On countertransference: Bridging the gap between neuroscience and clinical practice

Countertransference is a crucial component of the therapeutic relationship that is strongly related to multifaceted processes involved in producing the patient’s change in psychotherapy. This dimension has become a valuable source of knowledge for better understanding the patients’ psychological and relational functioning, which is associated with their relatively stable patterns of thinking, feeling, behaving and regulate emotions and impulses (i.e., personality). In recent years, an ever-growing interest in countertransference processes has emerged in the neuroscience field. Mirror neuron theory and research have inspired theorizing about the brain activity and, especially, neural networks that underpin interpersonal and intersubjective interactions in the clinical situations. However, the current debate on the relationship between countertransference processes and neuroscience theories is very controversial. The present study showed some preliminary data on the neural pathways’ activation (evaluated in terms of electrophysiological responses, EEG) related to countertransference patterns in 30 therapists while watching three video-recorded clinical sessions (performed by the actors) between a clinician and three patients with different personality disorders. Results revealed significant differences on the grand average of the early components (P100, N170, and P300) on the occipitotemporal and parietal montages, and of the late components (LC) on the frontal montage. Moreover, high correlations between specific countertransference patterns and intensities of the cortical activity in response to specific facial stimuli were found (mainly on the frontal and cingulate brain areas). The clinical implications of neural correlates of countertransference patterns will be discussed, especially in light of mirror neuron system’s automatic simulation process.