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"Countertransference"
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Managing Transference and Countertransference in Cognitive Behavioral Supervision: Theoretical Framework and Clinical Application
Dysfunctional patterns, beliefs, and assumptions that affect a patient's perception of other people often affect their perceptions and behaviours towards the therapist. This tendency has been traditionally called transference for its psychoanalytical roots and presents an important factor to monitor and process. In supervision, it is important to put the patient's transference in the context of the conceptualization of the case. Countertransference occurs when the therapist responds complementary to the patient's transference based on their own dysfunctional beliefs or assumptions. Transference and countertransference provide useful insights into the inner world of the patient, therapist, and supervisor. Guided discovery is one of the most common approaches used by a supervisor and a supervisee to map all types and directions of transference and countertransference. Other options to map transference and countertransference are imagery and role-playing techniques. Keywords: supervision, cognitive behavioral therapy, therapeutic relationship, supervisory relationship, transference, countertransference
Journal Article
Countertransference towards suicidal patients: a systematic review
Countertransference towards suicidal patients may blur healthcare professionals’ clinical judgment and lead to suboptimal decision-making. We conducted a systematic review of the quantitative studies on this topic. Following PRISMA guidelines, various databases were searched for studies measuring countertransference in healthcare professionals treating suicidal patients. Two authors independently performed screening and the quality of included studies was formally assessed. Ten studies were identified (3/5/2 of low/intermediate/high quality, respectively). Cross-sectional studies showed evidence for specific and adverse countertransference (e.g., disinterest, anxiety, overwhelming, rejection, helplessness or distress) towards suicidal patients. Furthermore, countertransference was prospectively associated with suicidal behavior and ideation in studies that explored this issue, but the meaning of this association remains to be clarified. Healthcare professionals’ characteristics (e.g. professional background, gender, personality traits) influenced countertransference. Suicidal patients elicit adverse countertransference, which should be addressed in clinical practice and through dedicated training.
Journal Article
The Psychodynamics of Medical Practice
This title is part of UC Press's Voices Revived program, which commemorates University of California Press's mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1985.
eBook
OMNIPOTENT DELUSIONS OF BADNESS: SOME PSYCHODYNAMIC MEANINGS AND COUNTERTRANSFERENCE CHALLENGES
This paper describes several character disordered patients who had suffered considerable childhood neglect and who subsequently harbored conscious beliefs in their fundamental badness. This seemed related to a grandiose sense of their own destructiveness, which in turn evoked enormous guilt and reinforced their certainty that they were bad. This delusional certainty fueled sadomasochistic ways of relating to self and others and self-destructive preoccupations. The paper explores the multiple functions which the delusions of badness serve and the technical challenges involved when working in depth with such persons.
Journal Article
Towards a better use of psychoanalytic concepts: a model illustrated using the concept of enactment
It is well known that there is a lack of consensus about how to decide between competing and sometimes mutually contradictory theories, and how to integrate divergent concepts and theories. In view of this situation the Project Committee on Conceptual Integration developed a method that allows comparison between different versions of concepts, their underlying theories and basic assumptions. Only when placed in a frame of reference can similarities and differences be seen in a methodically comprehensible and reproducible way. We used \"enactment\" to study the problems of comparing concepts systematically. Almost all psychoanalytic schools have developed a conceptualization of it. We made a sort of provisional canon of relevant papers we have chosen from the different schools. The five steps of our method for analyzing the concept of enactment will be presented. The first step is the history of the concept; the second the phenomenology; the third a methodological analysis of the construction of the concept. In order to compare different conceptualizations we must know the main dimensions of the meaning space of the concept, this is the fourth step. Finally, in step five we discuss if and to what extent an integration of the different versions of enactment is possible.
Journal Article