Psychodynamic Practice

Individuals, Groups and Organisations

ISSN: 1475-3634 (Print) 1475-3626 (Online) Journal homepage: https://www.tandfonline.com/loi/rpco20

Developing countertransference awareness as

a therapist in training: The role of containing
contexts

Shelley Gait & Andrea Halewood

To cite this article: Shelley Gait & Andrea Halewood (2019) Developing countertransference
awareness as a therapist in training: The role of containing contexts, Psychodynamic Practice,
25:3, 256-272, DOI: 10.1080/14753634.2019.1643961

To link to this article: https://doi.org/10.1080/14753634.2019.1643961

Published online: 18 Jul 2019.

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Psychodynamic Practice, 2019
Vol. 25, No. 3, 256–272, https://doi.org/10.1080/14753634.2019.1643961

Developing countertransference awareness as a therapist in

training: The role of containing contexts
Shelley Gait*a and Andrea Halewoodb
a
School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, UK;
b
Chartered Psychologist, working in private practice

The psychodynamic literature suggests that countertransference is an inevitable

part of therapy and a significant feature of the client-therapist relation-
ship. However, countertransference is also considered to be a ‘double-
edged sword’: when it is reflected on by the therapist, it can offer valuable
insights into the therapeutic relationship, but when it remains outside of aware-
ness and therefore unmanaged it can result in the therapist unwittingly acting out
in the therapeutic relationship and responding in counter-therapeutic ways. The
purpose of this research was to explore the factors involved in the development of
countertransference awareness in therapists and to construct a grounded theory of
the process. Fifteen qualified therapists were recruited and interviewed, either
face to face or via Skype, using a semi-structured interview schedule. The
grounded theory constructed from the data suggests that during training partici-
pants initially experienced countertransference as threatening and overwhelming.
When this experience was contained in supervision and therapy, the organisa-
tional context and by participants’ theoretical framework, they could reflect on
their countertransferential responses and make sense of their experience, which
then developed their self-awareness and other insights to the benefit of the
therapeutic relationship. Conversely, a lack of containment in these domains
resulted in participants acting out their countertransference and becoming either
over or under available in the therapeutic relationship. The findings offer a useful
process model on the role containing contexts play in the development of
countertransference awareness for therapists in training.
Keywords: Countertransference; containment; therapists in training;
supervision

Introduction
The construct of countertransference
The construct of countertransference, broadly defined within the literature as the
therapist’s responses towards the client, both conscious and unconscious, has
undergone several modifications within psychoanalysis (Bichi, 2012). Freud
(1910) initially regarded countertransference as the analyst’s emotional reaction
to the client’s transferences and argued that it needed to be overcome lest the
analyst become emotionally involved. Freud recommended a neutral stance and

*Email: [email protected]
© 2019 Informa UK Limited, trading as Taylor & Francis Group
 Psychodynamic Practice 257
trainee analysts were required to undergo analysis to work on complexes evoked
by the patient’s transference. Consequently, many analysts believed that the
proper response to their countertransferential responses was to abolish them
(Hinshelwood, 1994); abstinence and neutrality were the order of the day.
By the 1950s an alternative understanding of countertransference was develop-
ing, one which suggested that while countertransference feelings in the therapist
were unavoidable and could be disturbing, they also yielded valuable information
about the internal world of the client (Heimann, 1950; Little, 1951). These theorists
argued that the therapist’s understanding of the client’s internal world was informed
by projective identification, a defence first conceptualised by Klein (1946), whereby
the client split off and projected disavowed affect into the therapist. According to
Klein, projective identification was intrapsychic process and did not include the
stimulation of affect in the therapist. Later Kleinians focused on projective identi-
fication as a communicative process; Bion (1957; 1961) in particular broadened the
construct to include the feelings experienced by the therapist in response to the
client’s projections. Bion described a process of ‘reverie’ whereby the client projects
part of their mind into the therapist who introjects and ‘metabolises’ it, before
putting it back to the client in a form that can be reflected on, thereby demonstrating
that disowned experiences can be tolerated, processed and understood (Gabbard &
Ogden, 2009; Money-Kyrle, 1956). In doing so, the therapist contains the client’s
anxiety and modifies, detoxifies and transforms it for them, thereby making the
‘unthinkable, thinkable’ (Gabbard & Ogden, 2009).
Bion (1962) suggested that the provision of ‘containment’ allows the client to
reintroject the experience which facilitates growth and development. In contrast, if
the therapist becomes influenced by the projected feelings and lacks the capacity
to tolerate them long enough to modify and detoxify them, they may then reject
them (Bion, 1962). This resulted Bion (1962) suggested in an amplification of the
projected material and a sense of ‘nameless dread’ in the client. Therefore, for
containment to occur the therapist needed to be able to tolerate the ‘emotional
storm’ long enough for it to be thought about and given meaning (Bion, 1962).
These theoretical and clinical developments have resulted in different construc-
tions of countertransference, although these are often used interchangeably despite
conceptual differences (Fauth, 2006; Hayes, 2004; Hayes, Nelson, & Fauth, 2015).
However, there is a broad consensus within the field of psychoanalysis that counter-
transference is an inevitable and central part of psychotherapy (Burwell-Pender &
Halinski, 2008; Coren, 2015; Gabbard, 2001; Gelso & Hayes, 2007; Hayes, 2004;
Ivey, 2008; Ligiéro & Gelso, 2002; Marroda 2004; Pope, Greene, & Sonne, 2006;
Rosenberger & Hayes, 2002). Furthermore, there is widespread agreement that while
unmanaged countertransference can result in a negative therapeutic outcome and
destructive enactments, countertransference which is contained, reflected on and
managed, can benefit clinical work by illuminating both the client’s and the therapist’s
interpersonal dynamics. It is suggested that the management of countertransferential
material requires of the therapist the awareness and motivation to examine and work
through countertransferential feelings as and when they arise (Burwell-Pender &
258 S. Gait and A. Halewood
Halinski, 2008). However, this is not an easy task for the neophyte therapist who is
faced with the task of processing and containing their clients’ often intolerable affects,
while also managing the various stressors and narcissistic injuries associated with
training.

The therapist in training

According to several authors (e.g. Hill, Sullivan Knox & Schlosser, 2007; Skolholt
& Ronnestad, 2003; Theriault, Gazzola & Richardson, 2009) the developmental
journey of therapists in training can be particularly difficult as they have yet to
develop the necessary experience, self-awareness and reflective skills, which
would enable them to manage the anxiety generated by the work, including
their countertransferential responses. The literature suggests anxieties encountered
when training can arise due to a number of factors, both internal and external.
It has been suggested that those attracted to the therapeutic professions may
have unresolved narcissistic issues (Halewood & Tribe, 2003), and therefore may
struggle when confronted with limitations and vulnerabilities, such as failing to
meet an idealised professional self (Barnett, 2007). According to Barnett (2007),
trainees often strive towards an idealised image of themselves as a way of
defending against feelings of inadequacy caused by their narcissistic vulnerabil-
ities (Barnett, 2007). Truell’s (2001) qualitative study into the stressors inherent in
counselling training found that participants felt that they should be able to solve all
their client’s problems and that they should be able to acquire counselling skills
with ease and to perform them perfectly. Truell (2001) concluded that many
trainees believed that they needed to have resolved their own personal conflicts
to become a good therapist, as difficult feelings experienced in the work were
attributed to themselves and therefore constructed as a sign of failure.
According to Kohut (1971, 1977) & Miller (1981), narcissistic vulnerability
develops when the caregiver fails to mirror the ‘normal’ narcissistic needs of the
infant, which impacts on the development of a cohesive self, leading to a fragile and
fragmented ego. In addition, these individuals may struggle with the ambiguous and
uncertain nature of therapy and the management of countertransferential material
(Barnett, 2007; Mollon, 1986). Symington and Symington (1996) observe that the
therapist’s capacity to tolerate uncertainty will influence what they can bear and
argues that this capacity is dependent on the demands of the superego. When the
superego is unable to bear not knowing then it can become persecutory; not
knowing can create anxiety in the trainee with a therapeutic ideal that they should
always know what to do (Casement, 1985; Colman, 2006). This can be also be
reinforced by the training experience, as trainees believe they need to conduct
themselves in an overly competent manner to meet the expectations of the profes-
sion and avoid negative evaluation and criticism (Eckler-Hart, 1987). Therefore,
when confronted with vulnerability and limitations, many trainees doubt their
suitability for the profession, which they fear may be shared by teachers and
supervisors (Eckler-Hart, 1987, Mollon, 1989).
 Psychodynamic Practice 259
This ideal can set up a ‘vicious cycle’ of anxiety and guilt, whereby the trainee not
only feels ineffectual in the work with the client, but they also fear being found out or
criticised by their supervisor or trainers (Barnett, 2007; Colman, 2006; Skovholt &
Ronnestad, 2003; Yourman, 2003; Yourman & Farber, 1996). Supervision and
training can therefore increase rather than decrease trainees’ anxieties, until they
come to understand that their countertransferential material is a normal and central
aspect of the work (Burwell-Pender & Halinski, 2008; Marroda, 2012; Truell, 2001).
Willingness to disclose countertransferential responses is also highly dependent on
the supervisor’s invitation to disclose, as well as their ability to normalise the trainee’s
experience (Ladany, Constantine, Miller, Erickson, & Muse-Burke, 2000; Southern,
2007). However, as Bridges (1998) notes, many supervisors don’t have the skills or
confidence necessary to help supervisees examine their own material, which can
restrict supervisory discussions to an exploration of client data. The provision of
containment would therefore seem to be important to enable the trainee to develop
their own capacity to contain the client’s anxieties (Price & Paley, 2008) and to
practice non defensively.
Mollon (1989) suggests that many problems arise for trainees when transference
and countertransference are not covered in the training curriculum, particularly in
trainings where there is a focus on the client and not on the responses of the therapist.
According to Fitzpatrick, Kovalak, and Weaver (2010), the teaching of psychody-
namic theory can leave trainees feeling overwhelmed, scared, disconnected, bom-
barded and daunted.
This is supported by the research literature. Stefano, D’Iuso, Blake, Fitzpatrick,
Drapeau and Chamodraka’s (2007) qualitative study into trainees’ experiences of
therapeutic impasse, indicated that trainees tended to construct impasse as a failure;
many trainees felt that there was a ‘right’ way to intervene which they had failed to
grasp. Many of these participants reverted to basic listening skills in these cases –
a method of coping which was ineffective in addressing the tension and conflict that
they felt in the room. This suggests that participants became preoccupied with
containing themselves, rather than focusing on how to tolerate or contain their
clients’ projections.
Given the stressors and anxieties encountered when training to be a therapist, it
seems pertinent to explore the contexts within which trainee therapists are working,
and their role in containing the anxieties that trainee therapists experience.
Furthermore, it seems important to identify the processes that enable therapists in
training to develop awareness and understanding of their countertransference and to
offer a containing environment to their clients.

The present study

The study adopted a qualitative methodology; this is suggested to be particularly
suited to the study of psychotherapy processes (Hansen, 2004); as it enables the
gathering of data that is rich and illustrates the phenomenon of interest intensely
(Polkinghorne, 2005). The current paper is taken from a doctoral study (Gait, 2017).
260 S. Gait and A. Halewood
Methodology
Sampling and participants
Initially a purposeful sampling strategy was employed to identify eight therapists
who met the inclusion criteria of (a) a recognised qualification in a school of therapy,
e.g. counselling psychology, counselling, psychotherapy; (b) at least 1 year clinical
experience of working one-to-one with clients, (c) some awareness of the construct
of countertransference, to enable them to reflect on how, if at all, it had influenced the
therapeutic relationship with their clients. There were no explicit exclusion criteria.
In accordance with the grounded theory method as the analysis developed
a theoretical sampling strategy was adopted in order to refine categories, with
a further seven therapists recruited, two of whom had qualified in the last year to
capture the development of countertransference awareness over time, two who were
not working with countertransference awareness explicitly to further develop the
theoretical pathways under construction and three who were also practicing super-
visors to further explore the role of supervision on the development of counter-
transference awareness. See Table 1 for participant demographics.

Procedure and analysis

Following ethical approval from the University of the West of England Research
& Governance board, information regarding the study was posted on a number

Table 1. Participant’s demographics.

Participant Gender Occupation/therapeutic approach

P1 Female Psychologist/private practice

P2 Female Psychological Therapist IAPT/trainee counseling psychologist
P3 Female Psychotherapist/CAMHS
P4 Female Psychotherapist – Humanistic & Integrative/Private Practice
P5 Female Psychodynamic Psychotherapist – Psychoanalytic/University
counseling service
P6 Female CBT therapist/trainee counseling psychologist
P7 Male Integrative Counsellor/trainee counseling psychologist
P8 Female Counsellor & Psychotherapist – psychodynamic/University
counseling service
P9 Female Integrative psychotherapist/trainee counseling psychologist/private
practice
P10 Female Integrative counsellor/private practice
P11 Male Psychotherapist/Supervisor/private practice
P12 Female Psychotherapist/Supervisor/Mental Health service/private practice
P13 Female Psychological Therapist IAPT/integrative counsellor/private
practice
P14 Female Counselling Psychologist & Supervisor/private practice
P15 Male CBT Psychological Therapist IAPT
 Psychodynamic Practice 261
of sites pertinent to therapists: The British Psychological Society (BPS) Division
of Counselling Psychology (DCOP) website and Counselling Psychology and
Counselling & Psychotherapy sites on Facebook, JISCMAIL a free online email
database and LinkedIn, a professional networking site.
Fifteen semi-structured interviews were conducted; eight were face to face and
four were conducted online via Skype. Participants were asked about the develop-
ment of countertransference awareness and whether it had influenced the therapeu-
tic relationship. Participants were asked for two client examples to illustrate their
development before and after they had developed their countertransference aware-
ness. Each individual interview was audio recorded and lasted up to one hour.
Interviews were then transcribed in full and analysed using a Constructivist
Grounded Theory methodology (Charmaz, 2006, 2008, 2011), which involved
multiple stages of analysis. Initially, each line of data was open coded to capture
the actions and processes. These open codes were then used to sift through larger
segments of data, leading to the development of more nuanced, abstract focused
codes. The analysis of the transcripts took place concurrently with interviewing,
each process informing the other. Memos and diagrams were used to capture ideas,
theoretical links, relationships, differences within and responses to the data and the
codes throughout the analysis and to develop theoretical categories.
Theoretical sufficiency (Dey, 1999) was considered to have been reached when
the pre-existing categories were sufficient to capture the new data obtained through
further sampling and analysis. The study used Charmaz’s (2006) method for
evaluating a grounded theory study to ensure the analysis remained grounded in
the data. As part of this validity checking process, the diagram of the research
process was sent out to five participants who took part in the study, who confirmed
the diagram had captured their experience.

Reflexivity
The first author and principal investigator is a relational Counselling Psychologist
with an interest in countertransference and the two-way, intersubjective nature of
the therapeutic endeavour. A research journal was kept throughout the research
process as this is understood as an effective strategy to facilitate reflexivity to
capture personal assumptions, biases and goals, making them more available for
reflection and scrutiny (Etherington, 2004, 2001).

Findings
The grounded theory constructed from the data describes the role containment
played in the development of countertransference awareness for therapists in train-
ing. Early in their training participants described experiencing a number of threats to
their personal and professional sense of self, leading to high levels of anxiety. As
participants progressed through their training, the absence of a containing other or
framework to help them to think about and understand what was being evoked in
262 S. Gait and A. Halewood
them by their clinical work led many to follow a defensive pathway; the focus here
was less on understanding countertransferential responses and more on managing
what were sometimes overwhelming levels of anxiety through the adoption of
defensive strategies. However, this lack of awareness, and for many a lack of
containment, led some participants to act out their countertransferential responses
in the therapeutic relationship, as their anxieties became ‘amplified’. Conversely, if
these anxieties were contained, participants’ anxieties were detoxified and they
were able to develop their own reflective capabilities and therefore their counter-
transference awareness. This enabled participants to move away from feelings of
incompetence as they began to develop a framework which helped them to develop
and make sense of their countertransferential feelings and responses. Over time
a small number of participants began to reflect in the moment; some appeared to
have internalised containing others who supported their developing countertrans-
ference and self-awareness. This enabled participants to engage more fully in the
therapeutic relationship.
Movement between the two pathways seemed to occur primarily when there
was a change in containment or when participants re-experienced threats to self.

Experiencing a threat to self

Participants described the threats to both to their personal and professional sense
of self during training which led to high levels of anxiety. For many participants,
the reality of client work was somewhat different to their expectations; partici-
pants described feeling overwhelmed, both by what was evoked in them by their
client work, and by their struggles to understand both theory and practice.
A further threat was experienced by the process of engaging in a high level of
self-scrutiny which left many participants feeling inadequate and incompetent.
Participants also feared the scrutiny of others believing that this would expose
their vulnerabilities and confirm that they were unsuited to be a therapist. The
category Experiencing a threat to self, compromises the subcategories, being
overwhelmed by countertransference response, struggling to understand theory
and practice, and judging self and fearing judgement.

Being overwhelmed by countertransferential response

Participants described feeling unprepared for the emotional responses that the
client material and the client could evoke in them. Lacking either a theoretical
or an experiential understanding of countertransference at the outset of their
training, participants were understandably ill-equipped to cope with remaining
present and responsive to their clients, while regulating and reflecting on their
own responses in the therapeutic relationship. In the absence of a framework for
processing these experiences, participants were left feeling emotionally over-
whelmed, as illustrated by the following quotes:
 Psychodynamic Practice 263
‘He had this enormous sense of power about what he was saying and I felt very
frightened at the time’ Participant 1

‘It was quite scary I remember her being quite … … not her being but the work
being quite scary in terms of it being my first sort of experience’ Participant 3

Feelings of confusion, uncertainty and doubt added to the sense of overwhelm:

‘Because of certain similarities in our background it was, she was very, it was
incredibly difficult for me to ascertain, and I had her quite early on in my
experience, um ascertain what exactly was going on in the room’ Participant 10

‘I got into quite a tangle at the time because when I was younger I was scared of
anger … I got confused with my fear of her anger. So again, the spotlight was on
me, oh dear it’s my problem with anger’ Participant 8

Struggling to understand theory and practice

Being introduced to the theoretical construct of countertransference in advance
of working with clients was similarly problematic as it was a difficult concept to
understand without experience. This led to further anxieties and self-criticism:

‘I remember feeling quite stupid because it’s so fundamental to the work and
I don’t understand it’Participant 9

‘When you first train and you kind of get in a room with a client and you know
your there with your theories and you know when you first start out basically it can
be really difficult until you get enough clinical experience to sort of understand
situation’ Participant 3

Judging self & fearing judgement

Lacking either a theoretical or experiential understanding of countertransference
at the outset of their training, participants struggled to make sense of their
responses to their clients, which were instead constructed as an indication of
incompetence:

‘I felt pulled to him and I felt really bad, I thought I’m being really unprofessional,
you know having some kind of feelings for someone’ Participant 2

When participants’ feelings and responses didn’t fit with their therapeutic ideal
they became self-critical and feared that their personal failings and incompetencies
would be exposed resulting in them being judged as unsuited to the profession:

‘I didn’t want to look weak, I didn’t want to look like the therapist in training, who
hadn’t sorted her own stuff’ Participant 9
264 S. Gait and A. Halewood
As participants progressed through their training they began to follow a reflective
or a defensive pathway; the adoption of a particular pathway appeared to be
influenced by the level of containment provided to the trainee, as well as by the
development of self-awareness, experience and level of defensiveness.

The reflective pathway

Experiencing containment
Participants who experienced containment were able to process their experiences;
and this was instrumental in the move away from defending against internal and
external threats and developing countertransference awareness through the process
of reflection. A critical component of a containing framework was that it offered
participants a space and time to reflect and think about their countertransferential
responses. Supervision, the training and organisational contexts, trainee’s theoreti-
cal framework and personal therapy were all identified as performing a containing
function.

In supervision
The supervisor’s response to the sharing of clinical material seemed to be
a critical; this enabled participants to experience supervision as a supportive,
safe and trusting space; one where they didn’t fear judgment as their experiences
were normalised and understood:

‘I was really embarrassed to take it there … by actually talking about it and kind of
understanding what was going on.I could., I could see it in a different way. I didn’t
feel embarrassed as I understood it’ Participant 2

This seemed to foster a strong alliance enabling the more difficult aspects of the
work to be shared and considered which helped participants to move away from
feeling shamed, incompetent and defensive Furthermore, the supervisor’s
response seemed to stimulate participant’s interest in, and curiosity about,
their countertransferential material, enabling them to develop both their emo-
tional and intellectual awareness:

‘this sense that not only that I should take everything but I can.at the same time it’s
a feeling on my part I want to know’ Participant 10

Training contexts
Countertransference development was also supported by training contexts, which
privileged an attendance to countertransference by offering both a guiding frame-
work and opportunities for reflection on countertransferential responses:
 Psychodynamic Practice 265
‘I would say. by virtue of my training countertransference has become one of the
key aspects of my practice’ Participant 5

‘I have got the breadth of theory that gives you the sense making explanation and
the vocabulary to actually be able to describe what I am experiencing’
Participant 10

Organisational contexts
Some participants worked in contexts where attendance to countertransferential
material was part of the organisational culture, and where there was an expecta-
tion and requirement to participate in reflective practice:

‘We have once a week clinical meeting as a way to think about client, um try to see
what comes up from, you know different people and we think we are picking up
different things’ Participant 5

‘I think because I work with a bunch of therapists as well were always kind of
discussing those kinds of things’. Participant 3

Personal therapy
For some participants their personal therapy offered a space for reflection,
enabling them to recognise and separate out their own dynamics and material
from that of their clients:

‘to have the therapeutic work on yourself so you know what your own material is
and then you can join up the dots’ Participant 4

‘I don’t really think the training course covered CT enough and I became aware of
it more in my personal therapy’ Participant 7

Containment in these domains appeared to increase participants’ capacity to offer

containment to their clients. Participants became more able to tolerate their clients’
projections enabling them to be more available to their clients and to engage in
reverie – thinking about the clients experience rather than trying to discharge it.

Tolerating vulnerability
By becoming more able to tolerate their own discomfort and vulnerability in
supervision, therapy and in session, participants became increasingly able to
tolerate their clients’ projections and to make sense of them:

‘When is out of awareness I don’t feel, I don’t like this, it’s just uncomfortable so
you know there is something to be said for sitting with the discomfort but also
really trying to unravel it’. Participant 10
266 S. Gait and A. Halewood
Being with but staying separate
Participants began to interpret their countertransferential responses in a way that
helped them to remain therapeutically involved with the client, whilst also
remaining sufficiently separate to think about the experience:

‘I think you have to be caught up in it, sometimes to understand it, you have to be
in the experience, if you’re not going to allow yourself to be caught up in it, you
won’t understand something’ Participant 12

This ability increased participant’s capacity to pay attention to, and think about, their
experience in the room with their clients. Developing levels of self-awareness
facilitated participants’ insight, which increasingly enabled participants to differ-
entiate between their own dynamics and those of their clients, thereby facilitating
the provision of a containing environment.

Discussion of the findings

The findings indicate that developing awareness of countertransference is not an
easy task for a therapist in training, who can feel unprepared for the challenges and
realities of the work. As a result, they can struggle to remain present in the
therapeutic relationship, as they became caught up in containing their own powerful
affect. The existing research and theoretical literature indicates that feeling over-
whelmed as a trainee therapist is not unique to the participants in this study, with
many trainees reporting they felt ill-equipped to respond to another’s distress, and
that they frequently felt distracted and overwhelmed by their internal affective states
(Cartwright, Rhodes, King, & Shires, 2014; Cohen & Hatcher, 2008; Hill, Sullivan
Knox & Schlosser 2007; Nutt-Williams & Hill, 1996; Theriault 2009; Truell, 2001).
When this resulted in defensive disengagement from the client, trainees constructed
this as an indication of incompetence and doubted their therapeutic abilities.
Participants in the present study were able to move away from a need to defend the
self when they were offered sufficient containment in a number of contexts. This offers
a conceptual framework for understanding how participants in the present study faced,
understood and effectively thought about their countertransference, rather than defen-
sively discharging it. According to Bion (1961) for reflective practice to be possible,
‘containers’ need to be provided, which offer the appropriate physical, mental and
emotional space required to engage in reflection. The findings of the current study
indicate that containing contexts plays a central role in the development of reflective
practice and the ability to contain and think about the work for therapists in training.
Furthermore, the findings add empirical support to Bion’s container/contained model,
in particular how training initially amplified trainees’ anxieties, and how these became
detoxified through the experience of a ‘containing other’, i.e. the supervisor, training
environment, theoretical framework and personal therapist. This enabled the experi-
ence to be thought about, which then enabled the participant to tolerate the experience
and use it to the benefit of their clinical work.
 Psychodynamic Practice 267
Within the counselling and psychotherapy literature, it is suggested supervision
is often where therapists first begin to develop their countertransference awareness
(Pakdaman, Shafranske, & Falender, 2015), a suggestion that is supported by the
findings of the present study. Pope et al. (2006) highlights that a sense of safety and
basic trust in the integrity of supervision is essential as to explore topics, which may
feel ‘taboo’, or threatening in some way, involves taking a risk on the part of the
supervisee. They suggest that the notion of safety comes from the knowledge that
what is shared will not be a threat to the personal and professional self (Pope et al.,
2006). The findings add support to the need for a containing supervisor for
a therapist in training, as it is initially the supervisors mind which performs this
function for the trainee, transforming threatening material into a meaningful experi-
ence which can be tolerated, understood and integrated. In contrast without
a containing supervisor, participants were unable to reflect and consider their
countertransferential material, which resulted in defensive strategies and unwit-
tingly acting out their countertransference in the therapeutic relationship.
Countertransference awareness was also identified by participants’ as developing
in personal therapy as this offered a space for the exploration of material evoked by
the work, which often seemed to lead participants to reintegrate previously disowned
parts of the self. There is some support in the wider literature on the benefits of
personal therapy in developing self-awareness. According to Kumari (2011) personal
therapy can help therapists gain more insight into interpersonal dynamics by increas-
ing self-awareness in the therapeutic relationship. Kumari suggests that personal
therapy can aid therapist in separating out their own issues from those of the clients
and in doing so, reduces the possibility of countertransference reactions. There is
some debate in the literature on whether personal therapy should actually be manda-
tory for therapists in training as according to some authors there is no proven benefit
to therapists engaging in personal therapy and client outcomes (Clarke 1986, Macran
& Shapiro, 1998).
The findings of the present study seek to challenge this assertion; participants
in the present study used their personal therapy to develop awareness of their own
dynamics, which led to personal and professional development, with participants
more able to identify their countertransference when it arose in the work. Given
that personal therapy can develop therapist awareness and insight into their own
dynamics, these findings would seem to suggest that it is beneficial to client
outcomes if it enables therapists to manage their countertransference behaviours
rather than acting out unwittingly within the therapeutic relationship. Perhaps the
disparity in findings suggests that for therapy to be effective, it needs to be
experienced as containing.
It is also important to note that participants were from different training back-
grounds, therefore, the understanding and motivation to develop countertransfer-
ence awareness varied; participants on psychoanalytically informed trainings were
more familiar with the construct and were expected to engage in personal therapy to
a greater degree than participants training in CBT.
268 S. Gait and A. Halewood
Implication of the findings
The grounded theory outlined above indicates the importance of containment in
developing reflective practice, countertransference awareness and personal devel-
opment in trainee therapists. The findings suggest that unless trainees have a way
of conceptualising their responses to clinical material they are left experiencing
a great deal of anxiety regarding their own competence in addition to containing
their clients’ anxieties. Therefore, ensuring trainees are offered some teaching on
countertransference would seem of great importance to the development and
containment of trainees while training. The findings illustrate the struggles faced
by therapists in environments where there is a failure of containment. Given that
therapists are increasingly working in mental health-care systems which privilege
targets and outcomes (Rizq, 2009), this clearly presents a challenge; how to
maintain reflective practice and attention to the therapeutic relationship, while
working in services with differing priorities.
While the training context may serve as a place for trainees to begin to learn
about countertransference theoretically, the findings seem to suggest that it is the
clinical supervisor who may be in the best position to support the integration of
theoretical and experiential learning. According to Ponton and Sauerheber (2014),
supervisors are essential in the transition from theory to practice, and in supporting
trainees to use themselves in the therapeutic relationship. For supervision to be
effective in these circumstances the supervisor needs to be able to facilitate a culture
of trust where the trainee can begin to develop their awareness. Helping neophyte
therapists to manage their countertransference through supervision requires super-
visors themselves to have a theoretical knowledge and understanding of the con-
struct of countertransference or a comparative framework, which focuses on the
therapist’s feelings and responses as much as the clients. Without a framework,
supervisor’s risks facilitating a culture where the more challenging aspects of the
work are not disclosed.

Limitations and recommendations for future research

Participants who took part in the study did so because they had an interest in the
topic, which may also have impacted the findings as they may have offered what
they considered to be, socially acceptable or desirable responses. Furthermore,
participant’s transferential responses to the researcher and the researcher’s counter-
transferential responses to the participants may have influenced what participants
felt able to disclose.
The decision to use Skype as a method of interviewing was based on the
assertion that Skype affords both the researcher and the researched many benefits,
for example, access to a larger geographical area, flexibility and reduced research
costs (Hamilton & Bowers, 2006; Hanna, 2012; James & Busher, 2009; Sullivan,
2012). However, using Skype may have also limited the findings as the technology
broke down on several occasions during a few of the interviews, which disrupted
the interview, and may have impacted on the development of rapport. Currently
 Psychodynamic Practice 269
there is some debate amongst researchers and authors on the development of
rapport via a Skype interview, with some researchers and authors (Hanna, 2012;
Seitz, 2016) arguing that Skype can increase the development of rapport, remaining
in their own environments is thought to facilitate participants’ safety and comfort
thereby leading to greater openness. This claim has been challenged by some
researchers and authors (Seitz, 2016; Sullivan, 2012), who have suggested that
technical glitches break the flow of the narrative, creating a level of stress and
distraction and inhibiting rapport. With the present study, it is hard to ascertain how
much technical difficulties impacted the data or whether or not participants would
have made the same disclosures in a face to face interview. Therefore, it is difficult
to draw any real conclusions on whether online interviewing increases disclosure
due to its perceived anonymity, suggesting more research is needed in this area.
It would be fruitful to build on the findings of the present study to investigate
how countertransference is taught in different schools of therapy and how this
relates to awareness and management of it. It would also be useful to explore
how different therapists engage in developmental work and reflection and
whether there are difficulties and/or limitations in practice of assimilating the
construct of countertransference into different theoretical perspectives.
The findings therefore offer a useful conceptual framework for understanding
the training experience, as they highlight that to provide containment and develop
countertransference awareness, trainee therapists need to experience containment
for themselves. It is the introjection of this experience that appears to enable the
trainee therapist to offer this experience to another. The framework also indicates
how the absence of a containing other can result in trainees following a defensive
pathway, to the detriment of their own development and the therapeutic relation-
ship.

Disclosure statement
No potential conflict of interest was reported by the authors.

Notes on contributors
Shelley Gait is a HCPC registered and BPS chartered Counselling Psychologist and
Senior Lecturer at the University South Wales.
Andrea Halewood is a Chartered Psychologist and relational psychotherapist,
Department of Psychology, School of life sciences, Frenchay campus, Coldharbour
Lane, Bristol, UK.

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