Saturday, October 29, 2016

Countertransference

coun·ter·trans·fer·ence
ˌkountərˌtransˈfərəns,-ˌtranz-/
noun
PSYCHOANALYSIS
  1. the emotional reaction of the analyst to the subject's contribution.


As a therapist I have experienced countertransference many times. Most people assume it is a negative reaction to  a patient... and sometimes it can be, but also it can be an overwhelming rush of empathy.

I have several patients who tug my heart strings and leave me thinking of them at random times. I do keep boundaries in place and I am self aware, but in the end, I am human...

Yesterday a young man sat in my consult room weeping. He reminds me a bit of my nephew, similar features, similar background, similar upbringing...
This is a young man working on his masters, who has an incredible vocabulary, comes off as intelligent and self aware, exhibits strong values, but has had his heart broken by the world.

He feels he is "not good enough" because a woman toyed with him, used him and then cruelly dumped him. He insists if he were 6' tall, blue eyed and blond she would love him... He hates himself, he says. He feels betrayed by his brother too... he loves his family but honestly when he talks about his brother, his brother sounds like a spoiled brat who also takes advantage of this guy. We are working on boundaries and self esteem. He is a sweet man but many will not look past the exterior to see that. 

Another patient, an older female, comes in and is visibly nervous, shaking, eyes darting around. The student shadowing me conducts one of the screens I use to determine diagnosis. I review it and talk to the woman about how she is showing signs of depression and anxiety, but given the history we just took, it appears situational. So how can we help? We talk about case management and put some resources into place. She bursts into tears. I ask what are the tears about? She replies, she was scared that I would put her in a "padded cell and tell me I am crazy". She states she didn't realize that we could help in so many ways. My heart breaks for her, she is so grateful and relieved to discover that she is "not crazy after all".

They come in and out of my door, the broken and wounded. My time with them is short. I often pray during the session "God help me help them". And I believe he does...

I can see how everything that has happened in my life has prepared me for this job. How all the pain, all the joy has enabled me to feel along with the patients. How it has broken open my heart so I can find something to love in them all. 

I do have countertransference, I do love them. I can't save them all, but I can love them...

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