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How to Deal with Countertransference as a Therapist

Transference and countertransference are both common occurrences in therapy. Going to counseling or therapy can be a truly emotional experience, depending on the circumstances that brought the client/patient to seek help. Sometimes in therapy, the people who are working together can blur the lines of emotions and feelings and connect them to other parts of their life.

What is Transference?

Transference occurs when an individual redirects their feelings for one individual toward an entirely different person. In therapy, transference occurs when a patient connects feelings they have about another person in their life and ties those same feelings to their therapist. Transference usually is a result of patterns established during a child’s behavioral development in relationship to their caregiver.

An example of transference could be that a therapist has characteristics that remind the patient of their grandmother. However the patient feels about their grandmother, they start to feel that way about their therapist. These feelings can be good or bad.

Transference is not always a bad thing, and some therapists actually support it. Understanding a person’s transference can give a therapist insight into their client’s mental process. For example, if a client views their therapist as someone with wisdom or knowledge and has positive feelings toward them, the relationship could result in equally positive dynamics.

On the other hand, negative transference can damage the therapist-client relationship. If the client associates their therapist with someone they have negative feelings toward, this could result in less-than-ideal dynamics. For example, the client might be more argumentative and unwilling to work with the therapist to achieve progress if they remind them of someone troublesome from their past.  

If a client is experiencing transference, therapists have a few different options. They should first assess the transference and determine if it is negative or positive. If it is negative, therapists should work on educating their clients about transference and shining a light on its impact during their visits. They should then ask their client to start reflecting on different experiences and relationships in their life. This can be done in a journal format and will help the client start to recognize patterns of transference.

What is Countertransference?

Countertransference, on the other hand, is always negative. Countertransference is when therapists start to transfer feelings that they have about someone else in their life and redirect them toward their clients. This can happen for a variety of reasons but usually occurs when a client shares characteristics of someone in a formative relationship in the therapist’s life. It can occur as a result of the client’s initial transference, but can also happen outside the presence of any transference.

Countertransference has a huge negative impact on the therapist-client relationship and can prevent progress from taking place.

Types of Countertransference:

Defensive: Client triggers their therapist’s unresolved struggles

Aim Attachment: Therapists have aims or motives that interfere with their relationship with the client (need for success, power, omnipotence, etc.)

Transferential: Therapists responds to the client as if they are a parental figure

Reactive: The client initiates transference and the therapist responds as if it is real

Induced: The client initiates transference and the therapist picks up the role suggested by the client in their behavior

Identification: When the therapist over-identifies or relates with the client

Displaced: Therapists displaces feelings form their personal life onto the client

Examples of it in Therapy:

Therapist talks too much about their own personal life

Therapist feels negatively toward their client due to a difference in values or beliefs.

Therapist starts to view their client as a friend

Therapist starts to feel frustration toward their client like they would a parent

How to Deal with Countertransference:

Therapists should always have their radar on for countertransference so that they can quickly identify it when it starts to take place. If a therapist is experiencing countertransference with their client, they should do the following.

1)     Recognize it

Countertransference can easily happen no matter how seasoned a mental health provider is or how long they have been in the field. The best thing providers can do to prevent the damage that countertransference can cause is to be able to recognize when it is happening as soon as possible.

2)     Consult with Colleagues

If a provider is unsure about how to manage countertransference, they should consult with others in the field. There may be people who have effectively managed what is happening in your situation and are able to provide helpful advice about how to handle it moving forward.

3)     Self-Care

Countertransference can easily happen when the therapist has a lot going on in their personal life or is stressed. Therapists should practice self-care to make sure they are always in a good mindset to work with their clients.

4)     Refer Your Client Out

If a therapist is having trouble preventing or managing countertransference with a particular patient, they need to put the patient first. If the client would benefit from a provider who is better prepared to engage with that individual, then the therapist should refer their client out to a different provider.

Countertransference can cause damage to the therapist-client relationship. Therapists should always remain aware that they are not immune from the effects of countertransference and always be willing to do what is best for their clients. Even if that means referring them to someone else.

To learn more about an EHR that can help you streamline and organize your practice management, click here.

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