Countertransference in the Treatment of PTSD

It is now widely recognized that mental health professionals who work with trauma victims are themselves at risk for powerful countertransference reactions (CTRs), vicarious victimization, and stress-related burnout. This volume is the first book in the field of traumatic stress studies to systematically examine the unique role of countertransference processes in psychotherapy outcome. Emphasizing the need for carefully deliberated action, this volume offers vital new insights into the victim-healer relationship and presents detailed techniques to promote awareness of affective reactions for anyone working with sufferers of PTSD and its comorbid conditions such as anxiety, depression, and substance abuse.

Part I introduces readers to theoretical and conceptual foundations of countertransference in post-traumatic therapies. Illustrated with case examples, the relationship of empathic strain to countertransference and two types of therapist defenses are examined. Chapters in Part II discuss countertransference issues that arise in the treatment of victims of sexual, physical, and emotional abuse, including survivors of rape and early childhood trauma; children traumatized by urban violence; patients with multiple personality disorder; and acutely traumatized children.

Part III examines therapists' reactions in work with victims of war trauma, civil violence, and political oppression, as well as other groups whose trauma must be understood in specific cultural and historical context. Explicit examples of avoidant and overidentification responses are presented. Finally, Part IV expands the discussion of trauma and countertransference to survivors of both direct and indirect trauma, such as that of rescue workers who, during natural disasters, are exposed to the threat of the disaster and the plight of those they attempt to help. Throughout, case vignettes illustrate the signs and symptoms of trauma-specific CTRs as they unfold during treatment. The roles through which clinicians can successfully engage survivors are also detailed.

Rich with explicit suggestions for providing compassionate and intelligent care, this insightful volume is ideal for psychotherapists, psychologists, and other mental health professionals working with people suffering from PTSD. Similarly, Countertransference in the Treatment of PTSD is a valuable classroom text for courses dealing with the treatment of trauma victims and its implications for psychotherapists.

John P. Wilson, PhD, is Professor of Psychology at Cleveland State University and widely recognized international expert in PTSD. He was a cofounder and past-president of the International Society for Traumatic Stress Studies. Dr. Wilson is the author of Trauma, Transformation, and Healing, and coeditor, with Beverley Raphael, of The International Handbook of Traumatic Stress Syndromes. At present, he is Director for Stress and Trauma in Cleveland, Ohio, and Chairperson of Emergency and Disaster Services for The American Red Cross.

Jacob D. Lindy, M.D., has worked as a clinician, researcher, and consultant in the area of trauma studies for over 20 years. A training and supervising analyst at the Center for Psychoanalysis in Cincinnati, Ohio, he is Director of the University of Cincinnati Traumatic Stress Study Center, and past president of both the International Society for Traumatic Stress Study Center and the International Society for Traumatic Stress Studies. He is also the first recipient of the Sarah Haley Award for clinical excellence in trauma therapy.