Response to Jeremy Holmes's Too Early, Too Late' - Countertransference and Endings

If we say someone has left too early or too late, we are clearly referring to the experience of the patient: we are making a therapeutic judgement about that person's inner state. But if we talk of a countertransference to the leaving, we are referring to the experience of the therapist who feels it is too early or too late, either because he or she is accurately attuned, or because - and this is the sense in which the term ‘countertransference’ is more likely to be used - he or she is caught perversely into some projection from the patient. I'm assuming here that most of us have arrived at some form of Hermann's definition of countertransference - that is, all our responses to a particular patient, responses which may be used both as a tool to understand the patient and as a monitor of the therapist's competence. In the matter of an ending that seems too early or too late, how can we distinguish between our countertransference and our therapeutic judgement?

Jeremy gives an attachment theory model for countertransference. Describing the establishment of a ‘secure base’, both in reality and as an internal representation within the patient, as the aim of attachment therapy, he says: ‘A secure base arises partly out of the responsiveness and attunement provided by the therapist, partly from her capacity to accept and metabolize protest and anger’. Responsiveness and attunement; the capacity to accept and metabolize protest and anger: that, I think, is a lovely description, both comprehensive and concise, of what many of us would call the ‘maternal reverie’ of the therapist.

The attachment theorist's ‘attunement’ may be likened to Freud's use of the unconscious receptive instrument; to the post-Kleinian ‘normal’ or healthy countertransference (perhaps based on ‘normal’ projective identifications from the patient); and, as Jeremy says, to Racker's ‘concordant’ countertransference. The words ‘accept and metabolize’ refer to the capacity to take the undigested material the p