“Ghosts at the banquet” - Scholarly Commons Home

Chapter Four: COUNTERTRANSFERENCE AND TREATMENT
APPROACHES
In this chapter I will define countertransference and then outline the presenting
factors surrounding it, as experienced and used in the therapeutic setting with
clients with Anorexia Nervosa. Countertransference is one of the
phenomenological and subjective tools used by the therapist to inform them in
understanding the client’s world. In considering a variety of treatment
approaches, I will review how psychodynamic approaches to
countertransference, in the context of ‘deadness to aliveness’ and the
‘movement towards a sense of self’ within the anorexic client, might be used
to indicate the ‘moment to moment’ process and motivational direction of the
therapy. Davies & Tchanturia (2005) note that “the major focus of therapeutic
work currently for Anorexia Nervosa is cognitive behavioural therapy,
cognitive analytical therapy, interpersonal therapy, dynamic therapy,
motivational enhancement therapy and family therapy” (p. 311).
The unspoken communication conveyed by the client and felt and experienced
by the therapist, is a strong feature of the therapeutic relationship with
anorexic clients. In summarizing this experience, Wallin (2007), observes that,
“That which we cannot verbalise, we tend to enact with others, to evoke in
other, and/or to embody” (p. 121). More often, what is openly expressed by
the anorexic client is the experience of a negative self scrutiny, which
accompanies depressive and anxious features (Bers, Blatt & Dorlinsky (2004).
Bers, Blatt & Dorlinsky’s (2004), research showed self judgment is a core
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