What is the role of transference in trauma work?

As we are just planning and thinking about Morit’s forthcoming CPD workshops on integrative trauma therapy, this topic is currently at the forefront of our minds, so I'm sharing it with you.

There is a wide spectrum of opinion as to what role working with the transference plays in trauma work. I believe that the therapist’s awareness of the transferential dynamics is essential. As in all therapeutic work, the question is how my therapeutic awareness might most usefully and appropriately translate into my presence (whether that is silence or an intervention), and in this respect traumatised clients present special difficulties, requirements and conditions.

In simple terms, as traumatised clients have learnt to avoid relational intensity for fear of being invaded or overwhelmed, for the therapist to impose attention to the intensity of transferential dynamics can often be pre-mature and re-traumatising. The fragility of the client’s bodymind system may require that the therapist hold their countertransference reactions internally, frequently for a long time, without ‘letting on’. The therapist, therefore, may need to stay and stick with being aware of and bearing feelings which the client cannot (yet) be expected to engage with.

The client, without necessarily being able to ask for this, needs the therapist to be a protective ally who puts the integrity of the client’s recovering system above their own needs for relating or mutuality. In the meantime, the therapist needs to hold unbearable feelings internally, transmuting them quietly rather then sharing or expressing them, even as a foundation for formulating an interpretation.

However, the fact that the client may need to see and experience the therapist as a wholly good and benign object, does not automatically mean that the therapist has to restrict her own experience to this idealised expectation, or has to positively define and construct her role in terms of precisely that protector figure who was by definition absent in the original trauma. Such an exclusively positive self-understanding on the part of the therapist numbs her to the complexities of the bodymind process involved in addressing the frozen reality of trauma in the here & now of the therapeutic relationship.

Messler-Davies’ work with trauma (Messler Davies, J. & Frawley, M.G. (1994) Treating The Adult Survivor Of Childhood Sexual Abuse: A Psychoanalytic Perspective) reveals how far into the relational dynamics a client and therapist may fruitfully go when both therapist and therapy itself may be experienced as a re-enactment of the abusive object, or when the client’s internalised abuser may be constellated in relation to the therapist.

This degree of working-through may not be required or appropriate (or not yet possible at a given point in time), but the dynamics addressed by such work are ever-present in the relationship with traumatised clients.

In my opinion, therefore, the question is not whether to work with the transference or not – unless we ignore or deny it and override it, the only question is whether to work with it implicitly or explicitly. In either case, the therapist’s handling of her countertransferential responses constitutes the relational container which the client subliminally experiences and which profoundly affects the work and the space she is able to provide for the process of recovery.