Matters involving transference and counter-transference can be especially tricky to navigate while working in the intimate settings of surrogate partner therapy. These lines can be especially blurred when working in a profession that relies on the development of genuine intimacy in order to help clients heal. What do we do, when feelings arise that were not expected? If the task of the practitioner is to teach intimacy, how deep should the connection go?
Wikipedia defines transference as a theoretical phenomenon characterized by unconscious redirection (projection) of a client's feelings onto the therapist. Countertransference is defined as redirection of a psychotherapist's feelings toward a client – or, more generally, as a therapist's emotional entanglement with a client.
If the feelings are one-sided, from the client toward the practitioner (transference) or the practitioner to the client (countertransference), it is somewhat easier to see what steps need to be taken so that feelings do not interfere with the client’s healing processes. But when both transference and countertransference are present, there may be a different type of exchange occurring which expands beyond the predetermined therapeutic container. Even if both parties remain professional in composure and the container looks the same from the outside, once these feelings arise, it can become difficult for the client and/or the practitioner to stay within the boundaries of the therapeutic relationship.
In surrogate partner therapy, we are creating an authentic bond with our clients to foster their growth and healing. It is vitally important to develop real emotional intimacy so that our clients feel truly seen. The surrogate-client relationship can be (and often is) a deep soul-to-soul connection. So, how does one work with this transference/countertransference situation in a manner that honors the client’s healing process and the ethical guidelines of our profession without denying or turning a blind eye to the soul aspect of this journey?
My own experience with transference and counter-transference dropped me smack into the middle of all of these questions, which offered me an incredible opportunity to learn, firsthand, what must be considered when moving through delicate situations such as these.
I had been working as a surrogate for a little under six months when I met James. He explained during his first visit that he was experiencing delayed ejaculation and was unable to maintain an erection during sex, and he hoped that surrogate partner therapy could help. After several sessions together it became clear that we had a connection which was different from the connection I had experienced with other clients.
The goal and purpose of my job was to help men and women learn to connect and I guided this process by teaching clients how to focus their touch not just on my body but on the felt sense or ‘essence’ of me. The first time James touched me there was no question that he felt me. I finished the session thinking that it was amazing to be doing work that was so rewarding. I could feel how meaningful it was to him to touch and be touched in this deeply present way. After a few more sessions like this our connection deepened and he asked me if I could feel the depth of what was between us. My belief that it is possible to experience deep and meaningful connection with anyone who is open to it is what drew me to this type of healing work -- I shared this with James and he agreed.
As my work with James progressed, I began to question more about what it really means to heal. Over the course of many years I have come to believe that emotional pain that isn’t related to some form of trauma stems from a deep disconnect -- a disconnect from one’s inner self and from the spirit of life. In witnessing many of my clients' journeys and looking back on my own extensive path of healing, it seems evident that the most powerful healing experiences come in moments of deep vulnerability and openness. It seems to me that the depth of one’s healing is directly related to the depth of connection one is able to experience (with oneself, with others, and with the world in general). I have heard many times and do believe that when one person heals, we all heal. I was able to experience the ripple effects of healing firsthand as my clients let go of traumas and belief systems that were keeping them bound; as they felt free, I also felt free. I wondered how much more I could help my clients, and our world, if I allowed myself to show up completely, as unmasked as I was asking them to be.
I began to put more of myself into the sessions with James, dropping any facades that kept us from connecting spirit to spirit. We grew closer. We experienced more freedom in our connection than I had with any other clients. The worries that had caused him to seek help from this type of therapy disappeared as he realized that his body was fine and his symptoms were no longer present. New worries arose when it became clear that he wanted to have this type of deep and meaningful connection in order to feel satisfied in body, mind, spirit, and life. He asked me if I realized this exchange was extraordinary. I couldn’t help but agree. I didn’t know what to do.
By our 8th session it became clear that our relationship had grown beyond the boundaries set forth by the therapeutic container. Our attraction to one another grew, instead of moving toward completion. I believed that in order to stay within the ethical guidelines of my employer, it would be necessary to sever our ties and he would need to find a different pathway to healing. This felt wrong to me. I believed that our spirits met in deep connection and attraction and there was a greater purpose at hand - a karmic contract playing out in order for all of life to heal. This is a spiritual belief that I live by. How was I to deny this innate understanding so I could maintain the standards of integrity set forth by my profession? Was there a way to move that honored my feelings, James' feelings, and clinical ethical guidelines?
The answer is yes. Unfortunately I didn’t see it at time but the first thing I should have done was share my feelings with the staff therapist as they were arising. My first mistake was failing to communicate my growing feelings with my employer and the clinician overseeing my work. In my case, I didn’t trust that the therapist would address my feelings with fairness or compassion, and this made me fear being honest with her. Deciding to meet James outside of work was my second mistake, and the one that eventually got me fired.
I met with James three times in a personal capacity outside of our work together before coming clean with my mentor. She listened compassionately as I shared the various elements of my dilemma, and shared that she too had experienced countertransference once, early on in her work as a surrogate partner. I felt terrible for deceiving her. She explained that we would need to talk with the therapist in order to sort this out. We quickly scheduled a meeting to address the situation. The therapist was furious I had not consulted with her before making decisions that had put the entire organization at risk. I had only good intentions, and did not mean to hurt my supervisors or our client, but the therapist insisted that I be fired.
The reason I came to this line of work is because I truly believe that we heal through connection, and what this process taught me is that it isn’t sustainable to give so much of one’s self to another’s healing journey. Nor is it healthy. I now understand that I do not have to take clients to the depths of their healing processes, like I did with James. My role is to hold their hand part of the way and to show them what is possible, but it is up to them to find their own pathway and course that will bring this possibility to fruition. This experience helped me to better understand how to maintain boundaries and that I must maintain a certain level of professional distance that comes with the role of teacher, if I am to help my clients and create a safe container.
I also learned how important it is to look outside of myself for help and guidance from peers and mentors. I realize now that it is imperative to align with employers and clinicians whom I trust will respect me and treat me with humanity and compassion when difficult situations arise. I feared that if I had shared the feelings that were arising for me with the therapist who oversaw my work when this happened, that I would be shamed and my feelings would be disregarded. This proved to be true. It was the main reason I didn’t share what was happening sooner. Even so, knowing what I know now, I understand that if transference and/or countertransference is arising then I must communicate it with my supervisors immediately, regardless of what fears are present. It is absolutely necessary for the surrogate partner to hold herself accountable to her client and supervising clinician. Accountability is so important when working in this developing field, and it is absolutely necessary for practicing this work ethically.
Our world is in a remarkable transition at this time and integrative somatic healing modalities are proliferating in support of this transition. My experience with countertransference showed me how important the triadic model is to the success and ethical practice of surrogate partner therapy. Sometimes we have to learn from our mistakes to truly internalize what we have learned through training, and through this difficult experience I learned how vitally important it is to hold myself accountable to my overseeing clinician in order to protect my clients and maintain my professional boundaries. When we align with professionals who support our growth and development, we can lean on them for support and guidance, and are able to see clearly, grow with integrity, and practice in a way that benefits the good of all.
For more information on transference & countertransference:
A Client's Guide to Transference
Attending to Countertransference