Countertransference in Psychology

Countertransference is a phenomenon that occurs in the field of psychology and psychotherapy. It refers to the therapist’s emotional and psychological responses to a client, which are based on the therapist’s own personal experiences, unresolved issues, or biases. These responses can influence the therapist’s ability to provide objective and unbiased treatment, as they often, when left unmitigated, project the therapists own feelings onto the client.

Transference and countertransference are part of a reciprocal process of communication. Typically, we refer to countertransference as part of the therapeutic relationship but it exists in all relationships. Outside of therapy, countertransference may be foundational to healthy communication, expressing emotional attunement and validation. It also can be maladaptive. A manipulating partner may brutishly project evil motivations onto an innocent partner then savagely attack their countertransference as evidence of the original transference.

However, in therapy countertransference is fraught with dangers that may impeded or destroy the therapeutic environment.

Patient Transference

Sigmund Freud wrote, “all these undesired happenings and painful affective situations are repeated by neurotics in the ‘transference‘ stage and re-animated with much ingenuity.” He continues to describe the behavior, “they struggle to break off the unfinished treatment, they know how to re-create the feeling of being disdained, how to force the physician to adopt brusque speech and a chilling manner towards them, they find suitable objects for their jealousy, they substitute for the ardently desired child of early days the promise of some great gift which becomes as little real as that was” (Freud, 1990).

According to Freud, transference in the patient is an attempt to repeat past conditions. Oddly, this compulsion to repeat the past supersedes normal motivations of pleasure and pain. Freud attributes this to the repetition-compulsion. “In the case of a patient in analysis, on the other hand, it is plain that the compulsion to repeat in the transference the occurrences of his infantile life disregards in every way the pleasure-principle” (1990).

Our patterns of interaction can be quite compelling. Patterns are predictable and establish a sense of comfort, even if they are destructive. Emotions relish repetition, flowing in recognizable patterns. Repetition-compulsion invites reoccurring themes into our lives that soothes anxiety through familiarity.

For example, “certain patients can be so contemptuous that everyone with whom they come in contact, including the therapist, may respond with negative or even hateful feelings.” D.W. Winnicott suggests that ” this hateful reaction had much less to do with the therapist’s own personal past or intrapsychic conflicts. Rather, it reflected the patient’s behavioral strategies and the need to evoke specific reactions in others” (Gabbard, 2020).

Three Modes of Transference

Anna Freud suggests that “the phenomena of transference come under three headings: transference of libidinal tendencies, transference of defensive attitudes, and acting in the transference” (Freud, 1937). Basically, transferences occur at our most basic impulses and desires. However, we may substitute those initials desires by transferring the strong overriding defensive mechanisms concealing the desires.

In many ways transference and countertransference correlate well with the psychological concept of projective identification. In projective identification, Arthur C. Nielson, Clinical Associate Professor of Psychiatry and Behavioral Sciences at Feinberg School of Medicine, Northwestern University explains that it is “an interpersonal defense mechanism by which individuals (inducers) recruit others (recipients) to help them tolerate painful intrapsychic states of mind” (2019).

Therapist Countertransference

Markedly, countertransference can manifest in various ways, such as feeling overly sympathetic or empathetic towards a client, experiencing personal triggers or reactions to certain topics, or even developing romantic or platonic feelings towards the client. Therapists must take great caution to limit countertransference reactions, addressing them in a professional and appropriate manner.

Allan Schore warns “more insidious and often more damaging, are behaviors of the analyst that are the results of inner defense against his countertransference reactions, such as rigid silences, unbending attitudes, repression or isolation of troublesome impulses, fantasies, or memories. . . . The analyst . . . in his effort to stay sane and rational is often apt to repress the very transference-countertransference resonances and responses induced by the patient that would give him the deepest but also the most unsettling understanding of himself and the patient” (Schore, 2003, p. 283).

Depending on how the therapist reacts to the original transference, the interaction may strengthen resistance to change, validate the patients transference, and waste everybody’s time. Sometimes, the transference is sexual in nature and a therapist’s countertransference violates ethical standards, taking advantage of their role that places others in vulnerable situations, designed to create openness.

Limiting Countertransference

By recognizing and managing countertransference, therapists can maintain a healthy therapeutic relationship with their clients, ensuring that their personal issues do not interfere with the client’s progress. This involves consistent self-reflection, supervision, and constant drawing on additional support from colleagues.

A Few Words by Psychology Fanatic

Overall, countertransference is a complex and nuanced aspect of therapy that requires ongoing attention and self-awareness from the therapist. By addressing and processing their own countertransference, therapists can provide better care for their clients and create a safe and supportive therapeutic environment.

References:

Freud, Anna (1937). The Ego and Mechanisms of Defense. ​Routledge; 1st edition.

Freud, Sigmund (1920/1990). Beyond the Pleasure Principle. W. W. Norton & Company; The Standard edition.

Gabbard G. O. (2020). The role of countertransference in contemporary psychiatric treatment. World psychiatry : official journal of the World Psychiatric Association (WPA), 19(2), 243–244. DOI: 10.1002/wps.20746

Nielsen, Arthur (2019). Projective Identification in Couples. Journal of the American Psychoanalytic Association, 67(4), 593-624. DOI: 10.1177/0003065119869942.

Schore, Allan N. (2003). Affect Regulation and the Repair of the Self (Norton Series on Interpersonal Neurobiology). W. W. Norton & Company; First Edition.

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