치료공동체에 있어서의 치료자의 역전이적 반응

Counter -transferential Reaction in a Therapeutic Community

Countertransferential reation, here was defined in a broader sense by the authors to mean not only therapist’s own problem, confilct, expectation and drive toward the patient, but also conflict originated from therapists’ subgroup interaction and conflict originated from the value system as a whole therapeutic miliea As individual psychotherapy, ther apasts own problem and countertransferential re action should be grasped, understood, and analysed also in milieu therapy to improve therapeutically the social system where they are belonged to. The authors deeply realized the importance of these reactions to improve the milieu system from their experiences of running Wonju Therapeutic Community for the last three years, and in this paper, they tried to grasp therapists’ problems and countertransferential reactions elicited through deep individual interview from 17 staff members who had worked or has been working in their community. The contents were discussed on four variables as follows : 1)Therapist Variable : Therapists usually feel much more psychological pressure and tension in the therapeutic community than in other hospital environment, and they also realize much change in the their personality mainly to positive direction since working in the therapeutic community. 2) Inter- Staff Variable ：The inter-staff conflict influences directly to the patients psychopathology so that it should be under stood and analysed through interpersonal and inter-subgroup communication. 3) Leadership Variable : Longing for strong, even charismatic leadership is expressed by all staflfe paradoxically in order to establish democracy in the therapeutic community, and various expectation and phantasy of the staffs were directed to the leader. 4) Counteransferential Variable : There always exists bipolar cycle of stable stagnation and oonflictual turmoil in the therapeutic community Interstaff conflic rather than individual staff conflict mare frequently provided the chance to provoke counter transferential reation, and most staff thought that occational direct expression of the reation toward the patient is much healthier than absolute suppres-sion