I've defined countertransference is those reactions that we have to patients
that are based primarily on our own unresolved or partially resolved
conflicts, as a result of our own developmental histories, our own
idiosyncratic reactions to patients that perhaps aren't widely shared by other
therapists that somehow there's some recognition that the work that we do
with patients and I think, particularly with patients of personality disorders,
inevitably it's gonna stir up some of our own issues and all therapists have these
reactions. It's not a function of being a trainee, there's no point in our careers
where we become immune to these kinds of reactions. So the point is to
understand that these reactions are going to be triggered within us, that
they can get in the way of our work if we don't understand them and it's really
important to try and pay attention, not just to the client, but understanding
what's going on internally and between the client and myself in the moment,
which is a tall order, but in terms of counter transference, what am I feeling, what am I thinking,
what's my body experiencing sensing and and what am I actually doing with this
client that raises some suspicions for me that perhaps my own issues are at
play here, and can I use my understanding of my own, especially internal, reactions
to facilitate the work. So for example, if the client is provoking some sort of
rage in me or anxiety in me, is this what might be called objective
countertransference, where the reaction is typical, that might be shared by one
of my classmates who would be seeing the same client, or the same type of
patient or is this reaction somehow a reflection on me because of my
own developmental history, there's some way in which what the client is talking
about, what the client is doing, what the client looks like, reminds me of someone,
including possibly myself, that causes me to react rather than respond, and in
particular if I find that I'm behaving or thinking or feeling in a way that's
atypical for me, I don't usually react this way to
clients and I don't usually react this way to this client in my work with them,
then there's real grist for the therapeutic mill here, how can I try and
reflect on those reactions in the moment, if possible, so that I don't act out
defensively and how do I reflect after the session on my reactions, either in
supervision, or with a classmate, or on my own, in a way that my understanding might
shed some light on the patient dynamics, on the relationship and even on the
course of treatment.