Countertransference arises when a therapist experiences an emotional reaction toward a client. This is common in therapy and does not pose a problem if the therapist is aware of it and makes an effort to prevent it from interfering with therapy. However, if a therapist is unaware of their countertransference and it affects their behavior toward a client, then it can be problematic and potentially harmful to treatment.
What Is Countertransference?
Countertransference is a therapist’s reactions and feelings toward a client in therapy.1 These reactions may be conscious or unconscious and can involve positive or negative reactions like anger, irritation, jealousy, or admiration. For example, a therapist may find themselves frustrated with a client’s lack of progress and react by cancelling sessions or ending sessions early. This can cause the client to feel hurt, dismissed, or abandoned.
In some cases, countertransference reactions can come from the therapist’s own past experiences. For example, a therapist may find themselves wanting to give advice in an effort to “save” a client. This therapist may be acting on their own feelings of inadequacy and desire to feel important, even though this may not be in the client’s best interests.
In other cases a therapist’s countertransference may be a reaction to a client’s behavior. For example, if a client is crossing boundaries in therapy, there’s a good chance they’re doing this in their outside relationships too. This indicates to the therapist how others feel toward their client. They can use their feelings of frustration to help the client understand their impact on others.
The term countertransference was originally associated with psychodynamic therapy, but it’s now recognized by therapists from many different orientations, including cognitive behavioral therapy (CBT). All therapists benefit from understanding and addressing their countertransference.2 It only becomes a problem when it interferes with their ability to work with their clients.
Problematic Countertransference
Countertransference becomes problematic when it leads to harmful or unethical behaviors toward a client or negatively affects the therapeutic relationship.4 For example, if a therapist experiences a strong reaction to a client and begins treating them differently, then the countertransference is problematic.
Therapists who behave unethically are often experiencing countertransference that they have not properly processed and addressed. One of the most harmful outcomes of problematic countertransference is when a therapist pursues a romantic or sexual relationship with their client. Therapists have an ethical and legal obligation to do no harm and should never engage in any sexual behavior toward their clients.5,6
In certain instances, countertransference can be helpful. When a therapist is aware of their reactions and seeks proper supervision, consultation, or their own therapy, it can give them a glimpse into how other people may feel toward their client. They can use this information to help the client understand their effect on others and work toward helping them develop more positive relationships.
Transference vs. Countertransference
While countertransference is a therapist’s reactions to a client, transference is when a client projects their feelings from another person in their life onto their therapist.7 For example, a client may have felt rejected by their parents growing up, and when their therapist cancels an appointment, they re-experience that feeling. They may falsely assume that their therapist is operating like their parents.
Both countertransference and transference involve feelings from the past that are projected onto another person. These feelings can affect how a therapist and client interact with one another in therapy. Like countertransference, transference can be positive or negative and conscious or unconscious. If it is acknowledged, it can be used to help a person understand their patterns. This understanding can lead to positive changes, especially in relationships.
4 Warning Signs of Countertransference
Good therapists will make an effort to acknowledge their countertransference with their clients and understand their feelings so that they don’t interfere with treatment. As a client, there are signs that you can look for that may indicate that your therapist’s countertransference is interfering or becoming problematic.
Four signs of countertransference are:
- Failing to maintain healthy boundaries
- Extreme emotional reactions to your behavior
- Inappropriate romantic or sexual behavior
- Inappropriate self-disclosure
11 Examples of Countertransference
Therapists are required to act ethically and in the best interest of their clients3 A therapist who is having countertransference and is unaware of it may behave in problematic ways. They may cross boundaries, fail to manage their emotional reactions, and in severe cases, act inappropriately with clients.
Here are 11 examples of countertransference:
- Pushing you to take action before you’re ready
- Wanting to “save” you from your problems
- Seeming overinvested in a specific outcome
- Giving unwarranted advice
- Getting frustrated if you don’t take their advice
- Expressing anger in a hostile or aggressive manner
- Agreeing to meet with you outside of therapy
- Increasing or decreasing the session time beyond what it should be
- Talking too much about themselves in a way that is unhelpful
- Flirting or expressing attraction to you
- Making sexual advances
How to Deal With Countertransference
Countertransference isn’t bad if your therapist is aware of it and making efforts to prevent it from interfering with your treatment. However, if you suspect that your therapist is having problematic countertransference, you have a right to express your concerns. In your next session, share the behaviors you have observed and how they make you feel.
You may even share your own transference reactions. For example, you can say something like, “I’ve been noticing that you have been doing X lately, and it’s causing me to feel Y.” In many cases this can provide a good opportunity to talk about your relationship and work through the dynamics. It could give you a chance to develop more insight into yourself and practice healthy communication and assertiveness.
Final Thoughts on Countertransference
Countertransference isn’t necessarily bad, but can become problematic when it interferes with a therapist’s ability to be objective or leads to harmful or unethical behaviors. If trying to talk with your therapist about their countertransference doesn’t feel helpful, consider finding a new therapist. Your therapist may even suggest this. Remember, therapists are human too and may have difficulty working with certain clients because of their history and experiences.
