Have you ever experienced restricted judgment during a therapeutic encounter? If so, you are not alone. More often than not, such a situation arises from countertransference. From an early psychoanalytic perspective, countertransference can be defined as the influence of a client's problems on the therapist's unconscious feelings and emotions. It may serve as an obstruction in the therapeutic alliance and overall therapeutic outcome. It is essential to manage countertransference as it interferes with the therapist's rational decision making and objectivity.
Moreover, 'beneficence and nonmaleficence' is one of the general principles of the APA code of ethics, but countertransference brings the opposite energy to the therapy room. It may cause harm to the client. If you are going through the same problem, then worry no more. We have got you covered. Let's dive into the 5-step model (Cartwright and Read, 2011) and see how to deal with countertransference.
1- Identifying triggers and countertransference responsesThe first step is to acknowledge your countertransference responses that can either be physiological or emotional. If the client's abusive marital life makes you cringe, that might be because of your own unresolved traumas. You have been there, right? Every therapist has to go through a tiring journey of self-actualization before they can finally unravel their triggers, leading to positive or negative countertransference. Maintaining a self-reflection journal may deem beneficial in this regard.
2- Understanding countertransferential thoughts within the context of therapyBoth therapist and client bring their idiosyncratic vulnerabilities to the relationship, and clients may provoke emotional responses in the therapist. Therapy is a two-way confidential transaction in which the client and therapist work mutually. Therefore, it is important to reflect on your and your client's individual contributions in evoking countertransference.
3- Conceptualization of countertransferenceThe next step is to understand the client's template for the relationships. You need to understand the client's representation of self and others that the client has built through past experiences. If the client feels unloved and resented in her life, she might assume that the therapist may feel the same about her. As a therapist, you may feel irritated by your client's misconception and acts on your feelings in the form of withdrawal from the client or annoyance. Once you do so, the client's transferential expectations will be fulfilled. It will bring the therapist's worst dream to life, i.e., sabotaging the therapeutic relationship. So, try understanding the client's need and work on it without being emotionally drawn to it.
Transactional Analysis model of Parent, Adult, ChildAccording to transactional analysis (Berne, 1961), there are three ego states – Parent (demanding, critical), Adult (healthy, rational), and Child (emotional, irrational). Clients often move to the parent or child mode to which the therapist's countertransferential responses may elicit. As a therapist, you may also shift to parent or child mode, complementing the client's ego state. You need to analyze the situation and identify your and the client's ego state to understand countertransference in a better way.
4- Using calming strategies to manage countertransferenceTo manage your emotions evoked by the client in session, you can use breathing techniques to soothe your nervous system. Try to give positive and calming messages to yourself, such as "It is okay. I am having a countertransference response", or "I am aware of my emotional state". By doing so, you signal your brain that you have emotional responses under control and try to calm yourself with mindful strategies.
5- Moving back into the Adult ModeBy this step, you will be aware of the triggers, countertransferential thoughts and feelings, yours and your client's contribution to the countertransference. Now you will be ready to move yourself back to adult mode (from either parent or child mode). Use the calming strategies to strengthen your impartiality and healthy self.
These steps will help to understand and manage countertransference in therapy. Moreover, it will eventually help regain empathy and compassion towards your client. It also helps you understand your emotions and vulnerabilities and teaches you to regulate your emotional responses while working with the client.
Hina Babar, Psychology Intern
Berne, E. (1961). Transactional Analysis in psychotherapy. New York, NY: Evergreen.
Cartwright, C., & Read, J. (2011). An exploratory investigation of psychologists' responses to a method for considering" objective" countertransference. New Zealand Journal of Psychology, 40(1), 46-54.