I cannot advise my colleagues too urgently to model
themselves during psychoanalytic treatment on the surgeon, who puts aside all
feelings ... (Freud, 1912, p. 115)
Countertransference is the transference
of the analyst or therapist towards the analysand or patient. For Freud – at least at the beginning – this is
something that the analyst shouldn’t have.
When countertransference emerged it was considered to be a sign that the analyst was not properly analyzed
because it indicated that the analyst was experiencing the patient as a version
of a person from her or his past, not as the person who was present here, in
this moment.
Somewhat crazily, Freud imagined that a psychoanalysis (he
was the only psychoanalyst who did not go through his own analysis – he analyzed
himself, but that’s not the same thing, believe me) would rid the analyst of
feelings towards her or his patient.
This sounds very strange to our modern ear. But it had two roots. One was in professionalism. A doctor should not feel things towards his
patients – he should have a “professional” relationship where his only concern
was in treating the illness that the patient has. The second was in science. A scientist should not be swayed by his
feelings but view the world “objectively”.
Especially when trying to establish a science which includes
aspects of human functioning that are not objectively observable;
consciousness, but even more so, the unconscious, it is important that the
scientist not be imagining, not be projecting into the person being analyzed the
things that that are being reported.
The surgical metaphor captures both the professional aspect
(the surgeon must ignore the repugnance against cutting through perfectly healthy
tissue to get to the diseased tissue) and the scientific one (the scientist
must not have feelings towards the observed object. This would interfere with his objectivity).
There is, actually I think a third reason. And this may sound really weird, but I think that Freud believed that a good analysis would lead to a kind of Buddhist state of living totally in the moment. If you don't believe me, read his very brief and beautiful essay, "On Transience". It was composed as a rebuttal to the Poet Rilke and his lover, Lou Andreas Salome, after Freud had gone a walk with them. In it, Freud maintains that our ideal state is to live within the present moment.
The problem with the ideal of a feeling-less professional
or scientist is that this is not, according to analytic theory itself,
possible. The surgeon, as Freud points
out elsewhere, has sublimated – that is hidden and transformed – feelings of aggression. The surgeon channels those feelings into the
destruction of good flesh – not ignoring the repugnance about it. Similarly, the apparently detached scientist
is able to maintain her or his detachment because, for instance, she or he is
deeply emotionally attached to the particular view that she or he has of the
world and when this is threatened the depth of this attachment is betrayed by
the power of the feelings that are expressed about an alternate view.
As later generations of psychoanalysts have come to grips
with our limits to manage or eliminate our feelings about our patients and the
work with them that we are deeply emotionally engaged in, there have been two
major shifts. The first is a shift in
understanding countertransference (and therefore transference). Countertransference has been broadened to
mean the feelings that are evoked by working with this particular patient. While some of that may come from our
experience of early development figures – it is also related to feelings
towards others in the more recent past – including other patients – but also
this patient – so that it is acknowledged that we feel things and engage in characteristic behaviors with
this patient because we are attuned to them, connected with them, and working
closely with them (just as they do with us).
The other major change has, then followed from this – that countertransference
is a source of useful information about the patient and our relationship to
them. Just as transference became
something that was not exclusively pathological (indeed, the “unobjectionable”
part of the positive transference came to be seen as a necessary part of the
working alliance), so countertransference feelings helped to inform a fuller
view of who the patient is – and is especially useful to identifying the
objectionable aspects of the patient’s impact on those around them. Essentially, “This guy is making me mad
because he is so obstinate. I bet that
happens in his other relationships.”
So, countertransference has been an essential conceptual
element in the relational turn of psychoanalysis. Psychoanalysis has transitioned from a “One
person” psychology in which that objective surgeon views an unrelated object
and reports on it, to a “One and one half person” psychology where the analyst
or therapist is a benignly concerned person caring for the other, to a true “Two
person” psychology – where both people are experiencing each other on a deep
and very powerful level as they interact in a relationship that is intense and
transformative for both of them, though the focus of that change and the
primary focus of interest is imbalanced – the focus is on the analysand’s mind
and psychological functioning, but there is at least an implicit and at times
an explicit focus on the analyst’s mind as well.
This has led to a greater awareness of enactments between
the analyst and analysand – unconscious replays or entirely new ways of
managing disturbing material that bypasses conscious awareness. In essence, the problematic behavior gets
replayed instead of understood. This is
a considerable concern. At its worst,
this becomes a path towards a sexual relationship between the analyst and the
analysand, something that early analysts, including Jung, though could be
beneficial to the patient. There is now
universal agreement that this is damaging to the patient and should be
avoided. Less apparent damaging
interactions are possible results of enactments, and the analyst needs to be
vigilant to these and to call the pairs attention to them so that they can be analyzed
when they have emerged.
The positive aspect of enactments and acknowledging their
presence (they have certainly been a part of both helpful and damaging
treatments since the dawn of psychoanalysis) is that they allow for an
awareness of what takes place interpersonally in a treatment. Thomas Ogden, for instance, has posited an
entity he calls the “the analytic third” that emerges between the analyst and
the analysand – a kind of shared mind that develops as the two get to know each
other. This leads to each learning, for
instance, to dream in the language of the other – and to work towards thinking
in tune with the way that the other works.
Imagine the mind of the analyst who has tendrils reaching
out towards the various analysands that they are currently working with or have
worked with in the past. What an image –
but then expand that to think about the ways that we are connected to all of
the important people in our lives. Don’t
we all reach out to find a private language that we use between us with these
important people? Isn’t this related to
the complicated ways that we feel toward each other – in a word – the transference/countertransference
interaction that is part and parcel of being alive in our relationships with
others?
Related posts: Transference,
What
is Psychoanalysis?
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