[Adta] RE: Thin/Somatic Countertransference
skdmt2
skdmt2 at bellsouth.net
Mon Feb 5 14:43:52 EST 2007
Hi Anne ,
Thanks for your interesting response. Those of us who work w/ ED all the
time know that it's all about the patient's primary relationship w/ "Ed" &
lack of meaningful relationship w/ self-w/ food, /w/ others.
It's a great opportunity to dialogue re our relationship w/ one another also
& to be able to articulate our own feelings re our experiences in treating
this population.
I hope that this discussion will continue.
Susan
_____
From: awenner at optonline.net [mailto:awenner at optonline.net]
Sent: Monday, February 05, 2007 1:32 PM
To: skdmt2
Subject: Re: Thin/Somatic Countertransference
Susan,
Thank you for your generous sharing of wisdom re: your impressions of the
function of ED as well as "his" many manifestations. I, as you, find it
useful to think of the "relationship" to food and one's body as an aspect of
the person's overall object relational world. Is the relationship
gratifying leaving one feeling reasonably satisfied and secure in the
knowledge of being able to rely upon internal cues and needs and get those
needs met in a good-enough way? Is it based on fear and scarcity, is it
impoverished and based on deprivation as in anorexia? Is it tantalizing yet
unattainable yet giving one a sense of special status, staying out of and
above the fray? (The pursuit of thinness) Is it to be unsatiabley binged
upon and than rejected/undone as in bulimia?
I often experience strong physical hunger after my sessions and have noticed
something about many of my close colleagues (the healthy ones!) in this
field (I've been specializing in treating ED's for almost ten years) we all
love cooking, restaurants, we consider ourselves "foodies", love gardening
and being creative in many other ways when we are not working with clients.
I understand this to be not only a critical aspect of self-care - important
for any therapist working with any population but also as maybe a particular
response to working around so much ED and so much obsession and deprivation.
I understand it as my own healthy response - pleasure principle if you will,
a strong need and desire to disobey ED and an attempt to counteract so much
deprivation.
Take Care, Anne
Anne Wennerstrand
am
Subject: Adta Digest, Vol 16, Issue 10
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> Today's Topics:
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> 1. RE: the movie THIN & somatic countertransference (skdmt2)
> 2. 2007 Conference (Gloria Farrow)
>
>
> -----------------------------------------------------------------
> -----
>
> Message: 1
> Date: Mon, 5 Feb 2007 07:29:53 -0500
> From: "skdmt2"
> Subject: [Adta] RE: the movie THIN & somatic countertransference
> To: ,
> Message-ID:
> <20070205122940.CEMP2921.ibm65aec.bellsouth.net at activevmmhybc5>
> Content-Type: text/plain; charset="us-ascii"
>
> 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
> protectthem, 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
> sensitiveand 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'sfeelings 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
> eatingdisorders 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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> Message: 2
> Date: Mon, 5 Feb 2007 09:26:51 -0500
> From: "Gloria Farrow"
> Subject: [Adta] 2007 Conference
> To:
> Message-ID: <003601c74931$cc5339e0$6601a8c0 at ADTAGLORIA>
> Content-Type: text/plain; charset="us-ascii"
>
> Deadline is fast approaching to send in your proposal to present
> at the
> ADTA 42nd Annual Conference in New York; New York Marriott at the
> Brooklyn Bridge
> September 27-30, 2007
>
> Proposals must be clear, complete and received electronically by
> gloria at adta.org no later than February 10, 2007
>
> If you would like to receive a proposal as an attachment, please send
> your email to gloria at adta.org
>
>
> Gloria J. Farrow
> ADTA Conference Manager
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