Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, philosophy and health care

Sunday, December 1, 2013

Morality, Disgust, and Countertransference in Psychotherapy

John D. Gavazzi, Psy.D., ABPP
Samuel Knapp, Ed.D., ABPP
At the most basic level, successful outcomes in psychotherapy require a strong therapeutic alliance between psychologist and patient. A strong therapeutic bond can be cultivated in many different ways including, but not limited to, similarities between psychologist and patient (such as age, socioeconomic status, gender, etc.), psychologist empathy and acceptance, and patient confidence in the psychologist’s skills. A similarity in moral beliefs likely enhances the working relationship and correlates with positive outcomes in psychotherapy.

Just as shared values and moral similarities can strengthen the therapeutic relationship, negative moral judgments about a patient’s behaviors and beliefs (both past and current) can erode or rupture the helping relationship. In clinical terms, moral judgments can lead to negative countertransference. When a psychologist experiences a negative, morally-driven emotion related to the patient, this dynamic may adversely affect the quality of the therapeutic relationship. Within the therapeutic discourse, there are many topics related to the patient’s values, personal responsibility, and moral behaviors. Moral judgments and beliefs, like countertransference, are complex, intuitive, automatic, and emotional. In this article, we will focus on one theory of moral origins to understand how these complicated, instinctive, and gut-level reactions may promote negative countertransference.

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