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Collusion designates a specific type of transference-countertransference interaction between two or more persons, linked by an unconscious and shared unresolved issue, which they avoid on an intrapsychic level by externalizing it in the interpersonal space. To find a way to identify collusion and to delineate it from other transference-countertransference interactions. We conducted this study based on a case series approach. The study material consisted of audiotaped clinicians-centered supervisions with oncologists. The case series methodology involved the systematic examination of a purposive sample of supervisions, with the aim to understand how and why they differ from one another with respect to the relational dynamic between the physician and his/her patient. Four cases/supervisions were selected as they allowed to situate collusion on the spectrum of transference-countertransference interactions. We report on it by describing a countertransference reaction, two transference-countertransference interactions, and a collusion. The study reveals the challenges and pitfalls of research on collusion. The results allow to confirm the criteria of our working definition of collusion and to delineate collusion from other transference-countertransference interactions, which represents a first step for the empirical investigation of collusion. [ABSTRACT FROM AUTHOR]

In the context of the socio-political instability that exists in Ukraine, the problem of stress resistance among psychological service professionals has emerged. The aim of the research is to analyse the professional activity of psychologists in Ukraine at the present stage under the influence of stress factors. The following methods were used to study the nature of stress and its impact on the personality of a psychologist: analytical and synthesis methods, statistical, comparative, survey and interpretive methods. The research results theoretically reveal the peculiarities of the concept of stress, the stages of stress development, and identify the main stressors of professional activity. An empirical study of the stress resistance of psychologists was conducted. The influence of stress on the quality of psychological care was determined. Professional qualities in the psychologist's personality structure were identified, the phenomenon of professional exhaustion, the role of countertransference in counselling were studied, the importance of the code of ethics for psychologists and its violation in the course of practice were revealed. The importance of interventions and supervision as a means of psychological support for the professional development of psychologists was investigated, and statistical indicators of the level of stress were analysed. The practical significance of the research is determined by the current coverage of the problem of the impact of stress on the professional activity of a psychologist and in the creation of effective ways of emotional self-preservation and development of stress resistance, which provide the search for their resources for self-healing and effective work. [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]

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]

This is the seventh entry in the Psychological Elements of Palliative Care (PEPC) series. Previous articles have focused on the psychological elements of the care we provide patients and the relationships we build with our referring clinician colleagues. In this entry, we focus on how the PEPC also impact clinician well being. The PEPC are bidirectional: we impact patients, but patients also impact us. The reactions that we have to patients and the boundaries we set around the care we provide are two examples of psychological factors of care that can influence our well being. Creating spaces to explore and reflect on the psychological impact of the clinical care we provide is a key component of wellness. Such spaces vary in their configuration, but all share the opportunity to self-reflect and to experience emotional validation, normalization, and reality testing from peers or mentors. In mental health training, clinical supervision is one common format for creating such a space. While this can be replicated in the palliative care setting, other strategies include integrating a psychological orientation into interdisciplinary team meetings, creating peer support or process groups, and creating small groups within teams for longitudinal self-reflection. [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]

This study deals with countertransference on the part of observers in analytical groups. It complements an earlier study by the same team on participants' feelings towards observers. In a content analytic evaluation of an anonymous survey conducted among group observers, only around a third of all response items, interestingly, referred to the observer's feelings towards participants, whereas about half of the items referred to the observer's own position as an observing person, and the remainder to the group leaders and other staff. In contrast, in the preceding complementary study almost all response items referred to the group participant's feelings towards observers. Almost all observers reported positive, sympathetic states of feeling touched or moved, while negative feelings towards participants were the exception. Where states of stress were reported, they referred to the setting or to situations by which the respondent felt stressed or productively impacted. Participants were found to be viewed consistently as individuals who were following a path that also concerned the observers themselves. The accompanying supervision was described as valuable and beneficial. By contrast, perceptions contained very little evidence in favour of views found in the literature according to which observers are able to provide support to group leaders by giving them feedback or by offering insight, through analysis of their own feelings, into unaddressed issues within the group. In a different setting this resource could possibly be made better use of. Clear evidence was found of idealizing transference from observers to group leaders. This can be readily explained as a natural phase in developing an identity as a therapist. The response items confirm the assumption that an important function of observers lies in "neutralizing participants' superego". Conversely, the reflective setting helped observers to attenuate their superego traits, thus promoting a lively development process. [ABSTRACT FROM AUTHOR]

Based on the idea that in the clinic of limit cases, the analyst needs to allow him/herself to contact his/her countertransference, in order to use it to produce a technique and adapt him/herself to the clinical case, we ask ourselves if our transmission processes in psychoanalysis, especially supervision, are prepared for this reality. For this, we seek to understand how supervision used to be thought over the time, from the Hungarian School of Psychoanalysis throughout the contemporary authors, who work with phenomena such as reflection process and parallel process. In this way, we come to psychoanalysts who bet that, through the regression in supervision, connected to the case's point of identification, it would be possible to produce some more empathic place for the analyst in relation to his/her patient. Finally, we show a quick example of clinical supervision to illustrate a beginning of understanding regarding the presented proposal. [ABSTRACT FROM AUTHOR]

Objective: Understanding and managing countertransference (CT) is challenging for therapists and more so for trainees. This study aimed to understand more about trainees' experiences of CT; and to consider the usefulness for reflective practice of a five component model of CT (origins, triggers, manifestations, effects, and management) and the importance of feedback. Method: Trainee psychologists in Australia and New Zealand took part in a CT training and were invited to take part in the study. Trainees were randomly assigned to 1 of 2 conditions in which they received regular feedback or feedback at the end of the study. Nineteen trainees completed 93 reflective logs. Data from the logs were analysed using thematic analyses. Results: Most trainees perceived their CT originated from formative experiences and personality qualities and were triggered by client concerns and behaviours. They described a wide range of CT manifestations; and perceived the effects of CT as mainly negative. More trainees in the regular feedback condition, compared to post-completion, engaged with the activity. However, there was no difference in themes that emerged in the two groups. Conclusions: The five-component model of CT provides a method for reflecting on CT and could be used to enhance trainees' reflective practice. Key Points What is already known about this topic: (1)Little is known about trainee psychologists' experiences of countertransference although there is evidence that trainees experience difficulties understanding and managing their countertransference reactions. (2)Understanding and managing countertransference supports positive therapy outcomes. (3)Hayes' (1995) model of countertransference proposes five components – origins, triggers, manifestations, effects, and management. What this paper adds: (1)The study provides greater insight into trainees' views of the five components of countertransference. (2)Hayes' (1995) model of countertransference appears to provide a useful model of reflective practice that could be used in post-graduate psychology training. (3)This model is also likely to be useful for psychologists and clinical supervisors in their own practices. [ABSTRACT FROM AUTHOR]

Analytic literature explains that the supervisee's countertransferential responses are shaped by the patient's transference and by the supervisee's unconscious internal conflicts and relational patterns. In this paper, I suggest that, rather than interpreting the supervisee's unconscious processes, the supervisor often struggles to expand the supervisee's capacity to sustain ambiguous and confusing inner experiences, perceptions, and thoughts that emerge in therapeutic interactions. I will elaborate on one approach to expanding the supervisee's containment of ambiguous and confusing therapeutic experiences: enhancing the supervisee's tolerance of ambivalence. Tolerating ambivalence enables supervisees to contain conscious contradictory feelings and intentions and unconscious personal and relational conflicts. Furthermore, the suggested approach may help the supervisor apply rich theoretical and experiential analytic knowledge adapted to the supervisory context to achieve a productive outcome. [ABSTRACT FROM AUTHOR]

Although Blatt's two-polarity model of depression has suggested that patients' interpersonal styles may shape countertransference phenomena in psychotherapy, empirical research on this topic has remained scarce. This article provides an in-depth study of countertransference processes in clinical work with dependent (anaclitic) depressed patients using a qualitative methodology. Thematic analysis of narrative material of psychodynamic therapists discussing patient cases during supervision (n = 7) resulted in four recurrent themes: "empathy, compassion, and support," "anxiety, feeling overwhelmed, and protection," "frustration, irritation, and confrontation," and "inadequacy, incompetence, and fatalism." We found that these countertransference processes mainly revolved around perceived adaptive and maladaptive aspects of patients' relational functioning. Regarding clinical practice, our study suggests that therapists can use countertransference to determine in which position they are maneuvered by patients, although we caution against the exclusive use of subjectively informed data as a benchmark in the diagnostic and treatment process. We conclude that further in-depth research on countertransference and personality styles is needed to identify pitfalls in the treatment of depression. [ABSTRACT FROM AUTHOR]

In this paper I ask what an investigation of the Budapest model of supervision may add to our psychoanalytic imagination. The Budapest model confronts us with a number of crucial questions for contemporary psychoanalysis, including the question of envisioning ways of working on the countertransference of the analyst. I discuss the lack of memory that surrounds the Budapest model, and I read it in relation to the unsettling issues it stirs up, including those of authority, horizontality, and the ethics of psychoanalysis. In the Budapest model, supervision can be seen as a form of "double dreaming" or of "dreaming up of a dream". In particular, in drawing on the writings of Sándor Ferenczi and Michael Balint, I point to some principles behind the Budapest model and to the epistemic, technical, and ethical implications of their ideas. I also work toward a Ferenczian "translation" of the idea of "parallel process". [ABSTRACT FROM AUTHOR]

Utilizing detailed, in-depth material from supervisory hours from around the world (explored in End of Training Evaluation groups), this paper shows that supervisors are subject to multiple, diverse and, at times, ongoing intense countertransferences and impingements on their ability to evaluate candidates' progress. Multiple external and internal sources of these impingements are explored. It is suggested that supervisory countertransferences and their manifestation in parallel enactments remain under-recognized, their impact underappreciated, and the information they contain underutilized. It is argued that the recognition, containment, and effective use of the parallel process phenomena and supervisory countertransferences are essential in order to evaluate candidates' progression and readiness to graduate. Common signals of such entanglements in the supervisor's evaluative function are identified. Three remedies, each of which provides a 'third,' are offered to assist supervisors in making effective use of their countertransference: self-supervision, consultation, and institutional correctives. [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]

Although establishing an evidence base for psychoanalytic practice has become a matter of increasing practical and accountability concern, the establishment of an evidence base for psychoanalytic supervision has yet to be given any consideration. In establishing a more comprehensive evidence-informed approach to treatment and training, the corollary need to build an evidence base for psychoanalytic treatment supervision would accordingly seem an important next step to address. What research supports the use of psychoanalytically informed constructs in supervision? With that research base considered, is there any sort of an evidence base for psychoanalytic supervision practice itself? In this paper, I would like to examine those two questions, giving particular attention to two psychoanalytically derived variables of supervision import: the supervisory alliance and parallel process. Based on research review, data thus far provide a high degree of empirical support for the supervisory alliance as perhaps being the crucial fundamental and foundational variable in making supervision work or not. While comparatively far more limited and less robust in nature, data about parallel process offer a tentative degree of support for that construct's importance in supervision as well. While still only in its most formative period, we at least appear to have an informed and informing evidence base for psychoanalytic supervision beginning to take more substantial shape. [ABSTRACT FROM AUTHOR]

Countertransference (CT) has been recognized as a significant variable in the process and outcome of therapy and counseling for over 100 years. A review of the literature suggests that little attention has been devoted to strategies that supervisors can use to address CT in supervision with novice counselors. Informed by models of CT proposed by Ladany, Friedlander, and Nelson () and Van Wagoner, Gelso, Hayes, and Diemer (), this article provides counselor educators and field placement supervisors with a reflective strategy for the holistic supervision of CT. [ABSTRACT FROM AUTHOR]

Transfer of patients to interns, while frequent in training sites, is often viewed negatively. However, transfer affords positive opportunities for therapy, training, and supervision. It provides a window into patients' experiences of loss, change, attachment style, capacity for working alliance, and affect tolerance. For supervisors and interns, an opportunity exists for deeper understanding of the patient, the therapeutic relationship, alliance building and the usefulness of ongoing feedback both in therapy and supervision. Dilemmas for intern therapists include narcissistic vulnerability and sibling dynamics. With case illustrations, countertransference issues for interns and supervisors are identified and suggestions are offered for addressing transfer in supervision. [ABSTRACT FROM AUTHOR]

The paper describes and discusses some aspects of the countertransference in relation to two patients whose state of mind could be described as psychotic during treatment. The clinical work took place in the context of a private psychotherapy practice, but some aspects of the countertransference became evident in relation to external, but related figures connected with the treatment. It was not until the treatment with both patients had ended, and the author had done a considerable amount of work on her own processes, that she was able to acknowledge, think about, and eventually write about, the ways in which the two patients had impacted upon her own psyche. In order to achieve this aim of understanding, the author undertook a research degree at MA level as the frame in which to study psychotic processes in more depth, along with studying the transference and the countertransference. As she worked upon her degree thesis she became more aware of, and less embarrassed about, the countertransferential processes that taken place. The paper makes particular use of Stephen Purcell's contributions to identifying the countertransference and Harold Searles's work with psychotic patients. [ABSTRACT FROM AUTHOR]

This article was written in response to receiving the 2012 Eric Berne Memorial Award for the author’s work on supervision. It underscores the value of theoretical knowledge of supervision for all practitioners, even those not directly involved in offering supervision. It also provides a practical approach to the analysis of the relational dynamics in both supervision and clinical practice through three questions practitioners might ask themselves: What am I feeling during the session? Why do I feel what I am feeling? Why does the other person want (unconsciously) me to feel what I am feeling? The use of these questions is described and illustrated through two case studies. [ABSTRACT FROM AUTHOR]

abstract Supervision work in a prison Therapeutic Community is used to explore countertransference implications for staff engaging with residents' disturbed states of mind. Parallel process (a psychoanalytic concept supported by contemporary neurological findings and particularly relevant to supervisory relationships) is used to explore vulnerabilities within the staff group towards acting out the dynamics they are working with therapeutically such as attacks on linking, feelings of helplessness and cynicism, and the denial of aggression. Conversely, the development and reinforcement of the staff group's capacity to generate and preserve a thinking space while under threat has a therapeutic effect upon residents' states of mind, again through the workings of parallel process. The establishment of this benign parallel process is a central task of the Therapeutic Community, and underpins its effectiveness. Its relevance for effective therapy with disturbed states of minds in other settings is also considered. [ABSTRACT FROM AUTHOR]

An approach is presented that introduces the concept of countertransference to predoctoral interns and externs in a unique way during their professional training. This approach goes beyond a didactic presentation of the concept and even beyond discussion of case material in supervision. Through an experiential role-play process called Mimesis, trainees are encouraged to enact scenes from literature that depict typical dilemmas that psychotherapists working in a psychodynamic framework must face. By using carefully chosen stories, supervisors can highlight aspects of the therapeutic process such as managing countertransference feelings. This approach fosters a more flexible and open inquiry into one of the most daunting aspects of professional development for both trainees and supervisors. [ABSTRACT FROM AUTHOR]

The author discusses supervision, transference and countertransference as seen in the context of the clinical case of a patient who had been first seen as a training analysis case and who later, in a fortuitous way, was treated by the supervisor of the training analysis. The supervisor, who in the first instance did not recognize the patient, discusses the reasons for this unusual experience in terms of the presence and absence of transference during the analysis of this patient as a training case and the problems inherent in the task of supervising. The patient's feelings towards the first and the second analyst and the vicissitudes of transference and countertransference during the supervision of the training analysis and its infl uence on the presentation of the analytical sessions by the student are also detailed and discussed. The question of recorded supervision presentations and their possible infl uence on the dynamics of supervision is raised. [ABSTRACT FROM AUTHOR]

Most psychologists who face board complaints experience significant personal and professional distress. As a result, they become vulnerable to cognitive, emotional, and behavioral responses that may compromise their clinical work as well as their ability to defend themselves. Awareness of some of the most common sources of distress associated with complaints can allow psychologists to take steps to minimize, if not obviate, problematic countertransference, impaired objectivity, and self-defeating responses throughout and beyond the complaint investigation and adjudication process. Further, awareness of these pitfalls can inform the work of the supervisors, consultants, and psychotherapists who assist psychologists facing ethics complaints. [ABSTRACT FROM AUTHOR]

This paper addresses the unconscious processes that manifest through organizational dynamics, transference relationships and splitting. I suggest that one of the primary tasks of supervision is to help the counsellor understand and manage the complexities of the setting and multi-professional working in order that the clinical work can be thought about and understood. Supervision therefore represents what Winnicott (1960) calls the environmental mother who holds and contains the object mother in undertaking the clinical work. A psychodynamic approach to supervision is considered and I argue that its focus on transference, countertransference, unconscious processes and defences is apposite. The frenetic pace of primary care is often recreated in supervision through parallel process. The challenge for the supervisor is to grasp the significance and impact of the setting on the clinical work and on the supervisory space and to create the necessary reflective space and boundaries where both the setting and the clinical work can be worked with. An intersubjective approach to supervision utilizes the countertransference to understand the multiple transference relationships that manifest between the counsellor, the patient, GPs, different members of the primary care team and the supervisor [ABSTRACT FROM AUTHOR]

The traditional role-set of the clinical social work supervisor has grown to be much more complex. From the exclusive position of teacher, administrator, and overseer she is now an integral part of a system wherein she is influenced not only by the therapist, client, and her own promptings but is a prime source of feedback to the client through the supervisee. As clinical social workers have shifted their conceptualization of therapy to a two-person psychology, this perspective has emerged as part of the supervisory process. Now the supervisor's countertransference responses to the supervisee, to his client, and to their interaction have assumed importance in supervisory work. This article is an attempt to demonstrate through case illustrations how the supervisor's disclosure of countertransference responses to the supervisee can strengthen the supervisory alliance which then enables the client and therapist to resolve therapeutic impasses. [ABSTRACT FROM AUTHOR]

This paper explores why open dialogue on the subject of erotic transference and countertransference is so difficult and attempts to offer an understanding of these phenomena which might enable counsellors to work more confidently with it. It also briefly examines the author's own research on therapists' thoughts and experiences of erotic transference, seeking to differentiate between inappropriate sexual contact between clients and therapists and the experience of erotic transference in the context of therapy as a reworking of the Oedipal relationship. Case examples illustrating the experience of countertransference within the therapeutic situation and how its presence can act as a help or a hindrance are offered. The paper concludes by examining the need to reflect on the erotic transference in therapeutic work and proposes its usefulness as a therapeutic tool. Suggestions about how the erotic transference can be managed to therapeutic effect are also explored. [ABSTRACT FROM AUTHOR]