COUNTERTRANSFERENCE EVOLUTION IN

THEORY AND PRACTICE

ROBERTL. TYSON,
M.D.

A framework tS suggested for conceptualizing countertransference,

based on expansion of the concept emerging subsequent to Freud‘s
original view of the phenomenon: ( I ) from Ucs to Cs; (2) from
reactions to transference to all reactions, (3)from the anaijds
neurosis to the anabst’s functioning, (4) from self-analysis to self-
scrutiny, (5)from obstacle to contribution. Particular attention is
called to the advantages of maintaining the distinction between the
patient5 transference and the analyst’s countertransference; the im-
portance for successful psyhoaiiabtic work of being aware of the
subtleties of countertransference i n work with neurotic patients,
especially in contrast to the blalant countertrairsference experiences
more disturbed patients thrust upon the analyst; the need forfurlher
investigation of the relatioils between the atlabst’s empothy, regres-
sion, and counlertraiuference; the lack of understanding of and
iiformation about the homosexual countertranvfrence, bused on
itrsufficient knowledge of the mechanirmr if resistance to self-anal-
jsis, among other reasons; and the need for more reliable infor-
mation about the limits of a n d indications for u s i n g
countertransference responses in particular kin& of clinical situ-
ations, whtherfor informing the patien&as to the analyst’s responses
to him, for informing the analyst in the interpretive process, or in
formulating reconstructions. A clinical example provides a n illus-
tration of the complexity of coiintertra,uference-transference inter-
action and of the impact of countertraiuference on &hetransference.

I F ITIS TRUETHATTRANSFERENCE IS THE “hardest part of anal-

ysis,” as Bird said in 1972, then countertransference must
come a‘close second. The clinical concept of countertransfer-
ence may well be one of the most crucial issues in psychoanalysis
about which Freud said the least. Beginning about 1950 the
growing body of writing on the subject reflects an increasing

This is an expanded version o f the Chairman’s Introduction to the panel

on “Countertransference in Theory and Practice,”held at the Annual hleeting
o f the Anierican Psychoanalytic Association, San Dicgo, California, hlay 4,
1984. Accepted for publication Decembcr 4, 1984.

25 1

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252 ROBERT L. TYSON

awareness of the importance of the phenomenon for the cli-

nician, together with a significant expansion in the meanings
of the term beyond Freud’s original definition. His initial ref-
erence (1910a, pp. 144-145) to countertransference defined it
as . . a result of the patient’s influence on [the analyst’s] un-
‘I.

conscious feelings. ...” Probably because the analyst’s uncon-

scious was involved, Freud felt obliged to point out that, in his
opinion, a special effort was needed for the analyst to become
aware of something in himself that would otherwise limit his
effectiveness in the conduct of the analytic treatment. At the
time Freud believed the effort of self-analysis was required to
achieve this awareness, an opinion he modified two years later
(1912b) when he recommended what came to be known as the
training analysis.
In simply pointing to the patient’s influence on the analyst,
Freud’s initial comments did not identifyjust what in the patient
was responsible for this “afferent stimulus” (Rangell, 1979, p.
97) to the analyst. His second and final direct reference to
countertransference (1915, pp. 160, 164) went further. Freud
attributed the patient’s influence on the analyst to the patient’s
transference to him; the result of unmastered countertransfer-
ence was, a loss of analytic neutrality. Thus he closed off from
consideration other reactions of the analyst to the patient, and
other aspects of the patient as perceived and reacted to by the
analyst-reactions and aspects that have since been extensively
explored and described. As Orr pointed out in his comprehen-
sive review over 30 years ago (1954, p. 648), a persistent theme
in the literature has been the distinction between countertrans-
ference conceived of simply as an unconscious reaction to the
patient’s transference, on the one hand (Freud’s original view),
and “the analyst’s own transference to the patient for whatever
reasons and arising from his own unresolved neurotic diffi-
culties,” on the other.
In still another respect these two articles by Freud fore-
shadowed later developments in psychoanalytic thought. While
in the first he focused on the patient’s impact on the analyst’s

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 COUNTERTRANSFERENCE EVOLUTION 253

unconscious, in the second he referred to the analyst’s coizscious

feelings about the patient. He was explicit about these conscious
feelings only in regard to the dangers of losing analytic neu-
trality if the countertransference were not kept in check, by
“letting oneself go a little way in tender feelings for the patient”
(1915, p. 164). This caveat was given when Breuer’s retreat
from Anna 0.3positive feelings for him undoubtedly was still
in Freud’s mind, and at a time when Freud was painfully aware
of Jung’s romantic involvement with one of his young female
patients in Switzerland (Freud, 1909; H. P. Blum in Panel,
1984).
Freud’s definition of countertransference dangers for the
analysis was limited to the loving feelings female patients de-
velop toward male analysts, though he was clearly cognizant
that negative feelings might go both ways, too (1912a, p. 105;
1915, p. 161n). While he subsequently made frequent remarks
about the positive transference feelings his male patients man-
ifested toward him, Freud did not comment directly about the
homosexual countertransference in analysts of either gender.
Indeed, there are suspiciously few references in the literature
to what must be at least as common as the heterosexual coun-
tertransference, a point to which I return later.
Given the countertransference polarities of positive and
negative feelings in the analyst, both conscious and unconscious,
and of course the accompanying fantasies, it is an easy step to
a somewhat more complex view encompassing more of the var-
iables than was originally the case. To make this step, a closer
look at Freud’s ideas about countertransference will be helpful.
There is reason to believe that Freud thought and perhaps
talked more about countertransference than he published. For
example, in an effort to aid Jung in his difficulties with Sabina
Spielrein, he wrote (1909): “[Such experiences] help us to de-
velop the thick skin we need and to dominate ‘countertrans-
ference,’ which is after all a permanent problem for us; they
teach us to displace our own affects to best advantage. They are
a ‘blessing in disguise’” (p. 231; italic words in English in the

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254 KOBERT [Link]

original). Another cogent example is in the same paper in which

he recommended a training analysis as a form of “psycho-an-
alytic purification” (1912b, p. 116). Leading u p to this advice,
he surveyed various principles of technique and pointed out
how they created in the analyst a counterpart to the patient’s
obligation to “relate everything that his self-observation can
detect” (p. 115). In this counterpart, Freud says, the analyst
must not substitute “a censoxship of his own for the selection
that the patient has foregone” (p. 115). Clearly he is referring
to dynamics of countertransference, though he does not call it
that. T o explain how the undesirable counterpart censorship
might work, he asserts, by analogy to telephone transmission
and reception, that the analyst “must turn his own unconscious
like a receptive organ towards the transmitting unconscious of
the patient” (p. 115), implying a kind of communication be-
tween their two unconscious, or preconscious, minds. Having
set up the image, Freud refers to an obstacle to communication
within the system, an obstacle or resistance located in the an-
alyst, one that would “hold back from his consciousness what
has been perceived by his unconscious,” and he mentions the
deleterious consequences of such a distortion for the analysis.
He believed the training analysis would serve to make the an-
alyst “aware of those complexes of his own which would be apt
to interfere with his grasp of what the patient tells him” (p.
116). Later (1937, p. 249) he took into account that, the training
analysis notwithstanding, analysts, too, employ defensive mech-
anisms and are affected by the nature of analytic work (a point
amplified by Wheelis, 1956); less op$mistic than before, he
recommended periodic reanalysis for analysts in addition to the
expectation that they would continue to do “spontaneous” self-
analysis following the termination of their own analyses.

Areas of Coiiceptual Expamimi

Since Freud’s sparse comments, the ongoing shifts and expan-
sions associated with the concept of countertransference may

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 COUNTERTRANSFERENCEEVOLUTION 255

be described as follows: first, there has been an expansion from

the narrow focus on how the analyst’s unconscious is affected by
tile analytic relationship, to a more encompassing approach
which also includes the analyst’s conscious feelings about and
reactions to the patient. Second, there has been an expansion
from defining countertransference simply as the analyst’s re-
actions to the patient’s transference to him, to include his neu-
rotically determined reactions to a particular patient, or to an
aspect of a patient, and then most broadly to take in any and
all feelings he has about any patient. These two areas are related
in that both have to do with defining exactly what constitutes
countertransference, the first in terms of specifying the analyst’s
responses, the second specifying what in the patient triggers
the analyst’s response.
The third area of expansion refers to explanations to ac-
count for countertransference, that is, the mechanisms by which
it comes into operation and explanations of countertransfer-
ence dynamics. The fourth area centers on dealing with couti-
tertransference-how the analyst acquires the ability to recognize
its presence and effects, and what to do about it. Finally, a fifth
area concerns the role countertransference plays in the treat-
ment, whether it is an obstacle or an aid.

The first two areas of expansion clearly have much in common.

The one moves from the analyst’s unconscious to include all
conscious feelings about and reactions to the patient; the other
enlarges the basis for the analyst’s responses, beginning with
the patient’s transference as a specific stimulus, to anything
about the patient that evokes a response in the analyst. Indeed,
the convergence has been carried to an extreme conclusion by
McLaughlin (1981), who, drawing on the work of Olinick
(Olinick, 1969; Olinick et al., 1973) and Bird (1972), has gone
so far as to suggest putting aside the concept of countertrans-
ference with all its anibiguitics in favor of a broad view of

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256 ROBERT L. TYSON

transference, one in which the patient’s and the analyst’s trans-

ferences are considered central. I am not sure such a move
would reduce ambiguity; it might rather increase it by confusing
and blending the analyst’s separate experiences with those ex-
periences of the patient with which the analyst identifies and
empathizes. As Khan ( 1969) has remarked, “[The] differentia-
tion of the analyst’s self from the patient’s experience [espe-
cially] in the area of counter-transference is essential to keep
in focus, because any blurring of boundaries in this context
leads merely to a clinical confusion of psychic realities. It is
imperative that, in the clinical equation, the psychic boundaries
and processes of at least one party, namely the analyst, should
always be distinctly structured and defined in terms of their
functions and aims” (p. 206).
A major impetus for the convergence of the first two di-
rections of conceptual expansion derives from the widening
application of psychoanalytically inspired treatment modalities
and the effort to understand the patient-therapist interaction
in treating grossly disturbed patients. Winnicott (1947, 1960),
Kernberg (1965, 1976), Searles (1965), Giovacchini (1975),
Boyer (1978), and Little (1981), for example, write convincingly
about their countertransference difficulties in treating psy-
chotic, extremely provocative, or highly unstable people. These
are not treatment situations in which one gradually becomes
aware of feeling something about the patient other than the
usual ideal of benevolent neutrality. Rather, conscious feelings
of this sort often arise quite soon, if not from the outset, and
they must be dealt with or there is no treatment. These affects
and the situations engendering them are often so dramatic that
it may be easy to lose sight of the fact that the analyst’s conscious
feelings are a superstructure which rests on a foundation de-
scriptively and dynamically unconscious. Sometimes, in moving
from treating such patients to those less disruptive, or in reading
about the experiences of those specializing in treating patients
who so successfully challenge analytic neutrality, one gathers
the impression that “real” countertransference exists only when

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 COUNTERTRANSFERENCE EVOLUTION 257

the analyst is made uncomfortably aware of it in the course of

his efforts to work with the grossly disturbed. The implication
is that countertransference by whatever definition is of greatest
importance in work with more severely disturbed patients, in
contrast to its supposedly lesser role in the analysis of more
stable, perhaps more neurotic ones. Takcn a step further, the
implication may lead to the inference that countertransference
is merely incidental in the psychoanalysis of a neurotic, a PO-
sition not at all supported by the broader perspective (0. Renik
in Panel, 1984).

Countertransference Mechanism
The problem of how the analyst comes to have the feelings,
conscious or unconscious, he has about the patient, was consid-
ered in object-relations terms by Sandler (1976), who thought
the usual explanations insufficient. He proposed that, in the
transference, the patient unconsciously attempts to induce or
impose and experience a role relationship with the analyst as
a means of obtaining gratification for a spectrum of wishes
arising from various sources. In fact, each party tries to .impose
an intrapsychic role relationship on the other. The patient’s
efforts to elicit this concordance have an influencc on the an-
alyst’s free-floating responsiveness, which is a counterpart to
his free-floating attention, and also elicit in the analyst a kind
of analytic susceptibility to the patient. To the cxtent that the
analyst is able to monitor his role responsiveness, he has access
to what Sandler called his ‘!useful” countertransference, that is,
an awareness of how his own blind spots have been forged into
a compromise formation by the unconscious acceptance of the
role relationship the patient seeks to establish. Sandler gives
examples of how this insight can be used to construct inter-
pretations relevant to the patient’s behavior and attitudes, to
the benefit of the analytic process. Whereas this formulation
has similarities to somc others (see Racker, 1968), it has the
merit of being cast in the clinically vital terms of the patient’s
and the analyst’s motivations, wishes, and conflicts.

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258 ROBERT L. TYSON

Sandler’s contribution leads naturally into the question of

the analyst’s functioning in the analytic situation, and to the
links between countertransference, the analyst’s capacity for
controlled regression, his empathy, and his personality char-
acteristics. Freud (1937) was concerned with the effects of the
analyst’s personal shortcomings and wondered “. . . if analysis
were the third of those ‘impossible’ professions in which one
can be sure beforehand of achieving unsatisfying results” (p.
248). Since it appeared unrealistic to require either prospective
or graduate analysts to be “persons of such high and rare per-
fection” as would assure a positive analytic result, Fliess (1942)
sought to define those conditions under which the less rare
though ‘‘infrequent combination of ‘born psychologist’and pas-
sionate theoretician that is indispensable for the mastery of our
profession” (p. 2 12) could work with some reasonable likelihood
of success. He proposed that the analyst in the analytic situation
functioned with his “work ego,” that is, “.. .the temporarily
built-up person who [functions] under the circumstances and
for the period of his work” (p. 225). (Schafer, 1983, added the
“work superego,” and “the analyst’s second self,” encompassing
both.) Fliess conceptualized the work ego in terms of structural
theory and in relation to the participation of the analyst’s id
and superego in the course of his analytic involvement, as well
as in relation to his narcissistic equilibrium. He envisioned the
role of empathy, based on trial identifications with aspects of
the patient, as central to the analytic process and to providing
the analyst with a basis for interpretation. Deutsch had earlier
(1926) discussed complementary identifications, i.e., the ana-
lyst’s identification simultaneously with the patient and with the
latter’s objects as the basis for countertransference.
Beginning in 1949, in a series of lectures and papers,
Racker (1968), a Kleinian analyst in Argentina, -elaborated a
theory of countertransference development and presented var-
ious ideas about the uses of countertransference in psychoan-
alytic technique. He incorporated Deutsch’s (1926) concept of
complementary identification, which he defined as the analyst’s

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 COUNTERTRANSFEKENCE EVOLUTION 259

identification with the patient’s fantasies in the transference

(Kacker, 1953, p. 124). Compkmentary identifications accom-
panied what he called concordant or homologous identifica-
tions, e.g., the previously recognized,‘ more or less transient
identifications of “each part of his personality with the corre-
sponding part in the patient-his id with the patient’s id, his
ego with the ego, his superego with the superego, accepting
these identifications in his consciousness” (Racker, 1957, p.
134). The use of projective identification on the part of the
analyst (1958, p. 65), in his view, is accompanied by projective
counteridentification as described by Grinberg ( 1957, 1979).
For many, the analyst’s empathy and trial identifications
are based on what Loewald calls a temporary “instrumental”
regression in thc service of attunement and insight-that is,
regression used as an instrument (1981, pp. 24,34). However,
I suggest there are difficulties in distinguishing between what
is required of the analyst for his therapeutic work and what he
offers as selfjustification for his actions. Arlow (Panel, 1983)
epitomized these in the aphorism, “One analyst’s empathy is
another’s countertransference,” a topic explored by Reich
(1966). The difficulties are the same whether they are called
countertransference or the analyst’s transferences, and it is to
be hoped that future efforts to elucidate the relations between
regression, empathy, and countertransference will be helpful
to the clinican and augment his technical proficiency. Jacobs
(1983, 1986) has offered beautiful examples of the analyst’s
emotional reactions to objects in the patient’s world. The ne-
cessity for other such studies has been illustrated by Stein
(198 I), who remarked on the double-edged nature of essential
constituents of the treatment alliance, especially in cooperative,
intelligent, and creative patients who tend to bring about an
ambience of mutual admiration and comfort in the analysis. He
points out the ease with which such patients evoke in the analyst
what Freud (1912a, p. 105) called the “unobjectionable” com-
[Link] the transference. Stein says: “[The analyst] finds him-
self regarding the patient as .. .a favorite child, going out of

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260 ROBERT L. TYSON

his way to be kindly and protective, taking considerable pride

in the patient’s accomplishments. . .” (p. 874). He delineates
the subtle impediments to the analytic process which result from
what we may here call the ego-syntonic or unobjectionable part
of the countertransference. The unobjectionable countertrans-
ference may be considered a part (or the whole) of a form of
countertransference seen as neutral to the analytic process.
Such neutral forms are implied in Sharpe’s (1947, p. 4)
“healthy” countertransference, Reich‘s (195 1, p. 154) “back-
ground” or “shadowy” countertransference, Tower’s (1956, p.
232) “ubiquitous and presumably normal” countertransference,
Sandler’s (1976, p. 43) “appropriate and useful” countertrans-
ference, and Kanzer’s (1979, p. 366) “benign” countertransfer-
ence. In Stein’s sense, the unobjectionable countertransference
is an unrecognized impediment to the analysis; however, it is
to be differentiated from neutral forms of countertransference
which may be recognized by the analyst, and if so, the conse-
quences of such recognition may further the analytic work.

Recognizing and Dealing with Countertransference

It is a mark of our current level of experience and understand-
ing that most recent writers on the subject hold the training
analysis to be necessary but insufficient to provide for all the
ways in which the analyst will understand how he or she may
be affected by the patient. They are unanimous in explicitly or
implicitly advocating that the analyst subject himself to unre-
mitting self-scrutiny and interminable self-analysis in order to
obtain and to maintain that degree of self-awareness required
for the optimal performance of his work, a view which has
supplanted the recommendation of intermittent reanalysis ear-
lier proposed by Freud (1937). Though often suggested, the
practice of self-analysis seems not so often to be followed. Un-
derstandably, reports of such self-analyses in the literature tend
to present successes, just as do reports of the analyses of pa-
tients. Gray (1973) has reviewed the few pertinent contribu-

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 COUNTERTRANSFERENCE E V O L U T I O N 281

tions, noting that the responsibility for developing the capacity

for self-analysis is ascribed to the training analysis, but that so
far no one has described how it might be accomplished. The
paucity of reports in this area is surprising, especially in view
of how critical the self-analytic function is agreed to be in un-
derstanding countcrtransference or, it might be said, in doing
analytic work.’ Indeed, Freud (1937, p; 249) commented, “in
so far as [self-analysis] happens it makes the analysed subject
qualified to be an analyst himself.” The ongoing monitoring
process Sandler (1976) mentioned was recognized as a necessity
by Freud from the beginning: “. ...we .. . require that [the
analyst] begin his activity with a self-analysis and continually
carry it deeper while he is making his observations on his pa-
tients” (1910a, p. 145).
Ferenczi (1919), too, while recognizing that the analyst
must let himself go in a “free play of association and phantasy,
the full indulgence of his ow12 ~ L ~ ~ C O I I S C ~ O ~fcIt
L S , ” it necessary to
warn about the need for a continual “logical scrutiny” on the
part of &heanalyst, who should heed certain signals from his
preconscious so as to “interrupt the letting oneself go” (p. 189).
Ross and Kapp (1962) surveyed methods for recognizing
countertransference so as to allow for the self-analytic cffort.
They described their own [Link] using the analyst’s asso-
ciations to his visual images of the patient’s dreams, but they
did not consider resistances to self-analysis. Kramer (1959) re-
ferred to the “autoanalytic function.” She described some of
the formidable resistances she encountered in consciously in-
spired attempts at self-analysis, and she came to the conclusion

I The number of published studies of countertransference in work with

children and adolescents is also surprisingly small. Van Dam’s report on a
panel (1966) on Problems of Transference in Child Analysis is truly remark-
able for the paucity of references to countertransference. Wliile the Panel
acknowledged the prevalence and complexity of countertransference factors
in work with younger age groups, countertransference was seen primarily as
an impediment to this work. Bornstein (1948). Kolirman et al. (1971), Bern-
stein and Glenn (1978), and Shane (1980) have contributed the bulk of ac-
cessible literature on the topic in which a conceptual expansion parallcl to
that in treating adults seems not to have taken place.

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262 KOlZEKT L. TYSON

that, for the most part, the capacity to analyze oneself was an
unconscious ego function over which one had little control.
Calder (1980) described in detail his technique of self-anal-
ysis practiced over 15 years, including various inner resistances
to his own efforts. However, his self-analytic endeavors were
not motivated by a wish to cope with the countertransference
in work with his patients, though his experience of enhanced
empathy through increased self-knowledge (p. 17) can be in-
ferred to be of value in doing analysis. Similarly, the heightened
sensitivity to one’s own inner state that such prolonged self-
scrutiny requires must also be helpful in initially recognizing
countertransference phenomena. Beiser (1984) has reported
an instance of self-analysis, dramatically precipitated by obvious
neurotic symptoms suddenly appearing in the analyst in rela-
tion to a piece of flawed analytic work with a patient.
A very few reports on serious illness in the analyst provide
a chance to examine the countertransference difficulties usually
to be found in this situation. Dewald (1982), Abend (1982), and
van Dam (Panel, 1984) are the most recent contributors. Abcnd,
in particular, focuses on the analyst’s resistances to taking an
analytic attitude toward the situation. All three writers make
clear that serious illness in the analyst and the attendant clinical
dilemmas must be much more frequent than the literature sug-
gests.
The obvious importance of resistance to self-analysis re-
quires an understanding of its origins. Freud recognized the
difficulties as early as 1897, in spite of his occasional enthusiasm
for it: “Genuine self-analysis is impossible; otherwise there
would be no [neurotic] illness” (p. 271). And again, “But in self-
analysis the danger of incompleteness is particularly great. One
is too soon satisfied with a part explanation, behind which re-
sistance may easily be keeping back something that is more
important perhaps” (1935, p. 234). This can be described today
also in terms of ego-syntonicor “unobjectionable”countertrans-
ference. Kramer (1959, pp. 18-19) describes the dynamics in-
volved and, in so doing, provides a rationale for that old saw

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 COUNTEKI’KANSFEKENCE EVOLUTION 263

to the effect that the biggest obstacle to self-analysis is the coun-

tertransference (though to Poland [ 1984, p. 2841, the primary
problem is one of case selection). Kramer points out that the
positive transference in the original analysis is, in self-analysis,
replaced by superego and ego ideal demands for approval, a
transition that occurs by way of identifying with the original
analyst. The analyzing functions are also taken over in this
identification, in particular the analyst as interpreter. She sug-
gests that in self-analysis, the regression in the transference
which gives “a sense of reality to the re-experience of repressed
conflicts” (p. 18) is now experienced in relation to others.
It seems to me, however, that the self-analyzing analyst who
undergoes regression in relation to important persons in the
environment, and without the “holding” aspects experienced
by the analysand, is likely to react unconsciously with efforts to
preserve inner safety, rather than to inquire into the origins of
the regression. Also, identifications with one’s former analyst
are subject to many influences; for example, they may have
been made in the course of identification with the aggression
of the aggressor, or, at termination, with an ambivalently loved
lost objcct, or in pursuit of narcissistic gratifications. This is
fertile ground for transference resistance or, in the case of self-
analysis, resistance based on the transference to particularly
sensitive aspects of one’s self. To the extent that self-analysis
is necessary for converting countertransference to “useful”
countertransference, progress will depend on increasing our
understanding and mastery of the resistances to self-analysis.
Perhaps it is resistance to self-analysis that accounts for the
striking dearth of references to the homosexual countertrans-
ference, a resistance based on an insufficient analysis of the
analyst’s own homosexuality. Kacker (1 953) has explicitly ex-
amined some of the issues involved in, for example, the con-
scious and unconscious love male analysts may have for male
patients who submit to them in the analytic procedure, when
for the analyst the submission has the unconscious meaning of
a homosexual conquest. When the analysatid does not submit

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2G4 ROBERT L. TYSON

in accord with the analyst’s unconscious homosexual desires,

the resulting frustration and anger may lead the analyst to
interpret the patient’s lack of compliance and apparent resis-
tance as an expression of hatred for him. When the patient is
female, the male analyst’s unconscious fantasy of a negative
oedipal homosexual relatio,nshipwith the husband could distort
his understanding of the transference, of the patient’s feelings
about the marriage, and so forth.
Glover (1955, p. 101) made a related point, that the male
analyst’s sensitivity to criticism by the male patient may reflect
the unconscious homosexual significance of attack, and that the
underlying homosexual countertransference can be rational-
ized in many ingenious ways-for example, that the patient’s
“narcissism” is the problem. Presumably, similar issues may
arise in female analysts working with female patients. However,
no one has yet esplored the homosexual countertransference
in female analysts who specialize in, prefer to work with, or
become the analyst of choice for women with conflicts over their
gender identity, gender role, or sexual object choice. Unver-
balized questions about homosexual countertransference dif-
ficulties, among other issues, are undoubtedly involved in
assessing the suitability for psychoanalytic training of overtly
homosexual applicants of either gender.

Countertrai~fereice:Obstacle or Aid
The final aspect of countertransference has to do with its clinical
usefulness, a topic that has fascinated analysts for over 30 years.
Interest in this aspect grew out of discontent with the original
view of countertransference as either an episodic or chronic
impediment to and limitation of the effectivenessof the analysis,
something to be avoided if not prevented. Its beginning was
marked by Heimann’s (1950) paper wherein she enlarged the
term to include all the feelings experienced by the [Link]-
ward the patient. Heimann, at the time a member of the British
Kleinian group, advocated that these reactions on the part of

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 COUNTERTRANSFERENCEEVOLUTION 265

the [Link] enlisted as a source of insight into the patient’s

unconscious conflicts and defenses, and she asserted that doing
SO “will protect him from entering as a co-actor on the scene
which the patient re-enacts in the analytic relationship and from
exploiting it for his own needs’’ (p. 83). A similar suggestion
had been made much earlier by Hann-Kende (1933), but it
attracted little attention: “.. .the analyst is guided by three
factors: Theoretical and experiential knowledge, desexualized
libido, and the countertransference .. . The analyst’s counter-
transference is, obviously, as unavoidable as the patient’s trans-
ference: However, if the countertransference is brought into
a suitable equilibrium with the transference, and if the ‘basic
atmosphere’ is assigned the leading role, countertransference
not only does not inhibit, but, on the contrary, actually facilitates
analytic work” (pp. 166-167).
Heimann was explicit in her view of the limitations on the
use of countertransference reactions and feelings, and consid-
ered it improper for the analyst to communicate them to the
patient. Orr (1954, pp. 657-658) points out that, since Hei-
mann’s paper, the technical handling of the countertransfer-
ence depends on which of the various possible ways i t is
understood by the analyst. Everyone seems to agree that coun-
tertransference may act disruptively, and that the analyst has
the responsibility for remedying the situation. There is some
disagreement both about the extent to which countertransfer-
ence phenomena can convey useful information to the analyst
about the patient, and about the means by which this infor-
mation can be utilized by the analyst or by the patient. However,
it is difficult nowadays to find anyone who maintains the view
that countertransference is izever useful.
In the expanded version of countertransference, most an-
alysts appear to retain the original view and add to it with
varying degrees of emphasis. For example, countertransfercnce
is seen as an ongoing, inevitable, perhaps ubiquitous, and often
enough useful contribution to the analyst’s understanding of
the dynamic equilibrium of the psychoanalytic process, what

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266 KOBEKT L. TYSON

might be called the creative or instrumental use of the coun-

tertransference. As Kanzer (1979, p. 366) put it, “. . . to treat
it merely as a symptom of the analyst’s own problems may
inhibit his freedom to understand the patient.” It may even be
seen as equivalent to or as a significant part of the analyst’s
psychic reality. This idea bears a similarity to the well-known
shift in Freud’s attitude about the transference when he rec-
ognized that the patient’s feelings about him were not simply
an obstacle to the treatment, but an essential part of it.
Khan has been an articulate advocate of the views proposed
by Heimann and by Winnicott. He conceives of countertrans-
ference as “a clinical instrument of perception” (1964, p. 68),
and for “deciphering. . .[the] affectivity and archaic object-
relationships” of a silent patient (1963, p. 169), based on “the
conscious and total sensitivity of the analyst towards the patient”
(1960, p. 137)’ or on the “non-pathological capacity of the an-
alyst’s affectivity, intelligence, and imagination to comprehend
the total reality of the patient” (1969, p. 206). While this work
centers primarily on responses to deeply disturbed patients,
Tower’s (1956) similar and clearly presented position refers
primarily to the psychoanalysis of neurotics, as does Reich’s
(1 95 1, 1960) differing view.
Reich’s (1960)criticism of Heimann’s and Tower’s advocacy
of countertransference usefulness is based on the idea that
countertransference reactions result only from a block in the
analyst’s empathic understanding of the patient. While the an-
alyst’s self-analysis of this block may be helpful or even crucial
for analytic progress, Keich says, it is second best, roundabout
and incomplete. In addition, she cautions against giving ther-
apeutic weight to the analyst’s complementary identifications,
since “such interplay replaces recall of the past o r . . . its re-
construction” (p. 28 1).
Both Tower and Reich point out that at least some of the
reactions to which analysts are subject in the analytic setting
arise from defects in their perceptions or experience and thus
cannot be considered countertransference, a circumstance that

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 COUNTERTRANSFERENCE EVOLUTION 267

would obviously apply to work with any patient. Their points

of view would, however, allow for the patient to react in the
transference to such events, and subsequently for the analyst
to be affected countertransferentially, thereby setting up the
familiar scenario. Whatever the source of the countertransfer-
ence reaction, there is general agreement that the analyst is
obliged to respond to it in some way, a part of the required
“management” in the analytic situation (Tyson, 1985).
Among analysts in France, McDougall(l972,1978) has had
the greatest exposure outside that country. She takes the po-
sition that certain feelings in the analyst reflect responses to
what she terms primitive communication by the patient who
has suffered preverbal, severe deficiencies or traumata in the
course of maternal caregiving. McDougall describes her work
first to discern in herself these reactions, then to articulate and
thus to make available to such patients their preverbal and
presymbolic experiences. M’Uzan ( 1976) describes an interest-
ing reaction he experiences in himself on occasion in the course
of his analytic work, which he calls “paradoxical thinking.” The
mental events are relevant to the analytic process at the time,
but appear at first not directly connected, seem to come from
nowhere, and do not derive from anything personal. He pro-
poses a mechanism based on introjective identification, as if the
duration of the temporary, trial identifications described by
Fliess (1942) have been prolonged and the new mental contents
function as a kind of introject. Pontalis (1977), although he
writes in the personal, idiosyncratic way typical of French an-
alysts, as Lebovici and Widlocher (1980) point out, does make
useful distinctions between psychic phenomena in the analyst
relevant to the work as a whole, on the one hand, and different
levels of responses to the patient and his fantasies, on the other.
The sensitive and intuitive analyst’s use of his perceptions
of his countertransference responses as an indication of the
inner state of the patient, perhaps even of states of mind of
which the patient was never aware, sometimes has an almost
magical, if not occult quality. This is especially so when the

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268 ROBERT L. TYSON

analyst takes moments of his own feelings to represent a point-

for-point corresponding emotional condition in the patient
which first existed very early developmentally, and perhaps
only episodically since, and for which the analyst provides the
words for the first time. Even in such extreme instances, how-
ever, the creative utilization of one’s feelings emerging in the
context of the analytic relationship can have a lasting thera-
peutic impact on the patient, the basis for which exists in the
degree of “psychic fit,” as described by Kennedy (1971), rather
than the extent of historical veridicality such reconstructions
may have. Of course, all the dangers of suggestive influence
and of “wild” analysis (Freud, 1910b) need to be guarded
against, pitfalls that too often may be taken for granted or as
of little importance.
One offshoot of the step in countertransference concep-
tualization from obstacle to aid is the attempt to use one’s coun-
tertransference responses, to the extent they are conscious, as
a diagnostic tool (e.g., Kernberg, 1965). This use seems to be
limited to the treatment of the severely ill patient, a circum-
stance already referred to. In reading the literature on the
subject one can sometimes become confused about who is the
object of the diagnostic inquiry-the patient or the analyst.
Additional concerns about the diagnostic use of the counter-
transference entail the question of the limits and scope of such
an inquiry, and of what checks and balances exist. One may
also wonder whether there are any essential qualitative rather
than quantitative differences in countertransference that arise
in the treatment of patients of different dynamic constellations,
o r different diagnostic categories. Such an investigation into
validation would also require a comparison of countertransfer-
ence reactions among different analysts.
Another and more recent application of countertransfer-
ence as a research tool was described by Windholz and Skol-
nikoff (1985). In this investigative use of countertransference,
the analyst reports weekly on his daily work with a patient to
a listening but unresponding colleague, while also writing pe-

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 COUNTERTRANSFERENCE EVOLUTION 269

riodic summaries of his impressions of how the work is going

and his reactions to it. Later, comparisons are made between
the written reports and the information gathered by the lis-
tener. Discrepancies in the two reports reveal the analyst’s de-
viations from neutrality and other indications of counter-
transference. A third application is for the analyst to tell the
patient of his feelings about and reactions to the patient, the
idea being that such communication has therapeutic value,
given the proper indications (e.g., Little, 195 1; Gitelson, 1952;
Benedek, 1953). This is currently probably the most contro-
versial application of the expanded version of countertransfer-
ence and awaits definitive discussion.

The Impact of Countertransference on Transference: An

Illustration
A number of authors (Little, 1951; Nacht, 1965; Lampl-de
Groot, 1976; Blum, 1983) have stated that countertransference
events can influence the transference. The usual depiction of
this influence is from the analyst’s point of view. In the personal
vignette that follows, a countertransference-transference inter-
play is described which illustrates the details of such an influ-
ence from the patient’s point of view. In addition, it demonstrates
what may be called countertransference collusion, a situation
in which a piece of the analysand’s acting out, together with the
cooperation of a third party, is met by a complementary aspect
of the analyst’s countertransference (Poland [ 19841 has de-
scribed something similar as “collaborative ignorance”).
Well along in my training analysis, I began a session with
no unusual portent, but soon found my associations driven to
the theme of time. For about 20 minutes I dwelled on the
customary complaints that there was not enough time to do
what needed to be done, that training took so much time, that
the weekend should be longer, and other even more petty con-
cerns. There was no response from my analyst, of course. 1
gradually became aware of and voiced an unusual desire to look

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 I
270 ROBERT L. TYSON

at my watch. After some debate I gave in and looked, and I

gasped on seeing that it was one hour earlier than my session
was scheduled to be. I asked my analyst if his watch said the
same. He replied in the affirmative. I was shocked, anxiously
said that I should not be there, and got u p and left, saying I
would be back the next day.
Feeling considerably shaken, I stopped off at the nearby
office of a colleague (we all had offices in the same building)
who was in a training analysis with the same analyst. I told him
what had happened, and he replied that that time had been his
hour, but that he had seen me in the waiting room and thought
that he, I, and our analyst had arranged a time switch as we
had done once or twice before, but that he must have forgotten
about it. I said 1 knew nothing about that and excused myself.
The next day, feeling unusually angry, I went to my session at
the proper time, glowered at my analyst, and demanded to
know how he could have let me come in like that when he knew
it was not my time. He replied that he thought that he, I, and
my colleague had arranged a time switch as we had done once
or twice before, but felt he must have forgotten about it. I knew
then that he was experiencing what I understood to be a coun-
tertransference of some sort, but I also knew this did not relieve
me from investigating my contribution to it.

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Suifc 102
3252 Holiday Court
La Jolla, Calfoniia 92037

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