研究生: |
林淑君 LIN,Shu-chun |
---|---|
論文名稱: |
心理治療者的反移情研究 A Study of Psychotherapists' Countertransference |
指導教授: | 陳秉華 |
學位類別: |
碩士 Master |
系所名稱: |
教育心理與輔導學系 Department of Educational Psychology and Counseling |
論文出版年: | 1999 |
畢業學年度: | 87 |
語文別: | 中文 |
論文頁數: | 251 |
中文關鍵詞: | 心理治療 、反移情 |
英文關鍵詞: | Psychotherapy, Countertransference |
論文種類: | 學術論文 |
相關次數: | 點閱:246 下載:0 |
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中文摘要
本研究之目的在較整體地探討心理治療者的反移情,包含心理治療者對反移情的定義與看法;反移情反應(情緒、認知、行為)、反移情反應對心理治療的影響、被個案觸發的材料、源於心理治療者本身的因素(來源);心理治療者對反移情的處理;在處理過反移情後,對個案的心理治療效果及自我效能評估,以及對個人及專業工作的影響;心理治療者在處理反移情的經驗中,曾面臨的困境以及如何因應。綜合上述結果,期能增進對反移情的瞭解,以減少反移情所導致的負面影響。
在文獻方面,本研究探討了反移情的相關概念、理論及研究,以及有效處理反移情的相關因素與建議。在研究方法上,本研究採用質的研究取向之「深度訪談法」,邀請四位心理動力取向之心理治療者為受訪對象,蒐集其個人的反移情經驗,並以謄錄訪談逐字稿的方式整理訪談內容,以現象學取向的方法步驟進行資料分析與歸納;以描述文方式呈現各受訪者個人的反移情經驗,並綜合四位受訪者的反移情相關因素。
綜合資料分析的結果,本研究有如下的發現:
一、四位受訪者都一致認為反移情有部份是來自於治療者個人過去的經驗或未解決的衝突;而個案的移情或投射所引發的治療者的感受也算是反移情。
二、本研究發現受訪者都曾出現過正向感覺及負向感覺,然大部份的反移情感覺都是令人不舒服的負向感覺。當受訪者對個案有反移情時,曾出現「對個案的動力或狀態有所假設」、「對治療的企圖或想法」、「對治療關係的期待或評估」、「對個案的期待」、「對個案的評價」等看法。反移情行為有:「順應個案需求」、「情緒過度涉入」、「形成非治療關係」、「忽略個案」、「介入受限」等。
三、綜合整理受訪者對個案的反移情對治療的影響有:「結束治療關係」、「阻礙治療的有效進行」、「阻礙問題判斷的客觀性」、「無法準時結束」、「緊張的治療關係」、「形成非治療關係」、「藉以瞭解個案的動力」等。
四、個案觸發治療者反移情的因素有:「個案的行為模式與特質」、「個案的過去經驗」、「特殊事件」、「特殊議題」、「對治療進展的評估」、「對個案的知覺」、「個案的移情」等。源於受訪者個人的因素有「治療者個人的性格因素」、「治療者的自戀與自尊的受傷」、「治療者的價值觀」、「治療者的個人經驗」、「治療者的工作角色或工作經驗」、「治療者對治療效果的期待」、「特定的內容主題」,以及其他。
五、處理反移情的方式有:「設定、堅持清楚的治療結構」、「不斷的自我覺察與瞭解」、「治療者的專業能力」、「治療理念」、「專業倫理」、「自我接納」、「克制與暫擱置」、「自我強度」、「宗教的理解與慰藉」、「理智化」、「終止或結束治療關係」、「和同事討論」、「藉助於督導」、「個案討論會」以及「接受輔導」等。
六、在成功的處理反移情感覺後,會覺得治療效果與自我效能頗高,如:「肯定治療關係的意義」、「個案有長足的進步與改變」、「治療成功」;自我效能如:「欣賞自己」、「成就感、驕傲」、「更為成熟的治療者」、「信心」等等。
七、反移情的處理經驗對心理治療者而言都會有所學習,綜合歸納包括「對心理治療所持的態度與想法的轉變」、「因反移情的處理經驗而有許多的學習與省察」、「對個人的其他方面影響」等。
八、在處理反移情的經驗中,受訪者曾面臨過的困境包括「沒有督導的幫助」,因應方式為「向外尋求資源」、「靠自己慢慢的覺察與瞭解」;「新手時的困境」,因應則為「自省」、「經驗的增長」;「個人的衝突」,因應之道在「想法上的調適」、「回顧與整理自己」、「在治療架構中控制自己」;「倫理上的困難」,則「以尊重個案為原則」。
九、對新手心理治療者的建議
「自我省察」與「自我了解」是最重要的工作,其他還有「藉由讀書瞭解反移情」、「開放的態度」、「理論架構:瞭解人類心理的內在機轉」、「瞭解自己的內在需求」、「接受輔導」、「持續的自我省察」、「保持適當的心理距離與界限」等。
本研究也對於上述的結果做進一步的討論及綜合結論,並與近二年來其他類似的反移情質性研究在研究方法上做一比較,最後敘明本研究的限制,並對心理治療實務上及研究上提出建議。
A Study of Psychotherapists' Countertransference
Shu-chun Lin
Abstract
The purpose of this study was to understand the psychotherapists' countertransference (CT) experience. Four psychotherapists with psychodynamic approach were interviewed .By using the depth interview of the qualitative research method , a semi-structured interview was conducted and used to collect data . These data include 1.CT reaction , 2.CT effect , 3.CT triggers , 4.CT origins , 5.CT management .
The findings are :
1. CT reaction includes CT feelings and CT behavior. CT feelings include (1)liking, (2)admiration, (3)pain, (4)regret, (5)fear, (6)inability, (7)guiltiness, (8)blame, (9)anger, and (10)others. CT behavior includes (1)complying with client's request, (2)emotional over-involvement, (3)forming a non-therapeutic relationship, and (4)neglecting client .
2. CT effect contains (1)immature termination, (2)blocking therapy effective progress, (3)blocking the objectivity while judging problems, (4)failure to end the session on time, (5)tense therapeutic relationship, and (6)understanding client's psychodynamic.
3. CT triggers contain (1)client's behavior pattern and traits, (2)client's past experience, (3)special events, (4)special issues, (5)the evaluation of the therapeutic progress, (6)therapist's perception of client, and (7)client's transference.
4. CT origins include (1)therapist's personality traits, (2)therapist's narcissitic injury, (3)therapist's value point of view, (4)therapist's personal experience, (5)therapist's expectation of therapeutic effect, and (6)specific issues.
5. CT management contains (1)setting clear therapeutic structure, (2)self-awareness and self-understanding, (3)professional ability, (4)self-acceptance, (5)abstinence, and (6)supervision.
參考文獻
中文部分
牛格正(民85):諮商實務的挑戰-處理特殊個案的倫理問題。台北:張老師出版社。
林家興(民80):情感轉移與反情感轉移。諮商與輔導,66,2-7。
林明雄(民87):反轉移關係。八十六學年度北區大學院校輔導諮詢中心校際觀摩活動暨大型個案討論會資料手冊(未出版)。
胡幼慧(民85):質性研究-理論、方法及本土女性研究實例。台北:巨流圖書公司。
許玉佩(民84):諮商員對諮商歷程中情緒的自我覺察與因應方式之分析研究。彰化師大輔導研究所碩士論文(未出版)。
張春興(民78):張氏心理學辭典。台北:東華出版社。
張學善(民87):諮商員反移情之分析研究。彰化師大輔導研究所碩士論文(未出版)。
黃慧涵(民81):反轉移。諮商與輔導,78,45-47.
蔡榮裕(民83):客體關係理論的"反轉移關係"(Countertransference)部份觀點。採菊東離下,第二卷第十二期(未出版)。
蔡榮裕(民87):【登堂入室反轉移關係:由投射性認同到神入】--替自己在自己的潛意識版圖裡找到座標(導讀)。八十六學年度北區大學院校輔導諮詢中心校際觀摩活動暨大型個案討論會資料手冊(未出版)。
呂紹文、劉慧卿譯(民85):心理治療實戰錄。台北:張老師出版社。譯自Basch,M.F.,(1980).Doing Psychotherapy.NY:Basic Books .
吳芝儀、李奉儒譯(民84):質的評鑑與研究。台北:桂冠圖書公司。譯自Patton,M.Q.,(1990).Qualitative Evaluation and Research Methods.Sage Publications.
張秀卿譯(民79):兒童治療之督導-治療困境之分析及反轉移處理。社區發展季刊,第二十五期。Weff,N.B.(1989).The Clinical Supervisor,Vol.7(4).
劉素芸、林進祿、廖偉君譯(民85):精神分析師與個案之間。採菊東離下,74期至79期(未出版)。譯自Meyers,H.C.,Between analyst and patient:new dimensions in countertransference and transference.
劉佳昌譯(民84):自戀的型態與轉化。採菊東籬下,第三卷第十六期(未出版)。譯自Kohut:Forms and Transformations of Narcissism.。
謝珮玲、楊大和譯(民87):客體關係理論與心理劇。台北:張老師出版社。譯自Holmes,P.(1992).The Inner World Outside-Object Relations Theory and Psychodrama.London:Routledge.
英文部分
Anderson, K.L.(1992).The development of countertransference scale. Unpubished Disseration. Drake Univertity.
Arlow, J.A.(1985). Some technical problems of counteransference. Psychoanalytic Quarterly, 54(2), 164-174.
Bachrach, H. M. (1976).Empathy:We know what we mean, but what do we measure? Archives of General Psychiatry, 33,35-38.
Bandura, A.(1956). Psychotherapists' anxiety level, self-insight and psychotherapeutic competence. Journal of Abnormal and Social Psychology, 52, 333-337.
Bandura, A., Lipsher,D.H.,& Miller,P.E.(1960). Psychotherapists' approach- avoidance to patients' expressions of hostility. Journal of Consulting Psychology, 24, 1-8.
Beier, E. G.(1966).The silent language of psychotherapy. Chicago:Aldine.
Berry, J.W.(1970).Therapists' responses as a function of level of therapist experience and attitude of the patient. Journal of Consulting and Clinical Psychology, 34, 239-243.
Beres, D., & Arlow, J. A. (1974).Fantasy and identification in empathy. Psychiatric Quarterly, 43, 26-50.
Breer, W.(1987).The adolescent molester. Springfield, IL: Charier C Thomas.
Butler,S.F., Flasher,L.V. & Strupp,H.H (1993).Countertransference and qualities of the psychotherapist. Psychodynamic Treatment Research.NY:Basic Books.
Cahoon, R. A. (1968). Some counselor attitudes and characteristics related to the counseling relationship .Doctoral dissertations ,Ohio State University, 23, 347.)
Cerney,M.S.(1985).Countertransference Revisited. Journal of Counseling and Development./February/Vol.63.
Chessick, R.(1993). A Dictionany for Psychotherapist-Dynamc Concept in Psychotherapy.Jason Aronson Inc,Northvale, New Jersey.見謝佩玲、楊大和譯 (民87):客體關係理論與心理劇。台北:張老師出版社。
Corey, G. & Corey,M.S.(1993). Becoming a helper. CA: Brooks/Cole Publishing Company.
Corey, G.,Corey,M.S. & Callanan, P.(1993).Issues and ethics in the helping professions. CA: Brooks/Cole Publishing Company.
Cutler, R.L.(1958).Countertransference effects in psychotherapy. Journal of Consulting Psychology, 22, 349-356.
Epstein, L.(1977).On the growing interest in countertransference as a therapist instrument. Contemporary Psychoanalysis, 13, 399-406.
Epstein, L., & Feiner,(1979)Conutertransference : the therapist's contrubution to the treatment process. New York: Aronson.
Fiedler, F.E.(1951). A method of objective quantifications of certain countertransference attitudes. Journal of Clinical Psychology, 7, 101-107.
Fish,J. M. (1970).Empathy and the reported emotional experiences of beginning psychotherapists. Journal of Consulting and Clinical Psychology, 35, 64-69.
Friedman,S.C. & Gelso,J.G.(1997).The development of the inventory of countertransference behavior. Paper presented at the 105 annual meeting of the American Psychological Association , Chicago , USA.
Friedinger,A.L.(1991).Counsellors' Strategies for Managing Their Stressful Reactions to Clients .University of Victoria , British Columbia , Canada . Master Theses.
Fromm-Reichmann, F.(1950). Principles of intensive psychotherapy. Chicago: University of Chicago Press.
Gamsky, N.R. & Farwell, G.F.(1966).Counselor verbal behavior as a function of client hostility. Journal of Counseling Psychology, 13, 184-190.
Gelso, C.J. & Carter, J.A. (1985). The relationship in counseling and psychotherapy: Components, consequences, and theoretical antecedents. The Counseling Psychologist, 13, 155-243.
Gelso,C.J.& Carter,J.A.(1994).Components of the psychotherapy relatiionship: their interaction and unfolding during treatment .Journal of counseling psychology , 1994 ,41,(3),296-306.
Gelso, C.J., Fassinger, R.E., Gomez, M.J., & Lattw, M.G.(1995). Countertransference reaction to lesbian clients: The role of homophobia, counselor gender, and countertransference management. Journal of Counseling Psychoiogy, 42, 356-364.
Gill, M. M.(1982).Analysis of transference (Vol. 1.).Madison, CT: International Universities Press.
Gorkin,M.(1987). The uses of countertransference. Northvaie, NJ:Jason Aronson.
Graff, H., & Luborsky, L. L.(1997).Long-term trends in transference and resistance: A report on a quantitative-analytic method applied to four psychoanalyses. Journal of the American Psychoanalytic Association, 25, 471-490.
Greenson, R. R. (1960). Empathy and its vicissitudes. International Journal of Psycboanalysis, 41, 418,-424.
Greenspun,W. (1992,August).Transference and Countertransference Reaction in Therapy with Incestuous Families. Paper presented at the 100 annual convention of the American Psychological Association , Washington ,DC.
Grey, A. & Fiscolini,J.(1987). Parallel process as transference-countertransference interaction. Psychoanalytic Psychology, 4, 131-144.
Haccoun,C.M. & Lavigueur, h.(1979).Effects of clinical experience and client emotion on therapists' responses . Journal of Consulting and Clinical Psychology, 47, 284-290.
Hayes,J.A.,Gelso,C.J.,Van Wagoner,S.L.,Diemer,R.A. (1991). Managing Countertransference:What the experts think. Psychological reports ,69,139-148.
Hayes, J.A. & Gelso, C.J.(1991).Effects of therapist-trainees' anxiety and empathy on countertransference behavior. Journal of Clinical Psychology, 47, 284-290.
Hayes, J.A. & Gelso, C.J.(1993).Male counselors' discomfort with gay and HIV-infected clients. Journal of counseling Psychology, 40, 86-93.
Hayes ,J.A., Riker ,J.R.,& Ingram,K.M.(1997). Countertransference behavior and management in brief counseling :A field study. Psychotherapy Research ,7,145-153.
Hayes,J.A., McCracken,J.E.,McClanahan ,M.K, Hill ,C.E ., Harp , J.S., Carozzoni,P.(1997,August).Therapist perspectives on countertransference : qualitative data in search of a theory. Paper presented at the 105 annual meeting of the American Psychological Association , Chicago , USA.
Hayes,J.A.(1995).Countertransference in group psychotherapy :Waking a sleeping dog . International Journal of Group Psychotherapy, 45,521-535.
Heimann, P.(1950).On countertransference. International Journal of Psychoanalysis, 31, 81-84.
Heimann,P. (1960).Countertransference. British Journal of Medical Psychology,33,9-15.
Kernberg, O.(1965). Notes on countertransference. Journal of the American Psychoanalytic Association, 13, 38-56.
Langs, R.(1974). The technique of psychoanalytic psychotherapy. New York: Jason Aronson.
Latts,M.G. & Gelso,C.J.(1995). Countertransference behavior and management with survivors of sexual assault. Psychotherapy,32.
McClure, B.A., & Hodge, R.W.(1987).Measuring countertransference and attitude in therapeutic relationships. Psychotherapy, 24, 325-335.
Mintzer, M.B.(1996).Understanding countertrasference reactions in working with adolescent perpetrators of sexual abuse .Bulletin of the menninger clinic,Spring96,vol.60.
Moursund,J.(1993): The Process Of Counseling And Therapy(3rd Ed).Prentice-Hall,Inc.
Mueller, W.J.(1969).Patterns of behavior and their reciprocal impact in the family and in psychotherapy. Journal of Counseling Psychology, 16(2,)341-345.
Panken,S.(1981).Countertransference reevaluated. The Psychoanalytic Review,68,24-44.
Peabody, S.A. & Gelso, C.J.(1982). Countertransference and empathy: The complex relationship between two divergent concepts in counseling. Journal of Counseling Psychology, 29, 240-245.
Reich, A.(1951). On countetransference. International Journal of Psychoanalysis, 32, 25-31.
Reich, A.(1960).Further remarks on countertransference. International Journal of Psychoanalysis, 41, 389-395.
Robbins,S.B. & Jolkovski,M.P.(1987).Managing countertransference feelings: An interactional model using awareness of feeling and theoretical framework .Journal of Counseling Psychology,34,276-282.
Robertiello, R.C. & Schoenewolf, G.(1987). 101 common therapeutic blunders: countertransference and counterresistence in psychotherapy. Northvale, NJ:Jason Aronson.
Rosenberger,E.W., & Hayes,J.A.(1997,August). Through a looking glass somewhat clearly : A case study of Countertransference. Paper presented at the 105 annual meeting of the American Psychological Association , Chicago , USA.
Russell, P. & Snyder, W.(1963).Counsellor anxiety in relation to amount of clinical experience and quality of affect demonstrated by clients. Journal of Counseling Psychoiogy, 22, 358-363.
Schneider, S. (1992). Transference, countertransference, projective identification and role responsiveness in the supervisory process. The Clinical Supervisor, 10(2),71-83.
Singer, B.A., & Luborsky, l.(1977).Countertransference: The status of clinical vesus quantitatitive research. In A. Gurman & A. Razin(Eds.0,Effective psychotherapy: Handbook of research. New York: Pergamon.
Slakter, E.(Ed.)(1987). Countertransference. Northvaie, NJ: Jason Aronson.
Snyder, W.U. & Snyder, B.J. (1961). The Psychotherapy Rslstionship. New York: Macmillan.
Van Wagoner , S. L., Gelso , C . J . , Hayes , J .A . , & Diemer , R . A .(1991) . Countertransference and the reputedly excellent therapist . Psychotherapy , 28 , 411-421.
Watkins,C.E.(1985).Countertransference : Its Impact on the Counseling Situation. Journal of Counseling and Development,63.356-359.
Winnicott, D. W. (1949).Hate in the counter-transference. In D.W. Winicott(1958),Collected Papers .NY:Basic Books.
Yulis, S. & Kiesler, D.J.(1968).Countertransference reponse as a function of therapist anxiety and content of patient talk. Journal of Consulting and Clinical Psychology, 32, 413-419.