00:00:00Tell me what it's like.
00:00:01Tell me what it's like to sit down opposite somebody
00:00:05who has 99th percentile cluster B personality disorder.
00:00:10Just describe that experience.
00:00:14- When we're talking about in a therapeutic context,
00:00:20something that's really important to mention
00:00:21is transference and counter-transference.
00:00:26So do you want me to go into that for your audience?
00:00:29- Give us a brief overview.
00:00:30I learned that, you know, interestingly,
00:00:32and I'm grinning because it's one of the few things
00:00:35that I've learned from reading chick novels.
00:00:36I read "The Silent Patient" by Alex Michaelades,
00:00:40or Andrew Michaelades, and in it,
00:00:42one of the main protagonists is a therapist
00:00:44who's trying to get this patient to speak.
00:00:46And he goes to his head therapist
00:00:49who's trying to help him get through
00:00:52this very difficult patient.
00:00:54And there's this line,
00:00:55"Tell me about the transference and counter-transference."
00:00:58And this was as I was starting to do therapy
00:01:00about two years ago.
00:01:01And I went in all impressed with myself
00:01:05to tell my therapist that I learned
00:01:06what transference and counter-transference was.
00:01:08But I didn't learn about it from proper research.
00:01:10I learned about it from reading like an absolute,
00:01:12like "USA Today" best-selling chick thriller.
00:01:16But anyway, transference, counter-transference,
00:01:18you're sitting down with somebody with cluster B, et cetera.
00:01:21- Yeah, well, I mean, just in general,
00:01:24we all transfer and counter-transfer in life
00:01:27and human relationships.
00:01:28It's not just exclusive to therapy.
00:01:30But it's important to notice that it's happening in therapy
00:01:33because it gives you a lot of information
00:01:35as far as what's happening in the interaction.
00:01:38So I mean, transference in the simplest terms
00:01:41is the feelings that are transferred
00:01:43onto the therapist by the patient.
00:01:45Counter-transference are some of the feelings
00:01:47or emotional reactions that take place
00:01:49inside of the therapist
00:01:51while they are interacting with the patient.
00:01:54So the reason why that's relevant
00:01:56is because we get to ask cool questions
00:01:58like would I have been feeling this
00:02:00if I were sitting with anyone else right now?
00:02:02Or is this feeling that just got activated in me,
00:02:05is it directly related to the dynamic of this person
00:02:09that I'm interacting with?
00:02:10Because it starts to tell you information
00:02:12about how maybe other people are experiencing them
00:02:15outside of therapy in their personal life
00:02:17that maybe they're not super aware of.
00:02:21And they might actually, even a narcissist
00:02:23could genuinely come into a therapy office
00:02:25and not have a clue why everybody thinks
00:02:27they're so insensitive, right?
00:02:29All the while the therapist is picking up
00:02:33on their insensitivity and having a counter-transference
00:02:35reaction to this insensitivity.
00:02:37Like gosh, it feels hard to sit in a room with this person.
00:02:40I feel incompetent, I feel scared,
00:02:43I feel like different than I did before they showed up, right?
00:02:47So it's really important.
00:02:49But the typical counter-transference that results
00:02:53when you're sitting with somebody who meets the criteria
00:02:57for cluster B, or I should say typical or common
00:03:00counter-transference, so what the therapist feels
00:03:02in the room with them, is you feel,
00:03:05I said a couple of them just now,
00:03:07oftentimes you just start to overwhelmingly feel incompetent,
00:03:11like you don't know how to do your job,
00:03:12or you're not qualified to do your job.
00:03:14And remember, this is just coming
00:03:16as you're sitting with someone.
00:03:17You weren't thinking about it earlier today
00:03:20on the drive to work.
00:03:20You were thinking, oh, I can't wait to go to work,
00:03:23I do a pretty good job, you know, I have a full practice.
00:03:25Then this person comes in and all of a sudden
00:03:27you feel like you can't do your job, right?
00:03:29So that's--
00:03:30- What is it, what is it, what are they doing?
00:03:32What is it--
00:03:33- They're devaluing you and not telling you
00:03:36that they're devaluing you.
00:03:38But you're starting to feel incompetent.
00:03:41So this is something that somebody
00:03:44with pretty severe personality pathology
00:03:47can sort of just put into the environment.
00:03:49They can export this out into the environment
00:03:52without saying a word.
00:03:53- Do you think they mean to?
00:03:54Is this an outcome that they want,
00:03:57or is this a spandrel that's come along for the ride?
00:03:59- So earlier you were asking about purpose,
00:04:03evolutionary perspective.
00:04:05I would say this is an evolutionary perspective
00:04:08that would be important to look into.
00:04:10Can they put this spell into the environment,
00:04:13into the air for some sort of advantage for themselves
00:04:17that they might not even fully be aware of in the moment,
00:04:19but it's happening and it's starting to work for them.
00:04:22- It makes people want to compete.
00:04:24Allow me to show you just how competent I am.
00:04:27No, no, no, no, I will over-deliver, I will over,
00:04:31because there is this odd sense
00:04:33of interpersonal competition of one.
00:04:35Oh, it's actually of none, right?
00:04:37It's just you, right?
00:04:38It's not a competition between you.
00:04:40It's that I need to prove myself
00:04:41because you don't seem impressed by me.
00:04:44Be impressed by me.
00:04:45Okay, I'll do a bit more.
00:04:47I'll do a bit more, I'll do a bit more.
00:04:48Beep, beep, finally, please just recognize that I'm here.
00:04:51- Yeah, or if I can get the professional
00:04:55to tell me to feel incompetent,
00:04:58then I get to direct the treatment,
00:05:02which means maybe if they feel incompetent,
00:05:05they'll agree with me more.
00:05:06So see, I take them off their high horse of expertise.
00:05:11Now I get to kind of get what I want from them a little bit.
00:05:15Maybe I can pull the wool over their eyes.
00:05:17So they're a bit more vulnerable.
00:05:19- This isn't exactly 100% conscious,
00:05:22but to me, I would still refer to that tactic
00:05:26as intentional abuse because you're not showing up
00:05:30with the intention of playing fair,
00:05:33even in the conversation, you know?
00:05:36- What else do you feel?
00:05:38- Fear and dread.
00:05:43- Okay.
00:05:46- And it's not always like 100% conscious
00:05:49of what you fear or what the dread is,
00:05:51but you can all of a sudden come up with this feeling.
00:05:53We also have a detection or a deception detection network
00:05:57in our brain, which gets hijacked by these types of tactics.
00:06:02You feel it and you stop thinking.
00:06:06If you get somebody who's good enough at manipulation,
00:06:09you could stop thinking, hmm, I'm feeling incompetent.
00:06:13I wasn't before, now I am.
00:06:15What's that about?
00:06:16You might just think maybe I'm not as good
00:06:18as I thought I was.
00:06:19And that would be a really important thing
00:06:22for a victim of a narcissist to say to themselves.
00:06:25Maybe I'm not as good.
00:06:26- Oh, of course.
00:06:27Because that's dissolved their defenses
00:06:31around I'm not in the wrong, they're in the wrong.
00:06:33- Right, yeah.
00:06:36And this happens in milliseconds, by the way.
00:06:40This is all happening unconsciously
00:06:41when you're interacting with someone.
00:06:42So someone like me, I'm a few steps ahead,
00:06:47but not by any means immune.
00:06:50And I would never tell anybody,
00:06:51because even the foremost experts of this
00:06:54would never claim that they could never be sucker punched.
00:06:58- Gazeed, finessed.
00:07:00- Yeah.
00:07:01But it's not really about becoming a human lie detector
00:07:04and knowing what everyone else is all about.
00:07:06That's not what you're trying to do.
00:07:07But you're trying to notice
00:07:10when I'm with this particular person, I feel incompetent,
00:07:12I feel dread, I feel fear, I feel insecurity.
00:07:16And in most other relationships in my life,
00:07:18I don't operate that way.
00:07:20What's happening in this particular dynamic
00:07:23that's making me feel that way?
00:07:24That's kind of some things that a therapist
00:07:26would want to certainly be aware of
00:07:28if they're interacting with someone
00:07:31who potentially has a socially maladaptive personality.
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