I hate therapists!

“I’ve been thinking about when to ask for feelings towards me. But I am still unclear when a feeling is based on a projection (in which case we clear it up) or a transference (which we explore). A client comes to mind. At his first session he raged at his previous therapist, whom he believed judged him. Security then removed him from her offices. Then he told me he hated my profession because of his last therapist. I didn’t address this in detail as I didn’t know what to do.” Great question!
The patient believed his previous therapist was judging him and then raged at her based on that projection. His loss of reality testing was so profound, security personnel had to remove him from her office!
Let’s take a look at the triangle of conflict. He comes to a therapist who invites him to look at his inner life. In response. like all patients, he experiences a mixture of feelings toward her for this offer of a relationship. The question is how he deals with those feelings. Moderate resistant patients can tolerate the feelings and still collaborate. Highly resistant patients with isolation of affect distance and detach from the therapist. Highly resistant patients with repression become depressed and somatize turn the anger inward and protect the therapist. Fragile patients cannot tolerate feelings internally, so they project those feelings onto others.
This patient projects his anger onto therapists, believes they want to judge him, and then he rages at the projection he places on the therapist. If you explored his rage, you would only reinforce his projection, making him regress.
Th: “Is there any evidence I am judging you?”
Pt: No. It just seems that way.
Th: “So although there is a thought about judgment, we don’t see any judgment here in me. Sometimes people who fear judgment tend to judge themselves too much. Is that something you have suffered from?”
This deactivates the projection onto you. Step one.
Th: “So coming here to let me know about yourself stirs up some feelings. They make you anxious, and then there is some self-judgment that comes up. Any ideas what feelings might be coming up here with me in the therapy?”
Why focus on feelings toward you? Feelings toward you mobilize anxiety and then he projects. Once we clear up the projection, we explore feelings toward us, building his capacity to bear feelings internally, so he doesn’t have to project them onto others. He learns to feel rather than project his feelings. This is the first step in integrating the personality of the fragile patient.