CT

NSGC 2025, Seattle, you were great! It felt heart warming to meet so many lovely people and hear such amazing discussions. As it is wrapped up, a talk that stood out to me the most was “Why Am I Reacting This Way? Finding Ways to Utilize Countertransference to Improve Genetic Counseling”

I was so touched by the stories shared by the panelists and how that it impacted them personally and professionally and they navigated that phase of their life. It takes a lot of courage to talk about something that people rarely talk about and acknowledge, and seeing them do that is commendable. 

Countertransference exists in books and the definition is taught, but is rarely accepted and acknowledged. Because it’s hard to accept something so abstract and we often gaslight ourselves that maybe it’s not countertransference. It feels like denial for these surfacing feelings is prevalent and most of us are not ready to sit with it or be vulnerable. Because once your guard comes down, you are doomed 😅

In a field that deals with patient emotions, we often ignore big emotions experienced by GCs, often pushed under the rug. One sided emotional recognition is never helpful in a clinician patient relationship. Holding both the parties’ emotions at the same level of importance is crucial when one is able to give space with and other one is able to take it with embrace. This is the true nature of dealing with human emotions, acknowledging that the clinician is a human too, not just a machine service provider. 

I loved how one of the speakers, Nadia Ali, psychologist who emphasized on the existence of countertransference in daily life and how important it is to acknowledge it. Her tips to navigate them were also great and I want to share those here:

  1. Recognize it and accept it

  2. Self reflection on reactions and emotions 

  3. Locate the source of the feelings

  4. Look for patterns and learn about triggers

  5. Seek peer advice from a trusted colleague or professional process group

This talk reminded of me my personal story of countertrasnference as a student. During my summer rotation, I was placed in adult and cancer rotation. My maternal grandmother (I addressed her as Ammi) passed away. I couldn’t travel home to support my mother due to travel restrictions placed on me. I was very close to her and adored her so much. Having lost my paternal grandmom in a few years earlier, I was holding onto Ammi as my anchor of comfort and love. It happened on a Sunday and I just showed up for the rotation next day, Monday and I didn’t mention it to anyone. I showed up like nothing happened and that my life was normal. (Biggest Red flag! 🚩)

It was a breast ovarian cancer patient and I had planned to do the whole session. I did contracting, and as I went through family history and I asked about the health of her maternal grandmom and this moment was so interesting, because I have never had a patient until then talk about a family member with so much interest and enthusiasm. She then goes on for a few mins about how much she adores her and how much she loves her grandma, so fond of her and I felt a sharp sting in my chest. My emotions about Ammi’s death were raw and super fresh as it just happened only 24 hours ago. I felt giddy and my vocal cords felt numb. I somehow completed the family history and did the initial part of the education part and I just stopped because I couldn’t continue and passed it over to my supervisor who was happy to jump in and continue.

When we debriefed, I felt heart broken and teary. She knew something was wrong because the indication was something I have done so many times before and we both know I was capable of doing that session on my own. I told her about what had happened the day before and she was so supportive and asked me why I didn’t take a couple days off and showed up for clinic. My reasoning was I wanted distraction from the overwhelming emotions I was experiencing, believing that staying busy would help me cope with my feelings. But I was wrong. that conversation helped me process on emotions and made me reflect that I have to sit with my grief of losing my grandmother, go through the acceptance that she is no more in order to be able to hold and embrace my patients’ stories. I got so conscious about this that whenever I would go over the patients’ mom side of the family, I would feel awkward. And every time I felt, I made sure to talk to my supervisor about it because verbalizing felt less isolating and that was helpful. 

As a student, there was shame around feeling this way, shame around working on my grief. I had this constant inner pressure that I need to be my best to be there for my patients, classmates and and other formalities of a training program. One tiny slip due to personal events can be injurious is what my inner thoughts told me. I had this preconceived notion that clinicians have to be their 100% to be with their patients. But is that realistically and always possible? I now know, nobody can be their 100%. However, showing up with imperfection is human and sometimes the only capacity you can provide. As along as you are acknowledging what you are experiencing, reflecting, the easier it becomes to process the feelings. Accepting is the most difficult part because that can make you vulnerable and we all run away from being vulnerable. These feelings are not shameful, this is difficult to comprehend being a student and even as a new GC and these conversations are extremely important during training and debriefing with supervisors. 

This talk was just beautiful because it was raw, messy and also accepting of countertransference as human. Hearing real stories is crucial to share the human experience and bonding between colleagues, students and patients.