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Some patients are unable or unwilling to step into the difficult and uncharted explorations that psychoanalytic work entails; in this paper the author shows how the effort to establish analytic contact with each individual can provide a level of valuable support, containment, and growth for many patients. Such patients may display great resistance to the challenge of psychoanalytic treatment, subtly inviting the analyst, through projective identification processes, to succumb to countertransference acting out. These turbulent patients often leave treatment in very abrupt and unprocessed manners. It is suddenly all over and that is that. This abrupt dismissal is usually a continued expression of the remaining pathology and conflictual phantasies that had been played out in the transference throughout the span of the analytic process. We cannot always prevent this. Rather than seeing this as a complete failure, we can try to maintain ourselves within the depressive position by realizing we are being used by turbulent patients as provisional placeholders and temporary containers. This is a model of grieving in which we acknowledge and accept what we cannot have, what we are not, and what should be but is not. Struggling with these issues in the countertransference is critical to our ability to help such patients because these are the exact issues the patients cannot bear in their lives. And, if we cannot bear them, then the patient has no hope of ever surviving them. [ABSTRACT FROM AUTHOR]

It has become widely accepted that nontransference interpretation can have power (Blum, 1983). My intent in this paper is to describe an active, intentionally evoked, but uninterpreted, positive transference that is designed to effect change in the patient in an otherwise psychoanalytically oriented therapy. The changes may range from symptom relief to more significant change, as reflected in modifications in the patient's self-perception, perception of others (self-object constellations), and experience in the world. Apart from interpretation of conflict revealed in the patient's experience of the world, the uninterpreted positive transference offers a new object relationship devoid of significant conflict that may closely approximate an ideal of the good parent (the internalization of a good object). In this respect, it contributes strongly to a change in the representational world. The positive transference is not only the substrate of the ongoing process of therapy, but also a useful product of the process. To implement this change the therapist develops a therapeutic stance through specific actions and an attitude that offers the patient a new and benevolent object. [ABSTRACT FROM AUTHOR]

While the real relationship has long been addressed in psychoanalysis and psychotherapy, the matter of the real relationship in psychotherapy supervision has yet to receive any attention. Ample supervisory focus has indeed been given to the working alliance and transference-countertransference configuration (including parallel processes), but after a century of psychotherapy supervision, any mention whatsoever of real relationship phenomena is absent. In this paper, the following hypotheses are proposed: The real relationship (1) is a crucial component of the supervision relationship that has transtheoretical implications; (2) exists from the moment supervision begins until its end; (3) is the forever silent yet forever substantive contributor to supervisory process and outcome; (4) exerts a significant impact on (a) the development and establishment of the supervisory working alliance and (b) the unfolding and eventual utilization of the transference-countertransference experience in the supervisory situation; (5) consists of at least two dimensions in supervision--realism and genuineness--that vary along valence and magnitude continua (building on the works of Greenson and Gelso), and (6) deserves a place of eminence equal to the working alliance and transference-countertransference configuration if supervision theory, practice, and research are to be most fully informed. The possibility of using recent real relationship research in psychotherapy as a prototype to inform future research in supervision is presented, and two case examples are provided to illustrate the seeming power of real relationship phenomena in psychotherapy supervision. [ABSTRACT FROM AUTHOR]

While the constructs of the working alliance, parallel process, and counter-transference have long had transtheoretical appeal for many supervision practitioners, what empirical data-quantitative or qualitative-are there that support their use in psychotherapy supervision? In this paper, I attempt to address that question by: (1) identifying empirical, data-based efforts to research the supervisory working alliance (n=17), parallel process (n=7), and countertransference (n=1); (2) reviewing and determining for each study sample characteristics, measures used, procedure, analyses used, findings, and limitations; (3) identifying the primary conclusions that can be drawn from that review and analysis; and (4) considering the implications and directions for future supervision research and practice. While the data appear strongest for the supervisory working alliance and tentatively support its place in psychotherapy supervision, research on alliance, parallel process, and countertransference is still very much in its infancy and sorely limited empirically. Some avenues for remedying previous study deficiencies are presented, and the hope and caution of future research on these constructs are considered. [ABSTRACT FROM AUTHOR]

It is difficult to locate, understand, and interpret the transference state of some patients In the course of psychoanalytic treatment. This paper examines the use of the countertransference to assist in making "analytic contact," the analyst's attempt to engage the patient in an exploration of unconscious phantasies, transference patterns, defenses, and internal experience of the world. The goal of analytic contact is the identifying, understanding, and working through of core object relational phantasy states. Countertransference can be valuable in helping analysts find their way to the transference, especially when projective identification processes exclusively shape it. Case material, examined from a Kleinian perspective, is used to show work with patients exhibiting difficult to access transference states primarily determined by projective identification based phantasies. [ABSTRACT FROM AUTHOR]

This paper examines the ramifications of a psychotherapist's self-disclosure stimulated by the film Gloomy Sunday (Barkow, N., 1988, Universal Pictures, 1999). It describes the five-year psychoanalysis of a depressed surgeon who made serious medical errors while treating family members. Analysis provided considerable symptom relief, but decades later the patient again became depressed. His depression was precipitated by his having made a major medical error while treating a family member, his daughter, which had an almost fatal result. The surgeon then resumed psychotherapy two times a week for three years. Cultural and professional similarities between psychiatrist and patient cemented the therapeutic alliance, but the patient's medical errors when treating his family members persisted. The psychotherapist's self-disclosure stimulated by the viewing of the film became a fulcrum for renewed investigation of the patient's childhood unconscious contributions to his psychopathology. It also stimulated self-analysis regarding counter-transference issues in the therapist which was related to his own perceptions of Nazis. The resumed treatment ameliorated the patient's tendency to make medical errors. The description of both treatments is intended to deepen the understanding of a "boundary crossing" intervention that assisted psychotherapeutic progress, and to contribute to further consideration of its benefits and risks. [ABSTRACT FROM AUTHOR]

In this article the classical concept and the use of the 'corrective emotional experience' in psychotherapy is described. This concept is not widely accepted within the standpoint of contemporary psychoanalytic psychotherapy and object relations theories. It has an unfavorable reputation. However, this paper does not advocate discarding this therapeutic idea and action because it does have therapeutic value. The case is made that the search for the bad object, and patient's reenactment of early experiences as they had been, is a corrective emotional experience in that it is a reparative experience. Furthermore, the search for the bad object is necessary for attachment. In addition, the point is made that patients find and create the object, therefore, the corrective emotional experience must be viewed as something that patients find rather than what therapists do. [ABSTRACT FROM AUTHOR]

The paper concludes with a discussion of the role played by existential death anxiety in the perpetuation of the errors rife in classical psychoanalytic thinking. Lessening our use of dental mechanisms in response to death anxieties is a key requisite for advancing psychodynamic theories in the next one hundred years. [ABSTRACT FROM AUTHOR]