Negative transference and therapy

I was aware that I had a negative transference toward my last therapist. I could keep it “turned off” – but to do that was not what I thought therapy was supposed to be about. I didn’t talk with my last therapist in terms of negative transference. I talked in terms of “parts”, consistent with her specialty in trauma and dissociation, the diagnosis she made when I first came to her of DDNOS.

I had been trying to understand and deal with some internal experience and feelings of “being possessed” for some time before I was referred to her. I even decided once to take that possibility seriously and went to an Episcopalian priest who performed some rites of exorcism. But it turned out he really thought psychotherapy was the best way to approach my situation. I wasn’t particularly interested in trying it with him – I didn’t feel it was very honest of him to do exorcisms when it seems like he didn’t really believe in them himself, so I continued on trying to find somebody else. When the last therapist made the diagnosis of DDNOS I looked it up and saw somewhere that it is often associated with people feeling possessed or having a demon, so that seemed to fit.

In other words, I have been trying to accept, own, and integrate this thing for a long time. Maybe that’s not really the best approach to dealing with it? But then what is?

Unfortunately, it was apparently too much for the last therapist. Negative transference, or I guess it was hostility and other negativity directed at her, was too much. I guess she hadn’t integrated some of her own negative feelings?

But then, where would/could I find someone who could? I had tried lots and lots of them.

That remains a dilemma for me to this day.

I could say something like “I have nowhere to run, nowhere to hide.” But I’m not trying to do that. I have been consciously trying to face this thing for a long time.

Unfortunately, it seems that’s something which there is not really any “help” for. Recent emails with my last therapist and the consultant who referred me to her confirm this – at least from their perspective. Perhaps that’s their limitation. Or perhaps it’s a communication problem. At any rate, another round of rejection and/or shaming by therapists, which is what I experience a lot when I have gone looking for other therapists since the last T, is not something that I feel I have any more ability to tolerate. Maybe that’s more transference, who knows, but I at this point I need to go with my own feelings, I believe.

Based on a report by another member on this forum that she had tried Betterhelp and found the person at least somewhat helpful, I decided to try that, too, and had my first video session this week. She’s a master’s level social worker and I am limiting what I’m going to talk about to understanding social dynamics better and help with social skills. She also would like to try to reduce my feelings of depression, but without dealing with the “demon” I think that’s unlikely. Nevertheless, she seems kind and I like her so maybe just talking with her will be some help.

Any other ideas?

A therapist who can't handle negative feelings should not be a therapist and most of them can't and shouldn't. They only do well getting their egos stroked. But I really believe that therapy is not a universal panacea. It does not help everyone and it is NOT the client's fault. Those people oversell and under-deliver. Look around at how clients twist themselves to overlook, forgive, excuse, and put up with horrible behavior from therapists. Good luck with betterhelp.

Thanks, stopdog.

When I was still slavishly trying to make therapy work for me, your comments and those of some others at the time helped me to see another aspect, which I believe -- know -- has been important.

The challenge is, how to go on from here.

I also think that the label negative transference is a way those guys use a label to defend themselves against thinking about what they have done to set it up.

Yeah Betterhelp T and that platform has done wonders for me as I am able to send message constantly through the day and could not do that with any other therapist. I get 2-3 responses back daily and it makes me feel heard.

I have been in dire straights since leaving my major therapist because of transference. I used to poo poo CBT but now I think maybe I should have practiced all those exercises. I asked Betterhelp T if he thought that would help. I did think it was above me and rudimentary but maybe I should just try.

"Personally, I like CBT. It can be super helpful for people to see pretty rapid change in a short period of time. I think you would be hard pressed to find any non-fringe clinician who does not use elements of it. The basic ideas of CBT are so ingrained in therapeutic practice these days. Whether or not you would find CBT to be helpful or not I am not entirely sure. I think just the practice of identifying unhelpful or unrealistic thoughts, challenging them, and then changing the behavior associated with the thoughts is something that we all can benefit from in one way or another. Have you ever heard of or even read the book Feeling Good? Great and classic CBT book. We can start doing some CBT work if you would like to give it a try. I imagine you must have had experience doing CBT with previous counselors. What did you think of it then? I tend to incorporate CBT into my work with clients. I don't typically like following lockstep, pre-fabricated treatment models where each session is pretty much spelled out. But that type of model is the direction that CBT and a lot of therapy in general is going. Not to say that some clients don't benefit from this type of approach. But I think it definitely detracts something from the process of therapy.

I don't think I understand. How do you "turn it off"??? I had a strong negative transference as well (more than one, in fact, as well as some strong positive ones) and when any of it was triggered, all I could do was try to keep my rational mind running smoothly enough that I could maybe do some damage control at least. I could maybe bury it all, sow the spot with salt and put some barbed wire around it for good measure, but not as long as I'm in further therapy (which I am) ... oh well, at least new therapist is willing to work on this.

Anyhow, I also had the experience of being too much for my therapist in some way. The way she put it, I needed her to bear for a while the same stuff I was struggling with, and she couldn't. She also said this was unique to me, usually she can bear it. Which I'm inclined to believe. Except it's still not very clear what this 'this' was

I just can. It's because of the trauma, I guess -- the DDNOS diagnosis. Fight response and/or aggression and/or something else got dissociated, apparently, because of a traumatic experience in the hospital when I was 3.

It sounds like what you do is to tamp things down and cover them over, but mine can go down, like an abyss, black hole -- or maybe wormhole?-- and appear sometimes as it's own "self". There is the main, normal me, and then these "others"/alters, like in people with dissociative identity disorder, but not so severe.. I was conscious that the "negative transference" was emotions coming from the alter, and I could turn that feeling complex off and be people-pleasing and compliant, like I could in my regular life. But then, that wasn't therapy, was it?

I think maybe a similar thing, that something in me was trying to communicate how bad things were in me may have been what was going on with my therapy, too. But my T didn't explain it like that. She just said she didn't "have the emotional resources" and terminated. Which came across to me as that I, and my emotions, were too much for her to deal with. And that attribution was definitely too much for me to deal with.

I beginning to think that maybe "this" may be unbridled anger/rage or hatred and when someone is feeling that for another, then it's like the other is the "bad object" to the person with that feeling. And that's a difficult challenge to one's own sense of who one is, for the person who is being felt about like that.

Again, it's probably a little different in me. When my mother looked at me in rage, like I was the bad object, I remember one time that I dissociated from the distress that might have caused me. So it would be kind of hard for me to understand how somebody else might feel with that feeling coming from me. Maybe your situation is somewhat similar?

I see. My 'parts' are not so dissociated, and my first instinct would have been to say that should make them easier to control, not harder, but ... kind of makes sense, although kind of doesn't - I guess one aspect of trauma is that it's hard to make sense of, or else it makes the wider world hard to make sense of, so maybe it's not supposed to entirely make sense.

I remember the impotent fury I had as a child, wanting to hurt my mother back the same way but knowing that I can't. I tend to feel the same sort of fury in situations where I feel helpless/ taken advantage of/ ignored etc. Although, a lot of the time I don't actually feel angry, sometimes I only notice because of the way people are reacting to me. At least I learned over the years that I better not argue with them and get even angrier in the process when that happens, but try to reduce any damage done instead

The people-pleasing thing also resonates with me.

Yeah, we had moments like this with ex-T, when I got the sense that she's willing to look at how this stuff affects me and be honest about her part in it, but sadly they never managed to expand into a real discussion. On this occasion, she even indicated that she'd like to try to work around it, but then next session it was like this never happened. I tried to bring it up a couple of times later, that it meant a lot to me and that I had a great deal of respect for her in that moment, but she mostly just looked uncomfortable and didn't say a thing. It was a very raw and vulnerable moment for her that perhaps I wasn't supposed to witness in the first place?

Yeah, very similar. My fear is that all there is of 'me', the 'real me', is this 'bad object', and everything else is just an elaborate pretense I put up in a desperate attempt not to be found out, and ex-T rejected me because she glimpsed that truth, and the facade will crumble altogether any moment now and ... what then? I mean it's probably not the case, but ... ...

Damn, I really should start writing this down in more detail. Maybe start a thread of my own. I can't seem to keep this stuff from distracting me anyway, so I might as well channel most of my energy into figuring out how to deal with it efficiently.

Anyway, for now, back to 'this' - yes, at least part of it would be the rage. But the specific situation that tended to trigger open conflict with ex-T seemed to be related to my feeling of being hopelessly overwhelmed and just wanting out,and not being able to appreciate the 'good', at least not enough to feel like it's worth the struggle. But feelings of being 'bad and unloveable' did come up in the process of trying to fix/ understand the problem, so did my anger being kind of frightening, so if nothing else, perhaps it broke down her defenses enough for the other stuff to get to her more than it usually would?

My understanding is that many or most therapists assume positive transference (even if they don't believe in the transference phenomenon due to their modality in the first place). They assume a positive therapeutic alliance that allows constructive work to take place - either on emotional or cognitive level.

I think it is somehow related to reward, in that the therapists want to get rewarded for their work and by reward I mean the feeling of being useful, the feeling of having a great connection with their patients, having the opportunity to see their progress and feel in some way as having contributed to it.

It seems that working productively with negative transferences requires giving up these assumptions and being willing to work without any visible reward, maybe ever. Which to my mind shouldn't be a problem because that's precisely what the session fee is for - this is the reward and that should be enough.

I found this interesting:
Dislikable Clients or Countertransference: A Clinician’s Perspective

Either way -- feeling empathy for the overwhelmed-ness or being-a-bad-object feeling, or having "bad object" (implicitly or directed) projected at one through the client's feelings of anger or rage -- it may all be pretty instinctive and near a basic level of one's being.

I wonder if there is something that could be taught and some kind of training that might be possible. Like the "don't panic" training I think is given to special forces like Navy SEALS. Especially for therapists who are going to specialize in trauma or other "deep diving" situations.

Yes, I didn't have that. It did show up as a emotion/impulse, and not in an alter, when the last T terminated me, though. Along with a rejected, being-a-bad-object feeling. Dealing with that has been an awful period of my life. Hard to say it was such a good thing that it was forced into consciousness that way, though.

My understanding is that transference is on emotional level by definition, and distinct from therapeutic alliance. Like, there can be a good therapeutic alliance with negative transference, or the other way around. We did have a decent therapeutic alliance much of the time w xT, despite the strong negative transference, but in the end there were too many / too big ruptures with nowhere near enough repair.

There's that, but I think it's more a matter of ways to cope than that of reward and willingness, at least for xT and a lot of others from what I've read. Like, xT was not afraid of negative transference per se, and was able to handle it to some extent, just not well enough or consistently enough to get through it. And yes, feeling worthless/bad/unlovable was a thing for her, but I think not so much because she felt entitled to a reward (though there might have been some of that too), but because it's terrifying.

Also, it wasn't all transference ... initially yes mostly, the intensity of my anger yes, but funnily enough, the more defensive she got, and refused to acknowledge the hurt caused / her part n it, the more similar it got to an actual abusive situation.

Yeah, I wonder what sort of training trauma therapists get. I'd think they should be prepared for strong negative transference, but sounds like your T handled it pretty poorly. Online resources seem to emphasize the importance of a good support system, but not sure about specific techniques for tough situations. I wonder, though, if therapists being less distant, more honest and more willing to ask for the client's cooperation wouldn't help both sides.

I got the sense from my T that she felt she had to tough my anger out, and should handle everything on her own (which would fail and she'd then do or say something hurtful), when from the feedback she did give, I gathered that we had very similar experiences of each other. So why not use this as a basis for cooperation? Yet, whenever I tried to bring it up, I was met with silence or she skillfully shifted the subject, or avoided discussion some other way. Like, was she embarrassed about having these feelings and vulnerabilities? No matter how many times I told her that it's massively helpful for me when she shares her perspective, I don't know if it even got though to her.

That reminds me, there's a book on trauma therapy and counter-transference that I read, that's pretty informative: Countertransference and the Treatment of Trauma, and the author seemed to be in favour of increased disclosure, so it might not be just me.

Yeah, I can imagine. Actually, I probably can't, but ... there was a reason you had that stuff dissociated, so to suddenly have it show up ... it's bad enough after having 40-ish years of getting used to

I just want to clarify that I felt that what I wrote was only a fraction that I wanted to express and thus very incomplete, but I did not have energy for more at that point. It seems to me that you quite rightly picked up this vibe from my post.

I think you are right in principle and still, I think in many cases therapists mix those things up, especially those therapists that do not explicitly work with the transference. From what I've read, many or perhaps even most therapists interpret agressive and rageful feelings towards the therapist as the sign that the treatment is not working and thus the patient needs to be referred. I don't know your specific story though, but it seems that your case did not fall into this pattern I was attempting to describe here.

How much personal therapy had they received during their training? Did they receive therapy and/or supervision while working with you? It seems that you really hit hard to their blind spot.

[1] Yes, I can see how that could be the case. Now that you say that, and in light of what came up in yesterday's session with new T, there might have been some blurring of that line in our case (though not because she didn't know better). One of the most hurtful aspect of it was that she seemingly failed to even grasp the magnitude of the effort I put into trying to fix things between us, and instead started to take things personally (while constantly reminding me that it's just transference, and it wouldn't hurt if I weren't extra sensitive to it, and she "only" re-traumatised me, and even remembering makes me angry enough that I feel the urge to continue fighting, even though it's nearly half a year after the fact, a bit less since our last email exchange)

[2] I will make a thread about it any day now, but yeah, different pattern here - she (and the institution I met her) subscribes to the school of thought that 'angry is good, means we're onto something'.

[3] Yes, that's exactly what I think happened (or rather, how she rephrased when I told her what I think).

I don't know about her training - she's a psychiatrist, so her degree wouldn't have required her to have personal therapy I think, but her psychotherapist training might have, or she might have had it anyway. She seems fairly sensible about taking care of herself, or at least aiming to, though I kind of got the impression that she has a tendency to overburden herself. In the institution, there was a support system, and major decisions were discussed within staff, for all the good that did me. In her private practice, when I finally asked she said she was going to supervision, but didn't want to share whether she discussed my case there.

Hey @stopdog: to be fair I don't think not tolerating hostility has anything to do with being a good or bad therapist. I think it many cases if a therapist feels threatened then they end the relationship. However there are plenty of therapists that have an ego problem. I'm in agreement with you that therapy doesn't always help and not everyone will do well, and it's often pushed on people who don't need it or won't benefit from that.

Quote:

Originally Posted by stopdog A therapist who can't handle negative feelings should not be a therapist and most of them can't and shouldn't. They only do well getting their egos stroked. But I really believe that therapy is not a universal panacea. It does not help everyone and it is NOT the client's fault. Those people oversell and under-deliver. Look around at how clients twist themselves to overlook, forgive, excuse, and put up with horrible behavior from therapists. Good luck with betterhelp.

Please do not @ me. I would turn it off if I could

Quote:

Originally Posted by stopdog Please do not @ me. I would turn it off if I could

I’m sorry about that. I didn’t know.

Hi Sarah,

I understand you didn’t @ me, but I want to comment anyway.

When I went to therapy, I was told to be open with my feelings, to discuss issues I had with the therapist, and that therapy was a “safe” place to discuss these things.

What happens, then, if/when I DO have feelings of hostility? That these feelings may have roots that I don’t understand? Don’t even remember? And that I have the ability to keep these feelings turned off in order to get along and be civil with other people, but then that means that I am being “fake”, not “authentic”, have few close relationships, etc.

To say that therapy not everyone will do well in therapy – that’s a copout. I was having difficulties and distress and therapy is, or was at the time that I started, the generally accepted recommendation.

I had no independent way, in my disordered or distressed mind, to understand that a therapist would be threatened by my feelings of hostility, which I understood were part of the feelings I was safe to and encouraged to feel and express. I didn’t understand that I needed to watch out for the possibility that they would have an ego problem and terminate me as a result. That was certainly not on the informed consent papers I was given.

I don’t understand what “being fair” about therapists has to do with it. They are professionals and provide what they claim is a service, in return for a fee. Sometimes they do it for free or for a reduced fee but that does not change the basis of the underlying business “relationship”.

Sometimes they fail and hurt people and there is no recourse. I think that’s where the focus of “fairness” ought to be, if anywhere.

((Hugs)). Just wanted to validate your feelings that sometimes are issues are too much for therapists when we open ourselves up and be very real to them. One would think that they would take it as compliment that we can even show the ugly side to them. Not saying that negative transference is ugly but why does it even have to be called negative or hostile when we are not adoring our Ts?

Ts are paid well. Even those who give a sliding scale but they can bow out when we get to be too much. We are being vulnerable and then get the too much, emotionally draining, hostility talk. Are we protecting them at that point?

I think that you are the ideal client for a therapist to have because you are willing to show all parts of yourself. Good for you and thanks for being an inspiration to the rest of us who wrestle with feelings and parts.