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Aviv, A. Springmann, R.R. (1990). Negative Countertransference and Negative Therapeutic Reaction:—Prognostic Indicators in the Analysis of Severe Psychopathology. Contemp. Psychoanal., 26:692-715.

(1990). Contemporary Psychoanalysis, 26:692-715

Negative Countertransference and Negative Therapeutic Reaction:—Prognostic Indicators in the Analysis of Severe Psychopathology

Alex Aviv, M.D. and Rafael R. Springmann, M.D.

THE NEED TO PREDICT the chances for a successful outcome, at the outset of a psychoanalytic or psychotherapeutic undertaking, has been discussed many times in the professional literature from both theoretical and practical aspects. Many authors have attempted to identify prognostic indicators that might serve as the "writing on the wall". Among these, Woolcott (1985) has recently listed twenty-five features, regarded as significant (negative) prognostic indicators in the psychotherapy of borderline patients.

In the present paper it is our intention to take issue with two items that rank high in Woolcott's paper as predictors of negative therapeutic outcome, namely negative countertransference and negative therapeutic reactions. We have opted to regard these "negative" phenomena from a perspective that differs slightly from the one in traditional psychoanalytic literature.

Some problems pertaining to countertransference and their possible solutions have been discussed at length by one of us in two recent papers (Springmann, 1986), (1988). We shall, accordingly, delimit ourselves here to a brief summary of our views in this field, corroborated by one clinical vignette and dedicate the bulk of this work to a somewhat more detailed discussion of Negative Therapeutic Reactions.

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