Associations between Countertransference and Patient Characteristics in Psychoanalytic Psychotherapy
DOI:
https://doi.org/10.21615/cesp.13.3.10Keywords:
Psychotherapy, Psychodynamic Psychotherapy, Patient Characteristics, Countertransference, Therapist Emotional ResponseAbstract
Objective: Objective: to explore therapists' countertransference reactions in the initial phase of psychoanalytic psychotherapy (between sessions 4 and 5) and to verify possible associations between these and the patient's personal characteristics (sociodemographic, psychological, and psychopathological). Method: naturalistic, cross-sectional, correlational, and observational study with a descriptive-analytical approach. The sample consists of 180 patient-therapist dyads, of which 180 were adult patients (32.82 ± 12.66 years old) and 48 therapists (32.69 ± 10.01 years old). Results: countertransference is affected by the patient's age, psychological aspects of his or her previous life (traumas and parental attachment) and elements of personality (empathetic skills and defensive mechanisms), but not by the showed symptoms. Conclusions: the findings support the scientific literature, which points to the relevance of childhood experiences and personality characteristics of the patient to evoke specific countertransference patterns in the therapist. Understanding such relationships can help clinicians identify their own reactions and deliver the therapy, as appropriate.
Downloads
References
Barros, A. J. S., Teche, S. P., Padoan, C., Laskoski, P. B., Hauck, S., & Eizirik, C. L. (2020). Countertransference, Defense Mechanisms, and Vicarious Trauma in Work with Sexual Offenders, Journal of the American Academy of Psychiatry and the Law Online, 48(3). https://doi.org/10.29158/JAAPL.003925-20
Bacal, H. A. (2017). Más allá de la transferencia y la contratransferencia: la especificidad diádica del proceso psicoanalítico. Clínica e Investigación Relacional, 11(2), 246- 257.
Barreto, J. F., Nata, G., & Matos, P. M. (2020). Elaboration of countertransference experience and the workings of the working alliance. Psychotherapy, 57(2), 141–150. https://doi.org/10.1037/pst0000250
Behn, A., Davanzo, A., & Errázuriz, P. (2018). Client and therapist match on gender, age, and income: Does match within the therapeutic dyad predict early growth in the therapeutic alliance? Journal of Clinical Psychology, 74, 1403– 1421. https://doi.org/10.1002/jclp.22616
Bergeret, J. (2000). A personalidade normal e patológica. (3a ed). Lisboa: Climepsi.
Bernstein, D. P., Ahluvalia, T., Pogge, D., & Handelsman, L. (1997). Validity of the Childhood Trauma Questionnaire in an adolescent psychiatric population. Journal of the American Academy of Child and Adolescent Psychiatry, 36(3), 340-8. https://doi.org/10.1097/00004583-199703000-00012
Blaya, C. (2005). Tradução, adaptação e validação do Defensive Style Questionnaire (DSQ-40) para o português brasileiro. Dissertação de mestrado, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre.
Breivik, R., Wilberg, T., Evensen, J., Røssberg, J. I., Dahl, H. S. J., & Pedersen, G. (2020). Countertransference feelings and personality disorders: A psychometric evaluation of a brief Psychotherapy Research 11 version of the Feeling Word Checklist (FWC-BV). BMC Psychiatry, 20(1). https://doi.org/10.1186/s12888-020-02556-6
Brody, F., & Farber, B. (1996). The effects of therapist experience and patient diagnosis on countertransference. Psychotherapy: Theory, Research, Practice and Training, 33(3), 372-80. https://doi.org/10.1037/0033-3204.33.3.372
Canavarro, M. C. (1999). Inventário de Sintomas Psicopatológicos: BSI. In M. R. Simões, M. Gonçalves, & L. S. Almeida (Eds.). Testes e provas psicológicas em Portugal, 2, (pp. 87-109). Braga: SHO/APPORT.
Cartwright, C., Rhodes, P., King, R., & Shires, A. (2014). Experiences of Countertransference: Reports of Clinical Psychology Students. Australian Psychologist, 49(4), 232–240. https://doi.org/10.1111/ap.12062
Chartonas, D., Kyratsous, M., Dracass, S., Lee, T., & Bhui, K. (2017). Personality disorder: Still the patients psychiatrists dislike? BJ. Psych Bulletin, 41(1), 12–17. https://doi.org/10.1192/pb.bp.115.052456
Colli, A., Tanzilli, A., Dimaggio, G., & Lingiardi, V. (2014). Patient Personality and therapist response: An empirical investigation. American Journal of Psychiatry, 171(1), 102-8. https://doi.org/10.1176/app1.ajp.2013.13020224
Colli, A., & Ferri, M. (2015). Patient personality and therapist countertransference, Current Opinion in Psychiatry, 28(1), 46-56. https://doi.org/10.1097/YCO.0000000000000119
Cowan, A., Ashai, A., & Gentile, P. J. (2020). Psychotherapy with Survivors of Sexual Abuse and Assault. Innov Clin Neurosci, 17(1-3), 22–26.
Dahl, H-S. J., Røssberg, J. I., Bogwald, K. P., Gabbard, G. O., & Hoglend, P. A. (2012). Countertransference feelings in one year of individual therapy: An evaluation of the factor structure in the Feeling Word Checklist-58. Psychotherapy Research. 22(1), 12-25. https://doi.org/10.1080/10503307.2011.622312
Daurella, N. (2018). Transferencia y contratransferencia desde la perspectiva del psicoanálisis relacional: a la búsqueda de la responsividad óptima. Revista Internacional Psicoanalítica Aperturas, 59(27), 1-21.
Davis, M. H. (1983). Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology. 44(1), 113-26. https://doi.org/10.1037/0022-3514.44.1.113
Dazinger, P. R., & Welfel, E. R. (2000). Age, gender, and health bias in counselors: An empirical analysis. Journal of Mental Health Counseling, 22, 135-49.
Derogatis, L. R., & Melisaratos, N. (1983). The brief symptom inventory: An introductory report. Psychological Medicine, 13(3), 595-605. https://doi.org/10.1017/S0033291700048017
Dewald, P. (1989). Psicoterapia: Uma abordagem dinâmica. Porto Alegre: Artes Médicas.
Eizirik, C. L. (1997). Rede social, estado mental e contratransferência: Estudo de uma amostra de velhos da região urbana de Porto Alegre [tese]. Porto Alegre: Universidade Federal do Rio Grande do Sul.
Eizirik, M., Schestastky, S., Kruel, L., & Ceitlin, L. H. F. (2011). Countertransference in the initial visit of women victims of sexual violence. Revista Brasileira de Psiquiatria, 33(1), 16-22. https://doi.org/10.1590/S1516-44462010005000019
Eizirik, C. L., Aguiar, R. W., & Schestatsky. S. (2015). Psicoterapia de orientação analítica: Fundamentos teóricos e clínicos. Porto Alegre: Artmed.
Fontelles, M. J., Simões, M. G., Farias, S. H., & Fontelles, R. G. S. (2009). Metodologia da pesquisa científica: Diretrizes para a elaboração de um protocolo de pesquisa. Trabalho realizado no Núcleo de Bioestatística Aplicado à Pesquisa da Universidade da Amazônia – UNAMA.
Formiga, N. S., Rocha, M. C. O., Pinto, A. D. S. S., Reis, D. A. D., Costa, S. M. D. S., & Leime, J. (2013). Fidedignidade da estrutura fatorial da Escala Multidimensional de Reatividade Interpessoal (EMRI). Estudos Interdisciplinares em Psicologia, 4(1), 64-79.
Freud, S. (2006). As perspectivas futuras da terapia psicanalítica. In: Edição Standard Brasileira das Obras Psicológicas Completas de Sigmund Freud. Rio de Janeiro: Imago, 11. (Original publicado em 1910).
Gabbard, G. O. (2016). Psiquiatria Psicodinâmica na prática clínica (5a Ed.). Porto Alegre: Artmed.
Geiser, F., Schulz-Werner, A., Imbierowicz, K., Conrad, R., & Liedtke, R. (2003). Impact of the turning-against-self defense mechanism on the process and outcome of inpatient psychotherapy. Psychotherapy Research, 13(3), 355-370. https://doi.org/10.1093/ptr/kpg033
Genova, F., & Gazzillo, F. (2018). Personality Organization, Personality Styles, and the Emotional Reactions of Treating Clinicians. Psychodynamic Psychiatry, 46(3), 357–392. https://doi.org/10.1521/pdps.2018.46.3.357
Goldfeld, P. R. M., Terra, L., Abuchaim, C., Sordi, A. O., Wiethaeuper, D., Bouchard, M. A., … Ceitlin, L. H. F. (2008). Mental states as part of countertransference responses in psychotherapists facing reports of traumatic events of mourning and sexual violence. Psychotherapy Research, 18(5), 523-34. https://doi.org/10.1080/10503300801968640
Grassi-Oliveira, R., Stein, L. M., & Pezzi, J. C. (2006). Tradução e validação de conteúdo da versão em português do Childhood Trauma Questionnaire. Revista de Saúde Pública, 40(2), 249-55.
Greenberg, J., & Mitchell, S. (2003). Relações de objeto na teoria psicanalítica. Lisboa: Climepsi Editores. (Obra original publicada em 1983)
Grudtner, R. R. (2009). Estudo da contratransferência e sua associação com características do paciente em psicoterapia analítica. Dissertação de mestrado, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre.
Gullestad, S. E., & Killingmo, B. (2020). The theory and practice of psychoanalytic therapy. Listening for the subtext (pp. 128). Routledge.
Hauck, S., Schestatsky, S., Terra, L., Knijnik, P., Sanchez, P., & Ceitlin, L. H. F. (2006). Adaptação transcultural para o português brasileiro do Parental Bonding Instrument (PBI). Revista de Psiquiatria do Rio Grande do Sul, 28(2), 162-8. https://doi.org/10.1590/S0101-81082006000200008
Hayes, J. A., Gelso, C. J., Goldberg, S., & Kivlighan, D. M. (2018). Countertransference management and effective psychotherapy: Meta-analytic findings. Psychotherapy, 55(4), 496–507.
Hoffart, A., & Friis, S. (2000). Therapists' emotional reactions to anxious inpatients during integrated behavioral-psychodynamic treatment: A psychometric evaluation of a feeling word checklist. Psychotherapy Research 10(4), 462-73. https://doi.org/10.1093/ptr/10.4.462
Holmes, J. (2014). Countertransference Before Heimann. Journal of the American Psychoanalytic Association, 62(4), 603–629. https://doi.org/10.1177/0003065114546164
Holmqvist, R., Hansjons-Gustafsson, U., & Gustafsson, J. (2002). Patients’ relationship episodes and therapists’ feelings. Psychology and Psychotherapy, 75, 393-409.
Ivey, D. C., Wieling, E., & Harris, S. M. (2000). Save the young the elderly have lived their lives: Ageism in marriage and family therapy. Family Process, 39, 163-75.
Jimenez, J. P., & Altimir, C. (2019). Beyond the hermeneutic/scientific controversy: A case for a clinically sensitive empirical research paradigm in psychoanalysis. The International Journal of Psychoanalysis, 100(5), 940–961. https://doi.org/10.1080/00207578.2019.1636253
Jordão, A. B., & Ramires, V. R. R. (2010). Vínculos afetivos de adolescents borderline e seus pais. Psicologia: Teoria e pesquisa, 26(1), 89-98.
Kächele, H., Erhardt, I., Seybert, C., & Buchholz, M. B. (2015). Countertransference as object of empirical research? International Forum of Psychoanalysis, 24(2), 96–108. https://doi.org/10.1080/0803706X.2012.737933
Latts, M. G., & Gelso, C. J. (1995). Countertransference behavior and management with survivors of sexual assault. Psychotherapy: Theory, Research, Practice and Training, 32(3), 405¬15.
Liebman, R. E., & Burnette, M. (2013). It’s Not You, It’s Me: An Examination of Clinician-and Client-Level Influences on Countertransference Toward Borderline Personality Disorder. American Journal of Orthopsychiatry, 83(1), 115-25.
Lingiardi, V., Tanzilli, A., & Colli, A. (2015). Does the severity of psychopathological symptons mediate the relantionship between patient personality and therapist response? Psychotherapy, 52(2), 228-37. https://doi.org/10.1037/a0037919
Lins, T., & Alvarenga, P. (2015). Controle Psicológico Materno e Problemas Internalizantes em Pré-Escolares Psicologia: Teoria e Pesquisa, 31(3), 311-319. https://doi.org/10.1590/0102-37722015032092311319
Machado, D. de B., Teche, S. P., Lapolli, C., Tavares, B. F., Almeida, L. S. P., Silva., G. B., ... Eizirik, C. L. (2015). Countertransference and therapeutic alliance in the early stage of adult psychodynamic psychotherapy. Trends in Psychiatry and Psychotherapy, 37(3), 133-42.
McIntyre, S. M., & Schwartz, R. C. (1998). Therapists’ differential countertransference reactions toward clients with major depression or borderline personality disorder. Journal of Clinical Psychology, 54(7), 923-31.
McLaughlin, K. A. (2016). Future directions in childhood adversity and youth psychopathology. Journal of Clinical Child & Adolescent Psychology, 45(3), 361-382. https://doi.org/10.1080/15374416.2015.1110823
Michaud, L., Ligier, F., Bourquin, C., Corbeil, S., Saraga, M., Stiefel, F., … Richard-Devantoy, S. (2020). Differences and similarities in instant countertransference towards patients with suicidal ideation and personality disorders. Journal of Affective Disorder, 265, 669-678. https://doi.org/10.1016/j.jad.2019.11.115
Moller, R. L., Serralta, F. B., Bittencourt, A. A., & Benetti, S. P. da C. (2018). Manifestações contratransferenciais no processo terapêutico de uma paciente com personalidade borderline. Psico-USF, 23(4), 705-17. https://doi.org/10.1590/1413- 82712018230410
Nissen-Lie, H. A., Dahl, H.-S. J., & Høglend, P. A. (2020). Patient factors predict therapists’ emotional countertransference differently depending on whether therapists use transference work in psychodynamic therapy. Psychotherapy Research, 1–13. https://doi.org/10.1080/10503307.2020.1762947
Parker, G., Tupling, H., & Brown, L. B. (1979). A parental bonding instrument. British Journal of Medical Psychology, 52(1), 1-10. https://doi.org/10.1111/j.2044-8341.1979.tb02487.x
Plotkin, F. (2000). Treatment of the Older Adult: The Impact On the Psychoanalyst. Journal of the American Psychoanalytic Association, 48(4), 1591–1616. https://doi.org/10.1177/00030651000480042001
Prasko, J., Diveky, T., Grambal, A., Kamaradova, D., Mozny, P., Sigmundova, Z., … Vyskocilova, J. (2010). Transference and countertransference in cognitive behavioral therapy. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 154(3), 189-97.
Putrino, N., Casari, L., Mesurado, B., & Etchevers, M. (2019). Psychotherapists’ emotional and physiological reactions toward patients with either borderline personality disorder or depression. Psychotherapy Research. https://doi.org/10.1080/10503307.2019.1690176
Queirós, M., & Caseiro, J (2018). Child maltreatment and mental disorders: the role of epigenetics. Nascer e Crescer [online]. 27(3), 166-175. https://doi.org/10.25753/BirthGrowthMJ.v27.i3.13431
Røssberg, J. I., Karterud, S., Pedersen, G., & Friis, S. (2010). Psychiatric symptoms and countertransference feelings: An empirical investigation. Psychotherapy Research, 178(1), 191-5. https://doi.org/10.1016/j.psychres.2009.09.019
Sampaio, L. R., Guimarães, P. R. B., Camino, C. P. S, Formiga, N. S., & Menezes, I. G. (2011). Estudos sobre a dimensionalidade da empatia: Tradução e adaptação do Interpersonal Reactivity Index (IRI). Psico, 42(1), 67-76.
Schwartz, R. C., & Wendling, H. M. (2003). Countertransference reactions toward specific client populations: A review of empirical literature. Psychological Reports, 92(2), 651-4. https://doi.org/10.2466/pr0.2003.92.2.651
Schwartz, R. C., Smith, S. D., & Chopko, B. (2007). Psychotherapists’ countertransference reactions toward clients with antisocial personality disorder and schizophrenia: An empirical test of theory. American Journal of Psychotherapy, 61(4), 375-93. https://doi.org/10.1176/appi.psychotherapy.2007.61.4.375
Serralta, F.B., & Streb, L.G. (2002). Notas sobre pesquisa em psicoterapia psicanalítica: situação atual e perspectivas. Revista Brasileira de Psicoterapia, 5(1), 53-65.
Silveira Jr, E. De M. (2010). Validação da escala para avaliação da contratransferência (EACT) no atendimento psiquiátrico inicial de vítimas de traumas psíquicos. Dissertação de mestrado não publicada, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre.
Silveira Jr, E. De M., Polanczy, G. V., Hauck, S., Eizirik, C. L., & Ceitlin, L. H. F. (2011). Can countertransference at the early stage of trauma care predict patient dropout of psychiatric treatment? Revista Brasileira de Psiquiatria, 33(4), 379-84. https://doi.org/10.1590/S1516-44462011000400012
Tabina, K. C., Kendall, C. J., Garret. R. K., & Stagner, B. H. (2020). Considering psychodynamic therapy for older adults. Psychodynamic Psychiatry, 48(2), 152–162. https://doi.org/10.1521/pdps.2020.48.2.152
Tanzilli, A., Muzi, L., Ronningstam, E., & Lingiardi, V. (2017). Countertransference when working with narcissistic personality disorder: An empirical investigation. Psychotherapy, 54(2), 184– 194. https://doi.org/10.1037/pst0000111
Vedel, A., Larsen, L., & Aamand, A. (2020). The Efficacy of Individual Psychological Interventions with Non-Clinical Older Adults: A Systematic Review. European Psychologist, 25, 200-210. https://doi.org/10.1027/1016-9040/a000410
Westerling, T. W. III, Drinkwater, R., Laws, H., Stevens, H., Ortega, S., Goodman, D., … Drill, R. L. (2019). Patient attachment and therapist countertransference in psychodynamic psychotherapy. Psychoanalytic Psychology, 36(1), 73-81. https://doi.org/10.1037/pap0000215
Williams, E. N., Judge, A. B., Hill, C. E., & Hoffman, M. A. (1997). Experiences of novice therapists in prepracticum: Trainees’, clients’, and supervisors’ perceptions of therapists’ personal reactions and management strategies. Journal of Counseling Psychology, 44, 390-9.
Zaslavsky, J., & dos Santos, M. J. P. (2006). Contratransferência: Teoria e prática clínica. Porto Alegre: Artmed.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 CES Psicología

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Each manuscript is accompanied by a statement specifyingThat the materials are unpublished, that have not been previously published in printed formatElectronic and that they will not be presented to any other means before knowing the decision of the magazine. ThroughoutIn case, any previous publication, sea in printed or electronic form, must be made known to the editorial staffWriting The authors attach a signed statement stating that, and the manuscript is acceptedFor publication, the rights of reproduction are the exclusive property of the Journal CES Psychology.Article metrics | |
---|---|
Abstract views | |
Galley vies | |
PDF Views | |
HTML views | |
Other views |