Under the Influence of Unconscious Process: Countertransference in the Treatment of PTSD and Substance Abuse in Women

This aricle examines countertransference in therapists treating women with posttraumatic stress disorder or addictions. Vicarious traumatization, unconscious affects about addiction, & pressures within the treatment pull the therapist away from the patient at critical points & toward abandonment or collusive indulgence. Support in the form of process supervision can assist the therapist to acknowledge, identify, & contain affective responses invoked in treatment. Clinical vignettes, including examples of patients who had attempted suicide or who were chronically suicidal, are used as illustration. (14 refs.)