An empirical study of countertransference reactions toward patients with personality disorders

Objective: The study examined to what extent patients with cluster A + B personality disorders (PDs) evoked other countertransference reactions among psychotherapists compared with patients with cluster C PDs as well as the relationship between the different countertransference reactions and outcome. Methods: A total of 11 therapists at the Department for Personality Psychiatry, Ullevaal University Hospital, Oslo, Norway, filled out the Feeling Word Checklist-58 (FWC-58), 2 weeks after admission and 2 weeks before discharge, for 71 patients admitted to the day treatment program. The patients were diagnosed with the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). Results: The study revealed that patients with cluster A + B PDs evoked more negative and less positive countertransference reactions than those with cluster C PDs. The psychotherapists varied significantly more in their reported countertransference reactions toward patients with cluster A + B PDs than toward those with cluster C PDs. Patients who dropped out of treatment evoked significantly more negative countertransference reactions after 2 weeks than patients who completed the treatment. In addition, the study revealed strong correlations between countertransference feelings and change during the treatment. Conclusions: This empirical study confirms clinical narratives on specified relationships between countertransference reactions, different PDs, and treatment course. (c) 2007 Elsevier Inc. All rights reserved.