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研究生: 謝珮玲
Pey-Ling Shieh
論文名稱: 心理治療師在心理治療歷程之反移情經驗研究
A Study on a Psychotherapist’s Countertransference during the Process of Psychotherapy
指導教授: 王麗斐
Wang, Li-Fei
學位類別: 博士
Doctor
系所名稱: 教育心理與輔導學系
Department of Educational Psychology and Counseling
論文出版年: 2003
畢業學年度: 91
語文別: 中文
論文頁數: 139
中文關鍵詞: 反移情心理治療歷程現象學
英文關鍵詞: countertransference, process of psychotherapy, phenomenology
論文種類: 學術論文
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  • 本研究跟隨一名心理治療師的治療歷程,以現象學取向藉由每次治療後30小時內的訪談,與結案後回顧療程的訪談,探索其在十次治療中的反移情經驗。研究焦點涵括反移情經驗的背景因素、內涵以及轉變,並以提取自訪談資料的架構進行分析。
    研究結果共整理出22個反移情經驗,與背景因素對照下,受訪者對特定案主之反移情經驗,比其對反移情之界定與既有經驗更多樣化且具有雙面的意涵。反移情經驗的相關因素同時包括治療師之固定背景與治療師--案主互動之獨特成份,可依經驗性質區分為「對個案的感受或觀點」、「治療師與治療的角色及地位」、「治療關係與治療維繫」、「分心與聯想」四個主軸。
    「對個案的感受或觀點」在療程中佔最多數,治療師對案主有多樣的感受,其中部分感受會進一步產生對案主的觀點。「治療師及治療的角色與地位」主軸的反移情出現情形居次,治療師在其中的經驗環繞著「治療師究竟是什麼角色」與「治療的地位是什麼」兩個問題,被利用、不被尊重的感受強度可能會影響治療的維繫。在「治療關係與治療維繫」主軸中,治療師對關係的評估直接關乎治療維繫。「分心與聯想」的反移情經驗在本研究出現最少,治療師在其中經歷到隨案主的描述,而有不同聯想內容與認同立場的經驗。
    在經驗轉變的整體趨勢方面,隨著治療的進展,受訪者對個案由不熟悉到熟悉,了解個案之依據由自己的刻板印象和經驗架構,轉變為依據個案故事的特異性。注意焦點由分心於自身議題而專注在「對個案的情緒」、「突兀的反應」和「故事」上。假設驗證的主題由「個案故事與治療師經驗是否一致」,轉為驗證「個案故事內的一致性」、「個案故事與假設的一致性」。在治療之間較細微的轉變上,反移情經驗的轉變是起起伏伏、來來回回的過程,四個反移情經驗主軸出現在療程初期,與其他經驗有著延續與互為因果的關係。
    依據反移情經驗在療程中展現多樣性質,以及由多重因素共同形成與影響其發展狀況的發現,本研究提出在實務訓練與未來研究上的的努力方向。
    關鍵詞:反移情、治療歷程、現象學

    A Study on a Psychotherapist’s Countertransference during the Process of Psychotherapy
    Pey-Ling Shieh
    Abstract
    The purpose of this study is to explore the countertransference during an ongoing process of psychotherapy. The study is conducted by the phenomenology approach. As a ten-session psychotherapy progressed, the psychotherapist was interviewed within 30 hours after each session. The data were analyzed by a framework retrieved from the data itself. The contextual factors, natures and transformation of the countertransference were all described.
    The result yielded 22 units of countertransference experience. When compared with contextual factors, the psychotherapist’s countertransference to the specific client was found to have dual implications and to be more various than her original definition of and previous experiences of countertransference. The related factors of countertransference consisted of the fixed background of the therapist as well as the unique portion of the therapist-client interaction. The four domains of countertransference were classified as ‘feelings or cognitions toward the client’, ‘the role and position of the therapist and psychotherapy’, ’relationship and therapy maintenance’ and ‘distraction with associations’.
    Most units of countertransference fall into the category of ‘Feelings or cognitions toward the client’. The therapist had various feelings toward the client and some of those feeling led to cognitions about the client. ‘Role and position of the therapist and psychotherapy’ is the second most frequent category of the countertransference, which happened when the therapist wondered about ‘what is the role of a therapist’ and ’what is the position of psychotherapy’. The feeling of being used and of not being respected would contribute to the discontinuity of therapy. As for the countertransference of ’relationship and therapy maintenance’, therapist’s assessment of the relationship was directly related to the maintenance of therapy. On ‘distraction with associations’, the therapist experienced various association and identification.
    During the process of the psychotherapy, the familiarity of the therapist with the client increased. The global trend of understanding moved from stereotype-based and experience-based toward specific issues of the client. The focus of hypotheses-testing moved from ‘content consistency between client’s story and therapist’s experience’ toward ’internal consistency within client’s aspects of story’ or ’consistency between client’s story and hypotheses’. The transformation between sessions fluctuated and was recurrent. All four domains occurred at the initial stage and were intertwined with each other throughout the psychotherapy. process.
    Given the findings that the countertransference displayed various natures and was formed by multiple factors, the author suggests some directions about future training and research.
    Keywords: countertransference, process of psychotherapy, phenomenology

    目 錄 致謝 中文摘要 英文摘要 目錄 表次 圖次 附錄次 第一章 緒論…………………………………….………………. 1 第一節 研究動機…………………………………………. 1 第二節 研究目的與研究問題……………………………. 4 第三節 名詞界定………………………………………….. 5 第二章 文獻探討……………………………………………….. 7 第一節 反移情的理論觀點……………………………….. 7 第二節 研究中的反移情………………………………….. 16 第三節 反移情經驗的歷程……………………………….. 26 第四節 現象學研究法…………………………………….. 32 第三章 研究方法……………………………………………….. 46 第一節 研究取向與基本精神…………………………….. 46 第二節 研究參與者……………………………………….. 48 第三節 研究工具………………………………………….. 52 第四節 研究程序………………………………………… 55 第五節 資料整理與分析…………………………………. 57 第六節 信度與效度的檢核………………………………. 63 第七節 結果撰寫…………………………………………. 65 第四章 結果……………………………………………………. 66 第一節 反移情經驗的背景因素…………………………. 66 第二節 各次治療中的反移情經驗……………………….. 76 第三節 反移情經驗的轉變……………………………….. 101 第五章 討論與建議…………………………………………….. 122 第一節 討論……………………………………………….. 122 第二節 建議………………………………………………. 128 參考文獻 ………………………………………………………….. 132 附錄 ………………………………………………………….. 138 表 次 表2-1 反移情的操作性定義整理表…………………………………. 20 表2-2 反移情研究的主題、素材與方式整理表……………………. 23 表4-1 反移情經驗的主軸與主題……………………………………. 78 表4-2 主軸一的反移情經驗:對個案的感受與觀點………………. 79 表4-3 主軸二的反移情經驗:治療師及治療的角色與地位……….. 81 表4-4 主軸三的反移情經驗:治療關係與治療維繫………………. 82 表4-5 主軸四的反移情經驗:分心與聯想…………………………. 83 表4-6 反移情經驗主軸內涵摘要……………………………………. 84 表4-7 反移情經驗相關因素類別與次數分析表……………………. 85 表4-8 反移情經驗主軸的相關因素…………………………………. 87 表4-9 反移情經驗影響類別與次數分析表…………………………. 94 表4-10 反移情經驗主軸的影響分析…………………………………. 95 表4-11 各次治療中的反移情經驗主軸………………………………. 114 表4-12 反移情經驗相關因素與背景因素之關聯表…………………. 117 圖 次 圖3-1 資料收集流程與治療歷程的關聯……………………………. 56 圗3-2 資料整理與分析步驟流程圖…………………………………. 59 圖4-1 反移情經驗的背景因素………………………………………. 75 圖4-2 反移情經驗的整體轉變趨勢…………………………………. 101 目錄次 附錄 研究說明書……………………………………………………. 138

    參考文獻
    李宜靜(民90)。婚姻暴力加害人心理經驗之研究。高雄:國立高雄師範大學輔導研究所碩士論文(未出版)。
    沈孟樺(民89)。精神衛生護理人員照護自殺傾向病患之經驗。台北:國立台灣大學護理學研究所碩士論文(未出版)。
    林淑君(民88)。心理治療者的反移情研究。國立台灣師範大學教育心理與輔導研究所碩士論文(未出版)。
    林淑君、陳秉華(民91)。心理治療者的反移情研究。教育心理學報,34(1),頁103-121。
    胡蓮珍、楊玉娥(民91)。初為人父在角色轉變過程的生活經驗。中山醫學雜誌,13(2),頁227-233。
    高俊一編譯(民71)。現象學宗師─Hursserl。台北:允晨。
    高淑清(民89)。現象學方法及其在教育研究上的應用。載於中正大學教育學研究所主編﹕質的研究方法(頁93-134)。高雄﹕麗文文化公司。
    張慶熊(民86)。生活世界是人類主體間交流的基礎。哲學雜誌,20,頁116-135。
    張學善、蕭文(民88)。諮商員反移情之分析研究。輔導學報,20,頁1-28。
    張憲(1995)。我與他人—胡塞爾現象學交互主觀性初析。鵝湖學誌,15,頁24-46。
    葉玉汝(民87)。精神分裂病患者對幻聽之主觀經驗。桃園:長庚大學護理學研究所碩士論文(未出版)。
    廖仁義譯(民80)。胡賽爾與現象學。台北:桂冠。
    穆佩芬(民85)﹕現象學研究法。護理研究,4(2),頁195-201。
    關永中(民89)。知識論(二):近世思潮。台北:五南。
    Bandura, A., Lipsher, D. H.,& Miller, P. E.(1960).Psychotherapists’ approach-avoidance reactions to patients’ expressions of hostility. Journal of Consulting Psychology,24,1-8.
    Bouchard, M.A., Normandin, L.& Seguin, M. H.(1995). Countertransference as instrument and obstacle: A comprehensive and descriptive framework. Psychoanalytic Quarterly, 64, 717-745.
    Brammer, L. M., Shostrom, E. L.& Abrego, P. J. (1989). Therapeutic Psychology:Fundamentals of Counseling and Psychotherapy. NJ:Prentice Hall.
    Brockett, D. R.,& Gleckman, A. D.(1991). Countertransference with the older adult:the importance of mental health counselor awareness and strategies for effective management. Journal of Mental Health Counseling,13(3),343-355.
    Casement, P. J.(1986). Countertransference and interpretation. Contemporary Psychoanalysis,22,548-559.
    Caspar, F.(1997). What goes on in a psychotherapist’s mind?Psychotherapy Research,7,105-125.
    Cerney, M. S.(1985). Countertransference revisited. Journal of Counseling and Development,63,362-364.
    Chessick, R.(1993). A dictionary for psychotherapist-dynamic concept in psychotherapy. NY:Jason Aronson.
    Corey, G., Corey, M. S.,& Callanan, P.(1993). Issues and ethics in the helping professions. CA:Brooks/Cole Publishing Company.
    Culter, R.l.(1958).Countertransference effects in psychotherapy. Journal of Consulting Psychology,22,349-356.
    Fiedler, F. E.(1951). On different types of countertransference. Journal of Clinical Psychology,7,101-107.
    Friedman, S.,&Gelso, C. J.(1997,August). Development on inventory of countertransference behavior. Paper presented at the 105 annual meeting of the American Psychological Association, Chicago, U.S.A.
    Gelso, C. J.(1979). Research in counseling:Methodological and professional issues. Counseling Psychology,8,7-35.
    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., 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 Psychology,42, 356-364.
    Gelso, C. J. & Hayes, J. A.(1998). The psychotherapy relationship:Theory, research, and practice. NY:John Wiley& Sons.
    Hayes(1995).Countertransference in group psychotherapy:Waking a sleeping dog. International Journal of Group Psychotherapy,45,521-535.
    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).Counselor’s discomfort with gay and HIV-infected clients. Journal of Counseling Psychology,40,86-93.
    Hayes, J. A. & Gelso, C. J.(2002). Clinical implication of research on countertransference: science informing practice. Journal of Clinical Psychology.
    Hayes, J. A., Gelso,,C. J., Van Wagoner, S. L.,& Diemer, R. A.(1991). Managing countertransference:what the expert think. Psychological report,69, 139-148.
    Hayes, J. A., McCracken, J. E., McClanahan, M. K., Hill, C. E., Harp, J. S.,&Carozzoni, P.(1997). Therapist perspectives on countertransference:qualitative data in search of a theory. Paper presented at the 105 annual meeting of the American Psychological Association, Chicago, U.S.A.
    Hayes, J. A., Riker, J. R.& Ingram, K. M.(1997).Countertransference behavior and management in brief counseling:A field study. Psychotherapy research,7(2),145-153.
    Heimann, P.(1950). On counter-transference. International Journal of Psycho-analysis, 31, 81-84.
    Hoffman, I. Z.(1983). Patient as interpreter. Contemporary Psychoanalysis,19,389-422.
    Ihde, D. (1977). Experimantal phenomenlolgy. New York: G. P. Putnam.
    Kernberg, O.(1965). Notes on countertransference. Journal of the American Psychoanalytic Association,13,38-56.
    Kiesler, D. J.(1982).Interpersonal theory for personality and psychotherapy. In J. C. Anchin & D. J. Kiesler(Eds.), Handbook of interpersonal psychotherapy(pp.3-24). New York:Pergamon Press.
    Little, M.(1951). Countertransference and patient’s response to it. International Journal of Psychoanalysis,32,32-40.
    McClure, B. A.,& Hodge, R. W.(1987). Measuring countertransference and attitude in therapeutic relationships. Psychotherapy,24,325-335.
    Moustakas, C.(1994). Phenomenological research methods. CA:Sage.
    Nisbett, R.E., & Ross, L. (1980). Human inference: Strategies and shortcomings of social judgment. Englewood Cliffs, NJ: Prentice-Hall.
    Reich, A.(1951). On countertransference. International Journal of Psychoanalysis,32,25-31.
    Reich, A.(1960). Further remarks on countertransference. International Journal of Psychoanalysis,41,389-395.
    Richards, B. M.(2000). Impact upon therapy and the therapist when working with suicidal patients:some transference and countertransference aspects. British Journal of Guidance& Counselling, 28, 325-337.
    Robbins, S..B.& Jolkovski, M. P.(1987). Managing countertransference feeling:An interactional model using awareness of feeling and theoretical framework. Journal of counseling psychology,34(3),276-282.
    Rosenberger, E.W.,& Hayes, J.A.(1997). Through a looking glass somewhat clear:A case study of countertransference. Paper presented at the 105 annual meeting of the American Psychological Association, Chicago, U.S.A.
    Sandler, J. (1976). Countertransference and role-responsiveness. International Review of Psycho-Analysis,64,35-45.
    Schleidt, W. M.(1982). Review of Lorenz’ The foundation of ethology. Contemporary Psychology, 27, 677-678.
    Singer, B.,& Luborsky,L.(1977). Countertransference:the status of clinical versus quantitative research. In A. Gurman& A. Razin(Eds.),Effective psychotherapy:A handbook of research. New York:Pergamon.
    Springmann, R. R.(1986). Countertransference:clarification in supervision. Contemporary Psychoanalysis,22,252-277.
    Synder, W. U.,& Synder, B. J.(1961). The psychotherapy relationship. New York:Macmillan.
    Van Wagoner, S. L., Gelso, C. J., Hayes, J. A.,& Diemer, R. A.(1991). Countertransference and the reputedly excellent therapist. Psychotherapy:theory, research and practice,28,411-421.
    Watkins, C.E.(1985).Countertransference:It’s impact on the counseling situation. Journal of Counseling and Development, 63,356-359.
    Winnicott, D.W.(1949). Hate in the counter-transference. International Journal of Psycho-analysis,30,69-74.
    Yulis, S.& Kiesler, D.J.(1968).Countertransference response as a function of therapist anxiety and content of patient talk. Journal of Consulting and Clinical Psychology,32,413-419.

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