A Therapist's Life-Threatening Disease: Its Impact on Countertransference Reactions and Treatment Techniques

One of the Major Advances in Psychoanalytic Theory and Practice during the last two decades has been the broadening of our understanding and use of the concept of countertransference. From Freud's original position that “the countertransference arises in the analyst as a result of the patient's influence on his unconscious feelings, and we are almost inclined to insist that he shall recognize the countertransference in himself and overcome it” (pp. 144-145), current practitioners tend to view countertransference as including “all of the emotional reactions at work” (Abend, 1989, p. 374). Rather than being experienced solely as an obstacle to be overcome, countertransference is now regarded by most clinicians as “all those reactions of the analyst to the patient that may help or hinder treatment” (Slakter, 1987, p. 3).

Although Freud's model of the cold, dispassionate clinician who unemotionally performs his work diligently and objectively has been part of most analysts' professional superegos during at least some part of their careers, this idealized image has been consistently challenged. Freud himself, as we know, did not always practice what he preached. He loaned money to his patients, fed some, hugged others, gave advice to many and went on vacation with a few (Jones, 1953). In his inner circle, although his adherents constantly reiterated Freud's notion of