May 30, 2011

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Weigert favours analysis of countertransference insofar as it intrudes into the analytic situation, and she advises, in advance stages of treatment, less reserve in the analyst’s behaviour and more spontaneous display of countertransference.

Briefly, is to consider countertransference in the history of psychoanalysis are that we meet with a strange fact and striking contrast. The discovery by Freud of countertransference and its great importance in therapeutic work gave to the institution of didactic analysis which became the basis and centre of psychoanalytic training. Yet countertransference received little consideration over the next forty years. Only during the last few years has the situation changed, rather suddenly, and countertransference became a subject examined frequently and with thoroughness. How is one to explain this in initial recognition. This neglect, and the recent change? Is there no reason to question the success of didactic analysis in fulfilling its function, if this very problem, the discovery of which led to the creation of didactic analysis, has had so little scientific elaboration?

These questions are clearly important, and those have personally attested of a great part of the development of psychoanalysis in the last forty years have the best right to answer them. Nonetheless, I will suggest or exemplify on or upon of only one explanation.

The lack of scientific investigation of countertransference must be due to rejection by analyst of their own countertransference - a rejection that represents unresolved struggles with their own primitive anxiety and guilt. These struggles are closely connected with those infantile ideals that survive because of deficiencies the didactic analysis of just those transference problems that latter affect the analyst’s countertransference. These deficiencies in the didactic analysis are in turn due to countertransference problems insufficiently solved in the didactic analyst. Thus, we are in a vicious circle, but we can see where a breach must be made. That is to say, that we must begin by revision of our feelings about our own countertransference and try to overcome our infantile ideals more thoroughly, accepting more fully the fact that we are still children and neurotics even when we are adults and analysts. Only in this way - by better overcoming our rejection of countertransference - can we achieve the same result in candidates.

The insufficient dissolution of these idealizations and underlying anxieties and guilt feelings leads to special difficulties when the child becomes an adult and the analysand an analyst , for the analyst unconsciously requires of himself that he be fully identified with these ideals, that it is at last, partly for this reason that oedipus complex of the child toward its parents, and of the patient toward his analysand, has been so much more fully considered than that of the parents toward their children and of the analyst toward the analysand. For the same basic reason transference has been dealt with much more than countertransference.

The fact that countertransference conflicts determine the deficiencies in the analysis of transference becomes clear if we recall that transference is the expression of the internal object relations; for understanding of transference will depend on the analyst’s capacity to identify himself both with the analysand’s impulses and defences, and with his internal object s, and to be conscious of these identification. This ability in the analyst will in turn depend upon the degree to which he accepts his countertransference, fo r his countertransference is likewise based on identification with the patient’s id and ego and his internal objects. One might also say that transference is the expression of the patient’s relations with the fantasies and real countertransference of the analyst. For just as countertransference is the psychological response to the analysand’s real imaginary transference, so also is transference the response to the analyst’s imaginary and real countertransference. Analysis of the patient’s fantasies out countertransference, which in the widest sense constitute the causes and consequence of the transference, is an essential part of the analysis of the transference. Perception of the patient‘s fantasies regarding countertransference will depend in turn upon the degree to which the analyst himself perceives his countertransference processes - on the continuity and depth of his conscious constant with himself.

Finally, the repression of countertransference (and other pathological fates that it may meet) necessarily leads to deficiencies in the analysis of transference, which in turn lead to the repression and other mishandling of countertransference soon as the candidate becomes an analyst. It is a heritage from generation to generation, similar to the heritage of idealizations and denials concerning the imagoes of the parents, which continue working even when the child becomes a father or mother. The child’s mythology is prolonge in the mythology of the analytic situation, the analyst himself being partially subject to it and collaborating unconsciously in its maintenance in the candidate.

Let us briefly consider one of these ideals in it specifically psychoanalytic expression: The ideal of the analyst’s objectivity. No one, of course, denies the existence of subjective factors in th analyst and of countertransference in itself, but there seems to exist an important difference between what is generally acknowledged in practice and the real state of affairs. The first distortion of truth in ‘the myth of thee analytic situation’ is that analysis is an interaction between two personalities in both of which the ego is under pressure from the id, the superego, and the external world, each personality has its internal and external dependencies, parents, and that of the analyst - responds to every event of the analytic situation. Besides these similarities between the personalities of analyst and analysand, there also exist differences, and one of these is in ‘objectivity’. The analyst’s objectivity consists mainly in a certain attitude toward his own subjectivity and countertransference. The neurotic (obsessive) ideal of objectivity lead to repression and blocking of subjectivity and so to the apparent fulfilment of the myth of the ‘analyst without anxiety or anger’. The other neurotic extreme is that of ‘drowning’ in the countertransference. True objectivity is based upon a form of internal division that enables the analyst to make himself (his own countertransference and subjectivity) the object of his continuous observations and analysis. This position also enables him to be relatively ‘objective’ toward the analysand.

The term countertransference has been given various meanings. They may be summarized by the state that for some authors countertransference includes everything that arises in the analysis as psychological response to the analysand, whereas for others not all this should be called countertransference. Some, for example, prefer to reserve the term for what is infantile in the relationship of the analyst with his analysand, while others make different limitation (Annie Reich and Gitelson). Hence efforts to differentiate from each other certain of the complex phenomena of countertransference lead to confusion or to unproductive discussion of terminology . Freud invented the term countertransference in evident analogy to transference, which he defined as ‘reimpressions’ or ‘re-editions’ of childhood experiences, including greater or less modifications of the original experience. hence one frequently uses the term transference for the totality of the psychological attitude of the analysand toward the analyst. We know, to be sure, that real external qualities of the analytic situation in general and of the analyst in particular, have important influences on the relationship of the analysand with the analyst, but we also know that all these present factors are experienced according to the past and the fantasy, - according. That is to say, too a transference predisposition. As determinants of the transference neurosis and, in general, if the psychological situation of the analysand toward the analyst, we have both the transference predisposition and the present real and especially analytic experiences, the transference in its diverse expressions being the resultant of these two factors.

Analogously. In the analyst there are the countertransference predisposition and the present and immediacy or the real, and especially analytic, experience; and the countertransference is the result. It is precisely this fusion of present immediacy and the past, the continuous and intimate connection of reality and fantasy, of external and internal, conscious and unconscious, that demands a concept embracing the totality of the analyst’s psychological response, and renders it advisable, at the same time, to keep for this totality of response the accustomed term ‘countertransference’. Where it is necessary for greater clarity one might say of ‘total countertransference’ and then differentiated and separate within it one aspect or another. One of its aspects consists precisely in what is transferred in countertransference; this is the part that originates in an earlier time and that is especially the infantile and primitive part within total countertransference. Another of these aspects - closely connected with the previous one - is what is neurotic in countertransference it main characteristics the unreal anxiety and the pathological defences. Under certain circumstances one might in saying of a countertransference neurosis.

To clarity better the concept of countertransference, on might start from the question of what happens, in general, in the analyst in his relationship with the patient, as one might think that everything happens that can happen in one personality faced with another. But this says so much that it says hardly anything - bearing in mind that in the analyst there is a tendency that normally predominates in his relationship with the patient: Is the tendency pertaining to his function of being an analyst, that of understanding what is happening in the patient. Together with the tendency there exist toward the patient virtually all the other possible tendencies, fears, and other feelings that one person may have toward another. The intention to understand creates a certain predisposition , a predisposition to identify oneself with the analysand, which is the basis of comprehension. The analyst may achieve this aim by identifying his ego with the patient’s ego, or put it more clearly although a certain terminological inexactitude, by identifying each part of his personality with the corresponding psychological part in the patient - his id with the patient id, his ego with the ego, his superego with the superego, accepting these identifications in his consciousness. But this does not always happen, nor is it all that happens. Apart from these identifications, which might be called concordant (or homologous) identifications, there exist also highly important identifications of the analyst’s ego with the patient’s internal objects, for example, with the superego. Adapting an expression from Helene Deutsch, they might be called complementary identifications. Such are that follows:

1. The concordant identifications are based on introjection and also projection, or, in other words, on the resonance of the exterior in the interior as justly as the outer is of the inner, on the recognition of what belongs to another as one ‘s own (‘this part of you is I’) and on the equation of what is one’s own with what belongs to another (‘this part of me is you’). The processes inherently in the complementary identifications are the same, but they refer to the patient’s objects. The greater the conflicts between the parts of the analyst’s personality, the greater are his difficulties in carrying out the concordant identifications in their entirety.

2. The complementary identifications are produced by the fact that the patient treats the analyst as an internal (projected) object, and in consequence the analyst feels treated as such: That is, he identifies himself with the object. The complementary identifications are closely connected with the destiny in the concordant identifications: It seems that to the degree to which the analyst fails in the concordant identifications and rejects them, certain complementary identifications become intensified. It is clear that rejection of a part of tendency in the analyst himself, - his aggressiveness, for instance, - may lead to a rejection of the patient’s aggressiveness (whereby this concordant identification fails) and that such a situation leads to a greater complementary identification with the patient‘s rejecting objects, toward which this aggressive impulse is directed.

3. Current usage applies the term ‘countertransference’ to the complementary identifications only: This is to say, to those psychological processes in the analysis by which, because he feels treated as and partially identifies himself with an internal object of the patient, the patient becomes an internal (projected) object of the analyst. Usually excluded from the concept countertransference are the concordant identifications, - those psychological content s that arise in the analyst by reason of the empathy achieved with the patient and that really reflect and reproduce the latter’s psychological contents. Perhaps it would be best to follow this usage, bu t there are some circumstances that make it unwise to do so. In the first place, some authors include the concordant identifications in the concept of countertransference. One is thus faced with the choice of entering upon a terminological discussion of accepting the term in this wider sense. Where for various reasons the wider sense is to be preferred. If one considers that the analyst’s concordant identifications (his ‘understanding’) are a sort of reproduction of his own past processes, especially of his own infancy, and that this reproduction or-re-experience is carried out as response to stimuli from the patient, one will b e more read y to include the concordant identifications in the concept of countertransference. Moreover, the concordant identifications are closely connected with the complementary ones (and thus with ‘countertransference‘ in the popular sense), and this fact renders advisable a differentiation but not a total separation of the term. Finally, it should be borne in mind that the disposition to empathy, - this is, to concordant identification, springs largely from the sublimated positive countertransference in the wider sense. All this suggests, then, the acceptance of countertransference as the totality of the analyst’s psychological response to the patient. if we accept this broad definition of countertransference, the difference between its two aspects as listed above, must still be defined. On the one hand we have the analyst as subject and the patient as the object of knowledge, which in a certain sense annuls the ‘object relationship’, such that is said arises in its stead the approximate union of identity between the subject’s and the object’s parts (experiences, impulses, defences). The aggregate of the processes pertaining to that union might be designed, where necessary, ‘concordant countertransference’. However, on the other hand, we have an object relationship like many others, a real ‘transference’ in which the analyst ‘repeats’ previous experiences, the patient representing internal objects of the analyst. The aggregate of these experiences, which also exist always and continually, might be termed ‘complementary countertransference’.

A brief example can be made if we are to consider in that of patient who threatens the analyst with suicide. In such situations there sometimes occur s rejection of the concordant identifications by the analyst and an identification with the threatened object. The anxiety that such a threat can cause the analyst to lead of various reactions or decence mechanisms within him, for instance, annoyance with the patient. This - his anxiety and annoyance - would be contents of the ‘complementary countertransference’. The perception of his annoyance may, in turn, originate guilt feelings in the analyst and these lead to desires for reparation and to intensification of the ‘concordant’ identification and ’concordant’ countertransference.

Moreover, these two aspects of ‘total countertransference’ have their analogy in transference. sublimated positive transference is the main and indispensable motive force for the patient’s work: It does not in itself constitute a technical problem. Transference becomes a ‘subject’, according to Freud’s words, mainly when ‘It becomes resistance, when because of resistance, it has become sexual or negative. Analogously, sublimated positive countertransference is the primary and indispensable motive force in the analyst’s work (disposing him to the continued concordant identification), and also, countertransference become a technical problem or ‘subject’ mainly when it becomes sexual or negative, and this occurs (to an intense degree) principally as a resistance - in this case the analyst’s - that is to say, as countertransference, in as much as of leading into the problematic function of the dynamics of countertransference.

Every transference situation provokes a countertransference situation, which arises out of the analyst’s identification of himself with the analysand’s (internal) objects (this is the ‘complementary countertransference’). These countertransference situations may be repressed or emotionally blocked, but probably they cannot be avoided; certainly they should not be avoided if full understanding is to be achieved These countertransference reactions are governed by the laws of the general and individual unconscious. Among these the law of talion is especially important. Thus, for example, every positive transference situation is answered by a positive countertransference: To every negative transference there responds, in one part of the analyst, a negative countertransference. It is of great importance that the analyst be conscious of this law, for awareness of it is fundamental to avoid ‘drowning’ in the countertransference. If he is not aware of it he will not be able to avoid entering into the vicious circle of the analysand’s neurosis, which will hinder or even prevent the work of therapy.

A simplified example: If the patient’s neurosis centre round a conflict with his introjected father, he will project the latter upon the analyst and treat him as his father. The analyst will feel treated as such - he will feel treated badly - and he will react internally. In part of his personality. In accordance with the treatment he receives. If he fails to be aware of this reaction, his behaviour will inevitably be affected by it, and he will renew the situation that, to a greater or lesser degree, helped to establish the analysand’s neurosis. Hence it is of the greatest importance that the analyst develop within himself an ego observer of his countertransference reactions, which are, naturally, continuous. Perception of these countertransference reactions will help him to become conscious of the continuous transference situations of the patient and interpret them rather than unconsciously ruled by these reactions, as not seldom happens. A well-known example is the ‘revengeful silence’ of the analyst. if the analyst is unaware of these interactions there is danger that the patient will have to repeat, in his transference experience, the vicious circle brought about by the projected introjection of ‘bad objects’ (in reality neurotic ones) and the consequent pathological anxieties and defences, but his transference interpretations made possible by the analyst’s of his countertransference expedience making it possible to open important breached in this vicious circle.

To return to the previous example: If the analyst is conscious of his own countertransference, he can more easily make the patient conscious of his projection and the consequent mechanisms. Interpretation of these mechanisms will show the patient that the present reality is not identical with his inner perceptions (for, if it were, the analyst would not interpret and otherwise act as an analyst), the patient then introjects a reality better than his inner world. This sort of rectification does not take place when the analyst is under the sway of his unconscious countertransference.

For some considering applications of these principles one mus t return to the question of what the analyst does during the session and what happens within him, one might say, at first thought , that the analyst liste ns. But this is not completely true, he listens most of the time, or wishes to listen, but is not invariably doing so. Ferenczi refers to this fact and expresses the opinion that the analyst’s distractability is of little importance, for the patient as such moments must certainly be in resistance. Ferenczi’s remark (which dates form the year 1918) sounds like an echo from the era when the analyst was mainly interested in the repulses, because now that we attempt to analyze resistance, the patient’s manifestations of resistance are a significant as any other of his productions. At any rate, but as Ferenczi refers is the countertransference response and deduces from it the analysand’s psychological situation. He says ’ . . . we have unconsciously reacted to the emptiness and futility if the associations given a this moment with the withdrawal of the real conscious charge’. The situation might be described as one of mutual withdrawal - which, however. Is are responses to an imagined or real psychological position of th analyst. If we have withdrawn - if we are not listening but are thinking of something else - we may utilize this event in the service if the analysis, in like any other information we acquire. And the guilt we may feel over such a withdrawal is just as analytically utilizable as any other countertransference reaction. Ferenczi’s next words, ‘the danger of the doctor’s falling asleep . . . need not be regarded as grave because we awake at the first occurrence of any importance for the treatment, are clearly intended to placate this guilt. but better than to allay the analyst’s guilt would b e to use it to promote the analysis - and so use the guilt would be the best way of alleviating it. In fact, we encounter a cardinal problem of the relation between transference and countertransference, and of the therapeutic process in general. For the analyst’s withdrawal is only an example of how the unconscious of one person responds to the unconscious of another. This response seems in part to be governed, insofar as we identify ourselves with the unconscious objects of the analysand, by the law of talion; and, insofar as this law unconsciously influences the analyst, there is danger of a vicious circle of reactions between them, for the analysand also responds ‘talionically’ in his turn, and so on without end.

Looking more closely, we see that the ‘talionic response’ or ‘identification with the aggressor’ (the frustrating patient) is a complex process. Such a psychological process in the analyst usually starts with a feeling of displeasure or of some anxiety as a response to this aggression (frustration) and, because of this feeling, the analyst identifies himself with the ‘aggressor’. By the term ‘aggressor’ we mus t designate not only the patient but also some internal object of the analyst (especially his own superego or an internal persecutor) now projected upon the patient, this identification with the aggressor, or persecutor, causes a feeling of guilt; probably it always does so, although awareness of the guilt may be repressed. For what happens is, on a small scale, a process of melancholia, just as Freud described it : The object has to some degree abandoned us, we identify ourselves with the lost object, and then we accuse the introjected ‘bad’ object- in other words, we have guilt feelings. This may be sensed in Ferenczi’s remarks, such of which mechanisms are at work designed to protect the analyst against these guilt feelings; denial or guilt (‘the danger is not grave’) and a certain accusation against the analysand for the ‘emptiness’ and ‘futility’ of his association. In this way a vicious circle - a kind of paranoid ping-pong - has entered into the analytic situation.

Two situations of frequent occurrence illustrate both the complementary and the concordant identifications and the vicious circle these situations may cause.

1. One transference situation of regular occurrence consist s in the patient’s seeing in the analyst hi s own superego. The analyst identifies himself with the id and ego of the patient and with the patient’s dependence upon his superego, and he also identifies himself with this same superego - a situation in which the patient places him - and experience domination of the superego over the patient’s ego. The relation of the ego to the superego of the superego over the patient‘s ego. The relation of the ego to the superego is, at bottom, a depressive and paranoid situation; the relation of the superego to the ego is, on the same plane, a manioc one insofar as this term may be used to designate the dominating, controlling, and accusing attitude of the superego toward the ego. In this sense we may say, broadly speaking, that to a ‘depressive-paranoid’ transference in the analysand there corresponds - as regards the complementary identification - a ‘manic’ countertransference in he analyst. This, in turn, may entail various fears and guilt feelings.

2. When the patient, in defences against this situation, identifies himself with the superego, he may place the analyst in the situation of the dependent and incriminated ego. The analyst will not only identify himself with this position of the patient; he will also experience the situation with the content the patient give it : He will also feel subjugate and accused, and may react to some degree with anxiety and guilt. To a ‘manic’ transference situation (of the type called mania for reproaching) there corresponds, then - as regards the complementary identification -a ’depressive-paranoid’ countertransference situation.

The analyst will normally experience these situations with only a part of his being, leaving another part free to take note of them in a way suitable for the treatment. Perception of such a countertransference situation by the analyst and his understanding of it as a psychological response to certain transference situations will enable him the better to grasp the transference at the precise moment when it is active. It is precisely these situations and the analyst’s behaviour regarding them, and in particular his interpretations of them, that are of decisive importance for the process of therapy, fo r they are the moment when the vicious circle within which the neurotic habitually moves - by projecting his inner world outside and reintrojecting his same world is or is not interpreted. Moreover, these decisive points the world - is projecting his inner world outside these decisive points the vicious circle may be-enforced by the analyst, if he is unaware of having entered it .

A brief example: An analysand repeats with the analyst his ’neurosis of failure’, closing himself up to every interpretation or representing it at once, reproaching the analyst for the uselessness of the analysis, foreseeing nothing better in the future, continually declaring his complex indifference to everything. The analyst interprets the patient’s position toward him, and its origins, in its various aspects. He shows the patient his defences against the danger of becoming too dependent, of being abandoned, or being tricked, or of suffering counter aggression by the analyst, if he abandons his amour and indifference of bad internal objects and his subsequent sado-masochistic behaviour in the transference, his need of punishment, his triumph and ‘masochistic-revenge’ against the transference patients; his defences against the ‘depressive position’ by means of schizoid paranoid and manic defences (Melaine Klein) and he interprets the patient‘s rejection of a bond which is the unconscious has a homosexual significance. But it may happen that all these interpretations, in spite of being directed to the central resistance and connected with the transference situation, suffer the same fate for the same reasons: They fall into the ‘whirl in avoid’ of the ‘neurosis of failure’. Now the decisive moments arrive, the analyst, subdued by the patient ‘resistance, may begin to feel anxious over the possibility of failure and feel angry with the patient. What this occurs in the analyst, the patient feels it coming, for his own ‘aggressiveness’ and other reactions have provoked it; consequently he fears the analyst’s anger. If the analyst, threatened by failure, to put more precisely threatened by his own superego or by his own archaic objects which have found an agent provocateur in the patient, acts under the influence of these internal objects and of his paranoid and depressive anxieties, the patient again finds himself confronting a reality like that of his real or fantasized childhood experiences and like that of his inner world, and so the vicious circle continues and may even be re-enforced. But if the analyst grasps the importance of this situation, if, through his own anxiety or anger, he comprehends what is happening in the analysand, and if he overcomes, thanks to the new insight, his negative feelings and interprets what has happened in the analysand, being now in his new positive countertransference situation, then he may have made a breach - be it large or small - in the vicious circle.

All this we infer from the reaction of the patient, who submits to the analyst’s suggestion, telling to previous criticism of his aspect of his internal reality, ‘overcomes’ the resistance, while in reality everything is going on unchanged. It cannot be otherwise, for the analysand is aware of the analyst’s neurotic wish and his transference is determined by that awareness. To a certain degree, the analysand finds himself, once, again, in the actual analytic situation, confronting his internal or external infantile reality and to this same degree will repeat his old defences and will have no valid reason for really overcoming to such as the his own resistance, however much the analyst may try to convince her or his tolerance and understanding. This he will achieve only by offering better interpretations in which the neurosis does not so greatly interfere.

The following more detailed examples demonstrate: (I) The talion law in the relationship of analyst and analysand: (ii) How awareness of the countertransference reaction indicates what is happening in the transference and what at the moment is of the greatest significance what interpretation is mos t suitable to make a breach in the vicious circle; and (iv) how the later associations show that this has been achieved, even if only in part - for the same defences return and once again countertransference points out the interpretation the analysand needs.

We will consider the most important occurrence in one session. An analysand who suffers from an intense emotional inhibition and from a ‘disconnection’ in all his object relationships begin the session by saying, that he feels completely disconnected from the analyst H e speaks with the difficulty as if he were overcoming a great resistance, and always in an unchanging tone of voice that seems in no way to reflect his instincts and feelings. Yet the countertransference response to the content of his associations (or, rather, of his narrative, for the exercise a rigid control over his ideas) does change from time to time. At a certain point the analyst feels a slight irritation. This is when the patient, a physician, tells how in slight irritation. This is when the patient, a physician, tells him how in conversation with another physician, he sharply criticized analysis for their passivity (they give little and cure little), for their tendency to dominate their patients, the patient’s statement and his behaviors mean several things. It is clear, in the first place, that these accusations, though couched in general terms and with reference to other analysts, are directed against his own analyst; the patient has become the analyst’s superego. This situation in the patient represents a defence against his own accusing superego, projected on the analyst. It is a form of identification with the internal persecutors that leads to inversion of the feared situation. It is, in other words, a ‘transitory mania for reproaching’ as defence against a ‘paranoid-depressive’ situation in which the superego persecutes the patient with reproaches and threatens him with abandonment together with this identification with the superego, there occurs projection of a part of the ‘bad ego’, and of the id, upon the analyst. The passivity (the mere receptiveness, the inability to make reparation), the selfish exploitation, and the domination he ascribes to the analyst are ‘bad tendencies’ of his own for which he fears reproachment and abandonment by the analyst. At a lower stratum, this ‘bad ego’ consists of ‘bad objects’ with which the patient has identified himself as a defence against their persecution.

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