Relationships between Affective Neuroscience primary brain emotional systems, working alliance and countertranference in a sample of adolescent helpseekers

Introduction Affective Neurosciences identify seven ancestral emotion systems, categorizing them in positive (SEEKING, LUST, CARE, PLAY) and negative (FEAR, RAGE, SADNESS/PANIC). The activation of one – or more – of the seven emotional systems is related to distinct affect feeling states, promoting some specific behavioral patterns according to individual’s experience. Each one of the seven systems is important to understand and define features of human personality. These domains are presented as fundamental for the development of the human personality, and can therefore be used as a potentially new model for the evaluation of the personality and for the therapeutic process. Futhermore, the consideration of these basic emotional sistems can produce longer therapeutical changes (Montag, Panksepp, 2017). In this regard, working alliance and countertranference are considered very important “common factors” of the therapeutic process (Norcross, 2011) and they are associated to a good outcome and to reduction of the drop-out (Horvath, Re, Fluckiger, Symonds, 2011). Therefore, we evaluated the relationship between Affective Neuroscience primary brain emotional systems, working alliance and countertranference in a sample of adolescent helpseekers. Method A sample of 87 patients, 48% males, (14-18 years) were included and referred to the clinic for Anxiety and Mood Disorders in Adolescence (Department of Psychiatry of Sant'Andrea Hospital in Rome). Subjects met diagnostic criteria for the following DSM-5 diagnoses: Anxiety Disorders (30%), Depressive Disorders (40%), Bipolar Disorders (15%), Obsessive-Compulsive Disorders (10%). The sample was evaluated with the Affective Neuroscience Personality Scales 2.4 (ANPS 2.4), Working Alliance Inventory-Therapist Form (WAI-T) and Therapist Response Questionnaire (TRP). Results and conclusions Higher levels of CARE correlate with a better working alliance and with a countertransference response Special/Overinvolved. Instead, high levels of RAGE and Dominance correlate with lower levels of working alliance. Low activation of SEEKING correlates with high levels of the factors Helpless/Inadequate, Parental/Protective and Disengaged. The emotive and motivational system FEAR correlates with the countertranference factors Positive/Satisfying, Parental/Protective, Overwhelmed/Disorganized, Special/Overinvolved. There is a relationship between the RAGE system and the countertransference factor Hostile/Mistreated. SADNESS/PANIC system correlates with Parental/Protective and Special/Overinvolved factors. Dominance is related to the factor Overwhelmed/Disorganized. In conclusion, the drive to care and compassion appears to be associated with a better ability to cooperate with the therapist in order to achieve common goals, contrary to the propensity to defensive, choleric and intrapsychic or interpersonal control (Gilbert, 2014), which also trigger reactions of antagonism in the therapist or a sense of confusion. The feelings of impotence, protection and detachment from the therapist can signal the hypoactivation of attitudes of exploration, problem-solving and curiosity in the patient (Panksepp, 2010). The activation of threat feelings seems to trigger a variegated countertransferential reaction. The sense of loneliness and the need for attachment activate therapeutic attitudes of care and hypercooling. References Montag C, Panksepp J. Primary emotional systems and personality: an evolutionary perspective. Frontiers in Psychology. 2017; 8. Horvath AO, Re ACD, Fluckiger C, Symonds D. Alliance in individual psychotherapy. In Norcross JC (Ed.), Psychotherapy relationships that work: Evidence-based responsiveness (2nd ed.). New York, NY: Oxford University Press 2011, pp. 25–69. Norcross JC. Evidence-based therapy relationships. In Norcross JC (Ed.), Psychotherapy relationships that work: Evidence-based responsiveness (2nd ed.). New York, NY: Oxford University Press 2011 Gilbert P. The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 2014; 53: 6–41. Panksepp J. Affective neuroscience of the emotional BrainMind: Evolutionary perspectives and implications for understanding depression. Dialogues in Clinical Neuroscience. 2010; 12: 383–399