The Development of A Psychotic Countertransference in Work with Two Severely Disturbed Patients

The paper describes and discusses some aspects of the countertransference in relation to two patients whose state of mind could be described as psychotic during treatment. The clinical work took place in the context of a private psychotherapy practice, but some aspects of the countertransference became evident in relation to external, but related figures connected with the treatment. It was not until the treatment with both patients had ended, and the author had done a considerable amount of work on her own processes, that she was able to acknowledge, think about, and eventually write about, the ways in which the two patients had impacted upon her own psyche. In order to achieve this aim of understanding, the author undertook a research degree at MA level as the frame in which to study psychotic processes in more depth, along with studying the transference and the countertransference. As she worked upon her degree thesis she became more aware of, and less embarrassed about, the countertransferential processes that taken place. The paper makes particular use of Stephen Purcell's contributions to identifying the countertransference and Harold Searles's work with psychotic patients.