Countertransference as instrument and obstacle: a comprehensive and descriptive framework.

A comprehensive and descriptive approach to counter-transference phenomena is proposed. Three types of mental activity are distinguished: the objective-rational attitude is an adaptive, relatively nondefensive mode of observation; the reactive mental state corresponds to the classical notion of unconscious counter-transference as an obstacle and a defense; by contrast the reflective attitudes involve preconscious and conscious psychical activity. Reflective activity involves four phases: (1) during emergence, an inner reaction appears; (2) immersion, through a regressive exploration, leads to introjective identification; (3) integrative elaboration involves a shift in cathexis, more distance, and an organization of the regressed contents, while (4) an interpretation is forming in mind. Three case examples from the literature serve to illustrate.