EDITOR'S NOTE ‘This paper is the first extended description by an American clas- sical analyst of the intensely interactional qualities of the analyst's countertransferences. It also offers the unique thesis that a counter- transference disturbance develops in the course of every analysis and, further, that the resolution of the patient's transference’ constellation depends on and is parallel to the resolution of the countertransference-based syndrome. ‘Tower takes us a long way toward recognizing the inevitability of ‘countertransference, its positive and negative effects, and the impli-, cations of its essential presence in respect to the actualities of the analytic experience and the process of cure. In part a reaction against the stress among classical analysts on interpretations as vir- tually the entire basis for adaptive symptom resolution, Tower's work provides a basis for recognizing that what has been broadly termed the transference-countertransference interaction, and its analytic resolution (for both parties) is a vital characteristic of sound analytic work—and, I would ada, is fundamental to the salu- tary effects of interpretive endeavors. There are many other valuable ideas and distinctions in this important paper. Of special note is Tower's tolerance of countertransference-based feelings and reactions, and her basic ‘commitment to their gradual analysis and to the understanding of the patient’s unconscious responses to their expression. She also suggests that the actual experiences of the analyst's errors offer the patient special opportunities for the modification of difficult trans- ference resistances —a concept adumbrated by Winnicott (1956; see chapter 38), who viewed the patient’s reactions to the analyst's actual failures as a new opportunity to rework the parents’ past failures as they pertain to the illness of the analysand. ‘One can only wonder why it is that so little subsequent research and writing has been stimulated by this insightful paper. We can suspect again that an undue dread of the actualities of the uncon- scious communicative interaction, and of the analyst’s pathological inputs, plays a significant role in this avoidance.162 I. THrorericat Consiberations References to countertransference appeared very early in psychoanalytic literature. Originally, they paid mostly lip service to its existence, with unelab- rated statements that, of course, analysts could have transference reactions to their patients. Little clse was said, other than to imply that these were dubious reactions and should be controlled, and for analysts to discuss their countertransference reac- tions in public would be somewhat indecently self- revealing. about ten years ago, a moderate number of articles began to appear. The general overtone of these articles has been of a rather embarrassed sort, as though these were major imperfections in our therapeatic procedures, and of course certain counteriransference phenomena are considered reprehensible in the extreme ‘The literature on countertransference has recently bbeen excellently reviewed by Douglass Orr (18). T shall make only cursory comments about this litera- ture beeause my main purpose is to present some ideas of my own and some detailed case material. Despite wide agreement among analysts about trans- ference, there has been wide disagreement about countertransference. Freud's first reference to it in 1910 was rather forbidding: “We have begun to con- sider the ‘counter-transference’... arising as a result of the patient's influence on his {the physicien’s}ounconscious feelings, and have nearly come to the point of requiring the physician to recog nize and overcome this counter-transference in himsel?” (9, p. 289). It is striking that a natural and inevitable phenomenon, s0 rich in potential for understanding, should have sustained so forbidding a tone toward its ‘existence for forty-five years. I refer to the fact that no analyst has ever been presumed to have been so perfectly analyzed that he no longer has an uncon- scious, or is without susceptibility to the stirring up of instinctual impulses and defenses against them. ‘The very phraseology of our training practices belies the mask of the “perfect analyst.” We state that the student’s personal analysis should “serve as a first- hhand experience with the unconscious’; it should (CounTERTRANSFERENCE in him “working freedom from his own disturbing emotional patterns";? and it should enable him to ‘continue his self-analysis on his own. At no time is it ‘expected that he will have been perfectly analyzed In addition, our recommendations for periodic reanalysis of analysts presuppose a large uncon- scious reservoir of sources for the development of new neurotic responses to emotional pressures from analytic patients upon the analyst’s unconscious. Conflicting conceptions of countertransference have covered a wide range. There were early ideas that it was the analyst’s conscious emotional reaction to the patient’ transference; attitudes that it covered every conscious or unconscious reaction about the patient, normal or neurotic; mechanistic construc- tions of the interpersonal relation between patient and analyst into some schematized oedipal picture (20); characterological disposition and personal eccentricities of the analyst were included; reactions to the patient as a whole have been considered trans- ferences, and to partial aspects of the patient, countertransferences; anxiety in the analyst has been taken to be the common denominator to all countertransference reactions and every anxiety- producing response in the analyst considered countertransference (7); and finally, only sexual impulses toward patients have been regarded as countertransference. Major differences center around “seeing the analyst as a mirror—versus the analyst as a human being” (18). Countertransferences are considered as being simply transferences—and nothing else—versus their not being transferences and being almost anything else. Other differences center around questions of whether or not to discuss countertransferences with patients;? whether countertransferences are always present and therefore reasonably normal; or whether they are always abnormal. “Carry over”* is mentioned several times as particularly ominous in its implica- tions, Almost invariably there are explicit probibi tions against any erotic countertransference manifes- tations. Only once, I believe, is it suggested that unless there are periods or occasions of ‘carry over,” the analysis will not be successful, and only once, I believe, is it suggested that there may be under normal, and perhaps even useful, circumstances 1. Read before the Chicago Prychoanalyic Society, May, 1955, and The American Psychoanalytic Association in New York, December, 1955, r ‘Reprinted from Jounal ofthe American Pyehoanalp Aoi 224-255 by permission of International Universities Press, Ine Copyright ©1956 by American Psychoanalytic Assocation. 2. Report of The Commitee on Training Standard, Board on Professional Standards, American Prychoanalytic Awocation, November, 1953, 3. Some suggestions along this line seem o approach the wild analysis" level 4. “carry over" lets persisting in the analyst in response to and following an analytic interview.Lucia E. Tower something approaching a countertransference neu- rosis. Mostly the latter are strenuously criticized. ‘The forbidding nature of writings on the subject is indicated by the following typical quotes (slightly edited); Our countertransference must be healthy [23]. {tis assumed that the appropriate responses pre- dominate (6) At least some analytical toilet is part of the ana- lyst’ necessary routine [12]. Countertransference is the same as transference — it is then immediately obvious that counter- transference is undesirable and a hindrance (8]. ‘The [countertransference mistake] should be ad- mitted, to allow the patient to express his anger, and he is entitled to some expression of regret from the analyst [16] It is not safe to let even subtle manifestations ‘of the countertransference creep inadvertently into the inter-personal climate. The analyst must recognize and control these reactions [1]. All of these—and similar attitudes— presuppose an ability in the analyst consciously to control his own unconscious. Such a supposition is in violation of the basic premise of our science—namely, that human beings are possessed of an unconscious which is not subject to conscious control, but which is (fortu- nately) subject to investigation through the medium of the transference (and presumably also the countertransference) neurosis Common evidences of countertransference are given as: anxiety in she treatment situation; disturbing feelings toward patients; stereotypy in feelings or behavior toward patients; love and hate responses toward patients; ‘erotic preoccupations, especially ideas of falling in love with a patient; carry over of affects from the analytic hour; dreams about patients and acting-out episodes. ‘The very recent literature on this subject includes number of perceptive articles, rich with descriptive material and clinical examples, and with a much less forbidding tone. 163 I would employ the term countertransference only for those phenomena which are transferences of the analyst to his patient. It is my belief that there are inevitably, naturally, and often desirably, many countertransference developments in every analysis (some evanescent—some sustained), which are a counterpart of the transference phenomena. Inter- actions (or transactions) between the transferences of the patient and the countertransferences of the analyst, going on at unconscious levels, may be—or pethaps always are—of vital significance for the out- ‘come of the treatment. The intellectual verbaliza- tions, consisting of the communications of the patient, and the interpretive activity of the analyst are the media through which deep underground channels of communication develop between patient and doctor. Interpretations as such do not cure, nor will any analyst ever be remembered primarily for his interpretative brilliance by any patient with whom he has been successful. This is not, however, to depreciate the importance of interpretation in the analytic procedure. Obviously, only through the patient's verbal communications, and the painstak- ing, dispassionate, interpretative efforts of the ana- lyst is it possible, little by little, s0 10 pect away defenses that those deep insights and communica- tions can be obtained that we know to be the essence of the curative effect of the analytic process. Transferences and countertransferences are unconscious phenomena, based on the repetition compulsion, are derived from significant experi- ‘ences, largely of one’s own childhood, and are directed toward significant persons in the past emotional life of the individual. Habitual character- ological attitudes should not be included as counter- transference phenomena, since these will find expression in almost any situation, and nearly always in virtually the same form. They lack the specificity to a given situation of the counter- transference phenomena. The fact that instinct derivatives have been permitted to become ego- syntonie through being incorporated into the charac- ter structure makes such attitudes essentially ‘conscious or preconscious in character, in contrast to the transference phenomena, which derive from deep unconscious conflicts, in a given situation at a given time, and in response to a given individual, in which are mobilized old, affectively significant expe- riences in relation to earlier important figures Indoctrination of patients, for example, is probably ‘not usually a countertransferene® phenomenon, but an impulse derivative. Many other things incor- rectly discussed as “countertransferences” are simply defects in the analyst's perceptions or experience.