Countertransference

Historical Development of the Concept

Freud introduced the term in 1910 in “The Future Prospects of Psycho-Analytic Therapy,” referring to countertransference as the result of the analyst's unconscious reaction to the patient. Although he offered no clear, comprehensive definition, he was explicit about the need to “overcome” counter-transference through self-analysis. Despite his prolific authorship, Freud made only one other direct reference to countertransference. In his 1915 paper “Observations on Transference-Love,” Freud cautioned male practitioners against responding to the transference love of their female patients by keeping their countertransference “in check.” These two references to countertransference as a hindrance to treatment form the cornerstone of the classical perspective.

Proponents of Freud's theories elaborated on the destructive elements of countertransference, describing it as the analyst's transference reaction to the patient, complete with infantile impulses toward a past object projected onto the patient. Although analogous to transference, countertransference was considered problematic and something to be worked through in the clinician's personal analysis. Transference reactions in the patient and his or her interpretation by the analyst were generally viewed as the sine qua non for successful psychoanalysis, while countertransference in the analyst reflected his or her subjectivity and hindered objectivity in regard to understanding the patient's psychodynamics. For example, a patient reminds the therapist of his disapproving and rejecting father, who found his son lacking in competence. Despite the patient's declaring that treatment has been helpful, the therapist dismisses his comments as gratuitous, believing instead that the patient views him as incapable. Here, the therapist's subjectivity and past life history interfere with his neutrality and ability to analyze the patient objectively. Only if freed of personal conflict, Freud believed, could the analyst be attentive to the patient's unconscious content.

This classical approach to the desired elimination of countertransference gradually yielded to a more constructive appreciation of its usefulness in treatment. Just as Freud's followers cited his 1910 [Page 157]and 1915 passages to fortify their positions, Sándor Ferenczi and theorists from the British School of Object Relations drew on Freud's references to the value of the analyst's unconscious as a receptor for the content of the patient's unconscious. Mastering one's countertransference negated using those reactions to better understand the patient's unconscious communication. In other words, while countertransference reflects the subjectivity of the clinician, it also serves as an objective measure of the patient's unconscious content, as well as a real reaction to the patient's transference and personality. Based on objective observation, Winnicott noted in his seminal 1949 paper “Hate in the Countertransference,” a clinician might experience strong negative feelings as a result of being provoked by the patient. To dismiss this reaction as purely the result of the clinician's transference to the patient would ignore one's objectivity and a vital part of the treatment process. For example, a female patient is demeaning and mocking of her therapist, engendering an angry response in him, similar to the one she elicits in her boyfriend. Here the therapist's reaction is diagnostic of the patient's interpersonal difficulty as he experiences what others have in relation to the patient's personality and style of communication.

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