Transference in therapy: What it is and why it matters

Throughout our lives, we all have experiences that shape our thoughts, feelings, and behaviors in our relationships. Most people can probably recall a time when an experience from a past relationship influenced how they felt or behaved in a later relationship. This is because an interaction or pattern of interactions with one person can affect how we respond to others. 

In the context of the relationship between client and therapist, this phenomenon is called transference. A largely unconscious process, transference can be positive, negative, or neutral. It happens when a client unknowingly “transfers” or projects feelings about someone in their past or present onto their therapist. Skilled therapists can use transference to help clients examine how their past experiences might be shaping their “here and now.”

Understanding transference in therapy

The concept of transference was named by the psychologist Dr. Sigmund Freud in 1912. The construct has evolved considerably since that time. But the main idea, that a client’s emotional response to their therapist is worth examining, remains a key component of most modern therapeutic approaches. As the term has evolved, experts have come to realize that transference isn’t always a negative thing. And in bringing attention to transference, a therapist can use it to help a client better understand themselves.

For example, imagine a client getting visibly agitated when their therapist suggests a “homework” assignment, like journaling outside of therapy. A skilled therapist would identify this pattern and ask the client about it. They might say something like “I notice you seem to get frustrated when I suggest an activity between sessions. What’s coming up for you when I talk about homework?

Through some discussion, they discover that the client’s mother always refused to go to therapy to address her anger issues. When the client expressed concern to her mother, saying that her anger was causing a division in their relationship, the mother refused to take responsibility for her behavior. The client endured years of verbal abuse to maintain the relationship with her mother. Now, she feels exhausted from spending so much time overcompensating. She resents that she still has to do the “work” in therapy when her mother never has. So being asked to do “homework” between sessions feels like adding to an already unbalanced emotional load. 

This example shows us how much can be revealed by examining transference in the context of individual therapy. It also shows us that how a client feels about their therapist can be influenced by many factors, including past relationships. Working to reveal and examine transference when it comes up can strengthen the therapeutic relationship and help the client better understand their emotional responses. 

Types of transference

Transference can take many forms. But there are a few main categories to be aware of, including:

• Positive transference: This occurs when a client projects positive feelings from a past experience or relationship onto their therapist. For example,  they might see their therapist as smart, caring, or kind because the therapist reminds them of someone in their past who had those attributes. Positive transference can help the client feel safe and connected in therapy.
• Negative transference: This occurs when a client projects negative feelings from a past experience or relationship onto their therapist. For example, a client may respond to their therapist with anger or hostility when the therapist does or says something that triggers an old feeling or memory. This isn’t necessarily a bad thing. Exploring these reactions can help a client better understand their unconscious emotional processes. 
• Sexual or erotic transference: This occurs when a client feels sexually or romantically attracted to their therapist. When this happens, the therapist must maintain strong professional boundaries as they help their clients navigate this experience.

What is countertransference?

Countertransference is a term that describes what happens when a therapist has an unconscious or conscious reaction to their client. 

Like transference, countertransference can be positive, negative, or neutral. But the experience is always tied to the therapist’s own emotional and psychological needs. Left unexamined, countertransference may shape how a therapist responds to their clients. It can also provide some powerful insight into how other people might respond to the client outside of therapy. 

For example, let’s say a therapist has a client who seems unwilling or unable to use any of the coping tools they practice in sessions. So each week, the client talks about the same problems. In turn, the therapist starts to get frustrated at what they perceive as a lack of progress. They begin to notice that they no longer look forward to meeting with this client. 

This awareness prompts the therapist to make an appointment with their supervisor to process the experience. Together, they brainstorm strategies for keeping the therapist’s feelings in check so that the countertransference doesn’t affect the client’s experience. They may also discuss the possibility of referring the client to another provider if the therapist cannot manage the countertransference.

Why is transference important in therapy?

Examining transference in therapy is important for several reasons:

• It can strengthen the relationship between client and therapist. 
• It can provide insights into the client’s inner world.
• It can keep the focus on the present when it’s helpful to do so.
• It can help the client learn more about their emotional responses.
• It can reveal how a client might respond to others outside of therapy sessions.

In addition to these benefits, there’s a form of therapy called transference-focused therapy (TFT) that’s been proven effective in treating personality disorders. Specifically, this framework is used to treat borderline personality disorder (BPD) and narcissistic personality disorder (NPD). 

Find care with Rula

Research shows that the relationship between client and therapist is one of the most important factors in determining the success of therapy. So it’s important to work with a provider who understands how transference and countertransference can impact the client experience. 

At Rula, our diverse provider network includes therapists and psychiatric providers with a wide range of specialties. So no matter the mental health issue you’re facing, we can help you find the right provider for your needs. 

In just a few minutes, you can use our therapist-matching program to find a therapist who takes your insurance and schedule your first appointment as soon as this week. 

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