Countertransference in Therapy

18 Jan Countertransference in Therapy

Countertransference is the process whereby a mental health therapist experiences feelings toward the client that are actually stemming from unresolved personal issues, such as those from the family of origin. For example, one therapist may bristle at a male client that reminds him of his controlling father. Another example would be a therapist that finds herself feeling maternal feelings towards a client that reminds her of her daughter that left for college. This may seem benign, but may actually end up doing harm to the client; making the client more dependent, for example.

Some researchers have gone so far as to say that countertransference is “innately exploitative” in nature (Nuttall, 2008). The word “innately” is used to express the idea that countertransference is an unintentional process and “exploitative” expresses the concept that countertransference can mean taking advantage of another person’s emotionally weakened state.

Unresolved negative emotions and powerful life experiences can leave a door open to countertransference, leaving the therapist vulnerable to automatic responses and nonverbal behaviors that were not consciously intended. More importantly, clients are left vulnerable to the effect that the therapist’s countertransference can have on them.

Individuals coming to counseling are already troubled or distressed in some way that is drastic enough that it brought them to seek outside help. To then add, on top of their original issues, the issues the therapist unconsciously heaps upon them could be incredibly dangerous to the mental well-being of these clients. Thus it is one of the most important and most challenging responsibilities of each therapist to avoid the hazards of countertransference.

Researchers have recently given much attention to this common but serious problem within the therapist/client relationship. Some authors attempt to define various levels or types of countertransference so as to better study the specific issues involved. Shubs identifies three different types of countertransference: Type I Countertransference- involving avoidance, Type II Countertransference- overidentification, and Type III Countertransference- communicative, ie. splitting, projecting, etc. (Shubs, 2008).

Some authors, such as Fauth and Hayes (2006) have asserted that while much of countertransference is negative, a therapist who is aware of it and is actively working on it may gain some helpful insights, from the countertransference feelings, into the therapist/client relationship. Furthermore, the same authors assert that stress factors, on the part of the therapist, can increase negative countertransference in therapists, thus indicating that stress-management would be a helpful tool for dealing with countertransference.

Countertransference and Effective Treatment

The old adage “physician, heal thyself” applies perfectly here. If a therapist wants to offer effective treatment, he or she must have achieved a reasonable level of mental health themselves. Unresolved issues of the past can taint the therapist/client relationship. While no one is ever completely safe from countertransference, the worst of it might be avoided by practicing proper self-care. Therapists need a healthy outlet for their stress, a sounding board such as a colleague, and healthy life habits such as proper sleep, healthy eating, and regular exercise.  A focus on effective treatment and what is best for the client can also help therapists avoid trying to satisfy their own unmet needs through their clients.

In the addiction treatment and drug rehab industries it is very common for recovered addicts to become licensed substance abuse counselors.  However a person with a history of addiction may have issues in their past that could make them vulnerable to experiencing countertransference.  No doubt some of our most successful counselors are in recovery, but to protect our clients we perform background checks and only hire recovered addicts who are in long term recovery.

Many potential countertransferrence issues are eliminated by understanding therapists background and performing a thorough clinical assessment on each client before making therapist assignments.  This also enables us to match a therapists expertise with our clients unique individual needs.

At Cold Creek Wellness Center our clinical team meets weekly during a round table lunch to discuss each clients progress.  During  these meetings staff members have occasionally identified countertransference issues.  When this occurs team case management can be arranged, the therapist can submit to peer reviews, and if a problem develops the therapist my recuse themselves from working with the client.

Finally, at Cold Creek our clinical director maintains an open door policy.  Our clients understand that if they need to talk with someone other than their counselor, they have that option.  This policy serves as a check and balance to protect our clients.

References

Nuttall, J. (2008). Review of The paradox of countertransference: You and me, here and now. Psychodynamic Practice: Individuals, Groups and Organizations, 14(1), 117-121. PsycINFO AN: 2008-01183-013.

Shubs, C. (2008). Countertransference issues in the assessment and treatment of trauma recovery with victims of violent crime. Psychoanalytic Psychology, 25(1), 156-180. PsycINFO AN: 2008-00996-011.

Fauth, H., & Hayes, J. (2006). Counselors’ Stress Appraisals as Predictors of Countertransference Behavior With Male Clients, Journal of Counseling & Development, 84(4), 430-439. PsycINFO AN: 2006-11473-006.

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