During therapy sessions with their therapists, patients are typically encouraged to be as open about their emotions as possible to create the setting in which a constructive discussion of key issues becomes possible. Therefore, patients are prone to building a rapport with therapists, which may lead to transference and similar situations. Particularly, a patient may transfer their feelings such as respect, appreciation, and even affection from an important person in their life onto a therapist.
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In the scenarios of clients experiencing complex mental health issues, the presence of transference may both advance the process of health issues management due to the patient’s trust but also impede it in case a patient lacks control over their feelings. The phenomenon of transference may develop in the opposite direction, with a therapist developing any positive feelings other than professional interest and empathy toward a patient.
However, the process of transference is not as common as its direct opposite, which is countertransference. Countertransference occurs if a therapist develops a strongly negative feeling toward a patient, which may range from the lack of empathy to resentment and affect the quality of the therapy significantly (Gabbard, 2017). The identified phenomenon occurs when a therapist fails to connect with a patient emotionally and, as a result, remains indifferent to the psychological issues of the latter.
Like transference, countertransference may be witnessed in a patient, who acquires a strongly negative attitude toward a therapist due to the transfer of the idea of negative relationships that they have experienced onto the communication with the therapist (Gabbard, 2017). Therefore, both phenomena need to be prevented with the help of relevant strategies and tools.
When considering the origin of the phenomenon of transferring, one should mention the development of an emotional bond between a therapist and a patient. While the specified connection is typically used to benefit patients and encourage an open dialogue, it may also lead to problems in patient-therapist communication unless controlled carefully. Countertransference, in turn, may be evoked by the presence of the characteristic that a therapist unconsciously deems as irritating or generally negative on a subconscious level, thus causing the bond between a psychologist and a patient to weaken significantly (Gabbard, 2017).
The resulting lack of investment in the patient’s recovery causes a therapist to fail to design an adequate therapeutic approach. Once either of the specified phenomena emerges, providing therapy does not seem possible since a therapist has to remain impartial, which both transference and countertransference impede. Although it could be argued that countertransference can serve as the basis for developing self-analytical skills, it prevents the process of therapy from occurring and reduces the efficacy of psychological strategies for managing patients’ needs.
As a rule, the cases in which the search for the solution takes substantial efforts and place a PMHNP under significant strain are those that have the strongest staying power. In my experience, the case of a 67-year-old female patient who was suffering from severe dementia caused by Alzheimer’s was the most important one. She came for help since she noticed significant memory problems. For instance, she had troubles remembering her family members, confusing her son for a stranger.
After a thorough examination, it was discovered that she also suffered verbal and sometimes physical abuse from her son, whose awareness about his mother’s state and needs was extraordinarily low. It was this specific case that made me realize the necessity to refrain from countertransference and use empathy instead. Furthermore, the case showed me that it was crucial to take all aspects of a patient’s life into account when determining an intervention and treatment strategy. For instance, unless the patient mentioned briefly poor interactions with her son and the fact that he called her names, the problem of verbal abuse and the threat of physical violence would have never been discovered.
In retrospect, the identified situation helped me to gain a more profound understanding of my personality, as well as its effects on my professional skills. For instance, I noticed a significant propensity toward emotional involvement and the fact that it was very difficult for me to remain impartial. Moreover, the case showed me that a psychopathologist must assume the role of a counselor and a therapist, thus providing a patient with crucial information about their health issue and at the same time locating the threats to their well-being.
Furthermore, the scenario described above indicates that, as a nurse, I need to focus on addressing my weaknesses such as the lack of attention to details, and enhance my strengths, including the ability to empathize and relate to patients. My empathy helps me to build a strong rapport with a client, while my weakness makes me overlook important information, which may lead to patients developing mistrust. My therapeutic use of self allows for an emotional bond, which encourages openness in patients.
Thus, the reflection on my practice has shown that I need to steer my emotional intelligence skills in the proper direction in order to help patients. I will apply this information to my practice by creating strategies for improving the emotional connection with patients and promoting faster recovery among them.
Gabbard, G. O. (2017). Long-term psychodynamic psychotherapy: A basic text (3rd ed). Washington, DC: American Psychiatric Association Publishing.