A)*DE(0%9!0::07(6!):!2*2<46$6!):!(#0!12($0*( – (#0%21$6(!%0<2($)*6#$1!$*! (#0!7)*(0c(!):!12($0*(6 ’ !10%6)*2<$(4!12(#)<)D4!2*&!(#0%21$6(6 ’ ! 12%0*(2
O2#<_!H>EQ>!i>_!5à6630%D_!i>!;>_!8%$(6E8#%$6()1#_!/>_!S2332%&_!S>!N>_!H0%6)BD_!=>!S>_!/0%%4_!i>!8>_!>!>!>!HàD<0*&_!/>!=>! [+,-]^>!A)*DE(0%9!0::07(6!):!2*2<46$6!):!(#0!12($0*(h(#0%21$6(!%0<2($)*6#$1!$*!(#0!7)*(0c(!):!12($0*(6Ä!10%6)*2<$(4! 12(#)<)D4!2*&!(#0%21$6(6Ä!12%0*(2! N">#+@B&"!&8"+(>B,)+L&@+*&8B)+)?@B&'(A?-"B"LAO& b+[P^_!]g,E]d->!! >-001(3! Transference work (analysis of the patient-therapist relationship) is considered a core active ingredient in dynamic psychotherapy. However, there are contradictory findings as for whom and under what circumstances working explicitly with the therapist-patient relationship is beneficial. This study investigates long-term effects of transference work in the context of therapists’ self-reported parental countertransference (CT), and patients’ level of personality pathology. Hence, we wanted to examine whether or not parental CT are associated with the specific long-term effects of transference work , and whether these associations change as a function of different levels of patients’ personality pathology. Transference work focus on the ongoing relationship between therapist and patient. We believe that this explicit focus will make CT affect the therapeutic process more than in the non-transference work group. Based on the sparse literature in the field we expected that transference work in the context of elevated parental CT might be beneficial for patients with more severe personality pathology, but possibly harmful for patients without personality pathology. The rationale for this differential prediction is as follows: When personality pathology is high, parental CT informs the therapist’s appreciation of the patient’s needs for protective (positive parental) engagement. However, when personality pathology is low, therapists are advised to be more neutral and adopt an “analytic” neutral stance. Parental CT may not be accurately attuned to these patients’ needs, and possibly impede exploration. One hundred outpatients seeking psychotherapy for depression, anxiety, and personality disorders were randomly assigned to dynamic psychotherapy with a low to moderate level of transference work, or to the same type of therapy, but without transference work. Transference work was defined broadly, as all interventions that allude to the therapist or the therapy. The same therapists did both treatments after extensive training. Personality pathology was evaluated before treatment as the sum of fulfilled personality disorder criteria on SCID II. Countertransference feelings were assessed with the Feeling Word Checklist-58 (FWC-58), the therapists were asked to rate to what degree they had experienced 58 feeling states after each session. In this paper we study the Parental countertransference (CT) subscale which had the highest mean value of the subscales. The parental CT subscale included the words: Motherly, Affectionate, Dominating, and Important. The outcome variables were the Psychodynamic Functioning Scales and Inventory of Interpersonal Problems, measured at pre- treatment, mid-treatment, post-treatment, one year, and three years after treatment termination. A significant treatment group (transference vs. no transference) by personality pathology by parental CT interaction was present. This indicates that parental CT had significantly different impact on the effect of transference work, depending on the level of personality pathology. In the context of low parental CT, transference work was positive for all patients. However, when parental CT increased, the specific effect of transference work was even more positive for patients with high levels of personality pathology, but negative for patients with low levels of personality pathology. These patients did not deteriorate, but the patients with little personality pathology in the non-transference
PCT
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