Back from the Abyss: Psychiatry in Stories

Trauma in the Transference—Repairing the therapeutic relationship


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The magic of psychotherapy is that it brings forth transference— the patient’s most important and formative relationships, typically with early caregivers, are unconsciously re-enacted in the therapy room. And this transference necessarily creates countertransference, the therapist’s unconscious reactions to the transference. 

Alexandria came to Dr. H originally due to her severe harm OCD. But over time, it became clear to him, and eventually to her, that she was increasingly, and unconsciously, trying to put him in the role of the abandoner, the critic, the emotional abuser. This process is called projective identification, and as you will hear, it played out very dramatically between them, and was a major factor in her plans to die.


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Back from the Abyss: Psychiatry in StoriesBy Craig Heacock MD

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