心理治療者的反移情研究

A Study of Psychotherapists' Countertransference

本研究旨在探討心理治療者的反移情經驗，邀請四位心理動力取向之治療者為受訪對象。採用「深度訪談法」，以一對一半結構式的訪談方式進行，每位受訪者接受2—5 次，共5至7.5小時訪談。研究問題包括：對反移情的看法與定義？對反移情的體驗？對反移情的處理？在經歷反移情後的治療效果與自我效能評估？個人在處理反移情上的壓力與困境？研究結果發現：1.反移情感覺包括喜歡、欣賞、痛苦、遺憾、害怕、失望、丟臉、責備及生氣；反移情行為包括順應個案需求、情緒過度涉入、形成非治療關係及忽略個案。2.反移情影響包括：過早結束治療關係、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、藉以瞭解個案的動力。3.反移情的觸發包括：個案的行為模式與特質、個案的過去經驗、會談中特殊事件與議題、對治療進展的評估、對個案的知覺、個案的移情。 4.反移情的來源包括：治療者的性格因素、自戀自尊受損、價值觀、個人經驗、對治療效果的期待及特殊議題。5.反移情處理包括：設定清楚的治療結構、不斷的自我覺察與瞭解、運用專業能力、自我接納、克制與暫時擱置、接受督導。

The purpose of this study was to explore psychotherapists’ countertransference (CT) experiences. Four psychotherapists using the psychodynamic approach were interviewed by the individual depth interview method. Each therapist took 5-7.5 hours on average to complete the interview. Five research questions were raised: 1.How to define CT? 2.What were the CT experiences? 3.How to manage CT? 4.What were the impacts of CT on the therapeutic effectiveness and experience of being a therapist? 5.What were the difficulties in managing CT?The findings were: 1.CT feelings included liking， admiration， pain， regret， fear， inability， guilty， blame， and anger. CT behaviors included complying with the client’s request， emotional involvement， forming a non-therapeutic relationship， and neglecting the client. 2.CT effects on terminating prematurely， blocking effective therapeutic progress， losing objectivity while judging problems， not being able to end the session on time， building tense therapeutic relationship， and blocking the understanding of the client. 3. CT was triggered by clients’ behavior patterns and traits， clients’ past experiences， special events， special issues， the evaluation of the therapeutic progress， therapists’ perception of clients and clients’ transference. 4.CT was originated from therapists’ personality traits， therapists’ narcissistic injury， therapists’ values， therapists’ personal experiences， therapists’ expectation of therapeutic effects and specific issues. 5.CT management contained setting clear therapeutic structures， enhancing self-awareness and self-understanding， self-acceptance， and professional ability， abstinence and receiving supervision.