Countertransference in Therapy: Types, Examples, and How to Deal

Countertransference is a psychological phenomenon that occurs when a clinician lets their own feelings shape the way they interact with or react to their client in therapy.

Often, countertransference is unconscious, and both the clinician nor the client realizes it is happening.

Countertransference is an important reminder that therapists are human beings too and that they have their own biases, history, and emotions which can influence their thoughts and reactions to clients.

In a therapy session, a client might remind the therapist of someone or something from their present or their past. As a result, the clinician might unconsciously treat the client in an emotionally-charged or biased way.

Because of this, clinicians must be aware of countertransference at all times and actively work to acknowledge and overcome it in their practice (Overstreet, 2021).

What Does Countertransference Look Like?

Countertransference occurs whenever a therapist brings in their own experiences to the extent that they lose perspective of the client’s own and stop being objective (Jacobson, 2022).

Examples of countertransference include when the therapist:

• Over-identifies with the client’s stories and shares too many about themselves
• Offers a lot of advice instead of listening to the client’s experience
• Pushed the client to take action the client doesn’t feel ready for
• Wants to relate outside of the therapy room
• Inappropriately disclosed personal information
• Develops romantic feelings for the client
• Does not have adequate boundaries with the client
• Is overly critical or supportive of the client

Transference vs. Countertransference

If countertransference is the emotional reaction a therapist might have towards their client, it follows that transference is the opposite: a client’s emotional reaction to their therapist.

Transference is a psychological phenomenon that occurs when a client redirects their feelings for someone from their past or present onto the clinician. This can include their feelings towards a family member, friend, or significant other.

Like countertransference, this phenomenon is mostly unconscious, and the client is likely unaware that they are being influenced by it. Unlike countertransference, transference in therapy is accepted. The therapist can even use transference as a tool to better understand their client’s personal relationships and emotionality.

Countertransference can be thought of as the clinician’s response to a client’s transference (Overstreet, 2021).

However, whereas transference is a normal and accepted part of the therapeutic process, clinicians are responsible for monitoring their countertransference so they remain objective in their therapy and do not harm the client.

Warning Signs

Given the often problematic and harmful nature of countertransference, it is important to identify when countertransference is occurring and know how best to respond.

So, how does one know if their therapist has countertransference?

If concerned about the presence of countertransference in a therapeutic relationship, it is important for both the therapist and the client to be aware of warning signs.

In adult therapy, both must be aware of whether the therapist has an inappropriate emotional response to the client. This can include signs such as an unreasonable dislike for the client, excessive positive feelings about the client or the therapist becoming over-emotional or thinking about the client between sessions.

Another warning sign of countertransference is if the therapist or client finds themselves dreading their therapy session or feeling uncomfortable during the session.

Importantly, countertransference can also present itself in child therapy.

Warning signs of countertransference on behalf of the therapist in child therapy may include: ignoring a child’s deviant or dysfunctional behavior, fantasies about rescuing the child from their situation or encouraging the child to act out (Fritscher, 2021).

Impact on Therapy

As described, countertransference can appear in many different ways, but most presentations of countertransference are harmful to the therapeutic relationship and can have adverse effects.

For instance, when a clinician brings their own outside experience or emotions into therapy, they lose perspective and can end up hurting the client. An especially concerning area to be aware of is erotic countertransference which is when the clinician develops attraction, love, or sexual feelings toward a client.

Personal relationships with clients are prohibited and have strict ethical and legal regulations (Overstreet, 2021).

Although therapists need to guard against feelings of countertransference toward their clients to avoid harmful impacts, some forms of countertransference have actually been found to be beneficial.

For instance, in a systematic review of 25 countertransference studies, researchers found an association between positive countertransference, such as feeling close to the client, and positive outcomes (Fritscher, 2021).

A Brief History

Sigmund Freud originally developed the concepts of transference and countertransference around 1910. He identified countertransference as a largely unconscious process in which a psychologist’s own emotions are influenced by their client, with their reaction to these emotions being known as “countertransference” (Sandler, 1976).

At first, countertransference was only believed to hinder the therapeutic process, with Freud referring to it as a blind spot in the analyst’s ability to understand the patient.

However, this line of thinking started to change around the 1950s, when countertransference started to be viewed as something that could be positive (Fritscher, 2021).

Present-day, countertransference is viewed with both a mix of negativity and positivity. Countertransference acknowledges that clinicians are human beings with their own emotions and feelings.

So, by recognizing and understanding countertransference, therapists and their clients can be observant of how it affects the effectiveness of their therapeutic relationship.