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Thursday, December 21, 2017

What is the Negative Transference in Psychotherapy?

In prior articles, I've discussed the positive transference, the erotic transference and the parental transference.  

Today I'm focusing on the negative transference and how it plays out in therapy (see my article: What is Transference in Psychotherapy?).  

What is the Negative Transference in Psychotherapy?

What is the Negative Transference in Psychotherapy?
The most basic explanation for the negative transference, which was first identified by Sigmund Freud when he was developing psychoanalysis, is that it is a term used in psychotherapy for the negative feelings that a client projects onto his therapist.

Just like the other forms of transference, the negative transference is usually an unconscious projection of negative feelings that the client "transfers" from early childhood relationships onto the psychotherapist (see my article: Discovering the Unconscious Emotions At the Root of Your Current Problems).

Although the client might be aware that he has similar hostile feelings towards his therapist as he did for a parent, he might not be aware that he is projecting these feelings onto the therapist.

Also, as I mentioned in earlier articles, transference in general is a normal part of relationships outside of therapy.  It's not just a phenomenon that occurs in therapy.

For instance, spouses can develop negative transferential feelings for each other, especially when one or both of them says something that triggers an emotional response related to a hostile relationship with a parent.

Another example is of an employee who has a negative transference for a boss that's based on a hostile relationship with a parent.

And so on.

Working Through the Negative Transference in Psychotherapy
The negative transference can show up in all kinds of ways in psychotherapy.  It can be a hostile projection that a client feels towards the therapist that is short lived or it can go on for a long time.

The negative transference is a dynamic that clients and their psychotherapist can work through in therapy.

As I mentioned in a prior article, it's important to distinguish transferential feelings from more objective feelings.

In other words, if a client has negative feelings towards his psychotherapist, it's not always about transference.  It's possible that the psychotherapist said or did something that caused the client to develop these negative feelings that is unrelated to transference and, if so, the therapist needs to own up to this and apologize (see my article: How to Talk to Your Psychotherapist About Something That's Bothering You in Your Therapy).

But, assuming that the problem is related to a negative transference, the client and therapist can often work through the hostile projections that the client places on the therapist--although it's not always easy and the working through will depend upon the particular client-therapist relationship.

Let's take a look at a fictional vignette, which is representative of a common situation in therapy where the client starts out with a positive transference for his psychotherapist, develops a negative transference and, ultimately, the therapist and client work through the negative transference.

Fictional Vignette:  Working Through the Negative Transference in Psychotherapy

Ed began psychotherapy because he was upset about a recent breakup with his girlfriend.

He tried in vain to reconcile with his former girlfriend of four years, but she refused to reconcile.  This left Ed feeling confused and very sad, especially since he didn't understand why his girlfriend broke up with him.

Initially, Ed felt comfortable with his therapist.  He found her to be empathetic and emotionally supportive.  He told his therapist that he was surprised that he actually looked forward to his psychotherapy session each week because he felt understood and cared about.

At that point, Ed had a positive transference for his psychotherapist and the sessions were going well.

When Ed thought about why he liked his therapist so much, he realized that she reminded him of his aunt, who used to take care of him after school until his mother came home from work.  He loved his aunt because, not only was she nurturing, she was also fun to be around.  He preferred being with his aunt to being with his mother, whom he considered cold and highly critical.

One day, during a psychotherapy session, while Ed and his therapist were talking about his confusion as to why his girlfriend left him and why she refused to reconcile, his therapist attempted to explore with Ed if he could think of anything that he might have said or done that might have contributed to the problem.

What is the Negative Transference in Psychotherapy?

Immediately after his psychotherapist asked Ed this question, she could see a shift in Ed.  His face turned white and he looked stricken.  His body became rigid and he sat very straight up in his chair as if he had just been attacked by the therapist (see my article: Shifting Self States).

When she asked the question, the therapist was trying to help Ed to explore his own thoughts and feelings about what might have happened between him and his girlfriend.  But she could see from Ed's intense reaction that he felt stung, so she attempted to address this with Ed, but he was too angry to listen to her.

Before the psychotherapist could talk to Ed about his reaction and explain the reason for her question, he told her that he was shocked that she would ask him such a question, "This is what my mother used to do!  She blamed me for everything!  Now, you're doing it. I thought you were on my side."

During the next couple of weeks when Ed came to therapy, he was either outwardly angry or quietly sullen.  It was obvious to the therapist that Ed was now experiencing a negative transference and he was projecting his angry feelings about his mother onto her.  She realized that she asked Ed this question too soon because he wasn't ready to deal with it.

Ed ignored his therapist's initial attempts to address his hostile feelings for her and each week he wavered as to whether he would continue in the therapy with her or not.  He said he was considering trying to find another therapist who would be more empathetic towards him and who would not criticize him.

After a few weeks, Ed calmed down somewhat and he was able to have a discussion about their therapeutic relationship.  Although he acknowledged that, at first, he felt comfortable with her, now he wasn't sure if he trusted her or not.

He felt that by asking him whether he knew of anything that he might have said or done that could  have contributed to the end of the relationship, his therapist was assuming that the breakup was all his fault.  And since he lived with his mother's withering criticism during his childhood, he found it especially hurtful that his therapist would make this "accusation" in therapy, a place where he should feel safe.

By the third week, Ed was more subdued.  He told his therapist that he received an email from his ex, who finally responded to him and gave him the reasons why she ended the relationship.  She told him that, before now, she wasn't ready to address his questions about the breakup, especially since she had been telling him about these problems throughout their relationship.

Ed went on to tell his psychotherapist that his ex gave him many examples of his lack of consideration for her.  When he read her email, he remembered that she had made these same complaints many times before, but he had never taken her complaints seriously.  Now, he realized that he took his ex and their former relationship for granted when they were together, and he also realized that he was at fault.

The email hit him like "a ton of bricks." But after reading it, he knew that he wanted to change this aspect of himself that tended to disregard the other person's feelings when he was in a relationship.  He recognized that he had this problem in his prior relationships, and he didn't want to continue to perpetuate this dynamic in a future relationship.

Then, Ed told his therapist that he now understood why she was attempting to help him explore what he might have done that contributed to the relationship, and he realized that she wasn't criticizing him.  He realized that, in fact, his therapist was trying to help him.

After that, Ed and his therapist were able to talk about the dynamic in his former relationship, including his part in the demise of the relationship.

He was also able to talk about his traumatic relationship with his mother and how he feared her criticism when he was a child.  He discussed how he was never able to talk to his mother about her hostility because she would never acknowledge it, and she always blamed him.  As a result, there was no way to reconcile things between them whenever she berated him.

After he and his therapist talked about what happened between them, Ed realized that he got emotionally triggered when he heard his therapist's question (see my article: Coping With a History of Trauma: Becoming Aware of Emotional Triggers).

With his therapist's help, Ed was able to distinguish his relationship with his mother from his relationship with her.  He could see that they were too very different relationships (see my article: Working Through Emotional Trauma: Learning to Separate "Then" From "Now").

He could see that, whereas he and his mother couldn't repair their relationship whenever she berated him, he and his therapist could work through difficulties between them (see my article: Ruptures and Repairs in Therapy).

Since his mother never admitted to a mistake and his father was mostly absent, Ed never experienced this kind of dyadic repair as a child, and he was moved and grateful to experience this in therapy.

These discussions allowed Ed and his psychotherapist to work through the negative transference.

Over time, Ed and his therapist had other transferential ups and downs in therapy, but they were able to work through these incidents.

His therapist also spoke to Ed about transference and explained transference reactions were a common experience in therapy as well as in other areas of people's lives (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation in Therapy).

Transference is ubiquitous.  It's not just a phenomenon that occurs in psychotherapy.

When a negative transference develops in psychotherapy, the value of working through the transference, aside from preserving the therapeutic relationship, is that the client can explore his negative projections, own them, and form a more objective relationship with his psychotherapist.

Working through the negative transference can be challenging for both the client and the psychotherapist.

When he is experiencing the negative transference, the client can be in a state of high agitation and might not be able to process his feelings or hear what the therapist has to say.

But as the negative transference gets worked through in therapy, the client gets to experience, possibly for the first time, that these kinds of issues can be worked out.  Like "Ed" in the fictional vignette, it is often a transformative experience.

For the therapist, who is obviously human and doesn't want to be disliked, it can be difficult to feel the client's intense dislike or hatred.  But a skilled psychotherapist also knows that she isn't there to be "liked," she's there to be helpful to the client, which can mean tolerating the client's hostility until they can work out these issues.

Getting Help in Therapy
It takes courage to ask for help (see my article: Tips on Overcoming Your Fear of Asking For Help).

The advantage of going to therapy, as opposed to relying solely on family and friends, is that the psychotherapist is a trained, objective person who will give you her undivided attention at a time and in a place that is devoted to you each week (see my article: The Benefits of Psychotherapy).

Many people, who could benefit from psychotherapy, don't come to therapy because they fear being emotionally vulnerable.

This is why it's so important to have an initial consultation to get a sense of the psychotherapist and if you and she would be a good match (see my article How to Choose a Psychotherapist).

If you've been struggling with a problem for a while and you've been unable to resolve it on your own, you could benefit from seeking help from a licensed mental health professional.

Rather than continuing to struggle on your own, you could work through your problems in therapy and then move on to live a more fulfilling life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist. 

I use an integrative approach in therapy to develop the treatment plan that works for each individual client (see my article: The Therapeutic Benefits of Integrated Psychotherapy).

I work with individual adults and couples in an interactive and collaborative way.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.