For The Whole Therapist: Countertransference: How to Manage When Things Feel Too Close

Written by Tanisha Christie, LCSW (she/her)

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Consider a therapist working with a client who shares a similar background of childhood trauma. The therapist begins to feel an overwhelming urge to protect the client, leading to over-involvement and difficulty maintaining professional boundaries. Or in another scenario, a therapist feels intense frustration towards a client who consistently resists therapeutic interventions. Or a therapist feeling discomfort or guilt related to their privilege compared to their client, these are experiences of countertransference in the client-therapist relationship.  Countertransference, a concept introduced by Sigmund Freud, refers to the emotional reactions and projections a therapist experiences towards a client. While Freud contributed significantly to the development of psychoanalysis, his work has been critiqued for its patriarchal biases and lack of cultural sensitivity. Despite these flaws, his introduction of countertransference laid the groundwork for future exploration. 

Modern therapeutic perspectives recognize countertransference as a valuable tool for understanding the therapist-client dynamic. This perspective is echoed in Irvin Yalom’s The Gift of Therapy, where he emphasizes the importance of therapists embracing their humanity and using their genuine reactions as part of the therapeutic process. Yalom’s work, while influential, also invites critique for occasionally universalizing experiences without fully accounting for systemic factors. However, when left unmanaged, countertransference can blur professional boundaries and hinder therapeutic progress. 

Freud ( originally described countertransference as ‘the therapist’s unconscious reactions to a patient’s transference’ —the projection of feelings from past relationships onto the therapist. Over time, this definition has broadened to include all emotional responses a therapist has towards a client, whether conscious or unconscious. According to Gelso and Hayes (2007), countertransference can manifest in various forms, such as over-identification, emotional distancing, or even feelings of frustration and anger.

Irvin Yalom expands on this concept by encouraging therapists to engage in authentic, transparent interactions with their clients when appropriate. In The Gift of Therapy, he argues that self-disclosure and genuine emotional responses can deepen the therapeutic alliance, provided they are shared thoughtfully and in service of the client’s growth. This approach aligns with the broader, modern understanding of countertransference as a potential therapeutic asset rather than merely a liability.

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As therapists, we’re not just navigating our clients’ emotions—we’re also contending with our own. In times of socio-political upheaval, such as shifts in administration or the shared global trauma of COVID-19, the line between our personal and professional lives can blur. We find ourselves experiencing the same anxieties, fears, and uncertainties as our clients. This parallel process can intensify countertransference, making it even more critical to recognize and manage our reactions thoughtfully.

Research highlights that countertransference is not inherently negative. When therapists become aware of their emotional responses, they can use these insights to deepen the therapeutic relationship and better understand the client’s needs (Gelso & Hayes, 2007). However, unmanaged countertransference can lead to ethical dilemmas, boundary violations, and impaired judgment, ultimately compromising the therapeutic process.

From an Indigenous and spiritual framework, countertransference can be understood not just as a clinical phenomenon but as an energetic and ancestral exchange that reveals what is unspoken between the healer and the person seeking support. Rather than something to be minimized or pathologized, these emotional reactions can be seen as invitations for the therapist to explore their own lineage, internal wounds, and spiritual teachings. In many Indigenous traditions, healing is relational and communal—when a practitioner feels stirred by a client’s story, it may be a sign that ancestral patterns or collective traumas are surfacing for mutual recognition and repair. Approached with humility, ceremony, and accountability, countertransference becomes a sacred mirror, showing the therapist where healing is still needed within themselves and within the broader web of community.

Recognizing countertransference is the first step towards managing it effectively. Common signs include:

1. Strong Emotional Reactions: Feeling unusually angry, anxious, or overly sympathetic towards a client.

2. Over-identification: Seeing oneself in the client’s experiences and struggling to maintain objectivity.

3. Rescue Fantasies: Feeling an overwhelming need to “save” the client from their problems.

4. Avoidance or Detachment: Emotionally withdrawing from a client to protect oneself from discomfort.

5. Boundary Blurring: Offering special treatment, bending rules, or becoming too personally involved.

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It’s important for self-awareness and supervision in managing countertransference. Research shows that therapists who engage in regular self-reflection and supervision are better equipped to recognize and address their emotional reactions. Mindfulness practices have also been shown to enhance therapists’ ability to stay present and non-reactive, reducing the likelihood of countertransference influencing their work. Therapists who acknowledge and explore their countertransference reactions with supervisors or peers' experience will allow for a better experience in the room for you and your clients. A collaborative approach fosters a deeper understanding of both the therapist’s and the client’s emotional landscapes.

I am constantly asking the therapists here in the practice, What tools are you using in the room? Incorporating various therapeutic modalities can also assist therapists in managing countertransference. Any modality where you can use some structured frameworks can help therapists maintain objectivity and navigate emotional responses.

If you desire to use CBT’s focus on identifying and challenging cognitive distortions can be applied to the therapist’s own thought patterns, aiding in recognizing when emotional reactions stem from personal biases rather than client behaviors. Similarly, psychodynamic approaches encourage exploration of unconscious processes, enabling therapists to uncover deeper layers of countertransference and its origins.

Mindfulness-based and indigenous modalities promote present-moment awareness and non-judgmental observation of thoughts and feelings, and/or touching on ancestral patterns.. This practice can ground therapists in the here and now, reducing the risk of emotional reactivity and enhancing their capacity to respond thoughtfully to clients.

Liberation-based practices encourage therapists to recognize how systemic oppression, cultural identity, and historical trauma influence the therapeutic process. Also, the daily effects that are also recognized by clients can be integrated so that therapists can become more attuned to how their own identities and social positions shape their emotional responses to clients. 

The use of self in therapy involves bringing the therapist’s whole being into the therapeutic relationship. This means acknowledging personal biases, cultural backgrounds, and emotional reactions as part of the therapeutic process. When therapists are transparent about their positionality and engage in ongoing self-examination, they can use their experiences to build authentic, empathetic connections with clients. But this has to be done mindfully with the client; attunement, rapport, and emotional containment are key.

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Collective trauma is real. We as therapists are finding ourselves grappling with similar fears and anxieties as our clients. Recognizing these shared experiences through a liberation-based perspective helps us not only to manage our countertransference but also to foster a deeper, more compassionate therapeutic environment.

Here are some strategies for managing countertransference:

1. Self-Reflection: Regularly reflecting on one’s emotional responses can help identify potential countertransference. Take a beat, breathe, journal, and note what you are feeling. These are valuable tools for fostering self-awareness.

2. Supervision and Consultation: Don’t be a hero/ine. Engage in supervision or peer consultation for perspective on challenging cases. Discussing emotional reactions with trusted colleagues will help clarify whether these feelings are countertransference and how to address them.

3. YOUR OWN Mindfulness Practices: Do what you would recommend to clients. Incorporating mindfulness techniques into your daily routine will enhance your emotional regulation and presence. Deep breathing, tapping, meditation, sipping tea or water during sessions, and body scans - all will help you stay grounded during sessions.

4. Setting Boundaries: Maintaining clear professional boundaries is crucial. This includes adhering to session times, avoiding dual relationships, and being mindful of the therapist’s role in the client’s life. The minute you think you can ‘fix’ a client’s problem, get into a supervisory session.

5. Personal Therapy: If you are a newer therapist and not in your own therapeutic process, you will struggle. Therapists benefit from their own therapeutic work for a space to explore unresolved issues that may influence their reactions to clients. Personal therapy also models the importance of self-care and emotional health.

6. Continuing Education: Staying informed about the latest research and theories on countertransference or modalities will help grow your clinical mind. The perception that being clinically objective would disrupt your empathy or attunement with your client is not giving the full weight and understanding of your positionality as a therapist. It will also assist in developing and managing your countertransference. Your development as a practitioner

7. Integrating Liberation-based Practices: Recognizing the broader socio-political context of therapy can help therapists manage countertransference by situating personal reactions within larger systemic frameworks. This perspective fosters empathy and a deeper understanding of the client’s lived experience.

Countertransference is an inevitable part of the therapeutic process, offering both challenges and opportunities for growth. Cultivating self-awareness allows therapists to navigate countertransference with greater resilience, authenticity, and compassion. This not only safeguards the therapeutic relationship but also enhances the quality of care you will provide to your clients. If you’d like to explore this topic more deeply, join us for our upcoming CEU course, Where’d You Go? Exploring Dissociation and Countertransference in Psychotherapy — September 16–17, 2025.

Research for this article references:

Gelso, C. J., & Hayes, J. A. (2007). Countertransference and the Therapist's Inner Experience: Perils and Possibilities. Mahwah, NJ: Lawrence Erlbaum Associates.

Grepmair, L., Mitterlehner, F., Loew, T., Bachler, E., Rother, W., & Nickel, M. (2007). Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: A randomized, double-blind, controlled study. Psychotherapy and Psychosomatics, 76(6), 332-338.

Hayes, J. A., Gelso, C. J., & Hummel, A. M. (2011). Managing countertransference: What the experts think. Psychotherapy, 48(1), 88-97.

Rosenberger, E. W., & Hayes, J. A. (2002). Therapist as subject: A review of the empirical countertransference literature. Journal of Counseling & Development, 80(3), 264-270.

Martín-Baró, I. (1994). Writings for a Liberation Psychology. Cambridge, MA: Harvard University Press.

Fuentes, M. A. (2020). Decolonizing Wellness: A Latina's Guide to Healing Mind, Body, and Spirit. Oakland, CA: New Harbinger Publications

Yalom, I. D. (2002). The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients. New York, NY: HarperCollins.

Martín-Baró, I. (1994). Writings for a Liberation Psychology. Cambridge, MA: Harvard University Press.

Ladany, N., Friedlander, M. L., & Nelson, M. L. (2005). Critical Events in Psychotherapy Supervision: An Interpersonal Approach. American Psychological Association.

Tansey, M. J., & Burke, W. F. (1989). Understanding countertransference: From projective identification to empathy. Psychotherapy: Theory, Research, Practice, Training, 26(3), 336-343.

Winnicott, D. W. (1965). The Maturational Processes and the Facilitating Environment. London: Hogarth Press.

Linklater, R. (2014). Decolonizing Trauma Work: Indigenous Stories and Strategies. Winnipeg, Manitoba, Canada: Fernwood Publishing.

Menakem, R. (2017). My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies. Las Vegas, NV: Central Recovery Press.

DeGruy, J. (2022). Ceremonial Practices for Healing Historical Trauma. Portland, OR: Institute for African American Health.