331nonstop, and dismissing/ignoring your interpretations and reactions. For instance,
sometimes in prenatal genetic counseling with couples, one of the partners will
use their cell phone or laptop computer during the session (cf. Lafans et al. 2003 ).
In summary, patient transference is based on patient misperceptions, and it
results in overreactions to the reality of the situation. Keep in mind, however, that
not all “first impressions” are transference (invalid perceptions). For example, when
you nonverbally and verbally express interest, care, and acceptance, most patients
will accurately view you as someone to whom they can relate.
Examples of Patient Transference
- A 40-year-old patient had prenatal testing that revealed Down syndrome. The
patient terminated the pregnancy by induction of labor. The genetic counselor
gave the patient the test results and provided some initial counseling over the
phone. The patient made an excessive number of phone calls to the counselor and
wrote her several letters. She requested a follow-up session but would not come
into the building, asking instead that the genetic counselor have lunch with her.
None of the genetic counselor’s suggestions or referrals to other health profes-
sionals would work. The patient continued to be helpless and was not open to any
suggestions. - A patient was seen for genetic counseling regarding a positive family history of
breast cancer. The genetic counselor called to give the patient the results of her
BRCA testing, and the patient acted as if she did not remember meeting with the
counselor. The counselor gave the patient some information about their last visit
and then asked if the patient remembered her. The patient replied in a very hostile
manner, “How could I forget you!” The patient was defensive and would not
disclose any feelings about the test results. - A patient was the mother of a 2 1/2-year-old child newly diagnosed with
Angelman syndrome. The child had a history of moderate-to-severe develop-
mental delay, no speech and language, and seizures. The mother was a single
parent and was managing a career and this child fairly well. She had, however, an
exceptionally intense reaction to the diagnosis, especially the mental impairment
component. She displayed excessive crying and emotionality and wanted the
genetic counselor to be a nurturer. She called several times with urgent questions
and had a need to go over the information repeatedly. She requested another
appointment to go over the information yet again. - A couple had an intensely negative reaction to a geneticist who was present dur-
ing their counseling session in which a postnatal diagnosis of achondroplasia
was given. They wrote a letter to the head of the hospital complaining bitterly
about his lack of compassion, when in fact he had behaved appropriately and in
a caring manner.
12.1 Transference and Countertransference