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THE ANALYTIC SPACE: COUNTERTRANSFERENCE AND EVOCATIVE KNOWLEDGE

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      Robert M. Young - Online Archive


      THE ANALYTIC SPACE: COUNTERTRANSFERENCE AND EVOCATIVE KNOWLEDGE

      by Robert M. Young

      The analytic space is the mental space within which psychoanalysis
      and psychotherapy occur. It is a space shared between patient and
      therapist. In this essay I shall characterize the two main processes
      which occur in the analytic space — transference and
      countertransference — and, while doing so, offer some philosophical
      reflections on the relations between psychoanalysis and the modern
      world view. I wish to begin with an important distinction — that
      between didactic and evocative knowledge. Didactic knowledge is
      imparted, while evocative knowledge is elicited.

      Everything with which I am concerned in this essay comes from what
      may at first glance appear to be a relatively trivial technical
      problem in psychoanalysis. I wish to argue, however, that it leads to
      the very heart of the analytic process and, beyond that, to our
      conception of human nature and how we may fruitfully think about how
      we come to know — the theory of knowing or epistemology. This is a
      considerable weight to place on the concept of countertransference,
      but I shall try to argue that it can bear it. My story has a nicely
      linear plot, taking us from the simple to the complex and on to the
      interactive and the dialectical.

      I want to start with the traditional stance of the therapist in the
      analytic session — that of neutrality, holding up a mirror to the
      patient. But in offering the image of a mirror Freud did not mean
      that one should not be human (Freud, 1912a, p. 118). He was not
      urging the theraspist to be inanimate glass and silver nitrate; he
      was saying that one should not tell about oneself. There was a
      tendency among the early psychoanalysts to be self-revealing. The
      mirror was an image in the service of the rule of abstinence: speak
      to the patient only about himself or herself and about characters who
      inhabit the patient's inner world.

      Before turning to countertransference, we must consider transference.
      Freud said, 'What are transferences? They are the new editions or
      facsimilies of the impulses and phantasies which are aroused and made
      conscious during the progress of the analysis; but they have this
      peculiarity, which is characteristic for their species, that they
      replace some earlier person by the person of the physician. To put it
      another way: a whole series of psychological experiences are revived,
      not as belonging to the past, but as applying to the person of the
      physician at the present moment' (Freud, 1905, p. 116). In a way,
      then, transference is a mistake, and, as Freud was to learn, the
      analytic process is based on this mistake — that the patient
      experiences the analyst as someone else. The patient, according to
      Racker, '"displaces" or "transfers" infantile and internal conflicts
      to current situations and objects which are out of place and
      inappropriate' (Racker, 1968, p. 15).

      A transference interpretation is basically pointing this out to the
      patient. Fenichel said, 'The process that requires demonstrating to
      patients the same thing again and again at different times or in
      various connections, is called, following Freud, "working through...
      Again and again the patient must in analysis reexperience 'there too'
      and 'there again'"'(Fenichel, 1941, pp. 78-80, quoted in Searles,
      1978-9, p. 176). Fenichel's view of the task in working through is
      this: 'An analyst giving a transference interpretaion says,
      schematically: "It is not I toward whom your feelings are directed;
      you really mean your father." But there are many patients who know
      about transference and defend themselves against emerging emotional
      excitement by referring to its transference nature. In such instances
      the "reversed transference interpretation" is necessary; "You are
      aroused at this moment not about your father but about me"'
      (Fenichel, 1945, p. 522, quoted in Searles, l978-9, p. 176).

      All of this seems relatively straightforward, even mechanical. The
      concept of transference became increasingly enriched, however, so
      that it was eventually perceived that what is transferred is the
      total situation, a relationship or objects in a context, and not
      merely an individual. Moreover, the objects transferred are not
      external ones but internal objects (Joseph, l989). As a consequence,
      ideas of the transference became broadened into a wider context and
      deepened into the object relations of the inner world.

      Turning to countertransference, you may think of it as an arcane
      topic; it is certainly an unwieldy word, one which conjures up the
      most abstract of latter-day metapsychological conceptualisations. In
      fact, it arose very early and was very immediate: it is why Freud's
      first collaborator, Joseph Breuer, gave up. He ran away from Anna O
      because she aroused him. If transference is projection,
      countertransference is projective identification — something elicited
      by the patient in the therapist: evocative knowledge. Anna O elicited
      in Breuer a sexual excitement which he found unacceptable and was
      unbearable to himself and his wife, so he abandoned the work (Gay,
      1988, pp. 63-9).

      For Freud the transference went from being an annoying interference
      to an instrument of great value to the main battlefield of the
      analysis. An analogous story can be told about the
      countertransference, but it is a story with profound implications.
      Now, to define countertransference. Freud rarely discussed the topic;
      he saw countertransference as the patient's influence on the
      analyst's unconscious. He said that no analyst could go farther than
      he or she had progressed in their own analysis, so the analyst's
      analysis was all-important. He first mentions the concept in
      1910: 'We have become aware of the "countertransference", which
      arises in [the analyst] as a result of the the patient's influece on
      his unconscious feelings, and we are almost inclined to insist that
      he shall recognize this countertransference in himself and overcome
      it. Now that a considerable number of people are practicing
      psychoanalysis and exchanging their observations with one another, we
      have noticed that no psychoanalyst goes further than his own
      complexes and internal resistances permit; and we consequently
      require that he shall begin his activity with a self-analysis and
      continually carry it deeper while he is making his own observations
      on his patients. Anyone who fails to produce results in a self-
      analysis of this kind may at once give up any idea of being able to
      treat patients by analysis' (Freud, 1910, pp. 144-5). (Later, of
      course, Freud also insisted on a training analysis conducted by a
      suitable analyst.)

      It is often thought that Freud held a limited view of
      countertransference, and he certainly had little to say on the topic.
      Even so, I would argue that the following quotation, properly
      contemplated and making due allowance for the technological imagery
      of his day, contains all we need to know: 'To put it into a formula:
      [the analyst] must turn his own unconscious like a receptive organ
      toward the transmitting unconscious of the patient. He must adjust
      himself to the patient as a telephone receiver is adjusted to the
      transmitting microphone. Just as the receiver converts back into
      sound waves the electric oscillations in the telephone line which
      were set up by sound waves, so the doctor's unconscious is able, from
      the derivatives of the unconscious which are communicated to him, to
      reconstruct that unconscious, which has determined the patient's free
      associations' (Freud, 1912, pp. 115-6). This quotation takes us much
      deeper; it is much more resonant and in touch with primitive
      processes than the previous one, even though it was penned only two
      years later.

      With respect to the subsequent history of ideas about
      countertransference, Laplanche and Pontalis trace three successive
      positions on the subject: (1) Get rid of it by means of one's own
      analysis, and concentrate on the patient's transference. (2) Exploit
      it in a controlled way, using the therapist's unconscious as an
      instrument for fathoming the patient's unconscious. (3) Go with it,
      treating the resonances from unconscious to unconscious as the only
      authentically psychoanalytic form of communication (Laplanche and
      Pontalis, 1983, pp. 92-3).

      Before embarking on that history, I want to say something about
      projective identification, since we will need this concept as we go
      along. I want to point out a congruence between projective
      identification and countertransference. In the countertransference
      relationship, the patient puts something into the therapist which the
      therapist experiences as his or her own. That's not a bad definition
      of one of the forms of projective identification, in which the
      patient splits off an unaccceptable or undesirable part of the self
      and puts it into another person. That person must have, if only to a
      degree, the potential to identify with and express that feeling. It
      rises up from the general repetoire of potential feelings and gets
      exaggerated and expressed. The projector can then feel: 'It's not me;
      it's him', while the identificatory process in the recipient may
      yield a bewildering feeling, reaction or act (Hinshelwood, 1989, pp.
      179-208). In an attentive therapist it can lead to a fruitful
      interpretation.

      We can now see this congruence in action, in a passage where Freud is
      quite explicit about a concept usually seen as originating with
      Klein. He is talking about the projections of jealous and persecuted
      paranoiacs, of whom it it said that they project onto others that
      which they do not wish to recognize in themselves. He
      continues, 'Certainly they do this; but they do not project it into
      the blue, so to speak, where there is nothing of the sort already.
      They let themselves be guided by their knowledge of the unconscious,
      and displace to the unconscious minds of others the attention which
      they have withdrawn from their own. Our jealous husband perceived his
      wife's unfaithfulness instead of his own; by becoming conscious of
      hers and magnifying it enormously he succeeded in keeping his own
      unconscious' (Freud, 1922, p. 226).

      Fenichel writes in the same vein: 'It is interesting to note that the
      hatred is never projected at random but is felt usually in connection
      with something that has a basis in reality. Patients with persecutory
      ideas are extremely sensitive to criticism and use the awareness of
      actual insignificant criticisms as the reality basis for their
      delusions. This basis has, of course, to be extremely exaggerated and
      distorted in order to be made available for this purpose... The
      paranoid individual is particularly sensitized to perceive the
      unconscious of others, where such perceptions can be utilized to
      rationalize his tendency toward projection' (Fenichel, 1945, p. 428,
      quoted in Searles, 1978-9, p. 177).

      Anyone who has ever worked in a mental hospital will recognize this
      instantly. Paranoid patients are geniuses at getting under the skin
      and ferreting out latent tendencies in others, especially staff. But,
      of course, this is only a relatively apparent exaggeration of the
      norm, as any of us can attest from our experiences of how much can
      get tangled up in a moment during telephone calls with prospective
      patients, and in relations with lovers or one's own children.
      Projection, introjection, exaggeration, reprojection — these are
      norms of social interactions. It is all a matter of degree.
      Nevertheless, as in the rest of life, everything can depend on
      matters of degree. Projective identification is a normal mechanism,
      but when employed excessively or virulently, it lies at the heart of
      paranoid processes, racism, narcissism, and innumerable other
      pathological conditions (see Young, 1994, chs. 6,7). When employed
      excessively, it is central to pathological conformism and ruthless
      ambition and acts as a defence against schizophrenic breakdown
      (Meltzer, 1992). Relinquishing its excessive use is essential to
      becoming a decent person.

      There is a rich history of ideas of countertransference, some phases
      of which I will not spell out, except to list familiar names, since
      the relevant papers are competently reviewed in a collection edited
      by by Edmund Slakter (1987): Stern (1924); Deutsch (1926); Glover
      (1927); Sharpe (1930); Hann-Kende (1933); W. Reich (1933); Strachey
      (1934); Low (l935). There are other overviews, for example, by Kohon
      (l986) and Orr (l988), a collection of Essential Papers on
      Countertransference (Wolstein, 1988) and a growing number of
      monographs and papers, which has brought forth the inevitable: Beyond
      Countertransference (Natterson, 1991).

      I want to begin my own story of recent work with a paper by
      Winnicott, startlingly entitled 'Hate in the Countertrans-ference'
      (1947). I am re-entering the history of ideas at the point where the
      transition is occurring between countertransference as 'that which is
      to be got rid of', to 'that which is to be made something of' or
      exploited. Winnicott said that to feel hate, when it has been
      projected into you and evoked by the patient, is part of the
      therapist's proper responsiveness. When the patient seeks the
      therapist's hate, the therapist must be able to make contact with it,
      to bear it without retaliating and to contain it; otherwise the
      analysis fails.

      Two years after Winnicott made this point, Paula Heimann took up the
      topic and began with the traditional view: 'I have been struck by the
      widespread belief amongst candidates that the countertransference is
      nothing but a source of trouble' (Heimann, l949-50, p. 73). She takes
      a contrary position: 'My thesis is that the analyst's emotional
      response to his patient within the analytic situation represents one
      of the most important tools for his work. The analyst's
      countertransference is an instrument of research into the patient's
      unconscious' (p. 74). 'Our basic assumption is that the analyst's
      unconscious understands that of his patient' (p. 75). She claims
      that 'the analyst's countertransference is not only part and parcel
      of the analytic relationship, but it is the patient's creation, it is
      a part of the patient's personality' (p. 77).

      Winnicott was writing about psychotics and borderline personalities;
      Heimann extended the point to include work with all patients.
      However, when she returns to the topic a decade later, she reflects
      at length on how to handle countertransferential material and takes
      up a cautious position, eschewing self-revelation. But in her
      conclusion, she reverts to the early view of Freud. In so doing, it
      seems to me, she fails to see the larger potential of the concept.
      She says, in her last paragraph, 'In conclusion, Freud's injunction
      that the countertransference must be recognized and overcome is as
      valid today as it was fifty years ago. When it occurs, it must be
      turned to some useful purpose. Continued self-analysis and self-
      training will help to decrease incidents of countertransference' (p.
      160). For her, countertransference was still a hot potato - something
      to learn from when it occurs but preferably to be got rid of.

      Another writer in this period, Roger Money Kyrle, takes up a position
      that acknowledges that countertransference can be both useful and a
      serious impediment. As his title implies, countertransference was
      coming to be seen as a normal part of the analytic process: 'Normal
      Counter-transference and Some of its Deviations'. He draws our
      attention to the fine texture of the process, whereby something is
      put into the analyst, re-projected in an interpretation and then
      taken in by the patient. If the receiving parts of the analyst are
      intact, what gets reprojected is likely to be helpful, but if the
      projection falls afoul of unresolved issues in the analyst's
      unconscious, a mess can be created. Everyone would be happy
      if 'normal countertransference' was all there was. 'Unfortunately, it
      is normal only in the sense of being an ideal. It depends for its
      continuity on the analyst's continuous understanding. But he is not
      omniscient. In particular, his understanding fails whenever the
      patient corresponds too closely with some aspect of himself which he
      has not yet learnt to understand' (Money-Kyrle, 1956, p. 24).

      In such cases, what ensues is a reprojection of something which is
      not helpful, not congruent with the patient's analytic needs. The
      analyst may recover then or in the next session, but the patient is
      not simply waiting for him to get it right. He or she may well have
      moved on and be relating to the analyst as a damaged object as a
      result of the distorted interpretation. The result will take some
      sorting out. What is attractive about Money-Kyrle's reflections is
      the light they shed on the process — the minute details — of these
      interrelations.

      A sense that countertransference was, in the 1950s and 1960s, still
      basically seen as something to be wary of has been driven home for me
      by a revealing incident in the publishing history of the work of
      Margaret Little. In l951, she wrote a paper on 'Countertransference
      and the Patient's Response to It'. It was duly reprinted in a
      collection of her writings, Transference Neurosis and Transference
      Psychosis, in l981. But when the book came out in a paperback edition
      five years later, she added an intriguing footnote: 'I read this
      paper in 1950, almost exactly three years after my analyst's death. I
      could not then give the true account, but disguised it as best I
      could. (That version has rightly been questioned.) I have given this
      account in chapter 21 [a dialogue between her and Robert Langs], and
      also in my paper 'Winnicott Working in Areas where Psychotic
      Anxieties Prevail: A Personal Record' in Free Associations (1985) 3:
      9-42' (Little, 1986, p. 33n). The last-mentioned article had been
      submitted to the International Journal of Psycho-Analysis and
      rejected with the suggestion that it should be put in a vault until a
      suitable date well in the future. One of the referees told me that he
      had urged its sequestration because it revealed that a practising
      training analyst continued to work while she was very ill, that her
      analyst, Donald Winnicott, permitted this and had broken various
      boundaries with respect to the analytic frame, and that knowledge of
      this would be too distressing to her former patients, including some
      analysts still in practice. When, after the most careful
      consideration, the article was published in Free Associations,
      Margaret Little received a gracious note from the Editor of the
      International Journal, saying how pleased he was that the article had
      been sufficiently modified so as to make it suitable for publication.
      Yet not a word had been altered from her original submission.

      My justification for telling this rather gossipy tale about the
      context of publishing these pieces is that when we are dealing with
      the complex, subtle and primitive processes which occur in
      transference and countertransference, we are moving about on a very
      perilous terrain, one which puts at risk the boundaries of the
      analytic frame, the maintenance of which are essential to the
      successful conduct of psychoanalytic work. Taking full account of
      countertransference — and not confining attention to transference,
      keeping the therapist's unconscious processes out of the question —
      means that the analytic frame is constantly at risk of being
      violated. Margartet Little has been remarkably candid about the
      vicissitudes of these interrelations, and I believe that this has
      troubled many of her colleagues. Many feel that the relations between
      her and D.W. Winnicott went beyond the appropriate boundaries.

      A strong reaction to Little's views came from an orthodox Freudian,
      Annie Reich (1951), who argued that countertransference was not a
      therapeutic tool and was not useful for understanding or
      communicating with the patient. Slakter comments that Annie Reich was
      defending a conception of psychoanalysis as the analysis of the ego's
      defences and rejecting 'the seductive, regressive pull of id
      psychology' (Slakter, 1987, p. 23). I thnk this reveals an important
      difference in approach to analytic work. Little has stressed in these
      and subsequent writings (l957, 1987, l989, 1990) that the relations
      between analyst and patient are much more primitive, both consciously
      and unconsciously, than is acknowledged by orthodox models of the
      therapeutic process. I believe tthat this and related debates about
      the relationship between countertransference and the analytic frame
      has an important bearing on how we do analytic work and how we
      conceptualize the maintenance of analytic integrity.

      At this point I want to interrupt my narrative of the history of
      countertransference and to broaden the frame of reference to revert
      to the philosophical issues raised by the ways we picture the mind. I
      have suggested that in the history of psychoanalysis there has been a
      subtle tension between 'picture thinking', on the one hand, and
      personal, evocative, story-telling accounts, on the other. These two
      ways of representing things are intermingled in two of the classic
      texts, `Project for a Scientific Psychology' (1895) and The
      Interpretation of Dreams (1900), and one can almost feel Freud's
      relief when he abandons the imagery of the telescope and the diagram
      (Freud, 1900, pp. 536-8) and replaces them with stories (pp. 611,
      615). After chapter seven of The Interpretation of Dreams spatial
      representations and pictoral diagrams are rare, e.g., the rendering
      of the structural point of view in The Ego and the Id (Freud, 1923,
      p. 24) and the oval diagram diagram in Lecture XXXI of The New
      Introductory Lectures (Freud, 1933, p. 78), and when they do appear,
      they are rather more metaphorical than truly spatial.

      In the traditional pictorial approach the knowing subject is at one
      end of an investigative instrument - typically a telescope or
      microscope (Freud, 1900, p. 536). What is essential about this way of
      representing the mind and the process of knowing is the spatial gap —
      the subject is at one end, while the object is at the other end or
      out there. The subject is the knower; the object is to be known. The
      object is open to scrutiny, and the subject is not. I now want to
      tell a story in which this representation of the problem of knowing
      within and between people is increasingly complicated, starting with
      the picture-thinking view and moving on to an interactional and then
      to a dialectical one.

      I am a subject. You are an object. I am here; my essence is in here.
      You are there — out there, across a physical and epistemological
      space. I can infer that you are also a subject — by eye contact, by
      tone of voice, by analogy to my own experience and by other cues —
      but you easily revert to being experienced as an object, and I may
      easily lapse into treating you as one — as someone who does not touch
      me: alien. You may sense this and be alienated from me.

      But the situation can be seen as much, much more complicated. I may
      experience myself as alienated from myself — as a thing, as dead.
      This is of the essence of the concept of alienation, where a person
      or a worker can experience himself or herself as alienated from the
      product, the means or instruments of production, from fellow workers
      and from one's own humanity (or 'species being'). Alienation is the
      subjective moment of the objective condition of exploitation at work,
      just as an analogous estrangement can occur in bad human
      relationships or in psychotic moments or states. Rather than
      experience yourself as dead, you may put that feeling into me by
      projection, and if I take up the projection (unconsciously) and
      display it, a successful projective identification is in being
      between us. There are other forms of projective identification which
      do not depend on what I feel or display, so that you can be in
      projective identification with me in other ways, depending on your
      inner state and mine.

      As we enrich the model, mental and interpersonal space lose the
      quality of a picture with simple locations. There are no simple
      spaces in this enriched account, one which can be called interactive,
      phenomenological or dialectical, depending on how mutually
      constitutive the relationships are conceived as being. In an
      interaction, things get batted back and forth. In a phenomenological
      description, you are no longer an 'it' but a 'thou', a person with
      whom I can identify and empathize, as I am for you. In a dialectical
      account, there are many layers and reverberations. I am here and
      there at once, as you are. You are in me. I can expel a part of
      myself. You can take it in and re-expel it, and I can experience it
      as you, while, in another part of my mind, knowing where that part
      came from. (It should be obvious that I am not listing the
      permutations systematically. I only want to make the point that
      interpersonal relationships are much richer and multi-layered than
      the subject-object 'picture' account allows.)

      Moving on to related expressions: I enter you. You withdraw. Or you
      may contain my distress. I push through your defences. We become one
      and then separate but feel love, hatred or ambivalence or frequent
      oscillations among these at many levels: a relationship. If we move
      on further to part-object relationships and on still further to
      tenderness, envy, spite and reparation, it soon becomes obvious that
      the simple subject-object model is a reductio ad absurdum of human
      relationships.

      Returning to my main theme, I suggest that the history of ideas if
      countertransference is a progressive closing of the spatial gap
      between therapist and patient. It is at the same time a turning away
      from pictoral models toward story-telling ones, in which knowledge is
      not seeing but evocation. I offer two longish examples to drive this
      point home.

      The first is from Tom Main's essay on 'Some Psychodynamics of Large
      Groups': 'Although projective processes are primitive attempts to
      relieve internal pains by externalizing them, assigning or requiring
      another to contain aspects of the self, the price can be high: for
      the self is left not only less aware of its whole but, in the case of
      projective identification, is deplenished [sic] by the projective
      loss of important aspects of itself. Massive projective
      identification of — for instance — feared aggressive parts of the
      self leaves the remaining self felt only to be weak and unaggressive.
      Thereafter, the weakened individual will remain in terror about being
      overwhelmed by frightening aggressive strength, but this will now be
      felt only as belonging to the other. Depending on the range of this
      projective fantasy the results will vary from terrified flight,
      appeasement, wariness and specific anxieties about the other, even
      psychotic delusions about his intentions.

      'The above instance concerns only the projector's side of the
      projective relationship: but projective processes often have a
      further significance. What about the person on the receiving end of
      the projection? In simple projection (a mental mechanism) the
      receiver may notice that he is not being treated as himself but as an
      aggressive other. In projective identification (an unconscious
      fantasy) this other may find himself forced by the projector actually
      to feel his own projected aggressive qualities and impulses which are
      otherwise alien to him. He will feel strange and uncomfortable and
      may resent what is happening, but in the face of the projector's
      weakness and cowardice it may be doubly difficult to resist the
      feelings of superiority and aggressive power steadily forced into
      him. Such disturbances affect all pair relationships more or less. A
      wife, for instance, may force her husband to own feared and unwanted
      dominating aspects of herself and will then fear and respect him. He
      in turn may come to feel aggressive and dominating toward her, not
      only because of his own resources but because of hers, which are
      forced into him. But more: for reasons of his own he may despise and
      disown certain timid aspects of his personality and by projective
      identification force these into his wife and despise her accordingly.
      She may thus be left not only with timid unaggressive parts of
      herself but having in addition to contain his. Certain pairs come to
      live in such locked systems, dominated by mutual projective fantasies
      with each not truly married to a person, but rather to unwanted,
      split off and projected parts of themselves. Both the husband,
      dominant and cruel, and the wife, stupidly timid and respectful, may
      be miserably unhappy with themselves and with each other, yet such
      marriages although turbulent are stable, because each partner needs
      the other for pathologically narcissistic purposes. Forcible
      projective processes, and especially projective identification, are
      thus more than an individual matter: they are object-related, and the
      other will always be affected more or less' (Main, 1989, pp. 100-01).

      This is an excellent exposition of some of the complexities of
      unconscious processes at work in everyday life. I trust that the
      analogy to transference and countertransference is obvious. In case
      it is not, I want to follow this example with a lovely account of the
      power of countertransference and the use that can be made of it in a
      clinical setting.

      I shall excerpt the relevant passage from a dense and illuminating
      account of a clinical case of Margaret Rustin's, which, for reasons
      of confidentiality, I do not wish to quote in detail. What is of
      interest in the present context comes out very clearly in the
      therapist's reflections, which is the point at which I shall begin
      quoting: 'There is much to explore in these associations, but I now
      want to add an important fact about this session which I was not able
      to make use of at the time. I myself was having two experiences in
      addition to the conversation I have reported. I was struggling with a
      frustrating conviction that I could not properly get hold of the
      transference situation in the session... Much more uncomfortable than
      this intellectual frustration was a state of irritable anxiety which
      was building up, particularly focussed on an urgent desire to suck or
      bite my fingers. Trying to understand these feelings and impulses is
      the process required of the therapist to work through the
      countertransference. I am here using the term countertransference to
      refer not to the neurotic response of analyst to patient, but to the
      broader current conception of countertransference which pays close
      attention to the feelings stirred up in the analyst by the patient's
      material.

      'In the following session, the meaning of this projection began to
      emerge.' There follows more material in which alcoholism and stealing
      drink loom large. Rustin continues, 'I found myself plagued by
      similar surges of anxious discomfort to those of last week's
      session...' Then more clinical material, including the alcoholic's
      sitting there with thumb in mouth saying how delicious the stolen
      drink was, which enraged and overwhelmed the patient. The account
      continues, 'At this moment, I felt the relief of illumination. The
      image of X with... thumb in... mouth linked with my impulse to suck
      and chew my fingers during these last two sessions, an impulse which
      I felt was being irresistibly projected into me. Now I knew where
      this was coming from. So I gathered together the threads I could now
      follow...' (Rustin, 1989, p. 315). The author's account makes
      admirably clear the central importance of the countertransference to
      the interpretation and its evident usefulness to the patient.

      There is an equally graphic - and, in this case, excruciating -
      account of projective identification and countertransference, in
      which the therapist found herself unaccustomedly an unaccountably
      buying and cooking squid, only to find to her chagrin and amusement,
      as she contemplated the cut up pieces frying in oil, that she was
      retaliating against a particularly murderous 'prick' of a suicidal
      patient (Eigner, 1986).

      I have chosen the foregoing examples to convey the power of the
      projective processes involved in countertransference.

      The person who has looked into these most extensively is Harold
      Searles. The collection of his papers on Countertransference (1979)
      contains what I regard as two profound essays on the subject, while
      the dialogue between Searles and Robert Langs explores in a very
      illuminating way the details of the interrelations between analyst
      and patient (Langs and Searles, 1980).

      In 1949 (just when Winnicott and Little were challenging the
      orthodoxy in Britain) Searles, an American psychoanalyst, sought to
      publish a paper which significantly broadened the clinical importance
      of the countertransference, but it was rejected by both of the
      psychoanalytic journals to which he submitted it. It was only
      published in the wake of his achievements as an analyst of
      schizophrenics. In it he anticipates much of his subsequent work on
      the real basis, in the analyst's personality, for transference
      phenomena, phenomena which appropriately evoke the
      countertransference. He summarizes his article as
      follows: '...transference phenomena constitute projections, and that
      all projective manifestations - including transference reactions -
      have some real basis in the analyst's behavior and represent,
      therefore, distortions in degree only. The latter of these two
      suggestions implies a degree of emotional participation by the
      analyst which is not adequately described by the classical view of
      him as manifesting sympathetic interest, and nothing else, toward the
      patient. It has been the writer's experience that the analyst
      actually does feel, and manifests in various ways, a great variety of
      emotions during the analytic hour' (Searles, 1978-9, p. 165).

      In his papers on 'The Patient as Therapist to His Analyst'
      and 'Transitional Phenomena and Therapeutic Symbiosis', as well as in
      his dialogue with Langs, Searles drives home again and again the
      centrality, the normality, the basic and essential utility of
      countertransference. Langs grants its ubiquity, but - if I read him
      aright - still wants to master and minimize it (e.g., Langs and
      Searles, 1980, pp. 96-7). Searles glories in its omnipresence and
      rich potential.

      Although the main sources of his ideas are the interpersonal
      psychiatry of Harry Stack Sullivan and his extensive psychoanalytic
      work with schizophrenics (he has worked with one woman for more than
      twenty years), he also makes alliances with the (independently
      developed) ideas of Winnicott and Little. I commend his cornucopia of
      examples to the reader; after reflecting upon them I would be
      surprised if anyone could retain the traditional view of the analyst
      as mirror or as a subject looking at the patient across physical or
      metaphorical space as an object to be known by peering, as it were,
      through some sort of technological instrument.

      I now have to draw breath and speak about the analytic frame. You
      will recall that this topic was raised in the context of discussing
      Margaret Little's work with Winnicott and Annie Reich's objections.
      Lurking around my whole account has been a whiff of scandal - a
      suspicion that if we get too involved with the countertransference,
      there's no telling where it will all end. Annie Reich feared that it
      would end in the id, not in the ego, where she seemed to assume that
      good analytic work is done. It is noteworthy, then that the writers
      who have set out to broaden and deepen the concept of
      countertransference have been people who were exploring primitive,
      psychotioc processes: Winnicott on borderline and schizophrenic
      patients, Little on her own psychotic illness and Searles, who has
      worked a great deal with schizophrenics.

      The analytic space is bounded by the analytic frame; it is the
      emotional environment in which it is seemly and safe enough to
      conduct the therapeutic alliance. It is a container, and containment
      is its essence. It is made up of a set of conventions quite mundane
      ones, but they are under constant threat. The session starts and ends
      on time; confidentiality is total; you never take notes (though many
      do); no interruptions are permitted; no personal information about
      the therapist should be made available; accounts should be presented
      on the same day of the month; there should be due warning for breaks;
      other missed sessions should be minimized and announced well in
      advance; patients should not be touched (though my analyst shook
      hands at the end of each term).

      Others would extend this list in various ways. Practically all would
      say that social relations between therapist and patient should be
      taboo, and most would say that those with ex-patients should be
      minimized. Sexual relations are strictly taboo. Others would make a
      distinction between current patients, recent ex-patients and ex-
      patients some years later (I would not).

      These aspects of the frame are important, but the essence is an
      attitude of abstinence. If that is right, and if the essence is
      internalised, it is silly to make a long list of prohibitions. As the
      cellist Tortellier was fond of saying, one must be pure but not
      purist. The frame must provide a bounded space in which it is
      bearable to do the work - for the patient to be safe enough to
      explore what is unsafe, i.e., defenses built up and maintained over a
      lifetime. Praising, blaming, encouraging - all such dimensions of
      normal social relations are eschewed in a strict interpretation of
      the analytic frame. What is on offer is interpretation, the
      understanding that the patient can take away and treat as food for
      thought. In their dialogue, one point on which Langs and Searles
      agree is that 'the therapist's appropriate love is expressed by
      maintaining the boundaries' (Langs and Searles, 1980, p. 130). Langs'
      view is that as soon as you modify the frame, the likelihood of a
      misalliance or pathological symbiosis is greatly increased (pp. 44,
      127). As he says, 'frame' is 'a nonhuman term for a very human set of
      tenets and functions. It serves to hold and to contain, to establish
      boundaries and conditions of relatedness and communication' (p. 179).

      There are those who advocate occasional suspension of what can be
      seen as rigid or strict maintenance of the boundaries of the frame -
      what Christopher Bollas has called 'Expressive Uses of the
      Countertransference' (Bollas,1987). Related views have been expressed
      by Symington (1986), Little (see above) and - perhaps most
      notoriously - by Nina Coltart, in a lovely essay entitled '"Slouching
      Toward Bethlehem"... or Thinking the Unthinkable in Psychoanalysis'
      (1986), in which she tells a gripping tale, the denoument of which is
      shouting at her patient to what appears to be good effect. Symington
      and Bollas tell similar stories. Indeed, Bollas tells us that on one
      occasion he quite deliberately and temperately said to a
      patient, 'You know, you are a monster' (Bollas, 1989, p. 38), and it
      turns out that she did know and in due course professed to be
      relieved that he could say so. Searles also owns up to revealing, at
      selected moments, aspects of his subjective feelings toward patients,
      though much more often with schizophrenics than with others (Langs
      and Searles, 1980, pp. 123-4). As I mentioned above, Paula Heimann
      counselled against such self-revelations and criticized Margaret
      Little for advocating them (Heimann, 1959-60, p.156). Rayner (1991)
      reports that the approaches of Coltart and Bollas are widespread
      among members of the Independent or Middle Group in the British
      Psycho-analytical Society, while it is usual among Kleinians to
      eschew such self-revelations. Among the authors I have mentioned,
      however, it is common ground that such practices are open to abuse,
      and great care must be taken to avoid 'acting out in the
      countertransference' (Heimann, 1959-60, p.157).

      While there are important differences in the degree to which various
      practitioners may be willing to express their countertransference, it
      is my impression that there is a growing consensus that being closely
      attuned to it is a, if not the, basis for knowing what is going on
      and for making interpretations. I want to leave this issue open,
      while making clear that my own bias is against expressive uses of the
      countertransference (which is not to say that I have never done it
      and never will). The tendency to 'get rid of it' is certainly waning
      among the writers whom I am examining, while more and more is being
      made of it. My best experiences in supervision have resulted from the
      supervisor asking me what I was feeling at a particlular moment -
      usually a moment when I felt I did not understand the material. I
      would go so far as to say that this has never failed to provide at
      least some enlightenment.

      I want now to move to the third of Laplanche and Pontalis' renderings
      of the countertransference: the injunction, not merely to exploit it
      but to 'go with it'. The experience of countertransference is, in the
      first instance, appprehensible but not comprehensible. What is
      occurring between patient and therapist is not merely interactive; it
      is interpenetrative or dialectical. Much, often most, of what goes on
      in an analytic session is non-verbal and atmospheric, and one could
      not say how it is imparted. The atmosphere may be soporific, tense,
      comforting, assaultive, arousing.

      I had a patient who spoke so horribly and in such a sustained way in
      one session that she filled the room with her (symbolic) vomit and
      had to flee, since, if she opened her mouth again, she would have to
      take in her own spew. I was able to make an interpretation in these
      terms, because I was feeling nauseous. I had another patient who
      spent many sessions standing on the threshold of the room. He had
      panic attacks. It took me the longest time to figure out that he was
      imparting to me the cliff-hanging feeling that was characteristic of
      his attacks. One reason I could not figure it out, by the way,
      because he was a training patient, and I was in a panic that I might
      lose him. When I belatedly made the interpretation, fruitful work
      began.

      Another patient would come to a session, never looked at me, would
      speak one or two sentences and often remain silent for the rest of
      the session. It eventually dawned on me that she unconsciously wanted
      me to feel starved the way her mother had made her feel. I had been
      feeling that way, but it took some time to convert that sense into a
      thought. When I did make that interpretation, she slowly began to
      give more, though she remained likely to revert to sullenness and
      withholding. Yet underneath this mean exterior was a longing and
      warmth and gratitude that no camera could detect but which I came to
      know and to find sustaining in innumerable bleak sessions.

      A patient can rob one of the ability to think. Indeed, there was one
      in a group I conducted who was able to project her sexulaity so
      powerfully that, on occasion, no one in the group, including me,
      could think of anything but her breasts and legs. As Bion
      said, 'Refuge is sure to be sought in mindlessnsess, sexulaization,
      acting out and degrees of stupor' (Bion, 1970, p.126).

      A paper by Irma Brenman Pick takes the normalityy of
      countertransference to its logical extreme, without a trace of seeing
      it as something to be got rid of. She carefully considers is as the
      basis of understanding throughout the session: 'Constant projecting
      by the patient into the analyst is the essence of analysis; every
      interpretation aims at a move from the paraniod-schizoid to the
      depressive position' (Brenman-Pick, 1985, p. 37). She makes great
      play of the tone, the mood and the resonances of the process: 'I
      think that the extent to which we succeed or fail in this task will
      be reflected not only in the words we choose, but in our voice and
      other demeanour in the act of giving an interpretation' (p. 41). Most
      importantly, she emphasizes the power of the projections and what
      they evoke counterrtansferentially: 'I have been trying to show that
      the issue is not a simple one; the patient does not just project into
      an analyst, but instead patients are quite skilled at projecting into
      particular aspects of the analyst. Thus, I have tried to show, for
      example, that the patient projects into the analyst's wish to be a
      mother, the wish to be all-knowing or to deny unpleasant knowledge,
      into the analyst's instinctual sadism, or into his defences against
      it. And above all, he projects into the analyst's guilt, or into the
      analyst's internal objects.

      'Thus, patients touch off in the analyst deep issues and anxieties
      related to the need to be loved and the fear of catastrophic
      consequences in the face of defects, i.e. primitive persecutory or
      superego anxiety' (p. 41). As I see it, the approach taken by Brenman-
      Pick takes it as read and as normal that these powerful feelings are
      moving back and forth from patient to analyst and back again, through
      the processes of projection, evocation, reflection, interpretation
      and assimilation. Moving on from the more limited formulations of an
      earlier period in the writings of Winnicott, Heimann and even Money-
      Kyrle, these feelings are all normal, as it were, in the processes of
      analysis. More than that, as she puts it, they are the essence.

      Implicit in the way I have been writing about the phenomena of
      countertransference is a model for knowledge - that the way we really
      learn is from the Other's response to what we convey. We learn by
      evoking and provoking. We do not learn by imparting but by re-
      experiencing what we have projected and has then been passed through
      another human being (though that person may be held in imagination).
      We learn by putting something out and finding out what comes back.
      Our relationship with the world is a phenomenological 'I-thou',
      not 'I-it'. It is evocative knowledge.

      It may be thought that this model for knowledge is appropriate to
      relations between people (and perhaps pets) but that it in no way
      applies to knowledge of the external world. Some such distinction
      would seem to be common sense. However, it does not take into account
      recent thinking in the history, philosophy and social studies of
      science which argues that we project onto nature particular versions
      of reality and frame it according to the prevailing value systems and
      preoccupations - the 'world view' or weltangschuung of a period or
      subculture or discipline.

      What is true for a particular version of the world is also true for
      the individuals who inhabit it. Jerome Bruner (1951) has shown this
      with respect to children's perceptions of ordinary objects: what they
      see - even the size of coins - is dependent on their social location.
      M.L.J. Abercrombie (l989) has shown it for the anatomical and
      scientific perceptions of medical students: the most mundane
      observations only make sense in the light of unconscious forces.
      Donna Haraway (l989, l991) has shown it for various fields of
      scientific research, particularly toe social construction of
      primatology, providing a pedigree for our humanity (see Young, 1992).
      Other versions of this position are now commonplace among students of
      scientific thought, e.g., Figlio, 1978, 1979, 1985; Hesse, 1980;
      Young, 1977, 1981, 1985, 1990).

      In the clinical realm, Searles' first book was a major study of how
      schizophrenics projectively perceive the external environment (1960).
      This provides an interesting link between views of the inner world
      and ideas of the outer one: both worlds are are highly interpretive.
      Karl Figlio has generalized this view to nature as projectively
      experienced by nuclear disarmers and members of the peace movement.
      These 'friends of the earth' relate to the planet as a significant
      Other - a thou. Moving beyond our culture, we have seen that the
      history of social anthrolpology can be seen as a case study of my
      thesis, as the work of Mary Douglas exemplefies (above, ch. 2).
      Similarly, philosophers now argue that truth is made, not found
      (Rorty, 1980, 1982, 1989). Those who reflect on the philosophical
      implications of the belief systems of different epochs, tribes and
      disciplines point out that each of these social groups has its own
      cosmology, which articulates more or less well with that of other
      tribes (Horton, 1967, Bloor, 1977; Douglas, 1975). Ordinary, didactic
      imparting of knowledge and learning from teachers and from the media
      do not thereby cease to occur; they become special, limited cases of
      a richer model for the process of knowing.

      The integration of psychoanalytic theory with developments such as
      those outlined here is, in my opinion, an important desideratum. What
      I have provided here is the barest sketch, in the hope that it will
      make attractive the project of bringing together a social, and
      cultural account of ways of knowing (epistemology) with the
      philosophical bearings of recent developments in psychoanalysis.
      Aspects of the work of Winnicott, Klein, Bion, and Meltzer seem to me
      to lie at the centre of this project. I have in mind, in particular,
      the concept of transitional space (chapter 6) and the notion that all
      experience is mediated through primitive processes and known through
      the mother's body (chapters 3, 7; cf. Young, l986, 1989).

      Returning to the psychoanalytic sphere, the weight I have put on the
      concept of countertransference need not be borne by that concept
      alone; it can be shared by ways of thinking across a broad range of
      disciplines. In the analytic relationship, it turns out that the real
      justification for the free-floating attention that is characteristic
      of psychoanalysis is that it makes our minds available for the
      patient's projections and facilitates their search for the resonances
      in us for what they feel. Freud said, 'He should simply listen, and
      not bother about whether he is keeping anything in mind' (S.E. 12, p.
      112). Bion put it poetically in his injunction that the analyst
      should 'impose upon himself the positive discipline of eschewing
      memory and desire. I do not mean that "forgetting" is enough: what is
      required is a positive act of refraining from memory and desire'
      (Bion, 1970, p. 31).

      If this sounds a bit mystical, so be it. Racker shares an
      appropriately Oriental parable: One day an old Chinese sage lost his
      pearls. 'He therefore sent his eyes to search for his pearls, but his
      eyes did not find them. Next he sent his ears to search for the
      pearls, but his ears did not find them either. Then he sent his hands
      to search for the pearls, but neither did his hands find them. And so
      he sent all of his senses to search for his pearls but none found
      them. Finally he sent his not-search to look for his pearls. And his
      not-search found them. (Racker, 1968, p. 17).

      Once one is in this state, one is open to the patient's unconscious
      and to the injunction that 'Constant projecting by the patient into
      the analyst is the essence of analysis' (Brenman Pick in Spillius,
      vol. 2, p.37). And at the other end of the analysis lies the ability
      of the patient to take back the projections. This is an important
      criterion of improvement. Bearing projections is the whole basis of
      containment: the therapist can bear to take in and contain the
      projections, to hold them and give them back, in due course, in the
      form of accessible interpretations.

      I am suggesting that countertransference is not only the basis for
      analytic work but the basic process in all human communication and
      knowing. We only know what is happening because we are moved from
      within by what we have taken in and responded to from our own deep
      feelings. The space between people is filled when it is and to the
      extent it is - by what we evoke in one another.



      This essay was joint winner of the Kelnar Essay Prize of the Lincoln
      Clinic and Centre for Psychotherapy, 1990. It appeared in a modified
      form in Mental Space (Process Press, 1994).

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      Margaret Rustin (1989) 'Identity: Fragmentation and Recovery in
      Psychoanalytic Psychotherapy'. Discourse Scocial/Social Discourse
      2:311-19.

      H. F. Searles (1960) The Nonhuman Environment: In Normal Development
      and in Schizophrenia. Madison, CT., International Universities Press.

      ______(1975) 'The patient as therapist to his analyst', in Searles
      (1979), pp. 380-459.

      ______ (1976) 'Transitional phenomena and therapeutic symbiosis', in
      Searles (1979), pp. 503-76.

      ______ (1978-9) 'Concerning Transference and Countertransference'. J.
      Psychoanal. Psychother. 7:165-88 (written in 1949).

      ______ (1979) Countertransference and Related Subjects. Madison,
      CT:International Universities Press.

      E. Sharpe (1930) 'The Technique of Psychoanalysis'. Int. J. Psycho-
      Anal. 2:361-86.

      E. Slakter, ed. (1987) Countertransference. Aronson.

      E. B. Spillius, ed. (1988) Melanie Klein Today, 2 vols. Routledge.

      A. Stern (1924) 'On the Countertransference in Psychoanalysis'.
      Psychoanal. Rev. 2:166-74.

      J. Strachey (1934) 'The Nature of the Therapeutic Action of
      Psychoanalysis'. Int. J. Psycho-Anal. 15:127-59

      N. Symington (1986) 'The Analyst's Act of Freedom as Agent of
      Therapeutic Change', in Kohon (1986a), pp. 253-72.

      D. W. Winnicott (1947) 'Hate in the Countertransference', in his
      Through Paediatrics to Psycho-analysis. Hogarth Press (1975), pp.194-
      203.

      B. Wolstein, ed. (1988) Essential Papers on Countertransference. New
      York University Press.

      R.M. Young (1977) 'Science is Social Relations', Radical Science. J.
      5:65=131.

      ______ (1981) 'The naturalization of value systems in the human
      sciences', in Problems in the Biological and Human Sciences, Milton
      Keynes: Open University Press, pp.63-110.

      ______(1985) Darwin's Metaphor: Nature's Place in Victorian Culture.
      Cambridge University Press.

      ______ (1986) 'Life among the Mediations: Labour, Groups, Breasts',
      talk delivered to Department of History and Philosophy of Science,
      University of Cambridge.

      ______ (1989) 'Transitional phenomena: production and consumption',
      in B. Richards, ed., Crises of the Self: Further Essays on
      Psychoanalysis and Politics. Free Association Books, pp. 57-74.

      ______ (1990) Mind, Brain and Adaptation in the Nineteenth Century.
      Oxford University Press.

      ______(1992) 'Science, Ideology and Donna Haraway', Sci. as Culture
      (no. 15) 3:7-46.

      ______ (1992a) 'Darwin's Metaphor and the Philosophy of Science',
      Sci. as Culture (no. 16) 3:375-403.

      ______ (1994) Mental Space. Process Press.

      Address for correspondence: 26 Freegrove Road, London N7 9RQ.

      robert@...

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