Clinical and developmental dimensions of hate.

Bridging concepts of aggression, affect, and attitude, hate emerges during the process of separation-individuation concurrent with ego development and persisting intrapsychic conflict and fantasy. Rage precedes hate developmentally, though later the two are amalgamated both developmentally and clinically. Hate is the negative pole of ambivalence and is a component of all self- and object representations and object relationships. When excessive and unmodulated, hate interferes with object relations and personality development. Paradoxically, hate may also subserve adaptation and personality organization. Transference hate is often a greater problem for the psychoanalyst or psychotherapist than is transference love. Transference hate threatens the analyst's narcissism and neutrality and tests the analyst's tolerance and patience. The patient's intense hate is often experienced as a direct assault on the analytic relationship and the analytic process. Countertransference hate and the need to defend against it are of great clinical importance. Because it runs counter to analytic ideals and values, the analyst's hatred of the patient may be denied, minimized, rationalized, enacted, or vicariously gratified and may occasion great resistance to analytic self-scrutiny. Countertransference hate is often an unrecognized determinant in cases of analytic and therapeutic impasse. A classic contribution by D.W. Winnicott to the recognition and elucidation of countertransference hate is reevaluated.