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Integrative psychodynamic therapy
Published in Stacy K. Nakell, Treatment for Body-Focused Repetitive Behaviors, 2023
Countertransference refers to the therapist’s internal responses to her clients, which can run the gamut of uncomfortable feelings, including love, frustration, disgust, attraction and hopelessness. The ability to hold and sort through these feelings is a critical therapeutic skill, one that helps us to understand both the suppressed feelings of the client’s body (congruent countertransference) and the feelings that significant attachment figures may have had toward them (concordant countertransference). These feelings are then available for us to process and release. As we repair therapeutic ruptures, old scripts can be rewritten, leading to new ways of relating to others.
Cautionary Issues
Published in Lisa Zammit, Georgeanne Schopp, Relational Care, 2022
Lisa Zammit, Georgeanne Schopp
Reflection and awareness are necessary to manage countertransference. A wide range of emotions influence the Patient/Clinician relationship. “If we cannot engage a patient around his or her belief system because of our reaction to their beliefs, we have allowed countertransference to adversely affect our care for this person” (Wendleton et al., 2006, p. 29).
Professional Betrayal
Published in Paul Ian Steinberg, Psychoanalysis in Medicine, 2020
The male physician who sexually abuses his female patients often cannot find meaningful relationships and satisfying sexual outlets outside his population of patients, some of whom are vulnerable to his invitation or coercion to intimacy. Physicians are financially reimbursed for providing medical care to patients. This care includes consideration of the patient’s psychological needs. Physicians who place these needs secondary to their impulses have defaulted in their commitment to provide professional care for their patients. The concept of countertransference includes the unconscious feelings of the physician regarding the patient in any doctor–patient relationship (Slakter, 1986). Physicians must consider their reactions to their patients, and use these reactions constructively, in their patients’ best interests. This includes a physician’s awareness of having sexual interest in his patient that he needs to contain, rather than act on. Inherent in a physician’s sexual involvement with a patient is not only abuse of the patient, but also a self-destructive tendency in the physician (Sreenivasan, 1989), who in abusing his patient damages his professional and personal self-respect, jeopardizes his marriage and family relationships, and risks losing his professional identity and capacity to work, as well as his income.
Telemental Health during a Pandemic: Third Space Conversations
Published in Smith College Studies in Social Work, 2021
Guralnik (2016) writes: “It is difficult to be talking about race and experience it working in real time in the transference/countertransference” (P. 662). From an intersubjective perspective, transference is the way the client experiences the therapist based on pre-established relational patterns. Countertransference is the way the therapist experiences the client based on her pre-established relational patterns (Stolorow, Brandcraft, & Atwood, 1995). “Transference and countertransference together form an intersubjective system of reciprocal mutual influence” (P. 42). Within a cross racial therapeutic dyad between a Black client and a White therapist, this includes the client’s experiences with discrimination and the therapist’s experiences with white privilege and racial microaggressions.
Survivor guilt in cancer survivorship
Published in Social Work in Health Care, 2019
Susan Glaser, Kimarie Knowles, Penny Damaskos
The concepts of transference and countertransference were first identified by Sigmund Freud in 1910 in his case studies of female hysterics who projected unconscious desires onto their therapists and in turn evoked unconscious feelings in the therapist towards the analysand (Hayes, Gelso, & Hummel, 2011; Phillips, 2004). For Freud, countertransference was viewed as problematic, requiring management by the clinician, and of little or no therapeutic benefit (Hayes et al., 2011; Phillips, 2004; Robbins & Jolkovski, 1987). Over the next century, the concept evolved and included constructs of the therapist’s reactions to the patient, as well as the needs, unresolved conflicts, and behaviors of both the therapist and the patient contributing to the countertransference in the session (Hayes et al., 2011; Robbins & Jolkovski, 1987). For the purposes of this discussion, countertransference is viewed as a valuable therapeutic and diagnostic tool which can lead to an increased understanding of the patient (Berzoff & Kita, 2010, 2010; Dunkel & Hatfield, 1986; Hayes et al., 2011; Robbins & Jolkovski, 1987).
Longing and Fear: The Ambivalence About Having a Relationship in Psychotherapy
Published in American Journal of Clinical Hypnosis, 2019
Countertransference refers to the therapist’s feelings toward the patient. Originally, feelings toward the patient were understood to reflect unresolved conflicts in the therapist. Gradually, this viewpoint enlarged. Racker (1957) articulated countertransference as a complex form of empathy in which the therapist vicariously feels what others in the patient’s past felt toward the patient or what the patient was feeling in his or her past that he or she is unable to verbalize. In this way, Racker conceptualized countertransference as data about the interior of a patient. Searles (1979) went one step further, toward a more fully interpersonal view of countertransference. Searles believed that impasses in therapy were due to a therapist’s unresolved unconscious anxieties and that the patient, through evoking and provoking the therapist’s feelings, helped heal the therapist (by means of the therapist’s decoding and repairing what was being exposed in himself or herself). Once the therapist healed, the treatment could become unstuck. Subsequent writers articulated the therapeutic nuance of projective identification (for explanation, see Peebles-Kleiger, 1989).