Countertransference and Attachment Patterns of Therapists in Couples Therapy with Eating Disorders

Abstract

To date, there are limited studies on the relational components of couples therapy for adults with eating disorders. The purpose of this study was to gain an understanding of countertransference experiences and attachment dynamics of therapists who facilitate couples therapy with eating disorders. A qualitative method, interpretive phenomenological analysis (IPA), was used. A total of four licensed psychotherapists were given the Experiences in Close Relationships Scale-Revised (ECR-R) to determine their attachment patterns followed by an interview. Fourteen major subthemes emerged from the interview transcripts and were organized into six broad super-ordinate themes: Strategies for Countertransference Use, Countertransference Experiences, Therapist as a Secure Base, Countertransference Interference, Aspects of Therapy that Encourage Positive Change Observed by Participants, and Affects on Therapists from Facilitating Couples Therapy. The themes were then reviewed and discussed in relation to the extant literature. Recommendations for future research include: examining which attachment combinations between therapist and client have the ideal working relationship dynamics, analyzing the relationship between specific eating disorder diagnoses and therapist attachment patterns and how it affects working alliances, and effective strategies in addressing problematic relational dynamics to provide exemplary care. Overall, this study contributed to the field of clinical psychology by investigating the coalescing intrapersonal and interpersonal experiences of therapists.