Abstract
Working therapeutically with anorexia patients can be difficult. The therapeutic process is
marred by many negative feelings experienced toward the anorexia patient who refuses to eat.
Learning to understand and knowing what is happening in the unsaid of therapeutic process is
important for both psychotherapist and patient. The psychodynamic therapeutic process
allows for the therapeutic relationship to develop, which in turn fosters the development of
various processes to come to the fore and into consciousness, such as, transference and
countertransference.
The transference-countertransference interplay that occurs in the therapeutic process can have
an impact, either positive or negative, on the therapeutic relationship. Anorexia patients are
known to have significant difficulties in relating to others, which manifests itself in the
countertransference situation between psychotherapist and patient. The therapeutic
relationship is therefore vital to engaging and retaining anorexia patients in treatment and in
facilitating a positive treatment outcome. It is important to understand psychotherapists’
perceptions and experiences of evoked countertransference with anorexia patients. Therefore,
this study aimed to explore how psychotherapists make sense of and manage the experienced
countertransference when working with their anorexia patients. Three therapists were
interviewed and their narratives were analysed using Interpretative Phenomenological
Analysis (IPA).
The data analysis revealed eleven themes that were explored and discussed. The themes
demonstrated that the quality of the countertransference felt ominous, overwhelming and
evoked a sense of accountability and inadequacy. Moreover, the participants experienced
their patients as detached and unreachable, which resulted in them taking responsibility for
developing and maintaining the therapeutic relationship to accommodate their patients’
ambivalence. The participants further appreciated using countertransference feelings as a
therapeutic tool while also being cautious of the impact of incorrectly understanding and
using their countertransference experience. The participants described how clinical
supervision, personal therapy and the use of self enabled them to connect with their patients’
experiences.
D.Litt. et Phil. (Psychology)