Abstract
D.Litt. et Phil. (Psychology)
Psychotherapy between an incest survivor therapist and incest survivor patient presents psychotherapists with numerous challenges, especially in terms of countertransference for therapists. It is believed that therapists‟ countertransference experiences play a pivotal role in the psychotherapy treatment of this population of patients, and if left unchecked, these countertransference reactions can be potentially detrimental to the process of therapy and to patients. This study aimed to gain in-depth understanding of the lived experiences of countertransference reactions of incest survivor therapists (ISTs) in the treatment of incest survivor patients (ISPs). This type of research can potentially enrich the clinical practice in South Africa.
Qualitative research, specifically a phenomenological paradigm, was employed as a research method. Using purposive sampling methods four registered psychologists, sourced predominantly from private practice, between the ages of 33 and 69 years old, who had between 3 and 20 years of psychotherapy experience, were interviewed regarding their lived countertransference experiences in psychodynamically treating ISPs. The semi-structured interviews were transcribed and analysed based on the interpretative phenomenological analysis (IPA) framework suggested by Smith and Osborn. The analysis of each participant‟s transcripts provided seven master themes, most of which are supported by superordinate themes. The master themes are: a) Emotional experience of treating ISPs; b) The experience of self in treating incest ISPs; c) The participants‟ perceptions of ISPs; d) The technical issues involved in treating ISPs; e) The importance of clinical supervision and personal therapy; f) Treating ISPs as a mutual and reciprocal process; and g) Unique individual themes.
Participants in this study experienced various yet expectable reactions to the reality and the narrative of their patients‟ trauma, such as feelings and behaviour of shock, disbelief, denial, ambivalence, powerlessness, frustration, anger, avoidance, shame, and re-traumatisation. While some participants experienced a sense of competence in treating ISPs, the majority of participants felt incompetent and ill equipped to treat ISPs as they believed they lacked theoretical and practical skills in treating this population of patients. Most participants experienced ISPs as defensive, dissociated, gullible, and frustrating, as well as resilient. Finally, the narratives of the experiences of all participants emphasise the importance of clinical supervision and personal therapy while treating ISPs. All participants experienced treating ISPs as a mutual and reciprocal process. These findings support existing literature in the treatment of survivors of gross interpersonal violations.