The Power of Projection: Navigating Patients' Emotions in Therapy
Have you ever found yourself in a patient encounter where the emotions and dynamics at play seemed to reflect more about the patient’s inner world than your own?
Did you know what to do in that situation? Did you engage with the patient to convince them otherwise? Did they storm out of the room angry? Did they break down crying because they thought you were shaming them? Did you break down crying?
We wanted to share with you a topic that has come up several times during our group supervision sessions and in the Psychotherapy Essentials Program:
Psychological Projection
Projection is just one type of defense mechanism. Defense mechanisms are processes that our mind uses to protect itself from emotional distress. While some operate consciously, others, such as projection, operate unconsciously.
Projection happens when we falsely attribute our own emotions, thoughts, or characteristics to another person. When we project, we do not recognize that a thought, feeling, or perception that we have about our own personal characteristics stem from ourselves. We come to believe that these thoughts and feelings are someone else’s, rather than our own.
Here’s an example of how projection may present itself between a father and son:
Son: “Dad, I want to quit the team!”
Dad: “What!? No, you don’t. Don’t throw it all away! You’ve worked so hard. You’re a star!”
Son: “But I hate giving up every evening and weekend! I feel like I’m missing out on everything because I have practice five times a week. I hate missing my friends’ birthdays because I’m traveling for games. I hate this!”
Dad: “But, Mike, you’re an amazing athlete! You love being a star!”
Son: “No, Dad, you love that I’m a star!”
A father who had tried but failed to achieve an athletic career in his youth has projected this wish on his son. Instead of recognizing that his son does not want to pursue an athletic career, he pushes his son into it. By doing so, rather than accepting his own failure to achieve his goals, he can live vicariously through his son.
This example highlights one of the challenges that unconscious defense mechanisms present: although they relieve the defended of some emotional pain, by projecting inaccurate thoughts and feelings onto others, they can cause harm. The son feels pushed into a dream that isn’t his.
So what do you do if you notice a patient projecting in session?
Normalize, Empathize, and Validate: This helps to reduce the patient’s shame and resistance, creating an environment of trust and safety to openly share their struggles.
Explore Early Life Experiences: Early life experiences and significant relationships oftentimes have projections that are rooted in them.
Teach Coping Strategies: Mindfulness and reflection practices can help patients become more aware of their thoughts and feelings. Emotion wheels can be useful here.
Set Boundaries: If projection becomes harmful to the therapeutic process, you may consider redirecting the conversation back to the patient’s experiences or emotions, ensuring the therapeutic process remains on the patient’s needs.
Evaluate Progress: Regularly evaluate the patient’s progress in recognizing and addressing projection, celebrating milestones and encouraging further self-discovery.
Supervision: Meeting regularly with your psychotherapy supervisor will help you evaluate and process your own feelings and attitude toward the patient (countertransference), thereby enhancing your confidence during sessions where tensions might run high.
You can expect to hear more examples of defense mechanisms and how they appear in people’s lives during actual psychotherapy sessions AND what to do about it in the Psychotherapy Essentials Program.
We can help you learn how to identify projection and other defense mechanisms that arise in session.
Watch this psychotherapy training webinar for more information about the program and registration details.
