Transference and Countertransference in EMDR Therapy

Abstract

Just like any other psychotherapy method, eye movement desensitization and reprocessing (EMDR) should conceptualize the intersubjective phenomena that are active during EMDR therapy, especially in the treatment of complex cases. This article describes the concepts of transference and countertransference and how to integrate them in the Adaptive Information Processing (AIP) model. In this article, research on mirror neurons, the concept of action systems, and recent considerations on attachment theory for patients with disorganized attachment are incorporated into the concepts of transference and countertransference. Input from each of these theories is illustrated with a clinical vignette that depicts how the client’s and the therapist’s conscious and unconscious processes are intertwined and how they may affect the efficacy of EMDR therapy. We propose the countertransference-based interweave to release the AIP when countertransference issues block the process. Integrating knowledge on transference and countertransference in EMDR therapy could increase the efficacy of EMDR, especially in complex cases.

Eye Movement Desensitisation and Reprocessing (EMDR) therapy for prolonged grief: theory, research, and practice

“…Previous clinical research has also demonstrated that a positive therapeutic alliance early on in therapy results in a greater reduction of prolonged grief symptoms ( 45 ). Considering this as a core tenet of our approach aligns with recent peer reviewed articles by Piedfort-Marin ( 46 ) and Hase and Brisch ( 47 ) which highlight the core role of the therapeutic relationship in EMDR.…”

The Therapeutic Relationship in EMDR Therapy

“…In addition the training should integrate basic knowledge on attachment theory, attachment-oriented self-experience and practice in respect to sensitivity training. The ideas proposed by Dworkin and Errebo ( 2010 ) and Piedfort-Marin ( 2018 ) to enhance the EMDR Therapy basic training by elements on keeping the patient within the window of tolerance and pay attention to rupture and repair are of great worth and could be integrated in an addition to EMDR basic training.…”

“…In so far a view on other concepts in psychotherapy suggest itself. Piedfort-Marin ( 2018 ) relates to the concepts of transference and countertransference, recent considerations on attachment theory for patients with disorganized attachment and how to integrate them in the Adaptive Information Processing (AIP) model. In this extremely valuable article Piedfort-Marin focuses on how the client's and the therapist's conscious and unconscious processes are intertwined and how they may affect the efficacy of EMDR therapy.…”

“…We are inline with his emphasis on the importance of the subsystems of social engagement, exploration and cooperation in EMDR Therapy and the importance of an attachment related view in EMDR Therapy. Of course this could lead to bringing up interweaves following a certain train of thought, e.g., transference/countertranference based (Piedfort-Marin, 2018 ) or relational based (Dworkin, 2005 ).…”

“…On can assume that in EMDR Therapy sessions the AIP System of patient and therapist alike need to be activated and there will be a dynamic interplay, or in other words a reciprocal activation of nodes in therapist and patients memory-networks, leading to patterns of perception and behavior, with positive or negative effects on the course of treatment. This would include also a definition of transference and countertransference in relation to the AIP Model, but is more open or broader as the proposal brought forward by Piedfort-Marin ( 2018 ). Such AIP based understanding of clinical phenomena could also integrate the concept of action systems and subsystems (Van der Hart et al, 2006 ).…”