Transference: An Energetic Volley in Clinical Settings

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Transference: An Energetic Volley in Clinical Settings

Andrew Pacholyk, LMT, MT-BC, CA

 

 

Abstract

In the clinical setting, the energies of transference and counter

transference are always present. Trying to balance these energies

that abound in a clinical interview are both challenging to

recognize, as they are to cope with. The process of being aware, as

well as conscious, plays a major role in the recognition of

transference and counter transference.

This research takes a look at the observations and understandings of

transference, counter transference, as well as boundaries in the

clinical setting. Observations from two distinct therapeutic

practices are utilized. Dynamic emotions of shame, humiliation,

power, anger and passive aggressive behaviors are sited. This

research will take a look

at the redirection of feelings and desires, especially of those

unconsciously retained from childhood toward a therapist, as well as,

the complexity of feelings of a therapist toward the patient as we

discuss Transference: An Energetic Volley in Clinical Settings.

 

Keywords

Transference, counter transference, boundaries, shame, humiliation,

anger, judgment, trust, observations, energy, balance, awareness,

consciousness, emotions, passive aggressive, feelings, behavior,

projection, power.

 

Transference is the feelings from your past interactions with others

that you transfer into a relationship.1. Transference is the

redirection of feelings and desires, especially of those

unconsciously retained from childhood toward a therapist. These

feelings and desires are convictions of patterns from the patient's

past interpersonal relationships, formed in their early lives,

repeated in their later lives, and can be understood through the

repetition they give to them.

 

Counter transference is the therapist's transference of feelings in

therapy and/or toward the client. 2. Therapists and other health

care professionals will also have counter reactions to their

patient's transference. The concept of counter transference, is an

expression of patterns from the therapist's past interpersonal

relationships, which are formed in their early lives, repeated in

their later lives, and can be understood as an energetic " volley "

utilized in response to a patient's situation.

 

In any clinical setting where there is an interview, there is an

exchange of energies. Through these energies, we can observe the

ability to relate to one another via intuitions, creative hunches,

the give and take of power, nonverbal and emotional insights and

nonverbal forms of communication that form a valuable source of

knowledge about the patient's personality, and his or her

transference.

 

Massage Therapy

As a massage therapist, I utilize the unyielding power of touch to

redirect, align and help to bring into balance, the structural,

muscular, as well as, the subtle energies of the body.

There are many different approaches to massage and applications of

it. Massage Therapy is a holistic procedure that affects all systems

of the body; digestive, elimination, respiratory, circulatory,

lymphatic, endocrine and nervous systems. It is accomplished through

specific manipulations with the hands on the soft tissue of the body

for therapeutic effect. Sexual energy is a part of any touch

therapy in many subtle ways. We are all sexual beings and the

transference of this energy from the patient can often be felt. It

is a situation I deal with on a daily basis and I have learned how to

channel it from the patient out through different avenues during the

massage.

 

I recently had a new client who visited me for a massage. She was a

female about 40 years old, in good shape with a pleasant disposition.

This was the first time I was seeing her. We went through the usual

introduction. I explained the massage process and then asked if

there was anything in particular she wanted me to pay attention to.

She told me she was having leg cramps and if I could work extra time

on her legs. I agreed and left the room, allowing her the privacy to

undress and lie on the table. When I returned, she had disrobed and

gently laid face down on the table. She chose not to cover herself

with the sheet that I provided so I began to cover her myself with

the sheet…and there it was, an expletive (* & ?#) regarding her desire

for intercourse, scrolled in lipstick at a rakish angle across her

thigh.

 

It was a good thing her face was down in the face cradle of the

massage table, for she could not see the expression of sheer shock,

fear, anger and then disgust that must have moved across my face in a

flushed wave and then made my whole body shake with uncertainty.

This very passive, yet aggressive act pushed all my buttons! The

professional boundaries, of which I knew, had been shattered. I did

not react, in fear that I would give all my power away in that

moment. I went about the massage. She said nothing, I said nothing.

I felt it was a match of wits! Meanwhile, my emotions were running

from sheer shock… " I can't believe this is happening " , " What was she

thinking? " " This is such an awkward situation " . To fear… " What is she

going to do? " " What if she says something? " " I'm afraid I don't

know how to handle this " . To anger… " She has a lot of nerve to do

this to me! " " I'm going to put her through the same mental lashing

she is putting me through! " , " I should just tell her to get off my

table! " To disgust… " Just what does she think she is going to get

from me? " " How desperate can she be? " " Does she think this is

funny, because it is making me sick " . I found my inner strength and

continued to say nothing.

 

I finally got to her thighs and with the massage oil proceeded to

massage the words right into her thighs with intense strokes. I could

feel the anger as I pressed deep into her flesh, trying to make it

hurt! Then I could " feel " what she was thinking… " Well, did he see

it? Is he going to act upon it? Did I not write it clear enough,

big enough? " I finished her calves and asked her to turn over slowly

as I covered her with the sheet again. She had a face of stone with

no expression as I finished the last 20 minutes of the massage. She

dressed and thanked me very pleasantly leaving me twice the amount

for the massage as she left, never mentioning or making reference to

her words of desire. I still relive the moments of how I struggled

with the breech of boundaries and the power to handle such a

situation.

 

Music Therapy

Music Therapy is the prescribed use of music and music related

techniques to assist and motivate a person towards specific,

nonmusical goals. Music therapists use their training to effect

changes in the cognitive, physical, communication, social, and

emotional skills.

 

Music is a magical medium and a very powerful tool. Music can delight

all the senses and inspire every fiber of our being. We are often

drawn to a particular type of music. Sometimes it is something you

can listen to all day or maybe you jump around the dial during the

day to find what appeals to you in the moment. This form of, what I

call " subliminal " or " subconscious " balancing (healing) plays a part

in our perspective on our emotional equilibrium. Music Therapy is

incorporated in a number of areas of medicine. Some of these include

labor and delivery, oncology, pain management, physical

rehabilitation, and pediatrics.

 

As a music therapist I tend to work with many difficult cases that

often involve the elderly. Dementia patients have often intrigued to

me. Dementia is a progressive, degenerative brain disorder that

causes intellectual impairment and disorientation. Often patients are

overcome by stress due to the frustration in not knowing where they

are or the loss of memory, when they need it to serve them. An

elderly gentleman in his 70's of Indian decent, was an ongoing

dementia patient who would come to me for help with these particular

problems, using music as an adjunct therapy to help him recall

certain times, ideas and memories he could not recall. He had been

a patient of mine for about a month. There seemed to be no apparent

change in his recalling of memories that meant anything to him. I was

beginning to feel a shamed and humiliated at the fact that he seemed

to have such trust and faith in my abilities. I felt as if I were

letting him down.

 

According to Dr. Lazare, this " shame may refer to the distress

concerning the state of the self that the person regards as no good,

not good enough or defective. " 3. My humiliation came from the fact

that he was just so trusting in my ability to help him! As Dr Lazare

states, " humiliation refers to a temporary state of the self, an

alteration, usually caused by someone else, which the person regards

as lowering or debasing " . 4. He would look at me with the eyes of a

child showing me such hope and appreciation even though I felt as if

I was making no progress at all. One day I found a piece of music

that was very relative to his life growing up in India. In the

Ayurvedic tradition, Gandharva Veda music is the eternal music of

Nature. The music is utilized as a tool in bringing peace and

harmony to their land and perfect health to all their people. As I

played this music for him this day, there was a light shining from

his eyes that I had never seen before! A spark of recognition that

placed a large smile on his face! I knew then, this temporary

feeling of humiliation I was feeling, began to melt away as I was

overcome by his transference of sheer elation! I responded back

indecisively wondering if what I was seeing in him was truly a

reflection of a memory he was recalling! " I can recall a time from

my childhood! " he gasped as I could feel my counter transference of

joy wash over him. I could feel the tears begin to stream down my

face. Something I could not contain! I could not have been more

grateful that day! " By enhancing the patient's power, I facilitated

his own way of finding control and mastery " 5. in dealing with his

illness in a small but significant step forward.

 

 

In conclusion

Energies in the clinical setting are constantly volleyed between

patient (transference) and therapist (counter transferences). The

professional boundaries of both parties can often be pushed without

even realizing it or as an absolute deliberate action in order to

illicit a response from either party. I have learned an important

point in dealing with off center situations. In most cases, it's not

the problem itself, but how one reacts to the problem. How one react

is determined by how one perceives a particular situation. The

constant give and take of power in any situation can be apparent or

it can be as subtle as a gentle breeze. The lasting effects it makes

is a continuing act of balance between the practitioner and their

patient. Shame and humiliation are the action of lowering our pride

or self respect and can either be a transference of energy or self-

inflicted. Taping into our standard ego idea, these actions all play

apart in how we give and what we take when we exchange our energies

with another.

 

 

 

References

 

1. Transference & Countertransference: A Common Sense

Perspective –Article: Babbette Rothschild, MSW, Energy and Character,

Vol 25, No. 2 Sept, 1994

 

2. Transference & Countertransference: A Common Sense

Perspective –Article: Babbette Rothschild, MSW, Energy and Character,

Vol 25, No. 2 Sept, 1994

 

3. Shame and Humiliation in the Medical Encounter- Article: Dr.

Lazare

 

4. Shame and Humiliation in the Medical Encounter- Article: Dr.

Lazare

 

5. Power in Treatment, Chapter 7, Therapeutic Relationship in

Complementary Care, Annie Mitchell & Maggie Cormack – Churchill

Livingston 1998