 | The examples and perspective in this article may not represent a worldwide view of the subject.(June 2011) |
Body-centred countertransference involves a psychotherapist's experiencing the physical state of the patient in a clinical context. [1] Also known as somatic countertransference, it can incorporate the therapist's gut feelings, as well as changes to breathing, to heart rate and to tension in muscles. [2]
Dance therapy has understandably given much weight to the concept of somatic countertransference. [3] Jungian James Hillman also emphasised the importance of the therapist using the body as a sounding-board in the clinical context. [4]
Post-Reichian therapies like bioenergetic analysis have also stressed the role of the body-centered countertransference. [5]
There is some evidence that narcissistic patients and those suffering from borderline personality disorder create more intense embodied countertransferences in their therapists, [6] their personalities favouring such non-verbal communication by impact [7] over more verbalised, less somatic interactions.
Susie Orbach has written emotively of what she described as "wildcat sensations in my own body...a wildcat countertransference" [8] in the context of body countertransference. She details her role responsiveness to one patient who evoked in her what she called "an unfamiliar body experience...this purring, reliable and solid body" [9] to counterbalance the fragmented body image of the patient herself.
Irish psychologists at NUI Galway and University College Dublin [10] [11] have recently begun to measure body-centred countertransference in female trauma therapists using their recently developed 'Egan and Carr Body-Centred Countertransference Scale' (2005), a sixteen symptom measure. [12]
Their research was influenced by developments in the psychotherapy world which was beginning to see a therapist's role in a therapeutic dyad as reflexive; that a therapist uses their bodies and 'self' as a tuning fork to understand their client's internal experience and to use this attunement as another way of being empathic with a client's internal world. [13] [14] Pearlman and Saakvitne's seminal book on vicarious traumatization and the effect of trauma work on therapists has also been an important directional model for all researchers studying the physical effects of trauma work on a therapist. [15]
High levels of body-centred countertransference have since been found in both Irish female trauma therapists and clinical psychologists. [16] This phenomenon is also known as 'somatic countertransference' or 'embodied countertransference' and it links to how mirror neurons might lead to 'unconscious automatic somatic countertransference' as a result of postural mirroring by the therapist. [17] [18] Hamilton et al (2020) revisited BCT in a larger sample of 175 therapists (122 females) and that the a similar pattern of body-centred countertransference was reported as in the previous two studies. The most common being: (a) Muscle Tension- 81%, (b) Tearfulness- 78%, (c) Sleepiness- 72%, (d) Yawning- 69%, (e) Throat constriction- 46%, (f) Headache- 43%, (g) Stomach disturbance- 43%, (h) Unexpectedly shifting in body 29%, (i) sexual arousal- 29%, (j) raised voice- 28%, (k) aches in joints- 26%, (l) nausea- 24%, (m) Dizziness- 20%, and (n) Genital pain-7.5%. The authors reported how previous researchers did not find BCT because surveys have previously failed to ask specifically about it, and have focused on emotional and cognitive and relational CT. The authors finally called for larger longitudinal studies and also larger sample sizes to allow a comparison of gender and orientation effects as well as whether higher levels affect levels of burnout and therapeutic engagement and treatment outcomes 26. Hamilton, L., Hannigan, B., Egan, J., Trimble, T., Donaghey, C., & Osborn, K. (2020). An exploration of body-centred countertransference in Irish Therapists. Clinical Psychology Today, 4(2), 26-38.
Loughran (2002) found that 38 therapists out of 40 who had responded to a questionnaire (which was distributed to a sample of 124 therapists) on a therapist's use of body as a medium for transference and countertransference communication reported that they had experienced bodily sensations (nausea or churning stomach, sleepiness, shakiness, heart palpitations, sexual excitement, etc.) while in session with patients. [19]
A list of the frequency of occurrence of body-centred countertransference symptoms reported by trauma therapists (Sample A: 35 Female Irish Trauma therapists [20] ) and Irish clinical psychologists (Sample B: 87 Irish Clinical Psychologists [21] ) in the previous six months 'when in-session with a client' is given below in order of frequency:
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A small but significant relationship was found between female trauma therapists' level of body-centred countertransference and number of sick leave days taken, suggesting a possible relationship between uncensored body-centred countertransference and somatization. This relationship was not however found in clinical psychologists who were working mainly with a non-trauma population. Therapists have noted the connection between a tendency for some clients to express emotional discomfort by focusing on bodily symptoms rather than being able to put their emotional distress into words. [22] It is thought that such processes are more common in people who have experienced childhood abuse and trauma. [23]
Recent research which measured female genital arousal in response to rape cues found that women when listening to rape, consensual sexual activity or violence developed genital arousal more frequently than men. It also might explain the relatively frequent reported experience of sexual arousal amongst Irish female trauma therapists. [24] Further validation of body-centred countertransference in psychologists and therapists is on-going in both NUI Galway and Trinity College Dublin.
Therapists have been warned against assuming too automatically that their body-feelings always involve somatic resonance to the client, as opposed to being produced from their own feelings/experiences - the same problem appearing with countertransference generally. [25]
Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. Numerous types of psychotherapy have been designed either for individual adults, families, or children and adolescents. Certain types of psychotherapy are considered evidence-based for treating some diagnosed mental disorders; other types have been criticized as pseudoscience.
Somatization disorder is a mental and behavioral disorder characterized by recurring, multiple, and current, clinically significant complaints about somatic symptoms. It was recognized in the DSM-IV-TR classification system, but in the latest version DSM-5, it was combined with undifferentiated somatoform disorder to become somatic symptom disorder, a diagnosis which no longer requires a specific number of somatic symptoms. ICD-10, the latest version of the International Statistical Classification of Diseases and Related Health Problems, still includes somatization syndrome.
Clinical psychology is an integration of human science, behavioral science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession.
Counseling psychology is a psychological specialty that encompasses research and applied work in several broad domains: counseling process and outcome; supervision and training; career development and counseling; and prevention and health.
Person-centered therapy, also known as person-centered psychotherapy, person-centered counseling, client-centered therapy and Rogerian psychotherapy, is a form of psychotherapy developed by psychologist Carl Rogers beginning in the 1940s and extending into the 1980s. Person-centered therapy seeks to facilitate a client's self-actualizing tendency, "an inbuilt proclivity toward growth and fulfillment", via acceptance, therapist congruence (genuineness), and empathic understanding.
Countertransference is defined as redirection of a psychotherapist's feelings toward a client – or, more generally, as a therapist's emotional entanglement with a client.
Art therapy is a distinct discipline that incorporates creative methods of expression through visual art media. Art therapy, as a creative arts therapy profession, originated in the fields of art and psychotherapy and may vary in definition.
Transference is a phenomenon within psychotherapy in which repetitions of old feelings, old attitudes, old desires, and/or old fantasies that someone displaces, are subconsciously projected onto a here-and-now person. Traditionally, it had solely concerned feelings from a primary relationship during childhood.
Psychodynamic psychotherapy and psychoanalytic psychotherapy are tow categories of psychological therapies. Their main purpose is revealing the unconscious content of a client's psyche in an effort to alleviate psychic tension, which is inner conflict within the mind that was created in a situation of extreme stress or emotional hardship, often in the state of distress. The terms "psychoanalytic psychotherapy" and "psychodynamic psychotherapy" are often used interchangeably, but a distinction can be made in practice: though psychodynamic psychotherapy largely relies on psychoanalytical theory, it employs substantially shorter treatment periods than traditional psychoanalytical therapies.
The Dodo bird verdict is a controversial topic in psychotherapy, referring to the claim that all empirically validated psychotherapies, regardless of their specific components, produce equivalent outcomes. It is named after the Dodo character in Alice in Wonderland. The conjecture was introduced by Saul Rosenzweig in 1936, drawing on imagery from Lewis Carroll's novel Alice's Adventures in Wonderland, but only came into prominence with the emergence of new research evidence in the 1970s.
Somatic experiencing (SE) is a form of alternative therapy aimed at treating trauma and stressor-related disorders like PTSD. The primary goal of SE is to modify the trauma-related stress response through bottom-up processing. The Clients’ attention is directed toward internal sensations,, rather than to cognitive or emotional experiences. The method was developed by Peter A. Levine.
Somatic psychology is a form of psychotherapy that focuses on somatic experience, including therapeutic and holistic approaches to the body. Body psychotherapy is a general branch of this subject, while somatherapy, eco-somatics and dance therapy, for example, are specific branches of the subject. Somatic psychology is a framework that seeks to bridge the mind-body dichotomy.
Somatization is a tendency to experience and communicate psychological distress as bodily and organic symptoms and to seek medical help for them. More commonly expressed, it is the generation of physical symptoms of a psychiatric condition such as anxiety. The term somatization was introduced by Wilhelm Stekel in 1924.
Psychological resistance, also known as psychological resistance to change, is the phenomenon often encountered in clinical practice in which patients either directly or indirectly exhibit paradoxical opposing behaviors in presumably a clinically initiated push and pull of a change process. In other words, the concept of psychological resistance is that patients are likely to resist physician suggestions to change behavior or accept certain treatments regardless of whether that change will improve their condition. It impedes the development of authentic, reciprocally nurturing experiences in a clinical setting. It is established that the common source of resistances and defenses is shame. This and similar negative attitudes may be the result of social stigmatization of a particular condition, such as psychological insulin resistance towards treatment of diabetes.
The therapeutic relationship refers to the relationship between a healthcare professional and a client or patient. It is the means by which a therapist and a client hope to engage with each other and effect beneficial change in the client.
Vicarious trauma (VT) was a term invented by McCann and Pearlman that is used to describe how working with traumatized clients affects trauma therapists. Previously, the phenomenon was referred to as secondary traumatic stress coined by Dr. Charles Figley. The theory behind vicarious trauma is that the therapist has a profound world change and is permanently altered by the interaction of empathetic bonding with a client. This change is thought to have three conditional requirements: empathic engagement and exposure to graphic and traumatizing material, the therapist being exposed to human cruelty, and reenactment of trauma within the therapy process. This change can produce changes in a therapist’s sense of spirituality, worldview, and self-identity.
Sex surrogates, sometimes referred to as surrogate partners, are practitioners trained in addressing issues of intimacy and sexuality. A surrogate partner works in collaboration with a sex therapist to meet the goals of their client. This triadic model is used to dually support the client: the client engages in experiential exercises and builds a relationship with their surrogate partner while processing and integrating their experiences with their therapist or clinician.
"Acting in" is a psychological term which has been given various meanings over the years, but which is most generally used in opposition to acting out to cover conflicts which are brought to life inside therapy, as opposed to outside.
Parallel process is a phenomenon noted in clinical supervision by therapist and supervisor, whereby the therapist recreates, or parallels, the client's problems by way of relating to the supervisor. The client's transference and the therapist's countertransference thus re-appear in the mirror of the therapist/supervisor relationship.
Marion Rosen was a German-American physiotherapist. She developed Rosen Method Bodywork and Rosen Method Movement. Under Rosen's guidance in 1980, the Rosen Institute (RI) was formed as the governing international organization that protects and sustains the quality and standards of Rosen Method. The Rosen Institute has affiliate training centers in 16 countries and has certified 1150 bodywork practitioners and 150 movement teachers.
