LAUSR

World Psychiatry 19:2 June 2020 ing self-disclosures of what they are feeling can be helpful to the treatment process. It is common knowledge that therapists are disclosing things about themselves whenever they are choosing to comment on a particular aspect of what the patient is saying. However, these inadvertent self-disclosures are not the same as specific technical interventions designed to allow one to use the countertransference constructively. In some treatments with some patients, self-disclosures may be constructive. Therapist’s feelings are often apparent to the patient and to deny them would be disingenuous. If the patient sees that the therapist is upset and asks “Are you angry?” , the therapist might, for example, say “I think you are accurately detecting some of my feelings, and I hope we can understand what is happening here to make me irritated” . Direct self-disclosure of countertransference feelings is often contrasted with containment of those feelings that ultimately lead to interpretation and understanding. In the reality of clinical practice, containment and self-disclosure are by no means mutually exclusive and often work together synergistically. Countertransference has moved to the heart of psychodynamic technique. It has evolved from a narrow conceptualization of the therapist’s transference to the patient to a complex and jointly created phenomenon that is pervasive in the treatment process. Much has been made about the “fit” between patient and therapist, and countertransference is largely determined by that fit. A clinician must remember that enactments involving countertransference provide valuable information about what is being re-created in the therapeutic setting. In this regard, therapists are wise to recognize that they will be drawn into various roles in the course of the therapy, and that maintaining an artificial aloofness is neither desirable nor helpful.