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Countertransference Issues in Psychiatric Treatment

Edited by Glen O. Gabbard, M.D.
Series Editors: John M. Oldham, M.D., M.S., and Michelle B. Riba, M.D., M.S.

  • ISBN 978-0-88048-959-1
  • Item #8959

Description

In psychiatry, clinicians recognize the influence of their own personal characteristics on the assessment and treatment of their patients. No interactions in psychiatry are entirely free of countertransference dynamics. Most major theories point to countertransference as a jointly created phenomenon involving feelings induced by the patient combined with the conflicts and preexisting self and object representations that the clinician brings to the encounter.

Countertransference Issues in Psychiatric Treatment provides an overview of theory and technique that gives the reader a detailed account of how countertransference is used in contemporary practice. This timely reference

  • Illustrates the usefulness of examining countertransference issues in a wide range of psychiatric settings, including pharmacotherapy, consultation-liaison settings, and forensic facilities
  • Explores the specific countertransference dynamics evoked when clinicians treat suicidal borderline patients and the common countertransference problems confronted when treating antisocial and violent patients
  • Describes the difficulties encountered in general medical settings when physician-assisted suicide is considered as an acceptable clinical intervention
  • Breaks new ground in considering psychiatrist’s emotional reactions to the patient as an integral part of psychiatric practice and discusses some of the current controversies about countertransference
  • Reviews cutting-edge psychoanalytic theory involving subjectivity, projective identification, role responsiveness and countertransference enactments

Whereas most literature on countertransference is geared toward psychoanalysis and dynamic psychotherapy, this volume illustrates how countertransference issues must be considered in every clinical setting in which a psychiatrist works. It is an excellent introduction to the topic for psychiatric residents and medical students.

Contents

Foreword. An overview of countertransference: theory and technique. Countertransference in the treatment of the suicidal borderline patient. Countertransference in general psychiatry. Countertransference issues in the treatment of antisocial patients. Countertransference and assisted suicide. Index.

About the Authors

Glen O. Gabbard, M.D., is Professor and Director of the Baylor Psychiatry Clinic at the Baylor College of Medicine and Training and Supervising Analyst at the Houston-Galveston Psychoanalytic Institute in Houston, Texas. He was previously Director of the Menninger Hospital in Topeka, Kansas. Dr. Gabbard is the author or editor of sixteen books and currently is joint Editor-in-Chief and Editor for North America of the International Journal of Psychoanalysis. His numerous awards include the 2000 Mary Sigourney Award for outstanding contributions to psychoanalysis.

Dr. Glen Gabbard has organized a superb section on countertransference issues for this volume of the Review of Psychiatry. Each of the chapters, but Dr. Gabbard’s in particular, informs and illuminates a dim and often pivotal path we must walk with all patients—especially those with whom we have long term relationships. The experienced psychodynamic psychiatrist will find the section to be a thoughtful and scholarly treatment of complex issues form the perspective of contemporary psychoanalytic thinking but informed by the best of historical concepts and ideas. The novice will find complex ideas like projective identification and enactment explained through compelling, experience-near, and earthy vignettes giving a new and important perspective to therapist/patient interactions. An additional feature for the more experienced teachers of psychiatry is that the section easily lends itself to supportive readings for psychotherapy courses or case conferences in which countertransference to particular patient populations or particular clinical situations (particularly suicidal crisis) are to be studied and understood in greater detail. This is a truly valuable contribution to our understanding of this important topic.—James W. Lomax, M.D., Associate Chairman and Director of Educational Programs, Department of Psychiatry, Baylor College of Medicine, Houston, Texas


These five chapters all contain excellent clinical as well as theoretical material related to the complexity of countertransference reactions to patients. I recommend this small book to trainees as basic reading, and to experienced clinicians for the clarity of the theory as well as for the many gems of clinical insight.—Judith H. Gold, C.M., M.D., F.R.C.P.C., F.R.A.N.Z.C.P., Private Practitioner, Psychotherapy, Halifax, Canada


Psychodynamic principles are relevant in all psychiatric settings. In this book, and in easily readable style, the authors give a brief but clear insight into counter-transference dynamics, which, if recognized, can be valuable aids to diagnosis and treatment. I welcomed the opportunity to read a volume entirely devoted to counter-transference issues and found it useful and relevant in my clinical practice. I would recommend this book to mental health professionals, particularly those in the early stages of clinical training.—British Journal of Medical Psychology, 1/1/2001

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