Cultural Countertransference

For instance, one client wanted to work on deeply troubling issues she had because she had chosen not to marry, which is unacceptable in her family. She carefully selected a middle aged female therapist, thinking she would ?nd the basic understanding that she needed to work on her feelings. Unfortunately, after a very few sessions, the therapist interpreted the woman’s no marriage decision as adolescent rebellion. There were some basic differences between the therapist’s worldview and the client’s, which made rapport, empathy, and eventual identi?cation very unlikely.

Identi?cation is the precursor to internalization. Object relations theorists hypothesize that as we develop, we internalize components of various caretakers and others in Relationship Variables and Clinical Interviewing 119120 Listening and Relationship Development

Coping with Cultural Countertransference

Pitfalls of countertransference are lurking everywhere. Imagine that you’re a Vietnam War vet and therapist, and a Southeast Asian client comes to you for therapy. Unless you’ve done your personal work previously, you’re likely to have a few reactions and issues to work through.

Countertransference is omnipresent because it can be triggered by so many different variables. Not only can you succumb to a client who behaves in ways similar to your domineering sister, but you can also overreact to clients who sound whiney or who are particularly handsome or particularly homely. Countertransference does not discriminate: We all can and will be affected by it.

As an example, the renowned group psychotherapist Irvin Yalom writes eloquently about his negative countertransference toward an obese client: Of course, I am not alone in my bias. Cultural reinforcement is everywhere. Who ever has a kind word for the fat lady? But my contempt surpasses all cultural norms. Early in my career, I worked in a maximum security prison where the least heinous offense committed by any of my patients was a simple, single murder. Yet I had little dif?culty accepting those patients, attempting to understand them, and ?nding ways to be supportive.