How to Deal with Transference

silhouette scene of mother and toddler and grown adult representing how to deal with transference in counseling and neediness: shows a young toddler trying to get attention of her mother who's

Yes, how to deal with transference. You started therapy to solve a problem and now you face an even greater one. Your therapist absorbs your everyday waking moments. 

One thing's certain....you can’t stop thinking about her - and it’s interfering with your life!

how to deal with transference consultations offered by dr. LaCombe

Updated: August 6, 2023

Hi there! My name is Dr. Susan LaCombe and I've practiced as a psychotherapist/psychologist for almost thirty years. 

I wrote an article online in 2006 on dealing with transference issues and soon after I received an outpouring of questions and comments from visitors. 

It turns out many of my colleagues' clients were suffering—mostly in silence—tortured by a transference that seemed to drag on with no end in sight.

I felt something was wrong with the depth of suffering they endured. This was not the same experience I was having with the type of therapy I used. I yearned to uncover a way to end their suffering. 

As fate would have it, the solution emerged from an unlikely source, marking a pivotal turning point in my journey. The article you are about to read chronicles this odyssey of discovery, culminating in a fresh perspective on transference and its resolution, all stemming from these unexpected and stirring accounts.


Common misspellings: transferance, transferrence, transferrance, transferece.

Related terms: projective identification, transference neurosis, parataxic distortion.

Dealing with transference—
as a teenager

As a young pre-adolescent I was obsessed with teen idols. Davey Jones (The Monkeys), Peter Noone (The Hermits) and Paul McCartney comforted me as I slept. They were my waking-hour companions. Thinking of them made my life feel magical.

By early adolescence my idols were replaced with a real live human being. Yes, I had a crush and I couldn't take my starry eyes off him! 🙂

Recall how easily you might have been embarrassed as an teenager. Now try having a crush in the worse public arena you can imagine: Junior High.

head shot of a exasperated female teen who is dealing with a transference in the guise of a teenage crush with her classmates standing in the background laughing

Of course I was not to know that both the attraction to my teen idols and my crush were serving a purpose. In fact, they served the same purpose as a transference might in therapy. In other words, transferential dynamics are attempts at the brain to make up for one's unmet developmental needs.

By the time I was an adult in ongoing therapy I already knew to distrust my inclinations in regards to transferential relationships. Thankfully, the type of therapy I received reduced the chance of transferences becoming full blown.

Not to say I was immune to the feelings that emerged in regards to my therapist - just that I could hold the feelings far enough away to feel I had a measure of control.

And with that control I had room to explore what actions on my part helped to reduce its hold on me. 

Why transference shows up in therapy

Transference occurs when you unconsciously 'transfer' or attribute the feelings, memories and desires you experienced in your early important relationships to your therapist (or other health care practitioner).

Therapy heightens this unconscious propensity for bringing your feelings into the therapeutic relationship. It's intensified because therapy happens privately, within strict personal boundaries, and where the conversation is typically one way. 

"I don’t understand what's happening. I’m not into women and now I’m attracted to my therapist who’s female.
It doesn’t make sense."

Within the boundaries of the therapeutic relationship there are no distractions to dilute how you experience your therapist. Indeed, the feelings that surface can feel as though they’re caused by the therapist.

Transference is an experience

Recall your earliest friendships. Would you experience a childhood friend the same way if you were to meet him or her for the first time today?

In fact, would you even become friends today? 

What about meeting an old love? Would the attraction still be there after all the experiences you've had in the intervening years?

How you experience someone is unique to you.

Here's an example from my personal life.

There's a professional colleague whom I regard as a father figure, even though we’re a similar age. I look up to him, and if I were honest with myself, I’m a little in awe.

But that’s not how my friend sees him. She finds him pompous!

So we all see each other based on our unique histories.

In effect, we 'transfer' the feelings, memories and sensations associated with our past significant relationships onto others in our own unique way.

Gaining control and dealing with a transference

Consider that how you deal with transference varies in every relationship. That includes your family and your friends (and even imaginary relationships triggered by teen idols :-))

It's useful to see the tendency towards transference on a continuum - the degree to which it's experienced is a matter of more or less.

It's the variability in your experience that holds the clue to gaining control and moving through your transference faster.

Transference is deeply rooted in the unconscious, in your early emotional experiences in particular. It's those memories that guide your moment-to-moment thoughts, feelings and behaviors.

Of course, those who cared for us early on - typically our parents - have the deepest impact on how we experience others.

The brain-wise approach for dealing with transference

If you’re in therapy you already know that the relationship you have with your therapist is not ‘typical’. For one, the focus of discussion is on you alone

Good therapists won't say anything about themselves that isn’t in the service of helping you, the client.

This experience can easily trigger early memories (good and bad) of being cared for as an infant, when someone had to feed, clothe and bathe you.

photo of one hand holding another representing a therapist holding the hand of someone who wants to deal with transference

Indeed, for many, therapy might be the first time in their lives they’ve gotten so much personal attention. In fact, this attuned care can be so unsettling that some clients never return!


Brain image like a light bulb.

Brain Fact: The brain's inborn drive for growth and wholeness will unconsciously direct you to seek experiences that complete you.

Even if you skip a stage of your emotional development you will still feel a need to deal with any unfinished business that resulted. Tying up those loose emotional ends could be the primary benefit. 

That’s the task that needs to be accomplished when dealing with your transference.

In other words, as your relationship with your therapist evolves, familiar feelings related to previous connections with others (even other therapists!) are triggered. You experience your therapist - in the present - in much the same way you had experienced another person from your past.

Again, transference happens when you unconsciously transfer the feelings, memories and desires you experienced in your early important relationships onto your therapist.

Why would I experience my colleague as a warm father figure when my friend finds him pompous? 

One clue is that my biological father wasn’t in my life very long, and the stepfather who came along later was emotionally unavailable.

From an emotional development point of view it stands to reason that inside I feel incomplete - I yearn to have a 'make-up' experience that would make me feel whole.

How to deal with transference in therapy

Basically, transference provides an opportunity for these early events to be re-experienced, not merely discussed in therapy.

Transference brings these buried memories to life, where you can work through the underlying unmet needs or developmental gaps. 

illustration of left and right brain skillset to show how one might deal with transference

What's key to dealing with a transference is to understand that it's a right-brain, emotional challenge, not a left-brain analytical problem to be solved.

For instance, you can easily think differently when you have more information - like reading this article. You might even have an "aha" moment: 

"Oh, that's why I have a Mommy transference!"

That's using your left brain.

However, to exploit and truly deal with your transference - to actually feel different - you'll need a new experience

The right brain changes as the result of experience. 

Thankfully, every session holds the opportunity for you to have that new "experience".

What a brain-wise "experience" looks like

Jennifer was now used to telling her therapist that she had feelings for her. 

At times these feelings were sexualized even though Jennifer was heterosexual.

well-dressed older caucasian female on a couch as she ostensibly talks about dealing with her transference towards her therapist

This was a important step for Jennifer. Instead of stuffing her feelings away she now felt sufficiently safe to bring them up again.  

older white woman pausing to deal with her transference in therapy


When these moments would arrive in the session her therapist gently guided her to stay with the feelings - and to go deeper with them.

Her therapist encouraged Jennifer to notice how the feelings showed up in her body. Jennifer might notice a clenching in her tummy or a tightness in her chest. 

This "body practice" made it easier for Jennifer to stay with the feelings long enough to explore them. 

Jennifer learned it wasn't just warm fuzzy feelings that emerged. With her therapist's gentle prodding, she also discovered deep-seated fears that her therapist might judge, and ultimately leave her. At other times Jennifer felt some anger towards her.

They would work towards Jennifer shifting to a new place with the feelings by conjuring up positive scenarios they could "play" with.

As her body-practice skills developed Jennifer learned to tolerate the feelings that arose. She was no longer at their mercy.

older woman happily done with her transference and looking towards her therapist while she hold a hot cup of tea

Talk to your therapist about dealing with your transference

Therapy can easily get stalled for a long time when ‘the elephant in the room’  (ie. your transference) isn’t brought into the work.

I strongly encourage you - to the best of your ability - to talk about any feelings towards your therapist. (For more info see Hannah in the Comments below.)

For one reason, it's no doubt the most pressing issue on your mind. Not to mention that resolving your transference has so many benefits.

This step though is not without risk - not just because you may feel  embarrassed.

The greater risk is in how your therapist reacts.

For instance, some therapists disregard transference, seeing it as an irrelevant but unavoidable by-product of therapy, more of a nuisance.

In other words, even if you disclose your true feelings your therapist may not think anything of it and continue working as though it didn't exist. He or she may just not understand the potential that transference holds for deep personal change.

Other therapists may feel uncomfortable if their skill set is not up to handling your disclosure. Some may even refer you to another therapist (I cannot tell you how many folks have written to tell me just that).

But even if he’s never dealt with transference in his practice, your therapist can simply do what others have done in similar situations - get supervision from a therapist who knows how to handle these situations.

Most clients are willing to work with therapists when an authentic connection has been made, even though the therapist openly acknowledges limited experience in this area.

(What client wouldn’t be thrilled to work with a therapist who values an authentic, attuned connection!)

Why some transferences are never resolved

Fundamental, lasting change is unlikely unless certain brain-wise conditions are met, even if the underlying emotions are released by talking about them in conventional therapy.

Here's the problem.

Conventional therapy takes one of two approaches to change, both of which I believe have serious limitations and a higher risk for emotional harm.

One involves the therapist presenting as a blank screen upon which you, the client, verbally project a picture of your emotional state. This is the psychoanalytic approach described above.

While many psychoanalytic approaches have softened the blank screen approach, this model still risks leaving you feeling abandoned in regard to emotional containment or attuned care.

That's because the main idea is flawed (ie. that you will change as a result of insight)

However, it's my belief that even if your psychoanalytic therapist is emotionally available, it's unlikely that you've been given the tools to help you deal with the flood of feelings that get stirred up. 

In other words, the question I pose is, how can you "take in" and "learn" from the caring interventions of your therapist if you're almost immediately triggered into the possibility of losing that same care? 

The second approach assumes that changing your thoughts  will change your emotions (in particular, rooting out irrational thoughts). This principle is used in cognitive behavioral therapy (CBT).

Anyone who understands how the brain is organized will appreciate what a tedious and almost impossible task this is.

For clients working through intense transference feelings, these two approaches ultimately end up sending clients into a re-experiencing of what got them to therapy in the first place: insufficient attuned care.

In my view, these approaches leave out what research in emotional development and neuroscience have confirmed over and over: personal change in therapy depends upon your experience in therapy, not on insight.

A therapist who is empathic, attuned and vitally engaged with you provides that life-changing experience in spades.

If resolving the transference is left to chance, it could easily take much longer than necessary, often years longer.

Given what we know about how therapy changes the brain, we can use body based techniques to resolve the transference while at the same time advancing, even accelerating, the therapy itself.

So let me be clear about this . . .

Can Cognitive Behavioral Therapy (CBT) resolve transference? 

As long your therapist goes beyond the standard technical aspects of the model I  believe it's possible to resolve a transference. There are always a few heartfelt CBT practitioners who manage to help their clients in deep and meaningful ways 🙂 (See Carol in Comments below) I

However, note that being emotionally available, being present to feelings, and being focused on moment to moment interactions is not taught as part of the CBT model. 

What if your therapist is psychoanalytically trained? 

Here the transference can be resolved only to the degree that your therapist departs from the traditional ‘blank slate’ model (ie. this model discourages the therapist from saying too much, does not value emotional availability, and prefers analysis over present moment experience).

And yes, there’s some heartfelt psychoanalytically-trained practitioners who manage to help their clients in deep and meaningful ways anyway 😉

Can transference be resolved if your therapist is ‘body-based’ (ie. somatic therapists)? 

Yes, and probably faster than the average therapist.

You see, the body-based approach is the clinical application of the best of brain science for one very important reason:

Brain-wise, body-based therapy reaches areas of the brain that 'talk therapy' never can.

(especially pre-verbal developmental patterns).


The basic working concepts of body-based work include attachment, emotional containment, moment to moment interactions, and presence. Each ensures that any transference reactions will be recognized, examined, and worked through in your therapy as they arise.

It’s also the best treatment model for anxiety because body-based therapists know more than anyone that their ability to regulate clients’ high states of emotion is based on their own nervous system capacity to modulate seemingly threatening emotional energies.

Body-based therapists also have numerous tools ("self-regulating techniques") that enable clients to manage overwhelming emotions on their own.

In particular, these self-managing techniques help clients to lay bare, resolve, then move beyond transference. Once free, they move on and fully develop their self-regulation skills.

On the other hand, even a body-based practitioner can take much longer to resolve transference if his or her nervous system can't contain and regulate a client’s emotional states.


If you've resonated with my writing and want to finally deal with your transference, check out Therapy Bootcamp.

product image for therapy bootcamp for dealing with transference and showing all the devices it can be seen on

Two tips for dealing with a transference in therapy

You must understand that recognizing transference is only the first step in working with it. No amount of reading about transference is going to change it - including this article 😉 

It's also good to recognize that some therapists leave it at that. The assumption is "hear the message enough times and you'll finally get it". 

This is a thinly-disguised left-brain approach.

In contrast, I've had great success when my clients followed a right-brain approach.  The reason is simply stated - transference is a right-brain issue.

Tip #1: Be present to your feelings

In order to get the most out of your therapy and to promote deep personal change, the brain needs to "experience" feelings associated with your transference in the present moment.

Just discussing your feelings in the abstract, disconnected from your emotional reactions in the here and now, won't resolve a transference.

In the example with Jennifer above, she stayed in the feeling all the time she spoke to her therapist. She used her body based sensations as a tool, like a compass. That kept her in the present moment.

Note that Jennifer didn't spend her time and energy trying to figure out why she was having a transference. She blamed neither herself nor her therapist for its emergence.

She understood that transference arises as a normal part of one's development - when there's a need for a "catch up" experience.

So instead, her sessions were less focused on "talk" and more on "feeling her way through".

Tip #2: Be open to a healing experience

Secondly, you need a “healing experience" that neutralizes old reactive patterns in the brain. Emotional unloading isn't enough.

(It's not enough to have a good cry. You need to shift into a positive feeling state. For example, as your tears subside you might spend a moment taking in your therapist's warm, positive feelings. Or maybe your therapist said the perfect thing right at that pivotal moment and you took the time to deeply take it in.)

These types of "healing experiences" normally occur in therapy, through interactions with your therapist. The not-so-good news is that usually these pivotal moments tend to occur randomly.

However with what we now know, we can be proactive. We've learned from brain-wise, body-based clinical practice that you can take some fairly simple steps to use the transference itself to create the kind of experience your brain needs.

Recall that Jennifer's therapist encouraged going deeper with the feelings, which resulted in her discovering some negative emotions. The two worked together to help Jennifer move into a more positive feeling state.

This practice of sustaining moment-to-moment awareness and shifting from a negative feeling state to a positive one actually builds the new neuropathic connections that change you at your core.

Bonus Tip #3

Even aside from knowing any brain science tips, you can be more purposeful in moving through your transference. You see, your "pivotal moments" can be recalled repeatedly at any time, automatically triggering the good feelings you had back then. (Hey, maybe you're already doing that 🙂

Practicing this "fills you up" on the inside by strengthening new, more efficient neuropathways in the brain.

It fills in the gaps!

Pat yourself on the back if you're in therapy!

Therapy is the most efficient and effective personal change agent I know. Within the safety and confidentiality of the therapeutic relationship, you can experience the powerful emotions of transference and use them to make incredible personal changes (and only two people in the whole world will know anything about it! 🙂 )

Final musings

 In terms of how health professionals deal with transference today, not a lot has changed since we first starting working with transference.

However neuroscience has a few things to say about the process from which we can take some lessons. It needn’t be the scary process many people describe. 

Transference will not be prolonged or if approached with these insights in mind, In fact, I'd advise every client to take advantage of their transference.

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From Dr. LaCombe . . . 

Related Topic

What is counter transference?

Reenactments

Get Over Transference FREE eCourse

Is it possible to get rid of anxiety without medication?

External Resources

Transference among people online

Feeling attached and ashamed

** It's not to say that the therapists during this era weren't caring individuals, it's just that the theories at the time promoted value in "analysis". In truth, I imagine the field attracted those folks who were good at analysis - whether they were also "caring" seemed to be less important. It wasn't until decades later that we had the science to back up the idea that the therapist's emotional availability was playing a key role.

Questions about Transference

Therapy Guru Avatar

Jack

Love and hate my therapist

Transference is a hard thing to deal with in therapy. I'm a man and I'm having a bad transference with my T currently. I feel like I Love her and I've told her and faced it all my feelings as honestly as I can, but it still hurts.

My transference goes back and forth between positive (love) and very negative(hate) with her. I also have trouble surrending to it and just working it through because I feel my T. has all the power and I'm the one who is very vulnerable.

Dr. Susan LaCombe Psychoshrink

Shrinklady

Please know you're not alone Jack. Having conflicting feelings is not unusual in regards to transference.

It’s good that you brought your feelings out in the open. . . . a good beginning. The healing part comes - as you correctly identified - in working through the feelings - both negative and positive that emerge in your session.

On a practical level it requires you to be present to the feelings and at the same time to experience a positive interaction with your therapist. I understand from what you’re saying that this is turning out to be a difficult task given the feelings of vulnerability that are arising and where you feel your therapist has all the power.

Can I suggest that these feelings are not unfamiliar to you Jack? You see, as you may know, what's projected onto our therapist - in the absence of truly knowing our therapist - are unmet needs from our early life.

You can imagine then how it wouldn’t be unusual for you to experience these conflicting feelings if for example in the case when you felt natural love towards your caretaker (ie. your Mom) and when the same caretaker was the source of pain (eg. through her own dissociative trauma).

For the infant who’s totally dependent on the caretaker for most of his needs, it can create enormous conflicted “push pull” feelings. It’s this conflict that I believe is emerging in your transference and that is triggering the feelings of helplessness.

The feeling that your therapist has all the power relates to not having a measure of control over feelings. This is something that you develop when you harness the power of the nervous system. As I have attempted to explain elsewhere - with practice - you can grow this capacity.

Hope this gives you some ideas to work with,

Shrinklady


Therapy Guru Avatar

Hannah (Manitoba, Canada

Feel like a stalker

I have a similar situation to that of Dale's. I am a lesbian as well, but I am married to my partner of 11 years and very much in love with her. I have been very concerned with my feelings that I have had towards my Psychiatrist (also female, but much older).

I have serious issues with talking to people about my personal 'stuff' so seeing a Dr. was a difficult choice to make for me. My first 10 sessions were very very quiet on my part. But yet after my 4th session I realized that I had significant sexual feelings towards her and started to research her on the net, finding out such personal things as her home address (which I have driven by).

I feel like a stalker and my partner is also becoming concerned with how interested I am in the Dr's life! I'm afraid to tell her (Dr.) how I feel because like everyone else, the thought of the rejection is horrifying. By the way, she has diagnosed me with an Anxiety Disorder with Panic Attacks.

I really noticed that I had deep feelings for her when she had suggested that our sessions end until I felt I was able to participate in the Talk Therapy she was offering me. I freaked and started to cry (the first time I showed any emotion in an appointment). I told her that we couldn't end the sessions because I wasn't ready and I didn't think that I could handle not coming, then explained how stressed I was when our appointments were cancelled over Christmas.

She decided to continue the sessions as I had made a breakthrough at that point. I should have said something at that point but didn't understand the feelings myself, let alone have to explain them to her.

I googled 'being in Love with your therapist' and came upon the word 'transference', I've now realized, after reading your site and others, that I am normal (so to speak). I think that because I had a very poor connection with my mother as a child/young adult (before she died) that I am possibly confusing sexual feelings with that of wishing she were my mother because of the compassion she shows, and her ability to make me feel like she cares.

Anyway, thanks for having such a great site, it's motivated me to talk to her about transference, if I can manage to get it out of me.

Dr. Susan LaCombe Psychoshrink

Shrinklady

Hannah, thanks for sharing your story with us. As you may have read elsewhere, transference is often a good sign that it feels safe enough to let your emotions out. There just might be enough connection in the relationship that the therapist is likely able to acknowledge and to help you work through these feelings. So I'm glad to hear you are on this journey of healing.

If you haven't already brought up the subject (it's been some time since you posted) I'd encourage you to do so – it can be a real door opener for you and a healing moment and more for your therapy.

You mentioned that "I should have said something" in reference to your breakthrough. You know, you can always pick this up at any time during your sessions and make it your right time.

For example, you can take a moment and recall that session with her. Tell her you've given it some thought and you realize now what you didn't realize then, that you've become attracted to her. Even if you've already raised the subject of transference with her, remember that earlier sessions and your interactions with your therapist always make for good therapy material.

Another observation: I felt it was unfair and unfortunate for your therapist to threaten abandonment because you weren't saying enough. When I read your post I was reminded of my own experience many years ago with a psychiatrist. I would sit there, session upon session, saying little. She was kind enough towards me, but now I know that being "nice" isn't the stuff that makes for good therapy.

Good therapists help clients learn to regulate their emotional states and that requires the hard work of being emotionally attuned and engaged in the present moment and throughout the session.

From neuroscience, we've learned that it is essential for our emotional brain to have safety. Yet my therapist then did little to foster the sense of safety I needed, other than to gently ask me questions. We never talked about the need to reduce my fears or find ways to help me feel safe in the sessions.

It's my belief that the therapists who get results teach folks to “ground" themselves through the body and/or to resource themselves by recallling pleasant experiences (i.e. using body psychotherapy techniques such as belly breathing and focusing). They make the task of grounding an explicit, concrete part of the therapeutic work.

The therapist's job is to meet the client where ever he or she is at. If a client isn't able to embrace the therapy approach - particularly when the presenting problem is around self-expression - then the working through might entail what blocks her from sensing into the energy of her words. (For instance in your case, what happens when you think about speaking. What shows up in your body? What are the sensations?)

You see, therapy isn't about getting it right before we arrive at the front door. It shouldn't be a sink or swim experience. Ideally, the therapist is there to help you take your small steps and to show you the way to your best life ever!

If you find these thoughts worthwhile, you might think about opening up a dialogue for further discussion with your therapist – I suspect it just might lead to a new line of therapeutic encounters.

All the best,

Shrinklady


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Shaz, London

Transference is not cool and should never be encouraged

I have suffered extreme transferance and don't find it cool at all. It has left me with feelings of rejection and abandonment and I will never get over the intense pain I felt. It has taken me two years to get to some sort of normal and I still get waves of deep sadness. I have spoken to many, many sad hurt people who suffer this and some,including myself, have been suicidal. I believe, until you know enough about the damage that can be done, it should not be encouraged at all. The last thing I would describe as is cool.

Dr. Susan LaCombe Psychoshrink

Shrinklady

I stand corrected Shaz. What you experienced is definitely not cool. The reality is that much can be gained in therapy without working with transference or encouraging it to develop. Without sounding self-serving, I wrote a whole program that took over three years to develop for just that purpose. You can get beyond it whether you’re still in therapy or not.

I also agree that transference need not be encouraged. I personally don’t ascribe to those therapies that purposely try to induce it (where the therapist says very little or is barely available emotionally to the client etc.). What’s worse is that I’ve heard from folks who’ve been in this situation and they’ve described having been left to their own resources to get through it. Like nothing is explained to them and no tools to speed up the process are provided.

In this latter instance in my view, the therapist’s role tends to perpetuate the same dynamics that the client experienced at the hands of an ill-suited caretaker.

Transference though is a reality in all relationships to some degree albeit it can be quite small in some regards. So whether the therapist encourages it or not, it’s bound to occur in some instances.

What I hope to make known is that neuroscience offers us a hope and the tools to get through much faster and much easier than was previously thought.

I hope that one day you will feel you’re beyond it and that your life is the richer for it.

Best regards,

Shrinklady


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Carol. Omaha, USA

Can my CBT therapist help me resolve my transference?

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.

Dr. Susan LaCombe Psychoshrink

Shrinklady

Yes, Carol, that's right. In order to heal we need some of the same conditions that were present when we first developed our emotional template. We need our therapist to be emotinally available to us. In this way we feel some of the same type of feelings that we had as infants. This helps us to reconfigure neuropathways and old emotional patterns.

When your therapist has been with you over a period of time, this helps to heal that part of you that didn't get consistent care. This care, in effect, helps heal old wounds. It seems that this might be the case with your therapist as he's been there with you for 3 1/2 years.

What's also necessary for healing is a therapist that is sufficiently present and attuned. This describes a therapist that appreciates the importance of relationship and being emotionally available. He or she works to be there for you. For instance, he might pull back and/or challenge you as he senses you're readiness for the next step. You feel he really "gets" you.

What troubles me Carol in your description of your therapist are the words, "this man". They appear to reflect a lack of felt connection (and maybe healthy anger at suddenly feeling dropped).

Let me propose a hypothesis. 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. In the former, the "familiar" feels comfortable. So, for example, if a lack of connection is all we know, then it 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 are now recognizing a need for more connection. Sometimes we don't know how we've grown until it is brought to our attention. And, your recent experience with your therapist may have been one of those times. That is, how you feel about connection with another may have become more apparent to you when he suggested terminating your therapeutic relationship.

However, crappy this proclamation by your therapist feels, it is all well and good as an indicator of your emotional growth.

It is true that some treatment approaches are not sensitive to relational dynamics. This doesn't necessarily mean that the therapist isn't. 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 optimal reflections a therapist that's concerned about the therapeutic relationship might make. 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?"

These of course are just a sample of ideas but hopefully they give you an idea of what's possible. It strikes me that a therapist that is able to work with a client for 3 1/2 years might have the kind of qualities that makes it easy for clients to continue i.e. he has some of the emotionally available traits I'm referring to. (Clients tend to leave therapists sooner who aren't good at relationship building.)

I think he might also be able to apply his treatment model to your issue and help you work this out. But it'd be good to tell him how you felt when he mentioned termination (hate that word...sounds like there's no hope and the image of Arnold Schwartzanager doesn't help) 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.

Carol, it's not unusual that one therapist is good for only a part of our journey. In fact, my therapist today would not have been a good fit for me years ago. So in your case, if you feel he is not making the kind of effort to connect with you especially over this issue, you may need to seek out someone who can take you to the next level.

I wish you well on your journey,

Shrinklady and Dr. Carole (we all need helpers )


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Audrey

Constantly worried about being close to anyone

I have issues with people walking out of my life. I am constantly worried about being close to anyone. However, I notice that i have a serious attraction to my therapist. I feel like I need to stop going to her because I feel like she will realize this and stop seeing me. I find it hard to open up to her like i sholud because of my feelings for her.

What is your advice to this problem. ps I am thinking of telling her how i am feeling. Is this a good idea?

Dr. Susan LaCombe Psychoshrink

Shrinklady

Hi Audrey, should you tell her? Yes, that's what therapy is all about.

It's been some time since I'm responding to your question Audrey so you may have already taken this step. And I believe you already answered this question for yourself in your post. You mentioned that you have a hard time being close to someone. Yet, here you are...deep into the beginnings of a new level of closeness with another human being and your fear of abandonment is coming up. Good.

We need the feelings to be present in order to change them. This is what therapy offers, a new experience from which the brain can learn from.

Try to remember that your fears arise from experience - experiences you likely had as an infant. What we've learned through neuroscience is that what develops in relationship, must be healed in relationship.

So, it is natural that you would be fearful of becoming close and then abandoned. Good therapy offers a chance for us to tease these crossed wires apart so that one day, feeling emotionally close is synonymous with trust and safety.

All the best on your journey Audrey,

Shrinklady

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