What is Transference Therapy & Examples

There is always an element of transference in all therapeutic approaches. Transference occurs when a client projects their emotions onto their therapist. This happens often as clients usually enter therapy to uncover their own tendencies, and the process of transference helps to reveal some of these tendencies to the therapist. It is an essential part of the therapeutic relationship between client and therapist and can be a profound catalyst for change for the client.

How does Transfer Therapy work

During conversations between a therapist and a client, transference is usually happening on an unconscious level. The client is often directing their emotions to the therapist, whatever these emotions are, and the therapist serves as a safe house for these emotions. In doing so, the client is able to express these emotions in a safe place to begin to heal issues that may arise out of them (Ensink and Normandy, 2023).

Transference Therapy Example

Joanie may go to therapy to deal with a pattern of emotionally volatile relationships with men in her adult life, specifically her boyfriend, Maxwell, and during therapy, the male therapist she sees, Peter may uncover that as a child, Joanie’s father was very abusive and absent in her life. Joanie may be nervous about opening up in therapy but when she doesn’t, she begins to speak about her relationships in a positive light despite these relationships being filled with relational trauma and volatility.

Peter may be aware of her need to try to people-please to gain acceptance, a pattern she often displayed as a young girl. Peter can facilitate a dialogue to help her recognize connections between her behaviors and help her identify the projection, and in doing so, can help her work through the self-abandoning behavior of people-pleasing and help her gain a stronger sense of self-worth. Throughout therapy, she may feel more emboldened to speak her truth and not take on the task of being responsible for someone else’s emotions.

Transference therapy can be a wonderful tool and catalyst for change for clients. It can reshape the entire trajectory of how clients live out their relationships and improve their quality of life by working through the mental shackles of their past. It is important for therapists to take this work seriously use their clinical judgment, and ultimately support the well-being of their clients, at their pace, ensuring their safety is at the forefront of every treatment approach.

Benefits of Transference Therapy

Transference is a great tool to help therapists understand their clients, and when managed appropriately, can be very transformative for clients. Therapists can learn a lot about their clients and recognize patterns and pain points and bring them up safely as the relationship they set with their clients is centered around client safety. The process itself of talking through these things and challenging belief systems and thoughts also demonstrates healthy ways to have hard conversations and work to validate the client and also give them new tools to use in their other relationships.

Managing transference takes a highly skilled therapist to ensure they are treating their client with the sensitivity they need to share without judgment. Therapists must be able to identify when their clients are projecting their feelings and experiences and understand why so they can use these moments to help their clients gain deeper self-awareness. Therapists sometimes enter into a back and forth dance with their clients to reach a certain feeling of safety before the feedback can be given, though ultimately this is crucial for the client’s healing journey (Kline, Hill Lu, & Gelso, 2023).

Common Types of Projections

• A client’s sudden shifts in mood when around the therapist.
  • Example: During a therapy session, Tim opens up to his therapist about feeling frustration with a family member who is critical of him and all of his life choices. While trying to express his anger, he begins to show agitation towards the therapist. The sudden shift Tim has towards his therapist is an example of a mood shift projection.

• A client having a very strong emotion for which they haven’t before
  • Example: During a therapy session, Jennifer started to talk about the violence her mother endured from her father before they got divorced. She often felt like she couldn’t express herself out of fear and needing to ensure she is safe. She began to recount her memories and showed a lot of grief and sadness around what she and her mother went through. She felt overwhelmed but muted her emotions until she burst out crying, which she has never done before.

• A client acting out similar negative patterns with the therapist
  • Example: John is in therapy because his girlfriend says that she feels he’s not emotionally available and acts out in rage when he is faced with uncomfortable emotions. He comes in to therapy usually pretty happy and today, he came in feeling irritated. The therapist mentions what she observed and John reacted in a hostile, short way, similar to the ways his girlfriend described he reacts. When the therapist made the observation and John snapped at her, that act was the mirroring of the same negative pattern. That is a projection in this situation.

• A client assuming to know their therapists “true feelings”
  • Example: Laura is in therapy talking about a recent relationship ending and is expressing heartache and loss to the therapist. The therapist crosses her legs the other way in her chair and Laura notices and assumes that the therapist is tired of hearing about her struggles. Laura perceives her therapist crossing her legs as an indication that she is tired of listening and isn’t interested. Here Laura is projecting her feelings of not feeling good enough or worthy on to her therapist.

• A client becoming quieter than they usually have been
  • Example: Brian is in therapy talking about the death of his mom and how challenging that was in sessions and in todays session, Brian was pretty quiet. The therapist checks in about Brian’s grief and Brian’s face becomes flat and he goes silent. Usually he’s active in therapy and today he’s been very quiet. The therapist checks in with Brian generally as he notices his mood is different and Brian becomes overwhelmed with vulnerability. Here the projection could be a fear of vulnerability and not wanting to overwhelm his therapist.

• A client needing to make a change in therapy where they’re worried about the therapist
  • Example: Emily has been in therapy for a few months with Sarah and lately hasn’t been feeling like therapy has been helping. She is worried about telling Sarah this because she doesn’t want to hurt her feelings. She doesn’t know all the options to help make this relationship work better and thinks she needs a new therapist. Emily decides to share her concerns and Sarah offers her reassurance and validation and support. Emily begins to understand that it’s ok to share these feelings and her being worried about Sarah was a projection of her own anxiety about letting down her therapist. It is a common projection for those recovering from people-pleasing tendencies.

When managed well, transference can facilitate change for the client. When clients become more aware of their own patterns, they become empowered to take more action in their life. This helps to support their healing from past relational issues as well as learn new ways of managing distressing life situations and gives them the confidence after having the opportunity  to practice in sessions with their therapist.

Challenges to Transference Therapy

Transference therapy can be challenging if not managed well and can yield in a lot of defensiveness from the client. When therapists are working to hold a mirror back up to their client, the way in which those conversations are handled is where the transformation can occur. Therapists must be aware and attuned to their clients ability to handle and navigate the feedback to ensure they are not further overwhelming their clients.

Clients may have deep seeded shame or guilt around their feelings and if these parts are also not considered by the therapist in the feedback, it can feel more triggering than therapeutic. Sometimes clients need a greater amount of time to reach a place where they can feel safe in hearing the feedback and understanding that depends on the relationship each therapist has with each of their clients, as each relationship is different (Prasko, et al., 2022).

It is also important for therapists to ensure they are maintaining appropriate boundaries. Therapy work is intimate in nature, and transference can escalate if clear and professional boundaries are not present. Sometimes therapists can become too involved in the projections of their clients and interventions could become inappropriate if an emotional line is crossed. It is important for therapists to continually assess their role to ensure the therapeutic relationship remains professional and healthy.

How can Transference Therapy help clients

Transference therapy can help many clients in a variety of life issues. The goal of using this as a tool is to help clients work through past pain and uncover areas in their life in which they have not healed from. Another key tenet is to help them become more self aware and recognize if and what may be coming up for them, identify their feelings and learn to differentiate triggers from true threats. Learning about their own emotional experiences and expressions is key and a foundation for them to be able to create healthy relationships outside of therapy.

Clients can bring all sorts of projections into the session such as parental projections, sexual and emotional projections and idealization projections. Parental projections can include viewing their therapist the way they view their mother or father or even a sibling. Depending on the clients relationship with their parents and siblings, these projections can be negative or positive.

Sexual and emotional projections can include the client developing intimate feelings for their therapist which can uncover relational and intimacy issues. Idealization projections can include a client viewing their therapist as perfect and on a pedestal. This can often reveal underlying issues in self worth and a need for emotional presence from current or former caregivers in their life (Yeomans, Caligor, & Diamond, 2023).

References

Ensink, K., & Normandin, L. (2023). Trust in therapeutic work with adolescents with and without personality disorders: A transference-focused therapy perspective. Journal of Personality Disorders, 37(5), 580-603.

Kline, K. V., Hill, C. E., Lu, Y., & Gelso, C. J. (2023). Transference and client attachment to therapist in psychodynamic psychotherapy. Psychotherapy.

Prasko, J., Ociskova, M., Vanek, J., Burkauskas, J., Slepecky, M., Bite, I., ... & Juskiene, A. (2022). Managing transference and countertransference in cognitive behavioral supervision: Theoretical framework and clinical application. Psychology research and behavior management, 2129-2155.

Yeomans, F., Caligor, E., & Diamond, D. (2023). The development of transference-focused psychotherapy and its model of supervision. American Journal of Psychotherapy, 76(1), 46-50.