Triggers and Countertransference Issues of a Family Therapist - Case Study Example

Countertransference Issues for a Family Therapist Any therapist working with must realize that there can be triggers from working with a client that can create countertransference. The client may have transference issues of their own, but a therapist is trained to help the client through these issues. This paper will focus on the triggers that a family therapist must confront when they are products of dysfunctional families. The needs of the therapist will be discussed using Attachment Theory, Bowen Family Systems Theory and Emotion-Focused Therapy (EFT). Triggers that May Cause Countertransference The therapist (we will call Jane) was raised by a mother and father who were alcoholics. The parents cared about appearances more than they cared about Jane and her other siblings. The therapist was supposed to act perfect in the eyes of her parents or she would suffer the consequences. Jane is now an adult child of an alcoholic and takes with her the memories of all the things that happened to her in her home as she was growing up. An alcoholic client could present a trigger if they were having difficulty staying sober. The client may act out in ways that would cause Jane to become angry toward the client in sessions. This could happen because Jane began to “see” the client as one of her parents. A client who was alcoholic and had children could also trigger anger from Jane. As a family counselor, Jane would see the entire family unit. She may become overly protective of a child or children in the family because they were experiencing similar problems that the Jane experienced growing up. This could cause Jane to call Children’s Services prematurely because she would want to stop the children from having the same experiences growing up. Jane’s mother and father were also emotionally abusive to her which could be another reason whey she would feel overly protective toward the children in sessions. This could also happen because Jane is reflecting the feelings of fear and anxiety that are left from her childhood onto the client and their family. As Jane talks with the family, she could feel the anger, fear, and anxiety building up as she is talking with the family and feel that there is something that she needs to do to protect these children. Through the description of the case study, it is clear that Jane did not have a strong attachment to her parents. This would ensure that she may be cold and distant toward her clients. A parent who appeared unloving towards their children could trigger Jane to become more distant during times in therapy sessions. Because her parents did not show love and did not nurture her, she may find it difficult to show love and nurturing to her clients. Jane’s mother is described as emotionally cold, manipulative, and she played mind games with her children. Because of this, Jane may find herself playing mind games with her clients as they began to relate similar problems that the Jane had when she was a child. This could happen because Jane is feeling vulnerable and insecure during these times. Neglect and abandonment were also aspects of Jane’s life growing up could trigger a need for her to try and “fix” her families by giving them advice instead of presenting objective listening. Jane may push parents to do what she says instead of giving them choices of how to work with this situation. Jane may still feel abandoned in her life so any situations that happen that make her feel this emotion again could trigger countertransference. Jane still has resentment toward her parents for what happened and this resentment appears when she states that her parents will not take responsibility to this day. These feelings can trigger an attitude of resentment toward families that show o remorse about what happened. She may push the families into looking at their problems instead of allowing this to happen in the therapeutic process naturally. These problems can cause a misunderstanding with clients and in many ways; she could lose clients because of her actions. What the Therapist Needs to Do The first thing that Jane needs to do is find a therapist that she can work with to resolve her childhood issues. She needs to be in therapy to learn to manager her emotions and to be more involved with her clients in their treatment. This is particularly true to help Jane understand her countertransference issues more thoroughly. She would also need another therapist that she could refer clients too while she is working through her own issues. When Jane elects to go to therapy there are several ways that a therapist could work with her. In the beginning, the therapist may ask her to consider her family as a unit that works together. If one part of the family is not functioning well, the other parts of the family may not function well. Jane may need to understand the dynamics of her family before she can move forward with her life. Bowen (2002) states in Family Systems theory that when there is a “Change in the functioning of one family member is automatically followed by a compensatory change in another family member” (p.260). This is what Jane as an adult, may need to understand about her family. She may need to examine each family member’s place in the family and how they created dysfunction together. Jane’s parents may still be drinking and this may be why they are not taking responsibility for their actions towards their children. Jane would need to address her feelings of anger and resentment toward her parents. The family unit created many challenges for Jane emotionally and mentally that she will need to move out of the way in order for her to set a clearer path with her patients. Bowen (2002) also states that alcoholism is a “common human dysfunction” (p. 262) and that it causes an imbalance in the family system. Jane may need to modify her patterns when dealing with her parents directly so that she can relax more and feel more comfortable toward her clients. Jane’s therapist may work with Family System therapy and help Jane modify her patters when dealing with her parents which can spill over into helping her clients using a different approach. Jane also has many feelings that she will need to work out in therapy. Emotion-Focused Therapy (EFT) could help her. Weeks and Treat (2001) stat the feelings are very important in family system relationships. They state that “close relationships, such as marriage, frequently evoke the strongest emotions an individual can experience” (p. 203). The therapist has deep and strong emotions about her parents and must lesson the intensity that she feels. Using EFT would help Jane figure out her feelings and again, learn to put them into a different perspective and change her patterns. Montago, Svatovic & Levinson (2011) suggest that EFT training is important for any therapist to do to be aware of feelings that can cause countertransference. Using EFT would help Jane learn how to manager her feelings about her parents and about issues in her life. Another issue that Jane may be facing is feelings of abandonment. She may be feeling this because she was never able to establish a connection (attachment) with her parents. The parents were more involved with saving face in front of their neighbors and friends. They did not bond with any of their children because of their preoccupation with alcohol and saving face. Attachment is a very important aspect of a child’s life. They form their first bonding with parents when they are babies and they learn whether or not to trust the bonds of their caregivers. According to Illick, McAllister, Jeffries & White (2003) “attachment is a natural state of symbiosis between mother and infant necessary for survival” (p. 204). As a child develops their independence, how they develop will depend on how well they are able to bond with their family unit (Illick et al., 2003). In fact, an individual’s ability to mature will depend on to what extent they are able to resolve emotional attachment issues (Illick et al., 2003). With unresolved emotional attachments, the individual will have difficulty moving forward in their life. It is this researcher’s assertion that the Jane also has challenges because she is grieving the lack of the presence of her parents in her life. Because of this, she has problems not only with attachment but the fact that she was not able to attach. She has unresolved emotions around this issue. In addition to the countertransference issues, she may also have issues forming good relationships in her personal life because she has not been able to trust her interaction with her parents who were her primary caregivers. (Gassin, 2010). Johnson (2008) suggests that an individual who has endured chronically traumatic events has a chance to heal them through love. Johnson states that traumatic events are events that automatically “change the world as we know it, leaving us helpless and overwhelmed” (p. 234). The trauma of being neglected and having to live with an unstable family with alcohol parents can qualify for a traumatic even in Jane’s life. Johnson (2008) suggests that individuals generally lock their feelings away from interaction with others when they have had a traumatic event. However, they must find a way to make secure attachments. The reason they must find a way to do this is because they are isolating their feelings in an attempt to try to protect themselves from feeling. When they do this, people around them can feel insecure and the relationship can weaken. In this situation, Jane may not be able to change her attitudes toward others without working through her attachment issues. Bonovitz (2009) adds to this discussion by stating that childhood memories can appear as countertransference for a therapist working with children. As stated previously, Jane could have challenges when working with children in family therapy who are expressing emotions and or events that happened in their lives that were similar to challenges that Jane felt. Bonovitz (2009) suggests that countertransference can actually be helpful in some situations if the therapist is able to look at these issues and understand why the countertransference is happening; this would be a goal for Jane to understand during her own therapy sessions. The use of EFT can also provide a way for an individual to understand their emotions and the part of these emotions play in their development. An effective EFT therapist would help Jane move through the nine steps of EFT. Sandberg and Kuestel (2011) state that in order for EFT to be successful, the therapist must help the client form a therapeutic alliance with the therapist and at the same time, examine how their client may find ways to attach to other people in a healthy way. The therapist might ask Jane to use a self-report to se how she is dealing with the relationships in her life. These issues would be used to help her lessen her anger, resentment and hurt that she is still feeling with her parents. Preventative Measures As stated previously, one preventative measure would be to have Jane go to therapy. This is the most obvious preventative measure. She would be able to work through her emotional issues around her parents and see how her problems with countertransference affect her relationship with her clients. Jane must be able to understand her own family and how it has affected her life so that she can help other families look at their families and sort out the information necessary for them to heal. Papero (1990) suggests that in Family Systems Therapy the client would create a visual method to look at their emotions and the emotions of each family member. Jane could create this with her own emotions relative to the emotions she still carries from childhood. Collecting family information may be beneficial for her to resolve specific issues. Popero (1990) also suggest that when interacting with the family, the members must take themselves out of the negative emotional situation and find new ways to interact with the family. As an example, if Jane is still interacting with her parents, she can still be in touch with them but refuse to interact with the emotions that usually are involved in a situation. She must also learn to become what Papero (1990) calls an accurate observer of the family instead of being engaged in the drama of the moment. This would help Jane step away from the emotions of the situation to see what is going on with her, and hopefully she would feel calmer dealing with her parents. She would also be able to understand how her parents are acting in terms of the total family unit, which will also help her in conducting family therapy. As Jane learns to lessen her reaction to her parents and to understand her own reactions with other people, she would be able to lessen her reaction to triggers in her own family therapy sessions. She would be able to identify when a trigger was beginning, and able to either excuse herself for a moment to compose herself, or use the countertransference in a more positive way during the session. The case study does not state whether her parents are still drinking, but if they are, she may consider attending Alanon even if they are not attending Alcoholics Anonymous. This action would provide her with a way to interact with her parents in a different way. She may need to understand what alcoholism is about and why her parents are still drinking. If they are not taking responsibility for what they did, they may still be drinking or just sober. They may need to find Alcoholics Anonymous or therapy to help. Bowen (2002) suggests that an individual dealing with an alcoholic family must understand the value of themselves in relationship to the rest of the family. In Jane’s situation, she must learn to change her feelings of being “de-selfed” so she can experience a stronger self-esteem. Although Jane has not said that she felt devalued, this information is apparent by what she has stated. Bowen (2002) explains de-selfed as something that happens that creates a pattern within an alcoholic family and the individual who has been de-selfed must find ways to move forward. Dunham and Wooley (2010) suggest that positive attachments can be made over time, but that individuals must be able to reform negative cycles into more positive ones. Emotionally Focused Therapy helps an individual mot out of the process of negative cycles. The authors state that “poisonous parents, impinge, negatively, on children’s internal working model of relationships” (p. 96). The way to circumvent these problems is to understand their own attachment needs and understand “how to repair events that damage attachments” (p. 96). In this author’s opinion, when an individual can repair events that created their problems in the first place, when they can come to an understanding of the problem, and heal it for themselves, they are better able to forgive the people who helped to create the detachment. Conclusion The basic issues for Jane are centered in the control of her emotions. She must go to counseling to gain control over her emotions. Family Systems Therapy could help her over the long-term but she would be doing this as an individual because it is doubtful hat her parents would enter into therapy with her to deal with family issues. It has already been said that her parents are not taking responsibility for their actions. Countertransference is often steeped in emotions. The triggers that create this issue are usually emotional in nature. As an example, a family that presents alcoholism may trigger Jane’s feelings of detachment, anger, frustration which could make her take these feelings out on the family. They may also cause her to think back to a childhood member that triggers more emotions. EFT can help Jane move through her emotions and learn how to lessen the challenges that trigger her in her work with other families. Attachment theory provides an understanding of what happens when families are dysfunctional. In Jane’s situation, the lack of her attachment with her parents encouraged insecurity, fear and eventually resentment, which could be moved over into problems with her clients. These emotions must be lessened or eliminated so they do not trigger countertransference. References Bowen, M. (2002). Family therapy in clinical practice. New Jersey: Jason Aronson. Bonovitz, C. (2009). Countertransference in child psychoanalytic psychotherapy: The emergence of the analyst’s childhood. Psychoanalytic Psychology, 26 (3), 235-245. doi: 10.1037/a0016445 Dunham, S. , Dermer, S.B., & Carlson, J. (Eds.) (2011). Poisonous parenting: Toxic relationships between parents and their adult children. New York: Taylor & Francis Group. Dunham, S. and Wooley, M. (2011). Creating secure attachment: A model for creating healthy relationships, in Dunham, S. , Dermer, S.B., & Carlson, J. (Eds.) Poisonous parenting: Toxic relationships between parents and their adult children. New York: Taylor & Francis Group. Erdman, P. and Ng, K-M. (2010). Attachment. New York: Taylor & Francis Group. Gassin, E. A. (2010). Cultural variations in the link between attachment and bereavement, in Erdman, P. and Ng, K-M. Attachment. 71-87.New York: Taylor & Francis Group. Illick, S.D., McAllister, G. H., Jeffries, S. E. & White, C. M. (2003). Towards understanding and measuring emotional cutoff in Titleman, Peter (Ed.) (2003)Emotional cutoff: Bowen family systems theory perspectives, 199-217. New York: The Haworth Clinical Practice Press. Johnson, S. (2008). Hold me tight. New Jersey: Little Brown. Montagno, M., Svatovic, M., & Levenson, H. (2011). Short-Term and Long-Term effects of training in emotionally focused couple therapy: Professional and personal aspects. Journal of Marital & Family Therapy, 37(4), 380-392. doi:10.1111/j.1752-0606.2011.00250.x Papero, D.V. (1990). Bowen family systems theory. Massachusetts: Simon & Schuster. Titleman, Peter (Ed.) (2003). Emotional cutoff: Bowen family systems theory perspectives. New York: The Haworth Clinical Practice Press Weeks, G. R. & Treat, S. R. (2001). Couples in treatment: Techniques and approaches for effective practice. Philadelphia, PA: Bruner Routledge. Read More

Because of this, Jane may find herself playing mind games with her clients as they began to relate similar problems that the Jane had when she was a child. This could happen because Jane is feeling vulnerable and insecure during these times. Neglect and abandonment were also aspects of Jane’s life growing up could trigger a need for her to try and “fix” her families by giving them advice instead of presenting objective listening. Jane may push parents to do what she says instead of giving them choices of how to work with this situation.

Jane may still feel abandoned in her life so any situations that happen that make her feel this emotion again could trigger countertransference. Jane still has resentment toward her parents for what happened and this resentment appears when she states that her parents will not take responsibility to this day. These feelings can trigger an attitude of resentment toward families that show o remorse about what happened. She may push the families into looking at their problems instead of allowing this to happen in the therapeutic process naturally.

These problems can cause a misunderstanding with clients and in many ways; she could lose clients because of her actions. What the Therapist Needs to Do The first thing that Jane needs to do is find a therapist that she can work with to resolve her childhood issues. She needs to be in therapy to learn to manager her emotions and to be more involved with her clients in their treatment. This is particularly true to help Jane understand her countertransference issues more thoroughly. She would also need another therapist that she could refer clients too while she is working through her own issues.

When Jane elects to go to therapy there are several ways that a therapist could work with her. In the beginning, the therapist may ask her to consider her family as a unit that works together. If one part of the family is not functioning well, the other parts of the family may not function well. Jane may need to understand the dynamics of her family before she can move forward with her life. Bowen (2002) states in Family Systems theory that when there is a “Change in the functioning of one family member is automatically followed by a compensatory change in another family member” (p.260). This is what Jane as an adult, may need to understand about her family.

She may need to examine each family member’s place in the family and how they created dysfunction together. Jane’s parents may still be drinking and this may be why they are not taking responsibility for their actions towards their children. Jane would need to address her feelings of anger and resentment toward her parents. The family unit created many challenges for Jane emotionally and mentally that she will need to move out of the way in order for her to set a clearer path with her patients.

Bowen (2002) also states that alcoholism is a “common human dysfunction” (p. 262) and that it causes an imbalance in the family system. Jane may need to modify her patterns when dealing with her parents directly so that she can relax more and feel more comfortable toward her clients. Jane’s therapist may work with Family System therapy and help Jane modify her patters when dealing with her parents which can spill over into helping her clients using a different approach. Jane also has many feelings that she will need to work out in therapy.

Emotion-Focused Therapy (EFT) could help her. Weeks and Treat (2001) stat the feelings are very important in family system relationships. They state that “close relationships, such as marriage, frequently evoke the strongest emotions an individual can experience” (p. 203). The therapist has deep and strong emotions about her parents and must lesson the intensity that she feels. Using EFT would help Jane figure out her feelings and again, learn to put them into a different perspective and change her patterns.

Montago, Svatovic & Levinson (2011) suggest that EFT training is important for any therapist to do to be aware of feelings that can cause countertransference.

Read More