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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 paper discusses why similar institutional rules (Municipal Plan, Fund, and Council) and intergovernmental transferences) may influence municipal decision-making to participate in inter-municipal consortia differently in two Brazilian federal public policies—health and education. The paper argues that the more institutionalized the national policy design, the higher the probability of the municipalities getting into IMC. Based on quantitative analysis, findings show why the financial dimension is relevant for health policy, the most institutionalized in comparison with education, regarding municipal options for IMC. Similar evidence was not found in both policies considering the effect of their institutional rules. [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]

This study explored the contributors that influenced the marital conflict between a Korean husband and a Japanese wife. The study found three triggering events and latent contributors in personal, familial, social and cultural levels. Although the three events triggered marital conflicts, the latent contributors were fundamentally maintaining and aggravating the couple's relationship. As a result, this study suggests that when family therapists counsel interracially married Asian couples, it is necessary to address cultural differences in families of origin, communication methods, and transference along with the cultural disparities. [ABSTRACT FROM AUTHOR]

We tested developmental trends in eyewitness identification in biased and unbiased lineups. Our main interest was adolescent's lineup performance compared with children and adults. 7–10-year-olds, 11–13-year-olds, 14–16-year-olds, and adults (N = 431) watched a wallet-theft-video and subsequently identified the thief, victim, and witness from simultaneous target-present and target-absent six-person photo lineups. The thief-absent lineup included a bystander previously seen in thief proximity. Research on unconscious transference suggested a selection bias toward the bystander in adults and 11–13-year-olds, but not in younger children. Confirming our hypothesis, adolescents were more prone to bystander bias than all other age groups. This may be due to adolescents making more inferential errors than children, as predicted by fuzzy-trace theory and associative-activation theory, combined with lower inhibition control in adolescents compared with adults. We also replicated a clothing bias for all age groups and age-related performance differences in our unbiased lineups. Consistent with previous findings, participants were generally overconfident in their decisions, even though confidence was a better predictor of accuracy in older compared with younger participants. With this study, we show that adolescents have an increased tendency to misidentify an innocent bystander. Continued efforts are needed to disentangle how adolescents in comparison to other age groups perform in forensically relevant situations. [ABSTRACT FROM AUTHOR]

This project explores the self-experiences of Black boys in public spaces, primarily in Chicago. Given the plethora of negative media attention placed on violence in the city and on violent encounters with law enforcement, this project asks how Black boys can experience themselves in a life-giving way when so many negative images and stereotypes denigrate their humanity. The author introduces the concepts of group-level racial delusion and demonic transference. The former term suggests a psychological split occurring at the societal level that historically has allowed emotional and physical violence to be disproportionately and callously inflicted on Black boys in public spaces, which society has internalized as normative while simultaneously extolling democratic and Christian values central to Western identity formation. The latter term suggests the interpersonal or group transference that occurs just prior to the infliction of emotional or physical harm on Black boys—a transference that is propped up by abject images and stereotypes of Black males. The article concludes first with reflections on a qualitative interview conducted with two groups of Black boys in Chicago pertaining to their self-experiences in public spaces and then with thoughts on future work. [ABSTRACT FROM AUTHOR]

The mechanism of projective and introjective identification has been re-evaluated in modern analysis. It is no longer just about the transference of mental content to an other, rather it addresses also the deepest psycho-organic sensations and vibrations, which in turn become the basis for interpersonal and family dialogues. The goal of this article is also to lay out the fundamental dynamics of body language as understood by the relational family paradigm. It is a novel analytical perspective on the individual, who is always part of any relational family configuration. [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]

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]

The experience of teaching a graduate seminar on aging led us to adapt and augment our teaching perspectives and approaches to help students gain insight into their own limitations in working with older adults. Role-play exercises helped students bring their own family of origin, personal experiences, biases, and beliefs about older adults into bold relief. New-found insights from these lived experiences included better understanding and appreciation for transference and countertransference issues, which are often overlooked or given short shrift in our training and work with older adults. Long considered not suitable for serious clinical work, older adults are increasingly asking for more than just life-sustaining case management, yet many clinicians feel limited in their abilities when they accidentally or unintentionally encounter older adults or adjunctive elder family members in their work. [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]

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]

Borders and rules define the psychoanalytical process and at the same time promote its 'magic' moments. Psychoanalysis contains thoroughly playful elements, even though it is concerned with severe crises and conflicts. These are very effective for example in working with transference. When a psychoanalyst assumes a transference role which has been unconsciously allocated to the psychoanalyst by the patient, the psychoanalyst becomes involved in the mental reality just as someone becomes involved in the reality of a game. In the game, which is played in earnest, something is portrayed in the psychoanalytical performance. In this context the asymmetrical rules for the linguistic game of psychoanalysis can be comprehended as 'disguise measures' which promote the magic of transference. This 'magic' is necessary in order to enter into a world detached from the everyday world and to set a process in motion. At the same time the psychoanalyst must be aware of the fact that the magic will be attributed to the psychoanalyst (and at the same time will be promoted by the borders and rules) who must never misuse this magic: it must always be used as a means of promoting the autonomy of the analysand. [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]

This paper confirms a marked change in developmental context and serious delays in identity development in all age groups, which have consequences for relationships in general and therapeutic relationships in particular. These changes in identity development have led to a depathologization of the prolonged transition to adulthood. In addition, it became obvious how much parents may hinder identity development. Recent societal changes leading to a more precarious life are responsible for an increase in reactive identity disturbances. In psychotherapy the endless search for identity, a difficulty to balance individuality and attachment and, considering transference, a too supportive relationship are important issues. Furthermore, it might be useful to discriminate between identity crisis, identity conflict and identity diffusion. [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.

A number of leading practice models have been found to be effective in the treatment of Borderline Personality Disorder (BPD). These include Dialectical Behavior Therapy, Transference Focused Psychotherapy and Mentalization Based Treatment. This article reviews the current evidence for these dominant practice models, and concludes that no single treatment has been found to be consistently superior in the treatment of BPD. Given the lack of evidence priviledging one single model of treatment, and the fact that it is not always feasible or desirable for social workers to practice using pure manualized treatment models, there is a need to develop more integrative approaches to treatment with this vulnerable population. By highlighting specific similarities and differences between practice techniques, this paper attempts to pave the way toward developing a more integrative treatment approach to working with individuals with BPD, an approach where interventions are selected based on appraisal of the evidence, clinical expertise, and client need. [ABSTRACT FROM AUTHOR]

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]

The Lubavitch Chassidim are one of several ultra-orthodox groups within Judaism. Their central focus is on their leader or Rebbe, who is seen as not only the possessor of all wisdom but also having supernatural powers. In working therapeutically with Lubavitch, one needs to distinguish if the beliefs of the individual are unique to them or reflect the belief system of the community. If the former, then it obviously needs to be analyzed. If the latter, then it is seen as an identification with the group and reflective of the need for group cohesion and often a regulator of self-esteem. The following article demonstrates these factors. [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]

In psychoanalysis and also in supervision the analyst's and supervisor's handling of the question of the vacant or missed session and a possible related fee are evident in word and action. In analysis the analyst and the analysand exchange views. In supervision the debate runs on two levels: the supervisand and the supervisor talk about the therapy processes that happen between the supervisand and the patient including the handling of vacant sessions and related fees. Above that there is a real and actual exchange on the question of vacant sessions in the supervisory relationship. Often the analyst's, supervisor's and supervisand's own conscious views about unacceptability and unreasonable hardship define which so-called exceptions and goodwill arrangements they believe they are obliged to offer with respect to their supervisands and analysands without these having their say. This article illustrates how a (unconscious) 'to-have-one's-say' of analysands in treatment and of supervisands in supervision can be initiated and how this can lead to a deeper understanding of the emotions and conflicts of the analysand and the supervisand as well as the dynamics of transference and countertransference in analysis and supervision. The important aim of the article is not the search for an ideal and universally applicable rule for vacant sessions but rather the analysis, by means of the context-related method, of the themes, beliefs and conflicts emerging in these special relationships, which in turn allows individual insights and suitable ways to approach the topic of the handling of vacant sessions and related fees. [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]

After many years where manualized mainly behaviour treatments dominated in forensic settings, psychodynamic therapies are gaining acceptance and are performed and evaluated more and more in forensic hospitals and in prisons. This encompasses individual, couple, family and group therapies. Individual and group analysts are starting to perform these tasks again, mostly as workers in forensic settings but also as external therapists and supervisors. All staff members are important in creating a therapeutic community based on group analytic principles. They are therefore required to build up a therapeutic attitude supported by regular external case and team supervision. Delictogenic situations occur in everyday life as well as in professional settings and are analysed mainly in group therapies, considering situations of the past and the effect on other people. Modern manualized analytical concepts, such as transference-focussed psychotherapy (TFP) and mentalization-based therapy (MBT) depthen the quality of therapeutic work of all professionals in forensic settings. The multimorbid and sometimes dangerous patients require good ethical and professional attitudes. The psychoanalytic concepts of defence and resistance, transference and countertransference are essential parts of changing internalization and corrective emotional experience, important parts of useful forensic treatments. [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]

Compared to Freud's use of six sessions a week, the frequency of therapy has now decreased to a maximum of three or four sessions. The current field of applied psychoanalysis using only one or two sessions a week is of much higher relevance for the worldwide supply of the population with psychotherapy. Not only frequency and duration have decreased over the years but also the sum of applied sessions per patient. This is especially the case in psychodynamic short term psychotherapy. With the change in frequency a change in therapy technique took place resulting in a more active and attentive therapist, an interactive pattern with more dialogue and an avoidance of regressive movements of the patient. The crucial role concerning the work with transference and resistance was maintained in tendency but the specific techniques also underwent modifications. The empirical state of psychodynamic psychotherapy is better than it used to be but further studies are urgently needed. [ABSTRACT FROM AUTHOR]