Countertransference difficulties in a time-limited psychotherapy

A dramatic episode of patient-therapist interaction near the conclusion of a brief, time-limited psychotherapy is described with the help of a verbatim transcript. Our understanding of these events is based primarily on an awareness of the therapist's countertransference. The traumatic nature of the event that brought the patient to therapy, his narcissistic and borderline character structure, the therapist's own personal vulnerabilities to feelings of loss and guilt, and the additional difficulty for both therapist and patient of a brief, time-limited psychotherapy were factors contributing to the development of these countertransference disturbances.