What is Countertransference?

Faust Im Studierzimmer, Painting by Friedrich Georg Kersting, 1829

Countertransference refers to the emotional reactions a therapist experiences toward a patient, which are influenced by the therapist’s own unconscious thoughts, feelings, and personal history. Just as patients project feelings from early relationships onto their therapist in a process known as transference, therapists may also respond in ways shaped by their own past experiences. These responses can often emerge subtly during therapy, making it important for therapists to be aware of how their own emotions interact with the therapeutic relationship.

In psychodynamic therapy, the therapist-patient relationship can cause emotional experiences, which can bring unconscious feelings to the surface. As patients transfer feelings from past relationships onto the therapist, the therapist may simultaneously have unconscious reactions that mirror their own unresolved difficulties. If the therapist is unaware of their countertransference, they may respond in ways that reinforce the patient’s maladaptive patterns, whereas awareness allows the therapist to respond more objectively and helpfully.

Although therapists can experience emotional reactions during treatment, their role requires a high level of self-awareness to distinguish between reactions that are appropriate responses to the patient and those that stem from their own psychological past. This can lead to the therapist remaining grounded and therapeutic, rather than unintentionally projecting personal biases or emotions into the treatment. Understanding countertransference, therefore, becomes a fundamental part of ethical and effective psychodynamic practice.

Pioneers of the Woods, California, Painting by Albert Bierstadt. 1861

Some patients, especially those who feel vulnerable or emotionally exposed in therapy, may engage in behaviours that provoke strong emotional reactions in the therapist which can include attempts to assert control or superiority as a defense mechanism against painful emotions like shame, fear, or helplessness. These usually come from the patient’s early attachment experiences and are repeated in the therapeutic setting. If the therapist becomes aware of how these interactions bring up their own countertransference, they can intervene therapeutically rather than react defensively or emotionally, which would only reinforce the patient’s existing relational struggles.

As a result, the more insight a therapist has into themselves, the more effectively they can use countertransference as a tool for healing. When understood, it allows the therapist to respond with empathy and precision, helping the patient recognize and change long-standing patterns in their relationships.