From Mr Lorne Loxterkamp

The Editor

Journal of Child Psychotherapy

Dear Madam,

In her recent paper, “Problems in the Use of the Counter-Transference: Getting it Across” (this Journal, vol. 9, no. 1, pp. 7-23), Anne Alvarez concludes that receptive containment is only part of the psychotherapist's function, and that the inner transformation of the material and the effective imparting of that thinking are equally important. Now I do not know whether I agree with this view, because I do not know what containment and transformation involve, because I do not know if she regards them as evaluative or only descriptive activities. It is one thing to record for the patient to the best of one's ability what obtains; it is another to assess the appropriateness of emotional states. I think that I do not know what containment and transformation are because I do not have an adequate understanding of what it is to engage in an appraisal of an emotion.

Some features of therapeutic communication are usefully exhibited in the third case Alvarez discusses. She shows how she employed the countertransference successfully, but does not ask what she essentially has got across, nor inquire why getting an interpretation across can be beneficial. She writes that the boy's intractable destructiveness made her despondent, so much so that she felt — heretically — that the actions were just habitual and done for their own sake, that the malevolent intention was frequently absent. At first she had to deal with the impulse to retaliate. Movement occurred when she adopted the strategy of looking away from him: her voice became weary and her manner cool. That is, she took on the appearance of one depressed. Indeed, her remark that he knew how to produce depression in her stopped him and seemed to inaugurate self-scrutiny. But why? It is most significant that the patient's relentless destructiveness and the therapist's depressed state parallel the situation outlined at the beginning: (1) When the boy was 2 years old the family l