Countertransference Strain and the Use of the Analyst

For many of us, our way of analytic listening has shifted over the last 15 years or so. We listen to the patient, but along with this we listen to the dialogue in the consulting room, to discern what kind of relationship is perhaps being enacted between the two participants. We hope to use this information to help us recognize patterns of transference and countertransference or “role responsiveness” (Sandler, 1976). But in all this, what are we to call real, actual, or illusory? Having come this far from a positivist opposition of transference versus reality, how are we to orient ourselves? As a contribution to making the ambiguities of this question discussable in clinical terms, I here present material from an analytic patient for whom, for a while, only the analyst's perceived failings were real.

I want to highlight a moment when the patient could begin to experience transference as partly his own subjective contribution rather than primarily trying to prove that the analyst is “really” recreating a failure of the object. Prior to this, the patient had been trying to establish how much the analyst contained unwanted aspects of the patient, or of the patient's defensive, masochistic, identifications with the failing object. I see this moment as an example of a turning point which occurs in some analyses, particularly with some traumatized patients who do not start treatment able to do ordinary analytic work. In this example, the