This was originally written on 3/27/2021.
What is countertransference? It’s often thought to be something like “what a therapist brings into the consulting room.” To an extent, this is true, in a somewhat reductive way. More particularly it might be thought of as the unresolved relationships or conflicts that a therapist re-enacts with their own patients; transference on the side of the therapist, as opposed to the side of the patient. I’m certain I’ve had plenty of countertransference reactions to patients before that have slid by unnoticed, but I had a recent experience that felt much more weighty and important. This is what I’d like to write about today.
Enter Roger, the pseudonym I’ll be using for one of my patients. Roger is a young teenager whose parents have been going through a rough patch. During one session Roger told me about how angry he is towards his father, and how simultaneously reluctant he feels to express that anger. We spent our time together describing that anger, giving it a voice and space to breathe, and then I told Roger, “now go tell someone else” as the end of our session.
When I said that it barely registered as something that might be a mistake. I said it automatically. When he left and I had a moment to myself, it immediately crossed my mind that I had just made a really big mistake.
First of all, I had given a directive to a patient, something I’ve never done except in really minor ways (for example, suggesting that someone who feels overwhelmed by a job they don’t like but has time off they can take, take some of that time). The overly pointed and specific way that I had given a command to this patient struck me as not a good thing.
Second of all, the overall structure of Roger’s situation felt very similar to my own when I was younger: my dad came home one day, told my mom that he was done, and then our lives were turned upside down. I had some anger on my own part that I was reluctant to express; or when I did express it, I was met with condescension. Clearly this had entered into my intervention with Roger. Of course, this hadn’t crossed my mind during the session and it wasn’t until after that I realized my mistake.
Something else happened later that has really made this experience stick out for me: I had a dream about this patient, something that has never happened before with any other patient I’ve ever seen. In the dream I was wandering around a school trying to find my way out. Everywhere I went in the school Roger followed. Eventually I found myself walking up a staircase, turning around to Roger, and yelling “No!” over and over. That was the end of the dream.
A week or so after that dream I reported it to my analyst, who had a few different interpretations to offer.
- The dream stages the fulfillment of a wish: I tell Roger not to follow the command I (mostly) unwittingly gave him, and fix the mistake I made.
- In the dream I tell myself not to be so easily swayed by my own history.
- This one draws a lot more from other parts of my analysis, but even without all that it’s still useful: my inability to leave the school stages the fact that there is no escape from certain facets of life, primarily that to get anywhere one must do the work first. One can’t become an analyst without doing the work that entails.
To leave off, I’d like to remind myself about something my analyst has said a few times before: after going through an analysis, a patient isn’t left without an unconscious. An analyst doesn’t become a passionless interpretation machine who never experiences any emotion or countertransference. Rather, an analyst is someone who has gotten something of a map, incomplete though it is, of their unconscious, and so has a way to set it aside when necessary.