Great and very clear video. I do couple therapy with my collegue and he experienced an universal counter transference yesterday: After working with a high conflict couple for 90 minutes the wife took full responsibility for her part and the husband refused to take any responsibility attributing his withdrawal completely to her damands. At this point my co-therapist got louder and said at the end of the session:"Enough! I am tired of you making the victim and if you can't take ANY accountability for your actions there is nothing we can do for you as a couple. Then it is your f..... problem." The patient was in silence and went away like a little child who got screamed by the teacher. In this case what would you tell us, Patricia? We'll see if we have lost the patient and with him the couple.
What would you say? While it is understandable to feel frustrated with such a patient, acting out by yelling and swearing seems ill advised and hardly therapeutic. The guy needed a wake up call but that was not the most elegant way to deliver the message. You'll see what happens.
Would this be a good time for accountability similar to what the co-therapist wanted the husband to do? It is indeed an infuriating scenario if it seems like the work is not equitable.
Yes, positive transference can be deleterious. It can preclude some from being efficient and curious due to the fixation of being liked. One might be very cautious to probe or explore something if they feel that the client might not "like" them if they asked questions.
Great explanation! I am working on my PsyD, and right now, I have an assignment about a case of counter transference. This was highly explanatory. Thank you!
Thank you. I experienced serious countertransference for the first time last evening with one of my clients. The client seems to have put me in the same boat as her past therapists she has complained to me about. It felt as if the session became more about her analyzing me and my style of treatment, rather than about her. Perhaps it's a form of avoidance....to blame others....in any case, I will talk to my supervisor about it tomorrow. Thanks again for the insight.
Thanks for sharing. Were you clear about your own countertransference to the patient's behavior? Sounds like you have reached out for help. Hope it gets resolved.
@@patriciacoughlinphd1852 Yes, thank you. I spoke with my clinical supervisor about it, and interestingly the follow-up session I had with the client was totally different.....client presented with an accepting disposition. However, I do understand now that experiencing challenging interactions with clients, may actually help promote growth for us as therapists. 🙂
What I'm finding about A LOT of these videos about transference, counter-transference, AND other issues too; is that the content creators (doctors much of the time), don't actually say WHAT to do. They go into LOTS of details about what it is, why it happens and such. Yet, I'm finding it nearly impossible to find WHAT to do about these things. Some just say, "get help" from colleagues or superiors. But, I'm STILL searching for practically anything about HOW to proceed. I'm the patient/client and my counselor doesn't seem to know what to do. There have been several issues that I have brought up over nearly 2 years. Yet, nearly every session is like starting over. I've been VERY open and have not held anything back, including telling her about my physical attraction to her, etc. I've also ASKED from the beginning that I need help to overcome childhood trauma, and get "unstuck" in my life. But so far, she just knows A LOT about me and my history, and yet... NO PROGRESS, and very little effort on "work" or whatever to heal.
In ISTDP we talk ALOT about how to pick up on transference, bring those feelings into focus and encourage their full experience and expression in fantasy in order to open the. unconscious and discover the links to the unresolved past. The research is clear - if you haven't started to see progress by 7-8 sessions you're not going to unless you change therapists or your therapist changes the approach. Sounds like it's well past time for a consultation. Look on the istdpinsitutie.com website to see if there are trained practitioners in your state.
On the supervision issue, it never made sense to me. OK...a therapist has a difficult client and needs advice from a mentor/supervisor. How can a supervisor possibly give advice on the client/therapist relationship, when the supervisor has never met the client, does not know anything about the client, other than what the therapist being supervised tells the supervisor? Which is again second hand information AKA what many therapists call "hearsay". The only way I see the concept of supervision working - is if the supervisor was also sitting in on all psychotherapy sessions with client and professional. Which at least doubles the price of each therapy session. And quite frankly, many clients don't want a SECOND person sitting in, OR just on the sidelines, hearing about their very private psychotherapy sessions. Supervision to me seems just completely an un workable concept. JMHO.
This is why supervision with videotape is actually the only practice associated with enhanced effectiveness. I hope you are taping your cases and bringing tapes for supervision.
@@patriciacoughlinphd1852 I can not imagine any scenario in which videotaping or recording psychotherapy sessions, is either healthy or ethical for a client - especially when clear and open, transparent informed consent is used to duly inform. I say this because it places a lifelong and undue burden onto the client - with client knowing for a lifetime that there exists a recording of intimate and personal psychotherapy sessions, with clients not having any ability to know who or whether or not others are in possession of such recordings at any given time. This can cause a large degree of emotional distress later in a person’s life - regardless of proper informed consent. However - you do state in your response: “…supervision with videotape is actually the only practice associated with enhanced effectiveness…”. Given your assertion, can you please cite and thus substantiate your assertion with just one Double Blinded, Randomized Controlled Trial that teaches both efficacy in percent of cases, as well as negative outcomes of video taping psychotherapy sessions and showing such tapes to professionals in supervisory roles?
@@dbsabo2 You might start with a special issue of the journal Psychotherapy, volume 48, on this topic. Allan Abbass has also done research in this area. In my experience, most of the resistance to taping comes from therapists, not patients. In fact, a number of patients have been delighted to be able to help train therapists, as they had had many unsuccessful attempts at treatment with clinicians who lacked skill and knowledge. Imagine trying to learn surgery without seeing and doing under supervision! We have been behind the curve on this.
@@patriciacoughlinphd1852 OK. So if this is the case - i.e., psychotherapy largely being an "experimental" process with patients/clients being used as guinea pigs in a largely personality driven profession, then why should people trust seeing a psychotherapist for mental health issues, if there is such a serious lack of training within the profession in the United States? Also - what are professional orgs doing to correct these issues on a regulatory and accreditation basis - that is REQUIRING therapists to engage in videotaping sessions - as a condition for psychotherapists obtaining and keeping their licenses to practice?
@@dbsabo2 Our profession has struggles, as all do. That said, psychotherapy is more effective than most medical procedures. 80% of those who avail themselves of mental health treatment regard it as very helpful. We must keep all this in perspective.
Thank you for all the videos. I am listening them carefully. My concern is really the countertransference-mainly enxiety with the group. I can say that It is my personal issue but in the same time it is group members unconscious dynamics as well, but i can not differentiate when it is about me or them. Then i get more confused, thinking maybe i blame my weakness on them and so on 😐
Great post on a very important issue in therapy. When you use the term universal counter transference is that then the same as an objective counter transference? I would love to hear a post on repression starting with the theoretical rationale from an analytical standpoint.
Repression is a process through which feelings, impulses and fantasies are kept out of consciousness. Identifying the specific defenses that serve the purpose of repression is your first task. Not sure what you mean about a rationale for this process?
What if a therapist sees the patient the wrong way, patient's behavior and patent's words are understood in the wrong way and in that wrong way he/she (the therapist) presents the case, I guess the only way to really know is to be there or see the tape of the session. What do you think? Thank you!
This refers to the unconscious ways that people elicit the very response from people they consciously want to avoid. For example, someone might complain that others are always controlling them and yet their passivity and indecisiveness invites or "pulls for" this kind of response. This is an example of cyclical psychodynamics - the phenomenon in which people unconsciously play out their unresolved conflicts with others.
@@patriciacoughlinphd1852 Thank you. You're response was helpful. (I am in my third and fourth class of a 3 year program. Its going to take me longer.)
