Exploring interoception through a psychoanalytic lens: an analysis of the relationship between the neuropsychological concept of interoception and the psychoanalytic concept of countertransference

This study examines the phenomenon of interoception – an individual’s perception or sense of their own body state (Pollatos, 2007) - and countertransference – the emotional experiences and reactions provoked in the therapist by a patient (Heimann, 1950). The study looks specifically at embodied countertransference – ‘the spontaneous arousal of physical feelings in the therapist…’ (Field, 1989: p.512). It employs theoretical and empirical research methods, both qualitative and quantitative, in order to capture something of the tension existing between empirical observation and the subjective emotional realm of feeling and intuition. The study explores links between interoceptive capacity and countertransference. Thirty-seven trainee child psychotherapists completed a qualitative countertransference questionnaire and Egan and Carr’s (2005) Body-Centred Countertransference Questionnaire. They performed an established interoceptive accuracy assessment (Heartbeat Counting (Schandry, 1981)) and completed a confidence measure pertaining to it. Data from the Heartbeat Counting task was used to generate a metacognitive measure of interoceptive awareness (Garfinkle et al, 2015). Empirical data pertaining to interoceptive capacity and body-centred countertransference were considered together, for the sample group as a whole and between training year groups, in order to explore the overarching research question: Is there a relationship between interoception and countertransference? Results: Interoceptive accuracy was not shown to increase with years of training in child psychotherapy. A statistically significant, non-linear, relationship between reported confidence on the interoceptive accuracy task and year of training was observed however; and interoceptive accuracy and reported confidence were also shown to be positively correlated. As a sample group, child psychotherapy trainees only approached ‘interoceptive awareness’. Embodied countertransference phenomena were universally reported, increasing in frequency with year of training to Year 3. In the qualitative research, countertransference emerges as a vital, albeit ‘opaque and disturbing’ tool, enabling the trainees to ‘go beyond words’ in their work with children and young people. A striking homogeneity was observed in participant responses, raising questions about the place for doubt and alternative perspectives upon a phenomenon much debated in psychoanalytic theory and the research literature. This a unique study contributing to the research literature in Child Psychotherapy. It highlights potential links between interoception and countertransference. Results may have implications for the training of Child Psychotherapists, in particular, to the attention that is paid to physical experiences. Further study of trainees and qualified psychotherapists may yield more connections between these two phenomena.