Using Countertransference

I have been working with a client for about six months, and he doesn’t seem to be making much progress.  Lately I’ve been feeling bored in the sessions, and I think maybe I should stop seeing him or refer him out for a different type of therapy or a group of some kind.  He comes every week and hasn’t expressed any dissatisfaction with therapy, but I have started to dread the sessions.  

This situation brings up the issue of using our personal responses, or countertransference, to the client to make decisions about the progress and process of therapy.  A previous blog addressed this topic in terms of understanding the client .  This post will look at how our personal responses help us understand ourselves.  The tasks that foster professional development and identity are covered in Chapter 14 of my book.

The term countertransference is used to describe the feelings that arise in us during psychotherapy, and it is an important tool in the therapeutic process.  There are many potential meanings to your feelings of boredom, and I’ll review several.  Self-reflection on your own, with your supervisor or consultant, and with your personal therapist will guide you to the meanings that apply to your experience with this particular client.  I start with the assumption that your boredom is an indication of a difficulty with this client that hasn’t emerged directly in your awareness, and I’ll suggest some areas to explore.  

The first area for exploration is whether you are experiencing emotional responses to your client, in addition to boredom, that may bring you discomfort.  In your next session, notice the full range of emotions that are present for you.  You may notice frustration, aversion, fear, or other emotions that you judge as incompatible with your therapeutic role.  Your boredom may be covering other more intense emotions that are unpleasant or uncomfortable but warrant exploration in supervision, consultation, or personal therapy.  The client may remind you of a difficult situation in your personal life or with a previous client, and it will be helpful to differentiate that past situation from your present one.  

A second area to examine is your interpersonal style regarding confronting or avoiding areas of potential conflict.  If you tend to avoid discussions about difficult topics, your boredom may be a manifestation of that avoidance.  Reflect on the therapeutic process with this client, and look for obstacles that may have arisen between you.  Example are  times when the client did things that undermined the therapy, when he externalized responsibility for his depression, or when he subtly devalued the steps you and he have taken toward progress.  If this is the case, it will be necessary to find a way to address these obstacles directly rather than to withdraw.  

A third area for reflection is whether you are feeling dissatisfied in other aspects of your work.  If so, your dissatisfaction may be reflected in feelings of boredom with this particular client.  For example, you may be scheduling more clients in a day than is comfortable, your employer may have changed some administrative requirements in ways that feel unnecessarily burdensome, or you may have agreed to see this client at an inconvenient time.  If any of these factors are present, your boredom may express your need to address your work habits or agency requirements.  

I hope these suggestions give you some ideas for how to understand the meaning of your countertransference responses, which contributes to your self-knowledge and professional development.  If you’re interested in reading more about this and related issues, click here to order from Amazon or here to order from Routledge.