Envy in the transference and countertransference

This article defines envy and describes the various ways in which it may manifest itself, pointing out that there may be positive as well as negative effects of envy. These concepts are then applied to the psychotherapeutic situation, and the effects of envy in the transference, and particularly the countertransference, are discussed. Finally a case presentation demonstrates how the therapist's recognition and understanding of envy in the countertransference were used in a positive way and helped the therapy to proceed in a more productive direction.     

The trainee and the borderline client: Countertransference pitfalls

Acknowledging and overcoming hostile countertransference is a major problem in treating borderline personalities, especially for clinicians in training. Borderline personality dynamics and transference/countertransference phenomena are described, and a compendium of trainess' negative countertransference reactions is offered, following Maltsberger's and Buie's (1974) schema. Myths of omnipotence, seen as antecedents to countertransference reactions, are discussed briefly. A case example illustrates some of the ways that a trainee may inadvertently foster a negative transference/countertransference experience; it also discusses the roles of supervision and consultation in explicating the particular difficulties that the therapist and patient created. The necessity for and nature of limit-setting with borderline patients is noted.     

Countertransference: A vehicle for reciprocal growth and repair in women psychotherapists treating women patients

In 1986 research the author described a constellation of gender related issues emergent in the transference and countertransference of women psychotherapists treating women patients. Shared gender-linked issues appear to foster special resonance between women psychotherapists and their patients. This paper posits that shared themes in the interplay of transference and countertransference can be reparative and growthful for the psychotherapist as well as her patient. Three examples from the author's clinical experience are used to demonstrate the process by which countertransference can give the patient greater access to unconscious material while simultaneously promoting growth in the therapist.     

Does Religious Attendance Moderate the Connection Between Pornography Consumption and Attitudes Toward Women?

Feminist theory and religious doctrines alike often suggest that pornography alters the attitudes of those who consume it, particularly with respect to how consumers view women. Many would assume that pornography would universally encourage sexism and female objectification, but recent evidence has linked pornography use with more gender egalitarian views. Using data from a large-scale, nationally representative survey, we argue that cognitive dissonance among pornography consumers could alter egalitarian attitudes. We found that those who reported consuming pornography had more egalitarian attitudes than those who did not, but this difference was stronger among those who attended religious services more regularly—those who would be likely to experience dissonance when consuming pornography. This pattern was consistent across the three egalitarian attitudes we examined: attitudes toward women in power, women in the workplace, and abortion. Our results suggest that pornography might foster progressive attitudes among those most likely to hold conservative beliefs.     

Clinical work with adolescents and their parents during family transitions: Transference and countertransference issues

This paper describes specific transference and counter-transference issues that commonly emerge in therapeutic work with adolescents and parents who are in the midst of family transitions such as divorce and remarriage. Psychoanalytic understanding and definitions of transference and countertransference are applied to short-term family-centered cases in which the parent-adolescent relationship is at particular risk. Case vignettes are presented in order to illustrate how transference and countertransference may guide or interfere with clinical interventions that are especially indicated with adolescents whose family structure has changed. Such interventions as well as the use of consultation are briefly described.At the time this paper was prepared, Ms. Springer was Associate Director and a senior clinician at the Center for the Family in Transition in Corte Madera, California. Funds for the research and clinical work that provided the basis for this paper were supplied by grants from the San Francisco Foudation. An earlier version of this paper was presented at the 66th Annual Meeting of the American Orthopsychiatry Association, New York City, March 31–April 4, 1989.     

From delusion to play

Winnicott suggested that delusions are a failed form of play. Using Winnicott's theories of the play space, this paper illustrates through clinical material how the therapist can join a delusion and convert it into an area of play. Discussion includes an analysis of the use of play in working with the transference and countertransference as well as the therapist's resistances to engaging in play.     

Supervision of trainees: Tending the professional self

This article seeks to demonstrage how self psychological concepts can be applied to the process of training psychotherapists in a variety of clinical and community settings. The author examines the role of clinical supervision in the development, consolidation, and maintenance of a cohesive professional self. The role of selfobject experience, needs, transference, and countertransference as manifested in the supervisory relationship is elaborated. Supervisor and supervisee form a self-selfobject unit, through which the trainee's anxieties and vulnerabilities can be managed. This selfobject matrix enables maintenance of self-esteem, expansion of cognitive understanding, and structure building in the arena of the professional self. To achieve these ends, the supervisor forms an empathic alliance with the internal, subjective experience of the therapist. The importance of focusing on the self experience and selfobject needs of the therapist in training via an empathic mode of observation is illustrated by several examples and vignettes. The application of theory to practice is emphasized, with examples chosen from a variety of clinical settings and modalities.     

The Intersubjective Experience of the Physical Body in the Clinical Setting of Eating Disorders

This paper will illuminate one dimension of self-disclosure as it relates to the inescapable presence of the body in treatment, and the female clinician’s ability to bring her physical body into clinical discussions during an encounter with a female client with an eating disorder. Although the clinical literature on eating disorders validates that transference and countertransference issues are particularly powerful, it generally neglects the exploration of these issues specific to the body’s physical presentation. Since body dissatisfaction is increasingly normative for women today, female clinicians need to have a theoretical road map on which to rely when they encounter a shared body experience. Thus, in order to encourage discussions of the therapist’s body in clinical social work practice, the body needs to be situated in a larger theoretical framework within which it can be explained and located; this framework is object relations theory viewed through an intersubjective lens. Concepts from object relations theory will demonstrate the importance of the body in the clinical exchange by highlighting the parallel between Winnicott’s ‘good enough’ mother and the ‘good enough’ therapist’s body. When the therapist is able to judiciously invite discussions of her body into the clinical arena, the client is given the opportunity to move from object relating to object usage. A case presentation exemplifies how this conceptual framework can be applied to clinical social work practice, strengthening the relationship between knowing and doing.     

Exploring the Therapeutic Relationship A Case Study

This paper is focused on the topic of the therapeutic relationship in systemic therapy. It is structured around the discussion of my experience of work with a particular family where the engagement issues were complex, and where there was the potential for a negative therapy sequence. The psychoanalytic concepts of transference, countertransference and projective identification are chosen to discuss my dilemmas — however, the differences between the analytic and systemic contexts of work are noted. Through the discussion of this case study, the potential benefits of using these analytic ideas to understand the therapeutic relationship in specific situations in systemic therapy are identified.     

Roundtable Discussion on Sexuality in Development and Treatment II: Clinical Application

This article explores the interesting, yet underinvestigated, phenomenon of unconscious communication. Newer psychoanalytic theories, which have expanded on the centrality of the analyst's subjectivity as well as the patient's experience of that subjectivity, have opened up the analytic space to explore the complexity of transference–countertransference dynamics. Detailed clinical process material is provided to determine if a coconstructed unconscious dialogue ensues, or if, in fact, the intrapsychic dynamics of patient and analyst are on independent yet parallel tracks. Several current theoretical issues are raised, such as how one- or two-person metapsychological frameworks can influence clinical process; the complex nature of enactments; the use of self-disclosure; and the possibility of unconscious communication.     

Spontaneous self disclosures in psychotherapy

The closeness and intensity of feeling that develops between therapist and patient raises complex issues related to the therapist's neutrality, the transference, the countertransference, the therapeutic alliance, and the very essence of the curative aspects of the relationship. The issue of the relationship of self disclosure and the evolving transference, countertransference complex is discussed. It is suggested that on some occasions, the pressure a therapist feels to spontaneously disclose something intimately personal is an indication that the therapeutic role has become reversed and the therapist is using the process to heal a vulnerability in himself or herself. The patient unconsciously participates in the interest of safeguarding the treatment process. In such instances the self disclosure need not interfere with the evolving transference. It may lead to great spontaneity in the process and to opening areas of affect previously unreachable. Self disclosures cannot be viewed as technical innovations to avoid stalemates in clinical practice. Rather, they are facts of our clinical life, facts that must be explained and understood rather than judged and condemned.     

Gender,Sexual Affect,and Motivations for Internet Pornography Use

ABSTRACT

The Internet has substantially changed the way society consumes pornographic material and as become the most popular venue for this sexual purpose. However, researchers have paid little attention to why people use pornographic material online. Arguing that the use of Internet pornography is a motivated behavior meant to obtain what one wants to see, this study attempts to identify specific motivations for Internet pornography use. In addition, this study analyzes how gender and sexual affect—positive or negative—are associated with motivations for Internet pornography use. Overall, 321 undergraduate students including males and females responded to an online questionnaire. Findings show that motivations behind Internet pornography use can be broken down into four factors—relationship, mood management, habitual use, and fantasy. Males revealed far stronger motivations than females; and those with more erotophilic tendencies were more likely than those with more erotophobic tendencies to be motivated to use Internet pornography for all four motivational factors. The implications of the findings are discussed.     

Building a Bridge Across the Ocean: Commentary on a Dialogue Between Adrienne Harris and David Lichtenstein

This essay is a commentary on the dialogue between Adrienne Harris and David Lichtenstein and aims to address the points of contact and divergence between relational and Lacanian perspectives. As a starting point, I focus on issues that are central to both schools of thought, including (but not limited to) the self as subject, transference and countertransference, the analytic relationship, interpretation, transformation and the goals of treatment, and the question of analytic authority. These areas are discussed with an eye toward understanding the way that theory informs technique and comes alive in the clinical situation ultimately effecting change.     

The Guilty Pleasure of Erotic Countertransference: Searching for Radial True

Although the use of the analyst's countertransference remains a point of controversy, it is a rare analyst who would not consider countertransference feelings useful fodder at least for the analyst's private reverie. But when the affective valence leans erotic, countertransference becomes once again taboo. This article explores the erotic meanderings of an analyst in relation to several patients with the aim of illustrating how erotic countertransference can be used to further the clinical process in each example. Cases include patients of both genders. Material is considered from within contemporary relational formulations, including the assumptions of multiplicity, the dialectic between relationality and autonomy, and judicious clinical technique that respects the complexity of clinical process.     

Resolving Some Therapeutic Impasses by Disclosing Countertransference

Clinical social workers have been shifting their conceptualization of countertransference from the traditional classical modal of a one-person psychology nearer to a two-person psychology, thereby moving the ideal of the blank screen model to one of participant observation. With a two-person psychology now more in vogue, clinical social workers feel much more inclined to share some of their countertransference responses with their patients. Where there is limited consensus is embodied in the question: “Under what circumstances is countertransference disclosure most helpful to our patients?” This paper is an attempt to demonstrate through case vignettes how countertransference disclosure can resolve certain types of therapeutic impasses.     

When the going gets rough ... difficult points in treatment: Identification,exploration and working through (panel)

This paper is a summarized report of a panel presentation made by three analysts on the topic of resolving difficult points in the treatment of three of their patients through the understanding of countertransference and transference issues. The first analyst presented a case in which a stalemate was broken by addressing three different kinds of countertransference. The second presenter addressed an impasse in the treatment of her drug addicted male patient which was caused by positive transference and countertransference. The third analyst discussed the resolution of a critical point in the third year of treatment of a female patient which was uncovered by addressing the parameter of appointment scheduling. The candor and honesty of these presentations takes the reader into the heart of practice issues and illustrates how stalemates are resolved and treatment deepened. Audience reaction indicated that more such presentations which illustrate how analysts really work would be welcome.     

Race and Trends in Pornography Viewership, 1973–2016: Examining the Moderating Roles of Gender and Religion

While some research has uncovered racial differences in patterns of pornography viewership, no studies to date have considered how these patterns may be changing over time or how these trends may be moderated by other key predictors of pornography viewership—specifically, gender and religion. Using nationally representative data from the 1973–2016 General Social Survey (GSS; N = 20,620), and taking into account different ethnoreligious histories with pornography as a moral issue, we examined how race, gender, and religion intersect to influence trends in pornography viewership over 43 years. Analyses revealed that Black Americans in general were more likely to view pornography than Whites, and they were increasing in their pornography viewership at a higher rate than Whites. Moreover, Black men were more likely to consume pornography than all other race/gender combinations, but differed only from White women in their increasing rate of pornography viewership. Lastly, frequent worship attendance moderated trends in pornography viewership only for White men. By contrast, regardless of attendance frequency, Black men and women showed increasing rates of pornography use, while White women showed flat rates. We conclude by discussing the implications of these findings for research on the intersections of race, gender, religion, and sexuality.     

Termination: When the therapist leaves

Despite an expansion of our knowledge about loss and grief little has been written on the experience and techniques employed during a forced termination. This article examines the theory, applications of theory, and transference/countertransference issues surrounding the author's experience as she moved to another state and transferred or terminated with her patients.Paper presented at the Fourteenth Annual Symposium of the New York Center for Psychoanalytic Training, March 1989.     

The Psychology of the Psychopharmacology Triangle

Abstract

The psychopharmacological triangle generated by recent changes in mental health practices requires social workers to deepen their understanding of the psychological meanings of such treatment. Many clients receive concurrent psychotherapeutic and psychopharmacological interventions from different providers, creating a triangular treatment relationship. To facilitate a successful outcome, social workers will need to understand how meaning, transference and countertransference are stimulated by this arrangement. The literature on these issues as well as clinical experience will highlight specific issues requiring attention. By attending to these dynamics, the social worker can maximize the chances for a successful treatment outcome.     

Parallel process: Emotional and physical digestion in adolescents with eating disorders

Abstract

This paper explores the emotional processes involved in psychoanalytical psychotherapy with adolescents with eating disorders. The central discussion is of two clinical examples, both of whom were seen by the author at the initial point of engagement with the therapeutic process. Through paying attention to the qualities of transference and countertransference, the idea of parallel physical and emotional processes is seen to emerge as central to the understanding of these two young people and their difficulties. The second half of the paper goes on to develop a comparison between the characteristics of the object relations of the two adolescent patients and the quality of early object relations in babies who have feeding difficulties. The latter is discussed with reference to infant observation, particularly the author's study of 'Five infants at potential risk'. The conclusions drawn are, first, that the therapist needs to take into account, in the countertransference, the 'pull' towards responding to the patient collusively, or through repeating an invasive experience and, second, that the patterns of object relations which are seen in the adolescents and experienced by the therapist in the countertransference relate to prototypes of specific defensive configurations that can be described, through observation, as occurring in early infancy.