The Role of the Psychotherapist’s Interoception in the Therapeutic Alliance

Abstract How therapists’ interoceptive accuracy or awareness affects the therapy process, and especially the therapeutic alliance, has not been previously studied. In this paper, data on objectively defined interoceptive accuracy and subjectively assessed interoceptive awareness were collected from forty Finnish psychotherapists. Interoceptive accuracy was measured with a heartbeat discrimination task and interoceptive awareness using the Multidimensional Assessment of Interoceptive Awareness, version 2, questionnaire. The therapists and their clients evaluated their experience of the alliance and provided written descriptions of each session in the study period. Using mixed methods, we then examined the associations between interoception and the therapeutic alliance and client wellbeing, as well as how psychotherapists used their internal bodily sensations as a source of information. The key result of this study showed that the therapists’ interoceptive accuracy and awareness were positively correlated with their experience of the alliance. Through thematic analysis, we identified five sub-themes that illustrate how bodily sensations serve as a source of information for the psychotherapist. However, the therapists’ interoceptive accuracy or awareness were not associated with the clients’ experiences of alliance or their wellbeing. In conclusion, a psychotherapist’s increased interoceptive accuracy and high level of interoceptive awareness enhance the therapist’s own experience of therapeutic alliance with the client. In addition, their increased awareness of internal bodily sensations also brings more elaborated information to the therapeutic process.