When sleepiness or anger washes over the therapist: countertransference as a message

At three in the afternoon, in the middle of a session, my eyes start to close.

Not because I am tired — I had a break beforehand, drank a coffee, went for a walk. Not because the story is uninteresting either. The woman in front of me is talking about the years she spent caring for her ill husband, about sleepless nights, about going to work and looking after the children at the same time. The content is heavy. And yet something in the room strangely settles, as if someone had quietly switched off the light.

This is the second post in a series on countertransference — what a therapist feels in response to a client. In the first post I explained what countertransference is and how the view of it has changed. Here I look more closely at how the most unpleasant feelings of all — sleepiness, anger, helplessness, the urge to rescue — can become a message about what a person carries with them.

Feelings are not random

In 2005, Ephi Betan, Drew Westen and colleagues asked 181 psychiatrists and psychologists to describe their reactions to one of their patients. They then compared these reactions with the patients’ personality characteristics. They found that countertransference was not randomly distributed. With people who had similar patterns, therapists who did not know one another reported very similar feelings: with some they felt overwhelmed and worried, with others criticised and helpless, with others parentally protective.

This means something important. A therapist’s feelings do not just reflect their mood that day. To a large extent they are a response to the way a person is in a relationship — to tone, pace, what they say and what they leave out. Each of us creates a certain atmosphere in relationships. The people around us feel it, but rarely put it into words. A therapist is one of the few people whose job is to put it into words.

Two ways a therapist feels

In 1957 the Argentine psychoanalyst Heinrich Racker described a distinction that still seems to me one of the most useful in all of countertransference theory.

In concordant countertransference, the therapist feels the way the client feels. When someone talks about humiliation, the therapist feels humiliated. When they speak of loneliness, the therapist feels a chill. It is something like empathy, only often stronger — the therapist also senses what the client does not feel or does not show.

In complementary countertransference, the therapist feels the way the people around the client felt. When someone talks like a child who always did everything wrong, the therapist suddenly feels impatience and an urge to correct them — just as their parents once did. The therapist finds themselves in a role the relationship unconsciously offers them.

The distinction matters because the same feeling leads to different understandings. When a therapist feels anger, they have to ask: is this anger the client carries but is not allowed to feel? Or is it the anger others felt around them — which is now, without words, being stirred in me too? The answer decides what the therapist does next.

Common feelings and what they may mean

There is no dictionary that assigns one meaning to each feeling. Every relationship is different, and every feeling has to be understood within its own story. But some patterns are described by therapists so often that they are worth knowing.

Sleepiness and boredom. These often appear when a story is told without the emotion that belongs to it. The woman from the opening was talking about years of exhaustion, but as if she were reading out minutes. When we later explored why, she said: “If I’d started to feel it, I would have fallen apart. I wasn’t allowed to fall apart.” My sleepiness mirrored her survival mechanism — her feelings had to go to sleep so she could function. In the profession we also call this emotional numbness.

Anger and irritation. These often arise with people who reject every suggestion, cancel out every offer of help, or are constantly polite in a way that lets no one in. The anger may mirror anger the client is not allowed to feel, or it may repeat a relationship in which others around them were always helpless and therefore angry.

The urge to rescue. The therapist suddenly gives advice, offers extra sessions, thinks about the client in the evening. This often happens with people who had to grow up early and look after others in childhood — and whom nobody rescued. The therapist feels a need the client was never allowed to express.

Helplessness. The sense that whatever you say, nothing will change. It often mirrors the client’s own experience — that they kept trying all their life and nothing ever moved. You will find a short explanation of this pattern in the knowledge base under learned helplessness.

Fear and caution. The therapist starts choosing words carefully, steering clear of certain topics, as if walking on eggshells. This may reflect a family atmosphere in which you always had to be careful that nobody exploded.

Pleasant feelings are countertransference too

When countertransference is discussed, unpleasant feelings get most of the attention. But pleasant ones are just as important — and often harder to notice.

A therapist may feel especially clever, successful or important with a particular person. The client admires them, thanks them for every observation, reports progress. Sessions are easy and the therapist looks forward to them. This can be a sign of good collaboration. But it can also be a repeat of a role the client has played all their life: the child who had to make their parents happy, who made sure the adults around them were satisfied, and who learned that they were loved as long as they pleased. A therapist who enjoys the admiration may not notice — and therapy will be pleasant, but nothing real will happen in it. More about this pattern in the knowledge base under idealisation.

The same goes for a particular tenderness or protectiveness. The therapist feels they would like to shield this person from the world, that they are fragile and need to be looked after. Sometimes this is a concordant response to real vulnerability. Sometimes, though, it repeats a relationship with a parent who saw the child as too weak to manage alone — and, without meaning to, took away their sense of their own strength.

Infatuation and attraction are a chapter of their own. They happen in therapy too, in both directions, and there is nothing shameful about it. The therapeutic relationship is one of the few in which someone listens to you completely, remembers you and does not judge you — no wonder it can stir strong feelings. For the therapist there is one rule without exceptions: such a feeling is taken to supervision, never into the relationship with the client. Psychotherapists’ codes of ethics are unequivocal here, and rightly so — power in the therapeutic relationship is not evenly distributed.

What all pleasant feelings have in common is that the therapist finds them harder to question. You want to avoid an unpleasant feeling, so you notice it. A pleasant one you want to keep. That is exactly why it deserves the same careful look.

How a feeling moves from one person to another

How is it even possible for a therapist to feel something the client does not say? The psychoanalyst Thomas Ogden described this phenomenon as projective identification. A person unconsciously cannot bear a certain feeling — too big, too dangerous, forbidden — so they push it out of themselves. But the feeling does not disappear. Through tone, pace and small behaviours it creates pressure in the relationship, under which the other person begins to feel it.

The woman who was not allowed to be exhausted was, in the room, a flawless narrator, calm and composed. That very composure stirred in me what she was not allowed to feel: a tiredness that just wanted to close its eyes. Her exhaustion had travelled to me.

In relational family therapy this phenomenon is one of the central themes. There is nothing mystical about it. It is a very human way of communicating that we know from everyday life — who has not come away from a conversation feeling oddly drained, sad or tense without knowing why? The only difference is that in therapy we notice it and talk about it. I wrote about how the same phenomenon works between partners in Why the same fight keeps coming back.

How it sounds in the room

A therapist almost never states their countertransference outright. They do not say “I’m bored with you”. They use it as a compass for a question. A conversation with the woman from the opening might sound like this (a composite, not a real person):

“As I listen to how you talk about those years, I notice it sounds very orderly. Almost like a report.”
“Yes. That’s how it had to be.”
“What would have happened if it hadn’t been orderly?”
A long silence. “Then I’d have had to admit I couldn’t go on.”

At that moment the light in the room came back on. My sleepiness vanished, because the feeling she had been carrying had finally been spoken. Neither of us had to carry it for the other any more.

Exercise: what your story does to others

This exercise is not for therapists but for you. Countertransference does not only happen in the therapy room — anyone who listens to you responds to your story in some way. Those responses can be interesting information.

1. Think of the last three people you told something difficult from your life.
2. Write down how they responded. Did they give you advice? Change the subject? Get angry on your behalf? Start talking about themselves? Comfort you?
3. Look for a pattern. Do people around you often respond in a similar way?
4. Ask yourself how you told it. Did you tell the story calmly, with a joke, quickly, with an apology? What in that might stir such a response in the listener?
5. Write down what response you actually wanted. And consider whether you have ever asked for it directly.

If you notice people always give you advice when all you want is to be heard, this may be connected to how stories were told in your family. It is neither your fault nor theirs. It is a pattern that can change — sometimes with a single sentence: “I don’t need advice, I’d just like you to listen.”

Where a therapist can get it wrong

Everything I have written has one big trap: a therapist’s feeling can be misread.

If a therapist interprets their sleepiness as the client’s numbness when in fact they simply slept badly, they will attribute to the client something that is not there. If they understand their anger as a reflection of the client’s when in fact the story hit their own wound, they will look in the client for what they should be looking for in themselves. That is why countertransference is never proof. It is a hypothesis to be tested — with a question, by watching how the client responds, and in supervision. The third post in this series, Where therapists take their feelings, is about how therapists do this.

The second trap is for the therapist to start believing they “know better” than the client what the client feels. That is dangerous, because it takes away the client’s authority over their own experience. A good therapist offers their hypothesis as a question and accepts that the answer may be “no, it isn’t like that”. Sometimes the client is right.

What to remember

• A therapist’s feelings are not random — research shows they are systematically linked to the patterns a client brings into relationships.
• In concordant countertransference the therapist feels like the client; in complementary countertransference, like the people around the client.
• Sleepiness, anger, the urge to rescue, helplessness and fear are common feelings that can open important questions.
• Countertransference is a hypothesis, not proof — the therapist must test it and separate it from their own wounds.
• In everyday life you too can notice how others respond to your stories — and what that tells you.