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.
