Michael J. Salamon

Therapists Need To Heal Too

There are world events that impact our lives and the emotional toll spills everywhere, not least in the therapists’ office. Tears, smiles, nervous anxiety are displayed without conscience awareness. Mental health practitioners are taught to follow guidelines that limit disclosing personal feelings, but those recommendations can be difficult to maintain under such circumstances. Countertransference, originally a psychoanalytic concept, is the feelings that a therapist has toward the patients they treat, is viewed as something that therapists should control. During stressful times that is not easily accomplished. Particularly if you are exposed directly and tears are flowing.

October 7 was such a day, and the pain and tension has not abated even as some hostages are released.

Around 9:15 on October 7 a man charged with security at the synagogue rose to the Bimah and halted services to make an announcement. Word was spreading about an attack in the south of the country, and he had a few details.

“We have information that the attackers have come by motorcycles,” he said. “That means they can get here in just a few short hours. I have a gun with 15 bullets and another cartridge with an additional 15. If some of you have weapons at home and live nearby, please get those weapons now. If an attack does occur here the shelter only holds so many people. The rest of you please lie still on the floor.”

From that day we spent listening to sirens, media warnings, hearing fighter jets and the reverberating thuds when an iron dome rocket intercepted an incoming missile. There were quite a few of those discomforting sounds. And we fervently pray for the hostages and soldiers.

I think about countertransference often, particularly in times of strong emotions. Psychologists have emotions. Freud took a strong view against allowing countertransference into therapy stating that it would be an obstacle to successful analysis. A therapist who shows emotions, according to Freud, will control the therapeutic environment by overwhelming the patient’s own feelings. More recently countertransference is viewed as a tool to better understand the patient in the therapeutic environment. Nevertheless, I choose to avoid discussing politics and limit personal experiences with those I treat though many are aware that I am licensed in Israel as a clinical psychologist and work as a consultant with an organization that treats sexual trauma survivors and another that treats survivors of other traumas. Still, despite years of training and experience I have feelings. Those emotions can seep out.

The conflict between Israel and Hamas has more than ever stirred not just levels of Post Traumatic Stress but misunderstanding, hostility and even verbal aggression that has spilled into my consultation room with almost every individual I have been seeing. As a result, I have found myself on most occasions empathizing with some patients and not an hour later feeling upset toward others. If a patient asks me about my views on the conflict I tend to deflect. I have had one individual ask me about my religious affiliations and when I tried to veer off that topic back to their issues they became visibly upset and stated that they could no longer work with me. My “mini me” internal countertransference response was “Not unhappy to see you go.” On the other hand, some of my patients offered hugs.

I recount these experiences because they, and many others like them, impact the way we handle our counter-transferential issues. I consulted with colleagues as we realized that there are times, such as these, that have no easy hard and fast rules. I think it is important to acknowledge that we cannot always know the best way to handle some situations and just being human is the best possible reaction at that moment. It is imperative to acknowledge the immense range of emotions that a crisis and subsequent trauma can induce in the individual seeking support as well as the person providing care. And those reactions may flow in many differing ways. Acknowledging those feelings will allow a start toward healing even in a therapeutic setting. Recognizing our pain is the first step in psychic healing.

About the Author
Dr. Michael Salamon ,a fellow of the American Psychological Association, is an APA Presidential Citation Awardee for his 'transformative work in raising awareness of the prevention and treatment of childhood sexual abuse". He is the founder and director of ADC Psychological Services in New York and Netanya, the author of numerous articles, several psychological tests and books including "The Shidduch Crisis: Causes and Cures" (Urim Publications), "Every Pot Has a Cover" (University Press of America) and "Abuse in the Jewish Community: Religious and Communal Factors that Undermine the Apprehension of Offenders and the Treatment of Victims."
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