Countertransference and the expert therapist. This study examines how beginning therapists rate five factors that are theorized to be important in countertransference management: (1) anxiety management, (2) conceptualizing skills, (3) empathic ability, (4) self-insight, and (5) self-integration.
Using an adaptation of the Countertransference Factors Inventory (CFI), 48 beginning therapists (34 women, 14 men) rated 50 statements on their value in managing countertransference. These statements make up subscales representing the five countertransference management factors. Both beginners and experts rated self-insight and self-integration highest. Males and females also rated these factors highest. Ratings of the factors decreased as months in personal and/or group psychotherapy increased, and a stronger negative correlation was found with age. Generally, beginners rated the factors higher than the experts.
Beginners who are older and/or have had more therapy rated the factors more like the experts. The word countertransference was coined by Sigmund Freud in approximately the year 1901, at the dawning of psychoanalysis. In classical psychoanalysis, transference was seen as a distortion in the therapeutic relationship which occurred when the client unconsciously misperceived the therapist as having personality characteristics similar to someone in his/her past, while countertransference referred to the analyst’s unconscious, neurotic reaction to the patient’s transference (Freud, 1910/1959). Freud believed that countertransference impedes therapy, and that the analyst must recognize his/her countertransference in order to overcome it. In recent years, some schools of psychotherapy have expanded the definition of countertransference to include all conscious and unconscious feelings or attitudes a therapist has toward a client, holding that countertransference feelings are potentially beneficial to treatment (Singer & Luborsky, 1977). Using more specific language, Corey (1991) defines countertransference as the process of seeing oneself in the client, of overidentifying with the client or of meeting needs through therapy. Common to all definitions of this construct is the belief that countertransference must be regulated or managed.
If unregulated, a therapist’s blind spots may limit his/her therapeutic effectiveness by allowing clients to touch the therapist’s own unresolved areas, resulting in conflictual and irrational reactions. With greater awareness of the motivating forces behind one’s own thoughts, feelings, and behaviors, the therapist is less likely to distort the therapeutic relationship. Indeed, because countertransference originates in the unconscious, the more the therapist is able to bring into conscious awareness that which was hidden in the unconscious, the less he will find that his patient’s material stimulates countertransference reactions (Hayes, Gelso, Van Wagoner). Nonfacilitative countertransference is not just the passive act of misperception. It occurs when, as a result of the misperception, the therapist’s response to the client is based on his/her own need or issue rather than that of the client. Countertransference is an important issue for all therapists.
Beginning therapists often address the issue in class sessions, groups, and supervision, as well as in impromptu discussions. Generally, no therapist wants their unresolved issues to cloud the therapeutic process. Being in personal therapy and supervision are two ways a therapist can bring issues to conscious awareness and deal with countertransference (Fromm Reichmann, 1950; Gelso & Carter, 1985; Heimann, 1950; Reich, 1960), but are there other ways? Are there specific personal characteristics that enable the therapist to deal successfully with countertransference? Although little theory and research address these issues, Hayes et al. (1991) and Van Wagoner, Gelso, Hayes, and Diemer (1991) studied the personal characteristics that therapists believe assist them in the management of countertransference.
The five therapist qualities theorized to assist in the effective management of countertransference are anxiety management, conceptualizing skills, empathic ability, self-insight, and self-integration. This study examines how beginning therapists rate the effectiveness of these five qualities in managing countertransference. It also explores whether gender, age, and months in individual and/or group therapy affect these ratings.
