Countertransference in Patient’s Mental Life

A significant step breakthrough in the development of the concept of countertransference in psychoanalytic research occurred when it became apparent how important this phenomenon can be to therapists in understanding the information they receive from their patients. Corey and Corey (2014) describe countertransference as “emotional-behavioral reactions toward a client that originate from some part of the helper’s life” (p. 70). In a sense, countertransference is the feelings a therapist experiences concerning their client’s transference.

There are several aspects of psychoanalytic interaction that contribute to the emergence of countertransference. The first aspect is continuous identification with the patient, based mainly on shared unconscious fantasies. When a therapist identifies with a patient, the patient’s unconscious fantasies and desires correspond to the therapist’s constant unconscious fantasies and desires. In this context, a distinction must be drawn between empathy and countertransference. Freud raised the idea that psychoanalysts carry the elements of understanding the processes taking place in their patients’ psyche. These elements are not immediately realized but can be discovered if the psychoanalyst observes their own mental associations. In the situation of countertransference, the analyst should be able to restrain their feelings, while the patient, on the contrary, has a cathartic experience communicating with the analyst.

Objective countertransference is usually limited in time to the interval of a therapy session. When the patient leaves, the therapist is open to new impressions and emotions from the next patient. The main characteristic of subjective countertransference is the frequent or regular prolongation of countertransference reactions after the session. For example, feelings of anger, excitement, or irritation that do not subside for hours and days often signify subjective countertransference. As soon as a helper realizes the unfamiliar thoughts that appear in their mind, such as “I hope they cancel” or becomes “intensely irritated by certain clients” (Corey & Corey, 2014, p. 108), it is their cue to reconsider their relationship with those clients. Another critical example is a therapist responding to a particular patient with a parental attitude. The sudden urge to help a patient in a more intimate and personal way is an indication of countertransference as well.

However, countertransference can lead to complications or incorrect conduct in the psychoanalytic process. It can happen if a therapist is not aware of certain aspects of their countertransference reactions to their patient or is unable to cope with them. Therefore, to prevent inappropriate reactions, it is every mental health specialist’s duty to explore their responses and trauma as well as help their clients identify their traumatic experiences and resolve them as early as possible. If a patient’s trauma and unhealthy patterns have not been analyzed and worked through, they could encompass their therapist and the entire therapeutic process. It is important to consider that the most common reason for countertransference reactions is childhood trauma.

Nevertheless, therapists must stay professional and eliminate any improper connections and patterns between themselves and their clients. To do so, it essential for counselors to have a strong mentality and use neutral, independent approaches in their work. Helpers must “monitor their feelings during their sessions with clients” and “use their responses as a source for understanding clients and helping them to understand themselves” (Corey & Corey, 2014, p. 105). It is suggested that counselors seek individual therapy or focus on individual supervisory sessions and reactions to patients. An analyst’s constant, careful examination of the entire variety of their feelings and attitudes towards their patients can guard both sides from unwanted scenarios and contribute to a deeper immersion into the processes of the patient’s mental life.

Reference

Corey, G. & Corey, M. S. (2014). Becoming a helper (7th ed.). Cengage Learning.