Countertransference effects of absence

In this paper the author aims to refine and explore some aspects of the clinical use and understanding of countertransference. Emphasising that countertransference is unconscious, the author proposes a specific approach focusing on the nature of the ongoing countertransference work that is required to unravel its meaning. Using a clinical vignette in which the analyst had to understand feeling impatient, irritated and then discouraged, the author describes how she was able eventually to understand what had been happening following insights she gained when she mistakenly understood how long a patient was going to be away and the function of the patient's response to her surprise on his return. This leads the author on to a wider consideration of the countertransferential work that may be needed when the analyst decides to take even regular breaks from patients, or when patients decide not to come. General aspects of the decisions analysts make about how and when to work as well as the specific opportunities presented when the occasion arises to inform patients of holiday arrangements, are considered. Finally, the author turns to possible countertransferential responses and the work that may be required when patients return to their sessions, whether they come back having suffered or acted out following the analyst's absence, or after having taken an absence of their own.