Where therapists take their feelings: supervision, personal therapy and countertransference

When the door closes behind the last client, a therapist’s day is not over.

Something remains that nobody sees. A feeling that snagged after the second session and will not be put down. A sentence someone said that the therapist carries home. Anger they are not sure is theirs. Sadness too big for the story they heard — or just the right size, except that it was not the client who felt it, but them.

This is the third post in a series on countertransference. In the first I described what countertransference is, in the second how a therapist’s feelings can become a message. Here I answer a question people rarely ask out loud, though many carry it: where does the therapist take all of this? And how do you know they will not bring it back to you?

Three places countertransference goes

A therapist has three spaces in which to explore their reactions. Each has a different job.

Their own therapy. A therapist who does not know their own wounds will meet them in every client without knowing what is happening. That is why most psychotherapy trainings require therapists to go through therapy themselves first — often for hundreds of hours. Research reviewed by John Norcross shows that roughly three quarters of psychotherapists across different countries have been in therapy themselves, and the great majority report it was one of the most important experiences for their work. In their own therapy, a therapist learns where they are vulnerable, what hits them quickly and which roles they slip into without noticing.

Supervision. This is a regular meeting with a more experienced therapist where the focus is not the therapist’s life but their work. They bring sessions that puzzle them, decisions they are unsure of and feelings they cannot place. The supervisor helps them separate what is theirs from what is information about the client. There is a short explanation in the knowledge base under supervision.

Peer consultation. A group of therapists who present cases and reactions to one another without hierarchy. Its advantage is that several people with different sensitivities look at the same case — and someone often notices what the others miss. See also peer consultation in the knowledge base.

How supervision works

As a therapist in training under supervision, this is everyday life for me rather than theory. People often imagine supervision as a kind of inspection or assessment, where someone checks whether the therapist is doing it “right”. It is partly that — but most of the time it is something else.

I bring a session that has been on my mind. I do not only recount what the client said, but also what happened in me. Where I became restless. When I wanted to fix something. Where I went quiet when I should have asked. The supervisor does not answer with rules but with questions — just as I work with clients. Whose anger is this? Where have you felt it before? What do you think would have happened if you had said it?

It often turns out that my reaction was not random. Sometimes it says something about me — about a place where I am sensitive because I went through something there myself. Sometimes it says something about the client and the relationship we are creating. Most often both. Once I separate them, I can return to the next session with more room — and with less risk of unknowingly acting out my own wounds on the client.

In Slovenia, supervision is an integral part of a trainee’s path to independent practice. A trainee does not work alone: behind each of their sessions stands another, more experienced pair of eyes, which you do not see but which is always present. That is why I always state that I work under supervision — not as a warning, but as an assurance. It means I do not decide alone about what happens between us, and that I have somewhere to take what I cannot process in the room. I wrote about what the new Psychotherapy Act brought in a separate post on the law.

But supervision is not only for beginners. Many experienced therapists attend it throughout their careers, because they know blind spots do not disappear with the years — they just hide better.

When therapy repeats itself in supervision

One of the strangest things that happens in supervision has a name: parallel process. The American psychoanalyst Harold Searles described it back in 1955: the relationship between client and therapist is often, without anyone planning it, repeated in the relationship between therapist and supervisor.

A therapist working with a client who keeps asking for advice and then rejecting it may suddenly start doing the same in supervision — asking for direction and turning down every suggestion with “yes, but”. A therapist who feels helpless with a client may talk in supervision in a way that makes the supervisor feel helpless. It is not conscious. It is a trace the relationship with the client has left in the therapist, which the therapist carries on because they have not yet put it into words.

A good supervisor notices this and uses it. “I notice I have the feeling I can’t help you, whatever I suggest. Is that similar to what you feel with your client?” The answer is often a stunned “yes”. And in that moment the therapist feels first-hand what it is like to be in a relationship with that person — and what might help them.

Parallel process is a fine illustration of something at the heart of all relational therapy: relationships do not end where sessions end. We carry them with us, in our bodies and in how we speak — until we recognise them.

Why this matters to you

All of this may sound like the profession’s internal business. It is not. The 2018 meta-analysis by Jeffrey Hayes and colleagues showed that a therapist’s ability to recognise and manage their countertransference is associated with better therapy outcomes — for the client, not the therapist. When therapists act out their reactions unconsciously, therapy gets stuck more often.

A therapist who does not take their reactions anywhere acts them out in the room. Perhaps by being too lenient with you because your story reminds them of their own. Perhaps by avoiding topics that hurt them. Perhaps in such a way that you start, without meaning to, looking after them. You will not necessarily notice — but you may sense that therapy has stalled, that you are going round in circles, that something is missing.

What therapists don’t tell even their supervisors

I want to be honest about the weaknesses of this system too. In 1996 Nicholas Ladany and colleagues asked more than a hundred therapists in training whether they had ever withheld anything from their supervisor. A full 97 per cent said yes. They withheld negative reactions to the supervisor, personal difficulties, clinical mistakes — and feelings about clients, including attraction and anger.

The reason is understandable. A trainee’s supervisor is also assessing them, and who wants to admit they were bored or angry with a client? But it means supervision works only to the extent that it feels safe. A good supervisor therefore creates a relationship in which even the awkward things can be said — exactly as a therapist tries to create with a client. I know for myself that the sessions in which I said something I was ashamed of were among the most valuable.

What about confidentiality?

People often ask me: if my therapist talks about me in supervision, does that mean someone else knows what I said? It is a fair question.

In supervision the client is discussed without their name and without details that could identify them. The supervisor is bound by confidentiality just as the therapist is. The conversation is not meant for anyone to learn about you, but for the therapist to better understand themselves in the relationship with you. I wrote more about how confidentiality works and where its limits are in the post on confidentiality in therapy.

If you want to know whether your therapist has supervision, you can ask. It is not a rude question — it shows you care about how they look after the quality of their work.

What it looks like in practice

A small example of how supervision changes a session (a composite, not a real person). A man came to therapy who brought a pile of documents to every session — medical reports, letters, notes on arguments with his ex-wife. I noticed I was becoming more and more irritated and interrupting him. In supervision it went something like this:

“What irritated you?”
“That nothing of his own gets a word in. Only evidence.”
“Who is he proving it to?”
“…Not to me. To someone who never believed him.”
“And you interrupt him.”
“Like the person who didn’t believe him.”

At the next session I did not interrupt him. I asked him who in his life he had always had to prove everything to. The story that followed was not in any of the documents.

Exercise: questions you can ask your therapist

If you are looking for a therapist or are already in therapy, you can ask directly how they look after their own reactions. Here are some entirely appropriate questions:

1. “Do you have supervision? How often?” For trainees it is mandatory and frequent; for experienced therapists it is often voluntary — but it is a good sign if they have it.
2. “Have you been in therapy yourself?” Your therapist does not owe you details, but they can say whether personal therapy was part of their path.
3. “What happens if something gets stuck for you with me?” The answer tells you whether the therapist thinks about this.
4. “Can I tell you if something about you bothers me?” The answer must be a clear “yes”.
5. Watch how they answer. Are they open, curious, calm? Or defensive, dismissive, or do they find the question out of place?

You will find more questions to help you choose a therapist in How to choose the right therapist for you.

Where even supervision isn’t enough

No supervision guarantees that a therapist will never make a mistake. Sometimes countertransference remains blind — precisely where a therapist is most vulnerable, it is hardest to see. Sometimes the therapist is going through a period when they are too burdened themselves, and they cannot separate what is theirs from what is the client’s.

It is also important to admit that there are situations in which a therapist cannot work well with a client, however hard they try. If the story hits a wound that is still too fresh, or a reaction keeps recurring with a client that they cannot get past, the responsible thing is to refer the client to a colleague. That is not rejecting the client. It is caring for them. I wrote about when ending therapy makes sense and when it does not in a separate series, beginning with Why people quit therapy.

And finally: a therapist is also a person who gets tired. Countertransference that builds up without being taken anywhere leads to burnout. So looking after one’s own reactions is not only a professional duty, but also a way of making sure the therapist stays present enough for the people who trust them.

What to remember

• Therapists explore their reactions in their own therapy, supervision and peer consultation.
• Roughly three quarters of psychotherapists have been in therapy themselves; most rate it as key to their work.
• Supervision only works if it is safe to say even awkward things — 97% of trainees in one study withheld something.
• In supervision you are discussed without your name, and the supervisor is bound by confidentiality.
• You may ask your therapist whether they have supervision — it is a sign of care, not distrust.