Transference and Counterference

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Transference and Countertransference by Lisa Marie Hilz

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 is the "transference" of past feelings, conflicts, and attitudes into
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The goal is to guide the patient to independence by teaching them to assume responsibility for their own behaviors, feelings, and thoughts, and to assign the correct meanings to relationships based on present circumstances instead of the past. Helping the patient work through the transference is beneficial in two important ways: the therapeutic value of the relationship may be restored and even improved, and the patient may also learn to identify this behavior in other relationships, thus improving interpersonal skills.
Countertransference involves the same principles, except the direction of the transference is reversed. Countertransference, a normal occurrence as well, involves the nurse’s reactions, behaviors, thoughts, and feelings toward the patient (Wilson & Kniesl, 1996). Unresolved conflicts from the nurse’s past may evolve as countertransference. For example, a patient who displays childlike dependency toward a nurse may evoke a parental attitude from that nurse, depending on the meaning that he or she assigns to the relationship with the patient, and if past conflicts are significant to the present situation. Nurses may be completely unaware or only minimally aware of the countertransference as it is occurring.
Interventions for countertransference involve

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