Team approach to working through transference and countertransference in a pediatric/psychiatric milieu

The principles of transference and countertransference are essential to understanding and working through the intense pain and anger that often dominate the emotional field of the pediatric/psychiatric milieu. Using Winnicott's model of the maternal/infant relationship, this milieu can be seen as a holding environment where transferential phenomena can be expressed, interpreted, and worked through. Anger and pain are common elements of the transference/countertransference relationship matrix of the milieu. Staff often have a strong bias regarding anger and hostility. If they are willing to examine their bias, and are given the forums within which to do so, then patients' anger and hostility can be viewed and interpreted in an adaptive and facilitative manner. Working through in a milieu setting is accomplished by both verbal processing and the lived experience.