Countertransference Dominance: Discussion of Karen Martin's Clinical Case

It is important to write openly about our experiences as therapists and analysts so that we can learn from one another. The author's interest in enactments seemed to be a guiding force for her to look critically at her work with Holly, a late adolescent. Her paper is the author's retrospective account of her struggle with countertransference in her work with a lesbian-identified adolescent. The author emphasized the lesbian identification of the patient as the predominant stimulus to her countertransference as a lesbian-identified therapist.

In the third to last paragraph of her paper the author clarifies its purpose. Martin says,

I chose to write about this case for many reasons. I believe it is an excellent example of a client whose relationships were … a manifestation of sexual enactments. It also demonstrates … how an unanalyzed enactment within the therapist-patient dyad was at the root of my being unable to help this patient extricate herself from this destructive pattern. And, finally … in my clinical practice over the last 20 years I have treated many women who identify as lesbians and who are hopelessly caught in a repeating cycle of serial relationships that last two to three years. I believe many of these women are trapped, as Holly was, in an unconsciously driven compulsion to relive early trauma embedded in their childhood relationships to their mothers. This is not to say that every lesbian is a lesbian because of an unanalyzed enactment relating to her mother.

I organize my discussion to address these three points.

The author opens her paper with a discussion of the term enactment, referring to it as “unconscious, symbolic repetitions of earlier trauma.” She continues, saying