Transference is everywhere. When you meet someone at a party and something about them puts you at ease, maybe their mannerisms are like your cousin. Or you have a boss that brings out those old insecurities you had of disappointing your parents and you never feel quite recognized. It can be the inspiration for a snap judgment you have of a stranger you see crossing the street; what colors you feelings for your kids 3rd grade teacher. Transference is when you are directing your feelings from one person onto another new person.
Understanding Therapeutic Transference
Transference is an important part of psychodynamic therapy. There isn’t one set definition of transference, but for the purpose of this discussion, let’s say it is when the patient redirects feelings about their early life relationships onto the therapist. This transfer of feelings about parents, friends, love partners or even adversaries can help illuminate previously unarticulated patterns of relating. The transference can feel positive or negative, or a mix- there is no right or wrong. It can feel familial, friend-like and/or erotic. Even though transference refers to the the patient's feelings- the therapist contributes to its formation with their explicit and implicit communications. The image of the opaque therapist with no personality has gone out of style, but therapists should think about what kind of personal boundaries and behaviors will ensure a safe space where patients can let their imagination and fantasies develop.
A common TV therapy trope is the therapist who answers questions with questions. Truth is, it’s actually an effective technique that I use. When I get asked a question about myself, I am curious about what is behind the inquiry. Typically, I find it helpful to explore before deciding if answering is going to be helpful to them. This is because when a patient asks me something like “Are you married?” or “Do you have kids”? They might be wondering if I can understand them or if I will judge them. They are really sharing something about their own desires, fears, ambitions. Their question has more to do with their early experience of being understood and seen than a true need to know something about me.
Understanding the Therapist's Countertransference
Another question I ask myself is: “Why would I answer this question?” Am I thinking about what is best for the patient? Am I thinking about my own privacy or desire to share? Did it catch me off guard and I impulsively answered or shut it down? Acknowledging my feelings allows me to re-focus on the person behind the question. Their fears, curiosity, desire to connect, ambition. This is part of understanding my countertransference.
Counter-transference is when the therapist directs their own feelings onto the patient. These may be unresolved issues from the clinician’s past or feelings that arise in reaction to their patients' transference. Countertransference is neither good nor bad. Transference and countertransference are happening at the same time and it takes an observant and reflective mind to acknowledge the different forces at play. And just like transference, it is shaped by real qualities in the patient.
Co-Transference and Intersubjectivity
A key component of intersubjective therapy is believing that all dynamics are co-created. This does not mean that each participant contributes equally, but only that they each impact the relationship. This is immensely important because of psychoanalysis' history of mistreating patients based on sexist and racist cultural assumptions as well as troublesome power dynamics. Co-transference, is a term that connects and highlights the co-creation of a therapeutic dyad and de-emphasized the perfectly objective therapist who knows all. It empahsizes that transference and countertransference are happening at the same time and shaping each other. This encourages the therapist to reflect on their own conscious and unconscious feelings and biases that will shape their patients' treatment and seek supervision when necessary.