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Core clinical concepts

Countertransference

The totality of the therapist's emotional, cognitive, and somatic reactions to the client, including those activated by the client's transference. When recognized and worked with, countertransference is a highly valuable diagnostic and therapeutic tool.

Definition

Countertransference refers to the full range of therapist reactions toward the client: emotional, cognitive, somatic, and relational. The concept evolved significantly from its original formulation by Freud, who saw it as an obstacle the therapist must overcome, to contemporary views that recognize it as a source of valuable clinical information.

The contemporary perspective distinguishes two types:

Concordant countertransference: The therapist feels something similar to what the client feels. For example, sadness when the client talks about a loss. It enables empathy and attunement.

Complementary countertransference: The therapist feels what the client cannot feel or what others in the client's life feel. For example, anger when the client describes situations where they were victimized but minimizes their own rage. This can indicate a relevant relational dynamic.

When it is a tool

Countertransference is useful when the therapist:

Example: the therapist notices they consistently feel bored in sessions with a client who describes their life in a very ordered, flat, unemotional way. That reaction may signal that the client is also emotionally disconnected, and the therapist's boredom is a response to affective flattening.

When it is an obstacle

Countertransference becomes an obstacle when:

Signs of unworked countertransference in session

References

Put it into practice

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