> Indira is a clinical psychologist at STARTTS.

When the helper’s emotional wounds interfere in the work with trauma victims

Traumatic experiences are an unavoidable fact of life. Opening up and exploring a client’s trauma memories can evoke the therapist’s personal experiences and pain. Our own “unfinished psychological business” can represent obstacles on the road to successful counselling or assisting people to recover from their traumas. No matter how experienced and well trained counsellors or helpers are, there is a possibility that our deep-seated hurts and emotional wounds can interfere, blocking a doorway to the clients’ power of self-healing.

Whether we are consciously aware of it or not, there is an interesting dynamic that can take place between our wounding and our client’s traumas, especially if the client's painful experiences are similar to our own. The more we identify with the type of trauma we’re exposed to, the greater its impact on us may be. It can be especially true in cases of interpreters and bi-lingual counsellors who work with the population with whom they have a history. While the familiarity and understanding of the traumatic experiences of the clients with whom we work may help guide us, it also can dramatically heighten our own vulnerability - as it is often difficult to perceive a clear line between the personal and the professional.

The worker’s response to the victims of trauma can be either over-identification with clients or detachment in attempts to avoid dealing with own feelings of vulnerability. When dealing with emotional distress triggered by the client’s pain, we are sometimes “too much in the head”, distancing or detaching emotionally from traumatic material, or “too much in the heart”, overidentified with traumatised clients and overwhelmed by the pain we do not know how to cope with.

Too Much in the Head

1. When we are “too much in the head” we tend to focus on theories and solutions:
Trained as psychologists, social workers or professional counsellors, we often approach our clients from a theoretical framework, trying to place their individual symptoms into a general category and look to the theory to find out about their type of problems and the solutions to them. In trying to avoid facing our own suppressed emotional pain or fears, we try to avoid feeling what it is like to be in the other person’s inner world, as their pain may reopen ours. (Instead, we prefer to provide the solutions, to be the face of authority, or, simply, we are not connecting to the client in an open and honest way. And, even when we are right in our thinking, the problem is that we might be completely out of touch with how the client actually feels.)

2. We push too fast... against the client’s resistance and denial...
In order to avoid facing the client’s pain, because it can trigger ours, we are eager to see positive therapeutic outcomes and “happy endings” as soon as possible. We sometimes tend to push change where the situation is not yet ready, at a pace that is faster than the client can handle... refusing to see that the client’s resistance and denial are useful survival mechanisms. (We can face our pain only in proportion to our hope that we will recover, and denial generally protects us from feeling more pain that we can handle).

….or “Slow down”... assessing the clients “as not being ready” for opening their traumatic wounds...

We may also unconsciously try to “spare the client from their emotional pain” by focusing entirely on a mental level of our work with them, or on their practical and settlement problems, doing case management instead of counselling. (Rather than deal with pain, we focus on rescuing others.)
Or we may assess the clients as “not being ready for opening their traumatic wounds”, and not trusting their healing abilities... The proper timing for discussing emotional issues is important. However, avoiding it might be a sign that we are feeling “not ready”. We project our reluctance to face our own inner wounding.

3. We don’t allow the clients to feel like victims (we see them only as survivors!)
We do not allow the client to feel that he or she is (or was) a victim, or we tend to “refraim” their position of victims into the position of survivors too soon. We insist on polarised thinking reflected by viewing the client as “victim or survivor”, thus failing to recognise both aspects of the experience. Viewing clients solely as victims discounts their survival skills and their use of them. Alternatively, seeing the client only as a survivor fails to recognise the suffering endured. Why do we do that? Allowing traumatised clients enough time and space to go through their own process, allowing them to feel their pain and accept the fact that they were helpless victims of highly traumatic circumstances, may trigger our own inner pain, or bring us right back to our own traumatic experiences, and horror of being disempowered and weak…

4. We do not tolerate silence in counselling session … (Fear of silence…)
We do not dare to be in that silent space with highly traumatised people. Some counsellors tend to ‘fill in the moments of silence’ in the counselling sessions with words, questions, therapeutic interventions… They believe that they are not helping the client If they “just sit there in silence, doing nothing…” … or they feel uneasy…. especially if the client is “in a dark, painful and depressive place”... His pain is sometimes so palpable and overwhelming...

Too Much in the Heart

From research on STS (Secondary Traumatic Stress) we know that empathy is a key factor in the induction of trauma material from primary to secondary victim. The process of empathising with a traumatised person helps us to understand the person’s experience of being traumatised, but, in the process, we may be traumatised as well. (Charles R. Figley, Compassion Fatigue, Brunner/ Mazel, sufering Inc, 1995)

Many professionals involved in the work with trauma victims are natural empaths – they have a natural inclination to sense moods and energies from other people. However, there is an important pitfall connected to this ability as well. Our sensitivity towards other people’s suffering may be so strong that we find it hard to distinguish between our own emotions and the emotions of our clients. It is not unusual for counsellors to start to carry burdens that are not their own.

This might also be the case with interpreters who assist in counselling sessions with trauma victims. They empathise with the clients and want to help to alleviate their pain, especially when they know what the clients have gone through, as they are coming from the same ethnic background. They

sometimes try to help others by taking on their worries and problems, but end up feeling heavy, tired and discouraged because they can’t find solutions for the clients’ problems, nor they can erase their suffering.

As trauma therapists, we are also bystanders and witnesses to damaging and often cruel past events. Our trauma survivor clients continuously invite us to acknowledge the tragedy, and in doing so, open us to our own grief. This helplessness to change painful reality can challenge our identity as efficient and helpful therapists.

My Case

My “initiation into the state of total helplessness” happened at the very beginning of the war in Bosnia. I was asked to provide counselling for two girls, two sisters age about 13 and 15, brought to Sarajevo by UN personal. I was told that they had been kept by the Serbian paramilitaries in a private house in their home town in Central Bosnia. They were raped and tortured. Meeting the girls was an overwhelming experience for me. They were in need of urgent medical assistance, with visible scars, cuts and wounds all over their bodies. The girls were in a state of shock, emotionally numb and dissociated, not even able to say hello. I could not make any verbal contact with them. I did nothing.

On my way home from the hospital where I saw the girls, I had to hide in improvised shelters to avoid shelling and sniper fire. Shelling, hiding in shelters, fear, screaming of wounded people and blood on the streets was our everyday reality for almost four years.

Working as a psychologist in Sarajevo during the war and as a STARTTS counsellor I have had an opportunity to see many highly traumatised people. Soon I forgot about “initial sense of helplessness and terror”, and although I was almost obsessively reading about the war crimes committed in Bosnia long after the war was over, I did not feel that my work with trauma victims took any toll on me personally. Until the day when I lost my composure and started crying, in the middle of the session with a client!

And I could not stop crying. The client felt very embarrassed, confused, and even guilty for “inflicting me with pain” by revealing her traumatic experiences. The trauma story of that client was not much different or particularly “more painful” than many other trauma stories of victims from concentration and rape camps in Bosnia. But just a few days before that session I was reading an article about a Serbian school teacher who participated in torturing young people and his colleagues from Muslim and Croatian backgrounds during the war, and who continued to work unpunished as a school principal in the same town.

Associating the client’s story and her heavy, depressed mood with this story from the Bosnian news, I suddenly felt that I was sinking in an “ocean of total desperation”. A “hand” came up from below and dragged me under. I felt helpless rage and grief about the intentional harm done to her and many innocent people and children.

The loss of meaning and hope that signalled my vicarious traumatisation alarmed me to pay attention to the fact that I was deeply affected. My overidentification with traumatised clients clearly indicated that I had some work to do on my own unhealed traumatic wounds. I felt overwhelmed by feelings of helplessness, despair and with rage against the offenders. I lost a sense of meaning not only in what I was doing, but in life in general. Everything seemed to be senseless and “just a waste of time”.

Soon I realised that my deep wounding was waiting for the proper timing when it would come to the surface to be noticed and accepted. It was time for me to allow myself to begin to feel the pain, and to heal it. Carol S. Pearson says in her book ‘The Hero Within’: “Each time we become aware that we are suffering, it is a signal that we are ready to move on and make changes in our lives. Our task, then, is to explore the suffering, to be aware of it, to claim fully that we indeed are hurting. In this way, suffering can be a gift.”

> Indira Haracic-Novic

Indira is a clinical psychologist at STARTTS. She has over 12 years experience working with survivors of torture and trauma.

Note from the author: Around the time of my experience with the two young sisters from Bosnia, I began to experiment with Buddhist Compassion Meditation and Holosync audio technology. Also known as loving kindness meditation, I find that this practice helps me enormously. If you are interested in finding out more, including comprehensive instructions and materials, send me an email at Indira.haracic-novic@sswahs.nsw.gov.au

© 2010 STARTTS  Contact: hintsforhealing@startts.org.au