Research Proposal: Countertransference Hate, Suicidal Patients, and Chuck Mahoney

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Countertransference Hate, Suicidal Patients, And Chuck Mahoney

What is Countertransference Hate?

In order to understand Maltsberger's concept of countertransference in a patient - therapist environment one must accept that the suicidal patient is sometimes able to turn the tables on the therapist. In a very real way the suicidal patient transfers the stress and pressure of this emotional clash onto the shoulders and into the mind of the therapist, according to Maltsberger. Indeed, if the therapist is aware of the patient's ability to use countertransference against the therapist, there should be no problem because the alert therapist is aware of this dynamic. But if the therapist is not conscious of the countertransference by the patient, it may "generate well rationalized but destructive acting out by the therapist" (Maltsberger, 1974, p. 625).

It goes without saying that simply because a patient is suicidal does not mean that patient is stupid or dull. To the contrary, some very bright people -- even geniuses -- have shown tormented personalities and considered taking their own lives. So with this understanding and acceptance Maltsberger (p. 626) explains that the patient may transfer his hate onto the therapist through various kinds of provocations. Those provocations may be "highly inventive, persistent, and effective" (p. 626). Some of the provocations may be brutally evil. The patient may attack the therapist's style of dress, or he may attack the therapist's personal life. For example, maybe the therapist went through a divorce and the patient found out about it and uses that as a flaw in the therapist's competence; or perhaps the therapist is an African-American and the patient calls him a "nigger" (p. 626).

Maltsberger references an incident in which female patients actually got their therapists' home phone numbers and telephoned threats to that therapist as the therapists were sitting down to Christmas dinner. In time, Maltsberger continues, the hate that the patient showers upon the therapist in a countertransference environment may cause the therapist to "…wonder if he himself is not deeply sick, and he may experience ideas of self-punishment, degradation, or possibly suicide" (p. 629). In a situation that places the therapist in a totally unacceptable compromising and defensive emotional condition, what might happen, according to Maltsberger, is the therapist then becomes a hater himself, and take out his "malice" by attacking the patient with a "masochistic stance" (p. 629).

Bernstein Article -- After a Suicide, Privacy on Trial

According to the Bernstein article, college officials at the institution Chuck had attended believed they had no right to call the parents regarding his dangerous behavior (of potential personal destruction), because the parents did not insist their son sign a waiver allowing the school to breach confidentiality and notify the parents of their son's condition. That having been said, Chuck did in fact sign a policy statement that assured his confidentiality would be respected unless he appeared to pose "an immediate threat" to himself or others -- including suicide (Bernstein, p. 2). But throughout the article there is circumstantial evidence that Chuck Mahoney was a terribly troubled young man, and his behaviors had alerted Ms. Kondrot, the counseling director, to seek help for him. There was no excuse for the failure of college officials to finally notify Chuck Mahoney's parents that he was spiraling downward into self-destruction.

Moreover, this article shows that again and again, Chuck displayed behaviors that were clearly dangerous to him and perhaps others. An alert reader cannot help but wonder why the seemingly petty regulation about notification of Chuck's family (e.g. "confidentiality") prevented Chuck from getting the help he needed. None of the intimate conversations between Chuck and the various doctors and counselors who worked with him are available to examine for this paper, so it is difficult to say for certain whether countertransference took place. It is impossible in fact to know if Chuck had verbally attacked Ms. Kondrot -- or any of the others who were trying to assess his problem or help him -- in a way that would cause Ms. Kondrot to lash back at him (countertransference), because those snippets of dialogue were not made available for this assignment.

Indeed, in reading the Bernstein article several times carefully, there is little if any evidence that Chuck transferred hate towards those professionals (or friends or his girlfriend) who were trying to help him. And there seems little evidence that Chuck Mahoney showed hatefulness towards those trying to help him, or anyone, other than perhaps himself.

The fraternity brothers who talked to the counselor, Ms. Kondrot, did not indicate that Chuck was being hateful towards them or angry. They simply said "…that he was spending a lot of time alone in his room, drinking heavily" (Bernstein, p. 3). The article raises a lot more questions than providing answers, and so subjectively a reader could assume certain things about Chuck's interactions with those in a position to provide comfort or relief for him.

Evidence of Consistently Poor Responses to Chuck's Pleas -- Balancing the Right to Privacy Against the Need to Prevent Chuck's March Toward Suicide

Again and again Bernstein presents journalistic information that clearly indicates Ms. Kondrot should have been alert enough to call Chuck's family. The counseling center's policy statement that Chuck signed allowed a school official to contact his family in the event that Chuck presented "an immediate threat" to himself and others. That should have been plenty of legal justification for Ms. Kondrot to notify the parents that their son was thinking of killing himself, because, for just one example, Chuck sent an email saying, "I hate living and I hate the prospect of going through another day…I am sad and angry and alone, alone, alone, alone…"

Wasn't that the ideal time to use the legal loophole that Chuck had signed? How much more evidence did Ms. Kondrot need to be able to see the darkness that was enveloping Chuck? The list of doctors that Ms. Kondrot herself consulted vis-a-vis Chuck's instability, included Dr. Klions, Dr. Bresner, but they were receiving second-hand information from Ms. Kondrot. Why didn't she set up appointments with those doctors, rather than relaying information second hand? She was not even licensed to be a counselor, notwithstanding her degree in counseling. Of course during his sophomore year Ms. Kondrot had called Chuck's parents because he had said, "It seems there is not a night, before I go to bed that I do not plead to God to please not let tomorrow come, but it comes and comes" (Bernstein, p. 2). And he spent five days in psychiatric ward after that incident, so when his suicidal signs showed in the subsequent periods, Ms. Kondrot surely must have felt compelled to phone his family -- and yet she did not.

Were there sign of countertransference in any of Chuck's sessions? That is impossible to know because, as mentioned earlier, the transcripts or notes from his sessions are not available. However, on the very day that Chuck committed suicide Ms. Kondrot had an hour and a half session with him. "At one point she started to cry and told him she felt he needed more help than she could provide," Bernstein writes. Did she cry because Chuck had shown hateful provocations against her in a transference of some sort? Was Chuck able to turn the tables on Ms. Kondrot through a "highly inventive, persistent, and effective" series of personal attacks (vis-a-vis a Maltsberger-described transference that led to a countertransference by Ms. Kondrot)? Readers simply don't know those details in this instance hence; it is pure conjecture as to why she cried.

When a Client Commits Suicide The Fallout Hurts the Therapist: In the Journal of Mental Health Counseling (McAdams, et al., 2000) the authors reviewed 1,000 cases of "randomly selected professional counselors" as regards the "frequency and impact of client suicide" (McAdams, p. 107). The survey showed that "Counselors reported having intrusive and avoidant thoughts about the crisis that were higher than those of either psychologists or psychiatrists" (McAdams, p. 107). The "severity and persistence" of those stress symptoms were "greater" for the counselors who were students at the time of the suicide than they were for professional counselors who had already been in professional practice, albeit both student and professional counselors experience "serious consequences" after a client commits suicide. This is perhaps what Ms. Kondrot experienced after Chuck's suicide, albeit that information was not available in Bernstein's article.

In the American Journal of Psychiatry (Lipschitz, H.H., and Maltsberger, J.T., 2000) the authors reviewed the responses of 26 therapists (81% of them were men) who had treated patients who later committed suicide. In reviewing those 26 therapists' responses to the suicides, seven emotional reactions were recorded. They included: grief (the most frequent emotion); shock and disbelief; guilt (some experienced dreams in which they were guilty); fear or blame or reprisal (some were afraid of being sued, others just did not want to be blames); anger or betrayal (some felt that they were angry because their efforts had been… [END OF PREVIEW]

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Countertransference Hate, Suicidal Patients, and Chuck Mahoney.  (2009, November 8).  Retrieved July 17, 2019, from https://www.essaytown.com/subjects/paper/countertransference-hate-suicidal/69897

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"Countertransference Hate, Suicidal Patients, and Chuck Mahoney."  Essaytown.com.  November 8, 2009.  Accessed July 17, 2019.
https://www.essaytown.com/subjects/paper/countertransference-hate-suicidal/69897.