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Dr. Amanda Fialk: Countertransference was a topic that came up at the dinner which sparked a lot of great conversation. We spoke about countertransference and how important it is to be on top of countertransference, especially when working with families. When we’re working with families, it’s not just one person — there are many people that we’re having reactions to at the same time. Can you expand on your thoughts on countertransference, and managing and understanding it?

Shara Turner: As we talked about at the dinner, countertransference can’t be a bad word in the therapeutic community. We have to be willing to talk about it, address it, and bring it to light. It comes up all the time, because we’re humans with human experiences, emotions, feelings, and thoughts. People will pull at our heartstrings and we’ll want to be their savior one day, and the next day someone will do something that will remind us of our abuser and we’ll want to repel them away. Those things will just always come up because of our human nature.

For me, I breathe before I speak. When I hear something and I feel my stomach churn a little bit, I take a second to tell myself to take a breath before I say anything. That pause allows me a moment to reflect internally on what I’m feeling and what I’m about to say. And, if I think what I’m going to say has any kind of personal bias, I’ll just keep asking questions. The more I stay in curiosity, the less countertransference I have. When I get into that judgment space, that’s when I can start becoming a fixer or giving advice. When I stay in curiosity, the relationship is much more attuned between myself, the client, and the family members as a whole.

I saw a family recently, and it was obvious to me that the mother held a problematic role within that system — there was a lot of resentment towards her husband, infidelity, and substance abuse. And in the middle of the family program, her son was in the middle of speaking about his experience when she let out a huge, very audible sigh. I just stopped everybody and said, “Okay, let’s name what’s going on right now. I’m not trying to call you out, but let’s name what’s happening because all the energy just got taken to this side of the room.” It wasn’t judgmental, I just got curious about what the energy was. They all felt it, and had I not named it, it would have just lingered in that room. Staying curious, and of course, breathing, are always the tools I turn toward when I feel any of my internal biases surfacing.

Dr. Fialk: Those are such great strategies. One thing that helped me was when I was in analytic training, my first supervisor advised me to keep a diary. And after every single session, before writing the session note, I would sit with the diary and just spend five minutes writing about how I feel. I don’t do as much direct clinical practice anymore, but when I do, I still keep a diary. I occasionally like to read and reflect on it over time — it helps me to understand where I easily get poked, which specific presentations or specific clients may elicit internal feelings.

As you mentioned, I don’t think countertransference is a big, bad, dirty word. In fact, I think that if we really lean into it and have a tremendous amount of self-awareness about the feelings that get brought up in the work that we do, it can be used as such a valuable tool, especially with complex client profiles who have everybody scratching their heads. I’m at a point where I feel like I can use my counter transference to help me get more diagnostic clarity because of all the patterns I see.

We’ve come a long way in the field in terms of understanding that this work isn’t like classical Freudian times anymore, where you’re not allowed to have feelings or emotions as a therapist.

We’ve come a long way, and I think that we still can talk about it more, especially with newer clinicians in the field, who may experience a lot of shame around navigating angry or hostile feelings towards our clients, or even really positive feelings. It can be scary for our clinicians to feel this way.

Clinicians are human beings too. We’re allowed to have those feelings, but they can’t interfere with the work that we’re doing. In talking about these feelings, the chance of our feelings getting in the way of our work decreases. It’s so important to give time in supervision to talk about countertransference, both on a one-on-one and group basis.

Turner: That’s right. Supervision is crucial. I still regularly sit down with my therapist once a week to talk through and reflect on that week’s sessions and events. I ask for guidance and help, because I don’t have all the answers. I’m human, and countertransference can come out of me too.

Another point of countertransference that is so important to remember is to not let our own biases or values get in the way. For example, if there’s a person that comes through the door from a cultural background or environment that we’re not as familiar with, we need to do some research. It’s really important that we’re well versed in anybody as much as we can be, and for the things we don’t know, we must ask questions and stay curious.

Dr. Fialk: I was just about to say the same thing too. We have an obligation to always be curious and to be lifelong learners. And that we are constantly learning about different cultures, different identities, and trying to do so in a way that is curious and not judgmental, which is really tricky. We’re human beings, and of course we’re going to have reactions to the practices and beliefs and ideologies of certain cultures, especially if they run counter to some of our own morals and values.