Countertranferance Among Play Therapists: Implications for Therapist Development and Supervision.

This study examined countertransference management among play therapists. Registered Play Therapist Supervisors (N=154) completed the Countertransference Factors Inventory-Revised and a demographic survey regarding a recent supervisee. The areas explored included countertransference management with regard to therapist gender, academic degree, license, theoretical orientation, type of supervision, population served, practice setting, play therapy training, and experience. A moderate positive correlation of 53% was found between play therapy training and countertransference management. A low positive correlation of 27% was found between years of experience and countertransference management. Differences were found among groups in the areas of degree, license, and practice setting. No significant findings were obtained for gender, theoretical orientation, population served, and type of supervision. The study provides recommendations and implications for supervision of developing play therapists, and suggestions for future research in the area of countertransference among play therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Countertransference in psychotherapy with children and adolescents.

Reviews the book, Countertransference in psychotherapy with children and adolescents edited by Jerrold R. Brandell (see record 1992-97833-000). Books on child analytic work are rare, and books on countertransference in child treatment are basically nonexistent, despite the proliferation of writing on countertransference in work with adults. Thus, Jerrold Brandell's edited volume is a welcome and long-overdue addition to the literature. Although the book is not strictly about analysis, it is analytically informed. Brandell's stated goal is to advance the principle that "countertransference is a ubiquitous factor in child and adolescent treatment, and that its recognition, understanding, and management are essential to effective psychotherapy." This is indeed a worthy if not essential undertaking, and the collection of articles in Brandell's book advances this goal. Brandell prefaced the chapters with his own thorough historical literature review of countertransference in both adult and child work. He then subdivided the book into two sections, with the first containing two classic articles an countertransference and the bulk of the book devoted to the following "scientific situations" in child psychotherapy: racial and cultural issues, depressed and suicidal children and adolescents, infant-family treatment, severely disturbed adolescents, eating disorders, abused children and adolescents, parent loss and divorce, borderline children and adolescents, life-threatening illness, and substance-abusing adolescents. This book is a very good resource for child analysts and therapists, especially those who espouse a more relational or intersubjective point of view. It is suitable both for inexperienced analysts and as a reminder to more seasoned ones of the importance and pervasiveness of countertransference issues in our work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group phases and induced countertransference.

Countertransference reactions are a rich source of clinical data. The present author contends that there is a potential for developing normative data relating countertransference patterns to distinguishable stages or phases in the course of a dynamic psychotherapeutic experience. It is concluded that identifying classes of therapist reactions, and refining them for individual therapists, will enhance the depth of dynamic group psychotherapy. Case illustrations are presented to support this contention. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Coasting in the countertransference: Conflicts of self interest between analyst and patient.

Reviews the book, Coasting in the countertransference: Conflicts of self interest between analyst and patient by Irwin Hirsch (see record 2008-02945-000). The term countertransference now often incorporates all the conscious as well as unconscious reactions a therapist has toward their patient, and as such has become a primary source of data about the patient’s intrapsychic and interpersonal experience. In his remarkable book Coasting in the Countertransference, Irwin Hirsch returns us to the earlier more problematic notion of countertransference, only Hirsch’s focus is no longer on the internal drives and resistances of the therapist. For Hirsch, the economic and social circumstances under which psychotherapists practice have a dire—and mostly unacknowledged—impact on clinical processes. This is an absolutely necessary book that forces us to reexamine some of the painful social conundrums of the current state of dynamic psychotherapy as well many of the contemporary technical innovations which we are most smugly pleased with. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference as a prototype: The development of a measure.

Countertransference is a concept that is widely acknowledged, but there exists little definitional consensus, making research in the area difficult. The authors adopted a prototype theory (E. H. Rosch, 1973a, 1973b; see C. B. Mervis & E. Rosch, 1981, for a review) to examine this construct because it conceptually fits well with constructs that elude explicit definition. In Study 1, 45 experienced psychologists highly agreed with the prototypicality of 104 different examples of countertransference providing support for the presence of a prototype. In Study 2, the usage of this prototype in a sample of 35 trainees was related to ability to perceive countertransference in a case example drawn from the literature and positively correlated with self-reports of their experiences of countertransference but not with their self-reported ability to manage countertransference once it was manifest. Implications for training and research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Countertransference in the treatment of PTSD.

Reviews the book, Countertransference in the treatment of PTSD, edited by John P. Wilson and Jacob D. Lindy (see record 1994-98036-000). This book purports to be the first to examine systematically the unique role of countertransference in working with victims of trauma. To help systematize clinical work with trauma victims, the contributors produced a theoretical model that attempts "to identify the core elements and dimensions of countertransference and their relationship to PSTD." The unique status of this book claimed by the editors is predicated on an assumption unexamined by the editors; namely, that the contributors have uncovered a new clinical phenomenon—countertransference to PSTD. This assumption rests on a second important and unquestioned assumption that the victims of PSTD suffer differently and more horribly than do other sufferers of the human condition. Haven't clinicians learned by now that suffering is suffering regardless of the external event that may have precipitated the hurt? If suffering is suffering, regardless of its provocation, then countertransference is countertransference regardless of the external events to which the clinician is responding. While this volume, by carefully delineating and systematizing a host of therapist responses to patient inductions, contributes to a better understanding of countertransference, it hasn't discovered a new clinical phenomenon. The value of this book resides in the thoughtful ways the contributors discuss monitoring one's countertransference and their compassionate and efficacious responses to the suffering of their patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The patient's contribution to the therapist's countertransference feelings

Countertransference feelings of psychiatric milieu therapists toward their patients were studied by using a self-report feeling word checklist. The feelings were scored on subscales of feeling states in a circumplex model. By using an analysis of variance model, comparisons between reactions to patients individually and reactions to patients with different personality organizations and with different Health-sickness rating scale scores could be made. A total number of 244 therapists at 21 small treatment homes were studied. It was found that approximately 15% of the therapists' countertransference feeling reactions could be accounted for by recurrent reactions to patients individually. Surprisingly, the personality organization and the Health-sickness rating scale score of the patient accounted for almost no variance in therapists' feelings. The results are discussed, and possible explanations are evaluated.     

Wounded healer: Psychotherapist grief over a client's death.

Psychotherapy with a patient who is seriously or terminally ill presents the psychologist with many challenges. This article describes the psychotherapy of a client in treatment for cancer. The author outlines the case and examines how ethical challenges and countertransference issues were important considerations in working with the client. Recommendations for psychologists who are providing psychotherapy to seriously or terminally ill patients are then offered. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The mental activities of trainee therapists of children and adolescents: The impact of personal psychotherapy on the listening process.

Three types of countertransference (CT) were studied by means of the Countertransference Rating System (CRS): rational-objective, reactive, and reflective. The CRS was applied to spontaneous reactions by 27 trainees in child and adolescent psychotherapy (mean age 24 yrs). Five clinical vignettes, depicting a broad spectrum of pathological issues, served as stimuli. Results regarding the pathology depicted in the vignettes suggest that CT could serve as tool in identifying the developmental quality of the relational processes and conflicting issues of the patient. Group comparisons show that trainees who had had personal therapy experience were less prone to block out or act on their first impressions and produced more elaborate formulations of the inner world of the patient and of psychotherapeutic interplay. Personal therapy, however, did not seem to impact on reactive CT. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The many faces of analytic interaction.

The patterns of interaction between analyst and analysand are discussed with special reference to the participation of both analyst and analysand in the analytic dialogue. The analyst's participation and interaction with the analysand can take place in one or all of the threefold constituents of the analytic relation—transference (and countertransference), real relation, and alliance. Although these components are continually present and mutually interactive in the analytic process, they can be differentiated in the diversity of patterns of interaction and their implications for technical aspects of the analytic process. Although transference and countertransference hold the primary place in analytic interest, other aspects deserve proper emphasis and exploration insofar as they make substantive and significant contributions to the effectiveness or ineffectiveness of the analytic process. The nature and quality of their influence on patterns of interaction are discussed as well as implications of their respective roles in the analytic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Metaphors are us: Countertransference in the writings of Thomas Ogden.

The author examines the countertransference theory and technique of Thomas Ogden, beginning with the necessary background theory of intersubjectivity and projective identification. From Ogden's early characterization of transference as the externalization of an internal object relation via projective identification, the article traces countertransference to his more recent discussion of the analyst's reverie as a conscious derivative of the analytic third. In the 2nd half of the article, the author examines the technical aspects of Ogden's approach to countertransference. Allusions to the unconscious with metaphors that create a sense of self are emphasized. The author argues that Ogden's approach should be extended to cover the mutual creation of such metaphors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference and the analytic instrument.

The concept of countertransference may have reached a point where it is too broadly defined. This article differentiates the inner states of the analyst, conceptualized as "the analytic instrument," from his or her behavior in the treatment. It further differentiates between behavior that only hampers an analysis because it permits the transference neurosis to remain intact (simply put, bad therapy) and a different kind of behavior (countertransference proper) that has the potential to destroy an analysis because it seriously damages the transference neurosis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference in the treatment of pathological narcissism.

Explores literature on countertransference reactions experienced in psychodynamic work with narcissistic clients, examines the various therapist–client variables involved in these reactions, and briefly suggests approaches to understanding and resolving them. Common types of narcissistic transference and countertransference include responses to the mirroring transference, idealizing transference, twinship transference, and negative transference. Underlying principles in understanding and effectively utilizing one's countertransference feelings in psychotherapy include differentiating subjective vs objective countertransference and determining whether to interpret these feelings with regard to both the client's developmental needs and phase of treatment. This is especially important in treating narcissistic clients whose self-esteem is fragile and who are, thus, prone to experience shame and rage reactions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role ambiguity, Type A behavior, and job satisfaction: Moderating effects on cardiovascular and biochemical responses associated with coronary risk.

Studied 217 male managers (mean age 44 yrs), classified as Type A (coronary-prone) or Type B (non-coronary-prone), to examine the effects of job satisfaction as a moderator between a common job stressor (role ambiguity) and coronary risk indicators. For Type A's, the results support the hypotheses that changes in ambiguity are associated with changes in blood pressure and that intrinsic job satisfaction has both a direct and moderating effect on these changes. Few similar effects were found for extrinsic job satisfaction. For Type B's, the effects on systolic blood pressure were opposite to those for type A's. It is suggested that either Type A's and Type B's differ in autonomic and cardiovascular response or that ambiguity as a stressor may have differential effects for Type A's and Type B's, indicating that their "fit" with ambiguous environments may be opposite. (53 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reenfranchising psychoanalysis.

This article explores the meaning of disenfranchisement as it relates to the estrangement of psychoanalysis from gays and lesbians, who were not included in the original conference on the disenfranchised. This oversight is examined as part of the lag between a more inclusive stance toward gays and lesbians by psychoanalytic professional organizations and adoption of a similar inclusiveness by doctoral programs. The author examines whether these programs are honestly acknowledging their gay and lesbian students; alternative supervisory clinical vignettes are presented to illustrate their difficulties. The implications of continued avoidance of open conversation around issues of sexuality in training programs are explored in terms of the possible consequences that arise from unexamined countertransference, for both patients and therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference and empathy: The complex relationship between two divergent concepts in counseling.

Examined the relationship of 20 male counselor trainees' empathic ability (the Barret-Lennard Relationship Inventory) to measures of countertransference behavior and countertransference feelings toward 20 undergraduate female clients. It was expected that empathic ability would be negatively related to the manifestation of countertransference behavior, operationalized as the withdrawal of personal involvement, but positively related to self-reports of openness to countertransference feelings. Empathy was found to be negatively related to countertransference behavior with seductive female clients but not with hostile or neutral clients. Counselor empathic ability was positively related to counselor reports of openness to countertransference feelings. Findings suggest, however, that there was a limit to how often countertransference feelings could be experienced in a given counseling session without spilling over into countertransference behavior. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The abuser and the abused: Sources of resistance to resolving splits in the countertransference in the treatment of adults who were sexually abused as children.

A primary challenge encountered in treating adult patients who were sexually abused as children is the experience of being divided between feelings of empathy for the patient as an abused person versus feelings that this person is sometimes being abusive and foiling or hurting us. This article examines some of the sources of what is seen as the collective difficulty of therapists in resolving the recurrent conflict between identifications with the abused and the abuser in countertransference toward these patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward more (and better) countertransference research.

This article addresses the definitional and measurement barriers currently inhibiting countertransference research and indicates new pathways toward meaningful and clinically relevant countertransference research. First, I review the countertransference definitional debate and advocate for the adoption of a moderate countertransference definition. Second, I review the extant countertransference research, with primary emphasis on measurement issues, and recommend new methods and instruments for assessing the construct. Finally, I conclude with a few remarks about clinical implications and directions for future CT research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Precursors to therapist sexual misconduct: Preliminary findings.

This article presents preliminary findings on the characteristics of and predisposing factors in therapists engaging in sexual intimacies with patients. Data were derived from comprehensive evaluations, consultations, supervisions, or analytically oriented treatments. Particularly salient were frequent misunderstandings of, rationalizations about or defensive transformations of love and hate in the countertransference. Common findings involved (a) long-standing and unresolved problems with self-esteem, (b) sexualization of pregenital needs, (c) restricted awareness of fantasy, (d) covert and sanctioned boundary transgressions by a parental figure, (e) unresolved anger toward authority figures, (f) intolerance of negative transference, and (g) defensive transformation of countertransference hate into countertransference love. Coexistence of multiple levels of reality within the psychotherapeutic dyad is discussed as an area in which misunderstandings and rationalizations frequently occurred. (PsycINFO Database Record (c) 2010 APA, all rights reserved)