Do you find the emotions a client has stirred up in you sometimes confusing? Would you like to have a tool to help clarify your countertransference towards a client?
If yes, you may wish to employ Dima Duprs Understand Your Countertransference Exercise. Dima Dupr is a creative social worker and therapist who works in Canada and specializes in therapeutic journaling. She is also the author of the book Feeling, Writing and Empowering, a guide for helping professionals on integrating therapeutic writing into practice.
Before delving into the journal exercise, a brief refresher on the difference between transference and countertransference follows. Transference refers to the clients conscious and unconscious feelings, fantasies and reactions toward the therapist, which are based upon feelings and perceptions the client has from past relationships.
Countertransference, on the other hand, is the therapists transference towards the client (Berzoff, 2008). Lisa Schwartz, M.Ed. and Ron Schwenkler L.M.F.T., L.P.C. provide some suggestions on how to cope when triggered by a client.
Denying or avoiding the emotions triggered by your clients is likely to interfere with the therapeutic process. Conversely, by recognizing and working through your countertransference feelings towards your clients, you gain valuable data about your client and/or personal issues that you need to address yourself (Berzoff, 2008).
To that end, employing Duprs Understand Your Countertransference exercise may be helpful to you when you seek clarity for why you are experiencing various reactions during or following certain sessions with patients. For your convenience, the steps are described below, as well as summarized in a graphic.
Understand Your Countertransference Exercise
Complete a cluster exercise as soon as you can after having some sort of reaction/emotion (positive or negative) during or following a client session.
List all feelings, thoughts and body sensations of which you are currently aware. Do so in a circular pattern, as illustrated in the graphic below, with the strongest emotion in the center and the other emotions and sensations surrounding it.
For each feeling/thought/body sensation listed, write how you feel about it and consider:
- Is it a new feeling, thought or body sensation that you are feeling when working with this client?
- Have you thought or felt this way in previous sessions?
- Does the clients story remind you of a person/situation in your own life?
- Are any of the thoughts or feelings ones your client needs to express, but has not yet done so?
For example: Your client has told you about several losses over the past six months but has expressed no sadness or anger. Your client retells the story in a detached manner.
When Your Thoughts/Feelings Belong to Your Client
Focus on Self-Care
If continuing to think of a client, write down some ideas of what you wish for him or her and then move on to taking care of yourself.
- Make a list of self-care strategies that you may refer to when needed.
- Create and employ a ritual for yourself to use between sessions to help you let go of your clients after each session. Some ideas you could try include: walking around the block, deep breathing for five minutes, saying a prayer or visualizing the client as well and whole and mindfully washing your hands to let go of what you are holding onto.
- Tap into what you have learned from past supervision sessions about similar situations.
- Consider consulting with a colleague or supervisor who can help you.
When Your Feelings/Reactions Belong to You
Try to process your feelings in one of the three below suggested ways.
Write using one of these prompts:
- Right now, I feel (or think)
- This particular clients story reminds me of
- Today I am affected by this client
Chat with your feeling/thought by asking it a question with one color ink and write what you think its response would be in another color ink.
- Just jot down your first thoughts and try to avoid judging or worrying about the content of what you are writing. Please see the graphic below for sample chat with Frustration.
Write about your current life situation. Consider the following questions as helpful prompts.
- What is going on? How is your self-care? Are you sleeping enough, working too much and/or have leaky boundaries?
- Is there a personal situation interfering with you/your work/your life?
- How will you take care of yourself?
Conclude process by completing these statements:
- I didnt know that
- I realize that
- What I need is
In this manner, you will be nourishing yourself by acknowledging the learnings you have gained from this exercise, ensuring separation of your issues from those of your clients and taking steps to ensure better self-care.
Do you have some suggestions on how to better understand your countertransference emotions? Please share them below!
Berzoff, J. (2008). Freuds psychodynamic concepts. In J. Berzoff, L. Flanagan, & P. Hertz (Eds.), Inside out and outside. Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts (pp. 1747). Lanham, MD: Rowman and Littlefield.
Dupr, D. (2016, November). Email exchange.