This blog is mainly interested in the connection between mood disorder, such depression, anxiety, OCD and PTSD and nutrition. Articles are for educational purposes only. Self-help therapy should only be in partnership with qualified health care practitioners

Friday, July 17, 2009

Transference in Counselling

Transference in Counselling

by Jurriaan Plesman, BA (Psych). Post Grad Dip Clin Nutr
Transference usually refers to a an emotional relationship between a client and an counsellor, where the counsellor is seen by a client as an important figure in the client's life, such as a parent, or sibling. For example, a client may see his counsellor or analyst as a father figure, or perceive the client/counsellor relationship to change into "love relationship". This alone may cause grave consequences for both client and counsellor. Emotions and desires originally associated with one person are now shifted to another person usually for the sake of therapy.
The concept of "transference" is usually associated with psychoanalytic theory and psychotherapeutic practice, that holds that many of our emotional problems have its origin in our childhood experiences. Thus a problem with authority figures is seen by many psychoanalysts to stem from a person's relationship with one or both parents or other parent/significant persons in the past. Thus a rebellious youngster may have a negative expectations from his counsellor. Parents who may have been reserved in expressing their feelings of love, may have created a low self-esteem in a child, who may then have developed a negative self-image as an adult. Many psychoanalysts seem to encourage the unconscious redirection of their clients' feelings towards themselves. This is believed to provide a therapeutic opportunity - so the theory goes - to address this "emotional problem". By providing a different interpretation of the origin of feelings, it is expected that a client will able to deal with an undesirable emotion in a more mature way.
The concept of transference should always be discussed together with "counter-transference" in a counselling situation. This refers to the emotional reactions of the counsellor to the client, that could misfire. See here . A counsellor who unwittingly enjoys being flattered or being able to control an other person by transference could easily instil a mutual interdependency between client and counsellor, thereby reinforcing a pathological submissiveness in the client, as well as an unhealthy reluctance by a counsellor to give up his authority over a client. But regardless of a counsellor's theoretical philosophy, every counsellor should be aware of transference in a counselling relationship, as exemplified from a personal counselling experience.
One day, a female client came to see me for an interview in order to prepare a social history for her coming court appearance. She took an instant disliking to me and reported me to my supervising counsellor. She said that she could not stand "this counsellor" and demanded to see another, because I reminded her too much of her grey-haired father. My supervisor - quite familiar with the phenomenon of transference - advised the client to report back to me and express her dislike to me. In the next interview she expressed her hatred of her father and realizing that we were dealing with transference I ask her to play the role of her father and I would then play the role of the client. In other words, we had an interesting session of "two-chair" work as in Gestalt therapy and also explained here . She attacked me in the role of her father and I countered her accusations with strategies employed in "Assertiveness Training Program". See here . She really enjoyed that session and we had a great laugh after that. She now wanted to learn all about how to handle her father the way I did from now on.
Counsellors who adhere to a more rational cognitive (RC) or rational cognitive behaviour therapy (RCBT) viewpoint - like myself - would view such an "transference as a therapeutic tool" with some caution. They tend to view a client/counsellor relationship to more like a "teacher/student" relationship, where emotions are discussed in an "about" fashion and from a more rational point of view. Here, undesirable emotions are more likely to be viewed as stemming from irrational attitudes and believes in the here-and-now, that upon calm analysis and considerations should be abandoned, if we want to get rid of unpleasant emotions. We may have to "re-learn" our thoughts by a repetitive learning process. Thus counsellors using RCBT insist on considering their clients to be fundamentally rational and looking at problems in the here-and now. This alone would bestow self-respect in the client.
It should be pointed out that both these approaches have some benefits and there are many others, but they tend to overlook the biological aspects of human behaviour. I believe that underlying biochemical factors play a primary role in mood disorder and need to be treated first, before considering "psychological" factors. In terms of TA I prefer to have an ADULT to ADULT relationship with my clients, where the aim is to make the adult ego or the "analytical mind" in control of our unwanted emotions.
Here are some more book references on Transference
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