Transference & Countertransference

[charabanc]

Hi Everyone--I posted a bit a year ago but have been mostly lurking since. I had a particularly intense therapy session yesterday and it's made me start thinking about transference and countertransference and how to deal with them as a client.

This is tedious to explain, but a bit of backstory: I was recently (in the past week, between sessions) contacted via email by my abuser and receiving the email triggered me into a prolonged dissociated state and I stopped sleeping or eating. I wrote to my therapist in the worst of it, explaining the dissociating I was experiencing but not the cause. It's not out of the ordinary for me to write to her in between sessions but the content of this message alarmed her to the point where she advised me to go to the ER because it sounded like I was at risk. I didn't go to the ER, didn't feel like I was at risk (still don't) but have continued to feel foggy and not "present" though I have been going to work and sleeping/eating better.

Yesterday I texted my therapist to cancel my session because I wanted a week off to get myself together and untriggered before delving into therapy and my canceling alarmed her, which I understand, but it feels as though she reacted in an emotional way that I'm not sure how to process. She first responded to my canceling by telling me that she has a 24 hour cancellation policy (though the one other time I canceled, it was the day of and she said nothing of a policy then) and then asked if everything was okay and we proceeded to get into this back and forth text conversation of me saying I wasn't feeling well and her saying if I wasn't feeling well, I should come in, was I going to come in?, etc. I felt a little bullied and pressured to do something I didn't want to do and also felt myself mentally retreating because of it, but went to the session and was unable to talk which alarmed my T even more and it just turned into this exhausting one-sided conversation of her telling me she was alarmed and that if I'd come in, part of me must want to talk and that I should know her well enough that she's going to be concerned by my behavior and then asking me repeatedly to look at her and when I did, her eyes were all glassy/almost tearful.

I understand that my emotional/mental state is going to affect my therapy and how my therapist "handles" me, and that if I'm displaying at risk behavior, I'm going to be treated as though I'm at risk, but having my T become visibly distraught (? maybe too strong of a word) over my mental state is incredibly overwhelming and filling me with a lot of guilt. Right now I feel emotionally involved in her as a person for the first time, which I absolutely do not want. Have others found themselves in similar situations with their therapists? Are moments of transference/countertransference unavoidable, especially in long-term therapy (I've been seeing my T for a year and a half)? Or am I reading too much into this (quite possible)?

 

[Rumors]

I don't really know, but I would think that on any human level that after a year and a half, in even a therapeutic relationship, your T would naturally worry with such a change. They are human and I think there are some that truly care. I would feel thankful to have someone who wants what is best for you and is genuinely concerned for your well being. I wouldn't feel guilty but I would try and be more communicative in your next session.

Good luck! I am sorry you had to deal with hearing from your abuser. That is the most important issue at hand! Sounds like you have a caring T on your team.

 

[rightkindofme]

Well, think about it from a therapists point of view--you are a suicide risk. She's trying to make you KNOW that she cares about you and is checking up on you. She doesn't want you to lose connection. She is pushier than you like in the moment, but it is coming from a reasonable place. She has no way of predicting which clients are sorta suicidal and which clients are seriously suicidal and which ones are just off the rails. It all looks the same from where she is sitting.

Which is to say, I support you in feeling great hostility towards being responsible for your therapists emotions. That drives me batty too.

 

[charabanc]

Well, think about it from a therapists point of view--you are a suicide risk. She's trying to make you KNOW that she cares about you and is checking up on you.

I do understand this, and I don't think she did anything wrong in being pushy with me, and I don't think I'm doing anything wrong by feeling guilty and responsible for her being so upset by my emotional state. It's both fascinating and frustrating for me to wonder whether this kind of situation is (like I said) unavoidable at times in therapy and how the client can navigate her way out of feeling burdened by a therapist crying, or getting angry, or resentful, etc. The obvious solution is to sit down in the next session and say, "Hey, you made me feel guilty because I caused you to get so upset and it makes me feel as though I need to hide what I'm feeling from you to avoid making you upset in the future," but that's easier said than done, I suppose.

 

[rightkindofme]

I totally concur that you did nothing wrong. :)

When I have these feelings towards a therapist I try to believe they are therapeutic. :) We have to work through how to talk about the discomfort.

 

[intothelight]

The obvious solution is to sit down in the next session and say, "Hey, you made me feel guilty because I caused you to get so upset and it makes me feel as though I need to hide what I'm feeling from you to avoid making you upset in the future,"

Actually, that is a great way to open up the conversation. You are being honest about how her reaction made you feel, and it would be a good starting point to set some ground rules in the future.

A therapist does have a professional responsibility for their clients safety, but I don't think being emotionally involved to the point of crying, being resentful, etc. is professional. That type of behavior would concern me, as it would cross a boundary with me.

 

[charabanc]

Thanks, intothelight. I'm going to try to work up the courage to put those words together for next week's session. It's a good exercise for me regardless, as I have such difficulty advocating for myself and asserting my needs (a common hurdle for a lot of us!). What a nice thing, though, to be able to identify a behavior that crosses one of my boundaries--it means that I actually have boundaries! Seems for many years I did not.

 

[maddog]

I agree with all that Intothelight said, but would simply add that for me, there is a subtle yet important difference between a therapist having an emotional reaction and allowing the client to see it, and using that emotional reaction, either intentionally or unintentionally, to guilt, pressure, distract or otherwise manipulate the client and the safe sharing context of the therapy room.

I have, on a couple of rare and memorable occasions, reduced my therapist to tears - somethingI found incredibly shocking at the time. Yes, this did cause me some short-term guilt similar to that which I feel when I believe I have caused anyone distress, but within a fairly short space of time, I actually found our interaction about the issues in question to be extremely validating, connecting and a real progress milestone in our relationship, both in spite of, and because of, the fact that he had demonstrated an emotional reaction.

In no way did he do or say anything to make me feel guilty or as though I needed to alter my behaviour or "make up for it" in any way. In fact, being totally objective about this, I think he modelled very healthy emotional behaviour - a genuine, unashamed emotional reaction which was acknowledged, communicated and then moved on from. At the time, I was so locked down and numb and desensitised about the extent of the abuse I had suffered that it seemed no words were capable of penetrating my wall of denial. While I genuinely believe it wasn't intentional, it is possible that the sight of my tough guy therapist in tears in front of me as the only thing that could jolt me into confronting the fact that terrible things had been done to me - things terrible enough to make a grown man cry. That was the start of a very very critical phase of self-validation, and the first offerings of compassion and sorrow to me that will stay with me forever.

Both at the time and since, I have longed for the ability to express and cope with my emotions in such an open and well-regulated way.

And so in this case, I think that his demonstration of emotion did me good, and certainly no harm. But I agree that the situation such as you describe in which the therapist allows his/her emotions to influence their subsequent behaviour or relationship with you is an indication of poorly managed emotions, and perhaps even of emotional manipulation that would strike me as an indicator of possible further boundary violations or, at the least, a professional struggling to keep their own issues and reactions in check.

All that to say that I think you are both wise and incredibly brave to bite the bullet and talk to her about this - it is likely to help shed some light on whether or not her behaviour has been a temporary lapse or part of a pattern of questionable boundary respect. It is also a damn fantastic opportunity for you to celebrate the existence of your own boundaries, and to share that celebration with someone else, whether she likes it or not!

Your insights and instincts will carry you a long way with this issue - always remember to trust them!

Maddog