Case Study: Countertransference and Marital Issues

When a couple walks into a therapy room, they bring far more than the conflicts they can name. They carry unresolved grief, childhood wounds, and unconscious patterns that have quietly shaped how they relate to each other – and to the therapist. The case of Thrivedi and Tulasi illustrates this with striking clarity. Their marital struggles – rooted in loss, dependency, and resentment – not only reveal the inner world of two individuals in crisis, but also activate something equally important: the therapist’s own emotional responses. Understanding how transference and countertransference unfold in this case offers a window into the real, often messy, work of psychodynamic couples therapy.

What transference and countertransference mean in couples therapy 🔗

Before examining the case, it helps to be clear about the core concepts. Transference is the unconscious process through which a person redirects feelings and expectations from past relationships – especially early ones with caregivers – onto someone in the present. Freud first recognized this pattern when patients began projecting feelings onto him that had nothing to do with their actual relationship. In couples therapy, this projection happens in two directions: partners transfer unresolved emotions onto each other, and both may also transfer feelings onto the therapist.

Countertransference is the therapist’s side of this equation. As defined in the Encyclopedia of Couple and Family Therapy, countertransference refers to the clinician’s reactions to a patient’s transferences – reactions that arise from the therapist’s own unconscious projections, often connected to unresolved experiences with parents or siblings. These emotional responses are not signs of failure; when handled with awareness, they become essential clinical data.

Crucially, countertransference has special significance in couples and family therapy because there are more points of activation when working with two people than with one. Every dynamic in the room – the power imbalance, the competing needs, the silent alliances – can trigger the therapist’s own relational history in ways that individual therapy rarely does.

The case of Thrivedi and Tulasi: presenting issues 🔗

Thrivedi and Tulasi have been in couples therapy for several months. Their marriage began to show serious fractures following the death of Tulasi’s mother, an event that triggered deep grief and an intensified need for emotional closeness. Tulasi turned increasingly toward Thrivedi for comfort and support. But Thrivedi, who tends to manage vulnerability through emotional withdrawal and passive-aggressive behavior, could not meet that need.

The result was a painful cycle: the more Tulasi reached out, the more Thrivedi pulled back. The more he withdrew, the more resentment built on both sides. On the surface, the therapy presented as a grief and communication problem. But the psychodynamic lens revealed something deeper – that both partners were unconsciously replaying relational templates forged long before their marriage began.

Tulasi’s heightened dependency was not simply a response to losing her mother. It reflected a longstanding fear of abandonment, an internalized anxiety that the people she needs most will not stay. Thrivedi’s emotional unavailability was similarly not a lack of love, but a learned defense – a pattern of shutting down intimacy to avoid the vulnerability he associated with past hurt. Psychodynamic theory emphasizes that unresolved grief can manifest through unconscious processes, influencing behavior in ways the individual may not consciously recognize – precisely what was happening for both partners.

Transference dynamics: how the past entered the room 🔗

In the therapy sessions, both partners demonstrated clear transference patterns – not only with the therapist, but with each other.

Tulasi’s transference 🔗

Tulasi’s transference was primarily relational: she began projecting the emotional qualities of her deceased mother – and the need for her presence – onto Thrivedi. Rather than grieving the loss of her mother as a separate emotional task, she unconsciously transferred the entire weight of that grief and unmet need onto her husband. When he failed to provide the comfort she sought, it felt to Tulasi not just like a marital disappointment but a re-enactment of deep abandonment. Research on transference in bereavement work suggests that when individuals struggle to reorganize their relationship to the deceased, the relationship to a significant other may absorb that unresolved longing – exactly the pattern Tulasi displayed.

Thrivedi’s transference 🔗

Thrivedi’s transference was less overt but equally significant. He perceived the therapy environment itself – and at times the therapist – as a space where his emotional deficiencies would be exposed and judged. His passive-aggressive responses in sessions mirrored the way he had learned to navigate critical or demanding relationships in the past. He also transferred feelings of inadequacy onto Tulasi’s grief: her need for him felt like an accusation of his emotional shortcomings, activating old shame rather than compassion.

Transference occurs when a patient’s previous experience with other people and with a therapist overlap – and Thrivedi’s history of suppressing vulnerability in close relationships was creating a direct obstacle to the intimacy his marriage now urgently required.

Countertransference: the therapist’s emotional responses 🔗

As the sessions unfolded, the therapist began noticing their own emotional reactions – the hallmark of countertransference entering the clinical picture.

Frustration and helplessness toward Thrivedi 🔗

The therapist experienced growing frustration with Thrivedi’s emotional detachment. This was not simply an understandable reaction to a difficult client. On reflection, the frustration mirrored the therapist’s own unresolved feelings around emotional unavailability in their personal history. Thrivedi’s silence and withdrawal were triggering something familiar. Recognizing this was the first step toward using the countertransference productively rather than allowing it to skew the therapeutic stance.

According to clinical psychologist Tamara Feldman, PsyD, patients communicate their wishes and fears in ways that are not verbal and not conscious – and attuning to countertransference is essential to truly understanding them. The therapist’s frustration, once examined, became a signal: it mirrored the same helplessness Tulasi felt, and potentially the buried frustration Thrivedi felt with himself.

Over-identification with Tulasi 🔗

The therapist also noticed a pull toward protecting Tulasi – a kind of maternal protectiveness that went beyond professional empathy. Tulasi’s vulnerability and her emotional expressiveness activated the therapist’s caregiving instincts, leading to moments where the therapist’s interventions subtly favored her perspective. This is a well-documented risk in couples therapy. As noted in clinical reviews of countertransference in couples work, the couple is always alert to the danger that the therapist might favor one partner over the other – and the wise therapist must be equally alert to this possibility, since differential responsiveness shapes the entire course of treatment.

Kaslow’s landmark analysis of countertransference in couples therapy documented how transference and countertransference are far more complex to identify and handle in couple and family treatment than in individual therapy – and the Thrivedi-Tulasi case demonstrates exactly why. The therapist was, in effect, managing two separate transference relationships simultaneously, while also monitoring their own emotional responses to each.

Turning countertransference into clinical insight 🔗

The turning point in the case came when the therapist began using their countertransference deliberately rather than defensively. Instead of suppressing the frustration with Thrivedi or the protectiveness toward Tulasi, the therapist brought these reactions into supervision and reflective practice.

A meta-analysis on countertransference management identified five therapist qualities that facilitate effective handling of these reactions: self-insight, conceptualizing ability, empathy, self-integration, and anxiety management. The therapist in this case drew on all five – using self-insight to recognize the personal roots of their reactions, and empathy to remain present for both partners without collapsing into one-sidedness.

The frustration with Thrivedi was reframed clinically: it became a mirror for what Tulasi experienced daily, and also for the emotional isolation Thrivedi was himself trapped in. The therapist was able to bring this insight directly into sessions – gently naming the emotional distance without siding against Thrivedi, and inviting him to explore what vulnerability felt like rather than simply demanding he produce it.

With Tulasi, recognizing the over-identification allowed the therapist to step back and help her see that her dependency was not simply Thrivedi’s failure to love her enough – it was a reenactment of older fears that no partner could fully resolve on her behalf. Self-awareness and self-reflection are essential tools for therapists navigating countertransference, and in this case that awareness directly shaped the interventions both partners needed most.

Balancing individual and relational work 🔗

One of the central challenges in psychodynamic couples therapy is that each partner arrives with their own history, defenses, and internal world – yet both must be held in view simultaneously. The case of Thrivedi and Tulasi highlights how grief, when left unprocessed individually, becomes a relational burden. Tulasi’s mourning was legitimate and needed direct attention, not just as a couple issue but as her own psychological work. Thrivedi’s emotional avoidance was similarly rooted in individual history that required exploration in its own right.

Brief psychodynamic approaches note that loss, separation, and grief are among the issues that respond well to transference-focused work – precisely because the emotions attached to loss tend to be displaced onto current relationships, including the therapeutic one. In Thrivedi and Tulasi’s case, helping each partner link their current emotional responses back to earlier experiences – and helping the therapist do the same with their own countertransference – created the conditions for real movement.

As Tulasi began to understand her dependency as a reenactment of early attachment fears rather than evidence of Thrivedi’s indifference, she started developing more self-sufficient coping strategies. This relieved some of the pressure on Thrivedi, which in turn made it slightly safer for him to risk emotional presence. Progress was slow and non-linear, but the direction of change became clearer once the unconscious dynamics were named.

What this case teaches us about psychodynamic couples work 🔗

The case of Thrivedi and Tulasi is not unusual – its dynamics play out in therapy rooms every day. What makes it instructive is how explicitly it shows the three-way field of transference: between partners, and between each partner and the therapist. Countertransference is a ubiquitous phenomenon – therapists enter every session carrying their own relational history, vulnerabilities, and emotional responses. The question is not whether countertransference will arise, but whether it will be recognized and used.

When a therapist can sit with their own frustration, protectiveness, or anxiety – and ask what it reflects about the client’s experience – countertransference stops being an obstacle and becomes one of the most honest signals in the room. In this case, it pointed directly to what both Thrivedi and Tulasi needed: to be seen clearly, neither idealized nor blamed, and to be helped toward the emotional work that only they could do.

What do you think? When a therapist becomes emotionally activated by a couple’s dynamics, is that a therapeutic liability – or a source of insight that individual therapy might never access? And how much of what feels like a marital conflict is really the unfinished business of each partner’s individual past?

References

1. https://en.wikipedia.org/wiki/Transference
2. https://link.springer.com/rwe/10.1007/978-3-319-49425-8_2
3. https://journals.sagepub.com/doi/abs/10.1177/1066480713504894
4. https://www.therapywithtalia.com/psychodynamic-insights-on-grief-and-loss-processing/
5. https://psychiatryonline.org/doi/pdf/10.1176/appi.psychotherapy.1998.52.2.215
6. https://pmc.ncbi.nlm.nih.gov/articles/PMC9384966/
7. https://www.apa.org/monitor/2025/09/managing-countertransference
8. https://psychiatryonline.org/doi/10.1176/ps.49.7.972
9. https://pubmed.ncbi.nlm.nih.gov/11449386/
10. https://centerhealthyminds.org/assets/files-publications/Goldberg-Countertransference-management-and-effective-psychotherapy.pdf
11. https://www.marriage.com/advice/counseling/countertransference-in-couples-therapy/
12. https://www.ncbi.nlm.nih.gov/books/NBK64952/
13. https://www.tandfonline.com/doi/full/10.1080/10503307.2021.1879404