Unveiling the Unseen Forces: Transference and Countertransference in Therapy

 

In the intricate dance of therapeutic relationships, there exist powerful, often subtle, forces that shape the dynamics between client and therapist. Transference and countertransference, though sometimes operating beneath the surface, are omnipresent, influencing the therapeutic process in ways both profound and transformative.

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Transference, a phenomenon where clients unconsciously project emotions, expectations, and unresolved issues onto their therapist, is a constant undercurrent in therapy. Similarly, countertransference, the therapist's emotional response to the client, can be an ever-present companion, coloring the therapeutic exchange in ways subtle or overt.

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Even when we are unaware, transference and countertransference quietly weave narratives that echo past relationships, unmet needs, and unresolved emotions. Clients may see the therapist through the lens of a critical parent, a supportive friend, or a distant sibling. Simultaneously, therapists may find themselves reacting based on their own personal history, potentially influencing the therapeutic process.

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As therapists, acknowledging the continuous interplay of transference and countertransference is essential, since they can lead clients and therapists towards profound self-discovery and transformation.

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Transference and countertransference can pose emotional challenges for both clients and therapists. Clients may experience intense emotions linked to past experiences and therapists might navigate their own emotional responses triggered by the client's projections. Fostering awareness and addressing these dynamics with sensitivity is paramount, ensuring that the therapeutic process remains a safe and transformative space for emotional exploration and healing.

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Glow My Space invites you to learn more about these two powerful dynamics because they are key to transforming clients' lives, but also because they have the potential to impact your own emotional well-being as a therapist.  

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Exploring the Foundations of Transference and Countertransference 

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Sigmund Freud, the founder of psychoanalysis, introduced the concepts of transference and countertransference as integral elements in the therapeutic relationship. These concepts play a significant role in psychoanalytic theory and have influenced various therapeutic approaches. Here's a brief overview of Freud's perspectives on transference and countertransference:

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Transference:

• Freud introduced the concept of transference to describe the unconscious redirection of a person's feelings from one object to another, often arising in the therapeutic relationship.

• In psychoanalysis, transference typically involves the patient's unconscious transfer of emotions and attitudes from significant figures in their past (such as parents) onto the therapist.

• Freud viewed transference as a valuable tool in therapy, providing insight into the patient's unconscious conflicts, desires, and unresolved issues.

 

Countertransference:

• Countertransference, in Freud's terms, referred to the therapist's emotional reactions toward the patient that may be influenced by the therapist's own unresolved issues or personal history.

• Initially, Freud considered countertransference as an interference in the therapeutic process. He believed that therapists should maintain emotional neutrality to effectively analyze the patient's transference.

• Over time, the understanding of countertransference evolved, and contemporary psychoanalytic and psychodynamic approaches recognize that therapists inevitably have emotional reactions. The key is for therapists to manage and utilize these reactions productively in the therapeutic process.

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"Working in the Transference"

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"Working in the transference" is a concept and therapeutic technique associated with psychoanalytic and psychodynamic approaches to therapy. It refers to the intentional and active exploration and analysis of the dynamics that emerge within the therapeutic relationship, specifically through the lens of transference.

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The therapist pays close attention to the emotions, expectations, and patterns that the client brings into the therapeutic relationship. By exploring and understanding these dynamics, the therapist and client can collaboratively delve into unresolved issues, unconscious conflicts, and deeply ingrained relational patterns.

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​The therapist may interpret and discuss with the client how their feelings and reactions towards the therapist mirror dynamics from their past. This exploration sheds light on unconscious processes and provides an opportunity for the client to gain awareness, understanding, and resolution. 

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While transference offers clients an opportunity for healing and growth, countertransference provides therapists with a powerful tool to heal both clients and themselves.

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Countertransference: A Therapeutic Tool and Catalyst for Therapists' Personal Growth

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Let's focus for a moment on the dual edge of countertransference. Countertransference can facilitate client healing but also can be a catalyst for the therapist's own exploration and growth.

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Countertransference occurs when the therapist unconsciously reacts to the client based on their unresolved issues or emotions. By recognizing and exploring these emotional responses, therapists gain valuable insights into the client's experience. This heightened awareness enables them to tailor interventions, empathize more deeply, and guide the client towards profound healing and self-discovery.

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However, the story of countertransference doesn't end with its application in client therapy. When triggered, countertransference can become a mirror reflecting the therapist's unresolved emotions and unexplored aspects of their own psyche. This phenomenon challenges therapists to embark on a journey of self-exploration, inviting them to confront their vulnerabilities, biases, and past traumas. Essentially, the triggered emotions point towards areas that demand attention, which therapists can explore in their own therapy.

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Here are a few examples to illustrate how countertransference can serve as a mirror for a therapist's unresolved emotions and unexplored aspects:

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Claudia, a therapist working with a client who shares a story of childhood neglect, may experience feelings of deep sadness and helplessness reminiscent of her own unprocessed emotions related to childhood experiences. These emotions surfacing in response to the client's narrative represent a form of countertransference.

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In another scenario, John, a trauma counselor, might experience heightened anxiety when working with clients who have survived traumatic events similar to those in his own past. Countertransference acts as a signal, urging John to delve into his own trauma history and encouraging him to seek personal therapy to process and heal from these unresolved issues.

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It is very common for therapists to experience countertransference reactions, but it is more frequently observed in therapists who have not done the inner work. It is crucial to recognize the need for personal growth and engage in our therapy when triggered by countertransference. If we are not aware of our own wounds, our response to clients can be biased by our unresolved emotions.

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Transference and Countertransference: Theory to Practice

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If you are unfamiliar with the transference and countertransference processes, you may be wondering what they look like in real life and how they can become the powerful tools that colleagues talk about. Let's explore further how this beautiful theory translates into practice.

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Transference unfolds in various ways within the therapeutic space. It can manifest as positive transference, where clients project positive feelings onto the therapist, viewing them as nurturing, supportive, or even as a parental figure. This manifestation is very common, especially in the beginning of treatment, and it can definitely make a therapist feel great.

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In negative transference, conversely, clients might project negative emotions onto the therapist, transferring unresolved anger, fear, or mistrust from past relationships. Although this manifestation can make a therapist feel not so great, it can hold the key to profound healing. Some therapists argue that real healing only occurs when negative transference occurs.

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In erotic transference, clients may experience romantic or sexual feelings toward the therapist, mirroring unresolved issues in their personal lives. When this type of transference manifests, therapists have a fantastic opportunity to help clients (besides providing the client with the "Therapy Never Includes Sexual Behavior" brochure, but that's a topic for another discussion).

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Here's a case example where a therapist named Sarah works in the transference with a patient named Alex:

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Therapist (Sarah): Good afternoon, Alex. How have you been since our last session?

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Client (Alex): Hi, Sarah. I've been okay, but I've been feeling kind of anxious. I don't know; it's just this fear that you might not understand or that you'll leave, you know?

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Therapist (Sarah): It sounds like you've been carrying some anxiety since our last session. I appreciate you sharing that with me. Can you help me understand what specifically triggers these feelings?

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Client (Alex): I started to feel this way when I texted you and didn't get your reply immediately. I think it's just a pattern for me. People have let me down in the past, and it's like I'm waiting for it to happen again, even with you. I know you are busy, and you replied to me within an hour, but I cannot help the anxiety these types of situations trigger in me.

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Therapist (Sarah): It makes sense that past experiences might influence how you approach our relationship. I'm here to understand and support you. Can you tell me more about those past experiences where you felt let down?

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Client (Alex): Well, my dad was never around when I needed him. It was like I didn't matter. And then, my ex... they said they'd always be there for me, but they left when things got tough.

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Therapist (Sarah): It sounds like you've experienced significant feelings of abandonment. I can see why that might create anxiety in our sessions. I'm here for you, Alex, and part of our work together is to navigate and understand these emotions.

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Client (Alex): I appreciate that, Sarah. It's just hard to shake off these feelings sometimes.

Therapist (Sarah): I understand. It's okay to feel that way. I want to explore these feelings with you, and we can work together to create a safe space where you don't feel alone or abandoned.

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As the sessions progress, Sarah continues to explore the transference dynamics with Alex, helping him understand and process his fears of abandonment. Through this ongoing dialogue, Sarah collaboratively works with Alex to build a therapeutic relationship that addresses past wounds and fosters a sense of security.

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If, in the therapeutic frame and relationship, Sarah acts in ways that foster a sense of security (with professional boundaries, of course), Alex could process his fears of abandonment and later transfer the learning he had in the relationship with Sarah to other relationships outside the therapy room.

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Now, let's complicate matters a little more. Suppose Alex comes to the session upset and, out of the blue, expresses strong negative feelings toward Sarah because she "didn't respond quickly" to his text message. Sarah, who has unresolved feelings toward her own emotionally unpredictable mother, feels overwhelmed and jumps into justifications or engages in activities like reviewing the policies that Alex signed at intake, etc. While doing this, Alex's upsetting feelings toward Sarah only escalate. Both feel tense during the session and carry the negative emotions throughout the week. Sarah, in particular, feels drained and starts to fantasize about excuses she could use to cancel the next session.

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This example has many layers. The first one is that Alex transferred onto the figure of the therapist (Sarah) the unresolved issues he has toward his father. Sarah was caught off guard, and while being trapped in countertransference feelings, she missed an opportunity to work in the transference. Furthermore, Sarah carried intense feelings after the session (feelings that resembled how she felt toward her own mother growing up, when her mother would get upset suddenly). Additionally, it may be that Sarah felt toward Alex how Alex's father felt toward him. If Sarah canceled the next session, we could say that Sarah was enacting Alex's father.

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Unconscious enactments in countertransference refer to instances where a therapist unknowingly acts out a technical failure without being consciously aware of their reaction or judgment toward the failure.

 

For instance, many years ago, I double-booked an appointment with a female patient. I felt terrible when I walked out of the room with my other client and found her still waiting outside. Initially, I was puzzled, but as the treatment progressed, it became evident that this patient had a history of severe neglect from her father, often feeling as though she was invisible to him. Was it just a simple mistake on my part, or was I unconsciously affected by this patient's past experiences? Why did this happen to me with this client and not with others? Was I enacting her father (acting like him) due to unacknowledged emotions from my client? The positive aspect of these types of casual/causal mistakes or enactments in the therapeutic dynamic is that they can lead to significant processing. I apologized profoundly but also explored every detail of it (why she did not text me while in the waiting room, what were her thoughts and emotions while she was waiting, when and with whom did she feel the same in the past, etc.). Most interestingly, it was a reparative experience. Her father acted that way, but never apologized. I did. That's a clear example of the reparenting process that occurs in therapy.

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As you can see, the processes of transference and countertransference work in complex but magical ways. In the scenario of Sarah and Alex described above, Sarah should reflect or seek consultation/supervision/or discuss in her therapy the feelings that she is carrying after the session. If she doesn't, her countertransference feelings may impact the therapeutic process. If Sarah handles the process successfully, she would process her unresolved feelings toward her mother and be ready to explore with Alex during the next session what happened. Alex would be helped to understand how the current experiences connect to his past experiences and how he unconsciously acts in ways that end up creating in people the same behaviors he is afraid of. This time, he played them out with the therapist, opening a chance to process it. Freud would wisely claim that the unconscious pushes to get out and heal. Alex's was no exception.

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Now, take a deep breath as we start to elaborate a little bit further on the complex dance that happens when we work with clients. Ready?

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Countertransference: Is this Feeling Mine or Not?

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Countertransference can be a valuable tool for therapists, but an important question accompanies it. How do you know if the countertransference feelings you are experiencing are related to your unresolved issues or your client's unresolved issues?

 

The answer is simple: do your inner work. In my role as a supervisor and program director, I have repeatedly encountered scenarios where therapists became trapped in countertransference emotions and enactments. I strongly recommend that they start their own therapy. When you know your unresolved issues, you may recognize much quicker when something from your own past becomes entangled in the therapeutic process.

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Over the years, I have had the honor of providing therapy to multiple therapists and other mental health providers. After helping them create what I call an emotional blueprint of themselves, they not only improved their personal relationships but also learned to handle countertransference in their caseloads. The more you know your own wounds, the less triggered you will get with cases. You may still get trapped in countertransference or enact once in a while, but you will be able to identify it and immediately reduce the intensity of emotions, acting in ways that are beneficial to your clients.

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If after a session, you are left with intense feelings that follow you home for some days, you need to first scan if they relate to your personal past and wounds. If you've done the inner work and know that they don't, then something amazing is happening in the transference and countertransference dynamic... Ready? You are either feeling how the client has felt, for example, toward his parent/s, or you are feeling toward your client as his parent felt toward him (the client). This is the most powerful tool in the universe. Now, you know how it feels to be in your patient's shoes, and you can help them process it.

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How does it look in real life when feelings that are not yours accompany you after work hours? You may suddenly feel ignored, or not validated, or not good enough as a therapist—insecure, etc. I would add that it takes practice to learn how to recognize that these feelings are not yours. But once you do, you can scan back in your mind and identify to which patient they belong. Boom! -a light bulb moment occurs- These feelings belong to my client Monica!! This is how she feels inside!!! Alternatively, you may reach the insight of how a client's parent may have acted toward your client because you are feeling it now. But what do you do with it? Well, you can go into your next session ready to help your client identify and process how they feel inside. You may start with something like... I wonder if you ever feel inside that..... (and you describe how you felt the days after the last session). It is very healing for people to know that someone finally understands them to the core.

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The more you understand and practice working in transference, the easier it will become. The problem is that, unfortunately, we are not fully taught in graduate school how to apply these concepts into the practice and how to tap into our intuition. Intuition is a fundamental piece to work in transference. To fully work in transference, we need to be aware of who we are and how we feel. A therapist is like a channel to the client's emotions. Although you may not be aware, your body tells you a lot of information that a client is transferring to you. Some therapists will receive images during sessions. Others will feel body sensations. All your senses are channels in the transference. We all have some senses more developed than others, but you need to get in contact with them.

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If you become aware of how your body channels your client's emotions and symptoms, you may realize that you can feel the transference not just after the session but during the session. For instance, you may start to experience fear, palpitations, lack of concentration, or you may start yawning repeatedly in a session. When a client is suppressing specific emotions, you will start to experience signs of it in your own body. The signs you feel will lessen only when the client gets in contact with that suppressed emotion. How do you reflect it back? Just look at the client and say something like, 'I wonder if there is something these days that has made you feel...'X.' Often times, what you feel is related to a client's childhood. Discovering the origin of the emotions is a piece of art to be co-created with clients during sessions.

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The transference is so powerful that it can start showing up in your body even before you meet with your clients. When I work in the field, I can start to feel my clients' symptoms while I am driving to their homes. Once I arrive, I inquire if they were experiencing 'X.' Once they acknowledge and process the emotions that fuel their symptoms, the sensation in my body disappears. Magic? No, it's just work in transference. If you have an image during a session, just be transparent and ask your client what they think that image is related to in their lives. You will be surprised at how that image can unfold into an amazing process.

 

Yes, as therapists, we work with our own bodies. We are vessels for clients' emotions. We feel what they feel. A gift and a curse, right? Many times, I am asked how I set boundaries with strong transference and countertransference emotions. Just in case my idea helps you, here it is. I incorporate my spirituality into the work I do. I believe that God is the one who sends me the people I can help. I remind myself that if God has sent them to me, it is because he knows that I will have the tools and strength to do it (strength that, of course, he - God - will fuel). If, as in the example above, I carry strong feelings during the week that are 'not mine,' I accept them, make insights about how that particular client feels, and thank God for giving me the chance to understand how my client feels. I would say that 90% of the time, the feeling will dissipate inside of me once I make the insight. If it lingers and doesn't dissipate because it is a strong transferential feeling, I pray and tell God, 'I got it; I know now how my client feels inside. Please detach me from whatever feeling is not mine.' It works every single time for me. It may sound like magical thinking... I call it the intersection between therapy and spirituality. If you don't believe in a God or higher power, you can ask the forces of the universe that sustain the planets or create a guided meditation exercise where you can deposit the feelings that are 'not yours' into an imaginary box until you can give them back to your client the following session.

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Transference and countertransference are inherent aspects of the therapeutic journey. By embracing and understanding these processes, therapists can transform challenges into opportunities for growth, both for themselves and their clients. Regular supervision, ongoing professional development, and a commitment to personal self-awareness are essential for navigating the complexities of transference and countertransference, ultimately fostering a more enriching and transformative therapeutic experience for clients and professionals.

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At Glow my Space, we believe that understanding the dance of transference and countertransference is crucial to managing your well-being as a mental health provider. Do the inner work, consult about your reactions and your cases, and never ignore your body, as it can detect more than you may be aware of in a therapy room. Cheers to the healing power inside of you!