exemplifies learning about and transforming such fear in both patient and therapist. Finally, the paper offers suggestions of how therapists might increase their awareness and turn this fear into a tool which extends their range of skills.