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Who's Afraid of Murderous Rage? When Euthanasia Colludes with Self-Destructiveness.
Psychodyn Psychiatry
January 2025
Psychologist, Transparant Centrum GGZ, Leiden, The Netherlands.
The impact of intense countertransference affects in working with patients experiencing complex trauma can have a critical effect on decisions about euthanasia, especially when such decisions are made solely on the grounds of a psychiatric condition. These countertransference dynamics become particularly significant in the context of the rising number of euthanasia requests by psychiatric patients in the Netherlands. We contend that for a subgroup of patients with complex trauma, attachment trauma, and personality disorders, the label "treatment-resistant" may be applied prematurely and incorrectly.
View Article and Find Full Text PDFCountertransference, alliance, and outcome in the treatment of patients with personality disorder: a longitudinal naturalistic study.
Front Psychiatry
December 2024
Section for Treatment and Research, Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
Objective: Relational dynamics, including countertransference responses and the therapeutic alliance, are crucial in the treatment of patients with personality disorders (PD). However, few studies on PD treatment focus on the dyadic process of therapy. The present study aims to investigate associations between therapist emotional response/countertransference (CT) and patients' experience of treatment alliance, and CT developments in therapies with treatment completion as outcome.
View Article and Find Full Text PDFThe Therapist Translator: Reflections on Working With Countertransference in the Therapeutic Relationship.
Psychoanal Rev
December 2024
6601 West College Drive, Palos Heights, IL 60463, E-mail:
While developments within psychoanalytic thought have expanded our understanding of the phenomenon of countertransference and its meaning, clinicians are often left with a sense that negative countertransference is a sign of a therapist's own "unfinished business." Within the context of clinical supervision, the model of putting countertransference reactions through The Therapist Translator is introduced as a means of exploring how to best give voice to and make use of the emotional responses that arise from within the intersubjective analytic field. In this article, the authors introduce a group process dynamic that utilizes the free association of multiple clinicians to assist in "translating" relatively unformulated material into conscious, linguistic information that can be incorporated into the treatment.
View Article and Find Full Text PDFFacing the Dilemma of Forced Termination: What to Consider and Address When Removing a Member from a Group.
Int J Group Psychother
October 2024
The authors explore the group leader's considerations before removing a group member from group sessions. The authors integrate an approach that warns against a too hasty decision without considering the group-as-a-whole dynamics and the possibility of scapegoating, with the approach that looks at the group therapist's countertransference that prevents them from considering the group's best interest. The rule of thumb the authors suggest is that when a severe breach of the group agreement happens, especially continuously, and when it cannot be followed by exploration, reflection, and an agreement by the group member who violated the agreement to make an effort to avoid repeating this event, the group leader might consider removing the person from the group.
View Article and Find Full Text PDFExploring the outcomes of psychotherapy sessions: how do therapists' responsiveness and emotional responses to patients with personality disorders affect the depth of elaboration?
Front Psychol
September 2024
Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
Background: The impact of depth of elaboration in individual psychotherapy sessions on overall treatment effectiveness was found in the empirical literature. In the best sessions, relevant content is processed with greater depth; in contrast, in the shallower sessions, the emerging content is more superficial. Evidence suggests that achieving a high level of depth is closely related to specific therapist characteristics and relational dimensions (including clinicians' emotional responses to patients).
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