Troubleshooting Counter Transference Ellen Seigel LI SW 2016

What are we going to do: • Setting your intention for this session • A view of our work with clients • Definitions • Variety of ways Countertransference shows up • Examples • 4 Manifestations of Counter Transference • Mental Checklist • Summarize 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

Looking for New Info (Even in areas I feel I've worked on to an extreme within myself). I'm expanding my self awareness to better serve clients (and I get bonuses for myself). 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

One of many ways to look at a client's work with us: • They are in some kind of situation (upsetting, limiting, oppressive, traumatic, triggering all manner of feelings within them. ) Our stance: • Self determination • Unconditional positive regard • Welcoming, attitude of helpfulness (not codependent) • Learning about the client, their relationships, their view of themselves, situation. Educating: • Feelings -- behavior -- developmental crossroads/tasks/stages milestones of growth -- effective communicating -- boundary setting • Self caring inner experience and outer action 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

Emotional Support: • Understanding, validation of client's perception albeit it has possibly created for them - pain and problems • Support for recognizing and acting from strengths - even negativity • Attention to what the client says and putting your mind together with theirs • You're inviting, setting the stage for development and nurturing the: Ø Therapeutic relationship Ø Therapeutic alliance Ø Client's growth 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

TRANSFERENCE (from Wikipedia, the free encyclopedia) Transference is a phenomenon characterized by unconscious redirection of feelings from one person to another. One definition of transference is "the inappropriate repetition in the present of a relationship that was important in a person's childhood". [1] Another definition is "the redirection of feelings and desires and especially of those unconsciously retained from childhood toward a new object". [2] Still another definition is "a reproduction of emotions relating to repressed experiences, especially of childhood, and the substitution of another person. . . for the original object of the repressed impulses". [3] Transference (German: Übertragung) was first described by psychoanalyst Sigmund Freud, who acknowledged its importance for psychoanalysis for better understanding of the patient's feelings. 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

COUNTER TRANSFERENCE (from Psychology Glossary) Counter Transference is a situation in which a therapist, during the course of therapy, develops positive or negative feelings toward the patient. These feelings may be therapist's unconscious feelings that are stirred up during therapy which therapist directs toward the patient. 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

A FEW PRINCIPLES for looking at this Today Do you recall this from the beginning of SW school? I have no judgments, no negative values, I'm non judgmental We all have feelings in the face of whatever is before our eyes/ears Aware of, not aware of sub/un conscious Feelings and thoughts: • Like a crush, they just come up • They are bound to come up for us! 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

A FEW PRINCIPLES for looking at this Today Conscious Use Of Self Awareness enables us to choose if and how much of an expression to reveal. The Real Reason We Chose Social Work ? ? ? Physician Heal Thyself We teach what we need to learn. 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

HOW COUNTER TRANSFERENCE SHOWS UP Let's hear some Counter Transferencial situations: Me: Sleepy something's coming up for me A push of resistance inside (identifiable or not) Something I don't know about Never think it's because you are tired : -) Shock expression, unanticipated. . . When client came in dressed in an extreme way - (triggered my thought of a doll in a Twilight Zone episode) Shock on my face, talked us down, client educated me about a style of dress in Japan that's popular among Anime (hand or computer animation) fans. 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

HOW COUNTER TRANSFERENCE SHOWS UP Judgmental --- heterosexual couples, me fighting wanting to take sides When this first occurred (even with lots of training) it put me in touch with the benefits of focusing on my marriage Client leaving therapy Strong feelings one way or another Mind wandering Twitching Need to use the restroom (I go between clients) Other items on definition sheet 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

4 Manifestations of Counter Transference 1. Subjective - therapists own unresolved issues is the cause (harmful if undetected) 2. Objective - therapists reaction to his client's maladaptive behaviors is the cause (can benefit therapeutic process) Example later 3. Positive (not productive) - therapist is over-supportive, trying too hard to befriend his client disclosing too much (can damage therapeutic relationship) 4. Negative - therapist acts out against uncomfortable feelings in a negative way, including being overly critical, and punishing or rejecting the client. 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

1. Subjective - therapists own unresolved issues is the cause: Mirroring Your Own Issues - even if your situations are very different from the clients‘ and even if you've done a lot of healing work (Just relate to the ones that resonate with you!) Issues we all get to navigate through: (and clients bring up variously) • Not getting what we wanted as kids (material or otherwise) • No or misplaced attention from adults/caretakers/parents if you had them • Emotional needs unmet • Treated not nicely (at times or all the time) • Peer rivalry (including sibling rivalry) 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

Often, various types of trauma, loss, pain etc. and many people: none or inadequate shelter, food, clothing, caretaker attention, education, loving touch and many physical, sexual, emotional abuse. Feelings about ourselves (demeaning self conclusions and adaptive/defensive and compensating decisions from early childhood) • I don't count, I'm invisible, I'm expendable • If they loved me, they would _____ • I'm not good enough, I'm defective, There's something wrong with me • I'm inadequate • Feeling inauthentic (I have a persona), acting one way and feeling differently on the inside, etc. • Confusing dots we've individually connected as children (understandably so) • Anger and violence are associated • Food and love, approval, ways to receive attention • Food and irritation, bickering, yelling etc. • The difference between how things are (how we experience them) and how (we think) they SHOULD be (where did we each pick this up from? ) 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

We all get to respond in our own ways to the above: • Disappointment • Desperation • Deprivation • Great creative approaches (decided upon) to get through the pain, confusion; upset/disturbances/horror/demeaning • Powering through • Toughing it out • Becoming quiet and reserved, stay out of the way • Hiding • Being the best girl or the best boy • I will fight my way through • I must do "it" myself; I'll never ask for help • I refuse to do anything I'm told to do by these people who don't respect or (care to) know me • I'm invisible, why bother? • I'll just wait 'til someone comes to take care of me • Asking for help and not getting it • I refuse to accept that there's no one here who will help me 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

2. Objective - therapists reaction to his client's maladaptive behaviors is the cause (can benefit therapeutic process) For example, a therapist who feels irritated by a client for no clear reason may eventually uncover subtle unconscious provocations by the client that irritate and repel others, and thereby keep the patient unwittingly lonely and isolated. This understanding can be used to assist the client. In using countertransference this way, therapist must consider multiple sources of his or her feelings. Feelings, positive or negative, may be evoked by the patient. These are particularly helpful ones to notice, especially when the cause is not immediately obvious, as in the example just given. 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

Often, however, feelings may be stirred up by irrelevant characteristics in the patient (e. g. , the client physically resembles therapist's sibling or spouse), by the prior client, by factors unrelated to therapy (e. g. , bad traffic getting to the office, a quarrel at home, an upcoming vacation). This strongly argues for dynamic therapists to pursue such therapy themselves - • Assertively facilitate their own growth. • Tuning yourself as the instrument to better distinguish countertransference evoked by the patient, versus similar feelings that arise from other causes. • Freud's advice for analysts — to seek additional analysis themselves in the face of countertransference — is wise. 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

3. Positive (not productive) - therapist is oversupportive, trying too hard to befriend his client, disclosing too much (can damage therapeutic relationship) • Co-dependent rescuing • Taking on responsibilities for therapy that are the client’s: Ø Helping client arrive on time Ø Repeatedly requesting payment • Thinking about the client more than you feel is fitting during your off time. 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

4. Negative - therapist acts out against uncomfortable feelings in a negative way, including being overly critical, and punishing or rejecting the client. Examples of punishing or rejecting behavior on the part of therapist: 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

What else? Feelings may be stirred up • By irrelevant characteristics in the client (e. g. , the client physically resembles therapist's sibling or spouse) • By the prior client • By factors unrelated to therapy (e. g. , bad traffic getting to the office, a quarrel at home, an upcoming vacation) 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

What else can taint your attitude toward the client? Identifying with Victim Consciousness, beyond empathy. Pressures of the agency: • You need your job and you are dissatisfied that the agency doesn't support your doing what you feel the client needs • Other dissatisfactions with the agency values you disagree with • Child program coordinator. . . administrator said the parents are always right • No room for education, "Really? " Ø Hebrew High School, had expelled after one offense of smoking or other rule breaking Ø Catholic school, no education regarding birth control permitted 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

MENTAL CHECKLIST 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

MENTAL CHECKLIST Conscious of possible counter transference? (1) Is this feeling characteristic, i. e. , Do I have it much of the time? If so, it may say a lot about me, but probably nothing about the client. (2) Is the feeling triggered by something unrelated to the client? Feelings caused by hunger, one's personal life, bureaucracy in the agency, and so forth are not useful data for helping the client. (3) Is the feeling related to the client in an obvious way? Feeling put off by a client who is acting out emotionally is countertransference of a sort, but not very illuminating. And finally, (4) Is the feeling uncharacteristic of therapist, a reaction to one particular client, and yet the exact trigger is not immediately obvious? These are the most helpful feelings to notice in oneself, as they often shed light on subtle yet important dynamics in the client. 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

SUMMARY • We set our intention to be open for new information for this session • A view of our work with clients • Definitions • Variety of ways Countertransference shows up • Examples • 4 Manifestations of Countertransference • Mental Checklist 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

Counter transference is not always helpful. Particularly when it is unexamined — or, worse, unrecognized — it can indeed interfere with effective treatment. This can occur even with positive countertransference, as when a therapist is so entertained by a client's jokes that a underlying bitterness is ignored, or when an attractive patient is never challenged because therapist desperately yearns to be liked. More often, though, countertransference is problematic when it is negative. The therapist feels bored, irked, paralyzed, or contemptuous in the presence of a particular client. It is therapist's job to recognize these feelings and deal with them. Occasionally a therapist must refer the client to a colleague when the original therapist's countertransference is unmanageable. Fortunately, in most cases these uncomfortable feelings, once recognized by therapist, can not only be understood but also used constructively in the treatment. © 2010 Steven P. Reidbord MD 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

THE INNER AWARENESS MODEL 1. Eradicate Victim Consciousness 2. Heal loose shreds and threads of old emotional wounds including self limiting thoughts and erroneous self demeaning conclusions 3. Assertively and continuously facilitate your own growth 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

EXPAND YOUR SELF AWARENESS CONTINUOUSLY 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

Download at the NASW OH Conference Site: • Troubleshooting Counter Transference Power. Point slides • References • The History of Counter Transference • Mental Checklist 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW

For more information: Ellen Seigel, LISW-S, ACHT, LCSW 614 -842 -4374 ellen. seigel@gmail. com www. Heart. Centered. Healing. info Private Practice in Worthington, Ohio: Psychotherapy / Hypnotherapy Supervision Free downloads available at: www. Be. Happy. No. Matter. What. com 614 -842 -4374 © 2016 ELLEN SEIGEL, LISW