Dissociation : Vol. 1, No. 4, p. 024-032 : Ten traps for therapists in the treatment of trauma survivors
Chu, James A.
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Chu, James A.
Patients who have survived trauma, particularly those who have experienced early childhood abuse, stand out in the clinical experience of many therapists as being among the most difficult patients to treat. These patients have particular patterns of relatedness, along with intense neediness and dependency which make them superb testers of the abilities of their therapists. They often push therapists to examine the rationales and limits of their therapeutic abilities, and frequently force therapists to examine their own personal issues and ethical beliefs. A conceptual framework for understanding treatment traps is presented, along with ten traps which these patients present, consciously or unconsciously, in the course of treatment. Included are traps around trust, distance, boundaries, limits, responsibility, control, denial, projection, idealization, and motivation. These are certainly not the only traps which occur in the course of treatment, but they highlight the experience of treatment and the difficulties which are encountered between the therapist and the patient. This paper is intended to be clinical in orientation to help prepare and support therapists in their work.