Countertransference in Trauma Therapy

Countertransference in Trauma Therapy

Background: Trauma is perceived as a highly subjective experience depending on personal resources and resilience. The therapeutic relationship in trauma psychotherapy seems to be a special one due to the powerful, emotional charged process of revealing and working with memories of traumatic experiences. This qualitative study explored the countertransference in trauma therapy by means of applying a special protocol in interviewing therapists from various cultural backgrounds.
Methods: Seven trauma therapists were interviewed following a specific in-depth protocol where the method of emergent scenarios was applied. In this method, the therapist describes a client’s traumatic event, thereby triggering various countertransference responses, which are registered and analysed in clusters.
Results: Participants indicated the exceptional use of defence mechanisms, such as minimisation of the clients’ traumatic stories and the presence of reactions such as: affective disconnection, absorption by the scene, use of metaphors, being invaded by the scene, identification with specific feelings, blank-out, confusion of feelings, dreaming and emergent scenario’s appearance. The findings indicated that therapists, who have experienced trauma in their life course and/or genealogy, showed stronger countertransference emotions and reactions. Therapists who did not experience trauma and who were still in the beginning of their career, showed relatively low emotional and physical countertransference responses. The therapists indicated the application of self-healing and other coping strategies to deal with the countertransference feelings and reactions.
Conclusions: The vivid descriptions of the participants gave deep insights into and highlighted the specificity of the therapeutic relationship in trauma therapy. This was presented in the stories of the therapists, which reflected personal aspects of their life experiences. Several participants mentioned silence surrounding personal trauma posed major challenges in trauma therapy. Moreover, the therapists indicated several measures to deal with countertransference issues, such as supervision, specialization and support.