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3. Countertransference and the concept of projective counteridentiflcation

Athina Alexandris Karnac Books ePub

Leon Grtnberg

I have made a fairly thorough study of the disturbances caused in analytical technique by the excessive intervention of projective identification on the part of the analysand, which gives rise in the analyst to a specific reaction for which I suggested the term “projective counteridentification”, and these have been published in various articles (Grinberg, 1956, 1957, 1958, 1962, 1979).

It is known that the psychoanalytical process is conditioned by a series of factors of different types. Among them it is important to single out the continual interplay of projections and introjections which develops during the analysis, on the part of both the analysand and the analyst. Starting from the approach of the latter, we can consider two co-existing processes: in one, the analyst is the active subject of those mechanisms of introjection and projection; in the other, he becomes the passive object of the projections and introjections of the analysand.

Reprinted and expanded from Leon Grinberg, The Goals of Psychoanalysis (London: Karnac Books). By permission of the author.

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9. Some thoughts on insight and its relation to countertransference

Athina Alexandris Karnac Books ePub

Athina Alexandras Grigoris Vaslamatzis

Introduction

Much has been written about insight, in both the broad and narrow sense of the term. Hatcher (1980) pointed out that insight is not a simple matter but a complex process in psychoanalytic therapy that depends on the interplay of several factors. Kris (1956) and Blum (1979) stated the view that in psychoanalytic therapy the therapist’s main task is to provide and facilitate the patient’s insight. Insight on the part of both patient and therapist have also been discussed, as has insight in relation to the psychoanalytic situation, interpretation, working through, goals of therapy, transference-counter-transference, and the patient’s individuality. In the literature, however, there are rather few clinical examples supporting the theories.

This paper will present clinical material from two cases of psychoanalytic therapy in an attempt to illustrate how counter-transference is related to the patient’s insight, but mainly how countertransference affects the kind of insight the therapist chooses to offer his patient. The clinical material is taken from cases supervised by the authors.

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7. Countertransference reactions commonly present in the treatment of patients with borderline personality organization

Athina Alexandris Karnac Books ePub

VamikD. Volkan

This chapter is concerned with countertransference reactions usually experienced by analysts during the course of treating borderline patients. These reactions are commonly shared, and they are more than just reflections of the analyst’s own unresolved childhood conflicts. The type of countertransference about which I am writing here is very much a part of the psychoanalytic treatment of borderline patients.

Boyer (1961) stated that the analyst’s unresolved counter-transference is one of the major impediments to success in treating regressed individuals. As far as I know, Boyer was the first person to introduce this concept in the psychoanalytic literature of North America, although European writers, especially the English (Balint, 1968; Heimann, 1950; Khan, 1964), implied something similar, as did Racker (1968), writing from South America. Boyer’s study of the analysts counter-transference during the treatment of regressed patients was supported by collaborative work with Giovacchini (1967), and by the independent work of Searles (1953, 1986). Their pioneering studies attracted considerable interest in this subject and, recently, a review of relevant literature has been compiled by Boyer (1990). Here I am simply acknowledging the influence of the writings of Boyer, Searles, and Giovacchini on the clinical technique I use with regressed patients, especially concerning the role of what I call “common” countertrans-ference manifestations, as an aspect of my technique. I should point out, however, that my metapsychological understanding (Volkan, 1975, 1976, 1979, 1981, 1987) of the psychic organization of such patients has followed the object relations theory as described by Jacobson (1964) and Mahler (1968) and as systematized by Kernberg (1967, 1975a).

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5. Countertransference and primitive communication

Athina Alexandris Karnac Books ePub

Joyce McDougall

Certain patients recount or reconstruct in analysis traumatic events that have occurred in their childhood. The question has sometimes been raised as to whether we treat this type of material differently from other analytic associations furnished by the patient. And if so, what are the differences? Ever since Freud’s discovery that the traumatic sexual seductions of his hysterical patients revealed themselves to be fantasies based on infantile sexual wishes, analysts have been wary of mistaking fantasy for reality. Nevertheless there are many “real” events that leave a traumatic scar on our patients—such as the early death of a father, having a psychotic mother, or a childhood handicapped by illness. When these events are within conscious recall, they inevitably present us with special problems because of the varied use the patient will make of them, and in particular because he will so frequently advance the argument that there is nothing to analyse in this material since the events “really happened”. They have, however, become part of the patient’s psychic reality and must therefore be listened to with particular attention.

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2. The analytic management and interpretation of proj ective identification

Athina Alexandris Karnac Books ePub

Thomas H. Ogden

Projective identification is not a metapsychological concept. The phenomena it describes exist in the realm of thoughts, feelings, and behaviour, not in the realm of abstract beliefs about the workings of the mind. Whether or not one uses the term or is cognizant of the concept of projective identification, clinically one continually bumps up against the phenomena to which it refers—unconscious projective fantasies in association with the evocation of congruent feelings in others. Resistance on the part of therapists and analysts to thinking about these phenomena is understandable: it is unsettling to imagine experiencing feelings and thinking thoughts that are in an important sense not entirely one’s own. And yet, the lack of a vocabulary with which to think about this class of phenomena seriously interferes with the therapist’s capacity to understand, manage, and interpret the transference. Projective identification is a concept that addresses the way in which feeling-states corresponding to the unconscious fantasies of one person (the projector) are engendered in and processed by another person (the recipient)—that is, the way in which one person makes use of another person to experience and contain an aspect of himself. The projector has the primarily unconscious fantasy of getting rid of an unwanted or endangered part of himself (including internal objects) and of depositing that part in another person in a powerfully controlling way (Klein, 1946, 1955). The projected part of the self is felt to be partially lost and to be inhabiting the other person. In association with this unconscious projective fantasy there is an interpersonal interaction by means of which the recipient is pressured to think, feel, and behave in a manner congruent with the ejected feelings and the self—and object—representations embodied in the projective fantasy (Bion, 1959; Ogden, 1979). In other words, the recipient is pressured to engage in an identification with a specific, disowned aspect of the projector.

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