Countertransference: what your therapist feels with you and why it belongs in therapy

“Do you ever get bored with me?”

The question came near the end of a session, half joking, with a smile that came a little too fast. And because it was half a joke, it would have been very easy to brush it off with a kind “of course not”. But in that moment I noticed that a few minutes earlier I really had caught myself drifting. Not because the story was uninteresting, but because it was told as if nobody were telling it — evenly, without a single emotion, like a weather report on one’s own life.

What I noticed in myself at that instant has a name in psychotherapy: countertransference. It covers everything a therapist feels, thinks and experiences in response to the person they are working with. This post is the first in a series of five, in which I will try to explain what countertransference is, why it is part of every therapy and why — perhaps surprisingly — it is one of the most valuable tools we have.

The therapist is not a blank screen

For a long time the therapist was expected to be a kind of neutral mirror: sitting, listening, feeling nothing in particular and reflecting back only what the person had brought. In 1910 Sigmund Freud first wrote the word Gegenübertragung — countertransference — and described it as a disturbance: the therapist’s personal reactions, which had to be recognised and removed so as not to get in the way of the work.

Forty years later, in 1950, the psychoanalyst Paula Heimann presented a short paper at a congress in Zurich that turned this view on its head. The therapist’s feelings, she said, are not only their private business. They are also an instrument for exploring the client’s unconscious. When a therapist suddenly feels anxiety, anger, sadness or boredom with someone, it is often no accident. It is a trace of something the person has brought into the room but cannot, or does not know how to, put into words.

Today most therapeutic schools agree — from psychodynamic to relational and systemic. The therapist is not a blank screen. They are a person who enters the relationship with their own body, history and sensitivity. And that is exactly why they can sense things no questionnaire would ever catch.

What countertransference includes

When I say countertransference, people often think of something dramatic — a therapist falling in love with a client, or getting angry with them. That can happen, but most countertransference is much quieter. Here are some of the forms therapists describe most often:

• Bodily reactions. Tiredness that arrives suddenly mid-session. A knot in the stomach. A sense that there is not enough air in the room.
• Emotions. Sadness at a story told without tears. Anger at someone who is unfailingly polite. Tenderness, almost maternal, towards an adult.
• Thoughts and images. A sudden memory, a song looping in your head, an image with no obvious link to the conversation.
• Behaviour. A session the therapist stretches by five minutes, though they do this with no one else. A question they “forget” to ask. Advice they give, though they do not usually give advice.

The last group is the most interesting, because the therapist often notices it only in hindsight. Then they ask: why, with this person in particular, did I do something I do not usually do? The answer nearly always says something about the relationship that is forming between us.

Where it comes from: two sources

When a therapist feels something, there are two possible sources — and most often it is a mixture of both.

The first source is the therapist themselves. Therapists have parents, losses, wounds and sensitive places too. If someone grew up with a mother who was often ill, a story about an ill mother will hit them differently than it would someone who never lived through that. Then the feeling says more about the therapist than about the client. The therapist must be aware of this — and the third post in this series, Where therapists take their feelings, is about exactly that.

The second source is the client and the relationship between them. People unconsciously bring into relationships the patterns they learned in their earliest bonds — we call this transference; you can find a short explanation in the knowledge base under transference and countertransference. The therapist responds to that transference, often in the same way the people in the client’s life responded. If someone was invisible at home, the therapist may find themselves overlooking them too. If they were always the one who had to sort everything out alone, the therapist may feel an unusual urge to rescue them.

In relational family therapy, which I am training in, we pay particular attention to this. Christian Gostečnik describes how the very emotional atmosphere a person grew up in is recreated in the therapy room — not because the client creates it on purpose, but because they know no other. The therapist feels it from the inside. And once they feel it, they can help put it into words.

Why this is good news

In a 2018 meta-analysis, Jeffrey Hayes, Charles Gelso and colleagues brought together decades of research on countertransference. They found two things. First, when therapists fail to recognise their reactions and act them out — for example by starting to avoid a client or comforting them unnecessarily — therapy outcomes are somewhat worse. Second, and more importantly, when therapists are able to recognise and manage their reactions, this is associated with noticeably better outcomes.

So the key is not for the therapist to feel nothing. A therapist who feels nothing with people is not neutral but absent. The key is what they do with what they feel.

What happened with that boredom

Let us go back to the question from the opening. When the client asked whether I got bored with him, I had several possible answers. I could have said “of course not” and reassured him. But that would not have been entirely true, and it would have closed something that was just opening. The conversation went something like this (a composite, not a real person):

“Why do you ask?”
“I don’t know. People get bored with me quickly. It was always like that at home — Dad read the paper at dinner.”
“I noticed you told me about your brother’s funeral very calmly. Almost as if you were talking about someone else.”
“If I’d told it any other way, nobody would have listened.”

My tiredness was not a sign that he was boring. It was a sign that he had learned to tell his life in a way that makes others stop listening — because that was safer than waiting for a response that never came. When we put this into words together, something in the room shifted. With his next story his eyes filled with tears. The tiredness was gone.

The second post in this series, When sleepiness or anger washes over the therapist, is about how feelings like these — sleepiness, anger, the urge to rescue — can become a message.

Why it is so rarely talked about

If countertransference matters so much, why do you hardly ever read about it? On therapists’ websites you will find descriptions of methods, training and fees, but rarely the sentence “I will feel many things with you, and that is part of the work”.

Part of the reason is shame. Therapists are often trained in the belief that we should be calm, stable and “above it all”. Admitting that you were bored with a client, that you got angry with them, or that you carried their sadness long after the session, can feel like admitting you are unprofessional. In 1949 Donald Winnicott wrote a paper with the bold title Hate in the Counter-Transference, in which he argued that a therapist working with deeply wounded people must be able to recognise even their own hatred — otherwise they will act it out unconsciously. The paper still reads as brave, precisely because it speaks of something the profession does not like to admit.

The other part of the reason is protecting the client. A therapist does not talk about their feelings to be interesting, but only when it serves the client. That is why most of the work with countertransference happens out of your sight: in the therapist’s notes, in their own therapy and in supervision.

That is how it is for me. As a therapist in training under supervision, every week I bring my reactions to sessions to my supervisor — not only what the client said, but what happened in me. When I became restless, where I wanted to fix something, with whom I caught myself talking more than usual. This part of the work is invisible, but it is one of the most important. You can read more about how supervision works in the knowledge base under supervision.

What this means for you as a client

You may be wondering why you should care what the therapist feels at all. Isn’t therapy meant for you? It is. And that is exactly why it helps to know a few things.

You are allowed to ask. If you sense that your therapist is uncomfortable, bored or angry with you, you can ask them. A good therapist will respond to that question with curiosity, not defensiveness. They will not necessarily tell you everything they feel — the fourth post, Will your therapist tell you what they feel?, is about when disclosure helps — but they will certainly take seriously that you noticed.

Your perceptions matter. People who grew up in unpredictable families often have an exceptionally precise sense of other people’s moods. In therapy that sense is valuable. Sometimes your perception will be wrong; sometimes it will catch something the therapist had not yet noticed.

Your therapist’s feelings are not your responsibility. If the therapist feels something with you, it is their job to understand it and use it for your benefit. It is not your job to look after them, relieve them or make sure they are not upset. If you notice you are doing that, that in itself is important information — it may be a role you know from home.

Exercise: when you notice yourself watching the therapist

If you are in therapy, you can do a small exercise after your next session. It takes five minutes.

1. Write down one moment when you were paying attention to the therapist’s face, tone or posture. What did you see?
2. Write down what you told yourself about it. “She’s bored.” “She thinks I’m exaggerating.” “She likes me.”
3. Write down what you did next. Did you change the subject, cut the story short, make a joke, say more?
4. Ask yourself whether you know this pattern from elsewhere. With whom else do you read faces this carefully?
5. Consider bringing it to your next session. Not as an accusation, but as an observation: “Last time I had the feeling that …”

If you bring it, you will open exactly the layer of therapy this series is about — a space where the relationship between you starts to be explored as part of the story, rather than the backdrop against which the story unfolds.

Where the line is

I want to be clear here, because the idea of countertransference can be misused.

Not every feeling a therapist has is a message about the client. If I slept badly, I will be sleepy whoever is sitting in front of me. If a story reminds me of my own loss, my sadness is first of all mine. A therapist who interprets every feeling as the client’s “material” is avoiding responsibility for their own inner life — and may load onto the client something that is not theirs.

Countertransference is not an excuse. No theory excuses a therapist who gets angry with a client and humiliates them, who enters into a different kind of relationship with them, or who uses their therapy for their own needs. The boundaries of the therapeutic relationship are strict precisely because it holds so much feeling — you can read about this in the knowledge base under dual relationship.

Countertransference is no substitute for listening. First you have to hear what the person says. Only then does it make sense to listen to what is happening in me as I hear it. A therapist who is mostly listening to themselves no longer hears the client.

What to remember

• Countertransference is everything a therapist feels, thinks and experiences with a client — in body, emotion and behaviour.
• Since Paula Heimann in 1950 we understand it not only as an obstacle but as an instrument for understanding the client.
• It comes partly from the therapist and partly from the client and the relationship — the therapist’s job is to tell one from the other.
• Research shows that managing countertransference is associated with better therapy outcomes.
• You may ask what your therapist feels — but their feelings are not your responsibility.