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Countertransference (CT) is now recognized as the most important tool in psychodynamic procedures. Despite extensive practical and theoretical research on the patient's interpersonal patterns reflected in the countertransference, little is known about the therapist's contribution to this phenomenon. A difficulty in studying this aspect is the recording of a phenomenon that many researchers unconsciously understand as ego-syntonic. So far, the topic has primarily been approached through case reports by clinically active authors. This article provides a comprehensive review of the empirical research on this subject, drawing on a systematic search of scientific databases. The systematic search was performed using the electronic databases PsycINFO, PsycArticles, PubMed and PSYNDEX and finally included 10 publications in the analysis after title and abstract screening of 1037 studies. It became clear that the studies included vary significantly in their definitions of therapist contribution and countertransference as well as their attempts to measure them. To address the therapistʼs contribution in the context of countertransference events an extension of the concept of Hayes is proposed, which integrates therapist personality traits and attitudes, sociodemographic characteristics, and biographical experiences (subjective assessments versus objective information) to better capture the therapist's role in countertransference. [ABSTRACT FROM AUTHOR]

In the article "Ronald Baker (1993) The Patient's Discovery of the Psychoanalyst as a New Object," Ronald Baker examines the role of transference in psychoanalysis. He emphasizes the importance of the analytic setting and refers to the works of James Strachey and Hans G. Loewald. Baker describes a case study in which he himself became the object of rejection and emphasizes the significance of surviving such attacks for potential change. He explains that the discovery of the analyst as a new object is a prerequisite for changes in the ego and its object relations. Baker compares this discovery to Christopher Bollas' concept of the "transformational object." Another work by Baker, "Finding the Neutral Position," deals with the inner work of the analyst. The article discusses the therapeutic effect of psychoanalysis and the role of transference and countertransference in analysis. It is emphasized that perceiving a new object in analysis requires careful analysis of transference. The analyst should be receptive to transferences but not act as a transference object. It is also noted that distinguishing between countertransference reaction and actual countertransference is important. The discovery of the analyst as a new object allows the patient a new perspective on their internal objects. It is emphasized that this discovery is a prerequisite for reorganizing the ego and its object relations. [Extracted from the article]

Although shared decision making (SDM) has become the most preferable way in doctor–patient communication, it is not fully implemented in mental health care likely due to the complex nature of psychiatric syndromes and treatments. In this review we provide a systematic overview of all perceived and reported barriers to SDM in the literature, acknowledging field-specific challenges, and offering perspectives to promote its wider use. We conducted a systematic search of the wider literature in different databases and included all publications mentioning specified barriers to SDM in psychiatric care. Relevant data and opinions were categorised into micro-, meso- and macro-level themes and put into clinical perspective. We derived 20 barriers to SDM from 100 studies and reports. Eight were on micro-level care delivery, seven involved meso-level issues, five concerned macro-level themes. The multitude of perceived and actual barriers to SDM underline the challenges its implementation poses in mental health care, some of which can be resolved while others are inherent to the nature of the care, with its long-term relationships, complex dynamics, and social consequences, all requiring a flexible approach. We present four perspectives to help change views on the potential of SDM in mental health care. [ABSTRACT FROM AUTHOR]

This article examines the importance of malignant regression in analytic treatment in terms of how such processes can be detected and limited as well as how they should be dealt with over the course of the treatment process. Different meanings of regression in psychoanalysis are briefly discussed, focussing on how and in which cases the treatment technique for fostering regressive processes can be helpful, namely in the perspective on regression under the aspect of an opening up or closing of an analytical space. The concepts of regression and malignant regression are considered in relation to other concepts. In this respect, the relation to an intact psychoanalytic framework proves to be pivotal as well as the perspective that malignant regression hinders a working through of negative countertransference. The article ends in a proposal for an ethical stance in psychoanalysis that consists of taking all psychologic instances into account in a balanced way. [ABSTRACT FROM AUTHOR]

In the view of the author the concept of regression has been explicitly little discussed in recent years, even though it implicitly represents a psychoanalytic concept that is known and used by everyone. She therefore recalls Balint's concept of distinguishing between malignant and benign regression and attempts to show how these two forms of regression can be distinguished clinically and through countertransference. The core of malignant regression is ultimately the lack of separation between subject and object. First of all, knowledge of the concepts, awareness of the danger of malignant regression and its limitation are decisive for dealing with regressive processes. [ABSTRACT FROM AUTHOR]

In both graduate classrooms and field placements, social work student interns are increasingly taught empirically-supported, behaviorally-focused models as the primary way to engage in ethical practice. They are less prepared, however, to handle the personal impact of powerful psychodynamic processes active in therapeutic settings. In adolescent group treatment environments, the combination of novice therapists with dual-diagnosed, involuntary/mandated teens sets the stage for both behavioral and transference/countertransference issues to arise. Although supervision at the field setting is expected to ameliorate emergent issues, the behavioral and group-level focus of field supervisors may not be enough to identify and overcome deeper psychodynamic challenges. Student interns, as they provide professional treatment to their clients, may therefore have to self-navigate emotionally charged inter- and intra-personal conflicts and attempt to metabolize their own reactions to trauma and dysfunction. This paper presents a detailed post-treatment review of a student intern's struggle to metabolize individual countertransference dynamics in a group setting in the service of a client, and provides supervisory insights on his approach to highlight the challenges and possibilities in such an environment. [ABSTRACT FROM AUTHOR]

With the terms horizon of expectation and transitional space mentioned in the title, some basic features of the psychoanalytic cure are named. They serve as a starting point to describe the mode as well as the goal of psychoanalytic supervision. Supervision works on and with the transitional space and horizon of expectation, helps the therapist to establish them or expand them. The term supervision is subjected to a critical revision. The psychodynamic factors that have to be dealt with in supervision are presented, especially the transference and countertransference processes taking place in the supervisory relationship but also other pitfalls that can endanger supervision and that must be taken into account. Instead of a summarizing closing remark a very old Chinese story is told and used to characterize the role of supervision in psychotherapy. [ABSTRACT FROM AUTHOR]

This paper is based on the premises that the conscious, active and purposeful use of self by the therapist in the therapeutic process is an essential aptitude in establishing an effective therapeutic relationship, and that this therapeutically purposeful use of self can and should be incorporated in the training of all therapists in a explicitly systematic manner. The paper will attempt to identify the contributions of the "what and how" the use of self by therapists contributes to the therapeutic process. First of all, therapists' use of self is meant to be viewed as a Common Factor as defined by Sprenkle, Davis & Lebow (2009), which is a perspective about the effectiveness of therapy that "asserts that the qualities and capabilities of the person offering the treatment are more important than the treatment itself" (p. 4). Secondly, the use of self by therapists emphasizes developing the skill set of the therapist in the conscious, active and purposeful use of self as is in the moment of the therapeutic engagement with clients, and does so without denying the importance of therapists working to resolve personal issues of theirs that may interfere with the therapist's professional effectiveness. Therapists' use of self gives particular emphasis to the purposeful use of self as is in therapy's relationship, assessment and interventions whatever the therapy model (Aponte & Kissil, 2016). Thirdly, the use of self represents an aptitude that can be developed and refined through well elaborated structures for schooling therapists in the therapeutic use of all they bring of their personal selves to the therapy relationship including through the use of their human vulnerabilities as they exist at the moment of empathic engagement with clients. [ABSTRACT FROM AUTHOR]

This work examines the irritating awareness of the culturally conditioned attachment of one's own perceptions of gender difference and identity. The article addresses the uncertainties both personal and also theoretical, when we consider gender not only as biologically natural as in Freud but also as socially, culturally and historically constructed. These irritations and (un)certainties in gender, which masquerade as certainties, become apparent in a psychoanalytic treatment of a trans man and become active in the analyst's countertransference. Being able to hold gender irritations and (un)certainties within oneself is seen as an equally important task as avoiding a slide into pathologization and standardization of the gender in the thinking of the treating psychoanalyst and in psychoanalytic discourse. [ABSTRACT FROM AUTHOR]

Inspired by the mutism-like falling silent of a patient in the analysis, in this article the author deals with the psychodynamic meaning of this phenomenon in the transference process. She understands falling silent here, as distinguished from the phenomenon of being silent, as an expression of a structurally early defense against unintegratedness, resulting in the collapse of language-related communication. The analytic relationship thus assumes characteristics of an adhesive pseudo-object relationship. Dealing with her countertransference, in which a sense of touch contrasted with an intense experience of meaninglessness, enabled the author to understand her sense of touch also as a countertransference resistance and to open herself to the perception of the nameless dread that was being mediated. Accompanied by theoretical reflection, this process of understanding is traced here. Based on her countertransference, the author illuminates the phenomenon of falling silent, first with regard to its possible function of forming a second skin to shield an autistic core, then in its effect on the analytic relationship, in which the analyst is deobjectified as a container and thus as a three-dimensional psychic object and finally with regard to whether the very quality of falling silent could in fact serve to communicate an ineffable, traumatically split off experience of psychic nonexistence. Emphasis is given to the special importance of the containment of the countertransference in the analysis of autistic transferences. [ABSTRACT FROM AUTHOR]

The book "Technik. Zur Dialektik der psychoanalytischen Praxis" by Fritz Morgenthaler deals with various aspects of psychoanalysis. The author, a psychoanalyst, traveler, painter, and juggler, emphasizes the importance of the emotional offering of the analyst and the role of countertransference in the psychoanalytic relationship. He values maintaining the coherence of the analysand and creates a safe space for psychological upheavals. Morgenthaler combines various psychoanalytic theories and techniques and emphasizes the power of the unconscious in the transference during a psychoanalytic session. Psychoanalysis does not allow for progress, but rather transformations. [Extracted from the article]

The effect of a therapist's personal and professional variables on their decision to treat or refer a suicidal adolescent was studied. 242 mental health professionals were randomly exposed to one of four case descriptions of an adolescent in crisis. The cases shared a common background story, however differed in suicidal condition (high vs. low) and gender. The questionnaires employed aimed to reflect the subject's evaluation of the patient's suicidal severity, countertransference, suicidal ideation, depression, professional competence, and seniority. Subjects were asked about their willingness to treat or likeliness to refer the case. Results indicate a lower willingness to treat and higher tendency to refer highly suicidal adolescents regardless of gender. Professional factors, countertransference, and trait-like suicide ideations positively contributed to willingness to accept the patient. Mental health professionals are unwilling to accept adolescents at risk for suicide for treatment. Nevertheless, professional factors contribute to the willingness to treat such adolescents, thereby underlining the importance of improving skills and tools with regard to the treatment of suicidal behavior. Acquaintance with a similar adolescent is a positive contributor for accepting a potentially suicidal adolescent patient to therapy. [ABSTRACT FROM AUTHOR]

The aim of this paper is to analyze countertransference experienced by a therapist while treating a 'difficult to treat' adolescent client. In doing so, the therapist discusses how his childhood experiences and the subsequent assumption of Carl Jung's wounded healer archetype fueled the countertransference in ways that were concurrently beneficial and detrimental to treatment. The client's symptoms, behavior, and family system are also examined to illustrate how they uniquely contributed to the intense feelings evoked in the therapist. Topics of omnipotence, curative fantasies, biblical myth, and childhood trauma are explored throughout this paper, as they uniquely intersected to create a complex web of psychodynamics between therapist and client. This is demonstrated primarily through an interpretation of the client's final session and the therapist's dream following treatment. The therapist shares reflections of the treatment, implications for wounded healer self-disclosure, as well as the archetype's importance to the social work profession. [ABSTRACT FROM AUTHOR]

While the construct of countertransference has been established in psychodynamic theory since its inception, it has received relatively little attention from cognitive-behavioral theorists. However, it is generally agreed that therapists’ reactions to patients powerfully influence treatment, for better or worse. Suicidal patients in particular are likely to evoke negative reactions in therapists. In this paper, we briefly review the theoretical literature on countertransference, with particular attention to suicidal patients, from standpoints of psychodynamic and cognitive-behavioral theory and research. We argue that the cognitive-behavioral perspective, together with the RAIN model proposed by mindfulness authors (Recognition, Acceptance, Investigation, and Non-Identification), opens avenues to assess, distance from, and perhaps modify cognitions that could lead to counter-therapeutic emotions and behaviors in working with suicidal patients. We conclude that, while work with suicidal patients can be challenging, cognitive-behavioral therapists can potentially improve effectiveness and enhance their own well-being by managing their reactions in a manner consistent with their theoretical orientation. [ABSTRACT FROM AUTHOR]

In this paper, we propose that therapist anxiety in the therapy room, especially anxiety stirred up by difficult or triggering clients, represents a challenge to effective therapy, and that effective management of this anxiety be considered as a necessary therapist skill for conducting quality couple and family therapy (CFT). We propose that effective therapists need to be able to manage their emotions, especially their anxiety, in order to truly help their clients. The failure to do this can lead to break downs in the alliance and the flow of therapy, and these deleterious effects can be prevented when therapists actively navigate their internal states through self-awareness and ongoing introspection. Bridging psychotherapy literature, we discuss specific strategies to this end, and make clinical recommendations for CFTs and CFT training programs. [ABSTRACT FROM AUTHOR]

Two clinical moments from patients in treatment for Binge Eating Disorder (DSM 5) are described where a manifest problem with body image difficulty was initially denied. Each patient entered treatment with the desire to lose weight as well as gain a fuller understanding of self and mastery over addictive eating patterns that caused considerable psychological anguish. An integrated treatment matrix of practical, contemporary psychodynamic interventions and more behavioral, experiential and supportive tools allowed each patient to uncover and work through heretofore split off aspects of their bodily selves. Defense mechanisms such as 'no entry' fantasies and 'the false body' that have recently been described in the analytic literature are applied in formulating each case example. The author underscores how therapists must probe for secrets in the personal and family history that are 'hidden, but in plain view' and pursue them in order for the patient to embrace a more coherent, true sense of her/his bodily self. These secrets often contain a less conscious rationale for treating the body poorly and perpetuating hated, shameful and derogatory aspects of body image that may become externalized onto the therapist. These externalizations can further complicate countertransference reactions that must be acknowledged and worked through by the therapist in personal or self-analysis. [ABSTRACT FROM AUTHOR]

Knowledge about the treatment of eating disorders is largely based on the experience of women with these disorders. The motivations, beliefs, vulnerabilities and developmental factors that cause and perpetuate eating disorders in men are often gendered. Engaging men in therapy and helping them build and sustain motivation requires therapeutic sensitivity to the impact of these gendered factors. Therapists' sensitivity to these factors inevitably activates personal experiences with gender and provides an important source of information about patients' experiences. This article focuses on how gender socialization and internalized views of masculinity affect client, therapist and the co-created therapeutic relationship. Male and female therapists can use awareness of gender influences to improve their ability to detect and communicate their gendered countertransference reactions. The article concludes with a discussion of how gendered assumptions and emotional reactions can affect treatment team interactions and treatment program protocols. [ABSTRACT FROM AUTHOR]

This paper will illuminate one dimension of self-disclosure as it relates to the inescapable presence of the body in treatment, and the female clinician's ability to bring her physical body into clinical discussions during an encounter with a female client with an eating disorder. Although the clinical literature on eating disorders validates that transference and countertransference issues are particularly powerful, it generally neglects the exploration of these issues specific to the body's physical presentation. Since body dissatisfaction is increasingly normative for women today, female clinicians need to have a theoretical road map on which to rely when they encounter a shared body experience. Thus, in order to encourage discussions of the therapist's body in clinical social work practice, the body needs to be situated in a larger theoretical framework within which it can be explained and located; this framework is object relations theory viewed through an intersubjective lens. Concepts from object relations theory will demonstrate the importance of the body in the clinical exchange by highlighting the parallel between Winnicott's 'good enough' mother and the 'good enough' therapist's body. When the therapist is able to judiciously invite discussions of her body into the clinical arena, the client is given the opportunity to move from object relating to object usage. A case presentation exemplifies how this conceptual framework can be applied to clinical social work practice, strengthening the relationship between knowing and doing. [ABSTRACT FROM AUTHOR]

Relational theory offers a structure from which to understand and treat the interpersonal and intrapsychic legacy of severe childhood trauma. During the course of treatment, particularly with such traumatized patients, therapists are challenged to tolerate and make meaning of intense feelings in the transference-countertransference matrix. Relational theory's ideas regarding adaptation to and perpetuation of the relational patterns of early life, dissociation of disavowed and intolerable self-states, and the inevitability of mutual enactments provide an organizing framework in which to weather and make bearable the unbearable. In addition, relational theory invites and supports the clinician in the vital task of meeting the patient's vulnerability with his or her own authentic and vulnerable self. The following case material demonstrates the use of relational theory to find and to work at the intimate edge (Ehrenberg in Relational psychoanalysis: innovation and expansion, Analytic Press, Hillsdale, pp 3-28, ) where the impossible becomes possible. [ABSTRACT FROM AUTHOR]

The complexity of long-term, dynamically oriented psychotherapy with a patient who belongs to an 'enemy' national group, requires more than cultural sensitivity, especially during ongoing violent political conflict. This paper deals with some of the transference-countertransference dynamics that face therapists from a minority group involved in a political conflict with the patient's majority group. Clinical examples from the Palestinian therapist-Jewish patient therapeutic dyad are presented in order to clarify these issues as they relate to setting, contract, interpretation, and termination of therapy. The main argument is that the therapist in such cases has to process not only his sense of threat, anger, and guilt in order to develop a good containment function during therapy, but also has to work on integrating different and denied parts of his national identity in order to be able to hear other, more internal dynamics in the patient's mind, which are conveyed via the political conflict reality and transference issues. [ABSTRACT FROM AUTHOR]

Jehovah's Witnesses are a Fundamentalist Christian religious group well known for their door-to-door proselytism. As a result of their belief in spreading the word of god and converting others, Jehovah's Witness populations are growing across the globe. A primary element of Jehovah's Witness doctrine and other Fundamentalist groups is a mandate to not develop associations with people outside of the religion. As a result of this isolationism, many Fundamentalists who experience psychological distress may hesitate to obtain help from the mental health community. Their belief system and cultural values, including the practice of 'disfellowshipping' or shunning members, influence the types of problems Jehovah's Witnesses and other Fundamentalists present with in therapy, obstacles to treatment, and issues that may arise within the therapeutic relationship. [ABSTRACT FROM AUTHOR]

The purpose of this qualitative study was to learn about social workers' experience of the therapeutic encounter with victims and perpetrators of elder abuse and neglect and its implications for their personal and professional lives. Participants were 17 experienced women social workers, who worked with abused and neglected older adults in Israel. Data were collected by in-depth semi-structured interviews, which were later transcribed and content analyzed. Four main themes were revealed: (1) The Complexity of the Experience of the Therapeutic Encounter; (2) Circles Echoing Between the Professional and the Personal; (3) Between Growth and Attrition; and (4) Experiencing the Mission and its Meaning. As time is running out for older adults, the 'now or never' perspective shapes social workers' encounter with elder abuse opening a unique kind of dialogue. Implications for practice and further research are discussed. [ABSTRACT FROM AUTHOR]

Taking up the age-old question of 'interpretation and relationship' leads this article into the differentiation between implicit and explicit treatment practice by Michael Ermann. Subsequent to this, implicit effect factors in the psychoanalytical practice are described based on routine daily therapeutic experience. Finally, the 'plica in countertransference' is singled out as an effective factor for the further course of treatment: the positioning of the history of the patient in the personal world of the analyst. Possible applications of this concept are discussed. [ABSTRACT FROM AUTHOR]

In this article the author discusses a report within the issue, titled "Transference, Countertransference and Mutuality in Relational Social Work with College Students," by Zachary G. Shaeffer. She notes the important aspects of Shaeffer's research of the psychodynamic, social, and interpersonal factors in a college student’s transition from childhood to adulthood, praises his views on relational therapy, and evaluates Shaeffer's research methodology.

While much has been written on social aggression in adolescent girls, less has been written on the clinical treatment for victims of such bullying. This paper will look at social aggression in girls from relational and psychodynamic perspectives. Further, the interplay of trauma dynamics which are integral to the social aggression paradigm will be reviewed. Using a clinical example, the author will show how victim/victimizer/bystander roles inherent in trauma dynamics were enacted in the clinical dyad. Enactments were discussed in the treatment process leading to a new and different outcome. Implications for practice with girls who experience social aggression will be discussed. [ABSTRACT FROM AUTHOR]

The college experience represents a major life transition from adolescence to adulthood, which is often fraught with challenges in relationships, identity formation, and communal belonging. Steady generational changes in self and relational identity have led to younger generations that increasingly embody a more interpersonal and less individualistic conception of the human person, with less rigid norms and greater openness to diversity. These characteristics make college students an appropriate target population for interpersonal psychotherapies based on mutuality of process. Relational therapy is a particularly fitting treatment modality for college students, as it focuses on these very qualities. This article reviews the current literature on relational theory in psychological and social work practice, describing its principal tenets and concepts, and applying this theory to clinical work with college students to reveal applications for constructive practice with this population. [ABSTRACT FROM AUTHOR]

Based on the analytic work on colleagues the author investigates a writer’s block of German psychoanalysts when writing about their patients. In the process of their own therapeutic analysis, an inhibition of association in these psychoanalysts comes to the fore by them falling into the professional role and talking about their patients. The accounts of these colleagues on their own patients function as a doubled imago revealing the unconscious conflicts of the patients as well as acting as a proxy of the psychoanalysts’ impulses, affects and foreclosed memories in their own analysis. The inhibition of thinking, leading to a writer’s block, is the result of the correspondence of the trauma of the patient with the trauma of the analyst when the transference-countertransference relationship evokes annihilation anxieties in the psychoanalyst. Therefore the writer’s block of these psychoanalysts is rooted in their professional work and is the result of the internalization of precarious emotional contents of their patients. The author examines the role of institutionalized psychoanalysis in developing a professional writer’s block, and the results of the paper highlight the need of an emotionally supporting professional environment for the psychoanalyst during his training and his practice work. [ABSTRACT FROM AUTHOR]

The neuroscience of trauma in increasingly oriented to the importance of understanding right brain to right brain dynamics and helping the therapist to respond to implicit communication, which is discussed, as well as Porges' polyvagal theory. The traumatized patient presents a variety of challenges to clinicians, including a dysregulated autonomic nervous system (ANS), compromised ability to self-soothe and diminished capacity for relatedness with others. Therefore, one effective approach to treating trauma (especially dissociation) includes conceptualizing and responding to our patients through three separate but interconnected lenses: (1) patient and therapist as human mammals-orientation to the ANS, (2) patient and therapist as personalities-orientation to the internal world and, (3) patient and therapist as inhabiting an intersubjective field together-orientation to shared, co-created body/psychological states. The capacity to be guided by countertransference is an especially valuable skill for therapists, as well as the ability to know when they are being experienced as helper or adversary by their patients. Different dynamics driving dissociation and different strategies for responding to the dissociating patient are discussed. Clinical examples are included. [ABSTRACT FROM AUTHOR]

In his seminal volume From Anxiety to Method in the Behavioral Sciences, George Devereux suggests that any therapeutic or scientific engagement with another human being inevitably will be shaped by one's own expectations, assumptions, and reactions. If left unacknowledged, such unspoken and unconscious influences have the capacity to torpedo the interaction; if subjected to critical reflection, however, they can yield insights of great interpretive value and practical significance. Taking these reflections on counter-transference as point of departure, this article explores how a range of unacknowledged assumptions can torpedo good faith efforts to engender 'cultural sensitivity' in a required course for American psychiatry residents. The course examined in this paper has been taught for seven successive years by a pair of attending psychiatrists at a longstanding New England residency training program. Despite the instructors' good intentions and ongoing experimentation with content and format, the course has failed repeatedly to meet either residents' expectations or, as the instructors bravely acknowledged, their own. The paper draws upon a year-long ethnographic study, conducted in the late 2000s during the most recent iteration of the course, which involved observation of course sessions, a series of interviews with course instructors, and pre- and post-course interviews with the majority of participating residents. By examining the dynamics of the course from the perspectives of both clinician-instructors and resident-students, the paper illuminates how classroom-based engagement with the clinical implications of culture and difference can run awry when the emotional potency of these issues is not adequately taken into account. [ABSTRACT FROM AUTHOR]

This paper chronicles the journey of a long term, suicidally depressed patient's struggle of growth and survival, only to be struck down by a form of Dementia: Lewy Body Disorder. Focus of the paper highlights the myriad complications and struggles that developed in the countertransference as therapist, patient, family, and medical caregivers, try to ascertain: What is psychological and regressive? What is neuro-degenerative? How can the therapist cope with this confusion while maintaining the frame? The paper highlights how the frame as we know it, is altered to meet the medical and psychological crisis presented and how that alteration impacts the treatment and the therapist's changing perception of what the work is about. [ABSTRACT FROM AUTHOR]

This paper focuses on the way political ideas infused the psychoanalytic treatment of Mr. N., a man who struggled with low self-esteem, paranoia, and rage. Mr. N. became increasingly identified with Republican political goals and attacked what he considered my Democratic political views and legislative advocacy. The way that his anger became focused on my political activity had a profound impact on me, leading to strong countertransference feelings of depression and hate. The ways that I tried to accept and use this countertransference in the treatment are summarized, in the context of D.W. Winnicott's paper on 'Hate in the Countertransference' and others. During the course of the treatment Mr. N. became less judgmental of others and himself, learned to give and accept love, and developed the capacity for self-reflection through use of the therapeutic relationship. [ABSTRACT FROM AUTHOR]

This article provides a commentary and discussion of alterations in the therapeutic frame in a paper by Paula Shatsky. [ABSTRACT FROM AUTHOR]

Teacher countertransference refers to conscious and unconscious, negative or positive emotional reactions to certain students that arise from the teacher's own areas of personal conflict. Our investigation of 14 expert teachers' countertransference experiences in the college classroom, yielded several themes. Countertransference triggers included challenging behaviors (e.g., student disengagement from learning, hostility, manipulation). Countertransference reactions included frustration, the questioning of one's own judgment, and identification with students. Participants managed countertransference by seeking social support, maintaining their professionalism, thinking before responding, practicing self-reflection, building relationships with students, and drawing upon personal characteristics (values, empathy, conceptualization skills) and teaching experience. We suggest implications for teaching and recommendations for research. [ABSTRACT FROM AUTHOR]

In the last 50 years inpatient psychosomatic psychotherapeutic treatment in Germany has undergone a special development in which the psychoanalytical and group analytical communities were substantially involved. This development will be analyzed in a review with respect to models of the clinical application of psychoanalytical treatment principles. Particular emphasis is placed on the analysis of transference and countertransference processes in a clinical multiperson situation and the resulting necessity of group and teamwork. Only such an integrative inpatient psychotherapy concept is from a psychoanalytical perspective in a position to utilize the interactional, scene-like restaging in a multiperson relationship field and to benefit therapeutically, by which the group analytical function of the team process plays a special role. The practical aspects of two applications of the integrative model in Essen and Dortmund will be presented and the results will be discussed. [ABSTRACT FROM AUTHOR]

This article examines the sources of relational difficulties inherent in clinical work with forensic clients. Left alone, common countertransference feelings, responses, and defense mechanisms can disrupt and ultimately derail treatment. Concepts relating to the management of countertransference offer a path with which to integrate therapists' affective reactions as a mechanism of therapy. A relational framework utilizing the affective dynamics between client and therapist to develop and promote treatment goals is introduced and the process of formulating it is described. Practice examples are offered. [ABSTRACT FROM AUTHOR]

A growing body of psychoanalytic literature recognizes that dynamic therapy can be transformative for therapists as well as for patients. Relational concepts such as co-construction and mutual regulation highlight interactive processes that facilitate bidirectional change. This paper summarizes the theoretical rationale for mutual transformation, presents a detailed case study illustrating how transformation evolves, and concludes with a brief commentary written by the patient. [ABSTRACT FROM AUTHOR]

The rates of no-show appointments in community mental health are reported to be as high as 50%. Yet there is a striking scarcity of clinical literature on this subject compared with the abundance of articles written from an administrative point of view. This paper describes a variety of countertransference responses to missed appointments. Drawing from object relations theory, the author maps out different pathways to guide thinking about the use of countertransference, listening to clinical material following a no-show appointment, and responding to organizational pressures. The paper aims to help practitioners make greater sense of the patient's inner world and of what is going on in the transference-countertransference matrix. [ABSTRACT FROM AUTHOR]

In this paper the author summarizes and illustrates with case examples her theory of the clinical significance of nonverbal interaction and the usefulness of her integration of aspects of movement theory to facilitate its recognition and analysis. In this discussion, she reviews the concepts of kinetic transference and countertransference, the kinetic temperament, embodied history, kinetic therapeutic action and the kinetic text. Case examples illustrate the clinical importance of recognizing various aspects of movement, namely, the qualities of tension change, preferred movement dimensions, and body attitude, which come meaningfully into patient-analyst interaction. [ABSTRACT FROM AUTHOR]

This paper explores the ways an integrated psychodynamic theory helps practitioners to maintain their therapeutic equilibrium. I discuss adolescent treatment at Chestnut Lodge Hospital, using case examples of projective identification and splitting on the milieu. I argue that theory helps the therapist to contain his own reactions to the intense, evocative work, which in turn helps him to contain the patient. I also discuss the ways theory can help us to make therapeutic use of countertransference enactments, allowing us to use discursive language to understand previously wordless experience. An integrated psychodynamic theory allows us to bridge the intrapsychic and intersubjective realms. It both facilitates, and helps us to understand, the novel attachment the patient forms in psychotherapy. Theory guides us regarding what psychological skills the patient has failed to master and organizes our efforts to impart these skills to him. [ABSTRACT FROM AUTHOR]

The study examined the experiences of 48 Israeli mental health practitioners who helped the residents of Gush Katif during the forced relocation. The practitioners spent between 1 week and a year-and-a-half assisting these residents. Shortly after the relocation, they participated in one of four debriefing groups, which aimed to process and summarize their work. Phenomenological analysis revealed three main themes: (1) Who are our clients: the government or the residents? (2) Blurring boundaries between professional and personal self; and (3) Returning home. The study highlighted the challenges associated with intervening in shared trauma, especially in realities of political conflict. [ABSTRACT FROM AUTHOR]

There has been considerable conceptual confusion about the differences between compassion fatigue and countertransference. This often results in them being treated as the same phenomena, both in the literature and clinically. This paper maintains that these are, in fact, two different concepts that derive from different sources and serve different functions. Each of these two concepts requires different kinds of interventions as well. [ABSTRACT FROM AUTHOR]

In this paper the author, a psychotherapist specializing in bereavement, recounts her personal experiences of loss and the ways in which they intersect and inform her professional life. One clinical vignette explores how unresolved grief in a patient and anticipated grief in a therapist emerge in transference-counter-transference issues. Another vignette illustrates a way in which supportive therapy can open the door to intra-psychic work with the ill or dying patient and how psychoanalytically informed psychotherapy with the aged can help them to re-imagine their lives and to form different relationships, in their minds, with significant others in their past. [ABSTRACT FROM AUTHOR]

Using formulations of female sexual development grounded in the Persephone/Demeter myth, this paper examines the treatment of two adolescent girls in the aftermath of rape. Case material is presented that illustrates the impact of rape on a developing adolescent girl’s relationship with her mother and on the transference to a female therapist. The nature of the mother/daughter relationship prior to the rape influences not only the treatment but the capacity of both mother and daughter to cope with the trauma of the daughter’s rape. Countertransference reactions and enactments related to developmental issues of separation/individuation as they are impacted by the trauma of rape and as they influence the course of treatment are examined in order to heighten awareness of possible pitfalls in treatment. [ABSTRACT FROM AUTHOR]

The author presents a counter-transferential dream of the director of a flat sharing community for mentally disabled persons. On the one side she realizes hereby a tension between the performances which have to be presented for external quality assurance and the “work which is not to be seen”, i.e. the coping with emotions and phantasies of the caring staff. On the other side she discovers, motivated by Freud, Morgenthaler and most of all by Elisabeth Lenk, in this dream a mimetic (ecstatic, sexual) dimension which may become a threat for the coherence of the subject. An attempt at interpretation leads to the extremes of exhibitionism and voyeurism as they are activated in the care work. Institutions produce their own counter-transferences steeped in the phantasms prevailing in these institutions (here: mental disability). In the counter-transference dream analyzed here the author discovers elements of the primal scene and examines the relevance of the associated phantasies in the constitution of the subject of the caring staff, of the cared-for persons and of the author herself. [ABSTRACT FROM AUTHOR]

Treating clients from diverse cultural backgrounds, and supervising clinicians who are treating clients of the same ethnicity and gender, are now common experiences in our mental health system. As the growth of minorities in the US greatly outpaces the training of minority clinicians, more attention to these situations is needed. Operating from the premise that interpersonal sensitivity is a fundamental aspect of cross-cultural and cross-ethnic sensitivity, we describe the treatment of a Latino male by a Latino male clinician, in this case both of Puerto Rican descent. We outline the contours of the therapy with a man whose life history included numerous incidents of humiliation and thwarted efforts at efficacy, mastery, agency, and competence, resulting in an adult character structure based on shame and self-doubt. We also discuss the challenges to the clinician posed by working with a man whose traditional upbringing mirrored his own, with all the positives and negatives that must be considered in the countertransference. We describe clinical and cultural reasons for various interventions, and their resulting outcome. The framework of a dynamic interpersonal therapy and the challenges of transference, countertransference, therapist disclosure, and working-through are covered. [ABSTRACT FROM AUTHOR]

The sweeping revisions in the understanding of major mental illness brought about by the biological revolution in psychiatry moved the spotlight away from the treatment relationship. In recent years, however, a resurgence of interest in subjectivity underscored the fact that despite dramatic scientific breakthroughs the existential realities of illness were largely unaltered. Even with this shift in inquiry, however, little attention was shown to the inner experience of practitioners engaged in long-term therapeutic relationships where movement of any kind was barely detectable. Clinicians and clients alike frequently travel a long and difficult road in search of pathways to recovery. Tracing their shared journey through a detailed case presentation illuminates the interior worlds of both travelers and illustrates that neither is left untouched by the complexities of change. [ABSTRACT FROM AUTHOR]

This paper concerns the author's countertransference reflections on her work with a gay adolescent who identifies with powerfully destructive internal objects, including Hitler and the Monster. The author describes her countertransference inquiry through which she experiences her own potential destructiveness in order to help accommodate her adolescent patient's rejected and disowned self states. [ABSTRACT FROM AUTHOR]

Eros is like a huge spark that ignites our passion and then confronts us with the problem of living out this fire in ordinary space and time. What do we each know of this spark, this flame? Who or what was it’s object? Where have we felt this force for unity in ourselves, with another person, with life itself? Where are we unlived erotically? Where are the chinks in our erotic life? In focusing on the erotic in clinical work, we usually begin with the analysand’s transference. I want to explore eros in the life of the analyst for our relation to eros influences the clinical work we do. When eros is constellated, two possibilities of relationship present themselves: to an actual other who must be reckoned with as real, and to a psychic content, equally real, which we do not invent or control. How do we experience this electricity? What is our desire like? What does it take us back to, and toward what unseen purpose does it propel us? Eros brings with it a sense of purpose, of going somewhere important, something that enlists body, soul, and spirit. [ABSTRACT FROM AUTHOR]

This article was presented as part of a 2005 American Academy of Religion book panel on Pamela Cooper-White's recent book on countertransference in pastoral care and counseling. A response to Dr. Cooper-White's contribution is offered from the perspective of large group dynamics and their countertransference implications for pastors and church consultants. [ABSTRACT FROM AUTHOR]

The purpose of this article is to suggest richer potential meanings of spiritual wisdom and theological reflection in response to a critical reading of Pamela Cooper-White's book, Shared wisdom: Use of the self in pastoral care and counseling. [ABSTRACT FROM AUTHOR]