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Countertransference, both as obstacle and therapeutic instrument, is the most significant factor in working successfully with patients. The narcissistic defense and the resistances aroused in both patient and analyst need to be resolved for effective therapeutic progress. It is the primary responsibility of analysts to resolve their countertransference resistances, postive and negative, for therapeutic leverage.
Modern psychoanalytic theory and technique apply to schizophrenic, preoedipal and neurotic disorders. It is unfortunate that the word "schizophrenic," a loosely used term for many emotional disorders, has taken on such pejorative meaning. For the modern analyst it refers to those patients in whom a narcissistic defense may lead, or has already led, to psychotic episodes.
The narcissistic defense is the major resistance of the schizophrenic patient and those with preoedipal disorders. It is predicated on the concept that frustration aggression experienced in the first few years of life is released against the psychic apparatus of one's own mind and body. This serves as a defense against the danger of acting on impulses that might destroy the self or the frustrating, but necessary-- for-survival, object.
The process in treatment is to facilitate arousal of the original traumatic and frustrating situations by appearing to be like the original object, and thus enhancing the establishment of the narcissistic transference. The existence of various defective patterns of functioning is a response to the most powerful and intense negative impulses which have originated in the preoedipal level of development and may lead to schizophrenia and/or other severe narcissistic disturbances. This is the core problem which challenges therapists. Why some patients have this potential and others do not is still largely unknown.
This paper focuses on the understanding of countertransference reactions induced by narcissistic transference and it refers to the systematic utilization of all feelings induced in the analyst by the patient's transference feelings. It may be referred to as an internal radar system, which may be a development of the instinctive knowledge with which humans are born. Objective countertransference analysis is the means by which the therapist can best understand and make therapeutic use of his response to these patients' transference reactions. These reactions must be distinguished from subjective countertransference which is based on the analyst's own life history and requires the...