Ethics Concepts

Transference is the process in which clients respond to us (project) with feelings and attitudes that they had toward significant people in their lives such a parents and siblings.  It happens in all relationships, not just with clients. 

You can tell when someone is transferring (or projecting) when the response to something seems over-reactive.  You can tell when you are in transference when you get a severe “gut” reaction to something and it usually displays itself in anger or pain.  Learning to recognize transference in yourself and in others is essential for building a successful practice.  Creating and maintaining strong boundaries is essential in working with clients who are in transference with you.  

The process of transference occurs in all relationships.  Transference is a projection of internal drama that usually comes from early childhood relationships.  (You come home angry at a co-worker and kick the cat.

  You yell at your spouse when they don’t pay enough attention to you, when it was an absent parent who is really the cause.)

It is important to learn about the power of transference so that you can be more present for your clients’ needs.  Transference creates a power differential that is a key component in healing.

When clients seek us out for specific reasons they are usually looking for an expert to help them with their issues.  They come to believe that we know more about them than they do themselves.  They come looking for answers to their pain and dysfunctions.  They come looking to get the unmet needs of early childhood attended to without really knowing it. The fact that clients take their clothes of to some extent creates a vulnerability that is unique to the massage profession. The power of touch also takes people to a deeper part of themselves where these unmet needs and repressed feelings live.  It is an unconscious process in all relationships.  

Becoming more aware of yourself can help you become more aware of when a client is in a state of transference.

Some common signs of transference:

  • giving gifts to the therapist

  • needing/demanding extra time on the table

  • buying products you may be selling to please you

  • calling you at home

  • wanting to date you or become socially connected to you or having a crush on you

  • wanting an extremely reduced rate (they want you to show them that you think they are special and deserving.)

  • discussing personal issues with you ( you are only qualified to do massage)

  • client idealizes you, think you are the authority on massage and healing 

  • not being able to tell you what they really want as far as pressure, room temperature, music or whatever

  • expressing more affection than you feel comfortable with

  • sexual advances direct or indirect

  • not wanting to offend you 

Dealing with transference.

Client’s usually are not aware that they are transferring these feelings or behaviors onto you.  How we can deal with the issue is transference is to be aware of ourselves and our own needs.  When you know what you need, you can create clear boundaries.  Setting up the framework of your business with clear policies and procedures in one way to create boundaries.

Setting fees, setting work hours, setting rules about social interaction and dating clients will all help keep the interaction clean (and you not ending up in counter-transference.

The process of supervision and peer supervision groups can assist you in dealing with such client interactions and help you create your ideal practice.

Counter-transference occurs when we react to clients from our feelings and attitudes that come from our past relationships with parents and family.  It often comes in the form of feeling a need to “fix” clients and constantly give them advice. It can be seen when we feel we are called to “help others” rather than be of service to others.  Rescuing clients and participating on the Drama Triangle in relationships is counter-transference. When we work with clients to get our own needs met it sets up an agenda for healing and takes away from the clients’ experience.  The client is paying you to be there for them, not to have you project all of your unmet needs onto them. It happens often in the healing professions, as we are often drawn to the very thing we need most to heal ourselves. Building a practice with clear boundaries is they way to work with transference and counter-transference issues and build a safe container for healing.  

Counter-transference is when we the therapist allow our unresolved feelings and behaviors to influence our work with clients. 

 When this occurs, we are operating on a hidden agenda to get our own needs met, rather than focusing on the needs of the clients.

Signs of Counter-transference

  • thinking that only you can help this person and it is a good thing that they found you.

  • acting out on the crush the client has on you, accepting the date or request for social interaction

  • needing constant approval of your work

  • constantly giving advice to clients

  • reducing our fees thinking it will bring more clients or help someone out

  • rescuing clients – see Drama Triangle

  • reacting strongly emotionally to a client being late or requesting something

  • feeling frustrated when a client is not getting better

  • feeling exhausted, giving too much, injuring yourself, burnout, not taking care of yourself physically

  • not taking care of your emotional and spiritual needs

  • being sexually attracted to clients often

  • feeling like a client is pushing your buttons

  • over-identifying with a client

  • coming home with neck pain after working on people with neck problems

  • thinking that everyone has the same thing that you do

  • trying to solve the client’s personal problems or work problems

  • unable to feel compassion and empathy

  • unable to say “I don’t know” to the client

  • dreading the session with the client, hoping they will cancel or not show up

  • boredom

Dealing with Countertransference

Transference and countertransference happens.  It is a normal part of any and all relationships.  

Becoming aware of yourself, your needs and getting them met outside of your practice will help you create boundaries to keep you and your client safe.  

Supervision and peer supervision groups is essential in learning about yourself from a more experienced practitioner and massage peers.

How Countertransference Jeopardizes the Therapeutic Relationship   Nicole Cutler, L.Ac.

The Drama Triangle

Bonding, Attachment and Attunement

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