Countertransference in psychotherapy and clinical practice

Counter Transference

Countertransferrance"

This is a paper that outlines the concept of countertransferrance. It has 4 sources.

Psychoanalysis is a process that requires the participants to accept and adhere to certain regulations. The closed environments in which these patient therapist sessions take place describe a predetermined analytic or mental space that will involve sharing and projection of ideas and emotions between the two individuals [Young 1990]. The processes of transference and countertransference are the basis of all communication not just the product of interpreting and interacting with powerful and often pathological emotions. [Young 1990; Racker1968] Psychotherapy is an intense form of communication that inevitably affects the doctor as much as the patient. As Harold Searles observed, 'the analyst actually does feel, and manifests in various ways, a great variety of emotions during the analytic hour' [Searles, 1979].

Transference describes how a patient '"displaces" or "transfers" infantile and internal conflicts to current situations and objects which are out of place and inappropriate'. [Racker, 1968] Transference interpretation was easily and almost eagerly accepted as an important tool that could be used in psychoanalysis and psychotherapy.

Countertransference or "projective identification -- something elicited by the patient in the therapist: evocative knowledge," however was less easily acknowledged as an inherent consequence of the psychoanalytic process [Young 1990]. Freud described it as the influence a patient exerted on a therapist's unconscious and that it was upto the analyst to 'recognize this countertransference in himself and overcome it.' [Young 1990]. It is only recently that consultants are recognizing a possible role for it in therapy [Young 1990].

Psychoanalysis of any situation or person by a therapist is limited as Freud said by his 'own complexes and internal resistances.' [Young 1990]. If it is to be successful an analyst must first be aware of himself through initial and constant self-analysis [Young 1990]. The best way for an analyst to recognize the presence of countertransferrence feelings in himself would be to expect them as they are only natural.

Countertransferrance occurs when the patient's subconscious is able to identify and provoke characteristics in the analyst which are similar to the ones being projected. It is the analyst's role to recognize this potential in himself and then distinguish between his own emotions and those being projected on him by his patient [Young 1990; Searles 1979]. Usually the latter will be exaggerated, unexpected, and unwanted. Through repeated self-analysis and observant examination of his subject will an analyst be able to retain a sense of objectivity while still being open to communication. Only then can he use this unconscious transmission of information constructively for his patient [Young 1990].

It is the fear of the inability of analysts to do so that has made countertransferrence such an abhorrent topic. Kyrle stated that as long as 'the receiving parts of the analyst are intact, what gets reprojected is likely to be helpful, but if the projection falls afoul of unresolved issues in the analyst's unconscious, a mess can be created.' [Young 1990]. Three ways to tackle the issue of countertransferrance have been recognized. These are:

1. Using self-analysis to get rid of it, 2. Using it as a controlled communication between the sub-conscious of the patient and analyst so as to further therapy and, 3. Encouraging and maintaining it to help in therapy [Young 1990].