Countertransference in Therapy

What Is Countertransference?

In psychoanalytic theory, countertransference occurs when the therapist projects their own unresolved conflicts onto the client. This could be in response to something the client has unearthed.

Although many now believe it to be inevitable, countertransference can be damaging if not appropriately managed. With proper monitoring, however, some research shows that countertransference can play a productive role in the therapeutic relationship.

Transference vs. Countertransference

The American Psychological Association (APA) defines countertransference as a reaction to the client or client's transference, which is when the client projects their own conflicts onto the therapist.

Transference is a normal part of psychodynamic therapy. However, it's the therapist’s job to recognize countertransference and do what's necessary to remain neutral.

Four Types of Countertransference

There are four manifestations of countertransference. Three of these can potentially harm the therapeutic relationship.

• Subjective: The therapist's own unresolved issues are the cause. This can be harmful if not detected.
• Objective: The therapist's reaction to their client's maladaptive behaviors is the cause. This can benefit the therapeutic process.
• Positive: The therapist is over-supportive, trying too hard to befriend their client, and disclosing too much. This can damage the therapeutic relationship.
• Negative: The therapist acts out against uncomfortable feelings in a negative way, including being overly critical and punishing or rejecting the client.

Countertransference is especially common in novice therapists, so supervisors pay close attention and help them become more self-aware. The mental health community supports seasoned clinicians by urging them to seek peer review and supervisory guidance as needed. Rather than eliminate countertransference altogether, the goal is to use those feelings productively.

Warning Signs of Countertransference

How does a therapist know they are experiencing countertransference? If you are someone in therapy, how do you know if your therapist is exhibiting the signs of it? If you're concerned about the presence of countertransference in your therapeutic relationship, be aware of these warning signs.

In Adult Therapy

In general, be aware of whether the therapist has an inappropriate emotional response to the client. This might look like:

• An unreasonable dislike for the client or excessive positive feelings about the client
• Becoming over-emotional and preoccupied with the client's case between sessions
• Dreading the therapy session or feeling uncomfortable during the session

In Child Therapy

Warning signs on behalf of the therapist include:

• Fantasies of rescuing the child from their situation
• Ignoring the child's deviant behavior
• Encouraging the child to act out

Impact on Therapy

While it was originally a psychoanalytic concept, countertransference has been adopted and is used in other forms of therapy today. Although it's important for your therapist to guard against feelings of countertransference toward you, countertransference has also been found to be beneficial.

In a systematic review of 25 countertransference studies, researchers found an association with positive countertransference, such as feeling close to the client, and positive outcomes, including improvement of symptoms and a good therapeutic relationship.

Additionally, a 2018 meta-analysis published in Psychotherapy examined countertransference's effect on therapy and observed the potential negative effects and also the beneficial outcomes when it was managed well.

What to Do

If you think your therapist is experiencing countertransference, you can bring it up with them if and when the time feels right. Your therapist should be receptive to your concern. If you're feeling uncomfortable, and that countertransference is getting in the way of effective therapy, it may be time to move on to a new practitioner.

Therapists can also take steps to manage countertransference. The 2018 meta-analysis recommends therapists closely monitor themselves and work on their conflicts through personal psychotherapy, meditation, and self-care. They may also consider clinical supervision.

History of Countertransference

Sigmund Freud first described countertransference in 1910. Attitudes of the concept have changed over time. Freud first defined it as being in reaction to transference from a client, and it was thought of as largely detrimental to therapy.

However, this thinking changed around the 1950s, when countertransference started to be viewed as something that could be positive. The definition of countertransference was also broadened to include any reaction a therapist had to a client.

Takeaway

Countertransference is common, and it's not always a bad thing. If you think this is something that might be affecting your therapeutic relationship, feel empowered to bring it up with your therapist. If having that conversation makes you feel uneasy, that's understandable. But it might mean it is time to move on and find a therapist who is a better fit for you.