Gabbard G O
Menninger Clinic, Topeka, KS 66601-0829, USA.
Int J Psychoanal. 1995 Jun;76 ( Pt 3):475-85.
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.
在过去十年左右的时间里，对反移情的理解已成为不同理论视角的精神分析学家之间一个新兴的共识领域。这种趋同可以追溯到两个关键概念的发展——投射性认同和反移情表现。投射性认同已从克莱因原著中患者的内心幻想演变为患者与分析师之间的人际互动。反移情表现的概念已被广泛用于描述这样的临床情境，即分析师的反移情反应与患者实现移情幻想的尝试相对应。这些观点，再加上社会建构主义者和关系理论家的贡献，以及桑德勒对角色反应性的概念化，导致了将反移情理解为分析师和患者的“共同创造”。分析师和患者的相对贡献根据分析师所支持的理论视角而有所不同。这个共识领域最好被视为一个梯度或连续体，在连续体的一端更强调分析师的贡献，而在另一端更强调患者的贡献。虽然反移情表现被广泛认为是不可避免的，但它们在产生内心变化中的作用更具争议性。
