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As a construct, the elaboration of countertransference experience (ECE) is intended to depict the implicit and explicit psychological work to which therapists submit their experiences with clients. Through ECE, defined as a mentalizing process of a particular kind, therapists' experiences are presumed to acquire and increase in mental quality and become available for meaning‐making and judicious clinical use. In this paper, we claim that such an ongoing process facilitates engagement with common therapeutic factors, such as the therapeutic alliance and countertransference management, enhancing therapist responsiveness in psychotherapy. We synthesize relevant literature on countertransference, mentalization, and, in particular, therapists' mentalization, informed by a systematic literature review. As a result, we propose a model for assessing ECE in psychotherapy, comprising 6 diversely mentalized countertransference positions (factual‐concrete, abstract‐rational, projective‐impulsive, argumentative, contemplative‐mindful, and mentalizing), 2 underlying primary dimensions (experiencing, reflective elaboration), and 5 complementary dimensions of elaboration. Strengths and limitations of the model are discussed. [ABSTRACT FROM AUTHOR]

Clinical supervision provides the foundation for cultivating ethical practice and professionalism for mental health trainees. Exploration and management of a supervisee’s personal reactivity or countertransference (CT) is a critical component of supervision and has clear ethical implications for clinical management and the development of clinical competence. This article discusses supervision practice and presents the results of a study that investigated the influence of supervisor–supervisee relationship on clinical and counseling doctoral students’ CT disclosures. Respondents completed the Working Alliance Inventory–Supervisee form and the Personal Reaction Disclosure Questionnaire, which assessed respondents’ comfort and likelihood of reporting CT reactions to hypothetical clinical interactions. Results of this analogue study demonstrated positive associations between supervisory alliance and reported comfort and likelihood of CT disclosures, highlighting the importance of the alliance and drawing attention to supervisors their responsibility to particularly attend to thebonddimension of the relationship. [ABSTRACT FROM AUTHOR]

In this paper I aim to outline the importance of working clinically with affect when treating severely traumatized patients who have a limited capacity to symbolize. These patients, who suffer the loss of maternal care early in life, require the analyst to be closely attuned to the patient's distress through use of the countertransference and with significantly less attention paid to the transference. It is questionable whether we can speak of transference when there is limited capacity to form internal representations. The analyst's relationship with the patient is not necessarily used to make interpretations but, instead, the analyst's reverie functions therapeutically to develop awareness and containment of affect, first in the analyst's mind and, later, in the patient's, so that, in time, a relationship between the patient's mind and the body, as the first object, is made. In contrast to general object-relations theories, in which the first object is considered to be the breast or the mother, Ferrari (2004) proposes that the body is the first object in the emerging mind. Once a relationship between mind and body is established, symbolization becomes possible following the formation of internal representations of affective states in the mind, where previously there were few. Using Ferrari's body-mind model, two clinical case vignettes underline the need to use the countertransference with patients who suffered chronic developmental trauma in early childhood. [ABSTRACT FROM AUTHOR]

This article presents the history of one until now unknown case of C.G. Jung: Maggy Reichstein. Born in Indonesia in 1894 in a very aristocratic family, she brought her sister to Zurich to be treated by Jung in 1919, and later she herself was in analysis with him. Jung used her case as example in his lecture in 1937 on the realities of practical psychotherapy, relating it to the process of transference and countertransference. Jung deepened his studies in Eastern psychology after a series of dreams she had, which culminated in the Yoga Kundalini Seminars. She was also the case presented in his article of 1951 on the concept of synchronicity. Jung wrote that her case, concerning synchronicity, remained unique in his experience. Jung also published some of her mandalas. He considered her able to understand his ideas in depth. Reichstein was for Jung an important case, which challenged and triggered his interests in different subjects. [ABSTRACT FROM AUTHOR]

This article attempts to deal with the feelings of despair and hope in the analyses of autistic spectrum disorder (ASD) children. The analyst’s therapeutic despair and hope might reflect both the child’s split-off and fragmented primitive unconscious phantasies regarding traumatic breakdown, as well as his or her hidden search for reparation. This autistic reparation involves the phantasised acquisition of bodily and mental coverage and containing forms. These phantasies are deposited in the analyst and are manifested in various, sometimes hallucinatory, states of body and mind. The analyst’s ability to move freely between states of despair and hope is thus a crucial factor in maintaining mental space, in reaching for a better understanding of the child and in promoting his development. Using clinical material drawn from two analyses of a young girl and a male adolescent, the article describes the analyst’s countertransference reactions of somatic hallucinations and the phantasies regarding ‘the virtual child’. These represent both the child’s attempts to use the analyst’s mind in order to get rid of catastrophic fears of breakdown and change as well as to convey various means of phantasised autistic reparation and hopes for a benign psychological birth. All these are part of the process of ‘mantling’, in which the child acquires advanced forms of psychic coverage replacing previous autistic objects and autistic sensation shapes. In addition, an attempt is made to differentiate between false and true hope in the process of emergence from autistic encapsulation. [ABSTRACT FROM PUBLISHER]

This paper presents clinical material from work with a latency-aged boy, the son of lesbian parents, who presented with an unformulated panic around his experience of gender. While one might expect that lesbian, bisexual, gay, transgender, and queer parents might be especially comfortable with such concerns, the paper argues the opposite: that such concerns almost invariably trigger historical traumas and normative messages about gender, both within parents and in clinicians. Grappling with those messages and the attendant panic, both in patients and in the clinician's countertransference, is viewed as a crucial part of the unfolding work. [ABSTRACT FROM PUBLISHER]

This article considers daydreams as a means of understanding the patient and fostering the therapeutic relationship. Daydreams are considered along with fantasies and reverie. The usefulness of the therapist's reverie in response to the daydreams of a patient who is conflicted about being seen and known is explored. Daydreams are considered in relation to creativity—both analytic and artistic; and as a way of bridging inner life and external reality. [ABSTRACT FROM PUBLISHER]

The author proposes an expanded notion of the concept of Agieren, introduced by Freud in his theory of transference, and to this effect discusses three metapsychological articulations. Firstly, the idea of the psyche is proposed containing different co-existing modalities of representing emotional experience. One is a verbal inscription governed by the logic of the dynamically repressed, and another is the registration of a mode of being, in the form of sequences of psychic gestures that the subject exchanges with his objects. The author proposes that the psychic gesture is the ideo-pictographic representation for certain emotional states never verbally thought and, consequently, its metapsychological status is unconscious but not repressed. Secondly, these unconscious registers contain specific modalities of processing reality, created by the projective attribution of the parental unconscious. Finally, by conceiving this model of unconscious, ideo-pictographically represented as psychic gestures, the author proposes that a patient's emotional state, becoming a psychic gesture of the analytic pair, is enacted within the analytic stage. His proposal departs from the frequent view of enactment as a result of the non-represented aspects of the psyche. It is assumed that what is played out by the analytic pair pertains to the unconscious imaginary represented. [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]

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

The practice of psychoanalysis places the analyst on strong pressures - the analyst works alone in the consulting room in a medium of isolation, he has to be permanently open to what is coming from the patient, he is emotionally affected by his patients and he has the responsibility to keep and maintain professional boundaries of this relationship. Hate in countertransference could generate a particular conflict in the analyst - conflict between his need to repair, to help his patient, and the hate he feels toward the patient. There is another side of psychoanalysis as a profession, in addition to the clinical practice -the psychoanalytic institutions. Intolerance to diversity, dogmatism and the proneness to schism can be seen as institutional symptoms. Some authors offer explanations from different perspectives - political, sociological, and even religious. The author suggests that in order to understand conflicts in psychoanalytic institutions one must take into account the anonymous psychoanalytic patient who maintains the psychoanalysis as a profession, and argue that hate in countertransference could be seen as one of the sources of conflict between colleagues. [ABSTRACT FROM AUTHOR]

This paper attempts to set out the conceptual history of countertransference and intersubjectivity. I will attempt to show the different histories that have occurred within British object relations compared with the developments in the post-ego-psychology era in North America. [ABSTRACT FROM PUBLISHER]

Background: The concepts of transference and countertransference developed within psychodynamic paradigms. While there is an increasing interest by cognitive therapists in the therapeutic relationship, there is less discussion of the relevance of transference and countertransference. Understanding these concepts may be useful to cognitive therapists as part of reflective practice, especially in regard to understanding and managing countertransference responses. Methods: This article briefly examines the concepts of transference from a number of different perspectives, including social-cognitive, attachment, cognitive analytic therapy, and schema perspectives. Two aspects of countertransference that are sometimes termed 'subjective' and 'objective' are also examined. A case example is given to illustrate a cognitive conceptualisation of countertransference. Results: There is some evidence that therapists' countertransference responses can provide insight into clients' experiences and patterns of relating to others. Cognitive therapists may therefore benefit from applying psychodynamic perspectives of countertransference in reflective practice. Conclusions: Transference and countertransference can be understood using cognitive perspectives. These concepts may be helpful for cognitive therapists to consider during reflective practice in self-supervision and in clinical supervision. It seems important that cognitive therapists do not dismiss these concepts because of their origins but rather investigate the potential applications of these concepts within cognitive frameworks. [ABSTRACT FROM AUTHOR]

Somatic phenomena in the countertransference have historically received minimal attention despite evidence of their occurrence in the therapeutic encounter. In the field of Counselling Psychology, there seems to be an apparent gap in the academic coverage and clinical utilisation of therapists’ somatic states. The purpose of this study was to explore therapists’ somatic experiences in the countertransference using a grounded theory methodology, based on a sample of 12 participants that was composed of psychotherapists, counselling and clinical psychologists. The results indicated that therapists made sense of their somatic experiences through a developmental process of ‘relating to the body’ that combined stages of defensive operations, intellectual reflections, attributions of somatic ownership and recognitions of various working patterns in the management of somatic experiences. This study addresses the factors that constituted therapists’ processing of the experience, and the findings suggest that therapeutic work may be affected when psychosomatic phenomena as such become undermined and ignored. [ABSTRACT FROM PUBLISHER]

The question posed in this article is how the therapist should deal with strong emotions she might experience in the session. This question is especially important if it concerns emotions that -at least on the surfacecannot be considered to contribute to a therapeutic alliance. We offer some reflections as preliminary steps towards answering this question and propose that therapists be sensitive to their own experiencing during the session, be careful to monitor the implicit invitations to join the family members in potentially destructive relational scenarios, reflect on the possible negative and perpetuating effects of her interactions with the family, and explore opportunities to proceed with the session in new and more constructive ways. In our approach the therapist's experiencing is seen as a tool that may be used to further the therapeutic process. This is consonant with the view of family therapists exploring the importance for the therapist of holding open a space of reflection, while it also fits with a dialogical approach to family therapy, in which the therapist's task may be described as listening to the stories the clients tell, and making room for other stories that have not been told before. Two case discussions illustrate our ideas. [ABSTRACT FROM AUTHOR]

My purpose in this article is to provide an example—through one person's psychoanalytic treatment—of how transference–countertransference enactments reflect significant and traumatic elements of a person's experience in one's community and society. I will use the term enactment to include system-level dynamic patterns as they are played out unconsciously among individuals or groups. I will offer a glimpse into one female-to-male transgendered person's individual psychoanalytic treatment. I believe that his analysis—during a difficult time when he was struggling to inhabit a fully male life—will provide a useful example of how we analyze community dynamics in analytic work. [ABSTRACT FROM PUBLISHER]

When trauma enters into the reality of the analyst and of the analysand, when it attacks the setting, what becomes of the analyst's role? How can transformations be brought about? With reference to three clinical situations, the author attempts to explore how the articulation between transference and countertransference - the inter-relation - structures the situation; the analyst must remain in his or her role as analyst through managing to create and to reflect upon the clinical aspects of that situation when faced with the unpredictability of what war brings in its wake. It then becomes possible to see how the work of the negative can be confined to the outer limits of the setting. [ABSTRACT FROM AUTHOR]

Research on body image and older women has grown in the past decade. However, there is a gap in the literature regarding body image, older women, and countertransference. This article provides 7 case examples of racially and ethnically diverse women over 60, drawn from MSW student and agency staff supervision, and participant feedback from a national conference on aging workshop. Themes related to loss and grief, adult daughter and aging mother issues, incest, anger, disability, personality disorders, phobic reactions, and shame are discussed. Recommendations and implications for social work practice, education and research are provided. [ABSTRACT FROM AUTHOR]

Violence inflicted on men and women has repercussions on succeeding generations. Indeed, suffering that is not narrated and shared can become masochism and destruction. Based on a clinical case, I will propose an illustration of this fact and discuss it. I will also propose a discussion of countertransference linked to this case history. Finally, I will approach some topics on metapsychology and the way I use this concept to understand my experience. [ABSTRACT FROM AUTHOR]

A qualitative study was undertaken to enhance awareness of the therapeutic needs of the male survivor of sexual trauma through exploration of counsellors' and psychologists' experience of working with this client group. The participants were 32 counsellors and psychologists who work for an NHS Trust department. Interpretative Phenomenological Analysis was used to analyse the data which was gathered by means of a postal questionnaire. Six categories emerged from the analysis that highlighted prevalent experience. These were: (a) that the therapist's gender was important, (b) professional concerns, (c) the importance of the relationship, (d) transference/counter transference, (e) that male and female abusive experiences are the same and (f) attention to client's presenting problems. The main conclusions derived from these results and implications for practice are considered. [ABSTRACT FROM AUTHOR]

This paper highlights some key features of a Jungian approach to transference and countertransference and suggests that a Jungian model has crucial aspects in common with contemporary views in attachment theory on the nature of the analytic relationship. The analytic relationship is examined in terms of the fundamental processes of psychic development described in attachment theory and affective neuroscience, namely affect regulation and development of reflective function and of self-agency. The relative value of three analytic techniques, those of interpretation, new relational experience and regression, are discussed in relation to these processes. I suggest that each of the traditional psychoanalytic and Jungian analytic models concentrates on differing aspects of these psychic processes and analytic techniques. I construct a grid to illustrate this and to demonstrate how attachment theory and developmental neuroscience offer a theoretical basis on which we can develop an integrated model of the nature of the analytic relationship and tasks. [ABSTRACT FROM AUTHOR]

Infidelity is a serious problem with serious consequences for couples and creates substantial obstacles for couples counselors. At the same time, it is the most often cited reason that couples come for counseling. The good news is that couples counselors can be effective in these areas, but not without understanding the emotional, mental, and physical complexity of infidelity. Unfortunately, many couples counselors do not feel adequately prepared to handle the subject of infidelity. There are several "pitfalls" into which counselors commonly fall. By understanding the relevant research on the effectiveness of couples counseling approaches and paying attention to a counselor's own personal reactions, a practitioner can help couples navigate the difficult, painful emotions that stem from infidelity. [ABSTRACT FROM AUTHOR]

This paper discusses the consequences of the importance that recent 3 papers assign to the countertransference. When the latter acquires a theoretical and technical value equal to that of the transference, the analytic situation is configured as a dynamic bi-personal field, and the phenomena occurring in it need to be formulated in bi-personal terms. First, the field of the analytic situation is described, in its spatial, temporal and functional structure, and its triangular character (the present–absent third party in the bi-personal field) is underlined. Then, the ambiguity of this field is emphasized, with special weight given to its bodily aspect (the bodily experiences of the analyst and the patient being particularly revealing of the unconscious situation in the field). The different dynamic structures or lines of orientation of the field are examined: the analytic contract, the configuration of the manifest material, the unconscious configuration – the unconscious bi-personal phantasy manifesting itself in an interpretable point of urgency – that produces the structure of the field and its modifications. The authors describe the characteristics of this unconscious couple phantasy: its mobility and lack of definition, the importance of the phenomena of projective and introjective identification in its structuring. The authors go on to study the functioning of this field, which oscillates between mobilisation and stagnation, integration and splitting. Special reference is made to the concept of the split off unconscious ‘bastion’ as an extremely important technical problem. The analyst’s work is described as allowing oneself to be partially involved in the transference–countertransference micro-neurosis or micro-psychosis, and interpretation as a means of simultaneous recovery of parts of the analyst and the patient involved in the field. Finally, the authors describe the bi-personal aspect of the act of insight that we experience in the analytic process. [ABSTRACT FROM AUTHOR]

This critical review of the current disputes concerning countertransference enactment systematically outlines the various issues and the perspectives adopted by the relevant psychoanalytic authors. In the light of this the ‘common ground ’ hypothesis concerning the unifying influence of contemporary countertransference theory is challenged. While the existence of enactments, minimally defined as the analyst’s inadvertent actualization of the patient’s transference fantasies, is widely accepted, controversies regarding the specific scope, nature, prevalence, relationship to countertransference experience, impact on the analytic process, role played by the analyst’s subjectivity, and the correct handling of enactments abound. Rather than taking a stand based on ideological allegiance to any particular psychoanalytic school or philosophical position, the author argues that the relative merits of contending perspectives is best evaluated with reference to close process scrutiny of the context, manifestation and impact of specific enactments on patients’ intrapsychic functioning and the analytic relationship. A detailed account of an interpretative enactment provides a context for the author’s position on these debates. [ABSTRACT FROM AUTHOR]

The analytic setting exists not only externally but also internally as a structure in the mind of the analyst. The internal analytic setting constitutes an area of the analyst's mind where reality is defined by unconscious symbolic meaning. Clinical examples illustrate how a secure internal setting allows flexibility in the external setting without sacrifice of its analytic quality. The internal setting can help analysts listen inwardly to themselves in a way that is free-floating with regard to their internal processes. This points beyond usual ideas of counter transference. An analytic encounter may stir up elements that belong to the analyst's psyche which, rather than impeding the analysis, can actively enrich it. Seamus Heaney's writings evoke comparisons between listening to poems and listening to patients, and a week in a patient's analysis is described in relation to these themes. [ABSTRACT FROM AUTHOR]

A method of classroom teaching as a paradigm of treatment situations is presented. The focus is on moving candidates from an intellectual to an emotional experience of regression, transference, and countertransference as it is manifested in the classroom setting, and to study these manifestations and the treatment approach used to elicit them. The purpose is to prepare candidates for work with disturbed patients. Some modern and classical psychoanalytic theories and practices are highlighted. [ABSTRACT FROM AUTHOR]

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]

Changes in the therapeutic environment can elicit intense and unpredictable responses from patients, who then react to the new elements with their own unique thoughts, fantasies, emotions and behaviours. When the change is very specific, and when it entails implications for the treatment itself, these patient responses can coalesce around more profound experiences of the transference as well as of the countertransference. The author, as a candidate or analyst-in-training, purchased an analytic couch for his office and observed the unfolding of what this new couch meant for existing treatments. Using clinical examples, he describes the three most common patient responses that occurred: rejecting, ambivalent, and embracing. The richly variant ideas and fantasies related to the analytic couch are described, and the couch's history within Freudian and Jungian contexts is reviewed. Personal determinants that could lead to the decision of whether to use a couch as part of analysis are considered from the standpoint of the analyst's preferences and own experience with the couch. The couch is discussed as a signifier of the analytic process with cultural meanings alluding not only to familiar stereotypes, but also to psychological healing and self-development. [ABSTRACT FROM AUTHOR]

The author’s conviction is that a successful treatment is based on feelings of love by the therapist/analyst toward his or her patients. One should differentiate between love that is based on biological erotic-sexual drives and emotional love without erotic biological drive. The treatment process, especially for severely disturbed personalities, should be regarded as a process of new birth and new kind of development. Thus what the patient needs most is a kind of parental “primary love” (according to Balint). This paper presents a full report of a session through which the basic love to the patient is illustrated as enabling the treatment. [ABSTRACT FROM AUTHOR]

Generally a distinction is made between the disclosure of personal information and the disclosure of countertransference feelings to a patient. While this may be a necessary distinction to make in the interest of carrying on a coherent conversation on this question, I argue that there is a sort of vanishing point where the difference between "facts" and "feelings" merges. What I wish to suggest here is that, to a certain and necessary degree, the context and the framing of the question of self-disclosure determines what we define as a disclosure. I propose that thinking about a dialectical relationship between sameness and difference is a particularly useful way into the question of self-disclosures in contemporary clinical work. The question of disclosing personal information to patients became a pressing one for me when I found that in some cases it felt necessary to disclose my HIV seropositive status. Here is an example of a fact that is particularly laden with feelings, confounding the distinction between a factual and a countertransferential disclosure. As might be expected in considering the disclosure of personal medical information, I felt there were a variety of reasons to do so, each with specific context. In a long psychotherapy treatment with an HIV-negative man I found that tracking each of our senses of sameness and difference offered a way of understanding the changing meanings of the disclosure of my HIV seropositivity. But more importantly it became clear that it was the process of disclosure rather than the content that exerted the greatest influence on our work, ultimately contributing to a transformative experience for the patient. [ABSTRACT FROM AUTHOR]

The author discusses Gilbert Cole's "Disclosure, HIV and the Dialectic of Sameness and Difference." The dichotomy often made between the disclosure of countertransference affects and the disclosure of facts is an oversimplification. The disclosure of HIV positive serostatus is more than just a fact, and is filled with transcendental meaning. While there are aspects of having positive serostatus that are unique to that condition, the dialectic between uniqueness and commonality is also important in understanding this process. Cole appears to eschew a classical view of neutrality. The author briefly reviews some of the controversy surrounding historical views on self-disclosure. The author also reviews some of the psychoanalytic literature dealing with disclosure of a therapist's illness to a patient. The author sees Cole's disclosure of his positive HIV serostatus to his patient as inadvertent. Inadvertent disclosures occur often in the course of psychotherapy; however, once they occur, they should be dealt with directly in the treatment. The author sees inadvertent disclosure as entirely different from answering a question about a fact that a patient may fantasize about, but about which he has no actual knowledge. The author feels it is important to confirm for a patient something that the patient already knows, but does not want to know. To do otherwise is to potentially retraumatize a patient. The author discusses the tendency to avoid aspects of the real relationship between therapist and patient. In particular, she underscores the pervasive denial of death in analytic theories and in clinical practice. While the course of HIV infection has dramatically change din the last decade, it nevertheless carries association to and risk of a potential disease, and a potential disease that carries the threat of death. The author offers a vignette from her own clinical practice in which a patient responded to an unexpected absence due to illness. The author concludes by noting that while most inadvertent disclosures are less significant than the disclosure of HIV serostatus, they all have an important impact on clinical work. [ABSTRACT FROM AUTHOR]

This paper discusses Gilbert Cole's book, "Infecting the Treatment: Being an HIV-Positive Analyst." The author provides some personal reflections on the outbreak of AIDS and the impact it had upon his work as a psychotherapist. The paper addresses the importance of the cognitive schemata Cole provides to psychotherapists working with seropositive patients. This paper then addresses a powerful technique, a therapist's self disclosure to a patient, upon which Cole's work focuses. Using the example of psychoanalytic strictures regarding self-disclosure, the author argues that self-disclosure is more likely to be adhered to in theory than it is in practice. The author agrees with Cole that non-disclosure is often a technique used by analysts to hide, rather than provide a therapeutic field of action. The specific case of therapists hiding their antihomosexuality when working with lesbians and gay men is used to illustrate the author's perspective. A specific case presented by Cole in his book is then used to both compare and contrast Cole and this paper's author's use of self-disclosure. The paper commends Cole's study for opening a debate on how to use countertransference and self-disclosure as tools which widen and enrich the therapeutic relationship. [ABSTRACT FROM AUTHOR]

Mental pain is a common concern of psychoanalysts in their professional life. Combining her clinical experience with previous contributions by others, the author presents a personal overview of the patient-triggered mental pain of the analyst. Countertransference is considered to be the major source of the analyst's work-derived mental pain. This type of mental pain is not to be avoided or discarded by the analyst. Rather, the analyst will benefit from tolerating and even welcoming professional mental pain: in most cases, mental pain will bring with it rich clinical material that, upon interpretation, will help him or her to offer previously intolerable contents back to the patient in a transformed version that now becomes acceptable. The analyst's mental pain may emerge in his dreams; clinical examples of this phenomenon are presented. It is suggested that there is an increased chance of the analyst undergoing mental pain when treating patients suffering from severe psychopathology, and a clinical case is reported to illustrate this assertion. The author proposes that a lifelong effort is to be expected from analysts in terms of enhancing their threshold of tolerance to professional mental pain. In situations of mental pain, analysts must be particularly aware of the need to modulate their interpretations before transmitting them to the patient. The capacity of analysts to transform their mental pain (Ta, according to Bion) will depend on the plasticity of their container functions, the quality of their transformation abilities and, in particular, their threshold of tolerance to mental pain. [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]

When the analyst is not aware of how he has been pulled into an unconscious enactment, but continues to regard the therapeutic alliance and the setting as if it were working smoothly, he might also intervene from that unaware- ness. He may then interpret what is going on with the analysis and in a way that indicates a 'foreclosure". That is, he will unconsciously try to finish the subject prematurely by an interpretation that will put a provisional end to the exploring process. Thereby, he will make what the author calls an inner frame break. Several vignettes are presented to illustrate derivatives of outer and inner frame breaks and how they are related to aversion of strong countertransference reactions connected to the unresolved life themes of the analyst himself These vignettes are also discussed in relationship to Lang's concepts of frame breaks and derivatives. Finally, the concepts of inner frame breaks and unresolved life themes are discussed as signals and instruments of countertransference awareness and are related to case presentations in supervision and at psychoanalytic conferences. [ABSTRACT FROM AUTHOR]