Countertransference: the emerging common ground

In the last decade or so, the understanding of countertransference has become an emerging area of common ground among psychoanalysts of diverse theoretical perspectives. This convergence can be traced to the development of two key concepts--projective identification and countertransference enactment. Projective identification has evolved from a patient's intrapsychic fantasy in Klein's original work to an interpersonal interaction between patient and analyst. The notion of countertransference enactment has been widely used to capture clinical situations in which a countertransference reaction in the analyst corresponds to the patient's attempt to actualise a transference fantasy. These ideas, in conjunction with the contributions of social constructivists and relational theorists, as well as Sandler's conceptualisation of role-responsiveness, have led to an understanding of countertransference as a 'joint creation' by analyst and patient. The relative contributions of analyst and patient vary somewhat according to the theoretical perspective espoused by the analyst. This common ground is best regarded as comprising a gradient or continuum in which more weight is given to the analyst's contribution on one end of the continuum and more emphasis to the patient's contribution on the other. While countertransference enactments are widely regarded as inevitable, their role in creating intrapsychic change is more controversial.