Understanding countertransference and its many critiques

23 Mar 2015

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Countertransference is described as redirection of a therapist's reactions to a patient or as a therapist's feelings tangle with a patient. Freud first pioneered the theory of countertransference in 1910; make a note of that the patient's control on the psychiatrist's unconscious emotions could impede with the treatment process (Ephi B., Heim, A., Conklin, C., and Westen, D., 2005). This early on and constricted analysis of countertransference as a barrier to treatment succeeded in the psychoanalytic literature for numerous decades (Ephi B., Heim, A., Conklin, C., and Westen, D., 2005). Over time, therapists expanded the theory, distinguishing that the therapist's responses to the patient could have diagnostic and therapeutic significance and can, if used correctly, assist rather than hinder treatment (Ephi B., Heim, A., Conklin, C., and Westen, D., 2005).

According to this observation, just as the patient's conduct with the therapist may provide in fundamental insight into their recurring interpersonal patterns and correlated thoughts, feelings, and motives, to may the therapist's reactions to the patient give insight into patterns the patient knowingly or unintentionally evokes from family members (Ephi B., Heim, A., Conklin, C., and Westen, D., 2005). Klein proposed that the patient may provoke the therapist to experience the feelings that the patient is having difficulty recognizing or possibly will portray the therapist into enactments that mirror the patient's continuing anticipations of relationships (Ephi B., Heim, A., Conklin, C., and Westen, D., 2005). Sandler established the notion of role responsiveness, where the therapist performs in accordance with a position that is part of a relationship pattern the patient re-creates with the therapist (Ephi B., Heim, A., Conklin, C., and Westen, D., 2005). Wachtel recommend the related theory of cyclical psychodynamics, in which patients' panics, desires, expectations, and actions often produce self-fulfilling prediction(Ephi B., Heim, A., Conklin, C., and Westen, D., 2005).

Even though the scientific literature on countertransference is vast and swiftly enlarging, the matching experimental literature is narrow(Ephi B., Heim, A., Conklin, C., and Westen, D., 2005). Research with bulky nonclinical examples has presented indirect support for several of these suggestions, revealing that depressed patients lean to draw out analysis from family members that equals their own self-criticism and that patients who are susceptible to rejection have a propensity to obtain rejection and therefore to authenticate and strengthen their inner working models of relationships (Ephi B., Heim, A., Conklin, C., and Westen, D., 2005). Giesler and associates exhibited that several of these procedures take place in scientific surroundings as well (Ephi B., Heim, A., Conklin, C., and Westen, D., 2005). A sequence of analogue studies try to operationalize the impression of countertransference, defining countertransference answers as therapists' responses to patients that are supported on the therapists' unsolved disagreement and operationalizing countertransference in terms of avoidant actions (Ephi B., Heim, A., Conklin, C., and Westen, D., 2005) .

Article Critique and Reactions

I found the article Psychotherapists ' Countertransference Reactions toward Clients with Antisocial Personality Disorder and Schizophrenia: an Empirical Test of Theory very interesting to read because this is a subject that was new to this student. The purpose of the study was to examine empirically the nature of induced countertransference reactions toward clients with Antisocial Personality Disorder and Schizophrenia.

This study found the existence of precise types of countertransference responses in therapists. Even though some countertransference responses are defiantly produced from a therapist personal life, unanswered problems, and internal discord, countertransference responses could also be provoked by patient personality. Experimental data currently encourages the assumptions, as portrayed earlier by theorists and therapists, that therapists are capable of and do have countertransference responses as an effect of their dealings with other people portraying distress. Therapists must be conscious that these persuaded feelings, attitudes, and responses may be helpful or harmful, be reacted to openly or confidentially, and be productive or damaging to therapy progression.

As a therapist this student understands that one could develop feelings for or have positive or negative feelings towards a patient, but this student did not fully understand the extent to which that could happen. Working with patients that have personality disorders can be difficult for any therapist. For this student separating her own feelings from that of a patient may be difficult. This student may find herself feeling sorry for that patient. Having empathy for a patient is not necessarily bad thing but it could go too far if not kept in check.

Right now in everyday life this student finds herself caring about and taking care of other people more than herself. As a therapist, with the possibility of countertransference, this student would need to learn to care about patients but not to become overly concerned with a certain patient. To do this, this student would have to learn to separate personal feelings from professional and if personal feelings towards a patient start to negatively effect treatment progress, then to recognize that there is a problem and talk to other therapists' for assistance.

Emotionally this student would find it difficult to treat a person with any personality disorder because of her family history. Coming from a family with a history of borderline personality disorders, treating patients with personality disorder could bring out old memories and some unresolved issues that this student would then have to deal with before continuing with that patient's treatment.

Treatment

For a therapist to put their awareness upon countertransference reactions throughout and following therapy sessions, the therapist must first be certain that the attempt is important, and second be eager to recognize their own emotional susceptibility. To be certain of its effectiveness, therapists must distinguish that patients persuade therapists both decisively and unintentionally. Much of the motivation patients present for therapy is related to the approach in which they accomplish their interpersonal relationships; these introspective information offer here-and-now understanding about other relationships. At least one study has established that therapists respond to their patients as do family members. To segregate the patient's involvement, therapists must foremost be motivated to observe the involvement of their own psychological vulnerabilities. This method entails therapists to surrender their supreme, perfectionist therapist image and, to understand their own humanity.



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