Transference and Counterference
Transference and Countertransference by Lisa Marie Hilz
Introduction
Transference and countertransference are both normal phenomena that may arise during the course of the therapeutic relationship. Understanding these phenomena in nursing is important because the primary focus of nursing is the nurse-patient relationship (Imura, 1991). This discussion will describe how these phenomena occur, and how they may manifest in the nurse-patient relationship. Furthermore, this discussion will highlight nursing interventions in these situations, in order to provide insight into how nurses can maintain and improve the therapeutic focus and environment.
Transference
Transference is the "transference" of past feelings, conflicts, and attitudes into present relationships, situations, and circumstances. According to psychoanalytic theory, transference evolves from unresolved or unsatisfactory childhood experiences in relationships with parents or other important figures (Wilson & Kneisl, 1996). From the behavioral orientation, people may be considered habit-forming in how they relate and interact with others. These habits involve the development of attitudes and preconceived ideas based on the learning and retention of information from past relationships. This may precipitate behavioral and thought patterns in subsequent relationships, even though certain actions and attitudes may be inappropriate for the current interaction (Strayhorn, 1982). As nurses generally have the most consistent and frequent contact with patients as compared with other disciplines, the potential for nurses to be objects of transference is significant.
Meanings and Role Casting
Transference, in essence, is the casting of roles (Taylor, 1994). Inappropriate meanings are assigned to the relationship by the patient. For example, Strayhorn (1982) discussed a patient who experienced anxiety around his father as a child. The father was a doctor, critical and impersonal, and generally demanded perfection
Introduction
Transference and countertransference are both normal phenomena that may arise during the course of the therapeutic relationship. Understanding these phenomena in nursing is important because the primary focus of nursing is the nurse-patient relationship (Imura, 1991). This discussion will describe how these phenomena occur, and how they may manifest in the nurse-patient relationship. Furthermore, this discussion will highlight nursing interventions in these situations, in order to provide insight into how nurses can maintain and improve the therapeutic focus and environment.
Transference
Transference is the "transference" of past feelings, conflicts, and attitudes into present relationships, situations, and circumstances. According to psychoanalytic theory, transference evolves from unresolved or unsatisfactory childhood experiences in relationships with parents or other important figures (Wilson & Kneisl, 1996). From the behavioral orientation, people may be considered habit-forming in how they relate and interact with others. These habits involve the development of attitudes and preconceived ideas based on the learning and retention of information from past relationships. This may precipitate behavioral and thought patterns in subsequent relationships, even though certain actions and attitudes may be inappropriate for the current interaction (Strayhorn, 1982). As nurses generally have the most consistent and frequent contact with patients as compared with other disciplines, the potential for nurses to be objects of transference is significant.
Meanings and Role Casting
Transference, in essence, is the casting of roles (Taylor, 1994). Inappropriate meanings are assigned to the relationship by the patient. For example, Strayhorn (1982) discussed a patient who experienced anxiety around his father as a child. The father was a doctor, critical and impersonal, and generally demanded perfection
References: Imura, S.(1991). Transference and countertransference in nursing. Emphasis Nursing,1, 77-81. Strayhorn, J.M.(1982).Foundations of Clinical Psychiatry. Chicago: Yearbook. Taylor, C.M.(1994).Essentials of Psychiatric Nursing,14th ed. St. Louis: Mosby. Wilson, H.S. & Kniesl, C.R.(1996).Psychiatric Nursing,5th ed. New York: Addison-Wesley. 10. Happ, Mary Beth. (2001, May). Communicating With Mechanically Ventilated Patients: State of the Science. AACN Clinical Issues: Advanced Practice in Acute and Critical Care, 12(2), 247-258.