Counter-Transference, Anxiety and Change

THIS IS A PAPER relating clinical evidence during analysis with evidence from other disciplines about the interplay between internal and external events, and the anxiety which accompanies it, especially when there is an impingement or breaking in upon an inner world which is not yet open to receive it. This can be in an infant, a regressed patient, or the regressed part of a more organized patient.

Analysis is seen as an interaction between people, where there is an awareness in the analyst of sustaining the process within the patient, side by side with an awareness of the part he himself plays in this development by his own changing reality, technique and counter-transference. Communication between analysts who see these aspects in a differently weighted way can become difficult. What the analyst does, his technique, may be seen as an impingement that reduces and destroys the so-called ‘closed vessel’ and the precious process within it, while emphasis on this process, letting things develop, can be felt as an anarchic threat.

In an attempt to see these aspects as a whole, I will describe an episode in the analysis of a rather regressed patient during a small change in the analytical environment, and go on to try to scrutinize what I did, and what happened to the patient, to myself and to the several pairs that we made with each other between different levels of consciousness. That is, the fate and effect of a small impingement will be traced.

It is at times of regression that impingements seem especially disruptive, and on the whole analysts try to avoid change at such times because the anxiety evoked is obstructive. I take the view that outer environmental changes and inner development go hand in hand, and that the anxiety generated by these changes, even when they have an impinging quality, can be a healthy influence if it can be transformed into a usable form. The counter-transference plays a vital role in this transformation.

One day I replaced the