Countertransference as the therapist's mental activity: Experience and gender differences among psychoanalytically oriented psychologists.

Compared the spontaneous written reactions to 2 clinical vignettes of 20 beginning (less than 1 yr) and 20 experienced (10 yrs or more) psychoanalytically oriented psychologists, using a countertransference rating scale (CRS). The Ss comprised equal numbers of women and men. The CRS distinguishes 3 major mental states: objective/rational countertransference is a detached, nonparticipating, observing position; reactive countertransference is an unconscious defensive reaction, in which the therapist is an unaware participant–subject; reflective countertransference is an aware, preconscious–conscious subjectively transparent participating state. Results indicate that beginning therapists were more reflective and that experienced therapists were more reactive. As for gender differences, female therapists were more reflective, and males were more objective/rational. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Values in psychotherapy: A survey of practitioners' beliefs.

Investigated whether psychotherapists believe their values influence treatment and, if so, how they should be communicated to the patient. Questionnaires completed by 319 experienced psychotherapists (average age 43.9 yrs) indicated that 89% agreed that values of the therapist have a direct influence on therapy. 43% agreed and 37% disagreed that the therapist's values should influence therapy, with behaviorally and humanistically oriented Ss more likely to agree than psychoanalytically oriented Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Verbal therapeutic behavior of expert psychoanalytically oriented, gestalt, and behavior therapists.

Asked 18 expert psychoanalytically oriented, gestalt, and behavior therapists to submit representative, audiotaped therapy interviews. A content analysis of therapist verbal behavior was conducted by means of the System for Assessing Therapist Communications, an instrument developed by the authors. Comparisons across the 3 theoretical orientations were made on 6 dimensions of behavior: type of therapeutic activity, temporal focus, interview focus, initiative, communication, and therapeutic climate. Results indicate that according to prediction, these expert therapists were similar in their communication of empathy, the basis for their therapeutic relationships. Theoretical orientation, however, differentially influenced the use of direct guidance and facilitative techniques, interview content focused on the client, therapist self-disclosure, therapist initiative, and supportive therapy climate. Gestalt therapists were most dissimilar from the other therapists. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Insights from behavior therapy: A case study combining behavioral and psychoanalytic therapies.

Discusses the effects of a hospital-based behavioral program on psychoanalytically oriented individual psychotherapy in terms of a case study of an 11-yr-old male. The introduction of a behavioral program in the hospital milieu, although far removed from the patient's therapy sessions, facilitated formation of a positive relationship with the individual therapist. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The spiritually responsible therapist: Religious material in the psychotherapeutic setting.

There exists a movement within the field of psychology to incorporate religious material into the overall conceptualization and treatment of the client. This article questions the appropriateness of such incorporation and emphasizes instead the distinction the therapist needs to make between religious and psychological material in the psychotherapeutic setting. The therapist must also be aware of how religious material can intensify the transference, resistance, and countertransference, thereby complicating the therapeutic process. Client issues that relate to the religious identity of the therapist or invoke a sense of exclusive similarity in the therapeutic dyad can further complicate the therapy. Such complications suggest that the avoidance of both overt and covert messages that communicate the therapist's personal values and beliefs may be beneficial for therapy. Case examples with 4 clients (aged 18–56 yrs) are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychoanalytic approaches to alcoholism and addiction: Treatment and research.

Discusses modified psychoanalysis as a treatment for addiction and reviews the outcome research for such therapy. Modifications to traditional psychoanalysis that may be made for addicts or alcoholics include an initial phase of treatment that is supportive and didactic, followed by more psychoanalytically oriented treatment; a therapist who is active rather than passive; the forestalling of transference; and the recommendation for participation in Alcoholics Anonymous. Two of 3 studies in which modified psychoanalysis was used with addicts or alcoholics found that those Ss derived significant benefit from the therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Who is afraid of STDP? Termination in STDP and therapist's personality.

The termination phase of Short-Term Dynamic Psychotherapy (STDP) is considered to be of major importance for the success of treatment as a whole. It encompasses the essential conflicts experienced by both therapist and patient in relation to the issues of separation, loss, and imperfection. This article discusses the personality characteristics and personal defenses that assist or hinder the therapist in successfully practicing this mode of dynamic therapy. It also aims at inspiring the psychotherapist to examine his or her attraction or repulsion to working as a short-term psychotherapist, thereby promoting insight, and enabling him or her to broaden his or her therapeutic repertoire. Vignettes from two cases are presented, highlighting some expressions of countertransference and their influence on the process of termination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference, attachment, and the working alliance: The therapist's contribution.

This study examined the relationship among therapist attachment styles, countertransference behaviors, and working alliance. Fifty therapists in training and their supervisors participated in the study. Therapists completed a self-rated measure of attachment style and a measure of working alliance with 1 of their clients. Supervisors completed measures of working alliance and countertransference behaviors about their supervisee's relationship with the same client. Results indicate that therapist attachment style did not correlate with either countertransference behaviors or working alliance. However, negative countertransference was associated with poorer working alliances, and positive countertransference was related to a weak bond within the working alliance. Additional analyses indicate that disagreement among supervisors and therapists about the bond component was predictive of countertransference behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Should men treat couples? Transference, countertransference, and sociopolitical considerations.

Describes couples therapy (CPT) as both a conversation and an experience which are significantly different for each member of the couple when the therapist is a male. CPT differs profoundly from individual therapy in that CPT involves 3 people, 2 of whom will share the same gender, resulting in an inherent imbalance with important transference and countertransference consequences and dilemmas. This imbalance and the transference–countertransference constellations that result are explored. Recommendations concerning gender sensitivity are made to the therapist to promote appropriate treatment. The author believes that if asked whether men should treat couples, the simple answer should be yes, because men are clearly capable of treating couples. The more complex answer is yes, but only with great sensitivity to gender issues, within the couple itself, and within the therapist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experienced psychoanalytically oriented therapists' narrative acounts of their personal therapy: Impacts on professional and personal development.

Examined the impact of personal therapy on the professional and personal development of psychotherapists through in-depth interviews with 5 psychoanalytically oriented psychotherapists (aged 40–50 yrs). An adaptation of the method of consensual qualitative coding was used to study the narrative accounts of therapy experiences leading to the identification 6 domains: (1) importance of personal therapy for therapists; (2) impacts on the professional self: identity; (3) impacts or one's being in the session: process; (4) experiences in previous and current therapy; (5) self in relation to the personal therapists; and (6) mutual and unique influences of didactic learning, supervision, and personal therapy. The authors found that personal therapy is perceived not only as an essential part of the training phase, but as playing an important role in the therapist's ongoing process of individuation and in the development of the ability to use the self, to achieve moment-to-moment authentic relatedness with one's clients. The domains and categories are appended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Status of sexuality in contemporary psychoanalytic psychotherapy as reported by therapists.

Contemporary psychoanalytic literature places less emphasis than its classical counterpart on sexuality in explaining human motivation. However, up until now no methodical research has been done on the status of sexuality in clinical work. We report on a qualitative interview study that examined the status of sexuality in psychoanalytically oriented psychotherapy (n = 10). We studied the extent to which therapists used sexual factors to explain patient behavior: To what extent were sexual themes dominant in the treatment, what importance did therapists attach to them, and what factors affected their place in therapy? The data gathered from the investigation were related to theoretical thinking on the marginalization of sexuality in psychoanalytic theory and practice. On the basis of the investigation, we describe four factors that affect the status of sexual themes in therapy: the extent of the belief in the centrality of sexuality in human motivation, the level of expressiveness of therapy, the narrowing of the concept of sexuality and the separation between sexuality and intimacy, and the tendency to avoid sexual issues because of the discomfort their discussion causes to patient or therapist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference play: Informing and enhancing therapist self-awareness through play.

The study of countertransference among therapists working with children and adolescents is a relatively recent phenomenon, but the lack of attention paid to resolving countertransference that arises during the course of play therapy is surprising. The most commonly suggested way to address countertransference in the literature is through the development of therapist self-awareness during verbal discourse in supervision. This article addresses the rationale for, and provides examples of, an active approach for dealing with potentially counter therapeutic reactions. This technique, known as countertransference play, derives from the field of art therapy and provides therapists with a logically derived means of understanding and working through countertransferential responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Active attention" and "focusing" on the transference/countertransference in the psychotherapy of the borderline patient.

Outlines an active approach to the treatment of borderline patients that includes the exploration of transference/countertransference paradigms, along with 2 active techniques: active attention and focusing. These variations of psychoanalytic technique are of particular relevance to more active forms of psychoanalytically oriented psychotherapy, such as psychoanalytic short-term psychotherapy. A review of the borderline personality organization as a clinical entity is presented, along with an exploration of the difficult psychodiagnostic, dynamic, and intervention issues that the borderline patient presents. The contraindications of an active approach to the treatment of the borderline patient are summarized. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The power of countertransference: Innovations in analytic technique.

Reviews the book, The power of countertransference: Innovations in analytic technique by Karen J. Maroda (see record 1994-98465-000). This is a remarkable and provocative book. On first examination, I thought it was going to be another diatribe against psychoanalytic theory and practice. In the introduction and first chapter, which Maroda entitles: "The Myth of Authority," she points out all of the flaws that she sees in the typical attitude of psychoanalytically oriented analysts. She criticizes the so-called "neutrality" of the analytic position, the authoritarian position of the analyst and the excess emphasis of interpretation as the most critical aspect of the "cure" in psychoanalysis. The rest of the book, however, focuses on countertransference techniques; that is, how to accomplish the countertransference. Maroda's clinical vignettes and technical discussions are detailed and useful. Although one might take issue with some specific clinical points, her discussion is well formulated and her case well argued. This is a rather brief and, at first blush, simple book. It is, however, an important statement of a position on countertransference that is both ground breaking, and a careful exposition. It is one that needs serious attention by both students and advanced clinicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The meaning of repeated absences in a case of psychoanalytically-oriented psychotherapy with a borderline patient.

Repeated absences from treatment are hypothesized to bear a central relation to the patient's separation–individuation subphase development. In the case presented of a borderline 22-yr-old woman in psychoanalytically oriented psychotherapy, the practicing subphase was literally reworked through the medium of action. Leaving and returning to the therapist represented a testing of the possibility of object loss in an effort to work toward a position of object constancy, resulting in the attainment of a higher level of integration of ego functioning. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Dimensions of psychotherapy: A factor-analytic study of ratings of psychotherapy sessions.

Rated tape recordings of 60 early sessions of psychoanalytically oriented therapy on 110 process variables. The ratings of 3 Os were clustered and factor analyzed. 4 factors were rotated and interpreted as (a) patient health vs. distress, (b) optimal empathic relationship, (c) active directive mode, and (d) interpretive mode with receptive patient. For 27 of the 30 patients, outcome ratings were obtained from the therapist (patient improvement and success + patient satisfaction). Patient improvement was not predicted by any process ratings. Success + patient satisfaction, on which women scored higher than men, was predicted by patient health vs. distress. Patients rated in early sessions as healthy and low in distress had better prognoses. Optimal empathic relationship qualities related positively to success in therapies low in directive mode, but for relatively directive therapies, this relationship was negative. (31 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist perspectives on countertransference: Qualitative data in search of a theory.

A consensual qualitative research strategy was used to examine data from 127 interviews conducted with 8 psychologists immediately following their sessions of brief therapy with 8 clients. Analyses revealed 3 domains relevant to countertransference: origins (including categories of family issues, needs and values, therapy specific issues, and cultural issues), triggers (including categories of content of client material, therapist comparing client with others, change in therapy structure or procedures, therapist assessing progress of therapy, therapist perception of client, and emotions), and manifestations (including categories of approach, avoidance, negative feelings, and treatment planning). The frequency of categories within and across cases was classified, and relationships among categories from the 3 domains were detected, generating hypotheses for future empirical research. Implications for practice, training, and continued research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An overview of psychoanalytic psychotherapy with schizophrenics.

Reviews issues in long-term psychoanalytically oriented psychotherapy with schizophrenic patients. The schizophrenic's conflict is traced to the symbiotic phase of development. Three types of therapeutic relationships are outlined in which the therapist is either maternal, open to his/her own regression, or analytically neutral. Four stages in the transference are described: an out-of-contact delusional stage, a distorted stage, an ambivalent stage, and a stage of symbiotic relatedness. Contraindications and alternatives to transference interpretations are explored as well as types of interpretations. A dual-axis framework for ordering the theories and the psychotherapeutic techniques is provided. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)