Shared realities, therapeutic settings, and countertransference in times of crisis: a multinational qualitative study...

The main aim of this study is to capture the impact of shared external realities - such as global crises - on the therapeutic process, with particular attention to how these events challenge the traditional structures of psychoanalytic and psychotherapeutic work. More specifically, the study seeks to understand how mental health professionals perceive and experience these disruptions, how they have been compelled to question their clinical frameworks, and how they have adapted their practices to maintain therapeutic continuity in a context marked by uncertainty, instability, and the frequent need for improvisation.

We conducted a qualitative study among a population consisting of mental health professionals, which were recruited in multiple countries through associations and societies of psychologists, psychotherapists, and psychoanalysts. Data was collected using semi-structured individual interviews. A total of 40 participants were interviewed. The interviews were analyzed using interpretative phenomenological analysis (IPA), which allowed for a dynamic exploration of the participants' lived experiences.

The analysis of the data revealed three superordinate themes that are best presented by following the journey of the mental health professional as he or she navigates from external reality (1) to virtual reality (remote therapy) (2), ultimately plunging into the internal reality (internal reorganization linked to his or her ability to create novelty within these complex situations) (3).

Our research shows that analysts and therapists experienced significant challenges to their professional identity due to external factors, including the COVID-19 pandemic. These shared experiences enabled the mobilization of creative internal resources and encouraged improvisation within an established framework. This facilitated working through the crisis and supported ongoing professional practice.