Little's paper begins with a clinical vignette designed apparently to illustrate, by means of an incorrect interpretation of a patient's behavior by an analyst, a type of mistake caused by a countertransference reaction. Subsequent to termination the patient, in a burst of insight, correctly interpreted not only his own behavior but also the analyst's countertransference.
The author then makes an attempt to define countertransference and raises the question of why this phenomenon is so rarely defined. She concludes that this is due largely to paranoid and phobic attitudes in the analyst toward his own feelings.
Quoting from Freud to the effect that technical progress was delayed by fear of interpreting the transference, Little wonders whether the same is not true of countertransference and suggests that we may find we have an equally valuable and indispensable tool in its correct use. The major theme of the paper is an attempt to establish the principle that correctly timed demonstrations of countertransference to the patient can 'have beneficial results, increasing the patient's confidence in the honesty and good will of the analyst, showing him to be
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human enough to make mistakes and making clear the universality of the phenomenon of transference'. In another place she states: 'In my view a time comes in the course of every analysis when it is essential for the patient to recognize the existence not only of the analyst's objective or justified feelings, but also of the analyst's subjective feelings'. This Little feels belongs in the later stages of an analysis. 'Without it, patients may fail to recognize objectively much of the irrational parental behavior which has been so powerful a factor in the development of the neurosis… It brings great relief to a patient to find that irrational behavior on the part of his parents was not intended for him personally, but was already transferred from their parents, and to find his analyst doing the same kind of thing in minor ways can give conviction to his understanding and make the whole process more tolerable to him…'.
It is of some interest to compare this statement with the formulation of Alexander and French who feel that the analyst should behave in exactly the opposite manner to that of the parents and thus provide the patient with a 'corrective emotional experience'.
Both these antithetical technical recommendations invade the still embattled arena of so-called 'active therapy'. The technical recommendation that countertransference reactions be demonstrated to the patient carries with it the danger of providing a rationalized method for acting out irrational impulses with or on the patient. Thus while such a device could perhaps be useful in the hands of a skilled and experienced analyst, it is certainly not one to be recommended to students.
The paper is a rambling one containing some remarkably stimulating and original concepts—for example, a formulation of 'working through'. There are also statements which seem positively naïve, e.g., a new edition of the fundamental rule which 'allows them [patients] to speak or withhold freely'. Also naïve is the implicit belief that if the analyst reveals his 'secrets', the patient will somehow 'take heart' and expose his own.
One technical recommendation in the paper calls urgently for a strong dissent: '… a good many … transference interpretations … are capable of extension to demonstrate the possibility of countertransference, for instance: "You feel that I am angry as your mother was …" can include "I'm not angry as far as I know, but I'll have to find out about it and, if I am, to know why…".' It seems to this reviewer that this technique emasculates the interpretation by casting doubt upon its validity, thus lending ammunition to resistance. If there is any likelihood that the analyst's behavior did provoke the patient's response, the transferenceinterpretation should be withheld for a more propitious time. It has been said that the major function of a training analysis is to enable the analyst to deal effectively with his countertransference reactions so that they will not intrude into and interfere with his analytic work.
Finally, although this paper is entitled Countertransference and the Patient's Response to It, it actually deals with the theory of countertransference. It seems obvious that no real contribution to the study of countertransference is possible without publication of detailed clinical investigations of the natural history of countertransference reactions in the course of individual analyses. This in turn hinges on increased willingness among psychoanalysts to publish
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such studies of their own responses. An alternative method is the analytic study of countertransference problems of students in training, or of analysts undergoing further analysis. Only when such studies become available will it be possible to decide whether countertransference reactions are utilizable as interpretations.
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Rubinfine, D.L. (1952). International Journal of Psychoanalysis. XXXII, 1951. Psychoanal. Q., 21:577-579