#27 Transference for beginners.
What I would say in our first supervision session.
Dear friends,
Supervisees often seek me out because they are interested in making psychoanalytic theory a more meaningful part of their work. They’re sometimes new psychologists, so have probably just been through a traumatic training experience and have had their confidence shot to pieces. Or, they’re not psychologists, have a complex about not being psychologists, and that has shot their confidence to pieces. (Becoming a therapist is kind of rough!!!)
Either way, I don’t want to be another imposing presence pressing on their self doubt, and I also don’t want to be part of the institutional tendency to present psychoanalysis as something inaccessibly highbrow. I do, however, want to teach them something.
When we’re starting out, I always talk about transference. It is easily the most widely applicable and useful part of psychoanalytic theory; and probably its most central tenet. Without transference, Freud’s theory of the unconscious would have no applicability to psychotherapy - if our important impulses and thoughts are beyond our conscious access, how are we supposed to track them down? Transference is the answer - the means by which, as therapists, we can gain clues to what our clients feel, know, and suffer of, but cannot tell us about.
Extremely clever people have written whole entire books and courses and essays on this subject, and you should read that stuff if you want to, but I think even an introductory level of knowledge on this subject can be transformational to one’s work and life. This is true not only for therapists, but any kind of medical or helping professional, people in customer service, and basically anyone who has relationships with other human beings.
Here’s how I explain it to someone just starting out:
Transference
Our patients have a myriad of reactions to us. Sometimes, it starts before we’ve even met, and sometimes, it arrives slowly over time. Some are extremely critical of us, telling us we charge too much, we don’t know what we’re talking about, we’re not helping. Alternatively, they might be very complimentary, about our clothes, our curtains, our clever insights. They might forget to pay our bills, or never leave enough time to find a park before their session. They might refer us all their friends, or ask a lot of personal questions, or find us disappointing and wish we would give them more direct advice.
It is easy in some of these situations to take all of this literally. We might feel like something is going wrong that needs to be tightened up or fixed. Perhaps in another type of situation, we might provide suggestions for good parking spots, or educate the patient about how therapists don’t normally share lots of personal details about their lives with patients, and request that they stop enquiring. We might think we’re doing a bad job, and print out some worksheets, or do some extra preparation to make the client more satisfied with what we’re offering. Alternatively, if the patient is effusively grateful at the end of every session, we might feel confident that the therapy is going really well. Many other types of therapists use this kind of feedback literally, implementing measures or surveys to check if the therapy is going well, and establishing KPIs to ensure they’re engaging in “best practice”.
But when we are working psychoanalytically, we don’t interfere or infer in these ways. Instead, all these dynamics become data points, little clues to the inner architecture of our patient that has become so intrinsic to them that they cannot describe it to us. We recognise at least some of these reactions as transference - old, automatic, constant reenactments and restagings of familiar dynamics from the past. Rather than taking it personally (for better or for worse), we can take these opportunities to ask:
What does this dynamic tell me about how this person experiences relationships?
How are they inadvertently setting up our relationship to mimic the other ones in their life? Especially the ones they find disappointing, hurtful, or frustrating?
What might this tell me about how they anticipate being treated, and how they’ve learned to treat others?
Countertransference
On our own side, as therapists we also have reactions to the people who walk into our consulting rooms. They might make us feel angry, or bored. They might make us think we’re the best therapist who ever lived, or the worst. We might notice ourselves thinking about them a lot outside of sessions, or realise we’ve forgotten their appointment for the second time when we’re normally very organised.
If you’re trained in another therapy modality, it can be easy to feel guilty about certain kinds of reactions, and to think we should only feel one certain kind of way towards our clients. It can also be easy to default into seeing any deviation from this as failure, or a reflection of some personal flaw or limitation. But working analytically lets us use a different kind of mind in these situations. In place of judgements against our reactions, we can be curious about what they might tell us about the person we’re sitting across from, especially if our reactions are unfamiliar, or make us feel like we are not entirely ourselves. If we know ourselves well enough to recognise our own familiar patterns and staging (our own transference, that comes from our own history of relationship), we can recognise these less familiar inductions as countertransference - a response to the projections and evocations of the patient’s transference. Instead of automatically scolding ourselves for being bored, or late, we can ask:
Is this how other people in this person’s life feel? Why?
Is something subtle happening between us to make me feel this way?
Am I feeling something the patient feels deep down, but cannot acknowledge?
Is my feeling a clue to something hidden, denied, or unspeakable?
The nuances of this exploration require months and years of study, practice, and contemplation, and require genuine self understanding to control for what each of us brings to the relationship as another fallible, complex human presence. Specifically, teasing out our own histories from the reactions evoked in us from the script handed to us by the patient is arguably lifelong work. But I have seen so many times how just the premise, the possibility that everything is not as it seems, can be truly transformational in the work.
We are not separate from one another, acting from concrete expressions of a fixed self, but rather sitting in each other’s atmosphere, cast in each other’s play, magnetised to the unconscious mechanisms activated by the whole history of each person we encounter. It is only by exploring these mysteries that we can really get to know ourselves, and then our patients and those with whom we share our lives.
In love, and the pursuit of a shared path to a greater truth,
Kate
PS. If you’re a therapist and want to expand your knowledge of psychodynamic therapy, I offer clinical supervision online to therapists around the world, and locally via my rooms in Brisbane, Australia. I also offer one-off consultations if you just want to chat about one specific idea.
I disagree. There are other pathways to the unconscious. Dreams and free association in the world of the psychoanalytic need to be added. Unless one has mental illness that requires clinical interventions then there are non clinical pathways.