International Journal of Behavioral Research & Psychology, 2013 © 1 Henriette Löffler-Stastka, Parth K (2013) Clinical Reasoning and Authentic Clinical Care. Int J Behav Res Psychol. 1(1), 1-3 International Journal of Behavioral Research & Psychology (IJBRP) ISSN 2332-3000 Clinical Reasoning And Authentic Clinical Care Editorial Henriette Löfler-Stastka, Parth K Medical University Vienna, Dept. for Psychoanalysis and Psychotherapy, Vienna, Austria. *Corresponding Author: Henriette Löfler-Stastka, Medical University Vienna, Dept. for Psychoanalysis and Psychotherapy, Vienna, Austria. Tel: +43-1-40400-3070 E-mail: henriette.loefler-stastka@meduniwien.ac.at Received: November 13, 2013 Published: December 9, 2013 Citation: Henriette Löfler-Stastka, Karoline Parth (2013) Clinical Rea- soning and Authentic Clinical Care. Int J Behav Res Psychol. 1(1), 1-3. Copyright: Henriette Löfler-Stastka © 2013. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. In the mental health sector it is the biggest and most important task of the psychiatrist, psychotherapist or interviewer to make a diagnosis that most closely approximates the inner condition of the patient in order to induce proper therapeutic and psychiat- ric treatment. In the ield of mental illness however, this is often very challenging due to the fact that there are feelings, dynamics and experiences that are central to the mental condition of the patient but cannot be verbally communicated. Especially in the ield of trauma, these issues become visible since traumatizing ex- periences often cannot be remembered. There are varying paths to diagnosis and treatment in the mental health sector differing in method and setting, however they all consist of some sort of assessment in the context of an interaction between mental health professional and patient. We argue that in order to achieve a proper diagnosis and treatment for psychic illness, the interac- tion between patient and therapist has to be taken into account to facilitate an understanding of internal dynamics. It is our position that only with proper use of countertransference concepts and the understanding of processes of projective identiication full use of the therapeutic setting for treatment and diagnosis can be achieved. In mental health care, we face the question how to offer adequate care for psychic problems in terms of diagnosis and treatment if there are numerous problems that lie so deep they cannot be adequately communicated by the patient. In the case of very early traumata and severe developmentally impairing experiences, the impact on development and psychic functioning in adulthood is signiicant, however the person affected often only vaguely or not at all remembers them. It must be expected that psychic impair- ments of that kind lead to extensive problems but there often is no conscious connection between these issues in adulthood and their cause in early childhood. We suggest that it is of utmost signiicance for the understanding of a patient’s psychic problems and in consequence for diagnosis as well as treatment, that the therapist takes into account not only the feelings voiced and expressed by the patient directly but also those feelings thoughts triggered in the therapist by the patient. These countertransference feelings, we argue, are key in under- standing those dynamics, feelings and processes in the patient, which he himself is not aware of. It is our position that, without including these concepts developed in psychoanalytic research, countertransference cannot be used adequately and to its full ex- tent. Countertransference has become a central aspect of think- ing about the relationship between patient and analyst and has become a vital tool for treatment in all schools of psychoanalytic thinking (Dresser 1985; Kernberg 1993). Moreover, it has been adopted by many other forms of psychotherapy, which equally make use of it as a central instrument for their work, rendering it ubiquitous and indispensable for modern psychotherapy (Weitz- man 1967). Similarly to transference, countertransference was originally con- sidered to be an obstacle to the analysis by Freud and his col- leagues, the widespread belief being that it is an expression of the analyst’s unresolved transference to the patient. It was understood as evidence for lacking emotional maturity and competence of the analyst, disturbing and distorting his or her objective position. A signiicant revision of this concept came with Heimann’s paper “On Countertransference” (1950), when psychoanalysts came to regard this phenomenon as the ubiquitous emotional response of the analyst to his patients, which relect feelings, defences, internal objects and object relationships unconsciously communicated by the patient. She writes: “our basic assumption is that the analyst’s unconscious understands that of his patient. This rapport on the deep level comes to the surface in the form of feelings, which the analyst notices in response to his patient, in his ‘counter-transfer- ence’. This is the most dynamic way in which his patient’s voice reaches him” (Heimann 1950: 82). Through acting out his con- licts in the relationship, by projection and pulling the analyst into acting out these unconscious dynamics, the patient displays his unconscious psychic structure. Therefore, Heimann argued that this makes countertransference “one of the most important tools for his work” as an “instrument of research into the patient’s unconscious” (Heimann 1950: 81). Only when recognized and understood, countertransference experiences can be utilized as a tool and the analyst’s participation in the patient’s unconscious dramatization of his conlicts can be avoided. These investigations into the close interaction between transfer- ence and countertransference and the reciprocity of introjection and projection (see Money-Kyrle 1956, Segal 1977) led to an un- derstanding of countertransference as not only the feelings to- wards the patient but also those what he is made to feel like by the patient and what atmosphere consequently develops between