What is Transference in Relationships?

I discussed the topic of transference in prior articles as it relates to psychotherapy (see the list of articles at the end of this article).

In the current article, I'm focusing on transference in relationships.

Aside from the transference that clients experience in therapy, transference can also occur in everyday relationships, especially romantic relationships.

Transference in Relationships

In general, transference occurs on an unconscious level when you redirect feelings, attitudes and behavior from the past onto a person in your current life. These can be both positive and negative feelings.

Transference can cause you to react to someone in your current life as if they were someone from your past.  Transference tends to happen more in intimate relationships.

This often leads to misunderstandings in your relationship and emotional responses that don't belong to the present relationship.  This usually occurs because you have unresolved issues from the past that get played out in your relationship.

One of the keys to having healthier relationships is to recognize and understand when you're transferring these feelings and attitudes from the past into your present circumstances (see my article: Learning to Separate Then From Now).

What Does Transference Look Like in Relationships?

• Redirecting Feelings: You redirect feelings from the past onto your current partner. 

• Unconscious Behavior: When you redirect feelings from the past onto your partner, this happens on an unconscious level. For instance, let's say you grew up with a critical father when you were a child and, now that you're an adult, your partner tries to be supportive by making a suggestion about how you can do something in a better way. If you're experiencing transference for your partner, you could hear their suggestion as being critical when it's not. If so, you could experience unexplained anxiety, anger or resentment towards your partner--similar to what you felt towards your critical father. You might get confused about your feelings in the current circumstances because the trigger is outside of your awareness (see my article: Coping With Triggers).

Transference in Relationships

• Replaying Old Patterns: You can replay old patterns from the past in your current relationship and, over time, this leads to unhealthy dynamics between you and your partner.

• Intense Reactions: As mentioned above, reacting to your partner as if they were someone from your past can lead to disproportionate reactions in your current relationship (see my article: Reacting to the Present Based on Your Past).

How Can You Manage Transference in Your Current Relationship?

• Develop Awareness: Notice when your reactions seem out of proportion to the situation. Ask yourself:
• Why am I having such a strong reaction to my partner when they're trying to be supportive?
• Have I felt this way before?
• When have I felt this way before?
• What was happening in that past situation?
• How do these feelings from the past remain unresolved for me?

• Be Aware of the Differences Between the Past and the Present: Be aware of how your partner is different from the person in your past. This is often easier said than done when you're trying to do it on your own (see my article: Making the Unconscious Conscious).

• Separate the Past From the Present: Make an effort to separate your past self from your present self. For instance, recognize that you're no longer a child struggling with this issue when you experienced it in the past. Also, separate your partner as an individual from the person you reacted to in the past. 

Transference in Relationships

• Communicate: Once you realize you reacted to your partner as if they were someone from the past, communicate this openly to your partner. This can help your partner to understand why you had such a strong reaction towards them. It can also help you to express your feelings under the current situation (as opposed to the past). You can also get clarification from your partner as to what they were actually trying to communicate to you as opposed to what you thought they were saying.

• Seek Help in Therapy: A licensed mental health professional, who is a trauma therapist, can help you to explore the origins of these feelings, learn how to cope with them and, ultimately, learn how to work through whatever unresolved traumatic feelings you have from the past (see my article: Working Through Unsolved Trauma From the Past So It No Longer Affects You in the Present).

Clinical Vignette

The following clinical vignette is a composite of many different cases with all identifying information changed to protect confidentiality:

Jim

Jim and his wife, Tina, usually got along well. But whenever Jim heard Tina telling him how he could be more organized, no matter how kind and supportive she tried to say it, Jim experienced her comments as critical and he reacted angrily.

Transference in Relationships

Immediately after he reacted, he realized his reaction was out of proportion to what Tina was saying to him and he felt confused, guilty and ashamed. Then, he would apologize to Tina and tell her, "I'm sorry. I don't know what came over me. I realize now you're trying to be supportive, but when you said it, I got angry."

Tina usually accepted Jim's apology, but after this occurred several times, she suggested he get help in therapy because she was fed up with his reactions. 

She told him, "I'm afraid to make any kind of suggestion to you, but now that you're calm again, I think you should get help in therapy because you keep having these big reactions and I'm getting fed up."

Jim realized that, even though he felt regret and remorse for overreacting, if he continued to react this way towards Tina, she might leave him. So, he obtained a referral from his primary care physician for psychotherapy.

Jim's doctor referred him to a trauma specialist.

After getting a thorough family history, the trauma therapist helped Jim to realize his reaction belonged to unresolved issues with his father. She told him he was reacting to Tina as if she was his critical father.

Jim told his therapist that his father had a hair trigger temper and whenever Jim made a mistake as a child, instead of trying to be supportive and helpful, his father would lose his temper and criticize Jim.

Jim recalled that, over the course of his childhood, his father yelled at him many times for small mistakes. His father also humiliated him in front of his friends and other family members which left Jim feeling ashamed, angry and upset.

Since Jim's father died, it was no longer possible for Jim to work out these issues with him. But Jim also knew that even if his father was still alive, his father wouldn't have been open to talking about it.

Over time, Jim's therapist helped him to work through his unresolved feelings from the past using EMDR and Parts Work Therapy. 

The work was neither quick nor easy, but Jim stuck with it because he wanted to save his marriage and he didn't want to continue to reacting in the present based on unresolved issues from the past.

As Jim learned to be aware of the present versus the past and to communicate better with Tina, their relationship improved.

By the time he completed trauma therapy, Jim felt relieved to no longer being carrying a burden from the past.

Conclusion

Transference occurs on an unconscious level when you redirect feelings, attitudes and behavior from the past to someone in your present life.

Transference can occur in any relationship including with your partner, a friend, a family member or your therapist.

Getting Help in Therapy

When you learn to distinguish your unconscious feelings in the present from your unresolved feelings from the past, you can develop a more conscious awareness of what's happening to you.

Although you might realize after you react that you're really reacting to some unresolved issue from the past, your awareness might not be enough to keep you from continually reacting this way.

A licensed mental professional, who is trained to help clients to work through unresolved trauma is called a trauma therapist (see my article: What is a Trauma Therapist?).

A trauma therapist can help you to work through unresolved problems from the past so you're no longer getting triggered and overreacting with your partner.

Once you have worked through your unresolved problems, you can have a healthier relationship and live a more meaningful life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist

As a trauma therapist, I have helped many individual adults and couples to work through unresolved traumatic issues.

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.

My Other Articles About Transference:

What is Transference in Psychotherapy?

Psychotherapy and the Erotic Transference 

Boundary Violations in Therapy  

Psychotherapy and the Idealized Transference. 

What Are the Similarities and Differences Between IFS Parts Work Therapy and Contemporary Psychoanalysis?

In my prior article, Integrating Contemporary Psychoanalysis and Experiential Therapy, I discussed integrating experiential therapy and contemporary psychoanalysis.

IFS Parts Work and Contemporary Psychoanalysis

As I mentioned in that article, experiential therapy includes :

• Hypnotherapy (also known as Clinical Hypnosis)

• EMDR (Eye Movement Desensitization and Reprocessing) Therapy

• AEDP (Accelerated Experiential Dynamic Psychotherapy)

• Parts Work Therapy (Ego States Therapy and IFS: Internal Family Systems)

• Emotion Focused Therapy For Couples (EFT)

• Somatic Experiencing

In the current article I'm exploring the similarities and differences between IFS Parts Work Therapy and contemporary psychoanalysis, in particular, relational psychoanalysis.

For a basic explanation of contemporary psychoanalysis and experiential therapy see my prior article.

Similarities Between IFS Parts Work Therapy and Contemporary Psychoanalysis

Both IFS Parts Work Therapy and contemporary psychoanalysis:

• Recognize the Importance of the Unconscious Mind: Mental processes in contemporary psychoanalysis and parts work in IFS emphasize the importance of the unconscious mind (see my article: Making the Unconscious Conscious).

IFS Parts Work and Contemporary Psychoanalysis

• Non-Pathologizing Stance: Both therapies have moved away from the pathologizing the client's internal world which was common in traditional psychotherapy in the past. Specifically, IFS views the client's internal world as made up of various parts that have good intentions. Contemporary psychoanalysis focuses on understanding the client's internal object relations and defenses rather than labeling them as problems.

• A Goal of Self Understanding: Both therapies promote the client's self understanding and self acceptance.

• The Influence of the Past in the Present Day: Both approaches acknowledge the here-and-now experiences of the client as well as the influence of the client's personal history, including early relationships.

Differences Between IFS Parts Work Therapy and Contemporary Psychoanalysis

The Client's View of Self

• IFS Parts Work: Assumes an inherent undamaged Core Self within every person. Core Self is composed of the 8 Cs: Compassion, calmness, curiosity, creativity, confidence, clarity, courage, connectedness. A primary goal of IFS is to access the Core Self so the client can be lead from Core Self and not by their various parts.

IFS Parts Work and Contemporary Psychoanalysis

• Contemporary Psychoanalysis: Assumes the self is a product of interpersonal relationships and internal representations (object relationships). The focus is on developing a cohesive, authentic self within the relational matrix.

The Therapist's Role

• IFS Parts Work: The therapist is a guide and a mediator to help the client to focus on their Core Self and work with their internal parts (also known as subpersonalities).

IFS Parts Work and Contemporary Psychoanalysis

• Contemporary Psychoanalysis: The therapist is an active participant in the therapy with a "real" relationship between the therapist and the client. The focus is on the therapeutic relationship as a vehicle for an emotional corrective experience and insight.

Technique

• IFS Parts Work: The therapist uses experiential techniques, including internal dialog and visualization, to interact directly with the internal parts.

• Contemporary Psychoanalysis: There is an emphasis on exploring transference and countertransference and the client's internal world as it manifests in the therapy.

Focus on Transference

• IFS Parts Work: Transference is understood as the client's internal parts interacting with the therapist's internal parts. When it is therapeutically beneficial, the therapist might comment on their own parts in an effort to inform the client's process.

IFS Parts Work and Contemporary Psychoanalysis

• Contemporary Psychoanalysis: The client's transference and the therapist's countertransference are central to the therapy. Both transference and countertransference offer important information about the client's internal world as well as past and present relationships.

Use of Metaphor

• IFS Parts Work: Uses a concrete metaphor about the client's "internal family" with specific roles for these parts (managers, firefighters, exiles) to understand the structure of the client's internal world.

• Contemporary Psychoanalysis: Tends to use more theoretical and nuanced language to describe internal dynamics, often viewing parts as metaphors for defended affects and anxiety responses.

Client Empowerment

• IFS Parts Work: Emphasizes "self leadership" (Core Self) to empower clients to foster lifelong skills and internal harmony (see my article: Parts Work Can Be Empowering).

IFS Parts Work and Contemporary Psychoanalysis

• Contemporary Psychoanalysis: Relational approaches to contemporary psychoanalysis have shifted to a more collaborative approach in therapy between the client and the therapist with the understanding that the therapy is co-created between therapist and client.

Integrating IFS Parts Work and Contemporary Psychoanalysis

As I mentioned in my prior article, many psychotherapists who have a contemporary psychoanalytic background, like me, are also trained in IFS Parts Work.

The integration of both approaches is beneficial for clients because they get the benefits of an in-depth, relational therapy, like contemporary psychoanalysis, and an embodied approach, like IFS, to combine the best parts of both approaches.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), IFS and Ego States Parts Work Therapist, Somatic Experiencing and Certified Sex Therapist.

I work with individual adults and couples

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.

Also See My Other Articles About IFS Parts Work Therapy:

How Does Parts Work Therapy, Like IFS and Ego States Therapy, Help You to Understand Yourself

Understanding the Different Parts of Yourself

Parts Work Therapy Can Be Empowering

How Can IFS Parts Work Therapy Help With Anxiety?

Is an Unconscious Part of Yourself Running Your Life?

Also See My Article About Contemporary Psychotherapy:

Redefining the Traditional View of "Resistance" in Psychotherapy

Undoing Aloneness: The Client's and Therapist's Parallel Experience of a Crisis

In a prior article, I began a discussion about undoing aloneness and what that means (see my article: Undoing Aloneness: Staying Socially Connected Even Though We Are Physically Disconnected).

In the prior article, I suggested ways that individuals could remain socially connected to loved ones, even though they are physically apart. I also discussed how therapists could maintain meaningful connections with clients through online therapy or phone therapy while they are out of their offices.

In this article, I'm focusing on the fact that therapists and clients are having parallel experiences of the COVID-19 crisis and how these parallel experiences can enhance therapists' ability to provide a safe therapeutic environment, which includes helping the client to feel that he or she isn't alone with the experience.

Undoing Aloneness: The Client's and Therapist's Parallel Experience of a Crisis

The Therapist's Clinical Judgement About Self Disclosure to Clients in Therapy During Parallel Experiences: Undoing Aloneness
In a prior article, I wrote about times when both the client and therapist are going through a similar crisis at the same time (see my article: Parallel Losses For the Client and the Therapist).

In that article, I discussed that therapists often find that a client comes to their office with a similar problem that the therapist might be experiencing at the same time.  I provided a fictional clinical vignette where a client, Lois, came to therapy because her mother was rapidly decompensating from Alzheimer's.

In this fictional example, Lois' therapist was able to provide both practical resources as well as clinical interventions to help Lois cope with her grief and fear about her mother's deteriorating condition.

Lois felt the calming and soothing holding environment that her therapist provided in her therapy sessions (see my article: The Creation of a Holding Environment in Therapy).  Even though Lois felt grief, she also felt her grief was being held and contained by her therapist and this was healing for Lois.

What Lois didn't know was that her therapist was also going through a similar experience with her own mother.  The therapist assessed whether it would be beneficial for Lois to know this and she made a clinical judgement call (to herself) that Lois needed to feel that her therapist was outside the world of Alzheimer's and nursing homes, so she opted not to tell Lois about her own situation.  She assessed that it wouldn't be helpful, so she didn't self disclose.

In another situation with a different client, the same therapist might assess that it would be beneficial for the client to know that the therapist was having a similar experience.  Self disclosure of this nature is, of course, done with much forethought and might even involve consultations with other colleagues.

The other consideration that must be kept in mind when the therapist and client are having parallel experiences is that, even though there might be similarities, there are also differences in the client's and therapist's situations.  This isn't a situation where there is "twinship" between the therapist and client.  Although similar, each of their situations will be unique and they will experience differences based on each of their particular situations and who they are as individuals.

The therapist has to make sure that any self disclosure, especially on this level, is for the benefit of the client and not for the benefit of the therapist.  This doesn't mean that the therapist might not derive some benefit or healing from it as a byproduct of the self disclosure, but the focus must be on what's best for the client.

Parallel Experiences During the COVID-19 Crisis and Undoing Aloneness For the Client
In the situation where a therapist is going through a similar personal situation to the client, the decision to self disclose or not, although not easy or done lightly, is easier to make, as compared to self disclosure in the COVID-19 crisis, because in the personal situation the client usually isn't aware of what's going on in the therapist's personal life.

But in the current COVID-19 pandemic, everyone is affected in one way or another, and most clients know this.  The therapist can't pretend that she's not affected by this crisis because the client already knows that everyone is affected, possibly in different ways and to a greater or lesser degree.

Similar to other situations where self disclosure is a clinical judgment call, during the COVID-19 crisis, the therapist must decide if, when and how much to self disclose on a case by case basis depending upon the needs of the client.

For some clients, any form of self disclosure or reminder that the therapist is affected is contraindicated because this reminder would be too overwhelming for the clients.  Even though, of course, they know, on some level, the therapist is affected, beyond knowing that the therapist is in good health and available to them, they don't want to be reminded that the therapist is experiencing the same crisis.

For instance, for some clients, who grew up with parents who were overwhelmed by one crisis after the next, these clients felt emotionally unprotected by their parents and had to fend for themselves as best as they could while feeling alone in their traumatic experiences.  They might even have had to function as parentified children to their parents where they took on the role of adults to take care of their parents--even though they were just children (see my article: The Roles of Children in Dysfunctional Families).

These clients often need to feel that the therapist can overcome any situation in order for the clients to feel safe in the therapy sessions.  This usually involves an idealized transference that the client develops for the therapist, which is an idealized view of the therapist (see my article: What is Transference in Psychotherapy?).

This is what undoes aloneness in the therapy session--the idea that, unlike the client's parent, the therapist is a competent adult who can handle any situation that comes up.

The resolution of the idealized transference will be determined by the client, and the therapist will take her cues from the client.  Over time, as the client's trauma begins to resolve and the client feels more empowered, s/he no longer needs to see the therapist as an idealized, powerful figure.

Converesely, other clients have a need to know that the therapist is also affected by a crisis that they're both experiencing, like the 9/11 World Trade Center attack or the current COVID-19 crisis.

For instance, during 9/11, many clients in New York City wanted to know if their therapist lost anyone at the World Trade Center.  Or, they wanted to know if their therapist experienced fear when the therapist heard about the attack.

Since both the therapist and client lived through 9/11, the therapist's willingness to discuss this as an experience that they each went through was often necessary and helpful. Obviously, the therapist needed to know each client very well to know what would be beneficial to help the client to feel less alone.

Another example is during the COVID-19 crisis a client might say that time feels distorted to her since the crisis began. In response, the therapist makes a clinical judgment as to whether it would be beneficial for the client to know that the therapist is having the same experience--with the same recognition, as mentioned before, that, although similar, each individual will have his or her own unique experience.

In addition, the therapist usually won't just end with self disclosure.  She would also talk about what the client can do to keep his or her perspective manageable.  So the therapist would provide the client with tools and techniques to accomplish this, so it's not just a shared experience but also an opportunity to learn how to manage emotions and maintain a perspective that's healthy for the client.

When the therapist self discloses, even if it's not a big self disclosure, it's always important for the therapist to metaprocess the experience with the client, which means asking the client what it was like to hear that the therapist was having a similar experience.  This helps to deepen the work and also helps the client to clarify the client's experience about the self disclosure.

In the event that the therapist made a clinical mistake in self disclosing, metaprocessing also provides an opportunity to repair that mistake (see my article: Ruptures and Repairs in Therapy).

Metaprocessing the experience of the therapist's self disclosure also helps the therapist to understand the client's experience.  This can lead to further explorations of the client's past, present and anticipated future.

The Therapist's Self Knowledge and Clinical Judgement About the Client
It's important for the therapist to know her own comfort level as well as knowing the client in order to make a clinical judgment call about self disclosure.

If the therapist knows that she tends to be reticent about self disclosure and that the client's question feels too personal for her, she needs to take this into consideration so that she's not uncomfortable with what she discloses.  At the same time, as mentioned earlier, she needs to know the individual client and what the client needs at any given time.  This is a balancing act.

At a particular point in time, a client might need to know something about the therapist's experience in order for the client not to feel alone in a situation.  However, over time, the client might have other thoughts and feelings about what s/he asked the therapist to self disclose.  All of this is grist for the mill and should be explored.

Undoing aloneness and self disclosure is an important and complicated topic, and one article isn't sufficient to address all the issues involved.  However, hopefully, this article gives you a sense of some important factors.

Getting Help in Therapy
As I've mentioned before, physical distancing doesn't mean that you can't connect in other ways to feel socially and emotionally connected.

If you're feeling overwhelmed, you could benefit from working with a licensed psychotherapist, who has the experience and skills to help you.

Rather than feeling alone and suffering on your own, you can get help from an experienced therapist.

Many therapists, like me, are offering online therapy while they're out of their office.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, Somatic Experiencing and AEDP therapist.  I also use EFT (Emotionally Focused Therapy) for couples.

I work with individual adults and couples.

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 or email me.

The Erotic Countertransference: The Therapist's Sexual Attraction to the Client

In an earlier article, Psychotherapy and the Erotic Transference: Falling "In Love" With Your Psychotherapist, I discussed clients' erotic feelings (also known as transference) for the therapist, the struggle that clients often have with these feelings, and how these feelings can be worked through with the therapist in a way that furthers the work in therapy.  

As mentioned in the earlier article, a client's erotic feelings for his therapist is a common issue in therapy.  In this article, I'm focusing on the therapist's erotic feelings (also known as countertransference) for the client.

The Erotic Countertransference: The Therapist's Sexual Attraction to the Client

Psychotherapists who have been trained psychoanalytically are aware that they can develop erotic feelings for some clients. Knowing in advance that this will occur at some point and being trained on how to deal with it in an ethical way helps therapists to be prepared for these encounters, and it allows them to handle these issues in a way that isn't harmful to the client or their work together.

Before I go any further, I want to make it clear that psychotherapists know that it would be a serious boundary violation to get sexually/romantically involved with the client whether that involvement occurred during their work together or even after the client terminated therapy.  Unfortunately, although the vast majority of therapists are ethical, there are some therapists who act unethically.  Fortunately, they are in the minority (see my article: Boundary Violations and Sexual Exploitation in Therapy).

A therapist who has in-depth psychoanalytic experience, knows how to attune to what's going on in her internal world, with the client, and in the intersubjective space between the client and therapist.

She is also able to  momentarily dip into her own subjective experience in a way that's useful for the therapy (see my article: Psychotherapy: A Unique Intersubjective Experience).

For instance, as an example having nothing to do with sexual attraction, while she is listening to the client, a particular song might pop into the therapist's head, and she would ask herself if this song has any relevance to the client or the therapy session. She would ask herself if this is a way for her unconscious mind to give her more information that she might not be picking up on consciously? (see my article: Making the Unconscious Conscious).

There can be many reasons why a therapist might feel sexually attracted to a client.  On the most basic level, some people, including clients in therapy, naturally exude a certain sexual magnetism.  Since part of the therapist's job is to be attuned to the client, she could be picking up on this magnetism.

Another common reason is that the client might be flirting with the therapist as part of a defense mechanism to divert the conversation from things that make him uncomfortable in the session. For an experienced therapist, this is usually easy to see and would need to be addressed by the therapist in a tactful way.

Another issue might be that the therapist might be at a point in her personal life where she is not romantically, sexually or emotionally fulfilled.  As a result, she might experience these unfulfilled needs in the therapy room with the client.  This is why it's so important for psychotherapists to be attuned to their own personal needs so that they don't make ethical mistakes.

The Erotic Countertransference:  The Therapist's Erotic Feelings For the Client
The following fictional vignette is based on many different clinical cases.  It illustrates how the therapist attunes to her own internal experience and how she uses this attunement to discover the meaning of her experience and how it relates to the work with the client.

Gina
Gina, who was an experienced psychotherapist, realized that she felt a sexual attraction for Jim, after their first session together.

As a seasoned psychotherapist whose original training was in psychoanalysis, Gina knew that it was common for both clients and therapists to have attractions for each other.

Not only had she learned about the erotic countertransference in her original analytic training and in her extensive supervision, she also experienced this occasionally with other male clients.  She and her colleagues also discussed this phenomenon in their peer supervision group.

Although she was clear that she wouldn't act on her attraction based on ethical and clinical reasons, there was something different about this experience as compared to other earlier experiences that concerned her.

So, rather than ignoring her sexual attraction, she paid attention to it, and after her second session with Jim, she thought about whether there was something familiar about him that might be triggering these feelings.

She also talked to her own psychotherapist about this sexual attraction in her next therapy session.  Since her therapist, Ruth, knew Gina well from having worked with her in her analysis for over 15 years, Ruth listened intently as Gina described the sexual feelings that came over her during the first two sessions with Jim.

As Ruth listened to Gina describe this attraction, she realized that Jim had similar characteristics to Gina's husband, who died several years before.  She knew that even though Gina had gone through a period of grief and mourning, she still missed her husband a lot.  She also knew that Gina had been unable to motivate herself to begin dating again even though several years had passed, which left Gina feeling lonely.

As they talked about the similarities, including appearance, between Jim and Gina's late husband, Gina felt a deep sadness come over her that she had not felt since Jim died unexpectedly.  Although she saw the striking similarities between Jim and her late husband, Gina also saw the differences, and as she began to differentiate the two men and her feelings towards them, she began to feel a little better.

These feelings for Jim were also a signal to Gina that she needed to take better care of herself and that her loneliness signaled that she might be ready to explore dating again--even though she had mixed feelings about it.

During her next several sessions with her therapist, Gina explored her ambivalence about dating.  Part of her hesitation was that she continued to feel loyal to her late husband, and she wasn't sure how she would feel dating someone new.

But she agreed with her therapist, Ruth, that she could take it one step at a time, and she was under no obligation to date anyone.  So, she thought of her foray into dating as a way to explore her own feelings and the next step in her mourning process, which included an acceptance that her husband would never come back.

This acceptance that her husband was gone forever brought a new and deeper wave of grief for Gina. She knew from her own training and clinical experience that this was a normal part of grief and mourning as time went on.  So, she continued to talk to her therapist to address her own emotional needs in her therapy and separate out these needs from her work with her client, Jim.

As Gina took care of herself emotionally by talking to her therapist about her emotions and to her friends, who were also colleagues, about her attraction to Jim, she noticed that her attraction began to diminish.  Her work with Jim continued without interruption to his clinical process in sessions, and the therapy was going well.

A few weeks after Gina started seeing Jim as a therapy client, she noticed that she no longer felt an attraction to him.  She could see the resemblance and similarities to her late husband, but she also saw Jim clearly for himself as an individual.

Four months later, Gina began dating again.  She met a man who was also a widower and who understood her mixed feelings about dating.  As she continued to see him, she realized that her feelings for her late husband would never change, and there was room in her heart for both her late husband and for the new man that she was beginning to really like (see my article: A New Relationship: Understanding the Loyalty Dilemma For Someone Whose Spouse Died).

As her emotional needs were met in her therapy, with friends and colleagues and with the new man that she was dating, Gina felt more emotionally fulfilled.  With time, her client, Jim no longer reminded her of her husband because, although there was a physical resemblance, she could now differentiate more clearly that they were two very different men.

She was glad that she took care of herself and used her resources in therapy and among friends and colleagues to deal with the countertransference issues related to her therapy with Jim.  She recognized that, in many ways, it was similar to what occurred occasionally with other clients in the past, but she also saw why her feelings were so heightened with the similarities to her husband.

Conclusion
Both clients and therapists can develop sexual attractions for each other.  It's usually related to transference for the client and countertransference for the therapist.

Therapists have an ethical responsibility to be aware of their feelings and, for the sake of the client and the integrity of the therapy, not to act on their feelings.

Occasionally it happens that a therapist, who sought help in her own therapy, in supervision and among colleagues, is still unable to handle the countertransference, she has a ethical responsibility to refer the client to another therapist rather than act on her feelings or continue to be in conflict about them.

It's of utmost importance that therapists have a strong sense of self awareness and engage in self care so that they don't compromise a client's therapy.  As in the fictional scenario above, this means that the therapist must have the necessary skills and training to self reflect on her own internal process and do what she needs to do to take care of herself.

Although it was not discussed in this article, there are times when both the therapist and the client have a sexual attraction for each other.  In those cases, even if the client behaves in a seductive way, it's the therapist's responsibility not to cross a boundary with a client.  She must analyze her own feelings as well as the clients to understand the root of the issue for each of them and then proceed in an ethical manner to do what's best for the client while taking care of herself.

Getting Help in Therapy
Most well-trained psychotherapists are aware that they will occasionally feel an attraction for a client.      This is a common experience.  Most of them will also know that this probably has less to do with the client than it does with whatever is or isn't going on in their life.

Although sexual boundary violations do occur from time to time, most therapists take their Code of Ethics, which states that therapists cannot be in a dual relationship with a client, seriously.  They know it would be devastating to the client, their work together and it would also jeopardize their professional license if they crossed this ethical boundary.

If you're already in therapy and some of the issues in this article resonate with you, you would probably benefit from discussing them with your therapist or, if you're not comfortable with that, seeking a consultation with a different therapist to discuss what's going on in your therapy.  Most of the time these issues can be worked out, but if you tried and they can't be resolved, you can also seek help from another licensed therapist.

We all need help at some point in our lives.  If you're not in therapy and you're struggling with unresolved issues that are creating obstacles in your life, you deserve to get help from an experience licensed mental health professional.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing and Emotionally Focused therapist, also known as EFT (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

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.

Psychotherapy as a Co-Created Process Between the Psychotherapist and the Client - Part 2

In my prior article, I began a discussion about psychotherapy as a co-created process between the psychotherapist and the client.  I'm continuing this discussion to delve deeper into this topic, specifically about how the client and psychotherapist co-create the therapeutic relationship.

Psychotherapy as a Co-Created Process Between the Client and the Psychotherapist 

How the Client and Psychotherapist Co-Create the Their Therapeutic Relationship
As I mentioned in my prior article, the concept that psychotherapy is a co-created process is part of contemporary psychotherapy and it's different from how psychotherapy was practiced in the past.

There is now a recognition that each client-psychotherapist relationship is unique--just as any other type of relationship between two people is unique.

It's the psychotherapist's responsibility to provide the client with psychoeducation about psychotherapy and how she works in therapy.

If the psychotherapist uses Integrative Psychotherapy, as I do, she will explain the different therapy modalities that she uses, which can be used individually or in combination.

For instance, if the psychotherapist is trained as a contemporary psychoanalyst and she also does EMDR Therapy, she can explain how these two modalities can be used in combination (see my article: Contemporary Psychoanalysis and EMDR Therapy: A Powerful Combination to Overcome Trauma).

Most likely, she will also explain that if one modality doesn't work for this particular client, she can switch to another modality.

The relationship between the client and the therapist is also known as the therapeutic alliance.  At the most basic level, the therapeutic alliance is based on the therapist being able to provide a safe, trusting relationship, also called the "holding environment"  (see my article: The Creation of the Holding Environment in Psychotherapy).

Contemporary psychotherapy is a two-person therapy.  It's an intersubjective experience between the client and the therapist where the therapist is attuned to the client (see my article: The Psychotherapy Session: A Unique Intersubjective Experience).

Even though the psychotherapist is the one with the expertise in doing psychotherapy, most  psychotherapists also rely on feedback from the client about what's working and what's not working in therapy for the client (see my article: How to Talk to Your Psychotherapist About Something That's Bothering You in Therapy).

Ideally, the therapist will ask at various points in therapy and encourage the client to give feedback at other times but, even if your therapist doesn't ask you for feedback, it's important to give feedback to her.

Why is it important?  It's important for the therapeutic process and also for maintaining a good relationship with your psychotherapist that you provide her with feedback as to how the therapy is going (see my article:  Why Being Honest With Your Psychotherapist is the Best Policy).

Many people have problems giving feedback to their therapists because they were discouraged or even punished for giving feedback to their parents when they were children, so even as adults, they still carry that fear.

Other people don't feel entitled to give feedback.  They think of it as "complaining" and they don't want to "offend" their psychotherapist.

So, instead of giving feedback, they might pretend that everything is going well in therapy, and the end result is that the client doesn't get what she needs in therapy, the therapy is an "as if" therapy and nothing changes.

Many psychotherapists recognize when clients are hold back from talking about misgivings in therapy or that a certain aspect of therapy isn't working for them, so they will try to elicit feedback.

But there are times when the therapist doesn't see it, and the therapy becomes ineffective or, rather than express himself, the client leaves therapy prematurely (see my article: When Clients Leave Psychotherapy Prematurely).

The client's trust and sense of safety develop over time.  For some clients, it happens relatively quickly and for others it can take a while, especially if they've had early experiences where they couldn't trust their parents or other close family members.

The therapeutic alliance is also based on there being a good match between the client and the therapist.

Initially, you might not know if a particular therapist is a good match for you.  You might need a few therapy sessions to be able to discern if the two of you are a good match.  This doesn't mean that the therapist isn't skilled or that you're being "resistant."  It might just mean that, like any two people, the two of you aren't a good fit.

Some psychotherapists are better trained, educated and more skilled than others as well as more empathetic than others.

An empathic failure can result from a psychotherapist's oversight, but in a good therapeutic relationship, once the client provides feedback about an empathic failure or other rupture in the therapy, there is an opportunity for a repair (see my article: (see my articles:  Why is Empathy Important in Psychotherapy?, What is Empathic Failure in Psychotherapy? and Ruptures and Repairs in Psychotherapy).

But if there are consistent empathic failures on the therapist's part, you would be wise to tell the therapist that you don't think the therapy is working for you and then seek out another therapist.

Even when you think the therapy isn't working for you, it's still important to provide the therapist with feedback rather than just leaving abruptly or disappearing from therapy.

Why?  It's not for the therapist (although it can be beneficial).  It's for your benefit to be able to assert yourself and speak up for what you need, especially if this is challenging for you (see my article: Ask For What You Need in Therapy).

So, if the therapy is going relatively well because you have a good therapeutic alliance with the therapist and you're starting to make changes in your life, does this mean that there will be all smooth sailing ahead?

Not necessarily.  There is the issue of transference, which is unconscious and which can change over time (see my articles:  What is Transference in Psychotherapy?,  Psychotherapy and the Positive Transference,  What is the Negative Transference? and Psychotherapy and the Erotic Transference: Falling "In Love" With Your Psychotherapist).

Having a negative transference at a certain point in therapy isn't necessarily a bad thing.  In fact, it can turn out to be beneficial.  Often, a negative transference is based on earlier relationships with parents where you weren't able to work out these issues with your parents.

But in a good therapy, you have a unique opportunity to work out these issues with a therapist who is receptive to working on issues in therapy that might have triggered earlier unresolved problems.  This can be healing to you and help you to resolve those earlier issues.

Getting Help in Therapy
It takes courage to admit that you have a problem and to ask for help (see my article: The Benefits of Psychotherapy).

Many people start therapy with a sense of ambivalence, especially if they've never been in therapy before (see my article: Starting Psychotherapy: It's Not Unusual to Feel Anxious or Ambivalent).

Getting help in therapy starts with calling for a consultation.

The purpose of the consultation is to talk about your problem in a general way and to ask the therapist questions about her experience, training, history of helping clients with similar problems, and how she works (see my article: How to Choose a Psychotherapist).

Working through your problems in therapy can lead to your living a more fulfilling and meaningful life without the "baggage" from your history.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

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.

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
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).

Conclusion
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.