Sunday, February 21, 2010

Transference Counter-transference

Hi Team this week Felicia is leading the discussion


  1. Transference and countertransference are terms used to describe reactions of the client and therapist engaged in psychotherapy. First discussed by Freud in the 1900s, theories about transference and countertransference and the role it plays in the therapeutic relationship has evolved.

    Transference is the feelings a client transfers onto the therapist (and other present relationships), occurring usually unconsciously and focus around unresolved issues or conflicts in past relationships.

    Countertransference is the unconscious feelings or reactions the therapist may have towards the client.

    Feelings experienced by the therapist and client can be intense; for the therapist, they may have a different reaction towards the client then they might have with most of their clients.
    In the past, the psychoanalysis field saw transference as a bad thing; transference would not occur if the therapist was a “good”therapist. That view has shifted since the 1950s. Many experts believe that transference and countertransference is inevitable and many times transference/countertransference is purposeful throughout therapy sessions.

    Some Key Concepts about Transference
    -Client’s attempt to resolve past conflicts or unmet needs in present relationships, often unconsciously
    -Can explore these unresolved conflicts in a safe manner with the therapist
    -Can lead to insight and subsequently, change in behaviors
    -Client may get a different response from the therapist, therefore leading client to insight into the past.

    Some Key Concepts of Countertransference
    -Therapist’s reaction to client’s transference, which is often linked to past issues or conflicts in therapist’s own life
    -Self-awareness is key: i.e., being aware of own feelings can often lead to insight into the client’s behaviors/thoughts feelings. The therapist’s feelings are a mirror of what the client is feeling or something the client may have experienced in the past. The client may be showing the therapist a glimpse of how the patient was treated as a child, or may be unaware of the depths of depression the client is in as the therapist acts as the mirror for the client. (Ever notice feeling extremely sad or tired for no reason during a session with a particular client?). This can be especially helpful with borderline personality disordered clients.
    -Countertransference is not isolated to psychotherapy, but extends to other therapeutic practioners as well, and can occur in one’s own personal life.
    -Acknowledging the countertransference during supervision or through feedback from peers is also helpful in managing countertransference.

  2. Hi all,
    Both in my last job and my current one, I see issues of countertransference and transferance daily. In my experience, transferance looks different sometimes in kids, who often do not feel shame around it. I have noticed that when adults become aware of their own transference they often express feelings of shame or try to hide what is going on. As a SW now who usually only works with pt.s for a day or two, I am able to observe pt.s and family interacting with nurses and doctors and often observe both transference and countertransference. Supervision should be a good place for MSWs to discuss their own transference, and I look forward to our discussion tomorrow of this topic. I also have to say that my own interactions with clients go more smoothly the more I am of my own transference.

  3. I think I was hyperaware of transference/countertransference issues, which, like you said, Emma, made interactions with my clients this week go more smoothly. It's interesting that in both my BSW and MSW programs we did not spend much time talking about this. I actually felt a little bit bad about admitting that I had those issues, like I wasn't a good social worker. This research showed me how to start to manage these things. It also helped me to start seeing the clients in a different way. Supervision group and suerpvision at work have really helped me this week. Looking forward to tomorrow.

  4. Thanks Felicia for your clear definitions. Like both you and Emma said, you have to be actively aware of issues with transference or countertransference that might be going on. Since we won't be able to prevent it, we need to be aware of it and note when our own feelings are affecting our practice. There are definitely times when I have to reflect on why I'm reacting a certain way, or why a certain patient is bringing up different feelings for me. I'm looking forward to discussing this more with the group tomorrow.

  5. Great Post Felicia! It is interesting because i think if you asked most social workers about either transference or counter transference, they would be able to give you a sufficient answer about the two concepts but not necessarily be able address transference and countertransference in terms of personal experiences.

    I think we all grow up with these sort of world agreements as we all are socialized with thousands upon thousands of perspectives. It is nearly impossible to remove ourselves from these agreements. No matter how far I want to free myself from my parents ideologies, their belief systems play a huge role in my belief systems. Although as a clinician I know better, I have this sort of "Agreement" if you will that countertransference is a behavior that happens to clinicians that really don't have a enough insight to their own issues when the reality is I don't know if many of us have comprehensive insight to our own agreements.

    Team, I want us to really begin to look at transference and countertransference than we ever have before and for starters to know that it is something that we deal with continually. It isn't just one removed isolated incident. As I teach with many things , I really like to teach and look at things on a continuum. For example, i think there have been many times I have been unaware of the countertransference that I have been exhibiting but it manifests itself in physical signs such as nervous shuffling, or facial expressions, faint sighs etc

    1. I wasn't aware and resultant I had to leave my job under pressure. I loved my job but now I know how it went wrong.

  6. Emma, I am glad that you introduced the ideas of settings to this discussion as I think my agreement about transference is that it typically happens in a therapists office in a 1 hour session, but does it ?

    Team, what are some of the agreements that you develop in your particular settings?