Transference and Countertransference in CBT and Schematherapy of Personality Disorders

Abstract

Countertransference occurs in CBT when the relationship with the patientactivates automatic thoughts and schemas in the clinician, and these cognitionshave the potential for influencing the therapy process. Countertransferencealso occurs during supervision and is an indispensable part of the supervisor's response to the supervisee. CBT is typically short-termtreatment – intensity of transference is usually muchlower than in longer-term, dynamically oriented psychotherapy. Neverthelessduring the long-term CBT of the personality disorder or other complex cases, high intensity of transference and countertransference can develop.

Schema therapy shares the view thatschemas are crucial to understanding of personality disorders, but also canhelp to understand the emotional reaction of therapist. A mode is the set ofschema operations that are in one moment functioning for a person. It is acircumscribed complex pattern of emotional, cognitive a behavioral experiences, which operate in typical situations. When therapist suspects that countertransferencemay be developing, he/she could try to identify her/his automatic thoughts andschemas. More comprehensive approach is to quickly identify in which modehim/her are at that moment and reflect it such reaction is for the patientbenefit or not. Understanding therapist countertransference reactions andtheirs management are a significant point of supervision. Self-reflection and realizing the countertransference can therapist help toovercome it and may be necessary for overcoming stagnation in therapy.

Understanding own mode and theirflipping into the therapeutic session is an important tool in psychotherapy andsupervision.