You probably remember the Freudian concept of transference from your Psych 101 class. Clients assume the therapist will think, feel, and behave in ways that replicate their earlier experiences with authority figures. This means they come into the therapy process with all kinds of assumptions and expectations about how we will act and how therapy will unfold. As if this wasn’t complicated enough, when we work with trauma survivors they bring an even more complex issue to the relationship: traumatic transference. They actually assume the abusive dynamics experienced with caretakers will inevitably be re-enacted with us.
Clients might fear that we will use, exploit, belittle, or shame them.
This can translate into a belief that the therapist has a narcissistic agenda for treatment. Clients might fear that we will use, exploit, belittle, or shame them. They may be on the lookout for the moment that we choose to emotionally, physically, or even sexually harm them. At the very least they expect that we will be disapproving, manipulative, controlling, intimidating, or rejecting. Coming into therapy with those kinds of fears and concerns means clients are often anxious, suspicious, defensive, pre-emptively angry, and hyper-vigilant. It’s quite remarkable that they can trust us at all, and certainly explains why building the relationship can be slow going.
As much as therapists see therapy as a “gift,” it’s important to remember that clients may enter the process from a very different mindset. Consider the possibility that they assume there will be an imbalance of power, our supportiveness has “strings attached,’ getting close to us will inevitably lead to getting hurt, and in order to be safe they can’t disagree with us or rock the boat. Clients who are being hijacked by traumatic transference might present as highly acquiescent, accuse the therapist of “not caring,” or bait and test the relationship boundaries to see if rejection is forthcoming.
When therapists act appropriately, establish safety, and exude unconditional positive regard the client’s fears are not an accurate reflection of therapy or the therapist. Rather than going on the defensive or personalizing the clients’ mistaken beliefs about therapy, we need to see these cognitions and emotions as information about prior important relationships in the client’s life that were dysfunctional, abusive, or exploitive. It can be helpful to use psycho-education to identify, normalize, and process the phenomenon of traumatic transference. Testing needs to be reframed as a necessary and inevitable part of relationship building. Trust is something that therapists need to earn and clients should be reassured that there is no expectation for them to blindly trust us.
When we can help clients navigate traumatic transference and give them the reparative experience of a relationship that can be genuinely safe and supportive, they can begin to open up to the possibility that other people in the world can be safe and trustworthy, too. This broadens their notion of relationship and in time, can lead to an expansion of resources for support, greater connectedness to other people, and healthy risk taking that can strengthen the quality of their intimate relationships.
What has been your experience with traumatic transference, and how have you navigated through it?
Thank you for your articulate insights. I can see the value of being aware of these possibilities early in the therapeutic relationship.
Thank you for taking the time to respond, John! You are right to suggest that the earlier we are mindful of these potential issues in the therapeutic relationship, the more quickly we can intervene and spare clients unnecessary additional emotional distress.
Thank you. It is for this reason, as a teacher, I am uncomfortable when young people are told that if they just be nice to and include students of deep trauma into their circle of friends, they can solve huge problems such as school shootings. The teenagers in my classroom are far from being in a knowledgeable position to know how to approach and befriend severely traumatized classmates.
You are right to suggest that traumatized kids need the wisdom, guidance and pre-frontal cortex of a mature adult to navigate their pain!