Therapy for PTSD is difficult on the patient, but it can be equally rough on the therapist.  It is nearly impossible to maintain a stance of theraputic neutrality when listening to patients' tails of brutal child abuse, torture, or being forced to watch a loved one brutally murdered (Friedman, 1996).  These accounts generate such powerful emotions in the therapist that  he or she may suffer from intrusive thoughts or nightmares concerning events recounted by patients.

Therapists may also experience guilt at having been spared from such a trauma and feelings of powerlessness because they could not protect patients from previous trauma and its resultant stress.

Herman (1992) suggests that powerful emotions in the therapist may result in her engaging in rescue attempts, boundry violations, or attempts to control the patient.  McCann and Pearlman (1990) characterize this phenomenon as "vicarious traumatization," while Figley (1995) simply refers to it as "compassion fatigue."

Friedman (1996) strongly suggests that therapists develop a supportive environment, limit PTSD cases, establish firm personal and professional boundries, and be regularilly supervised.

Questions?  E-mail the author: Gregory Bayse 

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