Transference & Countertransference in Somatic Work

TRANSFERENCE & COUNTERTRANSFERENCE

In my professional practice as a health consultant, scar tissue remediator, bodyworker, and teacher, I am increasingly aware of the way transference and countertransference play out across a psychological spectrum. This is an effort to identify that spectrum, so we, as somatic professionals, can successfully offer more dynamic and productive sessions. A picture is worth a thousand words. The image above has meaning to me because many of us have our attention out – in our hands – when we work with clients. Where do we hold our internal awareness?

The successful negotiation of somatic work cuts to right the essence of our ability to track our clients while working hands-on during sessions. I found that contrary to professional ethics codes, when a practitioner’s intuition is high functioning and accurately employed, the practice of bodywork is never really one-way touch. When doing touch-based work, the roles of giver and receiver are clear, but we as practitioners must skillfully divide our attention, by staying in touch with ourselves at the same time as we touch our clients.

INTUITION & MINDFULNESS

Information from the client may come flooding into our own mind/body continuum with as much impact on us as our work has on the client. While the client takes in information from our words, our fingers, or even our elbows, the influx of information moving from the client’s body into ours may raise questions about our ability to create and maintain effective psycho-emotional boundaries. Can we stay grounded; entirely in ourselves, rather than getting flooded by the intensity of that incoming information?

The ability to track self-awareness is often lacking when beginners practice the art of touch. Instead of grounding their attention in sensations, doubt shows up instead. It can manifest as acute self-consciousness that quickly spirals into a laundry list of personal shortcomings. That internal dialog might go like this: “Can I interpret the signals I receive correctly? Why not? What’s wrong with my perceptions that I can’t solve this riddle lying right in front of me on my massage table?” While proper assessment provides answers to these questions, it’s an art form that takes time to learn and a certain amount of experience to articulate. In the meantime, understanding the dynamics of transference and countertransference during bodywork or other somatically based sessions is a tool that can help.

PROJECTION vs PERCEPTION

Many students have told me about experiences where a client has left a session feeling angry or confused. Student-practitioners complain they don’t know what went wrong during that session. Accurate tracking refers to identifying four distinct spaces that the client and the practitioner occupy along a spectrum of relating while in session together. Knowing one’s precise location along this range of relating, while giving touch, can help to stay grounded when things get uncomfortable or confusing. Four nodes along the gamut of client relating include, but are not limited to: accurate perception, projection, spontaneous episodes of somatic recall, and client regression.

• Accurate perception is often what surprises us about what we notice or feel in a client’s tissues. We may have mistaken beliefs about what we believe is happening in the client’s body, rather than seeing what is actually happening. Until we are confident in our intuitive abilities, perception should be verified by reality checking – asking the client if they noticed in their own body what we thought we perceived.
• Projection is a feeling we have that comes from ourselves about we want, need, or unconsciously expect from our client. Another word for this is counter-transference. Do we need to hear how great the session was? Do we need to be a hero in the eyes of our clients?
• Somatic recall is an instantaneous and spontaneous retrieval of memories buried by years of dissociation. Dissociation protects the client from early attempts to integrate trauma before a safe opportunity presents itself. Episodes of somatic recall often spontaneously arise when we simply hold still and make space for them. No rush, no hurry, just be there with the tissue and wait. Notice what comes up.
• Regression in touch can instantly return the client to younger emotional (even infantile) ages, especially when touching sensitive autonomic tissues like smooth muscle or scars embedded in mucosal tissues. While regressed, the client may cast the practitioner in a role other than a service provider, for example, in the role of parent, lover, or trusted friend. Transference is another name for feelings that shift from someone in the client’s past onto the practitioner. Transference often arises during regression.

ACCURATE TRACKING

Tracking means knowing where our client is along this spectrum during session work. It also involves knowing where we are. Do we pause to take notice? Do we feel we risk our position as a credible practitioner by asking clients about their sensations? Do we believe it’s outside of professional etiquette to make such a request? It could be as simple as asking, “Where are you right now?” or “Are you aware of your developmental age right now?” or “Where (or how) do you experience that emotion in your body?”

We must also track ourselves. As practitioners, we are in a particular power dynamic with our clients. They come into the session, lie down on our table, and ask us to take care of their body for an hour or more. That’s a responsibility we implicitly take on by agreeing to work with them. Suddenly we have the power in the session. But – if we lose track of what we’re doing, feel uncertain about how we can be of service, or can’t figure out how to assess correctly, we give (project) our power onto the client. We present them our power when we start telling ourselves that the client KNOWS how lame we are and will never come back again. Then we have no income and can’t pay the rent. Then we will end up on the street…and suddenly we are no longer present.

When we forget that we know what we know, it’s easy to get lost and give in to confusion. When lost, practitioners tell me they fall prey to projections rather than hear what their fingers are actually telling them. Tissues always communicate, and it’s up to us to listen. But we have to stay grounded in what we know, and not be afraid to slow down.

SELF-DOUBT

When we succumb to confusion and doubt what we perceive, we may feel lost, and it’s easy to get pulled into a client’s regressed state. While the client projects or transfers feelings of helplessness, confusion, fear, or attraction onto us, in our discomfort, we may end up projecting our need for orientation back onto the client. At the very least, such mistaken projections interrupt the safety of the professional container. When we’re not present, are we telling ourselves a story about our own incompetence?

Transference versus countertransference seems like a typical Psych101 inquiry when engaged in conversational therapy, but the circumstances are different when doing somatic (body-based) work. To offer an example, I will share something of my own process while working. To an external observer, it might look like I’m merely offering hands-on skills while the session progresses. Yet internally, I’m in a continual state of self-inquiry about the accuracy of any given perception – to tease apart and differentiate accurate perceptions from possible projections.

SELF-TRACKING

It’s a tightrope dance of how much energy I give, and how much information I take in. While my fingers are noticing the nature of the tension I feel, I’m asking,

• What does the client want from me emotionally?
• Do I know where that ‘want’ is coming from?
• What do I want from the client?
• Can I check any desire for recognition, approval, or other intrusive need for validation at the door, and return my full attention to the session?

This is different than asking for objective verification from a client to reality-check my assessment abilities. And what am I taking in? Anything I don’t want to take on? Am I able to serve the needs of my clients while maintaining my own psychic and personal boundaries moment-to-moment? Sometimes clients are quite eager to project certain qualities onto me – they may need to see me as an expert, a magician, or a savior, and thereby let themselves off the hook, and not take responsibility for their own healing process.

ASSESSMENT

Proper assessment means knowing how to differentiate which kind of tension we encounter while engaging the flesh of our client. Biochemistry, biomechanics, emotional tension and scar-related tension are the four domains of accurate assessment. Clients come to us for our services. One of the best services we can offer them (that helps us serve our clients better) is an accurate assessment. It helps direct our therapies where they really count and also puts the ball in the client’s court by suggesting they assume some self-responsibility for their own healing.

Understanding the source of tension one encounters while touching bodies is a question of being able to differentiate the NATURE of the tension we feel. The best way to interpret the nature of the tension we encounter and the effects of our work is to ask:

• What is the nature of the tension I’m feeling?
• Scar-related? Biochemical? Biomechanical? Emotional?
• Assess accurately to the best of my abilities
• Reality test

Without the ability to accurately differentiate between each kind of tension (and each type has its own signature), it’s easy to get lost or confused during touch-based work. If you want to learn more about the process of assessment, one way to do it is to get assessed yourself.

Assessment will identify your particular barriers to health and provide you with a practical map to begin your own work. Expect a chart explaining where your barriers to embodied autonomy lie, and a plan of action to set your body’s systems up for success. For assessment clients who are ready to get continuing support while they apply the recommendations from their assessment map, there is the possibility to continue on through coaching with me. During coaching, we work together to implement the insight from your assessment session to rediscover your embodied autonomy one step at a time.

If you’d like to schedule an assessment, learn more here. If you’re not sure you’re ready for a full assessment, but would like to explore some basic questions about the assessment process or your embodied autonomy in an introductory session, learn more here. To read about what others have said about their assessments and coaching experiences with me, see the testimonials.

If you want to learn how to assess, I will be offering assessment training to select professionals who I feel are ready to take their next step with me toward professional development. Email me for more details.