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Struggles with God: Transference and Religious Countertransference in the Treatment of a Trauma Survivor
John R. Peteet
Abstract: Transference and countertransference in treatment situations where the patient and the therapist share religious faith can be complex. This article discusses the course of therapy of a Christian woman with a history of trauma and depression by a therapist who shared her religious orientation. Counter-transference reactions shaped the therapists responses to the patients struggles, and eventually contributed to a new level of trust in their shared God.
The growing literature on religious countertransference describes common types of negative countertransference (Grifth, 2006), nuanced relationships between the patients religious transference and the therapists countertransference (Abernathy & Lancia, 1998; Kehoe & Gutheil, 1984; Peteet, 1981; Spero, 1995), complexity added by dual roles such as pastor and therapist (Kahn, 1985; Spero, 1981), and potential therapeutic richness offered by shared religious imagery (Spero, 1994, 2004). No reports have traced changes in religious countertransference with changes in the patients transference and god representation over time. In the case described below, my own religious identity and countertransference were important in the way I engaged a depressed survivor of childhood physical and verbal abuse, who showed some symptoms of PTSD, and who shared my faith. Subsequent modications in her conception of herself and of God challenged my conception of my role, altering both my approach and countertransference.
John R. Peteet, M.D., Associate Professor of Psychiatry, Harvard Medical School; Department of Psychiatry, Brigham and Womens Hospital, Boston, MA.
Journal of The American Academy of Psychoanalysis and Dynamic Psychiatry, 37(1) 165174, 2009 2009 The American Academy of Psychoanalysis and Dynamic Psychiatry
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CASE HISTORY
A therapist at a Christian counseling center referred Clara (a pseudonym), a 60-year-old divorced former seminarian who had completed a hospitalization following a suicide attempt.1 Her overdose seemed to have been a reaction to the loss of her job, a move away from the seminary where she had completed a degree, and the loss of a churchs worship team where she had felt protected from my demons. During Claras hospitalization, one of her children who lived elsewhere declined to be involved and seemed afraid to have her visit for the holidays afterwards. Claras therapist had requested a psychiatric evaluation for antidepressant...