China
Africa
Explore chapters and articles related to this topic
Psychodynamics and the doctor-patient relationship
Published in Ruth Skrine, Blocks and Freedoms in Sexual Life, 2019
Such self-questioning will be familiar to anyone who works in a psycho-dynamic way, and this way of thinking is the basis of psychodynamic psychotherapy. The skill is used at its highest level in psychoanalysis when the words 'transference' and 'countertransference' are used to describe some of the many feelings that arise and are passed between the couple in that setting. Transference is the word used to describe the way in which feelings towards someone from the past get transferred on to and felt towards the therapist who is present. Thus old, sometimes very old, feelings can be re-experienced. Counter-transference is more complicated because it concerns feelings of the therapist towards the patient, and therefore is not only specific for that patient at that time, but also holds the potential of being influenced by feelings arising within the therapist that are personal to him or her.
Professional–patient relationships
Published in Jill Thistlethwaite, John Spencer, Professionalism in Medicine, 2018
Jill Thistlethwaite, John Spencer
Boundary violations, particularly those of a sexual nature, often arise through the phenomena of transference and counter-transference.7 These terms derive from the psychoanalytical school of psychiatry, but are common phenomena in many consultations over long periods of time. Transference refers to the feelings that the patient has for the therapist (the doctor or other health professional), which often mirror those that he or she has had for authority figures in the past. Such feelings may be therapeutic in that they provide insight into relationship problems in the past. The feelings for the therapist may involve affection and sexual attraction. Counter-transference refers to the feelings that the therapist (the doctor or other health professional) has for the patient. These feelings may arise due to the patient’s displays of affection.
The patient-clinician relationship
Published in Kathleen M Berg, Dermot J Hurley, James A McSherry, Nancy E Strange, ‘Rose’, Eating Disorders, 2018
Kathleen M Berg, Dermot J Hurley, James A McSherry, Nancy E Strange, ‘Rose’
Countertransference encompasses all of the clinician’s feelings, attitudes and behavioral reactions toward the patient (Kahn, 1997). It can be obstructive or useful. Obstructive countertransference interferes with the clinician’s empathy and clarity in responding to the patient (Kahn, 1997). For example, a clinician who avoids exploring body-image issues with the patient due to his or her own unresolved issues in this area, or who is weight-prejudiced, is engaging in obstructive countertransference. Useful countertransference refers to the clinician’s feelings and attitudes which are employed to the patient’s advantage (Kahn, 1997). These include genuine, well-timed self-disclosures which foster understanding and rapport and encourage the development of trust and hope in the relationship. The presence of both transference and countertransference underlines the importance of developing self-awareness with regards to unresolved personal issues, values and stressors in clinical training programs and ongoing supervision (Stewart et al., 1995).
Defining self-disclosure of personal cancer coping experiences in oncology social workers’ helping relationships: When cancer “hits home”
Published in Journal of Psychosocial Oncology, 2022
Kimberly Lawson, Allison Werner-Lin, Frances Fitzgerald, James Robert Zabora
As social work educators and students, we concur that cautions against self-disclosure are appropriate early in one’s career as developing clinicians find their clinical voice and align with theoretical paradigms that work for their populations’ presenting problems and their own values.38 However, participants joined in a call for robust training in graduate school and continuing professional education to reduce prohibitions against self-disclosure, open discussion of transference and countertransference, and promote seeking supervision without shame. This study’s findings suggest the lack of preparation for self-disclosure led to hesitation to initiate dialogue about one’s experiences or cancer status with supervisors to enable preparation for the range of ways clinicians can go about ethical disclosure. Study participants may have completed graduate school at a time in the evolution of social work practice when classic psychodynamic training prohibited self-disclosure. Today, disseminating positive examples of self-disclosure could stimulate conversations that increase comfort and confidence in sharing, enable proficiency in navigating ethical conundrums, and destigmatize self-disclosure in practice.
When the Assessor’s Limits Are Tested: Enactments and the Assessment Frame in Psychological Testing
Published in Journal of Personality Assessment, 2020
Modifications in the assessment framework, like the psychotherapy framework, are not always under the assessor’s conscious control. There is a difference, for example, between agreeing to a fee reduction because of the patient’s realistic presentation of financial exigency and modifying the fee without discussion of circumstances triggering the request. Here, the interactional pressures of transference–countertransference dynamics (Parth, Datz, Seidman, & Löffler-Staska, 2017) between patient and assessor come into play and lead the assessor to deviate from usual policy in ways that bring underlying conflicts not to conscious awareness and available for self-reflection, but to action. Such moments are representative of enactments, which Chused (1991) defined as “symbolic interactions between analyst and patient which have unconscious meaning to both” (Akhtar, 2009, p. 615). Akhtar (2009) offered five ways in which enactments manifest in therapy: (a) acting out in session, (b) inducing the analyst playing out transference fantasies, (c) patient and therapist cocreating the enactment, (d) analyst acting out a transference wish, and (e) a countertransference-based intervention. Jacobs (1986) anchored enactments to countertransference in the following way:
Working with British Sign Language (BSL) interpreters: lessons from child and adolescent mental health services in the U.K.
Published in Journal of Communication in Healthcare, 2018
This approach enables the child and family to fully participate in the assessment in partnership with the clinician [44], and enables the clinician to gain in-depth information about the children, adolescents, and their families. Interpreters should not try to make sense of language that is not clear and relay any dysfluency to the clinician, thus preventing misdiagnosis [21] and highlighting the need for possible further assessments such as cognitive or specific language impairments. The interpreter is at times a cultural broker; they reframe information to mediate cultural and linguistic differences, educational differences such as literacy problems, and fund of knowledge gaps [45]. They take into account the impact of belonging to a minority group or the barriers faced by deaf people in society, thus enhancing the clinical cultural competencies and understanding of the deaf person, which may lead to different outcomes [46]. They also consider issues of transference and counter-transference, while ensuring that the clinician maintains clinical responsibility for the therapeutic work [40].