[Adta] RE: the movie THIN & somatic countertransference

[skdmt2]

Hi Nava!
You said: " Hi Susan

I watched the movie THIN, which I believe was filmed

in your center (yes?) last year.  After the film, my

students and I felt an urge to eat and we experienced

a feeling of starvation.  As if we have/must eat

immediately and eat a lot!  It was very strange.  The

movie is difficult to watch and I wonder if this is

something you experience and what you are making of

it?  somatic transference?

 

Hope you don't mind the question and will appreciate

your comments

feel free to respond through the list,

 

thanks

Nava Lotan "

................................................................

 

 

Yes, I think you are probably experiencing somatic transference & I am not
immune however, I believe it can be transformed into a very useful
therapeutic tool, if we are able to understand what is we are dealing with-
what is getting triggered for us.

I am including a section of a Working Paper on group therapy- see
below-unfortunately it is no longer available- that explores this issue.

 

 Interesting isn't it!  let me explain a bit I think is relevant.  People w/
ED tend to make everything about food, physical weight, size, body parts
instead of the issues that underlie ED. I compare living w/ ED to living in
a very restricted space in one's house & trying to keep everything under
control in that space. Over the weekend in Central Florida, there were some
terrible tornados & one woman was shown on TV who sought refuge in her
bathroom. When she emerged after the tornado, she found everything intact in
her bedroom but when she opened the door to the rest of her house, it was a
shambles- That's kind if what happens w/ an ED- The ED person, in an attempt
to deal w/ life, tries to use only ED behaviors as coping mechanisms because
they are so scared or overwhelmed re their life. 

In their development & history there may be lots of control, trauma, perhaps
some genetic factors also- a predisposition to an ED, they feel so
overwhelmed & often frightened dealing w/ life through a more "normal"
route, that they detour & try to restrict their feelings & thoughts, pick on
themselves, put themselves down, run from themselves to try to find relief,
to find ways to purge their feelings, stuff them inside & try to protect
them, etc. Eventually, this turns into what is called an eating disorder.

 

 I try to refocus the women I see on the underlying issues & also to
separate food from feelings, physical weight & hunger from emotional weight
& hunger, etc. I let the nutritionists & medical staff deal with those
issues &   try  to understand & help them understand what they are
experiencing, express it, & connect the meaning of these feelings, patterns,
events, etc, in their lives, as well as to challenge them to take risks to
live more expansively.

 

Also, may people w/ ED have OCD or very ritualistic behaviors & that is seen
of course in their whole movement repertoire, as well as in the dining room,
where food rituals are not allowed. Cognitive thinking is often so black &
white- so linear- it's like swimming in a pool- up one lane & back, rather
then including abstract thinking- being in the gray areas- of course, d/mt
is grey.

 

 

Also, FYI As you noticed, I'm sure, barely any therapy was shown in THIN,
although it was filmed. It just wasn't what the director chose to show. 

 

I see that I've gotten somewhat off track from your specific question but
realize that what was triggered for me was one of the most impt issues I
believe in treating ED & that is understanding & as d/mts, that means
getting involved & working to understand & balance  our own personal
responses- physical, emotional-cognitive, often as cues.

 

Perhaps others who work w/ ED will also respond to these issues raised by
Nava & her students. Patrizia, you also may have some things to add ( see
below) 

 

Thanks for writing.

 

Susan

 

Susan kleinman, MA ADTR, NCC 

................................................................

Reference info: Kleinman, S., Gerstein, F., Botwin, S.,   Developing
Connections in Group Therapy. The Renfrew Center Working Papers, Volume 2,
Fall., 2004

 

 

>From Developing Connections in Group Therapy

Fran Gerstein, PhD, Shari Botwin, LCSW, Susan Kleinman, MA, ADTR, NCC

 

 "... Managing Countertransference 

  Eating disorder therapists are prone to certain types of
countertransferential, often visceral in nature.  One notable somatic
reaction to dealing with anorexic patients is that therapists can find
themselves hungry and fantasizing about food during a group session.  It is
as if the therapist picks up the sense of "hunger" and deprivation the
patient is attempting to ward off. Because Renfrew therapists deal with so
many patients with eating disorders, they are prone to very specific types
of somatic countertransferential feelings.  Pallaro, in explaining somatic
countertransference (1995), says that the attention between her own
cognitive functions and unconscious bodily-felt responses, allows her to
make sense of her own affective experience and to contain it, so that she
can offer it metabolized to the [patient] for her own process of
reintegration of her own split-off affects" (p. 146). Such exquisite
attunement to one's self can permit therapists to sift through and discard
feelings that indicate that they may be over identifying with patients,
while still allowing for the possibility that they may also be tapping into
the patient's issues in an embodied, less conscious, fashion.  

 One notable somatic reaction to dealing with anorexic patients is that
therapists can find themselves hungry and fantasizing about food during a
group session.  Hall (1995) noted that therapists working with eating
disorders often brought food to eat before the session. In being sensitive
and responsive to feelings that are present, a therapist may also feel
helpless when a group member's symptoms worsen, as if the task of helping
the patients overcome their eating disorder is hopeless. 

Therapists may also go through a phase of disenchantment, which may, in
fact, be a projective identification having to do with a group member's
feelings of frustration, disappointment or hopelessness.  At times like this
it is useful to assume that the therapist is functioning as a "container"
for the group's feelings, and if the group is far enough along in the
recovery process , it may be possible to acknowledge our own sense of
helplessness, as therapists. In so doing, we may create a window of
opportunity that may open other feelings previously not recognized, such as
fear, frustration or impatience. 

In being sensitive and responsive to feelings that are expressed directly as
well as coded in their nonverbal expression, we may also encounter anger, a
feeling that is particularly difficult feeling for patients with eating
disorders to experience and express. Consequently, if we find ourselves
experiencing anger, it is possible that we might be absorbing the group's
anger into our own bodies, and openly acknowledging this, allows it to be
explored ( Pallaro, 1995).  Our openness as therapists to listen to our own
bodies, and to glean understanding of the situation before us, also
demonstrates the importance for patients to reclaim difficult feeling
heretofore disowned.  Likewise, therapists are encouraged to utilize either
individual or group supervision so as to make sure that their
countertransference doesn't interfere with their objectivity."

      

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