339- Engage in self-disclosure that is of questionable value/relevance to the genetic
counseling goals (Balcom et al. 2013; Menezes 2012 ; Peters et al. 2004;
Redlinger-Grosse et al. 2013; Thomas et al. 2006; Weil 2010 ). For example,
Thomas et al. (2006) investigated genetic counselor self-disclosure and con-
cluded that “Evidence of possible countertransference is suggested by some par-
ticipants’ comments that they ‘tried not to give in’ to disclosure when it was
prompted by their identification with a patient” (p. 174).
Reeder et al.’s ( 2017 ) sample of clinical genetic counselors described six major
types of behaviors that demonstrated their countertransference: being self-focused,
projecting feelings onto the patient, experiencing intense emotional reactions to
patients, being overly invested, counselor disengagement, and counselor physical
reactions (e.g., sweating).
Hofsess and Tracey ( 2010 ) identified a variety of therapist behaviors that suggest
countertransference. Most applicable to genetic counseling are the following: - Daydreams about relationships or events related to client
- Loses all neutrality and sides with a client
- Treats client in a punitive manner during session
- Acts flirtatious or feels sexual attraction to a client
- Engages in too much self-disclosure
- Expresses hostility toward or about a client
- Acts in a submissive way with the client during session
- Dreads seeing a client
- Feels protective of a client
- Expresses a need to be respected, appreciated, and liked by the client
- Acts defensive when discussing a client with a supervisor
- Rushes in to solve a client’s problem
- Behaves as if he or she were “somewhere else” during the session
- Is apathetic toward a client in session
- Feels hurt by something a client says or does during the session
- Experiences anger and frustration when with a client
- Experiences envy, guilt, or pity when with a client
Remember, generally speaking, any behaviors, thoughts, feelings, or attitudes,
that either are out of character for you or are considered by others (e.g., your
supervisor, the patient) to be ineffective or inappropriate, could signal
countertransference.
Countertransference Examples
- The genetic counselor saw a family with whom she shared many similarities. She
knew that she was over-identifying with this family and the counseling (for her) was
much more intense emotionally. The patient was a 14-year-old healthy girl. The
patient had a brother who died at age 10 of Hunter syndrome (MPSII). The patient’s
mother brought the patient to a clinic for carrier testing for Hunter syndrome.
12.1 Transference and Countertransference