My therapist is cold emotionally

Transference in Therapy

My therapist of 3 1/2 years recently told me I was getting close to being ready to terminate therapy. I originally went to him as part of a compulsive gambling treatment program (I was also abusing prescription drugs at the time)

I have truly turned my life around to a miraculous degree--I have not practiced my addictions since about 6 weeks into treatment. However, my gut reaction to my therapist's pronouncement was to feel extreme fear of abandonment. He has been very like my own father to me throughout my process of reclaiming my life. (My dad died in 1991)

Anyway, my question is this: Must the therapist be psychodynamically oriented for me to resolve my transference? My therapist is very CBT focused and does not express very much emotion. I read something you wrote about a therapist needing to be emotionally responsive enough in the therapeutic relationship for the transference to resolve.

Am I out of luck if this man chooses to remain somewhat emotionally unavailable.

Thanks for your help,

Carol. Omaha, USA

Congratulations, Carol, you've done so well with your therapy!

And yes, Carol, I'm afraid your hunch is correct. If he's not emotionally available...if you don't feel that he deeply cares for you when he's working with you...your therapy will unlikely resolve your transference. I don't say anything's possible however...it just might take years longer than it needs to.

Let me clear what I mean by "emotionally available":

First, you sense that when you're moving through tough emotions he feels some of your pain. You feel he's moved by it.
Secondly, he allows you to experience your emotions and gives you encouraging words as you do so. He doesn't turn away or hurry you up by opening up another subject.
Third, he's at ease with the amount of emotion you're showing him. If you're feeling out of control with your emotions - he intervenes with some kindly words to consider. It's almost as if he's "holding" you energetically.
And finally, some therapists might offer to sit beside you or ask if you need a hug.

You know Carol it strikes me that a therapist who's able to work with a client for 3 1/2 years has the kind of qualities that makes it easy for clients to continue i.e. he already shows some of the emotionally available traits I'm referring to. (Clients tend to bail out sooner when the therapist isn't good at relationship building.)

It's possible that he could apply his treatment model to your issue and help you work this out. So it'd be good to tell him how you felt when he mentioned termination (hate that word...sounds like there's no hope) and ask him if he felt he could help you work it out. Based on his response, you can decide if he is up to the task. (Note: some therapists seek out supervision from a senior therapist in these cases.)

Now, in order to heal, we need to recreate some of the conditions in which our emotional template developed. This happens naturally for some during therapy, as they come to "depend" on the therapist. For them, the therapeutic relationship triggers the same memories of when we "depended" on our parents.

So we're triggered to feel similar types of feelings that we had as infants/toddlers/children. That's okay, just as long as we are also creating new memories of a positive connection.

This process enables us to establish new neuropathways that override old behavioural patterns. Over the course of therapy this helps heal that part of you that didn't get consistent care. This new "care" from your therapist helps heal emotional wounds and "fill" in the developmental gaps. **

What's also necessary for healing is a therapist who's consistently present and attuned, a therapist who might pull back or challenge you, as he senses you're readiness for the next step. You feel he really "gets" you.

Let me propose one possibility. We all choose a therapist based on our history. We either choose the familiar, or the scary (albeit not too scary) "expansive-for-us" therapist. If the former, it's because the "familiar" feels comfortable. For example, if a lack of connection is all we know, then it can feels "just right" - at least initially.

Carol, it is very possible this is how you initially came to your therapist. You chose what you knew. However with your growth over the years, you recognize a need for more connection. Sometimes we don't know how much we've grown until it's brought to our attention. Your recent experience with your therapist may have been one of those times. That is, how much your feelings about connection have changed may have become strikingly clear to you when he suggested terminating.

As crappy his proclamation feels, it still corroborates your emotional growth. It's true that some treatment approaches are less sensitive to relational dynamics. This doesn't necessarily mean that your therapist does. If you are up for the task of bringing your feelings into the therapy, he may respond in kind.

Let me give you an idea of the kind of reflections a therapist might make who's concerned about the therapeutic relationship. It's just a sample but hopefully they give you an idea of what's possible. So, he might say for instance:

"You know, I think you're doing really well. And I have noticed all these changes during our work together (such as x, y and z) and I'm so excited about how far you've come. Given this, I have an inkling that we may be heading into a home stretch."

"What do you think and how do you even feel that I am bringing this up to you today?"

The final part where he checks in with you after he introduces a subject that's potentially triggering illustrates the care and attention good therapists manifest. It's also easier to move through a transference with a therapist who's looking out for you in this way.

By the way Carol, it's not unusual to move onto another therapist once you've gone as far as you can. For example, my present therapist would not have been a good fit for me years ago. So, if you feel he is not making an effort to connect with you over this issue, you may need to find the one who can take you to the next level.

I wish you well on your journey,

Shrinklady and Dr. Carole (we all need helpers)

** Recall that in the first two years of life most learning is predominately body-based - sensing, feeling and moving. (The infant's left hemisphere, the "verbal brain", doesn't even come online for 18 months). Body-based techniques can reach down into the brain where the emotional patterns were first laid down. This is what makes a body-based approach to emotional change so powerful.

My therapist is cold emotionally

Transference in Therapy

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