Group Psychotherapy Column

Sparky speaks to his self about a particular countertransference issue in group psychotherapy: A metalogue

A discussion about reacting to a client’s history.

By John Breeskin, PhD, ABPP

Sparky: Self, we need to talk.

Self: Go for it.

Sparky: Are you patronizing me?

Self: Whom, may I inquire, is asking the question?

Sparky: It sounds like you are using your “New York Mouth.”

Self: It takes one to know one.

Sparky: Moving right along...

I have been seeing a number of clients these days in group therapy who have been sexually abused as children. The percentage, among my clients, of these people, is perhaps as high as 30 percent.

Since I’ve specialized in treating PTSD for more than 50 years, I am not unfamiliar with such concepts as:

  1. Secondary PTSD
  2. Survivor’s guilt
  3. Therapist burnout, and even
  4. Some identification with the role of the aggressor, although, as a defense against such thoughts, I found myself breaking into a chorus of “It Ain’t Me, Babe.”

Of course, the grandiose part of me tries to tell me that if I had been the client’s initial lover, this disaster would never have happened. My good common sense suggests that I not share such thoughts with my State Licensing Board as they would not conceivably understand.

The part of this equation that gives me the most difficulty is the fact that I am capable of taking on the client’s physical and emotional pain at being violated. I can clearly see that a woman therapist talking to a woman client would have this clearly empathic reaction, but I am a guy and that tends to shift the equation in an unfamiliar direction.

Since I have obtained much of my sexual education by riding the New York Subway System where I was subject to frottage (nonconsensual paraphilia or in this case of ephebophillia) in addition to being patted by the deans of private schools or even public high school principals, I would not at all be considered naïve. Since I thought such behavior was absurd, I was easily able to ignore it. Did such learning experiences delay my loss of virginity until I was 23 years old? Perhaps, but I quickly caught up for any lost time with willing partners.

Now, to get back to the matter at hand (pun intended) I was not at all prepared in my mind and my body to react in this powerful way to my client’s traumatic history (or herstory). Is this reaction contributed to my comfortable androgyny? In that specific sense, feeling another human being’s pain is not gender specific, in spite of whatever particular stereotypes abound.

Of course, since I strongly care for the client who is telling me the details, my reaction is multiplied, many times over, by my own personal sense of being violated or betrayed. This countertransference reaction caught me by surprise and has become the motivation behind this inquiry of self–examination.

I have looked very carefully, in my own therapy, as to the possible existence of events like this with which I might be able to identify and can find none, so that explanation is not applicable.

The strategy, which is most obvious to me, when I am aware of this countertransference event, is to self-disclose my feelings to my client so that the two of us and the other group members can work together on the issue and that is what I have decided to do. What will come out of this current piece of new learning is, as yet, unclear, but I am sure that the end product will leave all of us in the group both sadder and wiser, in that order.