Somatic Countertransference Research Articles

An Interpretative Phenomenological Analysis: Psychotherapists’ Lived Experience of Body-Subject

Cartesian dualism dominates psychotherapy and sociology, displacing the body-subject as described in philosophy. This research explores the experience of body-subject in psychotherapy by conducting a qualitative research based on the Interpretative Phenomenological Analysis. Eight semi-structured interviews were conducted with psychotherapists. The analysis identified 4 superordinate themes and 2 subthemes for each theme. The first theme explores what is a body and how embodiment is expressed. The second theme focuses on somatic countertransference which operates either as a guide to understanding or as another way of communicating. The third theme highlights the contradiction between the freedom and the power of the bodies while the last theme focuses on observation and self-observation which are utilized as a way of understanding or overlooked so that therapists can dwell on experience. The findings suggest that dualism permeates psychotherapy, with the body-object guiding the therapy although some experiences manage to escape it and focus on the body-subject thus giving substance to the lived body. Taking into account the limitations of the study, future research could focus on the experiences of psychotherapists from approaches such as dramatherapy since the body is very active and present. Keywords: body-subject, body-object, IPA, embodiment

Hot Feelings: Sexual Transference and Countertransference with Male Mid-Adolescents and a Female Psychoanalyst

The author focuses on the workings of the female analyst-male pair in the consulting room when sexual feelings emerge as part of the adolescent storm. The need for open-bodiedness in relation to the perception of the bodily states of both the analyst and analysand is described and discussed. The author shows how somatic countertransference, reverie, and projective identification are harnessed creatively in the service of transformation. The importance of the third to help provide an analytic space for thought and meaning, rather than enactment and impasse, is discussed. The trajectory from the analyst’s wish to silence sexual transference and countertransference in the consulting room, followed by the analyst’s initial reluctance to discuss the hot feelings with colleagues, and then the impact of publication anxiety when writing through the experiences and revising this paper is described.

Aches, Pains, Rumbles, and Stumbles: Applying Somatic Countertransference and Body Reactivity in Clinical Work and Teaching.

Recognizing somatic countertransference reactions is an essential tool for the psychodynamic clinician. Although the analyst's bodily reactivity has been written about throughout the history of our field, contemporary neuroscience, multiple code theory, and nonlinear system dynamics provide scientific buttressing to understand embodied phenomena. Patients often speak with and about their bodies, and the clinician who pays attention to these communications, as well as those emanating from his or her own body, has an additional resource to help the patient. Elvin Semrad's classic but largely unremembered "tour of the body" is one tool that can assist clinicians in how to receive and process body reactions that may be unconsciously split off, consciously withheld, or felt dangerous or beguiling. Three examples are used to illustrate embodiment and somatic countertransference as important clinical guides. An argument is made that these concepts should be taught and integrated into psychodynamic curricula.

Dynamic countertransference

ABSTRACT This article suggests a new concept, namely Dynamic Countertransference, which focuses on therapist’s movement qualities/Laban’s Efforts as a countertransferential response to client unconscious material. Particular significance is attributed to subtle involuntary movements, called shadow movements, which in 6 effort-combinations, explained by Marion North, can reveal pre- and non- symbolic unconscious material, and might support its symbolic expression and therapy progression. The portrayal of a dance movement psychotherapy family vignette aims to explain the Dynamic countertransferential mechanism. Familiarity with personal movement profile and competence to sieve through objective and subjective countertransference are important prerequisites for its efficient use. Not only does this apply to Dynamic, but also to the use of Kinetic countertransference, which we find to be significantly different. However, both concepts might be regarded as part of Somatic Countertransference, a still under-researched but crucial area for a thorough use of countertransference phenomena, especially in dance movement psychotherapy.

The day the clock stopped. Primitive states of unintegration, multidimensional working through and the birth of the analytical subject.

This paper is based on one idea and built around one clinical experience that helped me to broaden my comprehension of it. The idea, underlying the work of several authors, is that when the analytic field is saturated with primitive and unintegrated mental contents, the analyst's somatic countertransference is a precious indicator of a deep, dissociated form of communication. The clinical experience concerns the difficult elaboration of a complex, multifaceted countertransference that took place during the early stages of the analysis of a sensitive patient who used to communicate in a very dissociated way and that I found hard to contain. This experience, closely described in the article, led me to formulate the clinical idea that the transference field may be made of distinct layers (psychoid, affective, verbal), and that each one of them may potentially convey dissociated, even contrasting bits of information. The corollary of this is that the analyst should be ready to accept contrasting sensations, feelings and thoughts at the same time, as they might be the basic ingredients of a complex reverie. The analyst could find himself/herself in front of his/her own internal unelaborated multiplicity before a symbolic image may emerge to link the scattered pieces of the experience. Nevertheless, the heart of this paper is not about suggesting an idea, but in the sharing of a complex working through, which fostered the birth of a new, more human relational perspective: the capacity of being together in time, in a transitional space where there is neither total separation nor fusion.

Breathing and relating: exploring a therapist’s heuristic experience

ABSTRACT What is my experience of consciously breathing while in sessions with clients? As a beginning psychodynamic psychotherapist with a passion for body psychotherapy, this research question sparked a year of exploration into breathing and relating. Following a heuristic self-search methodology, I closely examined my subjective experience of breathing while in sessions with clients, and in the process my relationship with my own breath was illuminated. I discovered that I recruit my breath as a protective defence against feeling. With my clients, I discovered that my experience of breathing shifts from unconscious to conscious, and that shifting breath consciousness is influenced by intersecting client and therapist histories. My research demonstrates the potential for practising conscious breathing in psychotherapy. I explore the importance of breath in investigating the therapist’s somatic countertransference and establishing breathing space between therapist and client.

Tuning of the self: in-session somatic support for vicarious trauma-related countertransference

ABSTRACTTherapist countertransference reactions related to the phenomenon of vicarious trauma (VT) can be examined through polarising physiological responses. Through an integration of counselling and neuroscientific perspectives on empathy and traumatic countertransference, in-session somatic reactions are approached as valuable information sources. The VT field’s research gaps regarding intersecting sociocultural identities of therapists and clients are centred in the proposed framework to examine hyper personalised and depersonalised countertransference polarisations. Awareness of somatic cultural countertransference and power dynamics is proposed as a way to prevent VT and uphold ethical standards of practice.

Microprocesses at the body-mind border in the psychoanalysis of psychosis

ABSTRACTThis article presents clinical material involving the treatment of two patients suffering from delusional paranoia and psychosomatic disorders as the basis for investigating the significance of the body–mind border – with particular attention to the working through of body–mind dissociation. In the context of interpersonal transference-countertransference events, the authors focus on the importance of the analysand’s transference onto his own body and the analyst’s use of somatic countertransference. When the analysand is able to develop a relationship to his own body [as a “Concrete Original Object” (COO)], he starts to experience and to register mentally his body at a sensory level, consequently improving his awareness of reality and cognitive capacity. The approach outlined here is decidedly relational in nature – it mandates that the analyst draw from his own perceptions based on particularly intense bodily and emotional participation as the basis for understanding the analysand’s state of mind–body. The technical approach described here is a working through centred on the analysand’s body, strengthening his vertical axis with only minimal interpretative reliance on interpersonal transference.

Encountering Disenfranchised Grief: An Investigation of the Clinical Lived Experiences in Dance/Movement Therapy

This study employed a transcendental phenomenological methodology to understand how clients’ lived experiences of disenfranchised grief are present within the clinical therapeutic relationship in dance/movement therapy. Data were collected through individual semi-structured interviews from four dance/movement therapists who have worked with clients experiencing disenfranchised grief. Moustakas’ adaptation of the Stevick–Colaizzi–Keen method of data analysis was used concurrently with data collection. Data analysis resulted in four textural themes: (a) Disenfranchised grief can be described as disconnecting, overwhelming, complex, unrecognized, and pervasive; (b) It is distinguished by exacerbated grief; (c) It is recognized as a distinct form of grief; and (d) It involved consistencies in biopsychosocial and movement goals and focus. Structural themes describe how disenfranchisement was experienced: (a) social/cultural factors, (b) dance/movement therapy approach and interventions, (c) heightened kinesthetic empathy and somatic countertransference, and (d) the therapeutic movement relationship. These themes support the current literature and suggest that the experience of disenfranchised grief includes embodied effects. Furthermore, dance/movement therapy may assist with addressing these effects, restoring individuals’ right to grieve, and supporting them in their grieving process.

Somatic Countertransference as Evidence of Adhesive Identification in a Severely Traumatized Woman.

This paper discusses the use of somatic countertransference as a means of learning about the patient, about projective and adhesive identification and about the object relating nature of the most traumatized and withdrawn part of the personality. It assumes an elemental knowledge of British Object Relations and uses clinical material to illustrate the hypotheses that somatic countertransference is an indicator of a very elemental communication occurring from the aspect of the psyche that is united in a body mind or mind body. The paper assumes that this body mind was object seeking at birth and perhaps before. Because these early aspects of the personality are non verbal and non conceptual, the analyst must rely not only on the verbal material in a session but on the emotional and sensual experiences within the transference and the countertransference. Such reliance requires a faith in one's own intuition without a certainty that one is "right." Because speaking of such early experience is difficult, often writers and analysts appear more certain than they are. This is a hazard of this type of analytic work. What I am writing about is conjecture or imagination or dream, but I am suggesting that such dream work is a valuable tool for analysis.

Residues in the analyst of the patient's symbiotic connection at a somatic level: unrepresented states in the patient and analyst.

This paper discusses the residues of a somatic countertransference that revealed its meaning several years after apparently successful analytic work had ended. Psychoanalytic and Jungian analytic ideas on primitive communication, dissociation and enactment are explored in the working through of a shared respiratory symptom between patient and analyst. Growth in the analyst was necessary so that the patient's communication at a somatic level could be understood. Bleger's concept that both the patient's and analyst's body are part of the setting was central in the working through.

Somatic countertransference experiences of nurse therapeutic touch practitioners: A content analysis

Somatic countertransference experiences of nurse therapeutic touch practitioners: A content analysis

The Borderline Client, Shame and Somatic Counter-Transference

This paper is about understanding possible source causes of Borderline Personality Disorder (BPD) and how it differs from Bipolar Disorder (BP), Narcissistic Personality Disorder (NPD), Post Traumatic Stress Disorder (PTSD) and Attention Deficient/Hyperactivity Disorder (ADHD). The distinctions can be hard to grasp, are often overlapping, co-occurring at times and/or possibly mis-diagnosed. An overview is offered that compares the similarities and differences between these conditions. The core affect of shame is explained in how it may be experienced somatically in a Borderline client and the relationship of shame to distinct negative feelings of disgust, abandonment, and rejection are discussed. When working with difficult emotional states, some ideas are presented to work as a body oriented (Bioenergetic) psychotherapist to support a more integrated healing and recovery program for a BPD client. Some suggestions of diet, supplements and natural remedies are also included. Finally, recommendations are presented regarding how a psychotherapist can track and understand their own somatic counter-transference issues in order to work more effectively with a BPD client.

The Lived Experience of Dance/Movement Therapists Working with Patients with Eating Disorders

This qualitative study highlighted the lived experiences of five dance/movement therapists who work with patients diagnosed with eating disorders. Using a phenomenological research approach, participants’ lived experiences were explored through semi-structured interviews and seven themes were developed using Kvale’s interview analysis. Findings also highlighted somatic countertransference as identified through differing body tensions as well as a need for constant self-care among participants. Implications highlighted how essential it is to bring the body of the client and the body of the clinician into the treatment process while maintaining healthy self-care practices.

Dance/movement therapy during adolescence – Learning about adolescence through the experiential movement of dance/movement therapy students

Emotional processes during adolescence occur in the psyche (mind) and the soma (body). This article will present a preliminary phenomenological study with 20 dance/movement therapy students. The objective of the research was to learn about adolescence through the type of emotional content that would surface as a result of movement experiences that focused on patterns of movement during adolescence. The participants were asked to move to the music that symbolized their adolescent years to them in the same way they used to move during adolescence. Based on their written reflections of the movement experience, two main themes emerged. In one, the adolescent body is experienced as a vehicle to express urges and desires, and in the other, the adolescent body is experienced in a threatening and revealing manner. These results serve as the basis for my discussion of the therapeutic technique and the somatic countertransference process in movement therapy with adolescents.

A cross-cultural study of somatic countertransference: a brief overview

Whilst countertransference is commonly experienced as feelings, thoughts, images, symbols and dreams endured by the therapist in relation to their client, somatic countertransference is positioned as embodied, physical manifestations in the therapist’s body. Common examples include headaches, nausea, aches, pains, sleepiness, sexual arousal, dizziness and trembling felt by the psychotherapist in session. Current interest in somatic countertransference spans the spectrum from the psychoanalytic, post-Jungian, dance movement and humanistic modalities to empirical studies originating from the trauma research field. Although the clinical literature emphasizes the therapeutic relevance and richness of somatic countertransference for understanding unconscious communications occurring in the session, trauma research advocates greater self-awareness and management of somatic countertransference to prevent therapist burnout. This article will outline the rationale and research process for proposing the first cross-cultural study of somatic countertransference. This study is suggested as a means to extend our understanding of, and ability to work with, somatic countertransference. Preliminary results from an initial study of Chinese psychotherapists will be discussed.

Craving Interpretation: A Case of Somatic Countertransference

Contemporary psychoanalysis views the countertransference as equally important to the therapeutic endeavour as its counterpart, the transference. This paper focuses on a particular kind of countertransference phenomena: those which are bodily in form and perceivable to the patient. It begins with a brief rehearsal of some of the fundamental psychoanalytic principles related to bodily symptoms, and then reviews the developments and changes that have occurred in the understanding of the concept of countertransference. The focus then shifts to theoretical developments around somatic countertransference in particular, and the division seen in the literature between authors who locate the source of the phenomenon of somatic countertransference in the patient's unconscious, and those who locate it in the therapist. The paper will argue that exploring the uniqueness and specificity of the therapeutic dyad will reveal important information about the dynamics at work in the therapy. A clinical example illustrates the specificity of the form that a somatic countertransference takes in a particular therapy. It then proposes that in order to make sense of the rich information that this unique response provides, the therapist must mentalize and make meaning of her particular somatic experience by way of a therapeutic analysis of reverie.

EPA-1237 – Polyglot therapies - the implications of neuroscientific findings and child development research on clinical practice

Freud started his career as a neurologist studying polyglot aphasias. In a globalised world, the question of polyglot psychotherapies is increasingly important. Neuroscientific findings and child development research support theories on embodied semantics (Pulvermuller, 2013): the emergence of meaning primarily from somatic/sensorimotor experiences. Increasing evidence supports the importance of the mirror neuron system in the process of language acquisition (Moreno et al, 2013) and the development of cognition (Perlovsky, 2013). Threvarthen's studies suggest that onthologically, language development is dependent on dynamic patterns of the embodied intersubjective experiences of the child. Age and contextual factors influence language acquisition. Nevertheless, little is known as to what extent and in what quality multimodal experiences are at play at the time of second language acquisition and in what way these are superimposed on early embodied experiences. Neuroimaging studies have proved that with second language acquisition differential activations remain within brain regions; (Halsband et al, 2002) yet with the progression of proficiency, the different languages converge onto a shared neural system underlying language processing (Perani et al., 2005). In light of these findings, the author will discuss the advantages and difficulties of working across languages in the therapeutic setting. Cultural aspects of dynamic patterning and thus their influence on emotional development will be highlighted. Questions will be raised about the possibility that the retrieval of emotional aspects of memories varies in different languages and how this can be utilised in polyglot therapies. Finally, the significance of the somatic counter-transference in polyglot therapies will be discussed.

Crossing the somatic–semiotic divide: The troubled question of dance/movement therapists (DMTs) professional identity

This article explores the issue of dance/movement therapists’ professional identity which, it is argued, is still overshadowed by the somatic–verbal divide. The discussion was generated by a small-scale research project, initially designed to examine therapists’ somatic awareness and awareness of somatic countertransference. The results of this study, briefly presented in the first part of the article, pointed to a prevalent preference for verbal training, supervision, and session processing, and to a surprising absence of awareness of and engagement with the therapist's own bodily response to the therapeutic encounter.Moving on from the findings of the initial research project, the article focuses on the troubled issue of DMTs professional identity through a contextualization of these findings and further elaboration of their symptomatic relevance. While some of the issues of professional identity are “external”, having to do with funding, status, institutional frameworks and training programmes, it is argued that the underlying sources of the problem are fundamentally related to the still unbridged somatic–semiotic divide, and the deep-rooted ambivalence of DMTs in relation to their own approaches and practices. It is proposed that the resolution of this ambivalence will be conducive to the development of a more robust DMT professional identity.

Is there any body out there?: A survey of literature on somatic countertransference and its significance for DMT

This survey follows the evolution of the concept of countertransference through its extrapolation into somatic countertransference (SCT) and its significance in Dance/Movement Therapy (DMT). The literature review highlights the controversial status of both the concept of countertransference (CT) and the derived concept of somatic countertransference (SCT) with regard to their definitions and roles in the therapeutic relationship. It indicates that, in contrast to the predominantly verbal focus of mainstream psychotherapeutic discourse, DMT practitioners, who relate to body and movement as their primary language, have acknowledged these constructs as central to their discipline since its inception, long before the body made a comeback into mainstream psychotherapy. Theoreticians who engage with body psychotherapy and DMT insist that somatic countertransference is significant to the therapeutic relationship as a tool both for understanding and managing the dynamics of the session and for enhancing the process of therapy.