Telling the Client what they Don’t want to Hear

The use of counter-transference within psychodynamic counselling….
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Telling the Client what they Don’t want to Hear
Covering up the Bang © Ben Husmann

Clients come into counselling often due to some form of conflict (which some of us call the “Presenting Problem”).

The conflict may appear obvious (“My partner doesn’t like this about me…”), or the conflict may be at a deeper, as-yet-not-understood level (“I don’t seem to have any friends…”).

When I listen to a client tell their story ~ no matter if it’s at the beginning or during the work ~ I’m not just listening to the words of the story, I’m also listening to my internal responses to the story. I’m listening to how my emotions are reacting to the story, I’m paying attention to if my body is responding to the story. In addition to listening with my ears, I’m “listening” to how everything else apart from my ears is receiving the client’s story.

In other words, as a psychodynamic counsellor I’m paying attention to my counter-transference.

How does counter-transference help?

Some counsellors’ approach is to pay attention (only) to the client’s story, reflecting back (summarising, paraphrasing) portions of the story so that the client may gain some benefit from feeling understood. There is merit and rationale to such an approach.

However, by paying attention to how I am responding at different levels to the story, I’m later able to invite the client to go to a deeper level of understanding. To go deeper in understanding parts of the story that the client is not (yet) consciously aware of. I use the word “invite” quite intentionally, as invitations may be declined as well as accepted.

Counter-transference – an analogy.

For those who are unfamiliar with a counter-transference experience, I might describe the different parts of me that are responding to the story (my “counter-transference response”) as being like when a tuning fork is placed on a surface. Without the surface, the tuning fork makes nearly-no audible sound when it is thumped into life. But, when a thumped-tuning fork is placed upon a surface, the tuning fork begins to be heard quite clearly. In a way, to use counter-transference in counselling, the client is a tuning fork, I am a surface upon which the client touches, and I help the client to notice the client’s “sound” previously not heard by him… until he “touched” me.

 

Distinguishing Counter-transference from Personal Material.

In the past, I have heard some other counsellors express:

…the anger I felt was the client’s, not mine.

The counsellor is saying that they felt angry (whilst working with the client) but that the anger did not belong to the counsellor; they are saying that it was the client’s anger they were feeling (in Melanie Klein terms: the anger had been “split-off” and, through projective-identification, the anger had been dismissed from the client and “placed” within the counsellor).

…except (in this example) this form of explanation seems to dismiss the counsellor’s own role within the therapeutic alliance. Almost: “that’s his anger, nowt to do with me, guv!”.

It is my position, as a psychodynamic counsellor, that I must have something previously established within my mind that is available to resonate with the client’s (unconscious) material. So, tuning fork-like, the client’s stuff and my stuff combine to produce a “note” that, to my mind and/or body, seems to “sound” to me like anger.

Again, continuing with the example of anger, my struggle when I notice such feelings within me (and that the client appears not to be expressing or feeling) needs some thought:

  • could this anger that I’m feeling be my anger, and mine alone?
  • could this anger that I’m feeling be resonating with the client’s anger (counter-transference)?
  • a little from column A, a little from column B?

 

Feeding back the counter-transference.

Having received different shades of the client’s story: verbal (conscious), counter-transference / projective-identification (unconscious) , how might I use all of this together to assist the client.

Various authors have written about different approaches.

  • Some are subtle (eg a Donald Winnicott-style of leaving a spatula to be discovered):

…you say that women don’t find you attractive, but I imaging that some women do.

…suggesting that the counsellor is feeling an attraction to the client, but is not stating this overtly. The “spatula” technique is to place something (such as a verbal intervention) in front of the client for him to “pick up” and play with as he sees fit, or to not notice it or to even actively ignore it. It’s up to the client to decide what they make of the counsellor’s intervention (the “spatula”) – see Spatula Game

 

  • Some are more overt (e.g. Karen Maroda – relational style psychotherapy):

…you say that you’re feeling happier today, and you’ve asked me how I am, so I’d have to say that I can’t understand why I’m feeling furious; quite differently to you. Shall we talk about this difference?

…the counsellor has stated different feelings to the client, and is inviting both of them to wonder about the difference (possibly the counsellor is capturing a split-off emotion from the client).

 

  • Some are positively challenging (e.g. Habib Davanloo – Intensive Short-term Dynamic Psychotherapy)

… you keep saying “I don’t know” to my questions, but I think you really do know, otherwise you wouldn’t be sitting in front of me waiting for me to tell you what you already know.

…suggesting that the counsellor is inviting the client to address a defence (denial?) by challenging a real experience between them both.

 

My own approach to using counter-transference varies between these examples depending on such factors as:-

  • The strength of the therapeutic alliance (early days I may take the subtle approach, later days I may take more overt approaches).
  • If I unsure that what I am experiencing may be more counter-transference or more my own personal material. This would be a discussion to go into supervision.
  • If the client has made an overt request to learn about their behaviour and impact upon me. I no longer entirely hold to the psychoanalytical tradition of saying nothing about myself (at least in the context of the therapeutic alliance).
  • How active are the client’s defences. Use of Patrick Casement’s internal supervision & trial identification concepts can be useful here.

… a deciding factor can be: can the client “digest” this “food” that I’m offering (and if he “spits it out”, what might he and I do with the regurgitation).

And even that (the regurgitation) is grist for the mill; worthy of a conversation:-

You asked me to tell you how I experienced what you’re telling me; when I did, you rejected the experience. What do you think may be happening between us just now?

 

When the client won’t hear…

A supervisor once suggested I offer an intervention to a client, and I responded: “But I’ve already said this”. Her response was: “What makes you think you offer it only the once?!”

The point of this exchange was that in counselling (we hope that) the client is growing, and at later times may hear what he has been unable to hear before (or heard in a different way to before).

So, when I offer back a counter-transference-informed intervention, the likelihood (being that the intervention is formed from unconscious material) is that the client may not be ready to hear it if my delivery it too early or misjudged. And that’s OK.  An inability (or a refusal) to hear may be import to keep the material “outside of the consciousness” right now. Should such a rejection occur, I’ll consider whether to look at the rejection or shelve the intervention for a later stage, and may not make this decision by myself; each client’s needs and each therapeutic alliance will be different.

The client may not wish to receive back that which they’ve dismissed into me (for safe keeping, perhaps).

 


 

In short, counter-transference is a process which a psychodynamic counsellor may use to help a client understand parts of themselves that, through their internal defences, they are unable to consciously appreciate.

The choice in technique of counter-transference interpretation will depend on any combination of the counsellor’s skills & empathy, the therapeutic alliance between counsellor and client, the client’s (in)ability to tolerate what they hear, and the counsellor’s respect that sometimes the client does not want to hear what they have just been told.

 

Related Reading:

Psychodynamic Techniques: Working with Emotion in the Therapeutic RelationshipPsychodynamic Techniques: Working with Emotion in the Therapeutic RelationshipExplores the role of both clients' and therapists' emotional experiences in the process of therapy.
The Power of Countertransference: Innovations in Analytic TechniqueThe Power of Countertransference: Innovations in Analytic TechniqueA signpost of the relational turn in contemporary psychoanalysis, Karen Maroda's 'The Power of Countertransference', published in 1991, is a systemati... Read More >
Psychodynamic Techniques: Working with Emotion in the Therapeutic RelationshipPsychodynamic Techniques: Working with Emotion in the Therapeutic RelationshipTitle: Psychodynamic Techniques Binding: Paperback Author: Karen J. Maroda Publisher: Taylor & Francis
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