Does Therapists' Disengaged Feelings Influence the Effect of Transference Work? A Study on Countertransference

Area of Science:

• Psychotherapy Research
• Clinical Psychology
• Psychoanalysis

Background:

• Transference work is central to dynamic psychotherapy, but its effectiveness varies.
• Therapist disengaged feelings (countertransference) may impede therapeutic processes, particularly transference interpretation.
• Patient's quality of object relations (QOR) is a key factor in treatment outcomes.

Purpose of the Study:

• To investigate the long-term effects of transference work.
• To examine the moderating roles of patient's QOR and therapist's disengaged feelings.
• To understand the interaction between transference work, QOR, and therapist countertransference.

Main Methods:

• 100 outpatients with depression, anxiety, or personality disorders were randomized to dynamic psychotherapy with or without transference work.
• Patients' QOR was assessed pre-treatment.
• Therapists' disengaged feelings were measured post-session using the Feeling Word Checklist-58.
• Outcomes were assessed at multiple time points up to three years post-treatment.

Main Results:

• A significant three-way interaction was found between treatment group, QOR, and therapist disengaged feelings.
• Disengaged therapist feelings were associated with negative long-term effects of transference work, particularly for patients with poor QOR.
• The negative impact of therapist disengagement on transference work was minimal for patients with good QOR.

Conclusions:

• Therapist countertransference, specifically disengaged feelings, significantly impacts psychotherapy outcomes.
• Transference work is especially vulnerable to negative effects from therapist disengagement in patients with poor QOR.
• Therapist training and supervision must address emotional reactions to enhance therapeutic effectiveness.