Countertransference

Countertransference is the concept that a therapist or clinician develops strong emotional reactions to a patient unconsciously. I sort of think of it as the feelings I get when I see a patient. I feel pity when I see a young person in a car accident or satisfaction when I talk to a patient who has finally gotten an exercise routine. But this is taken to a whole new level in psychiatry, especially since much of psychiatry depends on the therapeutic alliance. How one interacts with patients greatly affects whether patients will share personal details of their life, be willing to work on maladaptive behavior, and adhere to medications.

In this rotation, I've had patients threaten to kill me, call me a liar, and ask if I'm the FBI hunting them down. Even though I understand that these patients may be paranoid or borderline, it elicits an involuntary emotional reaction. I've found myself scoping out these patients before I see them to see if they are in a good mood or not. I brace myself before I go in, knowing that they may be furious and yell at me to get out. I have to dig deeper to find the empathy and patience to work with them and tell myself not to take what they say personally. It's emotionally weary to go through all that, but it's a prominent part of psychiatry.