Loving, Hating and Indifference Towards the Patient

During the course of psychoanalytic treatment, every psychoanalyst experiences many shades and degrees of love, hate and indifference towards each of his patients. This range of feeling is necessary for doing psychoanalytic therapy. Yet it is startling that, although Freud introduced the concept of countertransference in 1910, and a great deal has been written about it from the 1940s onwards, there is still much confusion and a remarkable diversity of opinion about its meaning and significance. (For a review of the literature, see Orr (1954), Kernberg (1965) and Sandler et al.(1970).) I believe that part of the perplexity and conflict about countertransference stems from the fact that it has never achieved the stamp of respectability accorded to transference. Despite or because of all the writings, countertransference has continued to have a predominant aura of wrongness or badness or dangerousness about it. In a brief presentation it is only possible to touch on some fundamentals and outline other areas for investigation. I hope this paper will clarify the nature, the dangers and the usefulness of the countertransference.

I propose to use the term countertransference to refer to all the analyst's transference reactions to his patient. Countertransference, like all transference phenomena, is characteristically a distorted and inappropriate response derived from the unresolved unconscious conflicts in the analyst's past. As such it may not be suitable for analytic work unless it can be detected, controlled and modified. There are instances (I shall submit one below) when a countertransference reaction is therapeutically useful.

Some analysts affirm that all the analyst's emotional reactions to the patient are countertransference. This 'totalistic' point of view negates the value of discriminating between countertransference reactions and those which are relatively free of countertransference. If there were no real relationship between analyst and