Implications of the Social Paradigm for Technique
The Impact of the Countertransference on the Fate of the Relationship
Because the analyst is human, he is likely to have in his repertoire a blueprint for approximately the emotional
response that the patient's transference dictates and that response is likely to be elicited, whether consciously or
unconsciously (Searles, 1978–1979, pp. 172–173). Ideally this response serves as a key—perhaps the best key the
analyst has—to the nature of the interpersonal scene that the patient is driven by transference to create. The patient
as interpreter of the analyst's experience suspects that he has created something, the complement of the transference,
in the analyst; that is, he suspects it at some level. What he does not know and what remains to be decided, is what
role the countertransference experience of the analyst will have in determining the total nature of the analyst's
response to the patient. In other words he does not know the extent to which the countertransference will combine
with the transference to determine the destiny of the relationship. The extent to which the analyst's "objectivity, "
the tendency which is inclined towards understanding more than enacting, the extent to which this tendency will
prevail and successfully resist the pull of the transference and the countertransference is unknown at any given
moment not only to the patient but also to the analyst.
Within the transference itself, there is a kind of self-fulfilling prophecy, and with it, a kind of fatalism; a sense
that the outcome is inevitable. The transference includes not just a sense of what has happened or is happening
7See Fourcher (1975) for a discussion of human experience as the expression of social reciprocity on multiple levels of psychological
organization and consciousness.
but also a prediction, a conviction even, about what will happen. The attempt to disprove this prediction is an
active, ongoing, mutual effort, which is always accompanied by a real element of uncertainty. The analyst's
uncertainty has as much if not more to do with his inability to know, in advance, how much his own
countertransference will govern his response to his patient, as it has to do with his inability to measure, precisely,
the patient's resistance and motivation for change. Moreover, the patient, as interpreter of the therapist's
experience, has good reason to think and fear that the countertransference-evoking power of his transferences
may be the decisive factor in determining the course of the relationship. Or, to say the same thing in another
way, he has good reason to fear that the analyst's constant susceptibility to countertransference will doom the
relationship to repeat, covertly if not overtly, the very patterns of interpersonal interaction which he came to
analysis to change.
Pitted against the powerful alignment of transference and countertransference is the interest that the patient and
the analyst share in making something happen that will be new for the patient and that will promote his ability to
develop new kinds of interpersonal relationships. This is where the "objectivity" of the analyst enters and plays
such an important role. It is not an objectivity that enables the analyst to demonstrate to the patient how his
transference ideas and expectations distort reality. Instead it is an objectivity that enables the analyst to work to
create another kind of interpersonal experience which diverges from the one towards which the
transference-countertransference interaction pulls. In this other experience, the patient comes to know that the
analyst is not so consumed or threatened by the countertransference that he is no longer able to interpret the
transference. For to be able to interpret the transference fully means interpreting, and in some measure being
receptive to the patient's interpretations of the countertransference (Racker, 1968, p. 131). What ensues is a subtle
kind of rectification. The patient is, in some measure, freed of an unconscious sense of obligation to resist
interpreting the analyst's experience in order to accommodate a reciprocal resistance in the analyst. Ironically, the
resistance in the patient sometimes takes the form of an apparently fervent belief that, objectively speaking, the
analyst must be the very neutral screen that, according to the standard model he aspires to be (see Racker, 1968, p.
67). The patient takes the position, in effect, that his ideas about the analyst are nothing but fantasy, derived
entirely from his childhood experiences; nothing but transference in the standard sense of the term. In such a case,
the analyst must interpret this denial; he must combat this resistance not collude with it. To the extent that the
analyst is objective, to the extent that he keeps himself from "drowning in the countertransference" (Racker, 1968,
p. 132), which, of course, could take the form of repressing it, to that very extent is he able to actively elicit the
patient's preconscious and resisted interpretations of the countertransference and take them in stride.
Interpretation as Rectification
Whether the therapist's response will be dominated by countertransference or not is a question that is raised
again and again throughout the course of the therapy, probably in each hour with varying degrees of urgency. Also,
it is a question that in many instances cannot begin to be resolved in a favorable direction unless or until a timely
interpretation is offered by the therapist. At the very moment that he interprets, the analyst often extricates himself
as much as he extricates the patient from transference-countertransference enactment. When the therapist who is
experiencing the quality, if not the quantity, of the countertransference reaction that the patient is attributing to him
says to the patient: "I think you think I am feeling vulnerable, " or "I think you have the impression that I am hiding
or denying my hostility towards you" or "my attraction to you, " at that moment, at least, he manages to cast doubt
on the transference-based expectation that the countertransference will be consuming and will result in defensive
adaptations in the analyst complementary to those in the transference. The interpretation is "mutative" (Strachey,
1934) partly because it has a certain reflexive impact on the analyst himself which the patient senses. Because it is
implicitly self-interpretive it modifies something in the analyst's own experience of the patient. By making it
apparent that the countertransference experience that the patient has attributed to the analyst occupies only a part of
his response to the patient, the analyst also makes it apparent that he is finding something more in the patient to
respond to than the transference-driven provocateur. Not to be minimized as a significant part of this "something
more" that the analyst now is implicitly showing a kind of appreciation for is the patient's capacity to understand,
empathize with, and interpret the analyst'sexperience, especially his experience of the patient (cf. Searles, 1975).
As Gill (1979) has pointed out, the patient, through the analysis of the transference, has a new interpersonal
experience which is inseparable from the collaborative development of insight into the transference itself. This new
experience is most powerful when the insight into the transference includes a new understanding of what the patient
has tried to evoke and what he has plausibly construed as having been actually evoked in the analyst. The
rectification that I spoke of earlier of the patient's unconscious need to accommodate to a resistance that is attributed
to the analyst is also more likely when the analyst is able to find the patient's interpretation of the
countertransference in associations that are not manifestly about the psychoanalytic situation at all. When he does
this, he demonstrates to the patient that rather than being defensive about the patient's ideas about the
countertransference, he actually has an appetite for them and is eager to seek them out.
Systematic use of the patient's associations as a guide to understanding the patient's resisted ideas about the
countertransference is a critical element of the interpretive process in the social paradigm. Without it, there is a
danger that the analyst will rely excessively on his own subjective experience in constructing interpretations. The
analyst then risks making the error of automatically assuming that what he feels corresponds with what the patient
attributes to him. In fact, Racker (1968), whom I have cited so liberally, seems to invite this criticism at times,
although he also warns against regarding the experience of the countertransference as oracular (p. 170). It is true
that in many cases the most powerful interpretations are constructed out of a convergence of something in the
analyst's personal response and a theme in the patient's associations. However there are other instances when the
associations suggest a latent interpretation of the analyst's experience which comes as a surprise to the analyst and
which overrides what he might have guessed based upon his awareness of his internal state. Thus, continually
reading the patient's associations for their allusions to the countertransference via the mechanisms of displacement
and identification (Lipton, 1977b) ; (Gill, 1979) ; (1982a) ; (Gill and Hoffman, 1982a) ; (1982b) is a necessary
complement to the analyst's countertransference experience in constructing interpretations and ensures that the
patient's perspective, as reflected in the content of his communications, is not overshadowed bywhat the analyst is
aware of in himself.
The Role of Enactment and Confession of Countertransference
The new experience that the patient has is something that the participants make happen and that they are
frequently either on the verge of failing to make happen or actually failing to make happen. That is, they are
frequently either on the verge of enacting transference-countertransference patterns or actually in the midst of
enacting them, even if in muted or disguised ways. Where Gill, Racker, Searles, and Levenson among others differ
from conservative critics like Langs is in their acceptance of a certain thread of transference-countertransference
enactment throughout the analysis which stands in a kind of dialectic relationship with the process by which this
enactment, as experienced by the patient, is analyzed.
I want to be clear that nothing I have said requires admission on the part of the analyst of actual
countertransference experiences. On the contrary, I think the extra factor of "objectivity" that the analyst has to help
combat the pull of the transference and the countertransference usually rests precisely on the fact that the nature of
his participation in the interaction is different than that of the patient. This is what increases the likelihood that he
will be able to subordinate his countertransference reactions to the purposes of the analysis. What Racker (1968)
speaks of as "the myth of the analytic situation, " namely that it is an interaction "between a sick person and a
healthy one" (p. 132), is, ironically, perpetuated by those who argue that regular countertransference confessions
should be incorporated as part of psychoanalytic technique.8 Such regular self-disclosure is likely to pull the
therapist's total personality into the exchange in the same manner that it would be involved in other intimate social
relationships. To think that the analyst will have any special capability in such circumstances to resist neurotic
forms of reciprocal reenactment would have to be based on an assumption that his mental health is vastly superior to
that of the patient. Admissions of countertransference responses also
8Bollas (1983) has recently discussed and illustrated the usefulness of occasional judicious disclosures by the analyst of his
countertransference predicament.
tend to imply an overestimation of the therapist's conscious experience at the expense of what is resisted and is
preconscious or unconscious. Similarly it implies an extraordinary ability on the part of the analyst to capture the
essence of his experience of the patient in a few words whereas the patient may grope for hours in his free
association before he reaches a verbalization that fully captures something in his experience of the analyst. Another
way of saying this is to say that countertransference confessions encourage an illusion that the participants may
share that the element of ambiguity that is associated with the analyst's conduct and that leaves it open to a variety
of plausible interpretations has now been virtually eliminated. Once the analyst says what he feels there is likely to
be an increment of investment on his part in being taken at his word. This is an increment of investment that the
patient will sense and try to accommodate so that the reciprocal resistance to the patient's continuing interpretation
of the therapist's inner experience can become very powerful.
Although countertransference confessions are usually ill-advised, there are times when a degree of personal,
self-revealing expressiveness is not only inescapable but desirable (Ehrenberg, 1982; Bollas, 1983). In fact, there
are times when the only choices available to the analyst are a variety of emotionally expressive responses. Neither
attentive listening nor interpretation of any kind is necessarily a way out of this predicament because the patient
may have created an atmosphere in which customary analytic distance is likely to be experienced by both
participants as inordinately withholding, compulsive, or phony. As long as the ambiance is such that the patient and
the analyst both know that whatever is going on more than likely has meaning that is not yet being spoken of or
explored but eventually will be, openly expressive interpersonal interactions may do more good than harm and may
continue for some time before it becomes possible to interpret them retrospectively in a spirit that holds any hope of
benefit for the patient. In other words, it may be some time before the act of interpreting will become sufficiently
free of destructive countertransference meaning so that the patient can hear and make use of the content of the
intervention.
Again, it is not that instead of interpreting in such circumstances one should merely wait silently, but rather that
a certain specific kind of spontaneous interpersonal interaction may be the least of the various evils that the
participants have to choose from, or, more positively, the healthiest of the various transference-countertransference
possibilities that are in the air at a certain time. It may be that such "healthier" types of interpersonal interaction
actually do have something relatively new in them or maybe something with weak precursors in the patient's history
that were not pathogenic but rather growth promoting. However it is crucial that the therapist not assume this and
that he be guided by the patient's subsequent associations in determining how the patient experienced the interaction
and what it repeated or continued from the past.
Exploration of History in the Social Paradigm
An important weapon that the patient and the therapist have against prolonged deleterious forms of
transference-countertransference enactment, in addition to the analyst's relative distance, is an evolving
understanding of the patient's history. This understanding locates the transference-countertransference themes that
are enacted in the analysis in a broader context which touches on their origins. This context helps immeasurably to
free the patient and the analyst from the sense of necessity and importance that can become attached to whatever is
going on in the here-and-now. The therapist's distance and ability to reflect critically on the process is aided by the
fact that he, unlike the patient, does not reveal his private associations. The patient's ability to reflect on the process
relies much more heavily on being able to explain what is happening on the basis of what has happened in the past.
Such explanation, because it demonstrates how the patient's way of shaping and perceiving the relationship comes
out of his particular history, also adds considerably to the patient's sense of conviction that alternative ways of
relating to people are open to him. Again, what is corrected is not a simple distortion of reality but the investment
that the patient has in shaping and perceiving his interpersonal experience in particular ways. Moreover, the past
too is not explored in a spirit either of finding out what really happened (as in the trauma theory) or in the spirit of
finding out what the patient, for internal reasons only, imagined happened (the past understood as fantasy). The
patient as a credible (not accurate necessarily, but credible) interpreter of the therapist's experience has as its
precursor the child as a credible interpreter of his parents' experience and especially his parents' attitudes towards
himself. (See Hartmann and Kris, 1945, pp. 21–22) ; (Schimek, 1975, p. 180) ; (Levenson, 1981). The dichotomy
ofenvironmentally induced childhood trauma and internally motivated childhood fantasy in etiological theories has
itsexact parallel in the false dichotomy in the psychoanalytic situation between reactions to actual countertransference
errors on the analyst's part and the unfolding of pure transference which has no basis or only a trivial basis in reality.
The Patient's Perception of Conflict in the Analyst
The therapist's analytic task, his tendency toward understanding on the one hand, and his countertransference
reactions on the other, often create a sense of real conflict as part of his total experience of the relationship. I think
this conflict is invariably a part of what the patient senses about the therapist's response. In fact one subtle type of
asocial conception of the patient's experience in psychoanalysis is one which implies that from the patient's point of
view the analyst's experience is simple rather than complex, and unidimensional rather than multifaceted. The
analyst is considered to be simply objective, or critical, or seductive, or threatened, or nurturant, or empathic. Any
truly social conception of the patient's experience in psychoanalysis grants that the patient can plausibly infer a
variety of more or less harmonious or conflictual tendencies in the analyst, some of which the patient would imagine
were conscious and some of which he would think were unconscious. In such a model, the patient as interpreter
understands that, however different it is, the analyst's experience is no less complex than his own. www.psychspace.com心理学空间网
