The Relationship between Theoretical Orientation and Accuracy of Countertransference Expectations

Does a psychodynamic orientation help practitioners’ accuracy with countertransference insight for differential diagnoses better than other theoretical orientations? Certainly countertransference (CT) insight is important to risk management and treatment success. Thomas's investigation (2005) found that most psychologists who face licensing board complaints needed greater awareness of countertransference issues. Similarly, Rossberg et al. (2010) found that symptom change was positively correlated with positive countertransference feelings and negatively correlated with negative countertransference feelings. Additionally, a recent meta-analysis by Hayes, Gelso, and Hummel (2011) found that managing countertransference successfully is related to better therapy outcomes.

More disturbed and acting-out patients tend to evoke more negative countertransference (Colli et al. 2014). Colli and colleagues (2014) found that DSM-IV cluster B personality disorders are significantly associated with consistent negative CT more than are patients with cluster A or C disorders, a finding supported by Liebman and Burnette's investigation (2013) of therapists’ reactions to individuals with borderline personality disorder (BPD). Further, Brody and Farber (1996), in a study of 336 practitioners, found that borderline patients evoked the greatest degree of anger and irritation within the practitioner, and that schizophrenic patients received the most complex mix of countertransference feelings, along with the highest perceived need for referral. Ultimately, research suggests that CT patterns are systematically related to patients’ personality pathology across therapeutic approaches, suggesting that clinicians, regardless of therapeutic orientation, can make diagnostic and therapeutic use of their responses to patients (Betan et al. 2005) given adequate insight into their own subjective states (Eagle 2000).