Basic Psychoanalytic Concepts: IV. Counter-Transference

Abstract

In previous papers in this series we have discussed two concepts which have been used in connection with aspects of the relationship between the patient and his doctor. These were the treatment alliance (Sandler, Holder and Dare, 1970) and transference (Sandler, Dare and Holder, 1970). Although these two clinical concepts originated within the psychoanalytic treatment situation they are capable of extension outside it. Both relate to and emphasize processes occurring within the patient and tend to stress one side of the relationship only. Even the concept of treatment alliance, although nominally appearing to include the roles of both patient and doctor, has tended to be regarded from the point of view of processes and attitudes in the patient; the aspect of the therapist's attitudes, feelings and professional stance have to a large extent been omitted. However, in recent years more attention has been paid in psychoanalytic and other writings to the relation of the doctor towards his patient. Just as the term ‘transference’ is often used loosely as a synonym for the totality of the patient's relation to his therapist, so is the term ‘counter-transference’ often used in a general sense (both within psychoanalysis and outside it) to describe the whole of the therapist's feelings and attitudes towards his patient, and even to describe facets of normal, non-therapeutic relationships (Kemper, 1966). Such a usage is very different from what was originally intended, and as a consequence confusion has arisen about the precise meaning of the term. It is the purpose of this paper to examine the concept in the light of its origins and development within psychoanalysis and to comment briefly on some possibilities of its extension outside the psychoanalytic treatment setting.

How not to do clinical supervision in nursing

“…Should we abandon such ‘unscientific’ concepts in favour of more objectifiable theories? Kohon (1986), after Sandler et al . (1970a ), included countertransference with transference to emphasize that they are clinical concepts, not metapsychological ones.…”

“…I refer to transference elements here, because it is just as important to ascertain non‐transference elements ( Sandler et al . 1970a ).…”

Countertransference Phenomena and Personality Pathology in Clinical Practice: An Empirical Investigation

“…This early and relatively narrow view of countertransference as an impediment to treatment prevailed in the psychoanalytic literature for several decades. Over time, however, theorists broadened the concept, recognizing that the clinician's reactions to the patient (conscious and unconscious, emotional and cognitive, intrapsychic and behavioral) may have diagnostic and therapeutic relevance and can, if properly used, facilitate rather than inhibit treatment (1)(2)(3)(4)(5).…”

Performance, Emotion Work, and Transition

“…Participants also considered questioning patients about sensitive topics, such as their sex life, to be potentially embarrassing for both themselves and the patients. At other times participants had to deal with their difficult countertransferences, that is, less conscious practitioner reactions to patients (Sandler, 1970), which might be adequately understood only in retrospect: I was probably quite defensive, which is why it escalated, into . .…”