PSYCHOBABBLE 2A There are two words that get used frequently in my profession that while in practice, are occuring throughout the process, ( one could posit they ARE the process), they are often not really understood by either the therapist or client. They are also very good examples of Psychobabble and are household terms in mental health circles. I will write these two as seperate articles as they become lengthy. The two psychobabbe jargon: Transference and Countertransference. TRANSFERENCE We see our client sitting in the chair glaring ferociously at us and all but shouting what a rotten therapist we are. HA ! We nod knowingly and feed back to them, " What is happening here is called Transference". BIG mistake. This is another instance where psychobabble has become so entrenched in our society and into our vocabulary that so often we use it to explain to ourselves and our clients what we are either: a) Uncomfortable hearing,seeing or feeling in reaction to their behavior. b) We need a reason for behaviour we have not fully explored with them and could be afraid to do so in case it goes beyond our experience and expertise. c) Our own countertransference or inexperience blinds us to recognizing what is truly happening. What is going on here (above illustration) MAY be transference. It MAY also be something quite different. I would like to give two examples from my training days as a Psychology student and use Anger to illustrate the meaning of transference. Example 1 : I had a client (actually, several!) who became angry with me and I fell into the psychobabble trap, with the ubiquitous response, " Aha, Transference. He's projecting his anger towards his wife onto me". So, with pride, I took this insight to my Supervisor. Pride comes before a fall, right ? Right. It turned out that my client's anger had nothing whatsoever to do with his wife. It was directed solely at ME. I wasn't listening carefully and had been feeding back to him what I thought was happening in their marriage, which, when I started to listen very carefully proved to be totally off track. His anger was real, and it certainly was valid and I hadn't put it where it belonged. On me. It was NOT transference. Another personal philosphy of mine is , " Put the feelings where they belong". Example 2: I was working with a woman for quite a while when after about three months, one day she stormed into the office and began literally yelling at me. I was a rotten therapist, I didn't listen, I couldn't hear her, it was a complete waste of her money to see me when I didn't understand, and on and on. If baleful glares could pin you to the wall I was stapled there as a permanent fixture. She blew out of the office when the tirade decreased to a steady roar and left me shaken and weak-kneed. I thought, " NOW what have I done?" I asked my Supervisor what I should do and he just looked at me for a moment then said, quietly, " You'll manage". I guess my open mouth must have resembled a beached fish because he smiled and repeated that I would know what to do when I saw her next. I all but pleaded on bended knee with him to help and tell me something to say to her, but no go. With much trepidation I awaited for her next sesssion. She came in, sat down and burst into tears. She told me that something about me reminded her of her mother whom she loved very much but who had never ever stopped to listen to her as a child. Never tried to hear her desperate need to feel loved, wanted and understood. In that last session, all the rage, hurt, grief, loss and pain stuffed for over 40 years had boiled over onto the mother-figure who reminded her so vividly of her unmet needs. She told me, " This is the FIRST time in my whole life that I have been allowed to be angry and it has been alright. You didn't yell back. You didn't punish me and tell me I was bad and shove me out of the office. As a child I would get so MAD at my Mom because she just didn't SEE me. I waited and waited and longed for her to say she loved me and I got mad and yelled at her to listen and then I got punished for getting mad. But you didn't get mad back, even though I thought you would, and it felt so different. I'm sorry I yelled at you". This was transference in its purity. I did, however, remembering my other client, check I had not done something that would be valid reason for anger, but she said no. So I learned that the therapist takes on the remembered figure of someone who has caused suffering to the client. This could be emotional, psychological, physical, sexual abuse or all of them, or some of them, and the client sees not the therapist, but IN the therapist, the one they have loved or feared, or both, and relives the old emotions AS THOUGH IT STILL IS so. In my article on Listening, ( http://www.goessoftlyishere.com) I wrote: << There are no WORDS to fully and truly describe emotional devastation, or the depth of what it is to be longing, aching, yearning for an unattainable someone, some thing or situation . This is especially true where transference feelings are from a preverbal state or adult trauma has robbed the ability to articulate emotions that have been beaten into numbness or silenced by external influence or persons). >> This is transference - not a psychobabble word tagged onto any reaction my client may emote that makes me uncomfortable but what is coming from the heart of my client to the one I represent for them. All the pain, the anguish, hurt, grief and rage. While our client is in transference the emotional and psychological toll is exhausting, draining and can be physically debilitating for them. I think as therapists, we need to learn the difference between feelings and behaviors from our clients that may belong to situations at work, school, home or other places and are legitimate reactions, or, as I found out, that belong to my errors in listening, and those that are transference projections onto us as other-figure people. For example: If I like my therapist a lot for whatever reason, this is normal and a sign for a good "fit" that could lead to a beneficial therapeutic alliance. However, if that liking becomes an uncontrollable longing to be with him/her, yearning to hear his/her voice, to feel a deep sense of loss and missing between session times, feelings far too intense for the formal therapist/client dyad, this is transference. Whatever stage of development where psychological and/or emotional growth has been stopped due to deficit in unmet needs or trauma, e.g . lack of nurturing, or verbal/physcial abuse, the transference will pass on of all the pent up feelings around such needs and trauma both at the time and through the years they occurred, and project them with age-appropriate affect onto the therapist in lieu of a past significant person, parent, guardian, teacher, or whoever they represent. Meaning, where an infant was never held, cooed to, lovingly fed and handled, the client's transference will be seen only in their eyes, their tears and possibly fury they cannot explain. This is preverbal transference where the infant cannot verbalize its feelings and needs and can only cry, throw a tantrum or become silent in despair and withdraw. Even an older child who is able to speak but has been silenced by punishment or torture for daring to express an emotion that has not been ordered, will be mute in the office. The longing for touch, for love, approval and belonging will be felt at the deepest level and be transfereed onto the therapist but fear will keep them silent. Sometimes to write or draw will help them express what they think and feel, and this is helpful but needs to be recognized as transference illustrations and not just depicting certain significant events or circumstances While these might be happening, it is good to learn what is transference and what isn't, and it is up to the therapist to observe closely and listen carefully so the tansference isn't missed or mistaken. Tone of voice, body language, use of language and attitude will all indicate at what developmental stage the transference is working. So how do we handle transference instead of talking psychobabble ? Maybe these could be some pointers? 1. I think the most important task we, as therapists have to learn is to distinguish between our client's transference feelings and our own countertransference feelings and thoughts. What is their stuff and what is ours, and keep each in their place. My issues in countertransference are brought to my supervisor and dealt with there and working in my own time. My client's issues are in the office and during sesssion. To mix them is very detrimental to the therapy, can become unprofessional as well as totally erasing the boundaries. 2. We cannot BE whoever we represent for the client. 3. Remember, we are the Therapist, NOT the idealized parent, the abusive adult, the unloving spouse, to whom the client is pouring out their soul in hopes of reaching the unreachable, replacing the unreplaceable and attaining the unattainable. If we think we can be any of these for our client we do them great disservice and unbelievable harm. I repeat, WE cannot BE whoever we represent for our client. 4. In light of above, it undermines the therapy as well as being futile, to put oneself as a surrogate for someone we can NEVER be. e.g. if I am a female therapist, whether my client be male or female, I can never be my client's " mother". The same applies for male therapists who would think they can be a father substitute. We represent a mother or father FIGURE. That is all. 5. The task for us in the transference is to make our client's experience DIFFERENT. If we try doing the things mentioned above there will be no difference mainly because in the end our clients will realize we are not, and never can be, who they saw us as, and find there is the same illusion working that what was longed for and hoped for ends with therapy termination. Retraumatization occurs because nothing has changed. Mommy will never be Mommy, Daddy will never be Daddy - they are not there, only the therapist in his/her chair and who will leave, distance and be unattainable. (see my article: Retraumatization at http://www.goessoftlyishere.com ) 6. The therapist can create a DIFFERENT experience and offer safety in the difference. Meaning, that where all that was felt as a child and/or adult that was silenced and told was bad, can be seen in a different light. That their feelings were valid, normal and acceptable within their frame of reference, the condition and circumstance of the time, and where there was self-doubt of not just the validity of an emotion, but an ability to recognize what the emotions really were, can be learned . So often, clients have told me, " I don't know if it really is anger I'm feeling? I don't know any more what's what". They can feel permission to express said emotions. That it is healthy to express genuine feeling and to learn how, when and where it is appropriate. ( Other pointers will be addressed in the Countertransference article. Psychobabble 2B ) So when we so quickly come out with " Mmmmm, sounds like transference to me", maybe we could give a little deeper thought to, is it really transference, or is what I am sensing connected to today, to now, or even to the past and to people who are not the therapist seen as parent figure, or an abuser in or out of the home. May we put not just the feeling but also the transference where they belong. Before closing I would like to state that in my own practice I do not use the actual words,Transference, Countertransference or Retraumatization for the simple reason the concept is far too complex for definition to tell a lay person and when a client is in session the work IS the transference/countertransference process, and takes place without the client needing titles for the therapy dynamics . At the begining of this article I quoted what I have heard said, " What is happening here is called Transference", and included it to show how we, as therapists can, and do, think, but such words have no meaning nor do they help the client better express what is happening for him/her. Perhaps the best thing we can do is to allow the transference process to work so healing can take place. 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