The Need to Self-monitor
Therapists’ reactions to their clients’ stories of interpersonal violence and neglect can trigger feelings that range from numbness to rage, helplessness to excessive control, and over-identification to distancing and detachment. As a result, all therapists need to continually self-monitor their responses to trauma clients, paying particular attention to the following areas.
Therapists working with trauma survivors commonly experience a sense of over-identification with a client (Stamm, 1999). This can lead to a blurring of therapeutic boundaries, with the therapist relying on the use of advice giving, self-disclosure and perhaps intentional contact with the client outside of therapy sessions.
These therapists often report ruminating about the client during the week, and will express strong feelings of concern or anger on behalf of the client (Figley, 2002). Some therapists can become caught up in the sensationalistic aspects of the trauma work and push clients to recount details of their abuse past the point of healthy processing. This causes the client to feel unduly distressed and overwhelmed. Rather than effective processing of the event(s), the result may be client retraumatization.
On the other hand, some therapists may feel so distressed by their clients’ stories that they may unconsciously distance themselves from their clients due to their own feelings of avoidance, denial, guilt or shame. This may appear in session as victim blaming or resistance to work on traumatic material. Therapists in these situations may avoid seeking consultation with other therapists or supervisors about their trauma patients, to the point of “missing” treatment team meetings about the client.