Countertransference as a Clinical Tool in Divisive Times

By Stan Tatkin, PsyD, LMFT

How do we treat couples, irrespective of their ideologies? The topic here is couple therapist countertransference, my own and perhaps that of my colleagues, recognizing that our professional community holds varied perspectives on the omnipresent cultural divide.  How do we put secure functioning first when one or both of the partners irk or even offend us? Countertransference acting-out is not only unprofessional but potentially harmful to our individual and couple clients. Consequently, this article aims to maintain neutrality, as the subject of countertransference should be met with neutrality, curiosity, and critical thinking. 

I have discovered fairly long ago, that when working with partners who are strongly “this” or “that” in matters that could personally trigger me, that working toward a goal of secure functioning, my own strong views suddenly disappear as I begin to understand the persons and not focus on their beliefs. I have worked with patients who hated Jews who knew I am Jewish, partners who have done very bad – even criminal – things, and some who continue to do so. Am I often offended by what they do or how they think? Absolutely. But our job is to investigate as a method of understanding the person(s) in front of us, and, in terms of couple work, view them through that lens, in order to help them become more secure-functioning. This doesn’t mean we are invested in changing who they are as individuals but rather, how they do business as teammates who must collaborate and cooperate with each other.

I acknowledge that maintaining an open mind has not always been easy for me. Like many, I have moments of judgment, compounded by impatience and intolerance toward certain behaviors. However, I am aware of these tendencies and actively work to manage and mitigate the anger that arises from such intolerance.  

This discussion is not about my personal political beliefs or my views on social justice. Instead, it centers on the role of clinicians in today’s polarized climate. The focus of this paper is on the importance of collaborating with individuals with whom we may personally disagree. Whether it involves addressing unfairness and injustice within a couple system, dealing with antisocial behavior, or navigating discomfort with a partner’s sexuality, couple therapists must remain neutral and capable of working with all clients. This includes a straight therapist working with a transgender couple, an LGBTQ therapist collaborating with a heterosexual couple, a left-leaning therapist engaging with a partner who supports Trump, or a therapist of a different faith working with a religious couple.  

A skilled couple therapist, much like a competent attorney, must be able to empathize with each partner. This requires accurately representing each partner’s perspective, signaling to them that their feelings and intentions are understood. If I fail to do this for either partner, it is likely that they could, or even should, consider terminating our therapeutic relationship.  

The crux of this article is this: there is a valuable opportunity to learn from individuals with opposing beliefs, sensibilities, and attitudes that may threaten to offend us and hinder effective collaboration. 

Here are few tips for dealing with countertransference when you disagree with your clients: 

Stay Curious

The key ingredient, in my view, is maintaining ongoing curiosity about the person or persons involved, rather than fixating on their ideology, behavior, or attitudes — unless those behaviors imply or result in abusive or aggressive actions between partners or toward the clinician.  If we can shift our perspective to focus on the individual, there is much to be gained — and in my experience, a win-win outcome for both our couples and us. This approach may serve as a method to heal our own as well as our collective divided minds.  

Feel, Think, Intervene

In the past, I have advocated for the importance of predicting, planning, and preparing when working with difficult couples. This involves mentalizing the scene and employing self-regulation techniques before the session. During the session, therapists can utilize these same self-regulation techniques, such as relaxing muscle tension and maintaining an outward focus on the visual details of the clients’ faces and bodies. This continuous, relaxed outward focus allows therapists the necessary time to process bodily sensations, feelings, impulses, and other drives to act, rather than simply sitting and thinking. This concept aligns with Daniel Kahneman’s seminal work, Thinking, Fast and Slow (2011), which discusses the two systems of thought that influence our decisions: System 1, which is fast, instinctive, and emotional, and System 2, which is slower, more deliberative, and logical.  

Understanding these systems is vital for therapists who aim to effectively utilize countertransference alongside projective identification and implicit cues that arise from the intersubjective field. This includes somatic reactions, emotional responses, and gut feelings, all paired with critical thinking to ensure that the therapeutic relationship remains intact and productive. 

Focus on Self-Care

Destructive countertransference acting out can occur when therapists fail to prepare adequately or when they neglect their own self-care. Under-resourced, burnt-out therapists are at a higher risk for countertransference acting out than those who are well-resourced. This issue of being resourced necessitates personal reflection and evaluation by the therapist. Recognizing when countertransference has been acted out may prompt a reevaluation of one’s work-life balance or the need for supervision and support, which could take the form of individual therapy or participation in a peer support group.  

Personally, during the pandemic, my self-care was compromised as I transitioned from in-person sessions to telehealth, which itself became a source of stress. As I navigated my work in relative isolation, I found that the fatigue from staring at a monitor all day, coupled with the demands of maintaining productivity, led to increased impatience and emotional impulsivity. I could have alleviated some of these burnout symptoms by pacing myself, reducing my workload, and incorporating more meditation into my routine. 

The pandemic also affected me in other ways, including my tendency to engage in doom scrolling and consuming social media, which heightened my awareness of the pervasive hatred expressed in online comments. It felt as though polite society was disintegrating before my eyes. I even published a paper addressing the phenomenon of dopamine-driven trolling, where individuals express hate and shame while cloaked in anonymity (Tatkin, 2021).  

In conclusion, the practice of maintaining neutrality, curiosity, and critical thinking in the face of countertransference is not merely a professional necessity; it is a pathway to fostering secure functioning in couples. By prioritizing the understanding of individuals over their beliefs, therapists can assist couples in navigating their differences and building stronger, more cooperative relationships. This approach not only benefits the couples but also contributes to healing the broader societal divides that mirror these intimate conflicts. As therapists, our commitment to this practice can serve as a model for others, demonstrating that empathy and understanding can bridge even the deepest divides. In doing so, we not only support our clients but also contribute to a more compassionate and connected world.

Curious about countertransference, political and otherwise? Join my upcoming workshop, Countertransference Toolkit: Feel, Think, Intervene, Friday, March 28, 8:00am - 10:30am Pacific time. 

References:

Kahneman, D. (2011). Thinking, Fast and Slow. Farrar, Straus and Giroux.

Tatkin, S. (2021). How the Pandemic Has Changed Us. Science of Psychotherapy (January), 39-43.