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Section 20
Patterns in Countertransference

Question 20 | Test | Table of Contents


 Battered women are slow to take action, and most never leave their potentially murderous mates. It is easy for workers to feel frustrated with the grim realities they must face when treating these women. When working with the batterer, workers form relationships with and must develop positive feelings about people who are violent. When working with the couple, workers are directly confronted with a violent family system where someone is aggressed upon and someone is the aggressor. In short, the worker faces a woman who has been injured physically and psychologically, and a man who has brutalized her.

Upon contact, the therapist is immediately assaulted by the horror of this reality. Barbara Mathias comments, “Therapists struggle with both their revulsion and their denial, a feeling that this just couldn’t be real.” But it is all too real, and the therapist treating battering cases needs to cope with and be effective in the work. Countertransference responses do not get enough attention. Unless therapists are acutely aware of the feelings evoked as a result of working with battering, these feelings left unattended can result in mistakes in treatment that can seriously hamper the work.

Countertransference
Countertransference “is the totality of the therapist’s experience in relation to a particular client, conscious and unconscious, feelings and associations, thoughts and fantasies; it includes the therapist’s feelings about the client as well as the therapist’s feelings about him or herself.” Any aspect of the therapeutic relationship can and inevitably does evoke countertransferential feelings, but the treatment of battering is particularly fertile ground for the growth of countertransference. It is easy for the therapist to develop feelings about the abused partner and the batterer even before treatment begins; indeed, the terms themselves—battering, batterer, abuse, beaten, victim—can elicit a cadre of feelings. Some of the feelings these words conjure up are: abhorrence, avoidance, anger, fear, sympathy, empathy, the desire to rescue, and control.

Of the choices available—the abused woman, the batterer, the couple—practitioners may be more comfortable working with the battered woman individually. She appears helpless and dependent, and they are the victim. Working with the batterer, with or without his partner, is less popular. They are the violent partners, and they have committed a crime.

Although countertransference must always be wrestled with in this work, it feels potent and overwhelming with battering cases. This problem has been noted: “Working with family violence puts the therapist under special pressures. . . Those who work with violent families have to find some way to avoid being overwhelmed.” Battered women tug at our feelings of the need to rescue.

Jody entered my office looking like a scared doe. She was petite and thin, with enormous frightened dark brown eyes. Although she hung her head down so that her curly brown hair hid most of her face, I could still see the bandage above her eyebrow and the purplish bruises around her eye.

Practitioner Response
This description can evoke many responses in practitioners. They may identify with helplessness and powerlessness, which every human being has experienced. They may feel anger at her assailant or at her for being abused. They can feel empathy, which can foster dependency and perhaps revulsion. The batterer can evoke fear and intimidation of his aggressive tendencies, anger and hatred for his bullying and unfair display of physical force, or a secret admiration for his ability to control. What is triggered in each practitioner is totally individual, but the feelings inevitably arise.

One way of coping with uncomfortable feelings is to distance from them. When the feelings aroused by clients are discordant with therapists’ professional self-image, avoidance is a reasonable outcome. In teaching a course on the treatment of battering, I asked the class to tell me what feelings were aroused by some case examples. The students resisted, responding intellectually, giving me interpretations, developing treatment plans, and so forth. When I insisted on an expression of their feelings, they conveyed anger at the batterer but noted they are not supposed to feel that way as professionals.

The feelings engendered by battering cases can result in a therapist’s avoidance of feelings and lack of involvement, which can be manifested by not offering services to these clients and a lack of exploration of the presence of violence because they do not want to know. I believe what they do not want to know is what the feelings are that may get conjured up, some of which are possibly alien. Moreover, working with couples compounds countertransferential feelings.

- Geller, J. A., PhD. (2002). Breaking Destructive Patterns. The Free Press: New York.

Update
Managing Transference
and Countertransference in Cognitive
Behavioral Supervision: Theoretical
Framework and Clinical Application

- Prasko, J., Ociskova, M., Vanek, J., Burkauskas, J., Slepecky, M., Bite, I., Krone, I., Sollar, T., & Juskiene, A. (2022). Managing Transference and Countertransference in Cognitive Behavioral Supervision: Theoretical Framework and Clinical Application. Psychology research and behavior management, 15, 2129–2155.

Peer-Reviewed Journal Article References:
Baumann, E. F., Ryu, D., & Harney, P. (2020). Listening to identity: Transference, countertransference, and therapist disclosure in psychotherapy with sexual and gender minority clients. Practice Innovations, 5(3), 246–256.

Berg, J., & Lundh, L.-G. (2021). General patterns in psychotherapists’ countertransference. Psychoanalytic Psychology. Advance online publication.

Connery, A. L., & Murdock, N. L. (2019). An interactive view of countertransference: Differentiation of self and client presentation. Psychotherapy, 56(2), 181–192.

QUESTION 20
Battered women may create stress for the therapist because of the therapist’s need to do what? To select and enter your answer go to Test.

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