How do psychodynamically oriented therapists understand, respond to, and work with negative racial sentiments amongst traumatized clients?

Fletcher, Tracy
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This study explored how psychodynamically oriented therapists understand and work with negative racial sentiments arising in traumatized clients. One of the aims of the study was to highlight and examine the technical, countertransferencial and ethical dilemmas faced when a patient brings ‘politically difficult’ material infused with negative racial sentiment to therapy. It was hoped that information gleaned would contribute to theoretical and technical understanding of this phenomenon and assist in working with such negative racial sentiments. In order to investigate the research questions eight therapists who identified themselves as ‘psychodynamically-oriented’ participated in semi-structured interviews on the topic of negative racial sentiment (NRS) in therapy. The study was located in the qualitative research tradition, and interview transcripts were subject to a critical thematic content analysis. The main themes were identified and presented under three sections, namely: how therapists understand, work with and respond to the phenomenon of NRS in traumatized clients. Understandings included the formation of NRS as inter alia reflecting the use of defenses such as splitting, projection, projective identification, the triumph of the bad object and a breakdown in the capacity to symbolize. Tensions in understanding the phenomenon of NRS post-trauma and related latent themes were also identified. Therapists’ approaches to working with NRS included the use of a range of implicit assessment criteria such as, whether, for example, the patient’s response was experienced as ego-dystonic or ego-syntonic. Technical strategies for intervention included adherence to a working model, interpretive interventions and cognitive strategies. The participating therapists’ countertransferential responses to negative racial sentiment were categorized, taking the form of: negative feeling towards or disidentification from the patient; negative feeling towards the perpetrator or identification with the patient and therapeutic impasse. Some guidelines proposed by the participating therapists for managing NRS, as it occurs in psychotherapy with traumatized clients, are presented.
Therapists , Traumatized clients , Negative racial sentiments