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Over the years, the psychiatric inpatient treatment paradigm has shifted to more brief stays focused on acute stabilization and psychopharmacologic-focused interventions, rather than individual psychotherapeutic engagement. Unfortunately, this has allowed patients with complex interpersonal dynamics, particularly borderline personality disorder, to slip through the cracks of effective treatment. This can contribute to repeated inpatient admissions, where both patients and clinicians feel trapped in a maladaptive, unhelpful cycle. In this article, we examine the evolution of inpatient treatment with de-emphasized psychotherapy practices, review the particular dynamics that patients with borderline personality disorder may evoke within an interdisciplinary treatment team, and provide a framework of clinically based vignettes for scenarios that may arise within inpatient treatment of this patient population. With attention to countertransference patterns and common pitfalls of communication, we offer alternative approaches and conversations with the hopes of improving outcomes and alliances in a new landscape of psychiatric practice. [ABSTRACT FROM AUTHOR]

Taking the liberty of imagining the lawyer in Melville's "Bartleby, the Scrivener" as narrator/therapist and Bartleby as patient, this article, written with the therapist/reader in mind, traces the vicissitudes of countertransference and speculates on what constitutes a "good enough" therapeutic effort. [ABSTRACT FROM AUTHOR]

Given some of the challenges beginning therapists experience in the development of their new roles, they may be more susceptible to becoming overwhelmed by their countertransference, lack the awareness to track all of the processes taking place in the therapy room (e.g., projective identification, transference/countertransference dynamics, etc.), and have a propensity to be pulled into enactments. This paper explores how therapy processes, client trauma, and clinician levels of experience intersect therapeutically with the dyad's identity features and may impact the therapist's ego functions. A case is discussed that explicates how racial identities in a dyad can create enactments resembling those of marked historic and cultural imbalances in Western society, taking away the minority therapist's ability to think and speak in English due to the intense projective identification and countertransference experience of inferiority and incompetence in the presence of a patient with various identities of privilege. The role of internalized racism within the minority therapist is also explored in rendering them unable to process the deeper dynamics evoked in the therapeutic and supervisory dyad with the patient when the patient used racially charged language. [ABSTRACT FROM AUTHOR]

Working through the different faces and vicissitudes of the death drive in the countertransference, and especially through projective identification, is a very challenging process. A thorough and versatile process of containment and working through of the manifold threatening expressions and influences of the death drive is required, experienced most specifically and deeply in the arena of projective identification. This paper demonstrates how each aspect that unfolds in the analyst's countertransference sheds light on a particular layer of anxiety and internal object relations related to it. The creation of a new meaning to the differing expressions of the death drive gradually lessens the compulsion to repeat and enables a better integration between the life and death drives. This process will be illustrated by a prolonged clinical case that involved intense internal working through of the death drive in the analyst's countertransference. [ABSTRACT FROM AUTHOR]

The therapeutic encounter with psychotic patients presents therapists with moments in which they may regress, together with the patient, toward primitive and psychotic areas of experience. Within this shared psychotic world, therapists might feel persecuted, as if the ground is slipping from beneath their feet. The author suggests that the psychotic part of the personality, as argued by Bion, is inherent to all of us and may come alive in the psyche of the therapist in response to patients in psychotic states. The psychotic dialogue that emerges between patient and therapist, which involves projective identification and counter-transference mechanisms, must be worked through. Therapists' capacity to survive the psychosis forced upon them and to move through and beyond it is highly significant. By examining clinical material from therapy with a patient diagnosed with schizophrenia, the author discusses this unique countertransference phenomenon, which he terms induced psychotic countertransference. [ABSTRACT FROM AUTHOR]

The author describes how his experiencing of the husband in a neurodiverse‐neurotypical couples therapy as narcissistic, led to a countertransference impasse. Using clinical material, he describes how his understanding of neuroscience helped him to view his patient as suffering from high functioning Asperger syndrome, and how this understanding helped in the resolution of the impasse. It is hoped that this clinical situation will emphasize the value of having a greater integration between our psychoanalytic and neurological understandings. [ABSTRACT FROM AUTHOR]

Learning how to identify and work with the countertransference is a cornerstone of any psychoanalytic training, yet it can't be taught solely through books or in the classroom. Experience of the countertransference and having it pointed out through supervision or a peer group is an essential component of this learning process. Nonetheless, countertransference can be missed as it's often an unconscious form of communication. This article explores, through the example of an infant observation, how an intense countertransference penetrated unchecked and unnoticed but was enacted through the creative act of knitting. The emergence of this countertransference is examined and is then considered through the lens of a 'creative block'. This idea gives a different way to think about unconscious processes and enriches the understanding of what is being communicated. [ABSTRACT FROM AUTHOR]

Countertransference, it is widely agreed can either deepen awareness of personal and relational dynamics to the benefit of the work or it can distort and become an impediment through the adoption of defences. The aim of this study was to explore what supported the development of countertransference awareness in an organisational context through a qualitative study. Semi-structured interviews were conducted with 15 therapists either face to face or online. The findings indicate that participants followed one of two pathways, a reflective pathway, where they developed their countertransference awareness to the benefit of the work, and a defensive pathway, the focus of the present paper. Here, the findings suggest that when the organisational setting, the supervisory relationship, and the adopted theoretical framework, did not support the thinking about the relational dynamics, including countertransferential responses, it resulted in the adoption of defences, to the detriment of the work with the client. The implication of the findings, including the limitations of the study and avenues for further research, are also discussed. [ABSTRACT FROM AUTHOR]

Psychotherapist’s profession brings challenges in many areas. One of them is emotional capacity and capability to be in touch with client’s suffering. The concept of containment is related to psychotherapist’s capacity to stay present and process at the same time demanding countertransferences. Psychotherapist deals within psychotherapeutic relationship with similar processes as mother with her child. She accepts and processes with respect and acknowledgement the child’s experiences, what helps the child to create capability of reflection, self-regulation and functional boundaries. On the contrary, containment that is not reflected can negatively influence psychotherapist’s capacity to be present and available during the session. The aim of this contribution is to describe the concept of containment in relation to psychotherapist’s self-care from the perspective of selected psychotherapeutic approaches. [ABSTRACT FROM AUTHOR]

The Covid-19 global pandemic has, for the moment, upended the traditional setting for analysing transference and countertransference dynamics, vital components to the work of psychoanalytic child psychotherapy. The physicality of the customary treatment setting provides a basis for the experiences of containment and understanding, along with the corresponding and familiar technical considerations within that setting. The absence of these fixed physical elements when transferring cases to virtual and other non-conventional settings points to a new set of technical challenges. How do we understand projective identification, transference and countertransference with children when the modified setting does not inherently afford a child the physical means to make contact with the consulting room as a container? What resources do we have as clinicians for persevering through the psychoanalytic process, in the face of the current global uncertainties? In this paper, I outline some of the theoretical underpinnings in psychoanalytic child psychotherapy that elucidate the challenges to the work I have encountered with my child patients during the pandemic, and explore the clinical implications stemming from those challenges. [ABSTRACT FROM AUTHOR]

Abstract: This paper offers an integration of social issues, psychoanalytic theory, and analytic experience in the treatment of a patient whose political values and identifications differed significantly from my own. Our political leanings facilitated a dynamic tension of difference, power, and aggression that mirrored how each of us felt in relation to the current social‐political milieu. In particular, the sadomasochistic dynamics on display in the treatment offered me a unique way of understanding my relationship with my patient and opened new ways of understanding the political present. In the end, I learned to stop worrying about getting rid of anger, aggression, and splitting, and instead to embrace what these feelings and behaviors can tell me as a therapist, and what they can inform for my patients about the nature of relationality, identity, and difference. [ABSTRACT FROM AUTHOR]

The intent of this article is to further explore and review the concept of countertransference, in its various, most commonly accepted meanings in the psychoanalytic literature. Major clinical and theoretical developments in this concept began in the 1950s, and have found centrality and coherence in Bion’s theory of containment. A basic issue in the discussion on countertransference is whether, and up to what point, analysts should allow themselves to be modified by the impact of their patients’ projections. Freud, Klein, Rosenfeld, and Bion all underline the importance of an impartial, balanced, and unstressed quality of the analyst’s receptivity with regard to the patient’s mental state, as well as the transformative complexity implicit in “trying to know.” In fact, the disturbance that is sparked in the analyst by his interaction with the patient is now considered unavoidable and has increasingly emerged as a specific topic of study. The author uses clinical illustrations from her work with children and adults, as well as observations from everyday life experiences, to exemplify the way countertransference interacts with the ability to observe empathetically, often hindering and distorting it, but also potentially enriching its depth and breadth. [ABSTRACT FROM AUTHOR]

Aims: The primary aim of this study was to investigate a psychotherapist's countertransference experience of gender mobility in response to a patient using projective identification to maintain a rigidly defended sexual identity. A secondary aim was to explore the utility of autoethnography as a psychotherapy research method, with a specific focus on understanding the complexities of countertransference experience. Method: The therapist's experience of gender mobility in response to the deployment and withdrawal of a female patient's projective identification is systematically tracked using thick description of session vignettes and autoethnographic self‐analysis. Findings: Autoethnography provides a viable form of practice‐led qualitative research, particularly useful in exploring countertransference experience. The contribution of the therapist's historical subjectivity and cultural positioning undercuts the asocial depiction of projective identification as largely the patient's creation. The therapist's own gender‐related conflicts are activated and contribute to the patient's projective evacuation of gendered self‐representations. The gendered complexity of the psychotherapeutic interaction defines not only defended identity, but also the therapeutic reclamation of projected self aspects in the course of treatment. Both patient and therapist experience an enlarged repertoire of sex and gender possibilities as a result of successful psychotherapy. Implications for practice: Gender mobility in the countertransference experience requires considerable self‐analysis in order to determine the therapist's unconscious contribution to the projective identification process. Awareness of the social context informing the therapist's gender construction can assist in facilitating countertransference understanding. Therapists’ openness to their gendered multiplicity is critical in aiding patients who manifest some form of gender or sexual orientation conflict. [ABSTRACT FROM AUTHOR]

Children with autism can have a paralysing effect on the clinician’s capacity to associate freely: connections that seem obvious on reflection may be impossible to notice in the child’s presence. The author argues that this situation can be reached by more than one pathway, and that the degree of the child’s bodily and emotional cohesion is an important factor. Children may seek to immobilise the therapist’s thought processes through projective identification, whether to communicate their own experience of paralysis or because these thought processes are equated with a parental intercourse that produces a ‘baby’ (as described by Bion and Britton). Vignettes are offered to illustrate how the therapist may be nudged into overlooking this baby as well as a potentially growing part of the child that is identified with it, with important consequences for development. A second possible pathway appears to involve the much more primitive mechanism of adhesive identification, in which the child’s sense of continuing existence depends on sticking to the therapist’s surface and any movement can lead to a sense of bodily disintegration. In the clinical illustration, the therapist felt physically constrained and unable to recognise links in the material: it is suggested that this was in resonance with the child’s fear that movement, whether physical or mental, meant losing parts of his body and must be avoided at all costs. These levels can mask each other, and it seems essential to attend to both in order to avoid impasse or the overlooking of essential aspects of the child’s experience. [ABSTRACT FROM PUBLISHER]

The authors present two clinical cases involving an existential crisis which led the patients to lose what had been the foundation in their lives, their faith. Although the therapeutic settings differ - the first patient had a few psychotherapy sessions following a psychotic episode with a mystical background, while the second was in the final stage of analytic treatment - the authors highlight how in both clinical cases a loss of faith becomes a total and urgent crisis of the Self. The fracture which ensues seems to generate an intense engagement of the body which, paradoxically during a loss of faith, induces an experience of ecstasy of the kind that has traditionally been reported. In the first case the experience of ecstasy was lived first-hand by the patient who thereafter redefined the psychotic breakdown as a 'moment of truth'; whereas the second patient, through a deep projective identification, induces an eerie countertransferential feeling of 'metaphysical' shortfall in the agnostic psychoanalyst, triggering bewilderment, physical discomfort and awe in him. In both cases the authors believe that the notable somatic involvement may be correlated to a potentially profound and unprecedented contact with the True Self. [ABSTRACT FROM AUTHOR]

Referring to Melanie Klein's unpublished views on projective identification, Bion's theory of container/contained and Money-Kyrle's understanding of countertransference as a process of transformation, the author develops a multiphase model of projective identification. He differentiates five subphases of (1) adhesion, (2) penetration, (3) linking of the projection with an internal object of the analyst, (4) transformation and (5) re-projection. In the author's view the differentiation of overlapping subphases may be helpful to better localize problems of working through the countertransference. Some technical implications are illustrated by brief clinical vignettes. To conclude, the paper discusses typical impasses and options for interpretation. [ABSTRACT FROM AUTHOR]

Curiously enough, the concept of projective identification was ignored, and even rejected in France for at least two decades after the publication of the founding texts of Melanie Klein and Herbert Rosenfeld. This rejection was due to a critique from child psychoanalysts close to Anna Freud and also from the teaching of Lacan: the first took the real mother-child relation extensively into account, while the latter only saw the internal object as a signifier. The fact that during this period the countertransference was a concept reduced to its negative content no doubt explains this deliberate ignorance. With the dissemination of a broader and more positive conception of the countertransference, a renewal of interest could be observed in the 1980s with references to empathic listening and to the effects of thought-induction. [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]

This article reflects on pivotal concepts of psychoanalytic practice and theory, applied to a single case study to create new meanings. Drawing from the concepts of transference, countertransference, and projective identification, the author presents the notion that the researcher's subjective reactions are created and induced by the subject of study precisely because this is one, and sometimes the only way available to the subject to communicate something that is out of its full awareness. In essence, some unconscious material can be expressed nonverbally by the subject by means of provoking visceral and bodily reactions in the researcher, or in some cases, psychic imagery such as dreams or fantasies. The material can be meaningfully interpreted by the researcher by receiving, containing, and sorting through these inchoate emotional reactions within self. [ABSTRACT FROM AUTHOR]

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

Countertransference is one of the most important tools of the analytic work. In this paper, I will try to show how countertransference has been considered in different ways according to the importance paid to the analyst's subjectivity. One important problem concerns the therapeutic value of the elaboration of countertransference. My hypothesis is that this necessary process is not enough to promote the therapeutic progress. I think that the analysis of countertransference is essential in order to keep the analytic process open but it is not a true therapeutic tool per se. The analyst should constantly and eagerly integrate the patient's world with every element (memories, reconstructions, considerations on life experiences, including his own) that can be useful in widening the patient's emotional life. The analytic relationship depends on the analyst's capacity to create and maintain in his mind a place for the patient (for his history, his difficulties and his tacit request for mental and emotive development) and on the patient's disposition to consider the analyst as a transformative object that is indispensable for his growth. The analytic process continues and progresses as long as this relationship remains alive. In this perspective, the analysis of countertransference plays a moderate and self-controlled role. [ABSTRACT FROM AUTHOR]

Many of our patients in psychoanalytic treatment introduce transference states that pull for particular countertransference acting-out. By their overreliance on projective identification, they invite us to recreate various unconscious phantasies involving paranoid and depressive object relational conflicts. Using one extensive case report, the author demonstrates the ongoing struggle in the countertransference to maintain an analytic balance. When taking the inevitable misstep toward enactment, the author demonstrates how to work towards regaining analytic balance. [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]

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 the course of a psychoanalytic treatment, many clinical situations create countertransference pulls or invitations to participate in enactments of various degrees. In these projective identification-based transferences, the patient is often successful in drawing the analyst into archaic object relational patterns of acting out. During these moments, the analyst must struggle to find a way to stay therapeutically balanced. The urge to rush to judgment with punitive, seductive, rejecting, controlling, or manipulative comments rationalized as interpretations must be managed. If these unavoidable countertransference enactments are managed and studied, they can provide useful information about the patient's internal struggles and can show the way to making more helpful and more therapeutic interpretations. Case material is used for illustration. [ABSTRACT FROM AUTHOR]

This paper shows a child psychotherapist learning and developing her technique as she attempts to make contact with a child who is extremely hard to reach. It is based on the first two years of three-times-weekly intensive psychotherapy of a latency girl who had little faith in a helpful therapeutic relationship. Her defences against such a relationship were entrenched and hard to shift. In this clinical work, the psychotherapist relies on close observation and her countertransference to develop a relationship with the child, in order to begin to make sense of her non-verbal emotional experience and communication. [ABSTRACT FROM AUTHOR]

The concept of countertransference has a long history in psychoanalysis. This paper sketches the phenomenon referred to by countertransference and the development of the concept, from being signs of disturbance in the analyst to an important road to knowledge about the patient's inner life. The complexity of the questions discussed today - how to understand the concepts of neutrality, abstinence, and empathy; the relative subjective mutuality and symmetry of the analytic situation; the analyst's enactments and self-disclosure of feelings - reflects the complexity of the contemporary view of the patient-analyst relationship. In conclusion, the author presents a model illustrating the disturbing and informative aspects of countertransference together with the conceptual relationship between countertransference on the one hand and empathy and projective identification on the other. Finally, by differentiating between intuitive and irrational levels of functioning, an integrated model for countertransference is presented, synthesising the essence of the concept as it is used today. [ABSTRACT FROM AUTHOR]

This paper describes combining music therapy and participant observation with a group of four mothers and their children, all of whom had special needs. The quality of interaction between each mother and child is described, as well as the obstacles which hindered each pair coming together in a harmonious way. Factors affecting the mothers' receptivity are thought about in terms of projective identification and containment, along with the traumatic impact of having a child with severe difficulties. The aim of the group was to engage the mothers actively in observation and to create an environment within which the mother and child relationships could continue to develop. [ABSTRACT FROM AUTHOR]

This paper considers unconscious aspects of ageism, particularly in the underlying, reciprocal projective identifications between the 'young' and 'old' which entrench ageism and contribute to the debilitating consequences of ageing. These projections are examined in the context of care for older people, between the carer and the older person and between the therapist and the older client. Illustrations are given of how opportunities to reflect on the projective process through the counter-transference can ameliorate the effects of ageist attitudes and behaviours. [ABSTRACT FROM AUTHOR]

In borderline or even narcissistic patients, the relation to the objects is built on the basis of omnipotent control, so that those patients present difficulties related to mourning for the loss, as well as for the independence, of the objects. Their basic trait is a huge inability to recognize the separateness of others, together with an excessive use of primitive defense mechanisms, such as projective identification. Each experience that contains the danger of re-experiencing the primal separation poses an attack on the analytic setting, in order to avoid such a re-experiencing. Those attacks sometimes take the known form of acting out, whereas other times they are limited to a special use of speech, which lacks any communicational faculty and is used rather as a weapon. This special climate affects the analyst, causing specific countertransferential reactions. Nowadays, we tend to consider such a communication not mostly as an obstacle, but rather as an opportunity, allowing the analyst to comprehend the patient, through his countertransference, and create a meaning to replace the void those patients usually experience. The transference and countertransference enactments, their silent dialogues taking place in the analytic setting, are those which progressively give meaning in this primitive non verbal communication. [ABSTRACT FROM AUTHOR]

This essay discusses the clinician's defense against and resolution of the experience of boredom in the countertransference as an incident of projective identification in the treatment of a woman with dissociative identity disorder. The essay details the inner mind of the therapist as she discovers both her own feelings and judgements of those feelings. As the essay progresses, she begins to grasp the significance of her discomfort in informing the therapeutic process. We watch as this material is made use of to move forward a stalled therapy into new territory. [ABSTRACT FROM AUTHOR]

Based on the theoretical assumption and clinical observation that projective identification is a natural, constant element in human psychology, clinical material is used to illustrate how projective identification centered transference states create situations where acting out of the patient's phantasies and conflicts by both patient and therapist is both common and unavoidable. Because they are more obvious, some forms of projective identification encountered in clinical practice are easier for the analyst to notice and interpret. Other forms are more subtle and therefore difficult to figure out. Finally, some forms, whether subtle or obvious, seem to create a stronger pull on the analyst to blindly act out. In some psychoanalytic treatments, one form of projective identification might embody the core transference. In other cases, the patient might shift or evolve from one level of this mechanism to another. Some patients attempt to permanently discharge their projective anxiety, phantasy, or conflict into the analyst. There is a patent resistance to re-own, examine, or recognize this projection. Some of these patients are narcissistic in functioning, others are borderline, and many attempt to find refuge behind a psychic barricade or retreat (Steiner 1993). In other forms of projective identification, the patient enlists the analyst to master their internal struggles for them. This occurs through the combination of interpersonal and intra-psychic object relational dynamics. This "do my dirty work for me" approach within the transference can evoke various degrees of counter-transference enactments and transference/counter-transference acting out. Another form of projective identification, common in the clinical setting, is when a patient wants to expand the way of relating internally, but is convinced the analyst needs to validate or coach the patient along. This is why such a patient may stimulate transference/counter-transference tests and conduct practice runs of new object relational phantasies within the therapeutic relationship. Over and over, the patient may gently engage the analyst in a test, to see if it is ok to change their core view of reality. Depending on how the analyst reacts or interprets, the patient may feel encouraged to or discouraged from continuing the new method of relating to self and object. The patient's view of the analyst's reactions is, of course, distorted by transference phantasies, so the analyst must be careful to investigate the patient's reasoning and feelings about the so-called encouragement or discouragement. This does not negate the possible counter-transference by the analyst in which he or she may indeed be seduced into becoming a discouraging or encouraging parental figure who actually voices suggestions and judgment. All these forms of projective identification surface with patients across the diagnostic spectrum, from higher functioning depressive persons to those who are more disturbed paranoid-schizoid cases. Whether immediately obvious or more submerged in the therapeutic relationship, projective identification almost always leads to some degree of acting out on the part of the analyst. Therefore, it is critical to monitor or use the analyst's counter-transference as a map towards understanding the patient's phantasies and conflicts that push them to engage in a particular form of projective identification. doi:10.1300/J032v14n02_04 [ABSTRACT FROM PUBLISHER]

This paper discusses the development of object relations theory which, in Britain, was developed as an extension of Freudian psychoanalysis by such thinkers as Melanie Klein, Fairbairn, Winnicott and their followers and later supported by research from attachment theorists like Bowlby. Object relations theorists made a shift from the conception of a drive-based psyche to one that was primarily motivated towards relationships. Contemporary object relations theory acknowledges the primacy of relationships, which results in the close attention and utilisation of the constantly active system of transference, countertransference, and protective identification in the space between therapist and client. This paper examines object relations in the context of its unique challenges for gay male therapists working with gay male clients in the gay therapeutic dyad. This paper reviews the legacy of homo-negativity in the therapeutic process. It then explores how knowledge of object relations theory can be useful for therapists working within a gay therapeutic dyad. [ABSTRACT FROM AUTHOR]

The author describes a type of mental development in which the primitive libidinal value of faeces and urine is kept unaltered all through adulthood. In this instance, individuals harbour fantasies of projective identification with the internal parents, denying their real dependence, which leads to a pseudomaturity. These fantasies are usually accompanied by anal and genital masturbation and have intense aggressive content. Furthermore, there is a significant confusion among all body orifices, leading to an inability to distinguish the self from the object, the inner world from outside reality. Individuals with this type of development can only maintain limited object relations and have highly erotized excretory activities. Manipulation of faeces may occur. This structure works as a defence against breakdown, but may also provide pleasure as it gives the illusion of omnipotent control of the object, as typical in pathological organizations. The author presents clinical material and discusses the difficulties of the analysis, in which the patient tries to seduce the analyst into colluding with his mental functioning, primarily as a means of communication as well as a projection of his despair and his disbelief in the analyst's ability to help him. [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]

This paper suggests that the interplay between transference and countertransference is considered to be a valuable channel of communication. The author puts an emphasis on the containing function of the analyst. The patient strives for an experience of an object (analyst) that tolerates and copes with the patient's projections. There are some moments when analysts feel themselves to be invaded, controlled or abused by their patient's products. As Bion has postulated, this situation takes the form of a sojourn in the analyst's psyche. Clinical vignettes are given to provide support for the ways in which the analyst contains and elaborates the projections of the patients in his or her own mind and the therapeutic role that these processes have. [ABSTRACT FROM AUTHOR]

In this paper I recount the difficulties of working with the group whose members were traumatized during the bombing of Serbia and Montenegro in 1999. The difficulties were most present in transference-countenransference relations. The focus will be the influence of the projective identification mechanism on counter-transference, and how this mechanism is used in order to express the feelings that cannot otherwise be expressed, except for the therapist to experience them. The communications aspects of Projective Identification (PI) were evident when the group members tended to provoke certain feelings and thoughts within the therapist, trying to involve him in some kind of an acting-out and so avoid anxiety related to their feelings. Therefore it was of great importance that the therapist should observe his countenransference feelings as the way for the feelings of the group members to be registered, since they cannot be registered in any other way. [ABSTRACT FROM AUTHOR]

This article focuses on a clinically observed event: the impact of the analytic session on the corporeality of the psychotherapist. The author sees this as an example of countertransference, in this instance 'somatic countertransference'. Short and long clinical extracts are used to detail these events. The author touches on some early ideas on somatizing. The Kleinian concept of projective identification is itself explored and then used to explore further the idea of somatic countertransference. [ABSTRACT FROM AUTHOR]

The transference-countertransference relationship is only one of five modalities of relationship that research has identified as potentially present in the therapeutic encounter. This paper gives the background and definition to one aspect of this - the countertransference - and traces the development of the concept from Freud's first use of the term in 1910 to the contemporary view that it is a useful tool of psychotherapy. The first part explains its connection with the Kleinian concept of projective identification and discusses its elaboration by the object relations school. There is general acceptance nowadays that the countertransference contains a great deal of information about the client's psychological world. It is therefore important to understand this process and the authors have identified three main dimensions to countertransference. These are its vector (or direction and force), its variance (the quality it represents), and its valence (its effect on the client). The second part of the article illustrates, through the use of example and metaphor, how these three dimensions are defined and can be recognized. Common themes and paradigms of countertransference are identified and discussed along with some ways in which experience has shown how these might be contained and worked with constructively. Finally, a clinical vignette is presented in which some of the dimensions of countertransference are identified and used to understand the client's psychic world and foster therapeutic change. [ABSTRACT FROM AUTHOR]