During two different therapy sessions this week, I cried.Not big, sobbing cries. But noticeable tears, nonetheless. Of course, I had a million things racing through my mind as my eyes started to go glassy. I was experiencing countertransference and something that I don’t think is explained enough to people outside the walls of clinical supervision.

Countertransference is a phenomenon that occurs within the context of psychotherapy and was initially coined by Sigmund Freud in the early 1900s. It has been viewed as an impediment to productive therapy; however, the interpretations have gradually shifted. While it can still be a hindrance to therapy, if handled properly, it can actually be advantageous for the clients.

So, what is countertransference? The experience refers to when a therapist has an initial internal reaction – conscious or unconscious – to their client based on the therapist’s personal thoughts and feelings. A client might remind the therapist of someone or something from their present or past. As a result, the clinician might lose their objectivity and unconsciously treat the client in an emotionally charged or biased way. This can alsooccur due to transference, which is when a client projects onto the therapist unconscious feelings that were originally directed toward important people in the client’s own life.

There are FOR SURE inappropriate displays of countertransference that may have adverse effects on the therapeutic process. I would feel negligent if I didn’t include a PSA for therapists encouraging them to continue to engage in clinical supervision throughout your career (not just when you are seeking licensure). I’m also a believer that therapists do their best work, and can avoid engaging in unhealthy countertransference, when they stay active in their own personal therapy.

If you are a client and feel that your therapist is causing you harm in any way, please consider speaking up. Here are some examples of countertransference that are on the no-no list:

lack of adequate boundaries
inappropriate oversharing of personal information
offering direct or explicit advice
developing strong romantic feelings (obv.)
being highly critical or overly supportive
pushing the client to take action the client isn’t ready for
allowing personal feelings to redirect the therapeutic process

Now, I could go on about countertransference from a more theoretical standpoint, delineate the four types (subjective, objective, positive, and negative), and provide examples; however, I’m more curious about the times that it serves as an important reminder that therapists are humans beings too. We have our own history, biases, and emotions which can influence our reactions to clients. My default is to call it out in the therapy room and say, “My own bias may be getting in the way here, but I am wondering…”

Sometimes it feels important to use self-disclosure to let my clients know they aren’t alone. I’ve been there. When I have a client struggling to manage or stop their drinking, I let them know I have walked that path. If a client is scared about their future because they are going through a divorce I can say, I get that. It’s normal. And it gets better. Surely, Freud would be able to see the benefit in my “over-sharing.”

As a therapist, what is appropriate to have as an emotional reaction to some of the incredibly difficult things our clients are dealing with? Is it better to be still and emotionless? Or show that you feel affected and normalize their experience that it is tough.

One of my longtime clients (we’ll call her Sandra) was sharing her experience of losing her dog and how her other pup (and littermate) was clearly mourning the loss. When the woman from Laps of Love was taking her deceased dog to the car on a doggy-stretcher (who doesn’t feel teary just imaging that?), the other dog was trying to get in the car, too. I apologized to Sandra because I was getting emotional during her retelling of the event. Her reply was, “No, it helps to see that it matters that much to you too.” My tears allowed her to feel seen in her profound sadness over her loss.

I think it is important for therapists to be hyperaware of their emotional and mental responses to what clients bring into the therapy room. That awareness is part of what facilitates a therapist’s growth as a practitioner. Countertransference can be a negative and a positive in the therapeutic experience and overall shows that clinicians are human. We just need to be cognizant of using these reactions effectively for a positive therapeutic relationship.

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