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March 20, 1978. THE ANALYST'S EMOTIONAL REACTIONS TO HIS CHILD AND ADOLESCENT PATIENTS AND THEIR PARENTS. Jules Glenn, M.D. and Isidor Bernstein, M.D.
Presenting a clinical vignette concerning the treatment of a latency child and his family, the authors drew attention to the variety of personal emotional
reactions experienced in the course of the analytic work. These could be classified as: (1) countertransferences; (2) transferences to the patient; (3) identifications; (4) instances of experiencing the patient as an extension of the analyst's self; and (5) reactions to the patient as a real person. The last group included (a) empathic responses which can generate insight, (b) signal affects which can also be used adaptively, and (c) failures to achieve empathy.
The authors distinguished countertransference reactions from other transferences to the patient by limiting the term to unconscious transferences of the analyst emerging in response to the patient's transferences. An analyst may have transferences rigidly frozen into his or her functioning, similar to character traits, which could repetitively invade the therapeutic work. Identification with the patient is not uncommon in child analysis, often appearing as part of the analyst's transferences to the parents of the child, equated with the analyst's parents. Reactions to the patient as a real person would be illustrated by the inevitable emotional response to a patient's sudden physical assault on the analyst. Although such responses are available to consciousness, self-analysis is indicated to ferret out the tranference aspects of the reaction involved.
When countertransferences are understood, particularly through the analyst's awareness of his or her accompanying affective state, they help to identify and interpret the patient's provoking transferences. Other, less intense feelings on the part of the analyst contribute to the empathy essential to the understanding of patients and their communication