Countertransference Disclosure and Models of Therapeutic Action

BEGINNING AROUND 1950, a heated debate ignited concerning the potential usefulness of countertransference as a tool for understanding the patient. Led by Annie Reich (1951), (1960), the classical camp argued that the term countertransference should be limited to the therapist's pathological response to the patient, emanating from his own unresolved conflicts. This viewpoint was vigorously opposed by what Kernberg (1965) called the totalist perspective. Under the leadership of people like Heimann (1950) and Racker (1957), the definition of countertransference had been expanded to refer to the therapist's total response to his patient. Even powerful and enduring emotional responses to patients were considered to be potentially useful sources of understanding.

In the four intervening decades, it is clear that the classical camp has winnowed in favor of the burgeoning totalist ranks. As testimony to this inexorable shift, we may consider the recent remarks of Abend (1989), who is himself a noted classical analyst. He asserts that the controversy over the definition of countertransference in its narrow, pathological sense versus the totalistic view has been "irreversibly settled" in favor of the broader definition. Indeed, he argues that the mention of countertransference in case presentations has become a "mark of analytic professionalism, " whereas once it was a stigma.

Despite the widespread acceptance of what Sandler (1976) calls our "role-responsiveness" to patients, the issue of countertransference disclosure remains plagued by "near phobic dread" (Bollas, 1983). Articles on the topic of countertransference and psychoanalytic technique (Abend, 1989) conspicuously bypass the subject of disclosure. It would appear that Feiner's (1979) notion of the therapist's "anxiety of influence" from the patient has been supplanted by an anxiety over the exposure of influence. In its own way, we