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RECENTLY, I was reminded of the story about the therapist who receives a call from a patient in the middle of the night. The patient gasps, "Dr. Rubenstein, it's all clear to me now. I've figured it all out!" "Herman it's two in the morning, why are you calling?" "Dr. Rubenstein, it was a vision. Now I understand." "What do you understand?" "You are my mother." "Herman. How many times must I tell you? I am not your mother. I am Dr. Rubenstein, your therapist." This dispute continues until the therapist in desparation suggests to the patient that he get off the phone and eat breakfast. "But I already did Dr. Rubenstein. Want to know what I had?" "What did you have Herman?" "Two pieces of bacon." "Herman! You call that a breakfast?"
Like Dr. Rubenstein, therapists also can become various figures from our patients' pasts. However, while we can easily imagine how we might behave solicitously like Herman's mother, we are less comfortable with sharing other feelings Herman's mother might have had. One of which is hatred. In contrast to Samuel Johnson who is reported to have loved a "good hater, " most of us neither wish to hate nor to be hated. But, sometimes we have no choice: we find ourselves working with a patient who abuses us and who elicits our own powerful hatred. With such patients we face a number of difficult questions regarding neutrality, empathy, and hate.
These thorny questions remained unaddressed in the literature until Winnicott's (1947) seminal article on countertransference hate. In his paper Winnicott differentiated idiosyncratic countertransference, those reactions arising from the therapist's internal world, from objective countertransference. By objective countertransference, Winnicott (1949) referred to "the analyst's love and hate in reaction to the actual personality and behavior of the patient