The Patient's Perception of the Analyst's Countertransference

In ever-increasing numbers analysts today are focusing attention not just on patients' and their own verbal communications, but on the more subtle patient-analyst nonverbal interactions that occur throughout every analysis. Certainly this is true for me. As I listened to patients and myself and the many ways in which we react to each other, I came to realize that in mid-phase, when an interpretation is not heard as intended because of the transference haze that fills the room, words— on matter how well they “explain”—often have little therapeutic effect It's as if no matter what I say, it's the transference-laden messenger who is heard and not the message To be sure, words usually, eventually, “work” again, but only after the patient's transference perception of me has changed, that is, after her experience of me has been modified by interactions within sessions that were dissonant with her expectations. This inability of words alone to initiate change has led me to believe that it is only when the analyst's behaviour—what she actually does in the session—is different from what is anticipated, that a patient can experientially understand the concept of transference and how it shapes the perception of reality. Stated simply, in the heat of the transference, it is primarily the analytic experience, not the content of the analyst's words, that convinces patients that their perceptions and reactions are coloured by their internal world Only then, with the experience of transference as transference, is an awareness of psychic reality born. Before then, transference may be understood intellectually as an explanation for feelings that seem out of proportion to external reality However, intellectual understanding is rarely en