Understanding Countertransference: Definition, Types and Management

Introduction

Countertransference is a term that has been used for decades to explain what happens when a mental health professional unconsciously adopts emotions, thoughts or insight about their patients. These emotions, thoughts, or insights mirror their own personal experiences and beliefs, affecting the way they perceive their patients, resulting in biased and irrational reactions. In essence, countertransference is a phenomenon that hinders the therapeutic relationship between the client and therapist, affecting the efficacy of the therapeutic process.

Definition

Countertransference can be defined as the emotional and psychological reactions or the personal experiences of the therapist that affect their therapeutic process with the client. In layman terms, it can be referred to as a ‘therapist’s emotional baggage’ that comes from the therapist’s personal history or belonging to a certain gender, ethnicity, age, etc. Countertransference can be both positive and negative, and can manifest in various ways, including projection, over-identification, emotional distance, enmeshment, and sexualisation.

Types of Countertransference

Projection

Projection is a common type of countertransference that happens when the therapist injects their own personal experiences or feelings into the therapeutic process, projecting them onto the client. For example, if a therapist has had bad experiences with men, they may perceive a male client as untrustworthy or dishonest.

Over-Identification

Over-identification is a countertransference type that happens when a therapist becomes too attached to their clients, assuming their patient’s problems as their own, leading to an inability to distinguish between the client’s experiences and their own.

Emotional Distance

Emotional distance is a type of countertransference where the therapist creates such a defensive barrier that they become emotionally detached from the therapeutic exchange with the patient. They may feel numb towards their client and may be unable to establish a therapeutic connection.

Enmeshment

Enmeshment is when the therapist ‘overcommits’ themselves to a patient’s life or work, even going beyond the scope of their professional obligation.

Sexualisation

Sexualisation is the most severe of all types of countertransference issues where the therapist perceives sexual attraction or feelings towards their patient. This is a dangerous scenario that can severely harm both the client and the professional, leading to the termination of the therapeutic process.

Management of Countertransference

Countertransference management is a critical aspect of the therapeutic process, and therapists must be equipped with comprehensive training to manage and overcome these issues. Here are some strategies that can be employed to manage countertransference in the clinical setting:

Self-reflection

Self-reflection is a critical tool for therapists to understand their personal history, biases, and prejudices. By actively reflecting on their practices and evaluating their reactions, they can change themselves by identifying how these emotions manifest in the therapeutic setting.

Training

Countertransference is a universal phenomenon permeating the therapeutic field. It is, therefore, recommended that therapists receive proper training and support in addressing and recognising countertransference.

Honest dialogue

A therapist must be open to having honest dialogue with their clients, allowing them to share their negative experiences or personal issues that may bring up feelings of countertransference. This can help the therapist to become aware of countertransference and find ways to manage it.

Supervision

Ongoing supervision during clinical sessions is essential in managing countertransference. Supervision refers to an experienced therapist monitoring the therapeutic exchange between the therapist and the client, providing feedback about the exchange to help manage countertransference.

Taking a break

If countertransference is affecting the therapeutic process, taking a break from the sessions is necessary. This break is to allow the therapist to attend to their emotions and those emotions of their patients.

Conclusion

In conclusion, countertransference is a common phenomenon that can impact the therapeutic relationship between the therapist and the client. It is imperative for therapists to be aware of their countertransference and learn how to manage it effectively, taking into consideration the impact on patient care. Countertransference must be effectively managed if the therapeutic process is to be successful. As a result, self-evaluation, training, honest dialogue, supervision, and breaks are critical tools that therapists need to use in their practice to minimise the effects of countertransference.

FAQs

FAQs about Countertransference

1. What is Countertransference in Psychology?

Countertransference is a term used in psychology to describe the therapist’s emotional reaction to a patient during therapy. It occurs when the therapist’s unresolved personal issues or feelings are triggered by the patient’s behavior, leading to an emotional response that can affect the therapeutic relationship.

2. How can Countertransference affect Therapy?

Countertransference can negatively affect therapy by creating confusion, bias, and discomfort in the therapeutic relationship. The therapist’s unresolved issues can interfere with the impartiality and objectivity necessary for treating the patient effectively. It can also affect the patient’s perception of the therapist and potentially damage the therapeutic alliance.

3. How Can Countertransference be Managed?

Countertransference can be managed by the therapist through self-awareness, supervision, and self-care. Therapists must recognize their potential for countertransference and take measures to minimize its impact. This may involve seeking supervision from an experienced therapist, regularly practicing self-reflection, and engaging in self-care activities to maintain emotional and physical wellness. By managing countertransference, therapists can create a safe and effective therapeutic environment for their patients.


References

1.

Luty, J. (2003). Countertransference reactions to patients with personality disorders. British Journal of Psychiatry, 182(6), 478-481. doi: 10.1192/bjp.182.6.478

2.

Gabbard, G. O. (2005). Countertransference: The emerging common ground. International Journal of Psychoanalysis, 86(3), 781-793. doi: 10.1516/MGGB-8V9T-1XH6-J3DE

3.

Barnett, J. E., & Cooper, N. (2009). The use of standardized patients in the assessment of countertransference. Journal of Psychiatric Practice®, 15(3), 173-180. doi: 10.1097/01.pra.0000350316.83025.79