How big a factor is pre-transference in the therapeutic relationship?

A lot has been written about transference and counter transference from the therapeutic relationship between counsellor and client.  Of course we do not approach people in any walk of life as a blank sheet but rather we ‘transfer’ what we have already learned from the past to the present.  However, in psychotherapy it is more intense and potentially more powerful that which we transfer.  This is due chiefly to two reasons.  Firstly, the therapist adopts comparative anonymity.  The refusal by the therapist to correct the client’s misconceptions can offer the opportunity to explore and discuss these misconceptions.  Secondly, the clients are asking for help and this can create a useful parental authority figure dynamic in which to work with.

But what about pre-transference when seeing clients?  Clients will have preconceived ideas about the therapy as well as preconceived ideas about the therapist before they arrive at the first session. They might already have had dialogue with the administrative staff before the initial consultation if the sessions are to be held within a counselling centre or they might have had telephone contact with the therapist before the first meeting.

Pre-transference is not, of course, restricted to the client.  The therapist will also have pre-conceived notions about the client based upon the preliminary discussions that have taken place before the initial meeting. For example, a client could perhaps have outlined a brief summary of the presenting issues before the initial meeting.  Or they might have revealed their expectations of therapy and this might tempt the therapist to fantasise about the client before they meet.

How can you deal with your pre-transference as a therapist? It is essential to be aware of what is happening in the room. You need to stay conscious.  As a therapist we ask ourselves who does the issue belong to? Is it mine or someone else’s? Are we in touch with our own centre and in touch with our essence? If we are truly in touch with our own baggage, then we can be better protected from bringing our own agenda into the therapeutic relationship.

Empathy and compassion can create a safe environment in order to allow difficult issues to rise to the surface.  If we explore the fantasies of the client then they could lead us somewhere. It is important for a therapist to remember that resistance is not malicious ill will but a coping strategy on the part of the client to avoid pain. In other words the defence systems are there for a reason and you are advised to ensure that the client has a healthy ego before you engage in challenge.  You must avoid the temptation to take client resistence personally. It can be argued that transference and “acting out” are at one when the client is acting in a way that repeats “the cycle” with the therapist, thereby exploring the core issues.  A lot of the material with a client is pre verbal and pre conscious.

Related posts. 

The 1-1 relationship between psychiatrist and patient
The importance of challenge in the therapeutic relationship 
Transference and counter transference
Resistance in therapy
Dr Marie Keenan interview
Why some patients trigger stuff and not others

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