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Countertransference issues when the therapist is ill or disabled

P A Dewald1

  • 1St. Louis University School of Medicine, MO.

American Journal of Psychotherapy
|January 1, 1994
PubMed
Summary

Therapist illness can disrupt psychotherapy, potentially leading to growth or avoidance. Effective management through conscious attention and consultation is crucial for therapeutic success.

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Area of Science:

  • Psychology
  • Psychotherapy
  • Clinical Psychology

Background:

  • Psychotherapy is typically private and isolated.
  • External life events can disrupt this traditional setting.
  • Therapist illness and disability are significant external events impacting psychotherapy.

Purpose of the Study:

  • To explore the impact of therapist illness on the psychotherapy relationship.
  • To examine how such events can be managed for therapeutic growth.
  • To highlight the risks of avoidance and the importance of managing countertransference.

Main Methods:

  • Qualitative analysis of clinical scenarios involving therapist illness.
  • Exploration of patient and therapist conscious and unconscious responses.
  • Discussion of factors influencing the handling of these events.

Main Results:

  • Therapist illness can activate patient and therapist responses, offering opportunities for growth.
  • Issues related to illness, separation, death, and power dynamics may emerge.
  • Avoidance of activated conflicts can occur due to patient and therapist factors.
  • Countertransference can impede conscious attention to critical therapeutic issues.

Conclusions:

  • Managing therapist illness requires anticipating challenges and fostering conscious engagement.
  • Colleague consultation is vital for therapists navigating these complex situations.
  • Properly handled, therapist illness can be a catalyst for significant therapeutic progress.

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