Table 88-2 Transference and countertransference with dependent patients

Table 88-2 Transference and countertransference with dependent patients
Transference	Countertransference
1. Patient makes many requests for help and guidance early in treatment.	Therapist withdraws from patient, increasing risk for early termination.
2. Patient idealizes therapist as all-knowing and gives him or her responsibility for important decisions.	Therapist assumes a directive role because of frustration with patient or wish to be idealized.
3. Because of a wish to preserve the attachment to therapist, patient fails to advance.	Because patient is overtly cooperative, therapist fails to confront the lack of real change.
4. Patient is unable to leave a repeatedly abusive relationship, evoking in therapist the desire to control or punish patient.	Therapist experiences frustration and pushes patient to leave the abusive relationship. Patient feels threatened, and separation anxiety increases.
5. Patient avoids mourning past losses and avoids anticipating loss of therapist at termination.	Therapist fails to confront patient's avoidance because of own fantasy of always being available or fear of provoking separation panic, thus hindering dynamic change and putting patient at risk for sense of betrayal after termination and subsequent deterioration.