Countertransference is an unconscious effect in mental health relationships, and neither the clinician nor the client realizes it is happening. It serves as an important reminder that mental health professionals are human too, with their own biases, history, and emotions that can influence their thoughts and reactions to clients.
In a mental health session, a client might remind the professional of someone or something from their past or present. Consequently, the clinician might unconsciously treat the client in an emotionally charged or biased manner. Clinicians must be aware of countertransference at all times and actively work to acknowledge and manage it in their practice. Countertransference in mental health refers to the emotional reactions, biases, or perceptions a professional may have towards a client, influenced by the professional's personal experiences, unconscious feelings, or issues. It can affect the therapeutic relationship and treatment process.
Countertransference is a professional's reaction and feelings toward a client in therapy. It contrasts with transference, which is a client’s emotional reaction to their professional. Countertransference is a common, unconscious phenomenon that can negatively impact the therapeutic relationship if not properly addressed. Freud first identified countertransference as a detriment to an analyst’s understanding of their patient. Today, it is viewed with both negative and positive associations in psychology.
Countertransference occurs when a professional brings in their own experiences to the extent that they lose perspective on the client’s situation and stop being objective. It can manifest when the professional over-identifies with the client’s stories and shares too much about themselves, offers excessive advice instead of listening to the client, pushes the client to act before they are ready, seeks to relate outside the therapy room, inappropriately discloses personal information, develops romantic feelings for the client, lacks adequate boundaries, or is overly critical or supportive of the client.
If countertransference is the emotional reaction a professional might have towards their client, then transference is the opposite: a client’s emotional reaction to their professional. Transference is a psychological phenomenon where a client redirects feelings for someone from their past or present onto the clinician, which can include feelings towards a family member, friend, or significant other. Like countertransference, this phenomenon is mostly unconscious, and the client is likely unaware of its influence. Unlike countertransference, transference in therapy is accepted. Professionals can use transference as a tool to better understand their client’s personal relationships and emotions. Countertransference can be seen as the clinician’s response to a client’s transference. However, while transference is a normal and accepted part of the therapeutic process, clinicians must monitor their countertransference to remain objective and avoid harming the client.
In subjective countertransference, the therapist’s own unresolved issues are the cause. In other words, experience from the therapist’s own history is re-experienced in response to their client.
An example of this includes a therapist who fears anger due to a family history of aggression, so they discourage any expression of anger from their client. This subjective form of countertransference can be harmful if not detected.
In objective countertransference, the professional's reaction to their client’s maladaptive behaviors is the cause. Maladaptive behaviors are behaviors that inhibit one’s ability to healthy cope or adjust to certain situations. Most people would have the same reaction to this person; thus, the professional's reaction is “objective.”
Unlike subjective countertransference, objective countertransference can actually benefit the therapeutic process. For instance, if the professional can accept and study this objective reaction they have to their client, they can use this countertransference as an analytical tool.
Positive countertransference occurs when a professional becomes overly supportive of their client. Signs include trying too hard to befriend the client, disclosing too much personal information, or over-identifying with the client’s experiences. This can harm the therapeutic relationship by diminishing professional boundaries and preventing the professional from treating the client objectively. Importantly, some psychologists believe this positive form of countertransference can have beneficial outcomes by improving the professional-client relationship.
Negative countertransference occurs when a professional reacts negatively to uncomfortable feelings. This includes being overly critical, punishing, rejecting, or disapproving of the client. It is also evident when the professional feels bored, irked, paralyzed, or contemptuous during therapy with a particular client. Negative countertransference is especially problematic as it can harm the client’s psyche and cause therapy to do more harm than good.
