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Psychoanalytic Psychology © 2009 American Psychological Association

2009, Vol. 26, No. 3, 235–245 0736-9735/09/$12.00 DOI: 10.1037/a0016445

COUNTERTRANSFERENCE IN CHILD
PSYCHOANALYTIC PSYCHOTHERAPY
The Emergence of the Analyst’s Childhood

Christopher Bonovitz, PsyD


New York, New York

The author focuses on a particular type of countertransference with children—


the emergence of the therapist’s childhood memories and experiences in child
psychotherapy. The revival of these childhood recollections in the analyst is not
a barrier or sign of pathology as previously held, but rather in some cases a vital
resource that may potentially deepen and facilitate analytic work. The thera-
pist’s memory and attendant fantasies, physical/sensory experience, and affect
states in the context of the childhood memory may afford the analyst the
opportunity to not only make contact with his or her “self” as a child, but also
to further symbolize these states of mind and use them in the exploration of
the child patient’s mind. Through intersubjective exchanges with the patient, the
analyst’s childhood memories are given new meaning in the context of the
therapeutic work with the child patient. The author highlights the uniqueness of
countertransference with children as compared with adults. A detailed clinical
vignette is presented, organized around the arrival of a memory from the
analyst’s childhood and how the analyst made use of it in the transference/
countertransference field.

Keywords: child psychotherapy, countertransference, enactment, play, memory

Probably most therapists1 who treat children have likely bumped up against reminis-
cences, recollections, and memories from their own childhoods. Sometimes these reflec-

Christopher Bonovitz, PsyD, Faculty and Supervisor of Psychotherapy, William Alanson White
Institute; Faculty, New York University (NYU) Postdoctoral Program in Psychotherapy & Psycho-
analysis, and Manhattan Institute for Psychoanalysis; Assistant Editor, Psychoanalytic Dialogues;
Associate Editor, Contemporary Psychoanalysis.
An earlier draft of this paper was presented as part of the child colloquium series at the William
Alanson White Institute, sponsored by the Freida Fromm-Reichmann Society, Spring 2007.
Correspondence concerning this article should be addressed to Christopher Bonovitz, PsyD,
Independent Practice, 119 Waverly Place, Ground Floor, New York, NY 10011. E-mail: chrisfb@
nyc.rr.com

1
The words therapist and analyst will be used interchangeably throughout.

235
236 BONOVITZ

tions are fleeting, roaming through our minds barely noticed. Yet, on other occasions, an
image, smell, kinetic or somatic experience transports the therapist back to a specific
memory from childhood. These excursions may take us by surprise, bringing us into
contact with memories that we may not have not given much thought to for quite some
time. In some cases, these childhood recollections bring with them an experience of
ourselves as children, allowing us to revisit a self-state that may have been dormant until
then and now is reexperienced within the relational context of a particular child patient.
But what comes to pass with these childhood reminiscences? What do we do with our
associations to ourselves as children? What utility, if any, do they have? How do we use
or not use them in relation to the patient? Do these private remembrances become part of
our own private dialogue, viewed as separate from the patient, or do we regard them as
intertwined with the patient’s relational configurations and the transference/
countertransference field? In this article, I will examine those moments or situations when
the analyst makes contact with childhood memories and experiences. Just as Freud (1912)
described in his discovery of transference that the presence of the analyst revives
“forgotten,” or dissociated, memories and feelings toward parental figures, so too I believe
that children stimulate memories of the analyst’s own childhood experiences. The revival
of these childhood recollections in the analyst is not necessarily a barrier or sign of
pathology as previously held, but rather in some cases is a vital resource that may
potentially deepen and facilitate analytic work. The focus here is on those situations when
the unexpected arrival of the analyst’s childhood in the playroom may be used to elucidate
the transference/countertransference field.
Although the analyst’s fantasies, associations to scenes, events, and affect states from his
childhood are at times a painful distraction that may interfere in the treatment, there are other
occasions when these memories may afford him the opportunity to not only make contact with
himself as a child, but also to further symbolize these states of mind and use them in the
exploration of the child patient’s mind. In the revival of the analyst’s childhood, the analyst can
use his own recollections to access and more fully understand the child’s conflicts, relation-
ships, and internal world. I believe that the stimulation and use of the analyst’s childhood
remembrances is sometimes a necessary, even essential, process that keeps the past alive in the
present. It allows for an evolving mental reorganization within the analyst and a potentially
new experience of himself in relation to the patient (Wolstein, 1959; Loewald, 1960). Or, in
other words, for the patient to change the analyst must come to know himself in a new way
(Slavin & Kriegman, 1998).

Evolving Perspectives on Countertransference With Children

Generally speaking, theorists in the field of child psychotherapy and psychoanalysis have
debated over the years the extent to which the analyst’s countertransference has utility and
some of the risks associated with it. On the whole, it appears that more has been written
about countertransference with adolescent patients compared with children (Akeret &
Stockhamer, 1965; Friend, 1972; Giovacchini, 1973; Levy-Warren, 1996). Marshall
(1979), who sees the analyst’s reactions as potentially useful, suggests that there is a
neglect of countertransference in the child field which he sees as a reflection of “coun-
tertransference problems” among therapists treating children. Some analysts saw these
so-called countertransference problems in the past only as barriers or obstacles to the
treatment, not as potentially useful in moving through impasses or thorny transference/
countertransference enactments (Corday, 1967; Slavson, 1952; Szurek, 1950). Similarly,
COUNTERTRANSFERENCE IN CHILD PSYCHOANALYTIC PSYCHOTHERAPY 237

Bornstein (1948) and Bick (1962) both warn of the intensity of the therapist’s reactions to
the child creating a strain on the therapist. From this point of view, the child therapist is
vulnerable to heightened anxieties and guilt and is susceptible to acting out with the child.
However, there have also been a number of child analysts who have endorsed the idea
that countertransference may be helpful and facilitative (Brandell, 1992; Ekstein, Waller-
stein, & Mandelbaum, 1959). Contemporary Kleinians such as Alvarez (1983) and Ferro
(1992) speak of countertransference with children in terms of projective identification.
Drawing on the work of Bion, who is responsible for “interpersonalizing projective
identification,” Alvarez stresses the importance of receiving and containing projections.
For Alvarez, receptive containment involves transforming the projection and then effec-
tively communicating it back to the patient in the form of an interpretation. The failure of
containment is manifested in a premature interpretation, giving the projection back to the
patient before it has been sufficiently modified. Ferro’s object of study is the transference/
countertransference relationship, or the “bipersonal field” in which the analyst’s counter-
transference is primarily viewed as an unconscious phantasy induced by the patient. Ferro
points out that the analyst may sometimes need to turn to the patient’s communication to
better understand his own countertransference. And beyond the Kleinians, in his seminal
paper on countertransference, Winnicott (1949) wrote about the analyst’s need to be able
to hate his patient, to tolerate and bear the strain of it. For Winnicott, hate was part and
parcel of love in that it was developmentally essential for the baby to feel the mother’s
hate to feel truly loved.
Interpersonal and relational analysts emphasize the intense reactions among child
therapists and the utility of countertransference reactions. In some cases, these analysts
advocate for the direct expression of countertransference (Colm, 1955; Gaines, 1995;
Green, 1971; Shafran, 1992). Altman, Briggs, Frankel, Gensler, and Pantone (2002) speak
about countertransference in terms of enactments in which analyst and patient enact, or
play out, the patient’s relational paradigms. Here, the analyst is not only an old object for
the patient, but also potentially a new one as well.
The idea that the analyst’s history may not only be revived, but also reshaped and
transformed through the analytic relationship with the child has its analogue in the
parent–infant dyad. The parent–infant model (Fraiberg, Adelson, & Shapiro, 1975;
Lieberman, 1992; Stern, 1995) and contributions from contemporary Kleinians (see
Klauber, 1991) offer a theoretical framework where the representational worlds of the
parent and baby are interacting within the same sphere and interpenetrating each other
through projective and introjective identifications (Altman, 2002; Bonovitz, 2006; Pan-
tone, 2000; Stern, 1995). The parent’s internal self-object representations, through real
experience as a parent, are reshaped and the parent’s childhood relationships and events
reexamined with a new lens.
Although he was not referring specifically to child patients, Jacobs (1991) has written
quite eloquently and in great detail about the use of his own childhood experiences in the
context of transference/countertransference enactments, memories that he effectively
utilizes to expand his awareness of the more subtle aspects of his own reactions.
In Ogden’s (1994) language, during the course of analysis the analyst’s experience is
intersubjectively generated, transformed through the interplay of the analyst and patient’s
respective subjectivities. Intersubjectivity as mentioned here and at other points along the way
refers to the developing capacity for recognition, the recognition of the other as simultaneously
separate yet connected, existing outside the self with his or her own feelings and thoughts (see
Benjamin, 1990). In the tradition of Winnicott (1971), Benjamin (1990) describes intersub-
jectivity as entailing the “transition from relating (intrapsychic) to using the object, carrying on
238 BONOVITZ

a relationship with an other who is objectively perceived as existing outside the self, an entity
in her own right” (p. 192). What I am describing as the revival of the analyst’s childhood
experiences is not merely the uncovering of something that had been buried, but rather these
experiences are given new meaning in the intersubjective context of the therapeutic work with
a child. For Benjamin (1990), intersubjectivity involves the capacity to hold the tension
between relating to the other as object (product of intrapsychic life) and relating to the other
as subject (other who exists outside of the self).

Varieties of Countertransference With Children Compared With Adults

Countertransference, as I use it here, refers to the total response of the analyst to the
patient (all the feelings and thoughts), conscious and unconscious. The totality of the
analyst’s reactions is infused with the analyst’s personal conflicts and internalized object
relations, as well as shaped by the particular context and “real relationship” with the
patient (Tansey & Burke, 1989).
The analyst’s own childhood remembrances and the inhabiting of child self-states
from the past is but one of many types of countertransference with children. In addition
to revisiting versions of herself as a child, the analyst also may access experiences of
herself as a sibling, parent, grandparent, or friend with the young patient. For instance,
recognizing my own countertransference in some instances has brought me back to those
relationships that predominantly involved play. For Sullivan (1953), these friendships,
which he termed chumships, are a critical and necessary part of the child’s development.
The child or preadolescent can begin to see himself through the eyes of his chum in a
different way compared with the past, and therefore may become more able to integrate
previously disapproved aspects of himself (Brown, 1995). Similarly, the therapist, through
working with the child, may be reminded of such chums and have the chance to reintegrate
these more dissociated aspects of himself from childhood.
In the analytic situation with a child patient, there is often more contact in the sensory,
somatic, and physical realms of experience. While of course speech is part of the play, it is
accompanied by elaborated sensory-somatic modes of experiences as well: high and low
pitched noises, whispering, yelling, olfactory wafting of a snack or a fart, hiding under
furniture, using and contorting one’s body to role play or enact the part of a character, and so
on. The therapist’s bigger physical self in relation to the child’s smaller self is engaged in an
ongoing negotiation of their respective physicality and its reciprocal impact. During fantasy
play or more concrete forms of play such as abbreviated games of soccer and football, the
respective body of child and therapist are in close proximity if not in occasional contact,
sometimes brushing up against each other, bumping into one another in the midst of a game,
taking part in a celebratory “high-five,” or more extreme forms of physical expression on the
part of the young child or more disturbed patient such as spitting, biting, and hitting.
The therapist holds the responsibility to keep the child physically safe, trying to strike
a balance between “playing” and tracking the unspoken communication which takes place
in the physical sphere. The feelings engendered in the therapist are not only contextualized
by the transference/countertransference field at any given moment with the child, but also
by the child’s parent, family, psychoanalytic culture, and the larger society.
As with adult patients, the child analyst may experience a range of affects in the
countertransference including love, hate, boredom, affection, contempt, tenderness, guilt,
excitement, and annoyance. However, as with physicality between a big person (therapist)
and small person (child), the varying intensity of these feelings, and the thoughts and
COUNTERTRANSFERENCE IN CHILD PSYCHOANALYTIC PSYCHOTHERAPY 239

images which accompany them, are shaped and given meaning by the mere fact that the
analyst is an adult and the patient is a child. For the child analyst to have loving or hating
feelings toward the child patient is a very different experience than feeling these same
sorts of emotions with an adult patient.
The sense of parental responsibility, protectiveness, and concerns with doing harm or
damage are heightened with a child patient as compared with an adult. The therapist’s
concern with unintentionally exploiting the child, arising out of her own (analyst’s)
narcissistic needs, have the potential to interfere with the extent to which the therapist
allows herself to experience the full force of her feelings and cultivate the internal space
for her fantasies to breathe. Depending on the nature and intensity of the therapist’s
emotional experience, the therapist’s analytic superego may limit her from inhabiting
these mental and affective states. If fear and anxiety prevail, it may foreclose private
exploration and interfere with her use of countertransference to illuminate the more subtle
and nuanced dimensions of the interaction.
Independent of the therapist’s “real” concerns and worries, which any child therapist
can sympathize with, how the therapist uses his countertransference with a child patient
also differs from that of an adult patient. Not only are language and verbal speech the
primary modes of communication for an adult, but the cognitive, intellectual, and
symbolic capacities are often more developed and therefore lend themselves to a more
direct, collaborative exploration. With children, as opposed to adults, the analyst cannot
rely as much on language and the symbolic sphere; how the analyst communicates his
countertransference with the child is quite different as compared with an adult as a result
of the child’s less developed cognitive abilities. The chronological and developmental age
of the child (among many other factors), as well as all that is packed in a specific clinical
moment, will affect the words we use, our tone of voice, and to what extent we interpret
or offer observations within the metaphor of the play or outside of it.
With regard to the unexpected arrival of the analyst’s childhood memories, the type of
countertransference that is the subject of this article, I am working off of the assumption
that these memories are not only revealing of the analyst’s history, but may illuminate
some aspect of the relational field which otherwise was out of awareness. The fact that the
memory arises with a child patient necessarily influences the analyst’s experience of her
memory such that the same memory, if it were to occur with an adult patient, would be
a different experience. The analyst’s identification with the child and the child’s uncon-
scious relationship to the analyst’s memory contextualizes the analyst’s experience of it.
The memory itself may not only shed light on something about the analyst and patient
respectively, but also their interaction and how each is impacting the other. The analyst
may silently “look” at his memory and associations in the service of generating an
observation, empathic observation, or interpretation. Or, similar to an adult patient, the
therapist may enlist the child to help him (therapist) to make sense and better understand
his own affective experience. Generally speaking, the use of the analyst’s countertrans-
ference holds the potential to open up reflective space in which the child can begin to
probe the other’s mind and come to know aspects of himself through the other’s
experience of him—to look at himself as an object through the eyes of the analyst.

The Analyst’s Guilt in “Just Playing”

In play therapy with children, the child uses the play space and the relationship with the
analyst as a vehicle through which to enact his or her fantasies, wishes, and the relational
240 BONOVITZ

scripts woven into the inner and outer world of the child. Play, as Frankel (1998) puts it,
is a “way of approaching a problematic part of ourselves, something in ourselves that we
do not yet fully accept, and of trying to find a place for it in our lives. Through play, we
integrate it into our experience of ourselves and into our interpersonal relationships” (p.
152). In play, the child’s representations of significant persons in his life not only make
themselves known in the characters of the play, but play presents the child with the
opportunity to bend and reshape these representations, therefore shifting the child’s
perceptual lenses. Play is an essential component of therapeutic action (Ablon, 2001;
Birch, 1997; Bonovitz, 2004; Cohen & Solnit, 1993; Neubauer, 1987; Slade, 1994).
In relation to play itself, another type of countertransference with children that often
accompanies the emergence of the analyst’s childhood memories is the guilt the analyst
experiences when involved in play. It is fairly common to hear child therapists admit
feeling guilty for “not doing anything but playing with the child.” Child therapists feel
especially guilty in those situations where the therapist experiences the play as enjoyable.
There is the feeling that one should be doing more of what might be deemed “real work,”
making astute observations and interpretations. The pleasure, excitement, and joy that a
therapist may sometimes experience in playing with a child makes the therapist question
what it is he or she is “doing” exactly, questioning their technique and approach with the
child. Furthermore, the analyst’s superego may contribute to the feeling that the analyst
should not necessarily be enjoying the play as much as he or she may be. It is cause for
concern. Although upon further reflection the therapist can of course begin to see that, in
fact, much more is going on than “just playing.” The actual play itself in the consulting
room may quickly become a complicated endeavor.
While the kind of guilt that I am describing is something every child therapist has
experienced at one time or another, deepening our understanding of it in the context of the
transference/countertransference may engage the therapist’s historical and ongoing inter-
nal relationship with play. The child patient’s play may bring to the fore a set of feelings
and conflicts rooted in the analyst such that the analyst’s relationship with play becomes
a critical part of the dyadic exchange, imbuing the shared act of play with a complex set
of meanings.

Losing as “The End of The World:” Enlisting the Child’s Aid to Understand
the Analyst’s Countertransference

Angus, a stocky 9-year-old boy, was a soccer fanatic. He usually came to his sessions
dressed in his favorite soccer jersey and ready to play. Our games would begin with
choosing a team—France, Brazil, United States, and so on—and a favorite player whose
identity we would assume for that day. Over time, we developed a ritual in preparing my
office for the game: moving around the furniture and setting up the goals. Angus was
proud of his soccer ability and often began the game with a brief report about his actual
soccer team and their performance the weekend past. He was highly sensitive and brittle,
yet, contradictorily, determined and willful. He rarely gave up, but instead battled to win.
Winning was everything or, put another way, losing felt like “the end of the world,” which
made competition take on life and death proportions. He had a precocious older sister who
could do no wrong in their parents’ eyes, and so Angus lived in his older sister’s shadow
with the feeling that whatever he did was lacking in some way.
Angus referred to himself as a “pessimist” with a hint of pride. To him a pessimist was
someone who preferred to think of things not working out in order not to get his hopes up.
COUNTERTRANSFERENCE IN CHILD PSYCHOANALYTIC PSYCHOTHERAPY 241

This attitude manifested itself in our soccer games so that anytime I had the lead, even
early on in the game, he would announce that I was probably going to win the game.
Although he would say this in a defeatist tone of voice, he in fact would not throw in the
towel but instead would dig his heels in even more. I, in turn, would find myself “letting
up” without consciously intending to do so. I would wind up not playing as intensely,
which made it much easier for Angus to score. In response to his anxiety about my
possibly winning the game, I became protective of him and worried that I might hurt him
if I were to continue playing hard and won the game. I sometimes even had the fantasy
of his hitting his head on the windowsill, or tripping and chipping his tooth. Although a
fantasy, what may have fueled this is that there were a few occasions when he had, indeed,
gotten hurt, though only mildly so. On these occasions, he seemed to play up his injury
and I felt guilty, as if I were throwing my weight around too much. I was big and he was
small, so I had to watch it. Needless to say, as this transference/countertransference pattern
became more pronounced between us, I ended up losing many of our games.
A feature of Angus’ family emerged in the background of these soccer games, as well
as my own conflict with winning. He was initially referred to treatment because of his
brooding tantrums during which he would cry hysterically, and then withdraw into himself
without communicating for long periods of time, sometimes up to several hours. When in
this state of mind, he felt persecuted by everyone around him. There was only one reality
in this kind of situation, and that was his version. Nothing his parents could say brought
him out of it, and they were often left feeling helpless and incredibly frustrated. Angus
was consumed with how he had been wronged.
Although these tantrums became less frequent over time, and he was able to recover
more and more rapidly from disappointment or perceived slights, his parents remained
highly attuned, and reactive, to nonverbal cues in Angus as signs that he might be headed
into a downward spiral— heavy breathing, a particular facial expression, or rapid eye-
blinking as if he were about to cry. Whatever feelings of exasperation his mother or father
felt were converted into accommodation, desperately searching for ways to pacify him
before he broke down. This kind of reaction on their part gave Angus a tremendous feeling
of power, which he wielded to his advantage, becoming demanding and insistent.
Conversely, his parents’ accommodations, particularly his mother’s, could reinforce in
him a feeling of fragility. Both his mother and father, weary of constant battles because
of their respective conflicts around aggression, retreated in the face of rising tensions.
To return to my fantasies of Angus getting hurt, I started to become more aware of
how my protectiveness toward him and urge to allay his fear of losing may relate to my
disowning, or dissociating, from my own aggressively tinged feelings. Was I fearful of
hurting Angus? Did a part of me want to hurt him? Was I frightened of my own power
in relation to him? Was I trying to avert disaster by giving in and “allowing” him to win?
Although there was evidence from those few occasions when I did win that Angus was,
in fact, capable of handling my victory, this was somehow not enough to reassure me.
Our respective interpersonal character styles became apparent from the way each of us
played the game. Angus was a good goalie, meaning he was vigilant and closely guarded
his goal, making it difficult for me to score. When in the lead, he worried about making
careless mistakes, so he tended to play more defensively, not risking being caught off
guard. He was skillful in figuring out my strategies, and adjusted his play accordingly. A
favorite gambit of Angus’ was to stand behind a large chair with the ball, using it as a
bulwark against me so that I had to wait until he moved one way or the other, or risk his
having a wide open shot on my goal. When the game was tied or if he had a slim lead,
242 BONOVITZ

he would seek out a moment of reprieve behind this chair. He described this place of his
as “heaven,” as he was not “disturbed” when resting there.
I began to find my so-called “let ups” in competition with Angus familiar. I was
reminded of those many instances when, in competition as a kid, I tended to back off when
in the lead. It was as if I decided to allow someone else to win instead of me. That was
safer for some reason. Reflections on my own relationship with competition in the context
of soccer with Angus led me back to my childhood friend Stephen, a friendship from
around the time when I was Angus’ age. In the midst of my soccer games with Angus, I
became increasingly aware of the resemblance between my office and the English
basement in my friend Stephen’s house where many a game took place.
My memories in this instance were organized around our athletic competition (foot-
ball, soccer, and baseball), all in this tight, narrow space. In these games, things became
heated, with each of us fiercely competing with the other to win as though “everything
were on the line.” Stephen, who was more courageous than I at the time, was more willing
to throw his body around for the sake of advancing the ball, or blocking a goal. An
inevitable part of these games involved one or the other of us stopping play to argue a
“call,” dispute a play, or to renegotiate the rules. While most of the time these arguments
were resolved, there were a few occasions when they escalated into a serious struggle,
which resulted in one of us becoming quite angry and then quitting the game. I recalled
the feeling afterward, worried that Stephen and I might not continue to be friends. What
had felt so important to me in the midst of the game gave way to an overwhelming anxiety
over losing my friend. I loved our friendship. It was the world to me, and I certainly did
not want anything to jeopardize it.
With my mind playing host to these passing, yet significant, memories of my
friendship with Stephen, I became curious about the threat of loss I experienced in
response to our heated, unresolved disputes. Unclear how all this related, but gradually
convinced of its relevance because of its recurrence in my own thoughts, at some point I
decided to enlist Angus’ help in understanding what might be going on between us.
In this particular session, I tried bringing my observations to him after our game, a
game that, true to form, he had won after I had had the lead and all the momentum at the
beginning. I told him something to the effect of, “I notice that sometimes when I have
the lead I begin to slow down, at which point you begin to play better and gain the
momentum. I wonder if you have any ideas about why this happens.” Initially, he looked
at me as if to say, “How would I know?” I persisted, stating, “I think you may have some
clues about it.” A moment later he said, “I get angry when I start to lose, and that makes
you scared.” I asked how he could tell I was scared. He replied, “You’re scared like other
people are. I see it in your face and the way you play; you stop playing hard.” There were
hints of disappointment in his voice.
I paused here and considered what Angus was telling me. Was I, indeed, scared of his
anger? Was the change in my play that he was referring to a version of abandonment? Did
he feel angry with me for backing off from our intense competition, something that was
taken away from him midstream? Unsure about all this, I asked him why he thought I was
scared of him. He replied, “Maybe because I like to be perfect, and you think you will hurt
me if you win.” I was surprised by Angus’ insight into his own narcissistic conflicts, as
well as his keen observations of my reactions to his perceived fragility. I told him that I
thought he was onto something very important, and that what he said felt right to me.
Why did I find myself taking precautions? Who was I protecting from my aggression,
me or Angus? For the following couple sessions, Angus’ impressions periodically took me
back to my friendship with Stephen. I returned to the feeling I had stumbled on before: my
COUNTERTRANSFERENCE IN CHILD PSYCHOANALYTIC PSYCHOTHERAPY 243

concern with losing my friendship with him following our arguments, my fear that we
would not be able to resolve our dispute. Curiosity about this “old” feeling of mine led me
to thoughts about loyalty and promises that were so essential to my friendships at the time.
What Angus had helped me understand through his impressions about my slowing down
in our games was the possibility that he felt I was reneging on my “promise” to play, and
play for the entire game. Though he could see why I backed off, he was also reminding
me that I was taking him to be less resilient than he really might be. He was letting me
know that I did not have to necessarily be so scared of his anger. He could take it, or at
least I could give it more of a chance.
I began to more clearly see the connection between my relinquishing my intense
competitiveness and my perception of Angus’ fragility, a situation not so unlike what
occurred between Angus and his mother. In becoming more acquainted with the interac-
tions between Angus and his mother, I came to see how she would sometimes very quickly
disengage from him when she sensed he was reaching his frustration threshold. Yet, it was
her disengagement, like mine, which left Angus with a collection of bad feelings toward
himself.
Having marked this pattern of ours in the game, while it did not immediately
disappear, we were able to more readily identify it together and leave it open for further
exploration. Not only had Angus stimulated and reanimated memories of mine, but they also
proved to be a useful avenue into deepening my understanding of what was transpiring in the
room with him. This was also an instance where I had enlisted Angus and his impressions to
help shed light on the shifts in me during our games. In doing so, he was showing me aspects
of my participation and its impact on him, which I had not been altogether clear on. Working
through my countertransference not only involved examining my reactions in the context of
Angus’ interpersonal world, but also further symbolized my childhood friendship and its
relation to my feelings around competition, aggression, and loss.

Conclusion

I have tried to show through this clinical vignette how scenes, memories, and states of
mind spontaneously emerged in the context of various transference/countertransference
configurations. Memories from the analyst’s childhood, emerging from within dyadic
exchanges with the child, are reanimated and coconstructed with the child. There is a
continual, fluid interplay between the present transference/countertransference enactment
in the treatment and excursions into analyst’s past, each giving shape and imbuing each
other with meaning. The therapist’s memories are not rediscovered in frozen packages
there to be found as if a buried antiquity, rather childhood scenes are recreated and then
transformed during the course of the treatment.
In some cases, as illustrated with Angus, periodically revisiting the analyst’s childhood
experiences at different moments in the treatment shifts one’s perspective on them, enabling
the therapist to grasp feelings and thoughts about them that had until then eluded him. Working
with countertransference involves developing the capacity to first recognize and tolerate it, and
then actively use it, as opposed to dismissing it as self-absorption or, similarly, as unrelated and
therefore something to be avoided or sectioned off from work with the child patient.
Aspects of the analyst’s childhood inevitably emerge with the child patient. The analyst’s
countertransference in relation to his own childhood is critical in keeping these experiences
alive in the analyst, and the past present in the moment. The analyst’s countertransference
is essential in deepening one’s understanding of the child’s emotional and mental life, as well
244 BONOVITZ

as that of the analyst’s. Developing ways to use countertransference has the potential to
facilitate analysis, working through impasses and protracted enactments.
On a final note, in writing this article, I discovered my childhood longings that
emerged with some child patients not only had to do with unmet needs, unresolved
conflicts, and loss from childhood, but also were reinvigorated by being presented with the
opportunity to revisit aspects of my childhood. As the word “opportunity” suggests, I
believe that the chance to engage the memories, associations, and fantasies emerging out
of our past and recreated with the child patient may aid us in recognizing the “other child”
in the room with us.

References
Ablon, S. L. (2001). The work of transformation: Changes in technique since Anna Freud’s
Normality and Pathology in Childhood. Psychoanalytic Study of the Child, 56, 27–38.
Akeret, R. U., & Stockhamer, N. (1965). Countertransference reactions to college drop-outs.
American Journal of Psychotherapy, 19, 622– 632.
Altman, N. (2002). Relational horizons in child psychoanalysis. Journal of Infant, Child, and
Adolescent Psychotherapy, 2, 29 –39.
Altman, N., Briggs, R., Frankel, J., Gensler, D., & Pantone, P. (2002). Relational child psycho-
therapy. New York: Other Press.
Alvarez, A. (1983). Problems in the use of countertransference: Getting it across. Journal of Child
Psychotherapy, 9, 7–23.
Benjamin, J. (1990). Recognition and destruction: An outline of intersubjectivity. In S. A. Mitchell
& L. Aron (Eds.), Relational psychoanalysis: The emergence of a tradition (pp. 181–211).
Hillsdale, NJ: The Analytic Press.
Bick, E. (1962). Symposium on child analysis: I. Child analysis today. International Journal of
Psychoanalysis, 43, 328 –332.
Birch, M. (1997). In the land of counterpane: Travels in the realm of play. Psychoanalytic Study of
the Child, 52, 57–75.
Bonovitz, C. (2004). The cocreation of fantasy and the transformation of psychic structure.
Psychoanalytic Dialogues, 14, 553–580.
Bonovitz, C. (2006). Unconscious communication and the transmission of loss. In D. Siskind, K.
Hushion, & S. Sherman (Eds.), Understanding adoption. Northvale, NJ: Jason Aronson.
Bornstein, B. (1948). Emotional barriers in the understanding and treatment of children. American
Journal of Orthopsychiatry, 18, 691– 697.
Brandell, J. R. (1992). Countertransference in psychotherapy with children and adolescents.
Northvale, NJ: Jason Aronson.
Brown, L. (1995). A glossary of interpersonal psychoanalytic concepts and terms. In M. Lionells,
J. Fiscalini, C. Mann, & D. B. Stern (Eds.), The handbook of interpersonal psychoanalysis (pp.
861– 876). Hillsdale, NJ: The Analytic Press.
Cohen, P. M., & Solnit, A. J. (1993). Play and therapeutic action. Psychoanalytic Study of the
Child, 48, 49 – 63.
Colm, H. (1955). A field theory approach to transference and its particular application to children.
Psychiatry, 18, 329 –352.
Corday, R. J. (1967). Limitations of therapy in adolescence. Journal of Child Psychology, 6,
526 –538.
Ekstein, R., Wallerstein, J., & Mandelbaum, A. (1959). Countransference in the residential treatment
of children: Treatment failure in a child with symbiotic psychosis. Psychoanalytic Study of the
Child, 14, 186 –218.
Ferro, A. (1999). The bi-personal field: Experiences in child analysis. London: Routledge.
Fraiberg, S., Adelson, E., & Shapiro, V. (1975). Ghosts in the nursery: A psychoanalytic approach
COUNTERTRANSFERENCE IN CHILD PSYCHOANALYTIC PSYCHOTHERAPY 245

to the problem of impaired infant–mother relationships. Journal of the American Academy of


Child Psychiatry, 14, 1387–1422.
Frankel, J. (1998). The play’s the thing: How the essential processes of therapy are seen most clearly
in child therapy. Psychoanalytic Dialogues, 8, 149 –182.
Freud, S. (1905). Fragment of an analysis of a case of hysteria. Standard Edition (Vol. 7, pp. 1–122).
London: Hogarth Press. 1953.
Freud, S. (1912). The dynamics of transference. Standard Edition (Vol. 12, pp. 99 –108). London:
Hogarth Press. 1958.
Friend, M. R. (1972). Psychoanalysis of adolescents. In B. B. Wolman (Ed.), Handbook of child
psychoanalysis (pp. 297–363). New York: Van Nostrand-Reinhold Co.
Gaines, R. (1995). The treatment of children. In M. Lionells, J. Fiscalini, C. Mann, & D. B. Stern
(Eds.), The handbook of interpersonal psychoanalysis (pp. 761–769). Hillsdale, NJ: The Analytic
Press.
Giovacchini, P. (1973). Productive procrastination: Technical factors in the treatment of the
adolescent. Adolescent Psychiatry, 4, 352–270.
Green, M. (1971). The interpersonal approach to child therapy. In B. Wolman (Ed.), Handbook of
child psychoanalysis. New York: Van Nostrand-Reinhold Co.
Jacobs, T. (1991). The use of the self. Madison, CT: International Universities Press.
Klauber, T. (1991). Ill treatment in the countertransference: Some thoughts on concurrent work with
an adopted girl and with her family by the same psychotherapist. Journal of Child Psychother-
apy, 17, 45– 61.
Levy-Warren, M. H. (1996). The adolescent journey: Development, identity formation, psychother-
apy. Northvale, NJ: Jason Aronson.
Lieberman, A. F. (1992). Infant–parent psychotherapy with toddlers. Development & Psychopa-
thology, 4, 559 –574.
Loewald, H. (1960). On the therapeutic action of psychoanalysis. In Papers on psychoanalysis (pp.
221–256). New Haven, CT: Yale University Press.
Marshall, R. J. (1979). Countertransference in the psychotherapy of children and Adolescents.
Contemporary Psychoanalysis, 15, 595– 629.
Neubauer, P. (1987). The many meanings of play. Psychoanalytic Study of the Child, 42, 3–9.
Ogden, T. (1994). Subjects of analysis. Northvale, NJ: Jason Aronson.
Pantone, P. (2000). Treating the parental relationship as the identified patient in child psychother-
apy. Journal of Infant, Child, and Adolescent Psychotherapy, 1, 19 –38.
Shafran, R. (1992). Children of affluent parents. In J. O’Brien, D. Pilowsky, & O. Lewis (Eds.),
Psychotherapies with children and adolescents (pp. 269 –288). Washington, DC: American
Psychiatric Press.
Slade, A. (1994). Making meaning and making believe: Their role in the clinical process. In A. Slade
& D. W. Wolf (Eds.), Children at play: Clinical and developmental approaches to meaning and
representation (pp. 81–107). New York: Oxford University Press.
Slavin, M. O., & Kriegman, D. (1998). Why the analyst needs to change: Toward a theory of
conflict, negotiation, and mutual influence in the therapeutic process. Psychoanalytic Dia-
logues, 8, 247–284.
Slavson, S. R. (1952). Child psychotherapy. New York: Columbia University Press.
Stern, D. (1995). The motherhood constellation. New York: Basic Books.
Sullivan, H. S. (1953). The interpersonal theory of psychiatry. New York: Norton.
Szurek, S. (1950). Problems around psychotherapy with children. Journal of Pediatrics, 37,
671– 678.
Tansey, M. J., & Burke, W. F. (1989). Understanding countertransference: from projective
identification to empathy. Hillsdale, NJ: The Analytic Press.
Winnicott, D. W. (1949). Hate in the counter-transference. International Journal of Psychoanaly-
sis, 30, 69 –75.
Winnicott, D. W. (1971). Playing and reality. London: Tavistock.
Wolstein, B. (1959). Countertransference. New York: Grune & Stratton.

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