How are clinical psychologists trained to deal with transference?

[Hurstw]

I'm both a psych undergrad student and a patient. After my first experience as a patient I've wondered a few things: how are therapists taught to handle their own feelings toward patients? And how does it feel to be helping someone yet knowing that you are hurting them at the same time? Not intentionally hurting them, of course, but some patients sometimes do get hurt, don't they, especially when their feelings are not requited?

I think it is of utmost importance for me to understand this subject as I suspect that therapy (both as a patient and a practitioner) might not be for me. I'm mostly interested in personal opinions but if someone can also recommend literature on the subject, please do.

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[aequitasveritas]

You'll have to wait for the moderator but my inkling is that we won't be able to talk too much about some of your points, since they are so intimately related to your own treatment.

You'll learn much more from reading a book or two on the issue than asking we grad students on a forum😉

try reading: "Long term psychodynamic psychotherapy" by Glenn Gabbard and eventually try out some Melanie Klein if you'd like to learn about the basis and theoretical foundations of CT and TR.

Be well...and discuss these things with your therapist as they are grist for the unconscious mill.😉

 

[psychmama]

Hi. I just wanted to second what Aquitas said. It's hard to talk about the topic of transference/countertransference as it relates to an individual's own treatment. That said, transference is a fascinating topic, and reading more about it is a great idea. In addition to the Gabbard book, I'd recommend Nancy McWilliams' book Psychoanalytic Psychotherapy. While it assumes some basic knowledge it avoids too much jargon and explains the process pretty well.

Take care.🙂

 

[Hurstw]

I am interested in understanding transference from the point of view of the therapist. I also want to know how they are trained to deal with it. And while it is true that my curiosity comes from my experience as a patient, I did not come to this forum to discuss my problems.

The only thing I'll say about my particular case is that I am not doing psychoanalytic psychotherapy (so I don't know if the book recommendations will help), and if psychologist's are supposed to discontinue working with patients the moment they identify transference, why should a patient not do the same and change therapists?

Furthermore, this subject worries me a great deal because the last thing I would want as a therapist is to cause my patients the amount of pain I have experienced. I would rather not be a therapist than live knowing that I have made innocent people who trusted me feel miserable. And I need to find answers soon, while I still have time to pursue a different career.

Instead of focusing on my own transference, why don't we just talk about transference, both toward the patient and from the patient, as it is experienced by the therapist?

 

[Student4Life0]

From my understanding, transference is a psychodynamic construct, which is why the book recommendations are all psychodynamic in nature.

I cannot add much more beyond that. I have a small case load right now, and I have felt some counter transference to some patients, and do not notice it with others. I am aware of it, but I do not let it affect the therapy that I provide. I work primarily in a cognitive behavioral framework, so perhaps I am less inclined to obsess of issues of transference and counter transference, although I do think it is an interesting and important topic.

 

[psychmama]

Therapists don't stop working with patients as soon as they recognize transference. This happens only when the transference becomes an impediment to the treatment. And there are all different sorts of transferences, some are quite positive and pose no serious obstacles when handled by a well-trained therapist. In fact, some models of treatment use working through of the transference to help the patient develop insight into their problems Not all therapists use transference in this way, but transference arises in many therapist/client relationships, even if it's not specifically acknowledged.

 

[aequitasveritas]

I am interested in understanding transference from the point of view of the therapist. I also want to know how they are trained to deal with it. And while it is true that my curiosity comes from my experience as a patient, I did not come to this forum to discuss my problems.

The only thing I'll say about my particular case is that I am not doing psychoanalytic psychotherapy (so I don't know if the book recommendations will help), and if psychologist's are supposed to discontinue working with patients the moment they identify transference, why should a patient not do the same and change therapists?

Furthermore, this subject worries me a great deal because the last thing I would want as a therapist is to cause my patients the amount of pain I have experienced. I would rather not be a therapist than live knowing that I have made innocent people who trusted me feel miserable. And I need to find answers soon, while I still have time to pursue a different career.

Instead of focusing on my own transference, why don't we just talk about transference, both toward the patient and from the patient, as it is experienced by the therapist?

No, therapists are not automatically supposed to discontinue working with a patient when there are feeling evoked by the patient unless the feelings present serious occlusions to objectivity or to sound ethical practice (like sexual feelings towards patient that cannot be talked about or ironed out in some way with the patient).

A cursory understanding of transference is this: you start to feel certain ways towards your therapist that are similar and perhaps caused by significant others from your past (most often mom and/or dad).

For countertransference: the therapist starts feeling certain ways about the patient that may be: 1. caused by the patient (and I would surmise this if I can estimate that others feel this way towards them) or 2. that is caused by the therpists own "stuff" so to speak. or 3. a mix of both which is harder to figure out.

it doesnt matter if you're in analysis or not. CT and TR are in the room and are the process through which the content of the stated problems are stated.

The discussion is infinitely more complicated than this but I don't have the tie to go into it. The books listed are a good reference. You should also talk to professors who also practice or some other person you can speak to. It is clear that there are some powerful feelings going on in your treatment right now so a didactic discussion of TR and CT is not going to be of much use.

 

[StudentBsMs11]

Therapists don't stop working with patients as soon as they recognize transference. This happens only when the transference becomes an impediment to the treatment. And there are all different sorts of transferences, some are quite positive and pose no serious obstacles when handled by a well-trained therapist.

Agreed. In fact, some of the more psychodynamically/analytically oriented clinicians of my acquaintance might say that transference and countertransference issues are where a lot of the real work happens in therapy, and are very valuable for creating change. Also, just to address the point about therapists causing pain to their clients - my limited experience has been that therapists rarely *cause* that sort of extreme emotional distress in their clients. If your personal relationship with your therapist is causing you pain, whatever the reason or source may be, then you really need to address that with him or her so that they have the opportunity to address it and work on it with you. If anything that I were to say or do were to cause my clients pain, I would want to know about it as soon as humanly possible. If I'm reading your posts correctly, that sort of experience is not a normal aspect of psychotherapy, at least not as I know it.

 

[psychmama]

I'm thinking that much more discussion about this will start to run afoul of the forum rules. I think we all need to tread lightly here...

 

[aequitasveritas]

I'm thinking that much more discussion about this will start to run afoul of the forum rules. I think we all need to tread lightly here...

👍

 

[Hurstw]

Agreed. In fact, some of the more psychodynamically/analytically oriented clinicians of my acquaintance might say that transference and countertransference issues are where a lot of the real work happens in therapy, and are very valuable for creating change.

But when the transference is obvious to the client, and the client understands the boundaries of the relationship, and the client feels wronged, can the transference still be useful for creating change?

 

[Student4Life0]

But when the transference is obvious to the client, and the client understands the boundaries of the relationship, and the client feels wronged, can the transference still be useful for creating change?

This forum is a place for interested students, graduate students, and professionals to exchange ideas and information. It is not a place for you to find answers regarding what happened in your personal therapy.

 

[jexa]

Check out the forums at psychcentral.com to talk about your personal experiences as a consumer of mental health services -- like Student4Life suggests, this isn't the place for this sort of discussion.

 

[Hurstw]

This forum is a place for interested students, graduate students, and professionals to exchange ideas and information. It is not a place for you to find answers regarding what happened in your personal therapy.

As a psych major, I am an interested student. As a patient, I am not interested in using this forum to explore what happened to me in therapy, just understanding transference and the way psychologists work with it and use it to help, not harm, the patient.

 

[Student4Life0]

As a psych major, I am an interested student. As a patient, I am not interested in using this forum to explore what happened to me in therapy, just understanding transference and the way psychologists work with it and use it to help, not harm, the patient.

And I think that there is nothing wrong with that. In fact, that makes for quite an interesting discussion. However, you have not left it at that, and continue to reference your own personal therapy experiences.

 

[jexa]

As a psych major, I am an interested student. As a patient, I am not interested in using this forum to explore what happened to me in therapy, just understanding transference and the way psychologists work with it and use it to help, not harm, the patient.

But, you are interested in learning this information for the purposes of resolving the issues / making sense of what occurred in your personal therapy. You are not interested from an academic/professional perspective, but a personal one. Your agenda does not fit the spirit of this forum.