Transfer and Countertransference

TRANSFER

Transference is the situation in which the individual re-experiences the feelings and attitudes that he had with important people in his childhood, now in the relationships he has established with the important person or people in his life. He shows similar reactions to these people as he did in his childhood. The transference during psychotherapy sessions is experienced more intensely and continuously than the transference in the daily life of the individual. (Ozturk, 2008, p.165).

Transference can be intangible, vague, and unnoticeable. In order to realize the transference, the interviewer should pay attention to the specific approach that the client establishes with him/herself. The client may react more emotionally than the interviewer expects, make unfounded assumptions about the interviewer, or express unrealistic expectations about the interview content. (Sommers-Flanagan and Sommers-Flanagan, 2007, p.177).

The persistence of childhood features in mental processes means that the past is repeated in the present. A clear example of this is experienced in psychodynamic psychiatry practices. The person who comes to treatment lives as if he were someone important to him in the analyst’s past (mother, father). Instead of remembering, the person experiencing transference reactivates his past unconsciously and transfers the information about his past experiences directly in the treatment environment. (Geçtan, M. 2018, p.51).

Transference is seen as the main treatment axis of classical psychoanalysis and most dynamic concepts. It is thought that it is not possible to talk about a cure without transference. An individual applying to therapy for various reasons is the situation in which he directs his feelings, which he has created from his relationships with the first generation, to his therapist. Based on these feelings, the therapist tries to make the client develop insight by making comments. In this way, it enables them to recognize their feelings, thoughts and behaviors. With this recognition process, the client begins to observe differentiation and various improvements. (Özakkaş, T. 2007, p.291)

Transference occurs in every psychoanalytic process, because it happens whenever a person is in a relationship with someone important to them. In a way, every relationship is a mixture of real relationship and transference phenomenon. Those working in the field of dynamic psychiatry consider that the relationship problems experienced by the person who comes to treatment may also arise in their relationship with them over time. The important thing here is not to experience the transfer, but to understand the resulting experiences. Therefore, psychoanalytically oriented psychiatrists respond to transference differently than other people. (Geçtan, M. 2018, p.51).

During the psychotherapy process, mutual feelings and attitudes can develop between the patient and the therapist. Some of these are emotions and behaviors that are appropriate and appropriate for the real situation of the client and the therapist. But an important part are manifestations of the process called transference reactions. (Ozturk, 2008, p.165).

The quality of the relationships that individuals have with their parents in childhood significantly affects the relationships they have established in their adult lives. Every lover has some parent. In cases of rebellion against authority, it is possible to find traces of rebellion against parents (Öztürk, 2008, p.165)

According to the classical dynamic theory, there are many areas that the therapist should pay attention to in order for transference to occur. In these, it is seen that there are many areas such as the arrangement of the room to be treated and the dimensions of the relationship established with the client. The main goal of all these practices is to prepare a neutral environment in the therapy room for the client not to make different associations and not to change the room during the process. (Özakkaş, T. 2007, p.291)

When the transference is evaluated from the cognitive point of view, we can say that the person has a strong cognitive representation of his sibling, for example, if the reason he does not like the person he sees for the first time is because he looks like his sibling. This sister-like woman activated cognitive representation, which triggered emotions and other associations. That is, the old cognitive representation is used to process information about the new person. As a result, he expected that this person would see the characteristics of his brother and that his feelings for her would be similar to the feelings he had for his brother. While cognitive psychologists explain this process, they say that transference develops outside of our awareness, although they do not say that it lives in the subconscious like the Freudian view. (Burger, JM 2006, p.644).

Transference is the repetition of emotions experienced in childhood in adult life. The sources of this repetition tendency can vary widely. Emotions and behaviors that were not satisfied in childhood may seek satisfaction or solutions in adult life. (Ozturk, 2008, p.168)

Another reason for the tendency to relive past experiences is an indication of the ego’s effort to dominate and overcome them. For example, going over a feared situation in order to relive it is a sign of effort to eliminate the fear and try to overcome it. (Ozturk, 2008, p.169)

One of the most common situations is the client’s beliefs that he does not reveal, but that the interviewer will evaluate him and find him inadequate. (Sommers-Flanagan and Sommers-Flanagan ,2007, p.177)

Intense and excessive reactions that are not appropriate for the situation in the therapy process can be seen as transference symptoms. These may manifest themselves in the form of the direct emergence of transference-related emotions or the defenses and resistance developed against them. For example, the desire for the therapist to be his only patient, being jealous of other clients, frequently bringing up the issue that he does not take care of himself enough, dreams and curiosity about the therapist are transference symptoms. These are mostly considered positive transference signs. From time to time, contradictory attitudes, angry and sarcastic words, excessive jealousy and excessive dependence can be seen. These are also cited as examples of negative transference. (Ozturk, 2008, p.169)

In long-term psychotherapy, it is natural for each client to have positive and negative feelings towards their therapist and behave accordingly. These feelings can intensify from time to time and reach the level that will affect the daily life of the client. (Ozturk, 2008, p.170)

Transference itself can be seen in positive or negative attitudes, emotions, and behaviors. While positive transference can be seen in situations such as giving affection, loving and affection, negative transference; It can manifest itself in situations such as hostility, rejection, or apathy. Each of these areas may emerge as areas that can be worked on as therapy progresses. The most important issue that the interviewers should pay attention to is not to comment on these issues by noticing the reactions and behaviors from their past relationships ( sommers-Flanagan and Sommers-Flanagan ,2007, p.177).

Transference responses can be self-fulfilling prophecies. Clients who anticipate that they will be rejected and negatively evaluated or not shown empathy look for these possibilities in their relationships in their normal lives. Clients may begin to react negatively to these minor mistakes, by refusing the interviewer to paraphrase or project emotion. If the interviewer fails to notice this pattern, the client may ultimately succeed without making a negative self-evaluation. (Sommers-Flanagan and Sommers-Flanagan, 2007, p.177).

The transmission symptom sometimes appears with a defense. For example, excessive respect for the therapist and praising the therapist with constant praise are often counter-reactions to covering up negative transference feelings. Pretending to have no feelings towards the therapist also indicates that a mechanism of denial and isolation is at work. (Ozturk, 2008, p.170)

Transfer can also occur at various resistances. For example; Resistance symptoms such as not coming to the therapy session, arriving late, forgetting, and silence should also be considered as transference reactions. (Ozturk, 2008, p.170)

The transfer may be conscious or unconscious. There is often a conscious side to a patient’s attachment to, love, or anger with their therapist. The client is aware of these feelings. Most of the time, the client does not recognize their feelings, does not accept them and may use various ways of defense. (Ozturk, 2008, p.170)

We may not gain anything by immediately connecting the client’s feelings and behaviors during therapy to their childhood experiences and saying that these are transference reactions. The client may not understand this situation. She may feel that the therapist does not understand her and that her feelings have been misinterpreted. If the client is told that the feelings he is experiencing now are his childhood feelings, it may cause him to feel that he and his feelings are not respected. (Ozturk, 2008, p.172)

The more the client’s personality structure includes childhood complexes and conflicts, the more intense and extreme the transference reactions can be. In severe personality disorders, neurotic states, and psychoses, transference symptoms may occur in a very short time and intensely. (Ozturk, 2008, p.172)

Transference can occur in all of the behavioral, cognitive, and existential dynamic therapies. A therapist, who knows the development and formation of transference, should be able to analyze very well what transference directed to him, if he wants to treat and motivate his client, no matter what treatment technique he uses. (Özakkaş, T. 2007, p.295)

Not every emotion and behavior of the client towards the therapist should be interpreted as a transference. Clients may be respectful, genuinely loving, or angry with their therapist. These may be real reactions. It is not always true that these are transference signs of childhood confusion and conflict. It should not be forgotten that there is some truth and some transference in every relationship. (Ozturk, 2008, p.173)

EXAMPLES OF TRANSMISSION EXPERIENCED IN INTREATMENT SECTIONS

Part 1; The man she met at the bar said to Laura, “You look so sad, Yes you are, it suits you.” Turning to Paul, Laura said, “What do you think? So am I beautiful when I’m sad?” Paul says, “I don’t think anyone is beautiful when they’re sad. Laura doesn’t get the answer she expects from Paul. Laura asks if Paul is disgusted by having sex with the man she met at the bar. Paul says that this situation does not disgust him. The bar man and Laura become close in the bathroom. But Laura cannot have sexual intercourse. She says she thought of Paul and didn’t continue. After their fight with Andrew, Paul says he wants to talk to Laura about cheating. “Didn’t you notice?” Laura turned to Paul. he asks. Paul doesn’t get it, and Laura tells Paul that she’s in love, but that shouldn’t be her reaction.

In the 2nd part; When meeting Alex, “You were said to be the best. I guess this must be you, the guy who is on the same frequency as those around him. You are the best.” Paul asked Alex, “Is it important to you that I’m well?” says. Alex: “Yeah. I always go for the best. Dentist, repairman”. Alex sees Paul as his superior, whom he expects to give him orders. Let Paul order and Alex carry out the order.

Chapter 3; Sophie asks if her mother spoke to Paul and hints that she may have spoken to her mother and starts to get angry. She sees Paul as her mother’s collaborator. She projects her anger at her mother onto Paul. He transfers his mother to Paul.

Chapter 7; Paul’s again matches success or failure. “You have to be smarter than me.” says. Again, Alex sees him as his commander in the navy, like an official who approves his decisions in the face of the questions he has asked.

Chapter 8; While Sophie was talking about her problems, she suddenly asked Paul, “What’s going on here?” he gets angry. She tells Paul that her daughter is a freak. He’s making evaluations over Paul’s daughter. He identifies with his daughter. Here, Sophie reflects on Paul what her own father needed to know. She asks if Paul has written her review of him, and she gets angry thinking he hasn’t. Paul says he wrote it and reads his review. Sophie reveals her distrust of her own parents by not believing Paul.

Chapter 13; Sophie shares with Paul what happened before the accident. As She begins to explain in more detail, she asks if what she tells will affect Paul’s evaluation, and she becomes angry with Paul again. She blames Paul. “You’re just like the others,” she says. She projects her anger at her mother and father onto Paul.

Chapter 14; Amy comes to the session alone. Jake doesn’t know he’s coming to the session. She woos Paul at the beginning of the session. She tells him that Jake blamed him and Paul. She approaches Paul as if she were a date. Erotic transfer takes place.

COUNTER TRANSFER

Countertransference is a situation similar to transference that is seen not in clients but in interviewers. Countertransference may arise from conflicts, behaviors and motives that are not experienced at the conscious level. (Sommers-Flanagan and Sommers-Flanagan, 2007, p.178).

In contrast to the transference experienced by the treated, the treater also experiences countertransference. Because what has been described for the treated also applies to the treater. The difference between them stems from the difference in managing emotions within the treatment setting. In order to ensure this difference, the psychiatrist must constantly consider the positive and negative feelings towards the person he/she is treating and the possible relationship between these experiences and his/her past. (Geçtan, E. 2018, p.52).

Countertransference reactions are rarely conscious and are likely to go unnoticed. If the interviewer cannot notice and control these reactions, it may have negative effects in the therapy process. It is useful to provide helpful guidelines for dealing with countertransference. The first of these; The therapist’s acceptance of the fact that countertransference reactions are normal and inevitable. Secondly; If the therapist has strong feelings and behaviors towards the client, they may need help from a colleague or supervisor. As the third; should read about countertransference. Fourth and finally; If his feelings, thoughts and behaviors continue despite all his efforts to cope, he can refer the client to another therapist or start his own therapy process about the feelings that he cannot cope with. (Sommers-Flanagan and Sommers-Flanagan, 2007, p.179).

The therapist’s reactions to the client arising from his relationships with important people in his childhood are called countertransference. The countertransference is not an event in opposition to the client’s transference to the therapist. The client’s reactions may trigger the therapist’s countertransference reactions from time to time, but their origin is not related to these, but to the therapist’s own childhood life, conflicts, unresolved infantile feelings. As with the client’s transference reactions, it is up to the therapist to recognize the countertransference reactions and to search for their sources and keep them under control. (Ozturk, 2008, p.179)

The concept of countertransference has undergone significant changes since it was first defined. Freud’s definition classified it as the transference developed by the psychoanalyst against his patient or the reaction he developed against the patient’s transference. In the following years, Winnicott observed a different phenomenon of transference in his work with psychotic patients, and named objective hatred as a direct natural response to the patient’s disturbing behavior that did not arise from the unresolved unconscious conflicts of the treater. The word objective is used to emphasize that most psychiatrists may show the same reaction to some provocative behaviors of their patients. (Geçtan, E. 2018, p.52).

Countertransference reactions can appear in many places. The therapist must first deal with his own personal processes, otherwise these reactions are inevitable. Countertransference can occur in many places at the same time because countertransference can be triggered by many different variables. (Sommers-Flanagan and Sommers-Flanagan, 2007, p.183).

Countertransference responses can also occur in ways similar to transference responses. The therapist may forget the meeting time, become unnecessarily angry with the client, or fall in love. Instead of listening to the client and understanding him, he can mostly speak by himself. He may become overly attached to his patient by making him his confidant or may say sarcastic, hurtful and hurtful words to his patient. He may get into unnecessary arguments, gossip about other doctors, feel sleepy during the meeting, and yawn. When all these situations are evaluated, it is seen that the therapist can see the client as a sibling, mother, father, and reacts like this without realizing it. (Ozturk, 2008, p.179)

It is always possible to be affected by the countertransference. You can try to react by not giving in to your client who acts like your oppressive big brother. (Sommers-Flanagan and Sommers-Flanagan, 2007, p.183).

It should not be forgotten that the therapist may also have feelings, expectations and troubles. He may feel closeness, sympathy towards his client and may get angry from time to time. These may relate to a real situation and should not always be interpreted as a countertransference reaction. (Ozturk, 2008, p.180)

The relationship in psychotherapy does not always develop in one direction. The relationship is always mutual. However, if the therapist is well-educated and has adequate training and equipment in countertransference, they can recognize their own feelings and behaviors and use them to develop a positive relationship. A person who cannot realize his own feelings and behaviors and is dragged unconsciously cannot do psychotherapy. (Ozturk, 2008, p.181)

COUNTER TRANSFER EXAMPLES IN INTREATMENT SECTIONS

In Chapter 4; Jake freaks out at Paul’s questions during therapy. Amy is pregnant and asks if they can have the child. “You should have the baby aborted,” Paul tells Jake. Paul puts his marital problems on Jake and Amy. He provokes the couple. It does a countertransference.

In Chapter 5; Paul asks to go to Gina for professional help. He waits for Gina’s approval on his erotic twist with Laura. Paul sees Gina as an authoritative figure, that is, an approving authority. Paul transfers all the negativity with his clients to Gina.

In Chapter 6; Laura tells Paul she is going to marry Andrew. She says she might be on the guest list. But Paul reacts to Laura’s decision to marry. It does a countertransference. Laura notices this and asks Paul, “Do you want to spoil my mood?” he reacts. Laura says she wants to sleep with Paul. Paul can’t be too indifferent to Laura’s reactions. He starts arguing with Laura. It’s more like a husband-wife fight than a therapist-patient relationship. Laura catches Paul’s behavior and says, “You and I became “We”. Erotic transfer continues with one difference. Laura realizes that Paul wants her too.

In Chapter 9; Jake and Amy come to the session, but in the middle of the session Amy feels pain. They interrupt the session. Blood from Amy was smeared on the chair he was sitting on. Paul asks Kate for help with this. But they start arguing over Max. Kate tells Paul that she cheated on him with someone. Paul is enraged. He loses control as this happens to him.

In Chapter 10; Paul tells Gina about his argument with Kate. “There are two women around you attacking you,” Gina tells Paul. “There are three women,” Paul says. Paul, who has a troubled relationship with Kate and Laura, conveys this to Gina. Gina mentions that the therapy process of Laura should be finished by Paul and it would be more beneficial for her to continue with another therapist. Paul does not accept this situation. Gina goes further and gives Paul an ultimatum. Paul realizes this and says, “You have faced a similar situation.” Gina tells Paul her own experiences. (Counter transfer)

In Chapter 11; Laura arrives 25 minutes late for the session. Paul goes over this situation. He clashes with Laura. Fearing that his feelings will come out, Paul mentions that he wants to end his sessions with Laura. Laura reacts to this. Laura treats Paul like a lover. The transfer takes place. Paul cannot hide his feelings. Laura notices this and tells Paul, “You can’t cure me because you’re in love with me too.” Paul has reflected his feelings on Laura. The countertransference has taken place.

In Chapter 12; Alex asks at the beginning of the session if meeting Laura poses an ethical problem. Paul says it’s okay. In the following minutes, Alex wants to tell Paul what happened with Laura. Paul shows jealousy. He asks Alex how he met Laura. Alex says that he mixed up the days and that he met Laura at the end of the session and they went to the dog that had the accident and they could not find it. Later, Alex explains that he drew a sketch of the area while Laura was having coffee together. Paul is jealous of this intimacy. Did you have coffee for Alex at Paula’s house?” he asks. Alex says, “No, where did that come from?” Paul sees Alex as his rival. It does a countertransference.

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