Psychiatrist Sigmund Freud described transference as the way people “transfer” emotions related to the important people in their lives, onto their therapist.1 Countertransference refers to instances when a therapist consciously or unconsciously transfers their emotions back to the person they are treating in response to transference. When these dynamics occur in therapy and are appropriately addressed, it offers important insights for patients.
Transference vs. Countertransference
Transference occurs when the patient brings strong feelings associated with an important past relationship into therapy and onto their therapist. Often this is an unconscious act. The relationship between a patient and therapist is the core of any type of therapy.
Transference can be a powerful tool in helping therapists gain a greater knowledge of their patients’ past conscious and unconscious thinking and behaviors. This helps therapists understand past and current relationships and how they were shaped.
The relationship between transference and countertransference involves contributions from both patient and clinician. The patient draws a therapist into playing a role that reflects the patient’s internal world, but the specific dimensions of that role are colored by the therapist’s personality.2 With countertransference, the therapist transfers his/her emotions and feelings towards their patients.
What Is Transference
Transference can include positive or negative aspects of previous relationships. In their article on transference, experts Patricia Hughes and Ian Kerr further define transference as being “at least partly inappropriate to the present. It is the transfer of a relationship, not a person. Only an aspect of a relationship, not the entire relationship is transferred.”3
Examples of Transference
Here are a few examples of transference that a patient might display:
- Psychologist Judith A. Schaeffer offers this example: “As my vacation approached, Ms. D. hinted repeatedly that I was selfish. When I attempted to link my vacation with her mother’s unnecessary and frequent excursions, she stomped out of the office, threatening not to return. She did not.”4
- Clients receiving therapy could have a sexual attraction to their therapist because the therapist reminds them of a past romantic relationship
- Clients could idealize their therapist, thinking they are perfect
- Clients could be in opposition to the therapist’s recommendations because they link it to someone else in their life instead, like a parent or sibling
What Is Countertransference?
Countertransference occurs when a therapist loses all objectivity regarding their patient. John E. Schowalter, MD, describes it as “the unconscious influence that a therapist’s past needs and conflicts have on their understanding, actions, or reactions within the treatment situation.”5
Examples of Countertransference
Here are several examples of countertransference:
- Therapists could blur boundaries and reveal a lot regarding their personal life turning the attention away from the patient to themselves
- Therapists could develop an attraction with romantic and/or sexual feelings towards a client
- Therapists could be overly protective of a patient who reminds them of their child
- Therapists could become angry at a patient who has an alcohol addiction because they had a parent who was an alcoholic
Final Thoughts on Transference vs. Countertransference
Doctors are responsible for the control of transference and countertransference since patients don’t have a conscious perception of it.6There are circumstances where transference and countertransference can offer a positive outcome for patients if it’s handled effectively. Both the patient and a skilled mental health practitioner can learn from transference and countertransference that occur in sessions.
