Transference and counter-transference

Transference is often manifested as an erotic attraction towards a therapist, but can be seen in many other forms such as rage, hatred, mistrust, parentification, extreme dependence, or even placing the therapist in a god-like or guru status.

1. Transference and Counter-Transference Thasleem 1st MSW Central University of Kerala

2. What is transference? Redirection of a client's feelings from a significant person to a therapist

3. In detail.. Transference is often manifested as an erotic attraction towards a therapist, but can be seen in many other forms such as rage, hatred, mistrust, parentification , extreme dependence, or even placing the therapist in a god-like or guru status.

4. TRANSFERENCE IN SOCIAL WORK ‘Transfer’ was introduced into social work literature by Jessie Taft in1924 who described it as “an emotional relationship to the client”.

5. Hamilton defines transference as a carrying over of irrational elements from other, relationships, particularly in the past, displaced on to the social worker, reflecting unconscious motivation.

6. In this sense, the therapeutic relationships would be viewed as a transference relationship, as opposed to a real relationship, thus permitting the worker to insulate himself or herself from any true reactions and personally meaningful interactions with the client

7. an example A from a home where his father was an arrogant and domineering person. As a man the client has never been able to get along with his boss or any other figure of authority. In the case work situation, he transfers to the case worker hostile feelings of the type of he originally felt toward hi father and accuse the case worker of the same arrogant treatment at the hands of his father

8. Because the transference between patient and therapist happens on an unconscious level

9. The reasons Anxiety and social isolation may lead to the therapist being central in a client’s life; as such they may be one of their only social contacts Reduced opportunities for romantic interests ( Asperger’s , LD, etc.) People with ‘Borderline Personality Disorder’ or very difficult interpersonal relationship styles, where they shift rapidly from loving and hating and see self and others as ‘all good’ or ‘all bad.’ This can be played out in the therapy room.

10. Continue.. Clients may have low self-worth, and feel that you as the therapist are a good role model and over identify with you. We may be asking clients about very difficult things that evoke negative emotions. We then may be central in re-experiencing those emotions, almost as if we are the personification of them

11. Potential difficult outcomes in transference We may reject the client, or fear we will. We May being complicit to their ‘maladaptive’ relationship patterns We may disclose information, which we are later uncomfortable about, so that the client is not so hurt (e.g. I am married with children) Difficulty in managing boundaries Therapist guilt Breakdown in therapeutic alliance

12. USE OF TRANSFERENCE There are three stages in dealing and using transference in social casework. these stages are: 1. Understanding the Transference 2. Utilizing the transference. 3. Interpreting the transference.

13. Understanding the Transference Understanding of the transference is essential for the worker as it helps to understand the behaviour of the client and to recognize its significance in his development process. It also explains the present unconscious needs of the client. Understanding of the transference of factors i.e. the present behaviour and problem, the environmental forces, the past experiences and earlier relationships

14. Utilizing the transference Utilization of the transference depends on the understanding of the social case worker of the phenomena. It explains many cures or treatments of emotional disturbance by life situations and by fortune relationships with other problems

15. Interpreting the transference The interpretation of the transference, that is, confronting the individual withthe awareness that his behaviour is the repetition of a specific unconsciousinfantile is definitely part of psycho – analytical therapy and requires ispreparation of the individual by the careful analysis of his unconsciousdefense

16. transference helps… transference helps in treatment in a numberof ways. The mature ego strengths of the worker serve to reinforce the weak egostrengths of the client. 2. The client feels relaxed. 3. The client starts abandoning resistances. 4. He perceives the problem situation more realistically. 5. The worker , when he does not respond neurotically, helps the client tosee and bear the reality. 6. Identification with the worker gradually helps the client to strengthen hisego power and capacity for reality testing and problem solving

17. The effects of transference are many but it is the leaven of treatment, nottreatment itself.

18. Counter-transference Counter-transference is defined as redirection of a therapist's feelings toward a client

19. it’s a therapist's emotional entanglement with a client

20. COUNTER TRANSFERENCE Relationship is a two way process. Social case worker has also unconscious tendency to transfer out the client. As in the case of transference, these counter transference feelings, both positive an negative, are unconscious but operate with force. Therefore, it is the job of case worker to recognize his feelings and must control them.

21. A therapist's attunement to his own counter transference is nearly as critical as his understanding of the transference

22. For example, if a male therapist feels a very strong sexual attraction to a female patient, he must understand this as counter transference and look at how the client is attempting to elicit this reaction in him

23. Some reasons for counter-transference Client reminds us of someone we have or had strong feelings for (positive or negative) We over identify with them (difficulties we have resolved in the past/similar personality/social standing/age/gender etc.) Feeling parental towards client Sexual attraction ( just to normalize this a bit and Pope & Tabachnik , (1993)* found that the vast majority of therapists (87%) had been sexually attracted to at least one if not more of their clients)

24. Potential Difficult Outcomes of Counter-transference Blurred boundaries Inappropriate levels of disclosure that compounds transference Not working with the countertransference Not acknowledging the countertransference Therapeutic alliance breaking down Unable to discuss case reflectively in supervision Reinforcing Client’s and own relationship patterns Difficulty ending therapi

25. What can we do? Ask yourself: Am I responding in a way that feels like me? Do I associate this client with anyone else? What feelings do I have about them? Are those feelings only those that I as a professional have towards all my clients or are there differences? Why am Feeling this? How is it impacting on my work with this client?

26. What can we do? Use supervision, more, not less Reflective and reflexive practice is key Accept that feelings towards a client is normal, and work with that Talk about the relationship in the therapy room Be consistent with boundaries

27. Conclusion Transference and counter transference are barriers for the case work in achieving goal. Sometimes it may help for the treatment. Here, case worker should be conscious about it. Otherwise it may leads to break the professional boundaries of case work.