“In order for us [therapists] to assist people to unmask, confront our demons, ground, and find our deep truth – our high selves – and then to be able to change the world into a kinder, more heartfelt place – we must be willing to learn and do this deep work ourselves – on an ongoing basis. There is no way around it!”
~John Pierrakos, MD (Psychiatrist, Super Shrink). John taught this concept to his student therapists.
“Counter transference issues no longer should be hidden or denied, and on the contrary, can bring the greatest treasures to both the Client and the Therapist.”
~Virginia Wink Hilton, PhD
Embrace Your Own Therapy to Become a Happier, Healthier, More Effective Therapist: Explore Your Countertransference! ©
~Pamela Chubbuck PhD, LICSW, LPC
(originally published in The Georgia Society For Clinical Social Work newsletter: The Clinical Page – Fall 2013).
It is the #1 job of the therapist to keep the client as safe as possible, first and foremost from the therapist’s own “stuff.” That, of course, requires the therapist to be willing to reflect, and get help to find what his/her stuff is!
Crucial questions are: What is a therapist to do with his/her own feelings that come up when working with clients? (And they do come up!) How can these feelings be used to best serve the client? How to become healthier and happier yourself as you work with difficult issues? The only way to know about and work with countertransference and become more conscious and healthier along the way is to first and continually do our own therapy.
This essential importance of working on oneself seems to be left out in current academic psychotherapy programs. Do you remember how therapists were historically trained? First they underwent their own therapy. They worked with a therapist/mentor for many years until finally the mentor said, “I think you are ready to take on a client.”
Most new therapists are coming out of programs lacking the most basic experience: the student’s own personal therapy – too often having not one day of personal therapy under their belts. This lack is very concerning, primarily because most new therapists tell me they feel unprepared to help clients.
Recent graduates also tell me that countertransference was skimmed over, poorly taught, or was left out of their professional academic program.
Ten years ago I surveyed all masters level MSW and counseling psychology programs in GA to discover that none had personal therapy as a curriculum requirement. Checking again this week I polled five of the top Georgia universities and found that policy unchanged. It was explained: “We suggest that students seek therapy if needed. School counseling centers are available.” One recent graduate told me it took six weeks to receive a call-back when she needed an appointment at her Atlanta-area university. She felt her issue was an emergency, so she sought help elsewhere in the meantime.
I have worked with therapists for over 30 years and they consistently tell me they do not really learn how to be social workers, professional counselors, psychologists, etc, in their academic programs; nor do they learn best by suddenly finding themselves in a practicum where they feel inadequately prepared and frightened for themselves and their clients (“It feels like going cold-turkey.”). Students tell me they are afraid to reveal how scary it is. While they say they don’t learn most during their academic education, upon coming to therapy they tell me they do learn most by doing their own work – i.e., working on themselves in therapy.
“Therapy” cannot be learned by reading about therapy or taking a class to study therapy, or going to a lecture about therapy. It also cannot be learned by having a student therapy group run by another student, or a professor, in graduate school to role-play therapy. According to my many clients throughout the years who have been in counseling/psychology degree programs, reading about therapy is too heady – without real emotion – and it is the emotions that they are unprepared to handle both in themselves and their clients.
The classroom format has been too frightening for students to open up and be real. Students have told me that they do not feel safe or supported to really work on themselves in those academic situations. Most class therapy situations are a setup for “mask-to-mask” therapy, where both the therapist and the client remain in defined roles and are unable to genuinely connect and also access their deeper feelings. The client cannot experience the therapist as supportive of his/her terror of feeling the deep emotions that have been suppressed and held in the body-mind; emotions which were not allowed expression in the original family system. The client continues to block unconscious feelings. Student therapists, therefore, learn to enhance the defenses that have kept them from feeling their deep issues all along. This fearful blocking is then passed on to their own clients when they are out in the work world. Vicious circle – destined to continue if professors, mentors and supervisors don’t do their own work.
A recent graduate of a top-rated GA school told me last week: “No one tells the truth, in my group therapy classes. Students quickly ‘get it’ that we are supposed to have it ‘all together’- that we should not need real therapy – or if we do get therapy we should not have anything really too serious or grizzly to deal with from our past. And if we do, we should have dealt with it already.”
I have two graduate degrees and completed three 4-year non-university trainings. I also had a few decades of personal therapy. When asked what helps me the most to be a pretty good therapist, I know clearly that it is my own experience as a client. Second to that, my training programs that focused on personal experiential learning inform my work. Third was experiencing the multiple levels of how master therapists work with clients (watching, listening, thinking, feeling, and intuiting) and role model the continual work they do on themselves.
One of my favorite mentors, psychiatrist John Bellis, MD, a former student of Harry Stack Sullivan, told me in the early 1970’s that he was a lot more interested in countertransference than in transference. John encouraged me to change my graduate paper from “The Case of the Client” to “The Case of the Therapist.” My countertransference! At that time, the idea of taking on and revealing my deeper issues scared me. Today I am very grateful to John and I find countertransference most fascinating.
I see every client who walks into my office as bringing an opportunity for me to further heal, expand, enlighten and become more conscious. Knowing about and embracing countertransference helps me learn about my client and myself. If I were not constantly learning about myself in the process of helping clients, I would have gotten bored and quit long ago.
Clients appreciate therapists who are not afraid to do their own work. They feel safer. One client wrote to me: “I trust you with my stuff because you are real – unmasked – and have done (and still do) your own work. And you don’t set yourself up above me, as better than….” John Pierrakos, MD taught that the therapist-client relationship is not hierarchical; it is a learning partnership of evolution. Most of us were not taught that we can more effectively assist our client by modeling the authenticity of our humanity.
If you are a therapist, you will have countertransference. I still have countertransference after 40 years of working as a psychotherapist. The stuff that I don’t see or am not conscious of is the “killer”; when I become aware, it is life-giving.
My countertransference is my teacher. It assists me in knowing more about my client and me, therefore making me better able to help. Gold mine! And when I have not been aware, my countertransference has been hurtful to my client. Uh oh – Land mine!
We all, at some time, have uncomfortable stuff that shows up when sitting with a client. Transference lives in the realm of the Wounded Child with its deep unresolved painful feelings. We steer away from our feelings in sessions because they are scary, by virtue of the fact that as kids we were not allowed to have them or they were too painful – so we stuffed them down into our unconscious. If we are aware of our disturbing feelings, we may fear feeling or sharing our emotions will show our weaknesses or show us as unprofessional. It makes us uncomfortable to even feel inside ourselves. We may fear it reveals or suggests incompetence. Our culture often teaches us not to show weakness – sadness, anger, fear. Many of us, therefore, prefer to mask our feelings, pretend we don’t have them. The kicker is that sometimes we are taught to mask our feelings; in the very professional licensure programs we hope to teach us how to handle clients’ deep problems.
Current psycho-neurology informs us that we must work with clients from the “bottom up”. That is – we need to be able to be aware of and know how to handle our clients’ fight-flight-freeze response of their reptilian brain, and the emotions of their mid-brain. Only then can we helpfully use cognitive skills with clients. We can only truly know/feel these things by having the experience of dealing with our own traumatic biologic responses.
Becoming consciously aware enough to “see” or know when our own transference issues are being triggered is what we strive for as therapists. We may then have clarity about what our “stuff” is that we need to work with, versus what is the client’s, which we can help the client explore. A client wrote: “Literally kicking, crying, yelling, and other work to express and heal my Wounded Child, has allowed increasing clarity, compassion, and the objectivity to not take a client’s anger personally, which used to bring a protective wall. I am now more undefended and even joyful in my work, for which my high self strives.”
Luckily for our own transformation and growth, we always have a part (our high self) that wants us to bring the dark into the light. We need to make friends with our shadow side to some degree; doing so will help us heal from the repeating patterns with which unawareness plagues us.
When we are able to work with our transference and feel grateful, hopeful and welcoming of the learning – even when it causes us some suffering – we can be good role models and more effective helpers for our clients. This will lead to our clients feeling safe, and we can then assist them to better learn from their transference with us.
Here are some examples of countertransference trouble that became Countertransference Gold when worked on by the therapist. As always, names and identifying info are changed in case examples.
Roy hired Sandra, a former student of his, to teach a form of therapy at the university. After a short honeymoon period, problems really began to show in their relationship. Sandra acted out her part by not showing up at an important faculty meeting and not telling him. Later she “blew me off” by saying that she did not like to do what he told her all the time. Roy, normally a clear, grounded man, acted out his transference issues by feeling incapacitated by the anger he was feeling. Roy felt awful and confused about what to do. In consulting with me it became clear that Sandra was acting out her unresolved father issues with Roy and Roy was treating Sandra as the sister he had a lot of trouble with in his teenage years. During our work together Roy’s tough defended façade, his mask, crumbled and Roy was surprised but relieved to be able to cry about the loss of his sister during that pivotal time. He said his heart felt broken. He was then able to see Sandra more clearly as herself.
With my encouragement, he had a talk with Sandra explaining as best he could, what he saw and felt was happening. This allowed a softening and gave Sandra the opportunity to feel her own transference, which was how being around Roy made her feel small, young and helpless. She had unresolved issues with her father and Roy became the catalyst to excavating the wounds that had become her unconscious feelings. When both worked on understanding and feeling their deeper pain, things between them improved greatly.
Suzanne, a therapist in her first year of private practice made an appointment for supervision.
She told me in session that she was so turned on by her very attractive, smooth-talking, dripping-with-sexuality, male client that she could not concentrate on their session. “I could not stand it!” Suzanne told me. “My client said he had so much love to give his girlfriend, and that all he wanted to do was to be with her.”
As we talked about her client it was obvious to me that her client was acting very much from his mask, not really knowing about, or grounded in, his true sexuality. He was needy, desperate in fact, to be with someone – and his acting-out with sexual body language, voice, jokes, and sexual innuendos, was a cover-up.
But my client was fooled. There was countertransference resonance. She was needy also. She had not had sex with her husband for years. She wanted to be turned-on to someone – to be turned-on, period. When I questioned and encouraged her deeper personal process she realized and said, “I know those are the things I want to hear someone say to me.”
Suzanne had longed for her husband to say those same things to her. She wanted to hear him say, “I have so much love to give you, all I want is to be with you and make you happy”. Maybe she simply longed for love. Her own dad did not do a good job of giving her a positive foundation of love in her early years and he died when my client was 13 years old, just when a girl most needs a father to be a role model for her future relationships. She longed for her father to say those words: “I love you. I want you to be happy.” She (we all) wanted Dad to give us inexhaustible, unconditional love.
So, Suzanne got hooked! We talked about how she was triggered and what she really wanted, and from whom. By the next session, two weeks later, she had begun to see through the mask of her client. No longer seeing him as so desirable – capable of giving real grounded love to her – or to anyone, Suzanne knew she needed to reach out to her husband for what she wanted, or to get love elsewhere – certainly not from her client. She was not pulled into her seductive client’s needy snare any longer.
Fred was a relatively new client to Richard. Fred normally held his body very tightly – stiffly. When Richard, his therapist, tried to help him release emotions – when Fred got even remotely close to a feeling, Fred would get scared and contract his body even more. Richard tried all he could think of, with few satisfying results. The longer Fred did not do what Richard thought he should do, the more uncomfortable Richard became.
Maybe I should refer him, he told me. Often the feeling of needing to refer someone – or get a new therapist – is a sign to search more diligently for the transference. We worked with this thought and his feelings and Richard began to sense his fear of failure. Richard’s father would berate him when he could not do things well within the first few tries. Richard was feeling like a child again. That is rarely a good place from which to be a therapist – scared and physically defended.
“Here it is,” I thought.
“What are the feelings Fred is repressing, do you think?” I asked Richard.
And later I asked, “And, what kind of a dad did Fred have?”
“His father was a bastard,” Richard blurted. “He hit him if he did not know his times tables!”
We were silent for some moments.
“Well this is beautiful, actually!” I proclaimed. Richard looked surprised.
“OK, so your dad and Fred’s dad were similar. And you probably feel scared too.”
Richard did not immediately see the beauty in this but he did begin to soften and feel his fear. He cried softly. This was the healing moment for Richard and later helped him work with Fred more compassionately and reportedly, more effectively.
We all need our own therapy. We need constant reflection, and vigilance about our own unresolved issues – that’s the tricky part – when unresolved, we often aren’t aware of them, so we need to ask for help. Someone with an unbiased and objective perspective can usually see our issues before we can, just as we, as therapists, can most often see others’ issues more clearly than our own.
When I feel uncomfortable about something that is happening with a client, first I look at myself. How may my unresolved feeling be impacting the therapy? If stumped, I still need help from a supervisor or therapist. Often I consult with a colleague. Sometimes I hire someone, with more experience and known to be good with countertransference issues.
I am honored to assist therapists with discovering their true selves – embrace working on themselves in therapy – and am most grateful to those who have and still assist my journey. As Super Shrink John Pierrakos taught: when we explore our own issues and work to “unmask, confront our demons, ground, and find our deep truth – our high selves” – we can become more conscious, expanded – and a happier, healthier, more effective therapist.