[Transference and countertransference problems in patients treated with bone marrow transplantation].

Psychological problems that restrain the patient before, during and after the bone marrow transplantation (BMT) are multiple and are very complex and often have significant effect on the transplantation procedure itself. What patient is going through followed with his expectations and dependence on the transplantation team, together with development of an archaic transference develops a number of counter-transference reactions within the team members. If we assume that during the time spent in a sterile unit and isolation, because of the regressive position, patients use early defending mechanisms, which again, reflect in the reactions of the team members. The aim of this project is to analyse transference and counter-transference problems of the patients and the team members during the BMT. The method used was psychodynamic clinical observance and analysis of transference and counter-transference problems of patients and the team members during the process of transplantation. Thirty-five patients with acute myeloblastic and acute lymphoblastic leukemia, treated with allogenic BMT, were observed during their stay in a sterile unit over the 5-year period. Transplantation procedure, based on observation of psychological dwelling and transference reactions of the patients, is divided into five phases while, from the perspective of the team members, the counter-transference problems are revealed especially during the moments of helplessness. The most important mechanism that the team members are using to protect themselves from this feeling is "selective avoidance of psychological", in other words, avoidance of empathy.