Using Countertransference in Treating PTSD
John A. Palumbo, Psy.D.


Countertransference, as described in the Dictionary of Psychology, is the analyst's transference on to his/her patient, often used more widely to describe the analyst's feelings toward the patient (Statt, 1981). In the practice of therapy, that is, psychotherapy that is non-analytical, the therapist's own personality is one of the most significant factors in treatment. The therapist's attempt to reach the patient on an humanistic level is equal to any technical skills and knowledge. The life experiences, attitudes and genuineness that the therapist brings into the relationship are critical factors in establishing trust. As Humphrey and colleagues (1983) suggest, "above all, therapists need to be skilled and sensitive. Mere knowledge of theories is of limited practical value if the therapists are not able to use themselves as persons constructively in sessions with individuals and couples."

Many paradigms are offered for sufferers of Posttraumatic Stress Disorder. These methodologies are efficacious to some, while others continue to feel their terror in an isolated world of fear and aloneness. The sufferer remains for the most part an outsider who is convinced that he/she cannot be fully understood for the pain they are enduring. My own experience with sufferers of PTSD is that the constant that seems to control their inability to extricate the affect of the memory is this feeling of aloneness. Indeed, for the most part, they were alone. The child, molested by the father who looked to mother for help - but for security, financial, and/or social implications was denied even recognition of the problem - was alone. She continues to believe that she is unique in her subjective world - different, bad, deserving of what happened to her, a traitor for "telling," and emotionally guarded (for it could happen again). Those of us who have not suffered such trauma, cannot begin to truly understand this feeling of solitary detachment. We can empathize, treat from a distance, and even allow our emotional selves to express our sympathy. But are we really aware? Are we really there - with our patient? It is this awareness that I am presenting under the guise of countertransference.

In treatment, as in love, there cannot be effective emotional connectedness without understanding. I am suggesting that we attempt to enter this world with our patient. Not solely from an impassive theoretical arena, but to actually walk, feel, see, smell, taste the trauma.

 

"Hold my hand, I want to go there with you. I am afraid, and I don't like where we may be headed, but I need to be there. Maybe then, I can truly understand what now I can only glance. Maybe then, together, we can touch this thing and take it out of the shadows."

I have found that this statement and action, have provided two significant areas of straightforward resolution in the therapeutic dynamic. First, the humanistic availability of myself to my patient allows them to afford a vulnerability that otherwise they contain. Secondly, my "wanting" to go there, to experience with all senses, instills a certain normalcy to their perceived uniqueness. Engaging in the full process of experience by allowing ourselves to encounter the trauma and relay to our patient our own upset about "being there," provides us with more than a glimpse of the distress. Perhaps giving ourselves a more acute sense of affectivity will open us to more creative, objective and effective ways of settling traumatic memory.

References

 

Humphrey, F.G. (1983). Ethical and professional issues in psychotherapy. Englewood Cliffs, NJ: Prentice Hall.

Statt, D. (1981). Dictionary of Psychology. New York, NY: Harper and Row.

©1998 by The American Academy of Experts in Traumatic Stress, Inc.