Professional–patient relationships
Jill Thistlethwaite, John Spencer in Professionalism in Medicine, 2018
Boundary violations, particularly those of a sexual nature, often arise through the phenomena of transference and counter-transference.7 These terms derive from the psychoanalytical school of psychiatry, but are common phenomena in many consultations over long periods of time. Transference refers to the feelings that the patient has for the therapist (the doctor or other health professional), which often mirror those that he or she has had for authority figures in the past. Such feelings may be therapeutic in that they provide insight into relationship problems in the past. The feelings for the therapist may involve affection and sexual attraction. Counter-transference refers to the feelings that the therapist (the doctor or other health professional) has for the patient. These feelings may arise due to the patient’s displays of affection.
Psychodynamics and the doctor-patient relationship
Ruth Skrine in Blocks and Freedoms in Sexual Life, 2019
Such self-questioning will be familiar to anyone who works in a psycho-dynamic way, and this way of thinking is the basis of psychodynamic psychotherapy. The skill is used at its highest level in psychoanalysis when the words 'transference' and 'countertransference' are used to describe some of the many feelings that arise and are passed between the couple in that setting. Transference is the word used to describe the way in which feelings towards someone from the past get transferred on to and felt towards the therapist who is present. Thus old, sometimes very old, feelings can be re-experienced. Counter-transference is more complicated because it concerns feelings of the therapist towards the patient, and therefore is not only specific for that patient at that time, but also holds the potential of being influenced by feelings arising within the therapist that are personal to him or her.
The nature and purpose of supervision
Jonathan Burton, John Launer in Supervision and Support in Primary Care, 2018
Much supervision within the field of psychotherapy focuses on the feelings of the practitioner as the main source of information regarding the patient and the nature of the patient’s problem. This is based on a belief that patients always ‘transfer’ their habitual patterns of dysfunctional behaviour, or their negative expectations, into their relationships with the professionals they meet. According to psychotherapeutic understanding, this stirs up reciprocal feelings (for example, of anger, pity or sexual attraction) in the professionals themselves: hence the terms ‘transference’ and ‘counter-transference’. Supervision in psychotherapy very often involves careful reflection on the therapist’s responses to the patient, and an analysis of how and why the patient has provoked these. This may include considerations of how relationships with important figures in the therapist’s own life – in particular parents – may also be playing a part in what is going on in the consulting room. Most psychotherapists and some other mental professionals argue, or simply assume, that this kind of work is the basis of all effective clinical supervision.
Longing and Fear: The Ambivalence About Having a Relationship in Psychotherapy
Published in American Journal of Clinical Hypnosis, 2019
Countertransference refers to the therapist’s feelings toward the patient. Originally, feelings toward the patient were understood to reflect unresolved conflicts in the therapist. Gradually, this viewpoint enlarged. Racker (1957) articulated countertransference as a complex form of empathy in which the therapist vicariously feels what others in the patient’s past felt toward the patient or what the patient was feeling in his or her past that he or she is unable to verbalize. In this way, Racker conceptualized countertransference as data about the interior of a patient. Searles (1979) went one step further, toward a more fully interpersonal view of countertransference. Searles believed that impasses in therapy were due to a therapist’s unresolved unconscious anxieties and that the patient, through evoking and provoking the therapist’s feelings, helped heal the therapist (by means of the therapist’s decoding and repairing what was being exposed in himself or herself). Once the therapist healed, the treatment could become unstuck. Subsequent writers articulated the therapeutic nuance of projective identification (for explanation, see Peebles-Kleiger, 1989).
Hypnosis and The Therapeutic Relationship: Relational Factors of Hypnosis in Psychotherapy
Published in American Journal of Clinical Hypnosis, 2019
Eric B. Spiegel, Elgan L. Baker, Carolyn Daitch, Michael J. Diamond, Maggie Phillips
On the other hand, others in the hypnosis literature have written about the inevitability of bidirectional experiencing of trance states between hypnotherapist and patient during hypnosis. For example, Hilgard and Fromm have both described a sharing of hypnoidal experience between therapist and patient because of the nature of the countertransference (Brown & Fromm, 1986; Hilgard & Hilgard, 1975). Their use of the term countertransference in this context matches what is now described in the current psychotherapy literature as intersubjectivity between patient and therapist (Safran & Muran, 2000; Stolorow & Atwood, 1996). Baker (1981) and Murray-Jobsis (2001) also described how the process of therapists entering trance with schizophrenic patients is curative because boundaries can be shared in the service of iatrogenic regression. Diamond (1984) also describes this bidirectional trance state in his discussion of the term he refers to as fusional alliance in his article “It Takes Two to Tango.” Finally, Banyai (1998) demonstrated synchronicity in physiological functioning between hypnotist and subject in her psychobiological research on hypnosis.
No Soy De Aquí, Ni Soy De Allá: Second-Generation Latinx Youth Belonging Everywhere and Nowhere
Published in Smith College Studies in Social Work, 2023
Maria Ximena Maldonado-Morales
In this particular case, I think our shared experiences certainly facilitated the development of a strong connection and the creation of a safe third space. In reflecting on this case, however, it is equally important for the clinician to be aware of their own countertransference and possible over-identifyication with the client. Projecting our own struggles and feelings onto the client, we might easily overlook the client’s unique subjectivities, thus possibly not meeting the cilent’s needs or potentially rupturing the therapeutic relationship. If the clinician over-emphasizes the similiarities with the client and over-identifies with the client, perhaps the clinician might fail to fully understand the client’s unique subjectivities. Having shared connections, commonalities and language can help create and strengthen the therapeutic relationship. As in any therapeutic relationship, the clinician must also be aware of and utilize the transference and countertransference to ensure the treatment and well-being of the client.
Related Knowledge Centers
- Mirror Neuron
- Object Relations Theory
- Psychotherapy
- Unconscious Mind
- True Self & False Self
- Transference
- Psychodynamic Psychotherapy
- Body-Centred Countertransference