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Title of the Study: A Beginning Analyst's Challenge:
Understanding and Managing Countertransference Anxiety in the Treatment of a Schizoid Patient
Author: Lynne F. Sacher
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ABSTRACT
This paper examines an analyst’s countertransference anxiety
while treating a schizoid patient, a thirty-five year old female who was
highly educated and accomplished, but who had difficulties in forming
and maintaining intimate relationships.
The study sought to discover a) what countertransference
reactions occurred and the reasons for them; b) which
countertransference resistances were present, and how they were
resolved; and c) how resolution of the countertransference resistances
affected the treatment. Close
analysis of verbatim material and summaries of the supervisory process
generated the following findings: the analyst's anxiety was primarily a
defense against aggressive feelings towards the patient; there was
consistent blurring of objective and subjective countertransference
reactions and resistances; close supervision and continuous
self-analysis were crucial elements of case management; the key to
reversing schizoid symptomatology lies in the management and resolution
of the countertransference resistances; an uninvasive treatment
technique, such as that suggested by modern analysts, is a treatment of
choice for a schizoid patient; the schizoid patient can be better
understood in terms of drive- rather than object-relations theory; the
patient's own constitution and methods of handling and discharging
tension is of equal importance as the invasive early environment in the
etiology of the schizoid personality disorder; the patient's schizoid
defense handles the overflow of aggression within the patient's psyche
and protects against loss of self; and, contrary to the reports in the
literature, the patient also may suffer from pervasive anxiety, which is
expressed openly.
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