Question: “How can I deal with countertransference during sessions with clients who trigger me? ”
This doesn’t happen often, but I notice I react when clients share their experiences of their partner, which I perceive to be unfair (and sometimes a little hypocritical).
I’m aware these are my perceptions and that I’m reading into what the client is sharing from a place of my own judgement. Nevertheless, even with that awareness, I struggle to not let it affect me in session.
One client of mine talks about his partner: she has a lot of responsibilities, works hard, has little time for herself, is often tired, and tries her best to take care of everyone. This includes caring for her parents and supporting her siblings.
So, he acknowledges this and initially appears sympathetic. But then he goes on about how she doesn’t meet his emotional and physical needs, and how he feels neglected and unloved. “It’s like we’re living as housemates rather than a couple.”
And I get it. He feels like his partner’s time and energy is taken up by everything else, leaving no room for him and the relationship. After spending time empathising with him and helping him to process his feelings, I wanted to get a sense of how he and his partner work together on issues. So I asked, “Just to help me understand your relationship a little better, can you let me know how you and your partner support each other through tough times? For example, how do you support her in helping her family?”
He replied, “I don’t, really – it’s her family, not mine. I have my own commitments and worries to see to.” While I was able to remain calm and non-judgemental on the outside, my whole body wanted to scream, “What the hell?!”
After that session, I was having all kinds of thoughts. Here’s this guy complaining that his partner isn’t there for him, isn’t supporting him, isn’t loving enough…and he’s doing *exactly* the same thing he’s criticising, except he has nowhere near the same number of commitments as his partner.
In session, I’m careful to be supportive and to be aware of how I’m interacting with him, but what I really want to say is, “Do you really expect your partner – who is struggling with so many things – to be able to give more time to you while you’re standing there watching her drown? Might your relationship improve if you showed your support and offered some help? She’s unable to be there for you precisely because no-one is there for her…and that includes you.”
How can a person be so lacking in self-awareness? And this is a client who is switched on, articulate, kind, and doesn’t appear to have a personality disorder (e.g., he’s not narcissistic).
I get the sense that I can work with him and make progress in therapy, but I first need some guidance on how I can manage my countertransference in session. It feels like an obstacle that’s getting in the way of our work together…even if I am able to hide it when we’re together.
Response from Dr. Chua:
Countertransference often happens when the therapist responds to the client’s transference or projection with certain feelings or behaviours. There is a personal element to it – you are reacting to your client as though your client is doing it to you. So, if you believe this is countertransference, it may be helpful to understand what you are responding to and why. I suppose I am wondering why his statements bother you so much?
I’m also wondering which of your client’s needs are not being met? I know he says his emotional and physical needs are not being met, but which ones? And were they ever met in the relationship? Did something change the relationship? I also wonder how he expresses his needs to his partner? Is he able to assert his needs in a healthy way and share his feelings with his partner honestly?
Rogers’ defines empathic understanding as “the therapist senses accurately the feelings and personal meanings that the client is experiencing and communicates this understanding to the client. When functioning best, the therapist is so much inside the private world of the other that he or she can clarify not only the meanings of which the client is aware but even those just below the level of awareness.
“This kind of sensitive, active listening is exceedingly rare in our lives. We think we listen, but very rarely do we listen with real understanding, true empathy. Yet listening, of this very special kind, is one of the most potent forces for change that I know. …To sense the client’s private world as if it were your own, but without ever losing the ‘as if’ quality—this is empathy, and this seems essential to therapy.
“To sense the client’s anger, fear, or confusion as if it were your own, yet without your own anger, fear, or confusion getting bound up in it, is the condition we are endeavouring to describe. When the client’s world is this clear to the therapist, and he moves about in it freely, then he can both communicate his understanding of what is clearly known to the client and can also voice meanings in the client’s experience of which the client is scarcely aware.”
You mentioned the internal vs. external split. Rogers’ conditions of change include the therapist’s congruency. Perhaps the incongruency you experience during the session might impact your empathic understanding of the client. I say this not to make you feel bad or to assume you are not empathic.
However, you did ask “how can a person be so lacking in self-awareness?”, which implies to me that you have not quite inhabited your client’s world if you don’t understand why your client feels and behaves this way in his relationship. I think we can (wrongly) reduce empathy to verbal reflection, but that can be quite mechanical. We can repeat the client’s words without understanding and accepting the client’s experience.
Our own reactions are best dealt with in our own personal therapy. After all, we are mere mortals who carry our own burdens. It is good to examine your reactions with your own therapist to understand what is triggering you to behave this way. Forcing yourself to keep it in and be incongruent is not helpful to either yourself or your client, in my opinion.
If you noticed, my suggestions are rarely to do things by yourself – but to examine things with your supervisor or your personal therapist. Just as we encourage our clients not to walk alone, our journey to be better therapists has to take place in a community, not in isolation.
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