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Towards a Transtheoretical
Definition of Countertransference

This book explores the analyst’s countertransference experience in clinical

settings from a number of theoretical perspectives in order to develop a
transtheoretical definition of countertransference.
Stemming from an examination of the definition of countertransference
itself, the author utilizes a philosophical hermeneutic approach to ask how
pathological countertransference develops, how analysts separate themselves
from the patient’s experience, and what analysts should do to prevent their
countertransference response from interfering with treatment. Through the
unique hermeneutic methodology, philosophical themes within selected
writings are explored as a way of gaining a deeper meaning and understanding
of countertransference. By re-interpreting these selected writings in a
new light, the book develops a transtheoretical definition and approach to
countertransference. As such, the author offers a timely reassessment of the
meaning and understanding of countertransference as it has evolved over the past
century, going from being considered an obstacle to treatment brought on by the
analyst’s unconscious conflicts to being understood as a way of communicating
and understanding the patient’s unconscious material. It also provides a unique
pathway through various depth psychological, therapeutic, and theoretical
approaches to countertransference, foregrounding the significance and
therapeutic value of the concept and seeking a new transtheoretical definition.
This volume will appeal to scholars and researchers of psychology and
mental health.

Dr. Rudy Roman is a clinical assistant professor of psychiatry and the

behavioral sciences with Keck School of Medicine of the University of Southern
California, USA, and an adjunct assistant professor with the School of Rossier
also at the University of Southern California, USA. He has a private practice in
Long Beach, California, USA, and has been providing mental health services
for over 14 years.
Explorations in Mental Health

Effective Group Therapies for Young Adults Affected by Cancer

Using Support Groups in Clinical Settings in the United States
Sarah F. Kurker

Fostering Resilience Before, During, and After Experiences of Trauma

Insights to Inform Practice Across the Lifetime
Edited by Buuma Maisha, Stephanie Massicotte and Melanie Morin

Hip-Hop and Spoken Word Therapy in School Counseling

Developing Culturally Responsive Approaches
Ian Levy

Compassionate Love in Intimate Relationship

The Integration Process of Sexual Mass Trauma, Racism, and Resilience
Josiane M. Apollon

Trauma and its Impacts on Temporal Experience

New Perspectives from Phenomenology and Psychoanalysis
Selene Mezzalira

Self and Identity

An Exploration of the Development, Constitution and
Breakdown of Human Selfhood
Matthew Tieu

Co-Production in Mental Health

Implementing Policy into Practice
Michael Norton

Towards a Transtheoretical Definition of Countertransference

Re-visioning the Clinician’s Intersubjective Experience
Rudy Roman

For more information about this series, please visit: www.routledge.com/

Explorations-in-Mental-Health/book-series/EXMH
Towards a Transtheoretical
Definition of
Countertransference
Re-visioning the Clinician’s
Intersubjective Experience

Rudy Roman
First published 2023
by Routledge
605 Third Avenue, New York, NY 10158
and by Routledge
4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2023 Rudy Roman
The right of Rudy Roman to be identified as author of this work has been
asserted in accordance with sections 77 and 78 of the Copyright, Designs and
Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or
utilised in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in any
information storage or retrieval system, without permission in writing from the
publishers.
Trademark notice: Product or corporate names may be trademarks or registered
trademarks, and are used only for identification and explanation without intent
to infringe.
Library of Congress Cataloging-in-Publication Data
Names: Roman, Rudy, author.
Title: Towards a transtheoretical definition of countertransference : re-visioning
the clinician’s intersubjective experience / Rudy Roman.
Description: First edition. | New York, NY : Routledge, 2023. |
Series: Explorations in mental health | Includes bibliographical
references and index.
Identifiers: LCCN 2022036589 (print) | LCCN 2022036590 (ebook) |
ISBN 9781032335568 (hbk) | ISBN 9781032335582 (pbk) |
ISBN 9781003320180 (ebk)
Subjects: LCSH: Countertransference (Psychology)
Classification: LCC RC489.C68 R64 2023 (print) | LCC RC489.C68 (ebook) |
DDC 616.89/14—dc23/eng/20220912
LC record available at https://lccn.loc.gov/2022036589
LC ebook record available at https://lccn.loc.gov/2022036590
ISBN: 978-1-032-33556-8 (hbk)
ISBN: 978-1-032-33558-2 (pbk)
ISBN: 978-1-003-32018-0 (ebk)
DOI: 10.4324/9781003320180
Typeset in Times New Roman
by Apex CoVantage, LLC
 Para mis padres, Emilio y Guadalupe Roman
and
To my pride and joy, my son, James Daniel Roman
Contents

Acknowledgments ix

Introduction 1
The Researcher’s Predisposition to the Topic 3
Autobiographical Origins of the Researcher’s Interest
in the Topic 3
Relevance of the Research for Clinical Psychology 6
An Outline of the Book by Chapter 6
Definition of Terms 10

1 Transference 12

2 Countertransference From a Depth Psychological

Perspective 23
Classical View 25
Sigmund Freud 25
Melanie Klein 26
Annie Reich 28
Totalistic View 29
Donald Winnicott 29
Paula Heimann 31
Margaret Little 33
Complementary View – Heinrich Racker 37
Relational View – Lewis Aron 44
Integrative View – Charles Gelso and Jeffery Hayes 48
Clinical Case Example – The Heroine in Disguise 50

3 Countertransference and Jungian Analysis 52

Clinical Case Example – The Trapped Inner Lion 59
viii Contents
4 Countertransference Dreams 61
Neurotic Countertransference Dreams 61
Projective Identification Countertransference Dreams 63
Intersubjective Countertransference Dreams 65

5 Countertransference From a Cognitive-Behavioral

Approach 69
Demanding Standards Schema 73
Abandonment Schema 74
Special, Superior Person Schema 75
Need for Approval Schema 76
Clinical Case Example – Perfectly Imperfect 77

6 Humanistic Psychology and Countertransference 79

Clinical Case Example – The Fearful Bully 82

7 Transtheoretical Definition of Countertransference 84

What Is Countertransference? 85
Pathological Countertransference 95
Distance 97
Analysis of the Analyst 98

8 Moving Forward: Implications and Recommendations 102

Benefits and Applications to the Field 102
Limitations and Recommendations for Future Research 103
Conclusion 104

References 106
Index 113
Acknowledgments

I would like to express my sincerest gratitude to those who played a role in

making this book possible. To Dr. Marybeth Carter, Dr. Christine Lewis, and Dr.
Edward Rounds for their nurturance and supportive approach during the writing
process. I will always be grateful for your knowledge, commitment, and dedica-
tion throughout the process. To my son James Daniel Roman for being my daily
motivator throughout the process. I do not have words to express my love for
you. You are my everything, and I love you with all my heart! To my father
Emilio Roman and my sister Ruth Roman for always pushing me to strive for
greatness. Both of you have served as an inspiration not only through your love
but also by serving as examples of greatness yourselves. Thank you for always
believing in me. I love you both very much. To my mother Guadalupe Roman
and my sister Virginia “Gina” Hassouneh for loving me unconditionally and
providing me with the opportunity to experience the true meaning of love. Both
of you are examples of the ideal mother, and I will always love you as you have
loved me. To my brother-in-law Amer Hassouneh for being such a wonderful,
supportive, and loving man. You have served as an example of what it takes to
be a model husband, father, and man, and I am grateful to have you in my life.
To Tania Valtierra for pushing me and helping me get across the finish line.
I am eternally grateful for your support and encouraging ways when I needed
it the most. You believed in me and I will always be grateful for that. To my
mentor Dr. Jack Wasserman for his guidance through one of the most difficult
phases of my life. You have been an inspirational presence in my life, and I will
always be grateful for that. To Marsha Welch and Dr. Henry Drummond for
always pushing me to become the best version of myself. To Ronald “Chris”
Bagley for always believing in me and what I am capable of being, not only
from a professional and academic standpoint but as a person as well. To Adrian
Romero, whom I have known for the past 25 years. Thank you for always
encouraging me and for being a rock I could lean on. To my classmate Bryce
McDavitt. Although we had our differences while attending Pacifica Graduate
Institute, you made yourself available in sharing your knowledge and helping
me understand things I may have found confusing during the writing process.
Thank you, my friend. And finally, to my higher power for guiding me through
the process and giving me the strength to persevere and never quit.
Introduction

The concept of countertransference has been a controversial topic since its

introduction by Sigmund Freud in the early 1900s. The meaning and under-
standing of countertransference have evolved over time; however, a standard
definition still does not exist. The Freudian drive model encouraged the avoid-
ance of the analyst’s emotional response as it reflected the analyst’s unmet
drive-related conflicts (Freud, 1910/1953). Later, the examination of the ana-
lyst’s subjective experience in regard to their emotional response represented
a shared experience with the patient and reflected the patient’s unconscious
material (Natterson, 1991). Although psychodynamic approaches tend to focus
more on this phenomenon, having a subjective response to patient material is
universal and inevitable, as well as being a part of psychotherapy regardless of
theoretical orientation. Therefore, it is valuable to be knowledgeable about how
the spectrum of theoretical orientations works with the phenomenon.
When examining the range of countertransference perspectives, the initial
views of the phenomenon centered on the Freudian drive model. Freud’s under-
standing of countertransference developed from his work with patients and what
appeared to be the patient’s unconscious redirection of feelings or affect toward
the analyst. Freud explained that this “transferring” of feelings was related to
an early life experience by the patient, with the affect transferred belonging
to another person within the patient’s experience. Freud called this phenom-
enon transference and considered it a portal into the patient’s unconscious as
it provided a greater understanding of the patient’s unconscious phantasies and
innate drives (Freud, 1912/1953). Since countertransference was seen as simply
transference on behalf of the analyst, countertransference was considered an
interference with treatment as a result of the analyst’s own infantile drive-
related conflicts triggered by the patient (Greenberg & Mitchell, 1983). As a
result, Freud stressed that analysts need to overcome and vigilantly resist their
countertransference response, even when the urge to indulge in it presented
itself by way of their narcissistic need. Freud deemed countertransference a
deviation from the central tenet of the “objective neutrality” of the analyst
(Freud, 1915/1958). Although Freud eventually came to the conclusion that
“everyone possesses in his own unconscious an instrument with which he can
interpret the utterances of the unconscious in other people,” countertransference

DOI: 10.4324/9781003320180-1
2 Introduction
and the idea of the analyst’s unconscious serving as a therapeutic tool remained
a concept commonly overlooked and avoided by Freud (Favero & Ross, 2002,
p. 221). Many argued that Freud’s avoidance was related to his negative views
on countertransference and his concern about others becoming aware of his own
infantile drive-related conflicts (Gelso & Hayes, 2007).
Stern (1924) continued with the Freudian drive model of countertransfer-
ence and considered it “the transference that the analyst makes to the patient”
brought on by the repressed libidinal urges stemming from the analyst’s child-
hood (p. 167). In other words, the origins of countertransference were the same
as transference: the analyst’s repressed libidinal needs or unresolved neurotic
difficulties. Ferenczi and Rank (1923) added an additional layer to the fold and
considered the analyst’s narcissist response as a form of countertransference. As
a result, two distinct concepts began to emerge: countertransference was either
the analyst’s response to the patient’s transference or a response triggered by
the analyst’s own unresolved issues (Orr, 1954).
By 1927, ideas concerning countertransference were moving away from the
classic drive theory; however, this was not the general consensus of the time
(Orr, 1954). Like those before him, Glover (1924) compared countertransfer-
ence to transference: just as positive and negative transferences occur, the same
could be said about countertransference (Orr, 1954). Reich (1947), however,
returned to the classic drive model and considered countertransference to be
a result of the unresolved issues of the analyst. Although many theorists such
as Horney and the Balints followed, the first real challenge to the classic drive
theory of countertransference occurred almost two decades later.
During the 1950s, there was a paradigm shift resulting in a wider range of
opinions on countertransference. Many theorists such as Winnicott, Heimann,
Little, and Racker (all later discussed in greater detail) challenged classic drive
theory, considering countertransference as a tool accessible for the analyst
to become more knowledgeable of the patient’s unconscious, allowing for a
greater understanding of the patient’s experiences and unconscious processes
(Zachrisson, 2009). Although Freud, like many of his predecessors, held a
strong belief that countertransference was a permanent problem because it could
pull analysts away from their ability to remain objective, the latter view was
embraced and accepted, and considered countertransference to be a useful tool
in better understanding the patient (Karamanolaki, 2008). The perspectives on
countertransference were no longer focusing strictly on the classic drive model
but instead were examining the analyst’s experience of the patient as a way of
gaining a deeper understanding of the patient’s internal world. Natterson (1991)
added, “the subjective experience of both patient and therapist are indispensable
ingredients of the therapeutic phenomenon” (p. 21). For Natterson, the inter-
subjective experience of the analyst served as a way of connecting the analyst
with the experience of the patient. When such a connection is made, there is a
deeper understanding on behalf of the analyst of the patient’s experience, hence
providing greater “relatability” due to the shared experience between the patient
and the analyst (Natterson, 1991). Although advancements have been made to
 Introduction 3
form new ways to understand countertransference, countertransference remains
linked with outdated perspectives that do not take into account the emotional
involvement or the subjective experience of the analyst, both of which are an
intricate part of the analytic process (Gelso & Hayes, 2007).

The Researcher’s Predisposition to the Topic

My interest in countertransference began during my master’s-level practicum at
Glendale Memorial Hospital. While learning about countertransference, most read-
ings and lectures I was exposed to describe countertransference as negative in nature,
a phenomenon that would hinder the therapeutic process, and require the analyst to
refer the patient. One of the most common definitions of countertransference used
within my master’s studies was that of Murdock. Murdock (2004) writes:

Countertransference is what happens when the therapist has not had a

proper training analysis. Conflicts from the counselor’s past are projected
into the analytic situation, and the therapist loses her objectivity. The client
becomes “special” to the counselor (a positive countertransference), or the
therapist begins to want to argue or gets angry with the client. The coun-
selor may find herself looking forward to or dreading seeing a particular
client. The only way to resolve countertransference is for the analyst to
seek the aid of her training analyst or a professional consultant.
(pp. 53–54)

According to Murdock (2004), countertransference was a hindrance to treatment

resulting in the analyst’s unresolved issues becoming the focal point of treatment.
In other words, therapy was no longer about the patient but about the analyst.
My first job as a therapist was in a context that paralleled Murdock’s view of
countertransference. This perspective was also the position of the county program
for which I worked: countertransference is negative and to be avoided. However,
while attending my doctoral program, I began reading about a completely different
approach to countertransference, which stimulated my intellectual curiosity. In
my studies of depth psychology, countertransference was seen as possibly benefi-
cial to the therapeutic relationship. I was fascinated by this approach to counter-
transference and the variety of perspectives offered depending on the theoretical
orientation. However, although there were many different descriptions of the phe-
nomenon, there was no clear-cut answer or middle ground: Countertransference
was to be embraced or eliminated. At the same time, I was experiencing difficulties
related to countertransference in working with an adult patient.

Autobiographical Origins of the Researcher’s

Interest in the Topic
Although I had a rudimentary understanding of the concept of countertrans-
ference and how to use it to assist with the transference/countertransference
4 Introduction
dynamic within sessions, I was conflicted when working with an adult female
patient on my caseload because I was unable to explain or understand my
immense dislike and uneasiness while in session with her.
One day, my morning was as uneventful as any other. Knowing I had my
usual Tuesday morning appointment with my patient of almost 1 year, I did my
usual routine of answering emails, returning phone calls, and reviewing the note
from our previous session before her arrival. After greeting her in the lobby
and walking her to my office, the session began the way it usually did with my
talking with her about her difficulty in limiting her alcohol consumption and
changing her unsafe sexual practices. However, during the session I felt an
intense feeling of anxiety and a sense of unwanted energy coming toward me
from her, and spoke of it. She responded by saying, “I have an attraction to teen-
age boys” with the look of a little girl fantasizing about her prince charming.
Immediately upon hearing her words, I froze and began to feel fear. I looked
at her and felt disgust and hatred. Not knowing if this reaction was brought on
by her comment or a psychic energy coming into the room, I chose to refrain
from commenting on my reaction, especially given that I was more concerned
about assessing for potential child abuse. Fortunately, my assessment did not
identify any current or potential victims. With each subsequent session, my
feelings and reactions intensified to the point that I no longer wanted to work
with the patient. I knew I was struggling with countertransference; however, I
could not understand why I became overwhelmed by these feelings or what was
causing them. Unsure of what to think or do, I turned to my clinical supervisor
for guidance and support.
While discussing the case with my clinical supervisor, I frequently mentioned
my hatred toward this client, a hatred that suddenly and unexplainably came on.
Although we looked at the case from different angles in hopes of uncovering
and resolving my difficulties, I could not link or understand my difficulties with
and immense feelings toward this patient until my clinical supervisor asked
me an unexpected question: “Rudy, have you ever been molested?” My initial
response to his question was one of anger and disbelief. I said, “Of course not!”
He again asked, “Are you sure?” My anger intensified when I was asked the
same question, and I said, “Of course not! How would I not remember being
molested?” At that point, I remembered a childhood memory that had been
repressed for over 20 years: I remembered Steve, the man who befriended me
as a child and attempted to molest me.
As a seventh-grade boy, I was befriended by my friend’s neighbor Steve.
Steve was a competitive weightlifter, and I gravitated toward him, especially
since I was a big sports fan who looked up to the athletes of the time. Like most
kids my age, I wanted to “be like Mike” and fantasized about someday leading
my beloved Phoenix Suns to their first NBA championship. I had dreams of
becoming a professional athlete. Steve frequently joined the neighborhood kids
for a game of football, displaying his superior strength for all of us to see. Steve
also took the time to give my friend and me a ride to the Boys and Girls Club
for our basketball practices while also sliding us a few dollars so we could buy
 Introduction 5
snacks after practice. Steve was not just my friend’s neighbor but my friend, a
parental figure, and someone I trusted.
One day while on my way to the Boys and Girls Club, I stopped by my
friend’s house to see if he wanted to come along, but to my surprise, he wasn’t
home. Thinking he might be at Steve’s house, I chose to go across the street.
Once Steve realized it was me, he invited me in. This was the first time I had
ever been in his house. As I looked around, I was surrounded by pictures and
trophies from his competitions. Seeing the look of amazement on my face,
Steve asked me if I was interested in “getting like that.” Steve was referring to
his physique in a picture I was looking at of him at a weightlifting competition.
After I expressed my desire to get stronger in hopes of getting closer to my
dream of becoming a professional athlete, he said, “Why don’t you take off your
shirt?” At the time I was confused by his request because I knew he was wrong
to ask such a thing of me. My parents always warned me against predators, but
in my eyes, Steve wasn’t a predator, he was my friend. I stood there, confused,
and not knowing what to do. Steve looked at me, smiled and said, “Go ahead,
take off your shirt.” Not knowing what to do, I complied and took off my shirt.
As I stood there – alone, vulnerable, and completely exposed – Steve took a
step in my direction while looking at me up and down from head to toe and
said, “Oh yeah, you most definitely have potential!” No longer feeling safe
and seeing him walking toward me, I ran out of his house while putting on my
shirt, jumped on my bike, and raced home as fast as I could. That short bike
ride home felt like the longest 10 minutes of my life. I was afraid and did not
know what to do. I knew I had to tell an adult but I was afraid of my father’s
reaction. What would dad do? Would he do something that would lead to him
going to jail or getting hurt? As a way of protecting my father, I never shared my
experience with anyone, and I never saw Steve again. I repressed my traumatic
experience, and it remained dormant for 20 years, until my patient awoke the
little boy within me. He was finally heard after all these years.
My patient became a reflection of Steve, due to her attraction to teenage boys,
a projection of my psyche that made it difficult for me to continue working
with her. In a sense, I became the same little boy that ran away from Steve 20
years ago. I struggled through the last few months of therapy with this patient
as termination approached due to funding issues within the program; however,
during those sessions I constantly found myself doing the only thing I knew
how to do: to run and run as hard as I could to protect the little boy within me.
My life became even more difficult when my patient began to stalk me after
termination. Her actions were constant reminders of my trauma and continued
for a year after termination. I endured the situation alone because my clinical
supervisor was no longer working for the program next door after it was closed
due to funding issues with the county. In addition, my program did not have a
clinical supervisor on staff and depended on the psychologist next door when
in need of clinical assistance or guidance. I was left to defend myself in the
same fashion I had 20 years prior – avoiding and compartmentalizing what
was happening to me. Eventually, I was transferred to another program within
6 Introduction
the county, which was a relief. Although this was a very difficult time for me,
I was able to overcome my struggles by finally facing Steve through personal
therapy and also by reconnecting with my clinical supervisor shortly after he
retired from the county.

Relevance of the Research for Clinical Psychology

Although there is vast literature on the topic of countertransference, a clear
and universal definition continues to elude the field of psychology. Attempts to
define the phenomenon vary largely according to theoretical orientation. The
analyst’s countertransference response within treatment, whether tied more to
their internal world or the subjective experience of the patient, is an intricate
part of treatment. However, the ways in which countertransference experiences
are perceived and handled differ widely within the profession. Throughout my
professional career, I have come to the understanding that strong, emotion-
ally charged countertransference responses are commonplace. Unfortunately,
such countertransference experiences are commonly “swept” under the rug as a
way of ignoring the analyst’s narcissistic wound and perceived failed attempts
at remaining the objective and detached surgeon originally urged by Freud
(1912/1953). The phenomenon of countertransference is then seen by many as
impermissible, shameful, and possibly damaging to the profession as a whole
(Sedgwick, 1994). This, however, is not necessarily true, as the perception of
countertransference is interdependent on the analyst’s theoretical perspective.
Given that a transtheoretical definition of countertransference continues to cir-
cumvent the field of psychology, further exploration of the subject is necessary.
Further investigation may assist analysts and therapists in gaining a greater
and more comprehensive understanding of countertransference while also pro-
viding a positive conceptualization of the universality of the phenomenon. In
addition, a universal understanding of countertransference would allow for a
greater self-awareness and understanding of countertransference manifestations
regardless of their origin. A greater understanding of countertransference will
lead to a greater understanding of analysts’ emotional response within treat-
ment, and a greater understanding of themselves.

An Outline of the Book by Chapter

Before venturing into the world of countertransference, I would like to provide
the reader with a few words on the content and organization of this book,
including an explanation justifying why the writings of specific theorists were
used and reviewed. In addition, I would like to provide the reader with some
limitations to the book as a whole. Please keep in mind that although a robust
sample of theoretical writings was selected for this book, not all theoretical
perspectives were included. Influential psychologists such as James Hillman,
Wilfred Bion, Marie-Louise von Franz, and Alfred Adler, to name a few,
were not included. In addition, a qualitative approach, or more specifically, a
 Introduction 7
philosophical hermeneutic inquiry, was used when examining the selected writ-
ings. Future research on countertransference would benefit from expanding on
the foundation of this book by including additional theoretical approaches on
the subject and integrating a quantitative point of view into the research. Limi-
tations and recommendations will be discussed in further detail in Chapter 8.
Chapter 1 is an in-depth explanation of transference, including a review of
its meaning and therapeutic use while also exploring how it can influence treat-
ment and the therapeutic relationship. This chapter focuses specifically on the
influential writings of Sigmund Freud and Melanie Klein since the concept
was initially introduced by Freud and later expanded by Klein. Throughout
the years, the writings of Freud and Klein continue to be foundational in the
development and expansion of psychological concepts and ideas, with this situ-
ation being no different. The second part of the chapter will review more current
writings on the subject while documenting the evolution of transference as a
whole. Although this book focuses specifically on the phenomenon of counter-
transference, it becomes difficult to gain a thorough understanding of coun-
tertransference without having an understanding of transference. This chapter
aims to provide the reader with that needed understanding.
Chapter 2 is a comprehensive analysis of countertransference from a depth
psychological perspective. As part of this analysis, the psychological under-
standings of some of the most influential minds in psychoanalysis, such as
Sigmund Freud, Melanie Klein, Donald Winnicott, Margaret Little, Heinrich
Racker, and Lewis Aron, were examined. In order to provide a comprehensive
analysis of countertransference, five distinct views on countertransference were
presented, with each view representing an evolution of sorts and a change in
the psychoanalytic understanding and approach to countertransference. This
chapter also explores the importance of the analyst knowing themselves as a
way of preventing their unresolved conflicts from interfering in treatment and
instead using such wounds as a way of gaining a deeper understanding of the
patient’s woundedness, creating a unique push and pull dynamic that provides
a view into the patient’s psyche and ultimately facilitating healing.
Chapter 3 focuses on providing the reader with an in-depth analysis of coun-
tertransference in Jungian analysis. Although many books on countertransfer-
ence tend to ignore the works of Carl Jung, his writings on the topic have been
instrumental in gaining a deeper understanding of the phenomenon, especially
since one of the main focal points of Jungian analysis is the use of countertrans-
ference. Similar to the Freudian view, the premise of Jungian analysis is the anal-
ysis and interpretation of the patient’s transference; however, when combined
with the analyst’s countertransference experience, an interaction takes place
between the patient and analyst, a push and pull between the transference and
countertransference response of the therapeutic dyad that allows for a greater
understanding of the patient. In addition, this chapter explores the interfering
aspects of countertransference while also promoting the benefits of the analyst’s
personal analysis. The final third of the chapter provides a thorough description
of the archetypal dimensions and manifestations of countertransference while
8 Introduction
also reviewing Jung’s understanding of the unconscious, more specifically,
understanding how the personal and collective unconscious affect countertrans-
ference responses and manifestations. Although many Jungian concepts were
developed in the early to mid-1900s, Jung was ahead of his time, setting the
path for many newer understandings of countertransference.
The primary focus of Chapter 4 is to examine the therapeutic benefits of
countertransference dreams, including providing the reader with a thorough
description and explanation of the role countertransference dreams play in
treatment. The subject has been scarcely discussed because of the changing
perceptions regarding its significance and prominence in analytic treatment,
and the belief that such dreams are a disturbance within the analyst that can
negatively impact treatment. In other words, countertransference dreams pose
a threat of exposure to the analyst’s own neurosis. As part of this review, the
different types of countertransference dreams were categorized and reviewed
while also highlighting the benefits of analyzing such dreams.
Chapter 5 discusses the significance of countertransference from a cognitive-
behavioral approach. Since cognitive-behavioral therapy focuses on technical
factors rather than relational ones, it is commonly assumed that countertrans-
ference has little therapeutic value or that it simply does not occur when using
such treatment modality. This has paved the way for expanding the cognitive-
behavioral understanding of countertransference and viewing it as a recurring
phenomenon, resulting in more literature being written on the subject. One fac-
tor that may have resulted in the minimalization of countertransference within
cognitive-behavioral therapy is semantics, as cognitive-behavioral theorists
prefer using theory-specific language to separate countertransference from its
psychodynamic origins. In addition, cognitive-behavioral therapy stresses the
importance of material close to the surface and relatively close to the present,
focusing on the here-and-now instead of influences from the patient’s past.
Cognitive-behavioral techniques are also considered to be more standardized
and formulaic than other approaches, making the therapist’s vulnerabilities and
internal conflicts less relevant to treatment. This belief, however, has evolved
over time, with a new school of thought emerging that stresses the importance
of the therapist’s role in treatment. This change has evolved to the point of
exploring the origins of countertransference by discussing the role of schemas
in countertransference reactions while also categorizing maladaptive schemas
that influence the course of treatment. Although cognitive-behavioral litera-
ture continues to minimize the therapist’s internal experience, it is essential to
review the effect countertransference can have on treatment, especially with
cognitive-behavioral therapy being one of the most commonly used treatment
modalities.
Chapter 6 explores the humanistic view and approach to countertransference.
Although there is an infrequent focus on the phenomenon of countertransfer-
ence, that is not to say that a therapist’s internal conflicts and vulnerabilities
are irrelevant. The countertransference phenomenon is evident in the works
of James Bugental, Betty Meador, Irvin Yalom, and Carl Rogers; however,
 Introduction 9
instead of using the term countertransference, they use language-specific to
humanistic psychology when describing the phenomenon. Countertransference,
however, goes against the very building blocks of humanistic psychology and is
counterintuitive to the basic tenets of humanistic theory. Humanistic psychol-
ogy argues the goodness of human beings by nature which negates the nega-
tive qualities of the therapist, minimizing unresolved conflicts of the therapist
commonly associated with countertransference. Since humanistic psychology
does not consider the therapist’s thoughts and feelings as countertransference
distortions, countertransference becomes nonexistent and is superseded by the
therapist’s respect and connection with the patient. This concept, however, does
not negate the fact that countertransference still occurs within humanistic treat-
ment approaches. This is examined by highlighting the inevitability of counter-
transference within treatment and how it can impact the required authenticity
of the therapist to promote change. In addition, this chapter discusses the six
necessary conditions outlined by Rogers that must exist within a therapeutic
relationship to promote change. When such conditions are not met, the therapist
loses their ability to remain authentic and congruent, affecting their ability to
provide the client with unconditional positive regard due to their own unre-
solved conflicts.
The primary focus of Chapter 7 is to provide the reader with an in-depth
description of the development of a transtheoretical definition of countertrans-
ference through the unification of commonalities observed from the interpreta-
tion of various theoretical writings dealing with the phenomenon. During the
interpretation process, additional points of inquiry emerged that exerted their
own significance and required further exploration, such as countertransference
dreams and somatic countertransference. In addition, this chapter reviews the
transcendent function, or the analytic third, that serves as a platform or bridge for
psychic interactions between the patient and the analyst to take place. Through
the exploration and interpretation of countertransference writings, additional
psychological concepts such as reflective countertransference and persecutory
countertransference were developed and provided a thorough explanation for
deciphering the difference between positive and pathological forms of counter-
transference and how to address them. This chapter also highlights the analysis
of the analyst to address the analyst’s susceptibility to countertransference.
However, this is not necessarily related to the analyst’s neurosis alone but also
to the extensiveness of the analyst’s unconsciousness, an unconscious realm
co-created in conjunction with the patient. Although distinguishing between
pathological and nonpathological countertransference responses is difficult,
this chapter stresses the importance of the analyst accepting their own counter-
transference response while maintaining distance from the patient’s experience.
This leads to a cycle where analysts learn about themselves through psychic
interactions, which helps them become more empathetic toward their patients
while improving the quality of treatment.
The eighth and final chapter explores the benefits of developing a transtheo-
retical definition for the phenomenon of countertransference. Additionally, this
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