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In this case commentary, I offered my musings related to what I imagined thinking about if I encountered Colette in psychotherapy, highlighting potential interpersonal dynamics that could infuse the treatment relationship. I explored several clinical issues, including themes of race, repetition of abuse, enactments, working with trauma, and other unconscious dynamics at play in the treatment of traumatized patients. These thoughts were provided from the perspective of a young, White therapist who practices from a relational position. [ABSTRACT FROM AUTHOR]

The clinician's experiences of race outside of the treatment room contribute to the formation of a racialized self, which influences clinical work with all clients notwithstanding race. Multiracial individuals at times must balance their external physical presentation-and the corresponding race-related categories that others place on them-with their own internally constructed racial identifications. The mechanisms of identification and disidentification can provide safety for the multiracial individual. How can clinicians effectively acknowledge their own identifications and disidentifications as lenses for seeing the multiracial person's racialized self and selves so as to more effectively work with the multiracial? [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]

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]

A Lacanian perspective privileges speech as the motor of cure in the treatment of this borderline patient. In assuming such an ethical position, the clinician fostered a symbolic transference marked by an outburst of rage that signified a rupture of her entanglement with her mother. In this way, the clinician's promotion of 'full speech' breached the patient's defensive need for 'invisibility' and led her to produce a socially useful project. [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]

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]

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]

The understanding of transference and countertransference has changed a great deal since Freud introduced the terms. A case example indicates one way the patient's and clinician's past experiences and expectations interact to create a here and now relationship that is highly influenced by transference/countertransference. The understanding of both terms as aspects of a mutually constituted interaction has practice implications for the treatment of adult survivors of abuse who have a somatoform disorder. [ABSTRACT FROM AUTHOR]

The author looks at the experience of hate in the countertransference and develops the idea that hate can be of particular value to the treatment process. He begins with an exploration of the therapist's needs and discusses how unmet self-regulatory needs sometimes lead to feelings of frustration and rage toward the patient. The author explores these ideas as they are connected to Winnicott's (1949, 1971) work on aggression and Jessica Benjamin's (1992) work on recognition and destruction. The author espouses a difference between rage and hate, where rage is seen as indicative of unmet needs, and hate is seen as a force that can emancipate the therapist from the encumbrance of unmet needs. Case examples are provided to show the utility of this perspective. [ABSTRACT FROM AUTHOR]

As psychoanalysts, we have to be constantly aware of the impact of external reality upon the analytic process, whether this comes from the world outside the consulting room or from within it. In particular, I am concerned with the disturbing influence that may come from the analyst's devotion to new theoretical positions and ways of working. Also we cannot prescribe 'good experience' for any patient. We can only follow the process, and this may require of us that we survive being used by the patient to represent all that has been worst in the patient's life. We should never deflect that. [ABSTRACT FROM AUTHOR]

Much has been written about paranoid anxieties as these occur in the patient. Less, however, has been written about primitive experiences as these occur in the therapist during the session. This paper recounts a patient's correct articulation of the therapist's self-perception, which, because of its accuracy, initially flooded the therapist with shame and dread. Nonetheless, the patient's perception was able to be used in a way that clarified, in the countertransferance, a piece of the patient's early experience in relation to her mother and strengthened the therapeutic relationship. [ABSTRACT FROM AUTHOR]

When the focus of the child treatment is on the therapist being a “good” object, this can accentuate a possible countertransference difficulty of the therapist becoming the protector of the child from the “bad” object. This countertransference can often resonate with rescue fantasies in the child. This paper will explore the topic of rescue fantasies in child treatment, while addressing the issue of coinciding fantasies existing unconsciously in both the therapist and child, leading to their enactment. A case of a nine-year old boy is presented which demonstrates how interpretation and resolution of rescue fantasies can lead to a deepening of the treatment. [ABSTRACT FROM AUTHOR]

Editorial. Comments on the rhetoric about reparative therapy. Change in the concept of sexual orientation; Contractual agreement between client and therapist; Affirmative psychotherapies for gays and lesbians.

Compensatory treatment theory rooted in object relations and self psychology is typically silent about issues of love in the therapeutic relationship, particularly the erotic and sensually infused affects and enactments that may permeate patient-therapist interactions, even in the treatment of preoedipal patients. This paper presents a series of case reports in which the therapist consciously or unconsciously experienced some permutation of love in response to the patient's loving and/or erotic feelings. The central thesis is that patients benefit when therapists recognize the sensual components in transference-countertransference interactions and use them to inform therapeutic interventions. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to define the presence of the clinician's cultural countertransference in the cross-cultural therapeutic dyad, and describe its impact on the delivery of culturally competent services. The recognition of the contributing role of the therapist's own subjectivity in psychodynamically oriented practice cannot be more vital than in the treatment of patients whose culture, race, or class markedly differ from that of the therapist. The cultural countertransference is viewed as a matrix of intersecting cognitive and affect-laden beliefs/experiences that exist within the therapist at varying levels of consciousness. Within this matrix lie: the clinician's American life value system; theoretical beliefs and practice orientation; subjective biases about ethnic groups; and subjective biases about their own ethnicity. The author proposes that these countertransference attitudes are often: disavowed by the clinician; exert a powerful influence on the course of treatment; and though unspoken, are frequently perceived by the client. [ABSTRACT FROM AUTHOR]

This article seeks to establish six guidelines for the use of self-disclosure in clinical social work. It examines the relationship between self-disclosure and countertransference, the timing of self-disclosure over the course of the therapeutic relationship, types of self-disclosure, the connection between assessment of the client and self-disclosure, and how self-disclosure is related to reality-testing. Objections to self-disclosure are also examined and clinical examples are used throughout. [ABSTRACT FROM AUTHOR]

Psychoanalytic literature has focused on the influence of the primary object during early development, and the transference is described as a repetition of these early object experiences. Yet, personality is informed by past and present experiences with primary objects and others. Thus, limiting our understanding of the transference to past object experiences does not fully demonstrate the complexity of this phenomenon, nor does it allow for the ongoing influence that a primary object may have on the patient's life. Using contemporary psychoanalytic theory, this paper looks at the way that adult interactions with their primary object figures and the attunement of their therapists to these present experiences also influence the therapeutic action. [ABSTRACT FROM AUTHOR]

This paper urges that attention be paid to the meaning and importance of early sibling relationships as manifested in clients' and therapists' lives and psychodynamic psychotherapy. [ABSTRACT FROM AUTHOR]

Countertransference reactions of sleepiness and disinterest in the clinical material being presented by patients can be annoying and confusing. This paper presents a theoretical framework for understanding the author's countertransference with Borderline patients in the schizoid continuum of borderline pathology, according to a classification scheme from Meissner (1984). In the case example presented projective identification and several interpretations of its meaning are reviewed and linked with the author/therapist's experience of sleepiness in the session. The understanding and containment of these projections, as well as interpretations offered to the patient, allowed for a successful resolution to the treatment. Implications for other cases with similar character structure are discussed with emphasis on the therapists using their subjective experience of sleepiness to understand their patients. [ABSTRACT FROM AUTHOR]

Understanding the role of sexualization in a depressed patient gives us the opportunity to re-examine the place of sexual activity in psychopathology. The self psychological concept of the mirror transference is used to explain the therapist's activity in the case illustration. [ABSTRACT FROM AUTHOR]

Projective identification has received much attention for its ability to elucidate certain types of countertransference reactions. However, many severely disturbed patients are unable to benefit from the insight derived from interpretations based on projective identification. For many of these patients, the initial benefit of therapy is based on the containing provided by the therapist tolerating the countertransference rather than insight based on interpretation. Denis Carpy (1989) has written that the patient's observation of the therapist's tolerance of the countertransference helps to build psychic structure in the patient. In this article, the author reviews Carpy's position and then illustrates the value of the patient witnessing the therapist manage his countertransference using the case example of an adolescent in residential treatment. [ABSTRACT FROM AUTHOR]

This paper illustrates the role of supervision in processing countertransference responses which might have disrupted the therapist's empathy with a patient who had killed her child. The clinical material demonstrates how the therapist's responses of initial denial and subsequent disgust and fear were dealt with in supervision. As a result, the treatment process led to genuine, albeit limited, therapeutic change in a patient with severe character pathology. [ABSTRACT FROM AUTHOR]

Verbal communications have dominated treatment theories and will remain a privileged source of communication. This paper directs the therapist's attention to some of the possible breathing behaviors in treatment which may, like verbal language, convey an unconscious or conscious message that is possibly interpretable. Breathing has meaning in the transference--countertransference intersibjective world. Behavior symbolized by breathing may be included in the earliest somatic, dyadic interaction and may therefore for with one through life and reappear in every new relationship. This paper directs the clinician's attention to some of the possible meanings and interpretations of breathing behavior during treatment. It calls attention to techniques for exploring the rich connection between breathing, body, object and somatization. [ABSTRACT FROM AUTHOR]

This paper unravels the treatment benefits of continued work with a 12 ½ year old girl who remained silent during the therapy. The multiplicity of meanings that silence represented for the patient are innumerated. In addition, the utilization of therapeutic tools such as movement therapy and countertransference are discussed in relation to the psychodynamics of the patient's silence. The paper shows how the therapist and the patient were able to reach a core self-space from which to develop and grow. [ABSTRACT FROM AUTHOR]

In 1986 research the author described a constellation of gender related issues emergent in the transference and countertransference of women psychotherapists treating women patients. Shared gender-linked issues appear to foster special resonance between women psychotherapists and their patients. This paper posits that shared themes in the interplay of transference and countertransference can be reparative and growthful for the psychotherapist as well as her patient. Three examples from the author's clinical experience are used to demonstrate the process by which countertransference can give the patient greater access to unconscious material while simultaneously promoting growth in the therapist. [ABSTRACT FROM AUTHOR]