Transference and Countertransference

By Laura Allen
[Heart of Bodywork]

Massage therapists should avoid psychoanalyzing clients; that’s the domain of another licensed profession and out of our scope of practice. Transference occurs whenever a client projects unresolved feelings and personal issues (often from childhood, and often related to an authority figure) onto the practitioner. Countertransference occurs whenever a practitioner allows unresolved feelings and personal issues to influence their relationship with a client.
It’s important to recognize transference as a natural occurrence and not take it personally—because it isn’t about you! For example, a person who had an abusive childhood may view you—the person who shows them compassion and touches them in a caring way—as the parent they wish they’d had. Or a person who has suffered domestic abuse may experience fear or anxiety about a therapist standing over their unclothed body. Maintaining professional demeanor, a nonjudgmental attitude, and exhibiting compassion without appearing to be a savior are the keys to moving the therapeutic relationship along in the right direction.
Countertransference is a little trickier … after all, we’d rather look at someone else’s issues rather than our own, wouldn’t we? However, a little self-reflection is a healthy thing, especially if we are experiencing countertransference with a client. We sometimes find ourselves having a reaction to a client—positive or negative—that truly has nothing to do with them. Perhaps a demanding client reminds you of the teacher you felt was always picking on you in school or the person you had a crush on in high school that didn’t know you existed. Or a very passive client reminds you of your mother, whom you always wanted to see stand up to your father, just one time, instead of putting her own feelings aside and always giving in to what he wanted.
We have to recognize that countertransference is also a normal occurrence, and we may have to be extra diligent in our behavior when it happens. It’s not your client’s fault that she looks like your ex-girlfriend or that her voice reminds you of a former coworker who always made you feel intimidated. If you realize you’ve taken an instant dislike to a new client, for example, reflect on that. Did the client actually say or do anything to upset you? Are they truly at fault in any way for the negative feelings you’re experiencing about them (or the crush you may develop on them, if it’s gone in the positive direction)? If you can’t point to any transgressions on the client’s part, it’s time to recognize that it’s all about your own perceptions, and that it has nothing to do with the client. That realization will allow you to move forward into a more mutually pleasant therapeutic relationship.

Laura Allen is the author of Nina McIntosh’s The Educated Heart (4th edition, Lippincott Williams & Wilkins, 2016) and numerous other books. She has been a massage therapist for 18 years. She lives in the mountains of Western North Carolina with her two rescue dogs, Fido and Queenie. Contact her at