Countertransference in the Therapy of Schizophrenics^†

Family Therapy in Trouble: Psychoeducation as Solution and as Problem

“…It is of course true that a therapist's blaming feelings directed toward parents can contribute significantly to treatment failures. However, as we have indicated, we believe that the explanation and the solution proposed by Terkelsen (60) and others (6,28,50) are inadequate. Not only do we believe that a rejection of psychoanalytically informed family therapy is not warranted by the difficulties Terkelsen reports, but we also suggest that the psychoanalytic approach is essential to achieving an effective understanding and resolution to the countertransference problems he encountered.…”

“…In this view, Terkelsen's moralism is best understood as a defense against some inner disturbance stimulated in the treatment (5). In other words, Terkelsen's blaming of parents was the result of countertransference (23,27,44,50,52,53,54,65). Thus, Terkelsen's adopting the "medical" model of schizophrenia can be understood as an intrapsychic defense.…”

Countertransference effects in acutely disturbed inpatients

“…Countertransference hate is a mixture of aversion and malice with the aversive component being the most dangerous to the patient as this is what tempts the therapist to abandon the patient (Maltsberger & Buie, 1974). Clinicians may try to avoid countertransference feelings by withdrawal, acting out, excessive mothering, denial, avoidance of unpleasant issues, over permissiveness, acceptance of the patient's distortions or application of authoritarian measures including drugs and electroconvulsive therapy (Savage, 1961). Countertransference feelings of anger in staff have been observed in patients who are agitated, belligerent and disobeying unit rules (Lion & Pasternak, 1973).…”

A Review of the Double Bind Theory

“…However, from the above it is not quite clear whether Searles refers here to the actual mother‐child interaction in a double bind situation, or to the particular game‐like quality of that later stage of a successful psychotherapy of a schizophrenic which is, for instance, described by Scheflen (71) in his extensive report on John Rosen's direct analysis and the deliberate use of therapeutic double binds by that therapist. In another paper Scheflen (70) refers to the occurrence of double binds in regressive one‐to‐one relationships in general and not only in the classic mother‐child symbiosis. The mutuality of double‐binding is also recognized by Ackerman (2), Perr (60), and Boszormenyi‐Nagy (9), whereas Hoffer and Callbeck (43) question the validity of the double bind theory on the assumption that the…”

“…The problem of the resolution of a pathogenic double bind and of the use of therapeutic double binds has been dealt with by a number of authors. Reference must here again be made to Schefien's rather extensive treatment of the subject (70). Pointing out that John Rosen uses double‐binding techniques in a highly intuitive and often not conscious way, the author states:…”