Digesting Countertransference

By Lorenzo Ramos, Spring 2011

The process and phenomenon of countertransference is enough to leave any clinician feeling a little unsettled. In psychotherapy, it’s often the trickiest aspects of the interaction that provide the us with the most potential for effective work to be done. Countertransference is no exception, and its proper use is something that will not only help your clients, but help you as well. Strangely, it’s all a matter of good digestion.

Let’s take a minute to talk about the mind. When comparing the mind to the digestive system, an interesting metaphor emerges. If you were to think of any sort of perceptual stimulus as your daily Boudin-fix, there’s always the possibility that the combination of ingredients could be a bit imbalanced--did you really need that bear-shaped loaf of bread? You can end up with a mental “stomach ache” for the rest of the day. This might make your clients seem like they’ve all got some digestive issues, right? Gross. Kidding. It could be that their perceptual diets are unhealthy, or that they’ve developed issues in their digestive processes, either from birth or a consistently poor mental diet. OK, break metaphor.

Countertransference in the session itself can be used to enhance and deepen the therapeutic space. Too often, our clients make us feel the way they do the inside during session. Countertransference can also be an insight into how individuals outside of the therapy room feel in the presence of your client. Furthermore, countertransference can simply be your own personal issues coming up in session. We’re still human, even when we're wearing our therapy hats.

Whatever flavor of countertransference you might be dealing with, it always provides an opportunity for you to bulk-up as a therapist and digest the inner-experience as fuel for your therapeutic work, right there in the moment.

A direct, shameless analysis of your feelings will often give you the self-awareness necessary to deepen the interaction with your client. Process statements that emerge out of your own self-reflection in session can begin to address the interpersonal climate between you and your client. Golden territory for Axis II clients. Also, consciously grounding yourself with your breath or a quick opposite action exercise can allow you to turn your countertransference into mindful presence on your behalf—which can serve to benefit you and your client. Both of these simple examples end up turning that raw emotional content into something else, be it a process statement or compassion itself.

See? You’ve just digested an experience, and this is a sign of some of the healthiest functioning a human being can offer. Forget Activia, countertransference is the psychologist’s new probiotic