On receiving the patient's transference: the symbolizing and desymbolizing countertransference

Area of Science:

• Psychotherapy Research
• Clinical Psychology
• Psychoanalysis

Background:

• Distinguishing therapist empathy from countertransference is crucial for effective psychotherapy.
• Understanding the therapist's internal experience, particularly nonverbal cues, offers insight into therapeutic dynamics.
• Previous research relied on retrospective accounts, lacking direct behavioral observation.

Purpose of the Study:

• To empirically delineate the boundaries between therapist empathy and constructive/destructive countertransference.
• To investigate the therapist's nonverbal behavior during listening as an indicator of their internal state.
• To explore the congruence between observed behavior and retrospective self-reports.

Main Methods:

• An empirical study utilizing video recording to analyze therapist nonverbal behavior during sessions.
• Observation of a single therapist in both a "not-so-difficult" and a "difficult" session.
• Analysis of nonverbal behavior rhythmicity (rhythmicity vs. arrhythmicity) to identify distinct experiential modes.

Main Results:

• Three distinct modes of therapist experience were identified: empathy (rhythmicity), symbolizing countertransference (transitory arrhythmicity), and desymbolizing countertransference (continuous arrhythmicity).
• Nonverbal behavior patterns directly correlated with the therapist's subjective experience of the patient.
• Observed behavioral patterns showed congruence with retrospective reconstructions from prior analytic literature.

Conclusions:

• Therapist nonverbal behavior, specifically its rhythmicity, serves as a valid marker for differentiating empathy from countertransference.
• Direct behavioral observation provides a complementary and enhancing method to retrospective analytic accounts.
• These findings contribute to a more nuanced understanding of the therapist's internal world and its manifestation in session.