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Karen Gubb's paper, ‘Craving interpretation: a case of somatic countertransference’, makes a valuable contribution to thinking about somatic countertransference. The body is making a comeback in analytical theory, through recent developments in neuroscience and the growth of body-based practices like eye movement desensitization and reprocessing (EMDR), energy therapies and yoga. Yet, as Dr. Gubb points out, the somatic countertransference, particularly that perceivable by the patient, has received little attention in the literature compared to more ‘mental’ forms of countertransference. Her paper exposes an important area of clinical work that requires more thinking, and this is much appreciated.
The paper offers a valuable account of the therapist's own internal process, including an analysis of her therapeutic ‘acting out’. It focuses on a clinical case during which the therapist's rumbling tummy would elicit a disapproving/disgusted response from her anorexic patient. This tummy-rumbling (borborygmi) came with hunger pangs and a strong craving for a specific kind of meat-laden pizza - the last thing her patient would allow herself to eat - which the therapist would then go and order after the session. The author describes this countertransference response in detail, in order to show how it had to be worked over and interpreted by the therapist, for and to herself, in order for its meaning in the context of this specific analytic dyad to become clear.