Countertransference
The correct answer is C. Countertransference, which describes the physician's emotional reactions and feelings toward the patient. 1
Definition and Clinical Significance
Countertransference refers to the emotional reactions a physician has toward a patient or their circumstances, which may be incompletely recognized. 1 This concept is fundamental to understanding the physician-patient relationship and represents natural human responses that occur in clinical encounters. 1
Key Distinctions
Countertransference specifically describes how the physician feels about the patient, distinguishing it from:
Transference (Option A): This is the opposite direction—it describes the patient's emotional reactions and feelings toward the physician, not the physician's feelings toward the patient. 2
Empathic/Empathetic (Options B and D): These terms describe the physician's ability to understand and acknowledge the patient's emotions through active listening and supportive responses (using techniques like the NURSE mnemonic: Naming, Understanding, Respecting, Supporting, and Exploring). 3 Empathy is a communication skill and therapeutic approach, not a term for the physician's personal emotional reactions to the patient. 3
Types of Countertransference
Countertransference can be categorized into two forms:
Internally-focused countertransference: Unrecognized reactions reflecting the physician's own unique psychological state. 1
Externally-focused countertransference: Reactions primarily deriving from the specific patient's behaviors or characteristics. 1
Clinical Relevance
Rather than being hindrances to clinical care, these natural emotional responses can actually facilitate stronger physician-patient relationships when properly recognized and managed. 1 Countertransference feelings can serve as valuable information about the patient's inner world and the treatment process. 4 However, there is always a risk of either avoidance or over-involvement with patients, particularly in cases of catastrophic illness. 4