Countertransference and Related Subjects: Selected Papers

Countertransference and Related Subjects (New York: International Universities Press, 1979; paperback 1999) is the second collection of Harold F. Searles's papers, following his Collected Papers on Schizophrenia and Related Subjects (1965). Its twenty-four chapters, with an introduction, come from his later career. Most concern the intensive psychoanalytic psychotherapy of schizophrenic and borderline patients, and the analyst's own emotional participation in that work. Searles treats the analyst's feelings, including guilt, hope, dedication and the urge to heal, as clinical evidence about the patient and the relationship rather than as interference to be eliminated. Several papers trace the phases of treatment from autism and pathological symbiosis, through ambivalent symbiosis, to a therapeutic symbiosis from which individuation can develop. Others take up delusional transference and the patient's realistic perceptions of the analyst; identity formation and dual or multiple identity in borderline functioning; paranoid processes within a hospital treatment team; violence in schizophrenia; and transitional phenomena. The volume also includes the long paper "The Patient as Therapist to His Analyst". Searles argues there that every person has a therapeutic striving toward others, that psychological illness is bound up with the frustration of that striving, and that the analyst must allow the patient to help them. Book reviews, discussions and an essay on unconscious processes in the environmental crisis widen the range. Library Journal praised its plain, jargon-free prose and vivid clinical portraits, and its sense of the humanity patients share with their therapists.