Body-centred countertransference involves a psychotherapist's experiencing the physical state of the patient in a clinical context. 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.

Various approaches

Dance therapy Dance/movement therapy (DMT) in USA/ Australia or dance movement psychotherapy (DMP) in the UK is the psychotherapeutic use of movement and dance to support intellectual, emotional, and motor functions of the body. As a modality of the creativ ...

has understandably given much weight to the concept of somatic countertransference. Jungian James Hillman also emphasised the importance of the therapist using the body as a sounding-board in the clinical context. Post- Reichian therapies like

bioenergetic analysis Body psychotherapy, also called body-oriented psychotherapy, is an approach to psychotherapy which applies basic principles of somatic psychology. It originated in the work of Pierre Janet, Sigmund Freud and particularly Wilhelm Reich who develo ...

have also stressed the role of the body-centered countertransference. There is some evidence that

narcissistic Narcissism is a self-centered personality style characterized as having an excessive interest in one's physical appearance or image and an excessive preoccupation with one's own needs, often at the expense of others. Narcissism exists on a co ...

patients and those suffering from

borderline personality disorder Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a personality disorder characterized by a long-term pattern of unstable interpersonal relationships, distorted sense of self, and strong ...

create more intense embodied countertransferences in their therapists, their personalities favouring such non-verbal communication by impact over more verbalised, less somatic interactions.

Orbach

Susie Orbach Susie Orbach (born 6 November 1946) is a British psychotherapist, psychoanalyst, writer and social critic. Her first book, ''Fat is a Feminist Issue'', analysed the psychology of dieting and over-eating in women, and she has campaigned against m ...

has written emotively of what she described as "wildcat sensations in my own body...a wildcat countertransference" 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" to counterbalance the fragmented body image of the patient herself.

The Irish experience

In female trauma therapists

Irish psychologists at NUI Galway and University College Dublin 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. 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. Pearlman and Saakvitne's seminal book on

vicarious traumatization 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. Charle ...

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. High levels of body-centred countertransference have since been found in both Irish female trauma therapists and clinical psychologists. 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. 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.

Frequency of symptom occurrence

A list of the frequency of occurrence of body-centred countertransference symptoms reported by trauma therapists (Sample A: 35 Female Irish Trauma therapists) and Irish clinical psychologists (Sample B: 87 Irish Clinical Psychologists) in the previous six months 'when in-session with a client' is given below in order of frequency: #Sleepiness (A; 92%, B; 76%) #Muscle Tension (A; 83%, B; 79%) #Yawning (A; 65%, B; 77%) #Unexpected shift in body (A; 77%, B; 57%) #Tearfulness (A; 71%, B; 61%) #Headache (A; 54%, B; 53%) #Stomach Disturbance (A; 41%, B; 46%) #Throat Constriction (A; 34%, B; 36%) #Raised Voice (A; 29%, B; 33%) #Dizziness (A; 26%, B; 19%) #Loss of voice (A; 32%, B; 18%) #Aches in joints (A; 37%, B; 18%) #Nausea (A; 23%, B; 18%) #Numbness (A; 29%, B; 15%) #Sexual Arousal (A; 26%, B; 11%) #Genital pain (A; 6%, B; 2%)

Somatization

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 Clinical psychology is an integration of social 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 ...

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 Body may refer to: In science * Physical body, an object in physics that represents a large amount, has mass or takes up space * Body (biology), the physical material of an organism * Body plan, the physical features shared by a group of anima ...

rather than being able to put their emotional distress into words. It is thought that such processes are more common in people who have experienced

childhood abuse Child abuse (also called child endangerment or child maltreatment) is physical, sexual, and/or psychological maltreatment or neglect of a child or children, especially by a parent or a caregiver. Child abuse may include any act or failure to a ...

and trauma. 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. Further validation of body-centred countertransference in psychologists and therapists is on-going in both

NUI Galway The University of Galway ( ga, Ollscoil na Gaillimhe) is a public research university located in the city of Galway, Ireland. A tertiary education and research institution, the university was awarded the full five QS stars for excellence in 201 ...

and Trinity College Dublin.

Cautions

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.Christiane Sanderson, ''Counselling Adult Survivors of Child Sexual Abuse'' (2006) p. 136-7 and p. 395

References

{{Reflist 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.

External links

Michael Soth, 'Embodied countertransference'

Psychodynamics Counseling Psychological stress Motivation