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Transference in Therapy

What is transference and why is it important?

Transference can be an aid or a hindrance in  therapy. It can also complicate any of our relationships.

Transference is the phenomenon of transferring feelings from a significant person in your childhood to someone else. It is unconscious and it happens all the time to all of us. For example: you meet a woman and she reminds you strongly of your older sister who you were very close to. You will probably like this person and wish for a close friendship even before you know her very well.

In therapy, there can be positive transference, negative transference, or countertransference.

Countertransference occurs when the therapist is transferring feelings about their important people on to the client. It’s very human of the therapist but it is imperative that the therapist is aware of it and keeps the transferred feelings in check. Otherwise the therapist’s therapeutic judgement and reactions to the client can become clouded and compromise the quality and progress of therapy.

Positive transference is common at the beginning of therapy when the client is wishing for a “super person” who will “save them”. Someone with all the wisdom and skill needed to succeed at giving the client everything the client needs.
Positive transference is helpful to the therapist as the client is open to what they say and compliant to requests. When asked people in positive transference will often enthusiastically characterize their therapist as “Wonderful!”

Negative transference occurs when the client transfers negative beliefs and feelings from someone who was hurtful to them, onto the therapist. The client may say to the therapist: “you are out to get me and make me feel wrong all the time, just like my father,” or “you are judging me just like my mother did” or “you’re angry but you cover it up.”

Great work can come from “working through” negative transference. A profound change can occur when a client sees the therapist as they are and then realizes how much negative transference influences the way they relate to other people in their lives. It’s eye opening! Some “people their world” with their hurtful parents and find it such a relief to stop.

Too much positive transference can be a problem because the therapist is bound to “fall from grace” at some point. Often when a client’s “wonderful therapist” disappoints them the transference turns negative.

Bringing this phenomena of transferring feelings and beliefs to conscious awareness gives the client access to reality.  Then they can see the actual positive and negative attributes of the person who has been the target of their transference. It often has the effect of moving the person forward in personal growth and maturation.

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Evaluate Your Therapist

Are you dissatisfied with your therapy? Is it you or is it your therapist? Let’s evaluate and find out.

First I will tell you what is reasonable to expect from a competent, experienced therapist. In the next post I will explain the notion of transference, positive and negative, and then how to work with your current therapist to see if negative transference is the problem.

Here are some fair expectations you should have of your therapy process and your therapist:

  1. You should make progress. If you don’t think you are, ask your therapist why they think you are or aren’t making progress. Don’t automatically discount your your own instincts. Listen but don’t assume the therapist knows more than you do just because they are “the professional” if what they say doesn’t make sense to you.
  2. You should get something new out of every session. If you are not, ask yourself if your therapist is:
    • not really working when you are in session – they should be.
    • just being “someone to talk to”: therapists should have a lot more than this to offer.
    • not clearly showing you how to get engaged in your sessions: You have to if you want to grow.
    • just giving advice: you should be learning how to answer your own questions and make your own decision.
  3. You should be learning from your therapist. Your therapist should know more than you do about the general kinds of issues you are dealing with. They should be able to clearly relate this understanding to your specific situation.
  4. You shouldn’t feel worried about your therapist’s feelings – it’s the therapist’s job to take care of themselves. The therapist should call you on doing this and reassure you they don’t need or want this from you.
  5. You should feel your therapist likes and cares about you. If your therapist doesn’t accept who you are and like things about you, you deserve more.
  6. Your therapist should have several ways to approach you and your problem. You should never feel like you are supposed to fit into their way of doing therapy.

If these expectations are not being met, talk to your therapist about them. It is also reasonable to look for another therapist. Remember, just because this therapist is set up in an office or clinic doesn’t mean they are good at their trade.

On the other hand, if you find yourself repeatedly switching therapists I would recommend you stick with your current therapist and make a sincere effort to work out your dissatisfaction.

If you fire a therapist, it may rid you of the problem at hand, but another version of that same problem will likely show up with your next therapist. You need to give your current therapist 3 to 5 more sessions while you focus on working out your relationship. This may well be about transference which is the unconscious phenomena of transferring feelings from one person to another; in this case unconsciously transferring your feelings for some one else in your life to your therapist.

Transference is one of the reasons therapy can work so well and it is also a reason why it can fail. More about that next in “Transference in Therapy“.

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Reluctant to take Medication for Depression, Anxiety or Bi Polar Disorder?

You are justified in your concerns about “putting strong drugs in my body,”  as many of my  clients put it.  How do you decide if it is the right thing to do?

It depends on how severe the depression, anxiety or bi polar symptoms are; how much it is effecting your life.  Some people with mild to moderate symptoms are sure they are not being effected enough to warrant the use of psychotropic drugs. Other people can get a clearer perspective by talking  with the people they are close to and spend a lot of time with.  The people who live around you can often see changes in you that, subjectively, you can’t see but can recognize  when they are pointed out.

Let’s say that your mood problem is effecting your life enough that you want to do something for relief. You can try the medication, see  how helps, and then decide whether or not to stay on it.  You can also try holistic methods, like daily aerobic exercise (for depression), acupuncture or homeopathy. I’ve had clients stop therapy because one of these methods improved their life so much they didn’t need it any more.

Of course there are people  who stay on a maintenance dose of medication to keep their lives worth living. Many have told me they are  glad the medicine exists, knowing that generations back people just suffered.

I strongly recommend seeing a professional if you think you have one of these mood problems.  Good therapists can often determine if the kind of problem you are struggling with will respond to medication or holistic help. You don’t need to suffer, or function at a lower level than you can.  Take hold of your life, it belongs to you. Make it good.

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Childhood Sexual Abuse is Not A Life Sentence

In my practice I have met people who have been in therapy for childhood sexual abuse, but have not been able to set it behind them and get fully involved with their lives.

There seems to be 3 stages of healing from this horrific crime against you as a child: (1) Being a Victim,  (2) Experiencing Yourself as a Survivor, and (3) Becoming The Person You Were Meant To Be. Let me explain what I mean:

When you are a Victim, you are reacting and suffering from the effects of the abuse. You may or may not be fully aware of what happened to you as a child.  You are strongly effected by the abuse and it has left you with a myriad of issues. These include problems with relationships and trust, sexual dissatisfaction, substance abuse, low self-esteem and more.  You may or may not have been in therapy, but you haven’t resolved the the pain and effects from the past.

When you are a Survivor you most likely have had a good bit of therapy. You are proud of yourself  and you deserve to be. You have worked courageously to own your  life, you have gained quite a bit of self understanding and confidence.  You have made progress and have a right to be proud of it.  Survivors are  warriors and stand tall.  The truth of your abuse is a fact of life, and a pretty conscious one. You may find yourself telling people about it,  feeling righteously angry that this injustice was done to you. And you have every right to feel this way.

But you are not over the abuse, it is not in your past, yet. It is a present, daily fact of your life and you are conscious of it every day.  “How can I not be?” you might demand, “Don’t you understand  how devastating that all is?” What I am saying, very gently, is there is another place to be with the truth of your abuse. You can get past being enraged and involved in what it did to you.  You  can get on with the rest of your life and be primarily involved with new challenges and self actualization: becoming the person you were meant to be.  At this stage of your healing you are invested in your life now as it unfolds before you.  I find myself saying to others when they ask about my family of origin: ” I didn’t have a normal childhood. But it’s OK, I don’t live there any more.”  You are truly finished with the work of your abuse  when you “don’t live there anymore”.

I wish I could say that the sexual abuse is no longer at the core of your personal growth as you continue on with your life.  It is.  You may wisely recognize that today’s problem or stuck place is stemming from what happened to you in your past. You might go back to a therapist to deal it.  But you don’t identify yourself as  a survivor anymore.  Now you are more involved in things like learning to be more assertive and getting the respect that your deserve at work, or raising your children better, the normal problems and growth areas  of regular life.

Your childhood abuse isn’t a life sentence.  Joyfulness and  deep satisfaction are  out here for you.  If you haven’t found them, keep looking.

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More Common Questions

I’m afraid of not liking my parents if I find out they hurt me when I was little.  I want to be able to love them and be close to them.  Maybe it isn’t worth finding out what happened to me, or is it?

That is a real and serious question.  Would you rather live with the truth or with your hoped for fantasy? Would you rather have your whole self, or your relationship with your parents?  I suggest you look at what troubles you in life and decide how much you want that to be different.

 

So what in me probably has to do with past childhood abuse? No one is perfect, what can I assume about myself is attributable to childhood abuse? 

Low self esteem, relationship dissatisfaction, trust issues, lack of self actualization, unnecessary fears and anxiety,  problems with your sexuality, to list only the most obvious.  I have never known a person who has worked on their childhood abuse be sorry they did.

 

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Recovering from Childhood Sexual Abuse

Recovering from Childhood Sexual  Abuse

Common Beginning Questions:

I think I might have been abused but I’m not sure. Does that mean that I probably was?

Not necessarily, but maybe.  In a way, your job is the same whether you were abused or not:  I would recommend you get into therapy (with someone who has experience with survivors of sexual abuse and who clicks with you) and do the therapeutic work about what ever is interfering with you having the life you want now.  If there was any abuse, and you are ready to deal with it, it will come up into your conscious awareness and you can address it.

What does it mean to be ready to work on abuse? 

Readiness has to do with being in the right place, internally and externally,  so that when you find out the reality of your own abuse,  you will profit from the therapy work and not be unduly  beaten down by it.   Abuse that you had to repress (forget happened) is likely the experience from your childhood that was the most destructive to your self-esteem.  Being ready to deal with this and having it be a healing experience takes readiness.  Left to your own devices, you  very probably won’t remember anything you aren’t ready to deal with.  This is why I don’t use hypnosis with my clients who want to remember what happened to them.

So being “ready” to work on abuse means that  the relationship you have with yourself  ( your internal environment)  is strong:  Your resources inside are lined up PRO YOU. You spend more time supporting and validating yourself than putting your self down.   No matter what else,  in the end you basically like yourself, enough anyway, so that you can help yourself through this process.  You can remember painful things that happened to you and heal from them rather than being over whelmed or  becoming self-destructive.   The good news is that once you are through this work,  you will like yourself,  love yourself,  more than you ever have.

What is this “outer environment” part?   This  could be about relationships and if you have good support, for example  being  in a good relationship or out of a bad one. It can be about finances and when you have the money for baby sitters or transportation or the therapist’s fees.  It is probably also about timing so that you can afford an occasional day off  when you truly need a mental health day.  Therefore  it’s probably not when you are a single parent of young children and working part time and going to school at night.

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Everybody Needs Their Version of A Horse (Tongue in Cheek Serious Advise)

Despite the wisdom of Freud,  (who said adult’s lives are about love and work)  I propose  that life for adults is really about Joy and Passion, or ought to be.*

That’s why I say everyone needs their version of a horse.

I have had horses, one or two,  in my life ever since I was in fourth grade.  They have brought me reliable joy, if there is such a thing.  This is not to  diminish the importance of my  partner, my family and good friends.  My partner and I  joke that,  as regards each other,  we are ” necessary but not sufficient.”  To have a full  life  don’t forget to include passion.  ( I don’t mean sexual passion here.)

I am passionate about my horse and riding dressage.  I get high nearly every ride, and get terribly excited about learning something new with him.  I miss him when I don’t see him,  and I love him dearly.

You need to be doing something you are passionate about. Don’t wait for your kids to grow up, or for there to be more money, or hold back because you will look like a beginner and your 45 already.  Go find a way and get into your passion now.    Live your life with joy and passion in it. Your own, very personal, way .

If you don’t know what it is you are passionate about, or believe you can’t do it, therapy could very likely help.  Therapy is about preparing for good living, after all.

*OK, you do need satisfying love and work .

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The Bottom Line on Therapy

So what is the purpose of therapy, anyway? What is it supposed to do for you?

Therapy gives you choice. It allows you to have choices instead of  automatically thinking/feeling /acting  from what your history taught you  – about yourself, other people and the world.

Your history, in this case, means your childhood.  During those early years you learned by experience what the world is like, what  to expect from other people,  and who you are.  For an example: for the child who was expected to mommy’s little helper and take care of her younger siblings learned that to be a good person was to figure out what someone else needed and do it for them. Maybe she learned to put her own preferences  and needs in the background, to never complain or think of herself first,  to think of herself as valuable only  in the ways she  could serve others.
So she grows up to be a what we all call a caretaker, giving “selflessly”, and  depressive without knowing why.  After all, everyone she knows says she is wonderful!  She finally decides to get her own career, and, you guessed it, she becomes a nurse. More depression.

She comes to therapy and discovers what she thought were her own choices where based on what she learned as a child  and decides to throw it all off.  Her kids do more chores around the house. Her husband comes into therapy with her because she is fed up of his self centered ways and expectations that she be his maid, lover on demand, and the one who takes care of the kids. She gets a new hair cut, loses weight,  quits the subservient good girl role at work and becomes an administrator…..you get the picture.

Therapy teaches you how your childhood effected you and gives you choices about what you want to do, who you want to be.  How does it do that? Look around at other blog entries, and if you have specific questions, leave a comment and I’ll do my best to explain.

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Roots of Self-Esteem

Positive self-esteem is developed in many ways in children.  If your parents value you and respect your feelings, thoughts, preferences, and proclivities, while challenging you with age-appropriate, achievable goals – you will likely develop good self-esteem. This positive sense of who you are becomes a natural part of yourself – something you take for granted and something that holds up against life’s disappointments and failures.

Negative self-esteem can develop in a myriad of ways.  It is pretty obvious, if you have been reading much of my blog, how being emotionally, physically or sexually abused teaches the child that they are worthless, and that certainly will grow roots of poor self-esteem.  One of my Stories for the Unconscious “The Good Prince” illustrates how negative self-esteem can develop in a person who is, by all outward measures, very loved and given lots of positive regard by his parents; but wasn’t allowed to find his true self.

I have seen over the years in my practice this exact problem in some adults of wealthy parents. In this situations,  the parents wanted control of their child and didn’t allow the child to investigate his /her own proclivities and learn his /her own strengths and talents. These parents have many values and directives that they press upon their child. As the child grows older,  the parents continue to hold the child hostage by the magic of their money and the threat of taking it away.  Other parents control the child by dint of their own personality – and use love, approval or fear as the currency of their control.  Most children are influenced to some degrees in this way in that we take on our parents values. (” Of course they expected me to go to college, they talked about it ever since I can remember” – can be a positive value and directive.  Oops! I guess my values are showing here!)

The difficulty lies for kids whose parents take so much control that their child, in order to win acceptance, pushes the best parts of themselves “underground” where the parents can’t see it. The abused child does this so the parents won’t damage that part of them.  For example, the boy who has talent as a writer and whose father would surely ridicule and beat him so he won’t embarrass Dad by being a sissy. This kid could shove that talent so deep inside himself that he wouldn’t even know he can write well until he takes a college course in creative writing.   The Good Prince put his real self underground in response to the enormous pressures of inheriting the Crown.

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The Therapist’s Commitment

Lately I’ve been thinking about this work, and what the therapist owes her/ his clients.  Therapists often say that they don’t want to be doing all the work, (meaning that the client must apply him or herself) or nothing useful will really happen.  Very true.

However, the therapist must also be working, and working hard, so that when the client leaves every session they take with them something new to ‘chew on’, a new awareness or an insight  they didn’t have before. Perhaps  they have gone through an emotional experience that has created a self-understanding. This is often more useful than then the intellectual putting together of a new concept. For example, crying teaches how significant something is (or was) in a deeper way than thinking about it.

The therapist  needs to connect things that their client said in a previous session to what they are saying today, or show them things about themselves they hadn’t recognized.  Good therapists pick up on things that other people  wouldn’t notice.  Then there is the timing and  presenting of things, so that the client can take in what the therapist is saying.   Skill, experience and intuition come in here. Therapists have to stay on top of their own reactions to things, so they know when something from their own life is influencing the way they feel and react to their client. Having different therapeutic approaches to the same issue is needed – the therapist needs to adopt to their client, not the other way around!

I guess I’m saying some people are more talented about this work than others — and  don’t settle.