Objective countertransference: do patients' interpersonal impacts generalize across therapists?

Abstract

Objective countertransference refers to the constricted feelings, attitudes and reactions of a therapist, that are induced primarily by the patient's maladaptive behaviour and that are generalizable to other therapists (and to other significant others in the patient's life). In interpersonal theory and therapy, the equivalent of objective countertransference is the impact message concept. Impact messages refer to the cognitions, emotions and action tendencies evoked in the therapist by a particular patient's interpersonal pressures. This paper tests the interpersonal hypothesis that interpersonal impact generalizes across therapists (and by extension across interpersonal relationships). Generalizability of impact messages across therapists was determined for different combinations of therapist pairs, independently rating a total of 131 psychiatric outpatients with the IMI-C (Impact Message Inventory, revised circumplex version). It was found that impact messages were most clearly generalizable across therapists for the Dominance (D) category, followed by the Hostile-Dominant (HD) and Hostile-Submissive (HS) categories. In contrast, the other five categories of impact messages turned out to be poorly generalizable across therapists. Impact messages within the Dominance (D) category were also strikingly stable over a period of time of 12 months or longer. Some possible causes of the limited generalizability of most impact message categories are discussed.

Systematic review of studies about countertransference in adult psychotherapy

“…CT is defined as a tool to expand the knowledge about the internal world of the patient through the feelings and fantasies elicited in the therapist. These feelings aid in diagnosis and management, 24,26,28,29,32,38,39 even in the case of pharmacological treatments. 23 CT, often defined as the therapist's transference, 21 is part of the field that is created by the interaction of the dyad.…”

“…This study compared different therapists when treating the same group of patients. 28 In general, the tools used to evaluate CT were very similar, as they were essentially lists of feelings and scales that rated CT from absent to very intense. The most frequent tool was the FWC-58, 22,[37][38][39]41 an option for future studies.…”

“…One of the results reported was the association of symptom severity and poor CT quality, 28 which may further demonstrate the usefulness of the CT concept.…”

“…33 A study that assessed the reactions that patients elicited in different group therapists found an important relation between some CT dimensions, such as dominance, hostility and submission, and different therapists. 28 The development of CT during the course of therapy was analyzed in a study using short-term PP that evaluated therapist responses in the first, second and tenth sessions and found that the therapists seemed to have a better understanding of their own reactions from the tenth session onward. 23 A study that included only one patient and therapist dyad found that positive CT increases over the course of therapy.…”

Interpersonal Influence in Families: Development and Psychometric Evaluation of the Influence in Families Questionnaire

“…A strong association was also found between positive influence and friendly impact messages and, to a lesser extent, between negative influence and hostile impact messages. The impact messages reflect a person's interpersonal style of interacting (Hafkenscheid, 2003;Kiesler & Auerbach, 2004). Conceptually, it is not illogical that a person with a friendly interpersonal style would evoke a great deal of positive influence while a person with a hostile interpersonal style would elicit more negative influence from a relationship partner.…”