Reaction Formation as a Counter-Transference Phenomenon in the Treatment of Alcoholism

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Abstract
Because of renounced infantile cravings, the therapist is angered by the constant seeking of indulgence by the alcoholic patient. He may express this directly by rejection of the patient. Because the therapist is often made anxious by any awareness of anger at his patients, he may defend himself by establishing a reaction formation in the form of an overly indulgent and permissive attitude toward the alcoholic. This attitude is destructive of the patient''s chance of recovery as it impairs his reality testing and encourages denial of the severity of the drinking problem. Thus the therapist''s unconscious hostility ultimately finds its mark. A treatment program for alcoholic patients should be scrutinized repeatedly to see whether routine techniques are dictated by what is really best for the patients or whether they are either overt expressions of hostility or the defense against such expression by adoption of an opposite, overly permissive attitude. Both diminish the potential value of a rehabilitation program.

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