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Spitz considers it worthwhile to inquire whether the 'counter-transference neurosis' (such a concept being proposed by several authors) might not have its uses in treatment in the same way as the transference neurosis is utilized in analysis. On consideration Spitz feels that the effect upon the patient of the release of counter-transference affects would be undesirable. Under optimum conditions the analyst should achieve a counter-transference sufficiently sublimated to allow him brief periods of identification with the patient.
The psycho-analytic setting places the patient in an anaclitic situation. Spitz suggests that that rôle of the analyst be termed diatrophic, i.e. supporting. The diatrophic attitude is a facsimile of the identifications which the young child forms with the parental figures. While the reality aspects of the anaclitic relationship gradually recede and disappear during development the diatrophic attitude, beginning with an identification phantasy leads to a progressively closer contact with reality. In the analytic situation both anaclitic and diatrophic attitudes have to operate on the phantasy level: neither should be translated into action. The analyst not only has to face the danger of acting out the diatrophic attitude, but there is the temptation to succumb to the unconscious wish for an anaclitic relationship with the patient.
Much of the analyst's insight results from temporary ego-controlled identifications with the patient. If such ego-controlled regression is replaced by acting out, then the analyst loses his capacity for awareness of the derivatives of his own unconscious and cannot use them in therapy.