Abstract

The doctor-patient relationship has been and remains a keystone of care. But there are many ways of understanding, classifying and practicing it. One of the ways is from the psychodynamic point of view. Transference and countertransference reactions influence the doctor-patient relationship. There is a permanent process of reciprocal and dynamic influence between the doctor and his patient. Doctor is a mirror in which the patient projects fantasies, desires, needs, or even bad relationships: patient transfer his expectation about the doctor’s knowledge. The transference of the patient generates a countertransference of the doctor. As patient is the mirror in which the doctor is reflected, one of the frequent mistakes of the doctor is not to consider his own conflicts (unresolved, manifest) in the countertransference with his patients. If the doctor does not have the sensitivity to perceive the countertransference phenomenon, sometimes reacts with anger, contained or manifest, when the patient does not submit. Positive countertransference allows the doctor the energy needed to understand the patient and generates a placebo effect on the patient; negative countertransference, on the other hand, interferes with the motivation and objectivity of the doctor to perform his interventions, and exerts a nocebo effect. To avoid negative effects, the doctor must take an alert attitude to sublimate your countertransference and keep it positive. Transference and countertransference (positive and negative) in the hands of the doctor becomes the most potent of the therapeutic instruments and plays an important role in the healing process. Therefore, transference and countertransference must not only have one cause (which should be recognized by the doctor), but also one purpose: to be used to obtain better therapeutic results.

Keywords: Communication; Physician patient relations; Psychotherapeutic processes; Transference (Psychology); Countertransference (Psychology); Placebo effect; Nocebo effect