Countertransference

Central to the psychodynamic viewpoint is that the clinician and the patient bring their own separate subjectivities to an encounter, and mutually influence one another. Countertransference, in this respect, is the counterpart of transference. In other words, as Freud originally used the term, it referred to the analyst's attribution of certain qualities to the patient based on the analyst's past experiences with similar figures. This perspective, often referred to as the narrow view of countertransference, regarded the phenomenon as an obstacle to be removed because it interfered with the analyst's objectivity.

Subsequent contributors to the literature on countertransference (9,19 noted that countertransference with severely disturbed patients often involves an objective component. The patient behaves in such a provocative manner that virtually anyone would respond with a certain set of emotional reactions to that patient. This way of looking at countertransference is often regarded as the broad or totalistic view. Inherent in this perspective is that the clinician's reaction has much less to do with his or her own individual past than with the specific characteristics of the patient and that patient's capacity to induce strong reactions in others.

As the definition has continued to evolve, countertransference is now generally regarded as involving both the narrow and the broad characteristics. In other words, most theoretical perspectives view countertransference as entailing a jointly created reaction in the clinician that stems, in part, from contributions of the clinician's past and, in part, from feelings induced by the patient's behaviour. (H> In some cases the emphasis may be more on the contributions of the clinician than the patient, while in other cases the reverse may be true. This model also regards countertransference as something of a unique construction that varies depending on the two subjectivities involved (see Box.1). In this contemporary perspective, countertransference is both a source of valuable information about the patient's internal world and something of an interference with the treatment.

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