12 Slices
Medium 9781855750289

10. The patient-therapist fit and countertransference reaction in the light of frame theory

Athina Alexandris Karnac Books ePub

Hector Worries

Bion has captured the concept of the frame in his metaphor of the artist in whose painting “something has remained unaltered and on this something recognition depends” (Bion, 1977, p. 1). The invariants of a painting by an impressionist and a realist would convey different meanings. The frame has been compared by Bleger (1966) to the mere background of a Gestalt that may evolve into a figure. The background would be the constant, the invariant factor or the non-process, and the figure the transformation, the variable or the process. The frame is therefore the invariant element that is “the receiver of the symbiosis” (p. 513) and in that sense expresses the maternal configuration. The analytic process itself is pregnant with ambiguity and multiple meanings and does not contain the symbiotic experience. The frame acts as a support of the analytic process but does not accept its ambiguity. It is similar to the child’s symbiosis with the mother, which enables him to develop his ego in a background of safety and support. Within the frame or the container, there is a space and an analytic atmosphere, which may have certain characteristics—that is, optimal distance, refusal to play a role, neutrality, self-effacement, and benevolence. The analytic frame is deliberately unbalanced in order to activate unconscious meanings. The frame of transference expectations usually finds sufficient fit with what is transpiring in the analytic frame.

See All Chapters
Medium 9781855750289

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.

See All Chapters
Medium 9781855750289

4. A parallel voyage of mourning for patient and analyst within the transference-countertransference voyage

Athina Alexandris Karnac Books ePub

AthinaAlexandris

1. THE VOYAGE OF ARGO: OEDIPUS COMPLEX

Oedipus Rex is what is known as a tragedy of destiny.

His destiny moves us only because it might have been ours—because the oracle laid the same curse upon us before our birth as upon him.

Freud, 1900a, p. 262

This is the study of a father, our patient, who had a problem in choosing a name for his second son; he could not decide whether to call him Alexander or Jason. Neither of these names appeared in either his or his wife’s family lines. He finally decided on the name Jason.

George, our patient, attempted to “resolve” the problems related to his oedipal situation—and change his destiny as a result—by the use of myths, songs, and fairy-tales. Of special relevance here is the myth that he employed, namely, “The Voyage of Argo” or “Argonautica”, which was written by Apol-lonius of Rhodes some time in the middle of the third century B.C. [In the Argonautica of Apollonius of Rhodes, we have the only full account of Jason’s voyage in quest of the Golden Fleece, a tale that seems to have stood, in the estimation of the Greeks, second only to the great cycle of legends that centred in the Trojan War. Apollonius’ poem is thus unique. It has often been claimed that here we have the finest psychological study of love that the Greeks have left us (E. V. Rieu).J

See All Chapters
Medium 9781855750289

6. Countertransferential bodily feelings and the containing function of the analyst

Athina Alexandris Karnac Books ePub

Athina Alexandris Grigoris Vaslamatzis

Ah, this terrible pain before prophecy

Aeschylus, Oresteia

Introduction

Psychoanalytic psychotherapy to persons exhibiting borderline personality or, broadly speaking, primitive personality—brought to our attention phenomena taking place during treatment, that are beyond the verbal interchange of patient-analyst. Kernberg (1987) describes these channels of communication and considers that during the analytic therapy of borderline patients, “The emergence of dominant unconscious object relations in the transference typically occurs by means of non-verbal communication” (p. 205). Also, McDougall (1980) refers to primitive models of communication by the patient, which indicate that the patient has suffered pre-verbal, severe traumas or deficiencies during the early maternal relationship.

It is generally accepted that in the treatment of this kind of patients with primitive personalities and/or severe traumas, the understanding and use of countertransference is of special value. In these cases the analyst often faces bizarre and intense phenomena in the primitive transference of the patient. Also, the analyst has to handle his own intense feelings, which these patients usually provoke.

See All Chapters
Medium 9781855750289

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).

See All Chapters

See All Slices