"Communication by impact" and other forms of non-verbal communication: a review of transference, countertransference and projective identification

ABSTRACT

This article aims to review the importance; place and especially the emotional impact of non-verbal communication in psychiatry. The paper argues that while biological psychiatry is in the ascendency with increasing discoveries being made about the functioning of the brain and psycho-pharmacology; it is important to try and understand what is happening between psychiatrist and patient. The importance of being aware of the subtleties of this interaction is argued; as are the roles of phenomena such as transference; counter-transference and projective identification. The workings and use of these phenomena are explored as central in the doctor-patient interaction; as well as the consequences of failure to utilize and understand these phenomena. The author reviews - amongst others - the work of the analysts Casement; Gabbard; Goldstein; Ogden and Symington