Wednesday, July 13, 2016

Countertransference

If there is one thing I stress to students and anyone I supervise... it's "get a handle on your own stuff." What does this really mean? I see a lot of posts about behaviors people need to stop doing, for example, complaining or worrying, nail biting.

But first you must be aware that you do these things at all. And most people are NOT because they can be very unconscious. Long before I knew this is what I wanted to do, I went to therapy for a year. I was 17 and I had issues, suffice it to say. I didn't think this therapist was any kind of guru but I learned what I needed to learn and threw away some of his sexist, assuming and occasionally belittling crap about me. I can laugh about it now! I also went to therapy in my 20s because my father was terminally ill but I went for ten years anyway. After I got married and had a baby, I was in marital therapy *surprise!* So I have done some time on the couch, and I think ALL therapists should. Why? Because you need to be aware of your own stuff! I cannot say this enough!

Counter-transference is the therapist's reaction to the client's reaction to them. Or to their story. Last week I saw a couple - only for two sessions. One wanted to work on the marriage, and the other was done with her spouse. I don't really want to see couples, and I was glad when they decided to stop coming. Why? Because I have gotten divorced, and clearly not long ago enough. My mind wandered and I struggled with staying focused on them because I could see all the similar issues. I also have a client who is getting divorced but it's a little easier to manage my feelings with just one person - I tend to align myself with one person vs staying in the middle - I am not a good mediator. Well, it is something I can work on. I have my areas of expertise and I do not have to be an expert in all things.

During my marital counseling time, I found a therapist whom I adored. She was an older lady (we both thought she resembled my mother but she was nothing like my mother as we found out!), French speaking Swiss ex-pat, elegant, and had this uncanny way of using her own counter-transference to work with us (I am sure this was her Institute training but she was gifted). She allowed her feelings to surface based on what each of us said. She used those feelings to respond to the person who was talking and not talking. I loved her and eventually went to see her on my own from time to time.

I once went to a training on counter-transference where we watched some film clips - Ordinary People, and Dead Man Walking are the two I recall the most. Any film with therapy scenes or
difficult issues are good opportunities for therapists to think. If you were sitting across from a sociopath on death row and he started making sexual innuendos - how would you handle that? Watch the movie - she did great. Granted - you'd feel pretty uncomfortable. Angry even - how dare he? Be aware of those things. Narcissistic people will piss you off constantly, be aware of that. Those feelings are telling you something not just about you but about your client.

The California psychiatrist Irving Yalom MD writes great books about therapy - I recommend them. The book "Love's Executioner" is specifically about counter-transference and is a must read on the topic. I have learned more from his books than any class or supervisor. While I was reading his book, "The Gift of Therapy" I got stuck on a chapter and stopped reading it. I mentioned this to a colleague and he asked what the chapter was about because it had triggered something in me... well of course it was something I was having a reaction to - I don't recall at this moment what it was. My point is that these things are all signs that point to our issues and we must listen.

Therapy is a GIFT. Managed care has made it all about billing hours and time limits, sadly, but if you really want to be a good therapist, dig deep into yourself and not only learn about yourself, but learn from your therapist. If you are not learning - find someone else who can be your guru.

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