Therapist emotional responses to patients: Building a learning-based language

Kimerling, Rachel; Zeiss, Antonette M.; Zeiss, Robert A.

doi:10.1016/s1077-7229(00)80089-9

Cited by 59 publications

(32 citation statements)

References 10 publications

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“…It may be useful to contront any fears about therapist emotions being "mistakes" or indications of failure in therapy and instead focus on ways of understanding the emotional antecedents. Therapist reactions can stem from a number of sources, including cultural of value-related beliefs, the therapist's view of his/her professional role, and unique learning history, as well as from the interactions with the patient's problematic behaviors 26 . The therapist can also use a self-directed inquiry of thoughts about a session, a situation or working with a particular patient or problem and log these thoughts into a dysfunctional thought record.…”

Section: Self-correction Of Counter-transferencementioning

confidence: 99%

Transference and Countertransference in Cognitive Behavioral Therapy

Praško

Divéky²,

Grambal³

et al. 2010

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Background. Both patients and psychotherapists can experience strong emotional reactions towards each other in what are termed transference and countertransference within therapy. In the first part of this review, we discuss transference issues. Although not usually part of the obvious language of cognitive behavioral therapy (CBT), examination of the cognitions related to the therapist, is an integral part of CBT, especially in working with difficult patients.In the second part, we cover counter-transference issues. We describe schematic issues that give rise to therapist counter-transference and explain how this interacts in different types of patient therapist encounter. We also examine ways in which the therapist can use CBT to help him/her modify the countertransference and, in the process, assist the patient.Methods. PUBMED data base was searched for articles using the key words "therapeutic relations", "transference", "countertransference", "cognitive behavioral therapy", "cognitive therapy", "schema therapy", "dialectical behavioral therapy". The search was repeated by changing the key word. No language or time constraints were applied. The lists of references of articles detected by this computer data base search were examined manually to find additional articles. We also used the original texts of A. T. Beck, J. Beck, M. Linehan, R. Leahy, J. Young and others. Basically this is a review with conclusions about how therapists can manage transference issues.Results. Transference. The therapist should pay attention to negative or positive reactions towards him/ her but should not deliberately provoke or ignore them. He/she should be vigilant for signs of strong negative emotions, such as a disappointment, anger, and frustration experienced in the therapeutic relationship by the patient. Similarly he/ she should be alert to exaggerated positive emotions such as love, excessive idealization, praise or attempts to divert the attention of therapy onto the therapist. These reactions open space for understanding the patient's past and actual relations outside the therapy. Countertransference. The therapist should be aware of countertransference schemas as they apply to him/her. He/she should monitor his/her own feelings that indicate countertransference. Further, the assistance of and discussion with supervisors and colleagues is useful in regard to countertransference even in experienced therapists. Countertransference can be used as an open window into the interpersonal relations of the patient.Conclusions. Both the literature and our experience underscore the importance of careful and open examination of both transference and counter-transference issues in CBT and their necessary incorporation in the complete management of all patients undergoing CBT.

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Section: Self-correction Of Counter-transferencementioning

confidence: 99%

Transference and Countertransference in Cognitive Behavioral Therapy

Praško

Divéky²,

Grambal³

et al. 2010

BIOMED PAP

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“…Self-reflection in therapy has been described as a cyclic process in which the therapist critically assesses emotional and cognitive experiences, observes behavioural reactions, uses an inner dialogue and generalization to achieve insight, and changes the original attitudes and convictions concerning a therapeutic (or supervisory) situation [4][5][6] . In self-reflective awareness, the mind witnesses and explores all experiences, including emotional and physical reactions 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Self-reflection in cognitive behavioural therapy and supervision

Praško¹,

Mozny²,

Novotný³

et al. 2012

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Objective. Supervision is a basic part of training and ongoing education in cognitive behavioural therapy. Self-reflection is an important part of supervision. The conscious understanding of one's own emotions, feelings, thoughts, and attitudes at the time of their occurrence, and the ability to continuously follow and recognize them are among the most important abilities of both therapists and supervisors. The objective of this article is to review aspects related to supervision in cognitive behavioural therapy and self-reflection in the literature. Methods. This is a narrative review. A literature review was performed using the PubMed, SciVerse Scopus, and Web of Science databases; additional references were found through bibliography reviews of relevant articles published prior to July 2011. The databases were searched for articles containing the following keywords: cognitive behavioural therapy, self-reflection, therapeutic relationship, training, supervision, transference, and countertransference. The review also includes information from monographs referred to by other reviews. Results. We discuss conceptual aspects related to supervision and the role of self-reflection. Self-reflection in therapy is a continuous process which is essential for the establishment of a therapeutic relationship, the professional growth of the therapist, and the ongoing development of therapeutic skills. Recognizing one's own emotions is a basic skill from which other skills necessary for both therapy and emotional self-control stem. Therapists who are skilled in understanding their inner emotions during their encounters with clients are better at making decisions, distinguishing their needs from their clients' needs, understanding transference and countertransference, and considering an optimal response at any time during a session. They know how to handle their feelings so that these correspond with the situation and their response is in the client's best interest. The ability to self-reflect increases the ability to perceive other people's inner emotions, kindles altruism, and increases attunement to subtle signals indicating what others need or want. Self-reflection may be practised by the therapists themselves using traditional cognitive behavioural therapy techniques, or it may be learned in the course of supervision. If therapists are unable to recognize their own thoughts and feelings, or the effects of their attitudes in a therapeutic situation, then they are helpless against these thoughts and feelings, which may control the therapist's behaviour to the disadvantage of the client and therapist alike. Conclusion. Training and supervision focused on self-reflection are beneficial to both supervisees and their clients. The more experienced the supervisor is, the more self-reflection used in therapy and supervision.

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“…Although prior literature has been focused on how a therapist may work with his or her emotions in therapy in general (e.g., Kimerling, Zeiss & Zeiss, 2000;Yalom, 2002), tears are not emotions themselves, but are social and interpersonal expressions of emotions, and their very presence (or lack thereof) is influenced by the presence of other people (Vingerhoets, Boelhouwer, Van Tilburg, & Van Heck, 2001). In the case of TCIT, the other person is the client.…”

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confidence: 99%

When Therapists Cry: Implications for Supervision and Training

Blume-Marcovici

Stolberg

Khademi

et al. 2015

The Clinical Supervisor

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The majority of psychologists cry in their role as therapists but no research has explored training or supervision in relation to this topic. Psychologists and trainees (N = 686) filled out a survey on therapist crying in therapy. Almost all (96.5%) reported that psychologists should be trained on how to handle their emotions, but only 36.4% reported receiving training on therapist crying. Half of all respondents reported having discussed crying with a supervisor; one third had never discussed their most recent tears with anyone. Suggestions are offered for supervisors in order to manage discussion of TCIT in psychotherapists' training. Keywords: therapist crying, tears, emotional expressions, supervision, training, consultationTCIT: SUPERVISION AND TRAINING 3 When Therapists Cry: Implications for Supervision and TrainingPsychologists cry in therapy. In 1987, Pope, Tabachnick, and Keith-Spiegel published results of a survey on which 57% of their 456 psychotherapist respondents reported that they had cried in the presence of a client. More recently, Blume-Marcovici, Stolberg and Khademi (2013) reported that 72% of psychologists and psychology trainees had cried at least once during a therapy session with a client. Findings from these studies indicate that the majority of psychologists and psychology trainees will experience therapist crying in therapy (hereafter, TCIT) at some point in their career. Indeed, research reports that those therapists who cry in therapy cry in approximately 7% of therapy sessions (Blume-Marcovici et al., 2013). Compared to prior research that has found clients to cry in approximately 21% of therapy sessions (Trezza, Hastrup, & Kim, 1988), these numbers allow us to estimate that therapists cry in therapy approximately one third as often as their clients, though this percentage does not account for intensity or duration of tears.Researchers have found that therapists are most likely to cry when session content focuses on grief, trauma, and termination of therapy (Blume-Marcovici, Stolberg, & Khademi, 2015), and that the most commonly reported emotions the therapist felt when crying in therapy are sadness, emotionally "touched," warmth, and loss (Blume-Marcovici et al., 2015). Although most of the time therapists reported that their tears were focused on the client, in 16% of cases therapists reported that their tears were related to their own (i.e., the therapist's) personal circumstance (Blume-Marcovici et al., 2015). And, although 82% of therapists reported that they believed TCIT helped the client feel that his/her therapist genuinely cared, 69% expressed concern that TCIT would cause the client to feel that the therapist would not be able to handle the client's emotion (Blume-Marcovici et al., 2013). Despite the fact that the majority of TCIT: SUPERVISION AND TRAINING 4 therapists believe TCIT can impact the therapy -in both positive and negative ways -no research exists regarding training, supervision, or consultation on TCIT.Given that the number of behaviors on which a s...

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Therapist emotional responses to patients: Building a learning-based language

Cited by 59 publications

References 10 publications

Transference and Countertransference in Cognitive Behavioral Therapy

Transference and Countertransference in Cognitive Behavioral Therapy

Self-reflection in cognitive behavioural therapy and supervision

When Therapists Cry: Implications for Supervision and Training

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