The Wounded Healer

Counter-Transference from a Jungian Perspective

David Sedgwick

• Publisher: Routledge
• Year: 2003
• Topic: Psychology
• eBook ISBN:
  9781134844869
• Subtopic: Mental Health in Psychology
• Index: Psychology

Countertransference is an important part of the analytical process. It is concerned with the analyst's emotional response to the patient. As such, it can be a particularly difficult aspect of the analytical setting and especially so because of the threat of possible sexual involvement with the patient. At present there is little available on this difficult topic. Jungian analyst David Sedgwick tackles the subject bravely and shows how to use the countertransference in a positive way. The result is one of the finest Jungian clinical texts of recent years.

1 Introduction

DOI: 10.4324/9780203359921-1

This is the first Jungian book exclusively on countertransference. Its purpose is to show what countertransference – the analyst’s subjective involvement in the psychotherapeutic process – is really like, and how it can be worked with from a Jungian perspective.

The phenomenology of countertransference is rarely discussed in print – for various reasons, some of them valid. This lack of thorough discussion may be defensive, as Little (1951) and other psychoanalysts first suggested 40 years ago¹. countertransference sometimes tends to be thought of in the analyst’s fantasy as impermissible, embarrassing or professionally damaging (to the analyst or to the profession as a whole). Thus the analyst’s subjective experience with the patient, which may be the core of in-depth analytic work, has been less well attended to than the patient’s experience of the analyst (transference). While attempts to “expose” countertransference may indeed collide with narcissistic-exhibitionistic issues, the “phenomenology of countertransference” is nevertheless of considerable clinical value.

This book is written primarily for psychotherapists and others interested in the therapeutic process. It is not intended for patients, though conceivably it could be informative for them too. It could be disturbing as well. As one female colleague noted, this kind of writing is somewhat like a gynecologist revealing fantasies about patients. Are these things better left unsaid (or at least unwritten)? Perhaps so, as far as the patient is concerned. On the other hand, the subject needs airing because it is real and it is denied, and it is an important topic for professionals.

My interest in countertransference stems from my own experience of strong reactions to patients. For a long time before and after my analytic training, I wondered if my often intense involvements in psychotherapy were a problem, caused perhaps by a poorly boundaried personality, oversensitivity, introversion, neurotic dependency, hyperconscientiousness, or whatever. Gradually, and somewhat reluctantly, I have come to appreciate the fact that patients will have an impact on me. Indeed, an absence of impact may mean as much as its presence. This too is part of countertransference, or can be a stage in it.

Part of the difficulty in writing about countertransference, aside from its burdensome nature, is that countertransference usually carries the negative connotations noted above. One tends to feel guilty. Freud’s early dictum about “mastering” countertransference has much to do with this, of course. Even today, mainstream psychotherapy and classical psychoanalysis remain cautious. This may not be inappropriate, in this era of well-publicized ethical and boundary violations by therapists. At the very least, countertransference and its usage therapeutically continue to require care and justification. Perhaps each clinician, coming from a place of initial concern about his/her own “neurotic countertransference,” must come then to a more sophisticated, natural relation to this complex area of analytic interchange.

Reticence about countertransference has been lessening in Jungian analytic circles, as it has for a longer time in psychoanalysis. Jung said something very significant when he suggested that the analyst is“ …as much ‘in the analysis’ as the patient” (1929a, p. 72). However, the precise meaning of this, as well as its possible clinical implications, were not enlarged upon in detail except by Michael Fordham and the London-based Society of Analytical Psychology group (beginning in the mid-1950s). Neither Jung nor his first wave of followers elucidated his position in a practical, clear way, though they did continue to promote the “dialectical” notion generally. As Harriet Machtiger noted about ten years ago, “Until fairly recently, [Jungian] analysts were largely, or completely, unaware of the importance of the countertransference for the outcome of therapy” (1982, p. 107).

With this gradual change in “awareness” in the last decade has come an increased volume of Jungian written material, which supplements the pioneering work in London. It would now probably be the rule rather than the exception for Jungian analysts and analytic candidates to attend, at least, to transference phenomena. And with a transference orientation of any type, issues of the analyst’s countertransference soon arise (or should), as Jung’s dialectical notions suggest.

A Jungian analyst’s or candidate’s task now involves not just an integrated understanding of Jung but also an understanding of the “post-Jungians.” In addition, a more thorough integration of non-Jungian psychoanalysts may be in order. For decades British Jungian analysts (Fordham, Hubback, Plaut, Gordon, Redfearn, Lambert, Samuels, et al.) have emphasized Freudian technique and the work of psychoanalytic theorists like Klein, Winnicott, Bion, and Racker. More recently, Jungian analysts have synthesized the work of Kohut (Jacoby, 1981, 1984, 1990; Schwartz-Salant, 1982), Langs (Goodheart, 1980; Parks, 1987) and Searles (Sedgwick, 1993) among others.

A significant aspect of these integrative writings is that they focus primarily on transference dynamics. In general they are part of an effort to fill in the gaps left by Jung’s more symbolic, less clinical stance. This “new” focus on transference has also shown evolution over time. At first, as Fordham et al. (1974, p. ix) point out, there was an interest, particularly in London, on analysis of transference per se. In other words the patient’s unconscious projections or reenactments in the analytic hour were paramount. This progressed to a situation where the analyst’s reactions, the countertransference, were more closely studied for their informational and not just neurotic value. The result has been a blended focus on both sides of the analyst-patient interaction. Transference and countertransference are now typically seen in conjunction in Jungian circles, appropriately so. More recent Jungian articles or collections of articles tend to have names or terms like “Transference/countertransference,” “countertransference/Transference,” “T/CT” (e.g. Stein, 1982; Hall, 1984).

This blend, while appropriate, does not necessarily mean that such articles lay the stress on countertransference that this study will. It is often the case that the transference side of the coin – the patient’s contribution – receives more attention than the analyst’s countertransference contribution (the literature review in the next chapter will tend to confirm this).

Thus Machtiger’s 1982 article (see p. 2) accurately emphasizes that it is only “recently” that any awareness of countertransference has been present in most Jungian circles. To explain this reticence, Stein cites the analyst’s defensive fears of revealing his or her “unwashed psyche,” and seconds Machtiger’s call for “a more courageous discussion of countertransference” (Stein, 1984, pp. 67–68). In a more recent article Steinberg, when characterizing countertransference as a sub-topic of “wounded healer” issues, suggests that little has been written on the specific wounds of the healer and how these might affect analysis (Steinberg, 1989, p. 11). He goes on to say that processes in the analyst need more detailed description.

This book is an attempt to further the discussion and description. It is one thing to take note of countertransference, as analysts increasingly do, and another to really work with it. It is still another matter, perhaps of more than just degree, to assert as Machtiger does that “It is the analyst’s reaction in the counter-transference that is the essential therapeutic factor in analysis” (Machtiger, 1982, p. 90, italics mine).

The thesis of this book is that countertransference can be used, not only as a secondary technique, but as a primary instrument in Jungian analysis. It is on a par with more “traditional” Jungian methods and can be readily coordinated with them. This book will demonstrate in detail a countertransference-based way of working and show the primacy of countertransference as an analytic phenomenon.

This study meets more than the author’s personal needs and the calls from contemporary Jungian analysts for deeper studies of countertransference. There are a fair number of what Andrew Samuels in his rigorous examination Jung and the Post-Jungians calls “unknowing Jungians” (Samuels, 1985, p. 10). He is referring to the fact that current trends in psychoanalysis and therapy sometimes tend in directions that Jung mapped out in general ways many years before. In particular Samuels mentions the use of countertransference as a therapeutic tool. For those who believe that the Jungian approach has much to offer, it is therefore important that his work does not continue to float outside the psychotherapeutic mainstream. Along these lines it is useful to note that excellent books on countertransference have been published in recent years by psychoanalysts (e.g. Searles, 1979; Epstein and Feiner, 1979; Masterson, 1983; Gorkin, 1987; Tansey and Burke, 1989). Meanwhile, analytical psychology has not produced any book-length studies on the subject². It seems important for the Jungian viewpoint to be addressed in further detail and at book length.

Jung himself is partly to blame for any lagging behind in the delineation of countertransference. As in other technical areas, Jung left the details to his followers. This is understandable, if frustrating. Jung’s fertile unconscious did lead him away from the more purely clinical interests of his early professional years (cf. Fordham, 1978a; Goodheart, 1980; Charlton, 1986). Likewise his personal style and typology, as well as his symbolic/archetypal focus, were involved, the latter tending to pull him away from the personal micro-analysis required for countertransference exploration. Besides, there was only so much Jung could do. When asked in his later years why he did not attempt a more systematic presentation of his theories, Jung replied, “Sorry … to complete this psychology would take more than a lifetime” (Harms, 1962, p. 732). Thus it is left to Jung’s followers to illustrate and further his theories in many areas.

In the realm of countertransference this is both easy and difficult. The difficulty lies in the more impersonal, collective focus Jung took in later writings and his content-over-process emphasis. This is well exemplified in “The Psychology of the Transference” (Jung, 1946), his definitive work on the subject. This treatise is an extremely important but almost exclusively symbolic amplification of transference phenomena via alchemical imagery. On the positive side, it has provided a vital jumping-off point for later Jungian ventures into the subject (e.g. Groesbeck, 1975; Schwartz-Salant, 1984). The alchemical symbols are vivid and evocative – one senses their power and parallels with actual analytic material.

However, Jung’s opus is virtually devoid of clinical examples. It begs for the grounding in therapeutic reality that a practical example would give. The unconscious material in impersonal form (in this case the fantasies of alchemists) is given prominence over the “personal,” just as it is in Jung’s extended case studies³.

On the other hand, as noted above, Jung leaves it to the involved reader to fill in the blanks. While somewhat tantalizing, his ideas and suggestions can be excellent guideposts. One can return repeatedly to “The Psychology of the Transference” to find value in Jung’s alchemical symbols and perspective. He may not mention the word “countertransference”⁴ but he notes the centrality of the analyst’s psyche. He comments on psychic infection, wounded healing and the analyst “literally taking over” the patient’s sufferings. He speaks of mutual analyst-patient influence and transformation. Psychic contents flash back and forth mercurially between the participants.

Mercurial and ever-changing himself, Jung fluctuated over time in his evaluation of transference itself (and therefore countertransference). This too may have contributed to a certain delay by his followers in following up on his astute hypotheses about the analytic interaction. Naturally his original, 1907 “alpha and omega” point of view on transference was closely tied to his early relationship with Freud (Jung, 1946, p. 172). After the break with Freud, Jung (1929a, 1935b) gradually evolved his innovative ideas about the importance of the analyst’s side of the equation (i.e. the countertransference). Yet in the 1935 Tavistock Lectures he strikes a distinctly skeptical, almost reactionary note: “Transference or no transference, that has nothing to do with the cure …. The dreams bring out everything that is necessary” (Jung, 1935a, p. 136)⁵. His ambivalence continues in his official 1946 work⁶ on the subject. However, his final written statement is that transference (again meaning, for Jung, the mixtum compositum of analyst and patient) is the “crux, or at any rate the crucial experience, in any thoroughgoing analysis” (Jung, 1958, p. vii).

All this points to the need for a book that emphasizes the primacy of countertransference. Again, however, it is this author’s personal interest in the topic that is generating the book. Jung himself said we must recognize that all psychologies, including his own, involve a “subjective confession” (Jung, 1929b, p. 336). This study will embody that idea – almost literally, as...

Table of contents

• Cover Page
• Halftitle Page
• Series Page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Acknowledgments
• 1 INTRODUCTION
• 2 JUNGIAN APPROACHES TO COUNTERTRANSFERENCE: A REVIEW
• 3 CASE ILLUSTRATIONS
• 4 CONCLUSIONS
• Notes
• References
• Index